Search results for: Simeon Cainday III

Authors: Adrian J. Forca, Simeon J. Cainday III

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The Jordan Water District Interactive Billing and Accounting Information Systems is designed for Jordan Water District to uplift the efficiency and effectiveness of its services to its customers. It is designed to process computations of water bills in accurate and fast way through automating the manual process and ensures that correct rates and fees are applied. In addition to billing process, a mobile app will be integrated into it to support rapid and accurate water bill generation. An interactive feature will be incorporated to support electronic billing to customers who wish to receive water bills through the use of electronic mail. The system will also improve, organize and avoid data inaccuracy in accounting processes because data will be stored in a database which is designed logically correct through normalization. Furthermore, strict programming constraints will be plunged to validate account access privilege based on job function and data being stored and retrieved to ensure data security, reliability, and accuracy. The system will be able to cater the billing and accounting services of Jordan Water District resulting in setting forth the manual process and adapt to the modern technological innovations.

Keywords: accounting, bill, information system, interactive

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Authors: Adrian Forca, Simeon Cainday III

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The Electronic Payment Recording with Payment History Retrieval Module is developed intendedly for the College of Science and Technology. This system software innovates the manual process of recording the payments done in the department through the development of electronic payment recording system software shifting from the slow and time-consuming procedure to quick yet reliable and accurate way of recording payments because it immediately generates receipts for every transaction. As an added feature to its software process, generation of recorded payment report is integrated eliminating the manual reporting to a more easy and consolidated report. As an added feature to the system, all recorded payments of the students can be retrieved immediately making the system transparent and reliable payment recording software. Viewing the whole process, the system software will shift from the manual process to an organized software technology because the information will be stored in a logically correct and normalized database. Further, the software will be developed using the modern programming language and implement strict programming methods to validate all users accessing the system, evaluate all data passed into the system and information retrieved to ensure data accuracy and reliability. In addition, the system will identify the user and limit its access privilege to establish boundaries of the specific access to information allowed for the store, modify, and update making the information secure against unauthorized data manipulation. As a result, the System software will eliminate the manual procedure and replace with an innovative modern information technology resulting to the improvement of the whole process of payment recording fast, secure, accurate and reliable software innovations.

Keywords: collection, information system, manual procedure, payment

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Authors: Rafael Estrada, Cristian Ruiz Rueda

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Carbapenems are last-resort antibiotics used in clinical settings to treat antibiotic-resistant bacterial infections. Thus, the emergence and spread of resistance to carbapenems is a major public health concern. Here, we have studied a carbapenem-resistant Aeromonas veronii strain previously isolated from a water sample from Sam Simeon Creek (Hearst San Simeon State Park, CA). Analysis of this isolate using disk-diffusion, CarbaNP, eCIM and mCIM assays revealed that it was resistant to amoxicillin-clavulanic acid and all carbapenems tested and that this isolate produced a potentially novel carbapenemase of the Metallo-β-lactamase family. Whole genome sequencing analysis revealed that this A. veronii isolate carries a novel variant of the blacₚₕₐ class β-carbapenemase gene that was closely related to the blacₚₕₐ₇ gene of Aeromonas jandaei. This isolate also carried a novel variant of the blaₒₓₐ class D carbapenemase gene that was most closely related to the blaₒₓₐ-₉₁₂ gene found in other Aeromonas veronii isolates. Finally, we also identified a novel class C β-lactamase gene moderately related to the blaFₒₓ-₁₇ gene of Providencia stuartii and other blaFₒₓ variants identified in Klebsiella pneumoniae, Escherichia coli and other Enterobacteriaceae. Overall, our findings reveal that environmental isolates are an important reservoir of multiple carbapenemases and other β-lactamases of clinical significance.

Keywords: β-lactamases, carbapenem, antibiotic-resistant, aeromonas veronii

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Authors: Simeon E. H. Davies

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This study investigated whether selected metabolic responses and the perception of effort varied during four different walk protocols where speed increased progressively 3, 4, 5, 6, and 7 km/hr (progressive treadmill walk (PTW); and progressive land walk (PLW); or where the participant adjusted to random changes of speed e.g. 6, 3, 7, 4, and 5 km/hr during a randomized treadmill walk (RTW); and a randomized land walk (RLW). Mean stature and mass of the seven participants was 1.75m and 70kg respectively, with a mean body fat of 15%. Metabolic measures including heart rate, relative oxygen uptake, ventilation, increased in a linear fashion up to 6 km/hr, however at 7 km/hr there was a significant increase in metabolic response notably during the PLW, and to a similar, although lesser extent in RLW, probably as a consequence of the loss of kinetic energy when turning at each cone in order to maintain the speed during each shuttle. Respiration frequency appeared to be a more sensitive indicator of physical exertion, exhibiting a rapid elevation at 5 km/hr. The perception of effort during each mode and at each speed was largely congruent during each walk protocol.

Keywords: exertion, metabolic, progressive, random, walking

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Authors: Felix U. Asoiro, Meshack I. Simeon, Chinenye E. Azuka, Harami Solomon, Chukwuemeka J. Ohagwu

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The drying kinetics, specific energy consumed (SEC), effective moisture diffusivity (EMD), flavonoid, phenolic, and vitamin C contents of onion slices dried under convective oven drying (COD) were compared with microwave drying (MD). Drying was performed with onion slice thicknesses of 2, 4, 6, and 8 mm; air drying temperatures of 60, 80, and 100°C for COD, and microwave power of 450 W for MD. A decrease in slice thickness and an increase in drying air temperature led to a drop in the drying time. As thickness increased from 2 – 8 mm, EMD rose from 1.1-4.35 x 10⁻⁸ at 60°C, 1.1-5.6 x 10⁻⁸ at 80°C, and 1.25-6.12 x 10⁻⁸ at 100°C with MD treatments yielding the highest mean value (6.65 x 10⁻⁸ m² s⁻¹) at 8 mm. Maximum SEC for onion slices in COD was 238.27 kWh/kg H₂O (2 mm thickness), and the minimum was 39.4 kWh/kg H₂O (8 mm thickness) whereas maximum during MD was 25.33 kWh/kg H₂O (8 mm thickness) and minimum, 18.7 kWh/kg H₂O (2 mm thickness). MD treatment gave a significant (p 0.05) increase in the flavonoid (39.42 – 64.4%), phenolic (38.0 – 46.84%), and vitamin C (3.7 – 4.23 mg 100 g⁻¹) contents, while COD treatment at 60°C and 100°C had positive effects on only vitamin C and phenolic contents, respectively. In comparison, the Weibull model gave the overall best fit (highest R²=0.999; lowest SSE=0.0002, RSME=0.0123, and χ²= 0.0004) when drying 2 mm onion slices at 100°C.

Keywords: allium cepa, drying kinetics, specific energy consumption, flavonoid, vitamin C, microwave oven drying

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Authors: Simeon Karafolas, Maciej Woźniak

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Mostly of public financing programs at national and regional level are funded from European Union sources. EU can participate directly to a national and regional program (example LEADER initiative, URBAN…) or indirectly by funding regional or national funds. Funds from European Union are provided from EU multiannual financial framework form which the annual budget is programmed. The adjusted program 2007-2013 of the EU considered commitments of almost 1 trillion Euros for the EU-28 countries. Provisions of the new program 2014-2020 consider commitments of more than 1 trillion Euros. Sustainable growth, divided to Cohesion and Competitiveness for Growth an Employment, is one of the two principal categories; the other is the preservation and management of natural resources. Through this financing process SMEs benefited of EU and public sources by receiving grants for their investments. Most of the financial instruments are available indirectly through the national financial intermediaries. Part of them is managed by the European Investment Fund. The paper focuses on the public financing to SMEs by examining case studies on divers forms of public help. It tries to distinguish the efficiency of the examined good practices and therefore try to have some conclusions on the possibility of application to other regions.

Keywords: DIFASS, grants, SMEs, public financing

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Authors: Felix U. Asoiro, Kingsley O. Anyichie, Meshack I. Simeon, Chinenye E. Azuka

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The work was aimed at studying the effects of microwave drying (450 W) and hot air oven drying on the drying kinetics and physico-functional properties of yams and cocoyams species. The yams and cocoyams were cut into chips of thicknesses of 3mm, 5mm, 7mm, 9mm, and 11mm. The drying characteristics of yam and cocoyam chips were investigated under microwave drying and hot air oven temperatures (50oC – 90oC). Drying methods, temperature, and thickness had a significant effect on the drying characteristics and physico-functional properties of yam and cocoyam. The result of the experiment showed that an increase in the temperature increased the drying time. The result also showed that the microwave drying method took lesser time to dry the samples than the hot air oven drying method. The iodine affinity of starch for yam was higher than that of cocoyam for the microwaved dried samples over those of hot air oven-dried samples. The results of the analysis would be useful in modeling the drying behavior of yams and cocoyams under different drying methods. It could also be useful in the improvement of shelf life for yams and cocoyams as well as designs of efficient systems for drying, handling, storage, packaging, processing, and transportation of yams and cocoyams.

Keywords: coco yam, drying, microwave, modeling, energy consumption, iodine affinity, drying ate

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Authors: Ayoola, Simeon Oluwatoyin, Omogoriola Hannah Omoloye

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The effects of 17α-Methyltestosterone Hormone on blood composition of the Sex Reversed Sarotherodon melanotheron were investigated. S. melanotheron fry were reared in six (6) plastic tanks for three (3) months, of which three (3) tanks served as treatment tanks while the other three (3) served as the control. The fry were fed with 17α-methyl testosterone enzyme, which functions as a sex reversal hormone. The fry were administered this hormone for 30 days, to ensure complete sex reversal. All the S. melanotheron fry were reared to table size for duration of three (3) months, after which, blood samples were taken from both the control and treatment fishes. The blood parameters showed no significant differences with the same values of White Blood Cell count (WBC) and Total plasma protein for the control and experimental fishes. A total protein value for sex reversed specimens was 3.99g/dL, while urea and creatinine values were 0.2g/dL. Alkaline Phosphatase, Aspartate transaminase and Alanine transaminase for the treatment specimen were 183nm/mg protein/min, 98nm/mg protein/min and 105nm/mg protein/min respectively. A total protein value for control specimens was 2.81g/dL, while urea and creatinine values were 0.2g/dL. Alkaline Phosphatase, Aspartate transaminase and Alanine transaminase for the control species were 174nm/mg protein/min, 93nm/mg protein/min and 106nm/mg protein/min respectively. The safety of MT on S. melanotheron is therefore proved since there is no adverse effect on the fish.

Keywords: 17α-Methyltestosterone, haematology, sex reversal, sarotherodon melanotheron

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Authors: Muhammad Bilal Mustafa, Javed Hussain, Simeon Babatunde

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The Covid-19 pandemic has exposed the vulnerabilities of countless organisations beyond their size, type, and location. However, some groups and sectors are disproportionally get impacted by the pandemic. In the context of the UK, ethnic Small and Medium Enterprises (SMEs) turn out to be the most precarious group among all private sectors. Many ethnic SMEs shut down their business operations during a pandemic. A large portion of Black, Asian and minority ethnic (BAME) owners have huge concerns regarding their business’ survival and resilience. The current UK-centric studies have focused on the large business population, and there is a gap in ethnic SMEs and how they get affected by the Covid-19 pandemic. Moreover, there is a need to further knowledge and academic research to investigate the fundamental factors that could strengthen the resilience of ethnic SMEs as well as contribute to long-term sustainability. Therefore, this study aims to capture the effect of the Covid-19 pandemic on ethnic SMEs in the UK and assess the survival measures taken by ethnic SMEs during Covid-19. Besides, this study adopts a dynamic capabilities perspective that how firms' specific capabilities enable ethnic SMEs to exploit entrepreneurial opportunities during the Covid-19 pandemic. Finally, this research will help ethnic SMEs to develop vigorous resilience to address future external shocks and market uncertainties.

Keywords: COVID-19 pandemic, ethnic minority SMEs, entrepreneurial resilience, dynamic capabilities, sustainability

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Authors: Simeon Mayala, Ida Herdlevær, Jonas Bull Haugsøen, Shamundeeswari Anandan, Sonia Gavasso, Morten Brun

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In this paper, we propose a minimum spanning tree-based method for segmenting brain tumors. The proposed method performs interactive segmentation based on the minimum spanning tree without tuning parameters. The steps involve preprocessing, making a graph, constructing a minimum spanning tree, and a newly implemented way of interactively segmenting the region of interest. In the preprocessing step, a Gaussian filter is applied to 2D images to remove the noise. Then, the pixel neighbor graph is weighted by intensity differences and the corresponding minimum spanning tree is constructed. The image is loaded in an interactive window for segmenting the tumor. The region of interest and the background are selected by clicking to split the minimum spanning tree into two trees. One of these trees represents the region of interest and the other represents the background. Finally, the segmentation given by the two trees is visualized. The proposed method was tested by segmenting two different 2D brain T1-weighted magnetic resonance image data sets. The comparison between our results and the standard gold segmentation confirmed the validity of the minimum spanning tree approach. The proposed method is simple to implement and the results indicate that it is accurate and efficient.

Keywords: brain tumor, brain tumor segmentation, minimum spanning tree, segmentation, image processing

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Authors: Sadia Idrees, Gianpaolo Vignali, Simeon Gill

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The study aims to establish the virtual size and fit technology features to enhance fashion online retailing platforms, utilising digital human measurements to provide customised style and function to consumers. A few firms in the UK have launched advanced interactive fashion shopping domains for personalised shopping globally, aided by the latest internet technology. Virtual size and fit interfaces have a great potential to provide a personalised better-fitted garment to promote mass customisation globally. Made-to-measure clothing, consuming unstitched fabric is a common practice offered by fashion brands in Pakistan. This product is regarded as economical and sustainable to be utilised by consumers in Pakistan. Although the manual sizing system is practiced to sell garments online, virtual size and fit visualisation and recommendation technologies are uncommon in Pakistani fashion interfaces. A comparative assessment of Pakistani fashion brand websites and UK technology-driven fashion interfaces was conducted to highlight the vast potential of the virtual size and fit technology. The results indicated that web 2.0 technology adopted by Pakistani apparel brands has limited features, whereas companies practicing web 3.0 technology provide interactive online real-store shopping experience leading to enhanced customer satisfaction and globalisation of brands.

Keywords: e-commerce, mass customization, virtual size and fit, web 3.0 technology

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Authors: Olumide Simeon Ogunnusi, Shukor Abd Razak, Michael Kolade Adu

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Inter-agent communication manager facilitates communication among mobile agents via message passing mechanism. Until now, all Foundation for Intelligent Physical Agents (FIPA) compliant agent systems are capable of exchanging messages following the standard format of sending and receiving messages. Previous works tend to secure messages to be exchanged among a community of collaborative agents commissioned to perform specific tasks using cryptosystems. However, the approach is characterized by computational complexity due to the encryption and decryption processes required at the two ends. The proposed approach to secure agent communication allows only agents that are created by the host agent server to communicate via the agent communication channel provided by the host agent platform. These agents are assumed to be harmless. Therefore, to secure communication of legitimate agents from intrusion by external agents, a 2-phase policy enforcement system was developed. The first phase constrains the external agent to run only on the network server while the second phase confines the activities of the external agent to its execution environment. To implement the proposed policy, a controller agent was charged with the task of screening any external agent entering the local area network and preventing it from migrating to the agent execution host where the legitimate agents are running. On arrival of the external agent at the host network server, an introspector agent was charged to monitor and restrain its activities. This approach secures legitimate agent communication from Man-in-the Middle and Replay attacks.

Keywords: agent communication, introspective agent, isolation of agent, policy enforcement system

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Simeon Christian Chukwu, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: Health service providers are offered in-service training periodically to strengthen their ability to deliver services that are ethical, quality, timely and safe. Not all capacity-building courses have successfully resulted in intended service delivery outcomes because of poor training content, design, approach, and ambiance. The Delivering Innovations in Selfcare (DISC) project developed a Moment of Truth innovation, which is a proven training model focused on improving consumer/provider interaction that leads to an increase in the voluntary uptake of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) self-injection among women who opt for injectable contraception. Methodology: Six months after training on a moment of truth (MoT) training manual, the project conducted two intensive rounds of qualitative data collection and triangulation that included provider, client, and community mobilizer interviews, facility observations, and routine program data collection. Respondents were sampled according to a convenience sampling approach, and data collected was analyzed using a codebook and Atlas-TI. Providers and clients were interviewed to understand their experience, perspective, attitude, and awareness about the DMPA-SC self-inject. Data were collected from 12 health facilities in three states – eight directly trained and four cascades trained. The research team members came together for a participatory analysis workshop to explore and interpret emergent themes. Findings: Quality-of-service delivery and performance outcomes were observed to be significantly better in facilities whose providers were trained directly trained by the DISC project than in sites that received indirect training through master trainers. Facilities that were directly trained recorded SI proportions that were twice more than in cascade-trained sites. Direct training comprised of full-day and standalone didactic and interactive sessions constructed to evoke commitment, passion and conviction as well as eliminate provider bias and misconceptions in providers by utilizing human interest stories and values clarification exercises. Sessions also created compelling arguments using evidence and national guidelines. The training also prioritized demonstration sessions, utilized job aids, particularly videos, strengthened empathetic counseling – allaying client fears and concerns about SI, trained on positioning self-inject first and side effects management. Role plays and practicum was particularly useful to enable providers to retain and internalize new knowledge. These sessions provided experiential learning and the opportunity to apply one's expertise in a supervised environment where supportive feedback is provided in real-time. Cascade Training was often a shorter and abridged form of MoT training that leveraged existing training already planned by master trainers. This training was held over a four-hour period and was less emotive, focusing more on foundational DMPA-SC knowledge such as a reorientation to DMPA-SC, comparison of DMPA-SC variants, counseling framework and skills, data reporting and commodity tracking/requisition – no facility practicums. Training on self-injection was not as robust, presumably because they were not directed at methods in the contraceptive mix that align with state/organizational sponsored objectives – in this instance, fostering LARC services. Conclusion: To achieve better performance outcomes, consideration should be given to providing training that prioritizes practice-based and emotive content. Furthermore, a firm understanding and conviction about the value training offers improve motivation and commitment to accomplish and surpass service-related performance outcomes.

Keywords: training, performance outcomes, innovation, family planning, contraception, DMPA-SC, self-care, self-injection.

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Authors: Simeon Adebayo Oladipo

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Institutional administrators are currently facing pressure and challenges in their daily operations. Reasons for this may include the increasing multiplicity, uncertainty and tension that permeate institutional leadership. Authentic engagement for institutional leadership is premised on the ethical foundation that the leaders in the schools are engaged. The institutional effectiveness is dependent on the relationship that exists between the leaders and employees in the workplace. Leader’s self-awareness, relational transparency, emotional control, strong moral code and accountability have a positive influence on authentic engagement which variably determines leadership effectiveness. This study therefore examined the role of authentic engagement in effective school leadership; explored the interrelationship of authentic engagement indices in school leadership. The study adopted the descriptive research of the survey type using a quantitative method to gather data through a questionnaire among school leaders in Lagos State Tertiary Institutions. The population for the study consisted of all Heads of Departments, Deans and Principal Officers in Lagos State Tertiary Institutions. A sample size of 255 Heads of Departments, Deans and Principal Officers participated in the study. The data gathered were analyzed using descriptive and inferential statistical tools. The findings indicated that authentic engagement plays a crucial role in increasing leadership effectiveness amongst Heads of Departments, Deans and Principal Officers. The study recommended among others that there is a need for effective measures to enhance authentic engagement of institutional leadership practices through relevant educational support systems and effective quality control.

Keywords: authentic engagement, self-awareness, relational transparency, emotional control

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Authors: Faizah Almalki, Simeon Gill, Steve G. Hayes, Lisa Taylor

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A core element of cultural identity is the traditional costumes that provide insight into the heritage that has been acquired over time. This heritage is apparent in the use of colour, the styles and the functions of the clothing and it also reflects the skills of those who created the items and the time taken to produce them. Modern flat pattern drafting methods for making garment patterns are simple in comparison to the relatively laborious traditional approaches that would require personal interaction with the wearer throughout the production process. The current study reflects on the main elements of the pattern cutting system and how this has evolved in Saudi Arabia to affect the design of the Sawan garment. Analysis of the traditional methods for constructing Sawan garments was undertaken through observation of the practice and the garments and consulting documented guidance. This provided a foundation through which to explore how modern technology can be applied to improve the process. In this research, modern methods are proposed for producing traditional Saudi garments more efficiently while retaining elements of the conventional style and design. The current study has documented the vital aspects of Sawan garment style. The result showed that the method had been used to take the body measurements and pattern making was elementary and offered simple geometric shape and the Sawan garment is composed of four pieces. Consequently, this research allows for classical pattern shapes to be embedded in garments now worn in Saudi Arabia and for the continuation of cultural heritage.

Keywords: traditional Sawan garment technique, modern pattern cutting technique, the shape of the garment and software, Lectra Modaris

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Authors: Sunday Oladele, Joseph Oluwagbeja Simeon

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Subsurface exploration, integrating methods of geotechnics and geophysics, of a planned construction site in the coastal city of Lagos, Nigeria has been carried out with the aim of characterizing the soil properties and their implication for the proposed infrastructural development. Six Standard Penetration Tests (SPT), fourteen Dutch Cone Penetrometer Tests (DCPT) and 2D Electrical Resistivity Imaging employing Dipole-dipole and Pole-dipole arrays were implemented on the site. The topsoil (0 - 4m) consists of highly compacted sandy lateritic clay(10 to 5595Ωm) to 1.25m in some parts and dense sand in other parts to 5.50m depth. This topsoil was characterized as a material of very high shear strength (≤ 150kg/m2) and allowable bearing pressure value of 54kN/m2 to 85kN/m2 and a safety factor of 2.5. Soft amorphous peat/peaty clay (0.1 to 11.4Ωm), 3-6m thick, underlays the lateritic clay to about 18m depth. Grey, medium dense to very dense sand (0.37 to 2387Ωm) with occasional gravels underlies the peaty clay down to 30m depth. Within this layer, the freshwater bearing zones are characterized by high resistivity response (83 to 2387Ωm), while the clayey sand/saline water intruded sand produced subdued resistivity output (0.37 to 40Ωm). The overall ground-bearing pressure for the proposed structure would be 225kN/m2. Bored/cast-in-place pile at 18.00m depth with any of these diameters and respective safe working loads 600mm/1,140KN, 800mm/2,010KN and 1000mm/3,150KN is recommended for the proposed multi-story structure.

Keywords: subsurface exploration, Geotechnical properties, resistivity imaging, pile

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Introduction: Digital innovations have been useful in supporting a client’s contraceptive user journey from awareness to method initiation. The concept of contraceptive self-care is being promoted globally as a means for achieving universal access to quality contraceptive care; however, information about this approach is limited. An important determinant of the scale of awareness is the message construct, choice of information channel, and an understanding of the socio-epidemiological dynamics within the target audience. Significant gains have been made recently in expanding the awareness base of DMPA-SC -a relatively new entrant into the family planning method mix. The cornerstone of this success is a multichannel promotion campaign themed Discover your Power (DYP). The DYP campaign combines content marketing across select social media platforms, chatbots, Cyber-IPC, Interactive Voice Response (IVR), and radio campaigns. Methodology: During implementation, the project monitored predefined metrics of awareness and intent, such as the number of persons reached with the messages, the number of impressions, and meaningful engagement (link-clicks). Metrics/indicators are extracted through native insight/analytics tools across the various platforms. The project also enlists community mobilizers (CMs) who go door-to-door and engage WRA to advertise DISC’s online presence and support them to engage with IVR, digital companion (chatbot), Facebook page, and DiscoverYourPower website. Results: The result showed that the digital platforms recorded 242 million impressions and reached 82 million users with key DMPA-SC self-injection messaging in the three countries. As many as 3.4 million persons engaged (liked, clicked, shared, or reposted) digital posts -an indication of intention. Conclusion: Digital solutions and innovations are gradually becoming the archetype for the advancement of the self-care agenda. Digital innovations can also be used to increase awareness and normalize contraceptive self-care behavior amongst women of reproductive age if they are made an integral part of reproductive health programming.

Keywords: digital transformation, health systems, DMPA-SC, family planning, self-care

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: The Delivering Innovations in Selfcare (DISC) project aims to increase access to self-care options for women of reproductive age, starting with self-inject subcutaneous depot medroxyprogesterone acetate (DMPA-SC) contraception services. However, the project has faced challenges in ensuring the continuous availability of the commodity in health facilities. Although most states in the country rely on the federal ministry of Health for supplies, some are gradually funding the procurement of Family Planning (FP) commodities. This attempt is, however, often accompanied by procurement delays and purchases inadequate to meet demand. This dilemma was further exacerbated by the commencement of demand generation activities by the project in supported states which geometrically increased commodity utilization rates and resulted in receding stock and occasional service disruptions. Strategies: The project deployed various strategies were implemented to ensure the continuous availability of commodities. These include facilitating inter-facility transfer, monthly tracking of commodity utilization, and alerting relevant authorities when stock levels reach a minimum. And supporting state-level procurement of DMPA-SC commodities through catalytic interventions. Results: Effective monitoring of commodity inventory at the facility level and strategic engagement with federal and state-level logistics units have proven successful in mitigating stock-out of commodities. It has helped secure up to 13,000 units of DMPA-SC commodities from federal logistics units and enabled state units to prioritize supported sites. This has ensured the continuity of DMPA-SC services and an increasing trend in the practice of self-injection. Conclusion: A functional supply chain is crucial to achieving commodity security, and without it, health programs cannot succeed. Stakeholder engagement, stock management and catalytic interventions have provided both short- and long-term measures to mitigate stock-outs and ensured a consistent supply of commodities to clients.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, commodities, stock-out

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: The DISC project collaborated with partners to implement demand creation and service delivery interventions, including the MoT (Moment of Truth) innovation, in over 500 health facilities across 15 states. This has increased the voluntary conversion rate to self-injection among women who opt for injectable contraception. While some facilities recorded an increasing trend in key performance indicators, few others persistently performed sub-optimally due to provider and system-related barriers. Methodology: Twenty-two facilities performing sub-optimally were selected purposively from three Nigerian states. Low productivity was appraised using low reporting rates and poor SI conversion rates as indicators. Interviews were conducted with health providers across these health facilities using a rapid diagnosis tool. The project also conducted a data quality assessment that evaluated the veracity of data elements reported across the three major sources of family planning data in the facility. Findings: The inability and sometimes refusal of providers to support clients to self-inject effectively was associated with the misunderstanding of its value to their work experience. It was also observed that providers still held a strong influence over clients’ method choices. Furthermore, providers held biases and misconceptions about DMPA-SC that restricted the access of obese clients and new acceptors to services – a clear departure from the recommendations of the national guidelines. Additionally, quality of care standards was compromised because job aids were not used to inform service delivery. Facilities performing sub-optimally often under-reported DMPA-SC utilization data, and there were multiple uncoordinated responsibilities for recording and reporting. Additionally, data validation meetings were not regularly convened, and these meetings were ineffective in authenticating data received from health facilities. Other reasons for sub-optimal performance included poor documentation and tracking of stock inventory resulting in commodity stockouts, low client flow because of poor positioning of health facilities, and ineffective messaging. Some facilities lacked adequate human and material resources to provide services effectively and received very few supportive supervision visits. Supportive supervision visits and Data Quality Audits have been useful to address the aforementioned performance barriers. The project has deployed digital DMPA-SC self-injection checklists that have been aligned with nationally approved templates. During visits, each provider and community mobilizer is accorded special attention by the supervisor until he/she can perform procedures in line with best practice (protocol). Conclusion: This narrative provides a summary of a range of factors that identify health facilities performing sub-optimally in their provision of DMPA-SC services. Findings from this assessment will be useful during project design to inform effective strategies. As the project enters its final stages of implementation, it is transitioning high-impact activities to state institutions in the quest to sustain the quality of service beyond the tenure of the project. The project has flagged activities, as well as created protocols and tools aimed at placing state-level stakeholders at the forefront of improving productivity in health facilities.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, barriers, opportunities, performance

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

Abstract:

Background The Delivering Innovations in Selfcare (DISC) project promotes universal access to quality selfcare services beginning with subcutaneous depot medroxy progesterone acetate (DMPA-SC) contraceptive self-injection (SI) option. Self-inject (SI) offers women a highly effective and convenient option that saves them frequent trips to providers. Its increased use has the potential to improve the efficiency of an overstretched healthcare system by reducing provider workloads. State Social and Behavioral Change Communications (SBCC) Officers lead project demand creation and service delivery innovations that have resulted in significant increases in SI uptake among women who opt for injectables. Strategies Service Delivery Innovations The implementation of the "Moment of Truth (MoT)" innovation helped providers overcome biases and address client fear and reluctance to self-inject. Bi-annual program audits and supportive mentoring visits helped providers retain their competence and motivation. Proper documentation, tracking, and replenishment of commodities were ensured through effective engagement with State Logistics Units. The project supported existing state monitoring and evaluation structures to effectively record and report subcutaneous depot medroxy progesterone acetate (DMPA-SC) service utilization. Demand creation Innovations SBCC Officers provide oversight, routinely evaluate performance, trains, and provides feedback for the demand creation activities implemented by community mobilizers (CMs). The scope and intensity of training given to CMs affect the outcome of their work. The project operates a demand creation model that uses a schedule to inform the conduct of interpersonal and group events. Health education sessions are specifically designed to counter misinformation, address questions and concerns, and educate target audience in an informed choice context. The project mapped facilities and their catchment areas and enlisted the support of identified influencers and gatekeepers to enlist their buy-in prior to entry. Each mobilization event began with pre-mobilization sensitization activities, particularly targeting male groups. Context-specific interventions were informed by the religious, traditional, and cultural peculiarities of target communities. Mobilizers also support clients to engage with and navigate online digital Family Planning (FP) online portals such as DiscoverYourPower website, Facebook page, digital companion (chat bot), interactive voice response (IVR), radio and television (TV) messaging. This improves compliance and provides linkages to nearby facilities. Results The project recorded 136,950 self-injection (SI) visits and a self-injection (SI) proportion rate that increased from 13 percent before the implementation of interventions in 2021 to 62 percent currently. The project cost-effectively demonstrated catalytic impact by leveraging state and partner resources, institutional platforms, and geographic scope to scale up interventions. The project also cost effectively demonstrated catalytic impact by leveraging on the state and partner resources, institutional platforms, and geographic scope to sustainably scale-up these strategies. Conclusion Using evidence-informed iterations of service delivery and demand creation models have been useful to significantly drive self-injection (SI) uptake. It will be useful to consider this implementation model during program design. Contemplation should also be given to systematic and strategic execution of strategies to optimize impact.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, innovation, service delivery, demand creation.

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