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Community Perceptions, Indigenous Coping Strategies, and Climate Resilience: A Mental Health Perspective from Northwest Nigeria

Yakubu, Abdullahi Abdulwahab; Bashar, Summayyah Muhammad; Aveka, Audu Ishaq; Surajudeen, Abdulkadir; Khalid, Sani; Muhammad, Aliyu; Attahiru, Abusufyan; Saulawa, Fahad Abubakar; Yakasai, Bashir Adam

Abstract

This study aimed to assess the understanding of climate change, identify coping strategies, measure climate resilience, and evaluate the associated mental health outcomes within these communities. A cross-sectional study was conducted among 15,000 adults across five states in Northwest Nigeria. Participants completed validated questionnaires measuring climate change perception, coping strategies (Brief COPE), resilience (Connor-Davidson Resilience Scale-10), and psychological distress (Kessler Psychological Distress Scale-10). Data were analysed using descriptive statistics, chi-square tests, and multivariate logistic regression. A limited scientific understanding of climate change was widespread (78%, n = 11,700). Coping strategies measured by the Brief COPE showed a high reported use of behavioural disengagement (72%, n = 10,800) and self-blame (65%, n = 9,750). Overall climate resilience was low (mean score: 18.2 ± 5.1). The prevalence of severe psychological distress was high (63%, n = 9,450). Regression analysis revealed that limited climate change understanding, reliance on the measured maladaptive coping strategies, and low resilience were significant independent predictors of psychological distress (p<.001 for all). The findings reveal a high burden of psychological distress linked to climate vulnerability, limited scientific climate knowledge, and specific coping and resilience profiles in Northwest Nigeria.

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Yakubu et al. (2025) Journal of Mental Health and Climate Change http://doi.org/10.5281/zenodo.17727943 Community Perceptions, Indigenous Coping Strategies, and Climate Resilience: A Mental Health Perspective from Northwest Nigeria Abdullahi Abdulwahab Yakubu1*, Summayyah Muhammad Bashar1, Audu Ishaq Aveka1, Abdulkadir Surajudeen1, Sani Khalid1, Aliyu Muhammad2, Abusufyan Attahiru3, Fahad Abubakar Saulawa1, Bashir Adam Yakasai1 1. Ahmadu Bello University, Zaria, Nigeria 2. Federal Neuropsychiatric Hospital, Kaduna, Nigeria 3. Usmanu Danfodio University Teaching Hospital, Sokoto, Nigeria ABSTRACT This study aimed to assess the understanding of climate change, identify coping strategies, measure climate resilience, and evaluate the associated mental health outcomes within these communities. A cross-sectional study was conducted among 15,000 adults across five states in Northwest Nigeria. Participants completed validated questionnaires measuring climate change perception, coping strategies (Brief COPE), resilience (Connor-Davidson Resilience Scale-10), and psychological distress (Kessler Psychological Distress Scale-10). Data were analysed using descriptive statistics, chi-square tests, and multivariate logistic regression. A limited scientific understanding of climate change was widespread (78%, n = 11,700). Coping strategies measured by the Brief COPE showed a high reported use of behavioural disengagement (72%, n = 10,800) and self-blame (65%, n = 9,750). Overall climate resilience was low (mean score: 18.2 ± 5.1). The prevalence of severe psychological distress was high (63%, n = 9,450). Regression analysis revealed that limited climate change understanding, reliance on the measured maladaptive coping strategies, and low resilience were significant independent predictors of psychological distress (p<.001 for all). The findings reveal a high burden of psychological distress linked to climate vulnerability, limited scientific climate knowledge, and specific coping and resilience profiles in Northwest Nigeria. Keywords: Climate Change, Coping Strategies, Mental Health, Psychological Distress, Resilience EMPIRICAL STUDY Open Access *Correspondence: [email protected] © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Yakubu et al., 2025 Page 2 of 10 INTRODUCTION Anthropogenic climate change represents one of the most formidable threats to global health in the 21st century, with impacts that are profoundly mediated by social, economic, and geographical vulnerabilities (Watts et al., 2021). The African continent, despite contributing minimally to global greenhouse gas emissions, is disproportionately affected due to its heavy reliance on climate-sensitive sectors like rain-fed agriculture and pastoralism, high poverty levels, and weak adaptive capacity (Intergovernmental Panel on Climate Change [IPCC], 2022; Serdeczny et al., 2017). Within Africa, the West African Sahel, including Northwest Nigeria, is a recognised hotspot for climate variability and change, characterised by rising temperatures, increased frequency of extreme heat events, severe droughts, and erratic precipitation patterns (Biasutti, 2019; USAID, 2021). The Hausa-Fulani communities of Northwest Nigeria are predominantly agrarian and pastoral, with livelihoods intricately tied to climatic conditions (Maiangwa & Agbiboa, 2021). Environmental degradation, desert encroachment, and the depletion of Lake Chad have exacerbated resource-based conflicts between farmers and herders, leading to widespread displacement, loss of livelihood, and social disruption (Okoli & Atelhe, 2014; Onuoha, 2016). While the physical and economic impacts of these changes are increasingly documented, the psychosocial and mental health consequences remain under-investigated, particularly at the large-scale community level (Cianconi et al., 2020). The theoretical framework linking climate change to mental health posits that environmental stressors can lead to psychological distress through multiple pathways: direct trauma from extreme weather events, chronic stress from gradual environmental degradation (e.g., drought), and the social and economic losses that ensue (Berry et al., 2010; Obradovich et al., 2018). Community perceptions and understanding of climate change are critical, as they shape behavioural responses and coping strategies (van Valkengoed & Steg, 2019). Coping can be adaptive (e.g., problem-solving, seeking social support) or maladaptive (e.g., substance use, denial, behavioural disengagement), with the latter being associated with poorer mental health outcomes (Carver, 1997; Doherty & Clayton, 2011). Furthermore, psychological resilience; the ability to adapt and thrive in the face of adversity, is a key moderating factor that can buffer the mental health impacts of climate-related stress (Southwick et al., 2014; Ungar, 2018). This study employs standardized instruments to measure constructs of climate understanding, coping, and resilience, while acknowledging the cultural context of the Hausa-Fulani people. The term ‘understanding’ here refers to awareness of the scientific anthropogenic causes of climate change. ‘Coping strategies’ are those captured by the Brief COPE inventory, and ‘resilience’ is measured as an individual psychological capacity. We recognize that indigenous epistemologies may encompass spiritual and collective dimensions of environmental understanding, coping (e.g., sabr - patience, tawakkul - trust in God), and resilience that may not be fully captured by these tools. Our aim is to quantify the relationships between these measurable constructs and mental health outcomes to identify potential entry points for public health intervention, while urging future qualitative work to explore the full spectrum of indigenous knowledge and coping mechanisms. Existing studies in Nigeria and West Africa have begun to illuminate this nexus, but they are often limited by small sample sizes or a narrow focus on specific climate events (Adegun et al., 2013; Amugsi et al., 2021). A significant gap exists in understanding how indigenous perceptions and coping mechanisms within a large, culturally homogeneous but climate-vulnerable population influence Yakubu et al., 2025 Page 3 of 10 mental health. This study, therefore, aimed to investigate the levels of climate change understanding, predominant coping strategies, climate resilience, and their association with mental health problems in a large sample (n=15,000) of Hausa-Fulani people in Northwest Nigeria. The findings are critical for informing targeted public health interventions and policies aimed at building psychosocial resilience in the face of the ongoing climate crisis. METHODS Sample and Setting A community-based cross-sectional study was conducted between January and April 2024 in five states (Kano, Katsina, Jigawa, Kaduna, and Sokoto) in Northwest Nigeria. This region is predominantly inhabited by Hausa-Fulani communities whose primary occupations are subsistence farming and cattle rearing. Participants were adult (18 years or older) Hausa-Fulani residents of Kano, Katsina, Jigawa, Kaduna, and Sokoto States, who gave informed consent to participate in the study. Inclusion criteria were: aged 18 years or above, resident in the community for at least five years, of Hausa or Fulani ethnicity, and provided informed consent. Exclusion criteria were: severe cognitive impairment or illness that precluded participation, and temporary residency. The sample size was calculated using the formula for estimating a single proportion (Daniel & Cross, 2018), with a prevalence of psychological distress (p) estimated at 50% to achieve maximum variability, a 95% confidence level, and a margin of error of 1%. This yielded a minimum sample size of 9,604. To enhance the power of the study and allow for sophisticated subgroup analyses, a final sample of 15,000 was targeted. A multi-stage sampling technique was employed. In the first stage, two local government areas (LGAs) were randomly selected from each state. In the second stage, five communities were randomly selected from each LGA. In the third stage, households within selected communities were chosen via systematic random sampling. One eligible adult (aged 18 years or older) was randomly selected from each household. If more than one eligible adult was present, the Kish grid method was used for random selection. Data Collection Data were collected by trained research assistants fluent in Hausa and familiar with local customs. The study purpose was explained, and written informed consent was obtained. For participants who were illiterate, the information sheet was read aloud, and thumbprint consent was obtained in the presence of an impartial witness to ensure comprehension. Questionnaires were administered verbally in Hausa through face-to-face interviews to overcome literacy barriers. The interview process took approximately 30-40 minutes per participant. Given the high rates of distress identified, all participants who screened positive for severe distress were provided with information on locally available support services and offered assisted referral. The study procedures were reviewed and approved by the Health Research Ethic Committee of Ahmadu Bello University Teaching Hospital, Shika-Zaria (Ref: ABUTHZ/HREC/C37/2024). Informed written consent was obtained from all participants prior to their inclusion in the study. Confidentiality and anonymity of participants was maintained throughout the research process. Participants were duly informed they could withdraw from the study at any time without any consequences. All instruments were translated into Hausa using a standard forward-backward translation process by a panel of bilingual experts. The translated versions were then pilot-tested with a sample of Yakubu et al., 2025 Page 4 of 10 150 individuals from similar communities not included in the main study to assess comprehension, cultural relevance, and conceptual equivalence. Cognitive interviews were conducted to ensure items were understood as intended. Based on pilot feedback, minor modifications were made to wording for clarity. Confirmatory factor analysis was performed on the pilot data, which supported the hypothesized factor structures of the adapted scales. The internal consistency of each scale in the main study sample is reported below. Socio-demographic and Livelihood Questionnaire. This tool captured information on age, gender, education, occupation, primary livelihood source, and experience of climate-related shocks (e.g., crop failure, loss of livestock). Change Perception Questionnaire (CCPQ). A 15-item tool adapted from previous studies (Le Dang et al., 2014; van Valkengoed & Steg, 2019). It assessed understanding of the scientific causes, manifestations, and personal relevance of climate change (e.g., “Human activities are a major cause of climate change”; “I have noticed changes in rainfall patterns over the last decade”). Responses were on a 5-point Likert scale from ‘Strongly Disagree’ to ‘Strongly Agree’. A total score was categorised as ‘Poor understanding’ (<50%), ‘Fair’ (50-75%), and ‘Good’ (>75%). The adapted tool demonstrated good internal consistency (Cronbach’s α = .87 in this study). Brief COPE Inventory. A 28-item measure assessing 14 coping strategies (Carver, 1997). It was validated for use in Nigeria (e.g., Adewuya et al., 2006) and underwent the cultural adaptation process described above. Strategies are grouped into adaptive (e.g., active coping, planning, positive reframing) and maladaptive (e.g., self-distraction, denial, substance use, behavioural disengagement) based on their typical association with mental health outcomes in the literature. Participants rated how often they used each strategy on a 4-point scale. The inventory showed acceptable reliability (Cronbach’s α for subscales ranged from .65 to .89). Connor-Davidson Resilience Scale (CD-RISC-10). A 10-item scale measuring the individual's selfreported ability to cope with adversity (Connor & Davidson, 2003). It was validated in Nigeria (Adeyemo & Adeleye, 2018). Items (e.g., “I am able to adapt when changes occur”) are rated on a 5-point scale. The total score ranges from 0 to 40, with higher scores indicating greater resilience. Scores were categorised as low (0-20), moderate (21-30), and high (31-40). It demonstrated excellent reliability (Cronbach’s α = .92). Kessler Psychological Distress Scale (K10). A 10-item scale screening for anxiety and depressive symptoms in the past month (Kessler et al., 2002). It has been widely used and validated in Nigeria (Gureje et al., 2006). Scores range from 10 to 50, and are categorised as: ‘Likely well’ (10-19), ‘Mild distress’ (20-24), ‘Moderate distress’ (25-29), and ‘Severe distress’ (30-50). It had high internal consistency (Cronbach’s α = .93). Data Analysis Data were analysed using IBM SPSS Statistics version 29. Descriptive statistics (frequencies, percentages, means, and standard deviations) were used to summarise socio-demographic variables and key outcomes. Chi-square tests were used to examine associations between categorical variables. Multivariate binary logistic regression was performed to identify predictors of severe psychological distress (K10 ≥ 30), with results presented as adjusted odds ratios (aOR) and 95% confidence intervals (CI). The model fit was assessed using the Hosmer-Lemeshow test, and the Nagelkerke R² was reported. Yakubu et al., 2025 Page 5 of 10 Multicollinearity was assessed using Variance Inflation Factors (VIF). A p-value of <.05 was considered statistically significant. RESULTS The study included 15,000 adults from the Hausa-Fulani communities of Northwest Nigeria. As shown in Table 1, participants were primarily aged 36–55 years (46.0%, n = 6,900), and gender distribution was nearly equal (52.5% male). A majority (68.0%, n = 10,200) had no formal education. Most respondents (87.3%, n = 13,095) relied on climate-sensitive livelihoods such as farming and pastoralism, and 68.7% (n = 10,305) had experienced a major climate-related shock. Table 1. Socio-Demographic Characteristics of Participants (N = 15,000) Characteristic Category n % Age group (years) 18–35 5,250 35.0 36–55 6,900 46.0 >55 2,850 19.0 Gender Male 7,875 52.5 Female 7,125 47.5 Education level No formal education 10,200 68.0 Qur’anic only 2,700 18.0 Primary 1,350 9.0 Secondary or higher 750 5.0 Primary livelihood Farming/Pastoralism 13,095 87.3 Trading 1,200 8.0 Artisan/Skilled work 525 3.5 Other 180 1.2 Experienced major climate shock Yes 10,305 68.7 No 4,695 31.3 Note. Percentages are based on the total sample (N = 15,000). As presented in Table 2, most participants demonstrated poor scientific understanding of climate change (78.0%, n = 11,700). The most frequently reported coping strategies were behavioral disengagement (72.0%, n = 10,800) and self-blame (65.0%, n = 9,750). The mean resilience score (CDRISC-10) was 18.2 (SD = 5.1), with 62.0% (n = 9,300) classified as having low resilience. The prevalence of severe psychological distress (K10 ≥ 30) was 63.0% (n = 9,450), while an additional 22.0% (n = 3,300) reported moderate distress. Multivariate logistic regression results are summarized in Table 3. The overall model was significant (Hosmer–Lemeshow p = .321; Nagelkerke R² = .36). Poor climate change understanding (aOR = 3.21, 95% CI [2.68, 3.85]), maladaptive coping style (aOR = 4.10, 95% CI [3.55, 4.73]), and low resilience (aOR = 4.85, 95% CI [4.22, 5.58]) independently predicted severe psychological distress. Experiencing a major climate shock and having no formal education were also significant predictors, while age and gender were not. Yakubu et al., 2025 Page 6 of 10 Table 2. Climate Change Understanding, Coping Strategies, Resilience, and Distress (N = 15,000) Outcome Measure Category / Score n % / Mean (SD) Climate change understanding Poor (<50%) 11,700 78.0 Fair (50–75%) 2,250 15.0 Good (>75%) 1,050 7.0 Predominant maladaptive coping (Brief COPE) Behavioral disengagement 10,800 72.0 Self-blame 9,750 65.0 Denial 6,750 45.0 Substance use 2,400 16.0 Resilience (CD-RISC-10) Mean score – 18.2 (5.1) Low (0–20) 9,300 62.0 Moderate (21–30) 4,125 27.5 High (31–40) 1,575 10.5 Psychological distress (K10) Severe (30–50) 9,450 63.0 Moderate (25–29) 3,300 22.0 Mild (20–24) 1,650 11.0 Likely well (10–19) 600 4.0 Note. CD-RISC-10 = Connor–Davidson Resilience Scale; K10 = Kessler Psychological Distress Scale. Table 3. Multivariate Logistic Regression Predictors of Severe Psychological Distress (K10 ≥ 30) Predictor Variable Category aOR 95% CI p Climate understanding Good (Ref) 1.00 – – Fair 1.85 [1.52, 2.25] <.001 Poor 3.21 [2.68, 3.85] <.001 Coping style Adaptive (Ref) 1.00 – – Maladaptive 4.10 [3.55, 4.73] <.001 Resilience level High (Ref) 1.00 – – Moderate 2.15 [1.88, 2.46] <.001 Low 4.85 [4.22, 5.58] <.001 Climate shock No (Ref) 1.00 – – Yes 2.02 [1.85, 2.20] <.001 Education Secondary+ (Ref) 1.00 – – Primary 1.45 [1.20, 1.75] <.001 Qur’anic only 1.98 [1.65, 2.38] <.001 No formal 2.82 [2.38, 3.34] <.001 Age Continuous 1.00 [0.99, 1.01] .865 Gender Male (Ref) 1.00 – – Female 1.07 [0.99, 1.15] .072 Note. Ref = reference category; aOR = adjusted odds ratio; CI = confidence interval. Model fit: Hosmer–Lemeshow test p = .321; Nagelkerke R² = .36. DISCUSSION This large-scale study provides evidence of a high burden of psychological distress within the context of climate vulnerability in Northwest Nigeria. The findings indicate a population with a limited scientific understanding of climate change, a predominant reported use of specific coping strategies measured Yakubu et al., 2025 Page 7 of 10 as maladaptive by the Brief COPE, low levels of individually measured resilience, and high rates of psychological distress. The extremely poor scientific understanding of climate change (78%) aligns with smaller studies from rural Africa which found that while communities acutely experience the effects of climate change (e.g., drought), they often attribute them to non-scientific causes such as divine will or a natural cycle of events (Etana et al., 2021; Tambo & Abdoulaye, 2013). This lack of a scientific framework, as our regression analysis confirms, is significantly associated with mental ill-health (aOR=3.21). It may prevent the development of a coherent narrative to explain suffering and can foster feelings of helplessness, which are fertile ground for anxiety and depression (Clayton et al., 2017; van Valkengoed & Steg, 2019). The overwhelming reported use of strategies like behavioural disengagement and self-blame, as defined by the Brief COPE, is a central finding. It is critical to interpret this within the cultural and religious context. Concepts such as sabr (patience) and tawakkul (trust in God's plan) are central to Islamic coping and may manifest in survey responses that resemble behavioural disengagement or acceptance in Western psychological frameworks (Doherty & Clayton, 2011; Reser & Swim, 2011). Therefore, these findings may reflect a complex interplay between culturally sanctioned endurance and a lack of perceived viable adaptive options in the face of systemic stressors. Nonetheless, their strong association with distress (aOR=4.10) suggests that these cognitive-behavioral patterns, regardless of their cultural roots, are linked to poorer mental health outcomes in this context. Self-blame, in particular, internalises systemic problems, potentially exacerbating feelings of worthlessness and guilt that are core features of depression (American Psychiatric Association, 2013). The low mean resilience score (18.2) is considerably lower than norms reported in general population studies in other developing countries (Burns et al., 2011; Connor & Davidson, 2003). This suggests that the chronic, multi-faceted stress of climate change, combined with pre-existing poverty and regional instability, is eroding the natural resilience of these communities. Resilience is not merely an individual trait but is built on social, economic, and institutional resources (Southwick et al., 2014; Ungar, 2018). The use of an individual-level instrument like the CD-RISC-10 may underestimate community-level resilience built through kinship and faith; however, the depletion of foundational resources; land, livestock, and social cohesion—appears to directly translate into a depleted psychological capacity to cope, as evidenced by its status as the strongest predictor in our model (aOR=4.85). The prevalence of severe psychological distress (63%) is high and far exceeds rates found in general population surveys in Nigeria (Gureje et al., 2020). It is consistent with studies focused on populations experiencing severe environmental stress, such as farmers in India experiencing climaterelated crop failures (Berry et al., 2018). Our findings suggest that for the Hausa-Fulani, the slow-onset disaster of desertification and drought may be as psychologically impactful as acute weather events. The application of the syndemic framework helps to conceptualize these findings. We posit a syndemic interaction between: (1) a climate crisis (environmental degradation and shocks), (2) a mental health crisis (high prevalence of distress), and (3) a crisis of resources (low education, limited economic alternatives, and depleted psychosocial capacities). These epidemics are not merely co-occurring; they are synergistic (Singer et al., 2017). Poverty and low education limit climate understanding and adaptive capacity, which fosters helplessness and maladaptive coping. This, in the absence of strong resilience resources, directly exacerbates psychological distress. In turn, poor mental health impairs cognitive function and motivation, further reducing the capacity for adaptive action, thereby deepening Yakubu et al., 2025 Page 8 of 10 vulnerability to climate impacts. This vicious cycle is mediated by social structures including a lack of safety nets, regional instability, and limited access to mental health care. Recommendations Based on our findings, we propose the following culturally-grounded actions: 1. Develop and implement community-based programmes that explain climate change science using culturally appropriate analogies and integrate messages on environmental stewardship from Islamic teachings, collaborating with respected religious leaders (Imams and Mallams). These programmes should incorporate basic mental health literacy to reduce stigma. 2. Integrate psychosocial support with existing structures by training agricultural extension workers and community health workers to teach adaptive coping skills (e.g., problem-solving) and provide psychological first aid. Establish peer-support groups for farmers and herders to foster collective resilience. 3. Partner with state and local agencies to promote climate-smart agriculture and create vocational training programs for off-farm livelihoods, particularly targeting youth and those who have lost their assets to climate shocks. 4. Train and deploy more community health workers to identify, support, and refer individuals with severe mental health conditions, developing a task-sharing model within primary healthcare. Policymakers must recognise mental health as a core, non-negotiable component of climate adaptation strategy. Failing to address this psychosocial dimension will undermine the effectiveness of all other efforts to build climate-resilient communities. Limitations The cross-sectional design limits inferences about causality, and the observed associations should be interpreted as correlations. The use of self-reported measures is subject to bias. The instruments, though rigorously translated and validated, are based on Western psychological constructs and may not fully capture indigenous coping (e.g., collective and spiritual practices) or community-level resilience. The high rate of ‘poor understanding’ may partly reflect the instrument's focus on scientific causality rather than local ecological knowledge. The K10, while validated, is a screening tool, and its cutoff in this population may be influenced by cultural idioms of distress. While random sampling was used, selection bias is possible if those with the most severe distress were unavailable, and regional insecurity may have limited access in some areas. We did not conduct a gendered analysis, which is a limitation given the potentially differential impact of climate stress. CONCLUSION This study reveals a critical public health priority in Northwest Nigeria, where climate vulnerability is inextricably linked with a high burden of psychological distress. The measurable constructs of limited scientific climate knowledge, specific maladaptive coping patterns, and low individual resilience are significant contributors to this distress. Addressing this crisis requires moving beyond siloed approaches to develop multi-pronged, culturally-grounded interventions. Yakubu et al., 2025 Page 9 of 10 DECLARATIONS ACKNOWLEDGEMENTS All authors substantially contributed to all the major aspects of this study, including conception, design, data acquisition, analysis, interpretation, and drafting the manuscript. All authors performed critical revision of the manuscript for important intellectual content and approved of the final version to be published. The research team reflects on its positionality, acknowledging that while it includes researchers familiar with the region, interpretation was conducted with an awareness of our external perspective to the specific communities studied. The authors sincerely thank all the participants who took part in the study, and the various state and local government officials who provided us with necessary data and information and their invaluable support throughout the study. FUNDING Not applicable. AVAILABILITY OF DATA AND MATERIALS Data are available from the corresponding author upon reasonable request. ETHICS APPROVAL AND CONSENT TO PARTICIPATE The study procedures were reviewed and approved by the Health Research Ethic Committee of Ahmadu Bello University Teaching Hospital, Shika-Zaria (Ref: ABUTHZ/HREC/C37/2024). Informed written consent was obtained from all participants prior to their inclusion in the study. Confidentiality and anonymity of participants was maintained throughout the research process. Participants were duly informed they could withdraw from the study at any time without any consequences. CONSENT FOR PUBLICATION The standardised instruments used in this study (Brief COPE, CD-RISC-10, K10) are copyrighted. Formal permission for their use in this research and for reproduction of the specific items in the manuscript and supplementary materials has been obtained from the respective copyright holders. 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