sub-Saharan Research Articles

Impact of Low Physical Activity on Cardiovascular Disease Across Regions and Demographic Groups: Insights from the Global Burden of Disease Study.

Cardiovascular disease (CVD) is a leading cause of death globally, with low physical activity (LPA) as a significant modifiable risk factor. The prevalence of LPA remains high, necessitating a comprehensive assessment of its impact on CVD. We applied Joinpoint regression to assess trends in deaths and Disability-Adjusted Life Years (DALYs) and employed ARIMA models to project future BMI-related burdens. From 1990 to 2021, CVD-related deaths due to LPA rose from 218,938 to 371,736 globally, with the most significant increases in Southeast Asia and Sub-Saharan Africa. DALYs surged from 4.47 million to 7.29 million. Although age-standardized death rates showed a slight decline in high-income countries (-2.27% EAPC), lower-income regions experienced a steady rise. YLDs grew from 344,680 to 725,181, while YLLs increased from 4.13 million to 6.57 million, with older adults (75+ years) carrying the highest burden. The growing burden of CVD linked to LPA highlights the urgent need for interventions, particularly in low- and middle-income countries, to reduce future risks and improve public health outcomes.

Determination of the Level of von Willebrand Factor, ADAMTS13, and Ratio of ADAMTS13:von Willebrand Factor in Sickle Cell Disease Patients.

Sickle cell anemia (SCA) is a hypercoagulable state characterized by a significant alteration in hemostatic parameters which may predispose an increased risk of vaso-occlusive crisis (VOC). Sickle cell disease (SCD) is the most common genetic disorder in sub-Saharan Africa. Nigeria bears a high disease burden with an estimated prevalence of 1%-3% of its population being affected by the disease. The study seeks to determine the role of von Willebrand factor (VWF), ADAMTS13, and the ratio of ADAMTS13:VWF antigen in the pathogenesis of VOC. The objective of this study is to evaluate the level of VWF, ADAMTS13, and their ratio in SCD subjects in Calabar and to determine their role in the pathogenesis of VOC. This is a comparative study carried out at the University of Calabar Teaching Hospital (UCTH), Calabar. Sixty SCA patients were evaluated in VOC and steady states as well as five parented healthy controls. VWF: Ag and ADAMTS13:Ag were evaluated using Assaypro enzyme-linked immunosorbent assay kits with Lot nos. 01751728 and 04222167R, respectively. Data were analyzed by IBM SPSS Chicago software version 21. The study was approved by the UCTH Institution Ethical Review Board. The mean ages of the SCA subjects and controls were 23.5 ± 7.2 years and 26.5 ± 5.6 years, respectively (P = 0.706). There were 23 (38.3%) males in the SCA group and 21 (42.0%) females in the controls. There was no significant difference in their sex distribution (P = 0.063). The mean (standard deviation [SD]) of VWF in VOC, steady state, and controls were 2.52 ± 0.34, 1.34 ± 0.23, and 1.41 ± 0.23 IU/mL, respectively. The differences in mean were significantly higher in VOC state (P = 0.003). The mean ± SD of ADAMTS13 in VOC, steady state, and controls were 0.61 ± 0.10, 0.44 ± 0.06, and 0.62 ± 0.10 μg/L, respectively. ADAMTS13 levels did not differ significantly across the groups (P = 0.270). Similarly, there was no significant difference between ADAMTS13:VWF ratios across the groups (P = 0.318). VWF level is elevated in VOC state and thus may be implicated in the pathogenesis of VOC. ADAMTS13 and the ratio of ADAMTS13:VWF are not significantly affected in VOC.

Contraceptive use and determinants among sexually active unmarried adolescents and young women (aged 15-24 years) in East Africa: insights from Demographic and Health Survey data.

Low contraception usage among adolescents is a significant public health issue, leading to a rise in unintended pregnancies and adolescent childbearing in sub-Saharan Africa. Despite global efforts to improve access to contraception, sexually active adolescents and young women in East Africa are often overlooked, exposing them to substantial health risks. This study explored the factors influencing contraceptive use among unmarried and sexually active adolescents and young women in East African countries. National representative data from the 2016 Demographic and Health Survey for eight East African countries were used in the analysis. Data processing and analysis were performed using STATA 17 software. A multilevel mixed-effect logistic regression was used to identify determinants of contraceptive use at p<0.05. A total of 7813 sexually active unmarried adolescents and young women were considered for the final analysis. Among these young women, 24.9% were using a contraceptive method. Age, place of residence, knowledge of contraceptive methods, employment status and educational attainment were identified as significant determining factors of contraceptive use among sexually active unmarried adolescents and young women (aged 15-24 y) in East Africa. Contraceptive utilization among sexually active unmarried adolescents and young women was relatively low in East African countries. Addressing the existing inequalities in access to contraceptive services for rural adolescents and young women in East African countries is crucial. Prioritizing policies that implement comprehensive sexual education is essential to enhance their knowledge of contraceptives and empower them to make informed decisions.

Prevalence of syphilis among men serving in the militaries of Sub-Saharan Africa.

The 2030 United Nations Agenda for Sustainable Development includes targets to end sexually transmitted infections (STIs) as a major public health threat. STI prevalence data to inform strategies towards this goal are lacking in middle and low-income countries, especially among men. Data from Seroprevalence and Behavioral Epidemiology Risk Surveys (SABERS) conducted among militaries in Cameroon, Chad, Democratic Republic of the Congo (DRC), Ethiopia, Liberia, Malawi, Republic of the Congo (ROC), and Sierra Leone during 2013-2018 were used to estimate the prevalence of presumed active syphilis among active-duty military men. Associations of active syphilis infection with age, education, marital status, and rank for each country were assessed. The prevalence of active syphilis was less than 1% among men in Cameroon (2018), Ethiopia (2018), Liberia (2018), Malawi (2013), ROC (2014), and Sierra Leone (2013). In Chad (2014), 6.2% (95% CI 5.2%-7.4%; n = 121/1949) of men tested positive for active syphilis. In DRC (2014), the prevalence of active syphilis was 15.5% (95% CI 14.1%-16.9%; n = 404/2611) among men. Active syphilis was associated with older age in DRC (p < 0.01), with less education in Chad (p = 0.03) and DRC (p < 0.01), and with rank in DRC (p = 0.048). These data help address a paucity of information on STI prevalence in sub-Saharan Africa and demonstrate the need for improved surveillance among men.

Genome-wide local ancestry and the functional consequences of admixture in African and European cattle populations.

Bos taurus (taurine) and Bos indicus (indicine) cattle diverged at least 150,000 years ago and, since that time, substantial genomic differences have evolved between the two lineages. During the last two millennia, genetic exchange in Africa has resulted in a complex tapestry of taurine-indicine ancestry, with most cattle populations exhibiting varying levels of admixture. Similarly, there are several Southern European cattle populations that also show evidence for historical gene flow from indicine cattle, the highest levels of which are found in the Central Italian White breeds. Here we use two different software tools (MOSAIC and ELAI) for local ancestry inference (LAI) with genome-wide high- and low-density SNP array data sets in hybrid African and residually admixed Southern European cattle populations and obtained broadly similar results despite critical differences in the two LAI methodologies used. Our analyses identified genomic regions with elevated levels of retained or introgressed ancestry from the African taurine, European taurine, and Asian indicine lineages. Functional enrichment of genes underlying these ancestry peaks highlighted biological processes relating to immunobiology and olfaction, some of which may relate to differing susceptibilities to infectious diseases, including bovine tuberculosis, East Coast fever, and tropical theileriosis. Notably, for retained African taurine ancestry in admixed trypanotolerant cattle we observed enrichment of genes associated with haemoglobin and oxygen transport. This may reflect positive selection of genomic variants that enhance control of severe anaemia, a debilitating feature of trypanosomiasis disease, which severely constrains cattle agriculture across much of sub-Saharan Africa.

Antimicrobial stewardship in sub-Saharan African community pharmacies: a systematic review of community pharmacists’ knowledge, practice and challenges faced

Abstract Introduction The indiscriminate use of antimicrobials contributes significantly to antimicrobial resistance (AMR). The World Health Organization (WHO) recommends antimicrobial stewardship (AMS) as one of the global sustainable development interventions to tackle AMR. Implementation of AMS interventions have been documented to be successful in high-income countries 1, however, there is paucity of data regarding the implementation and effectiveness of AMS in low-income settings including sub-Sahara Africa (SSA). Community pharmacies in the SSA play a critical role in the dispensing of medicines, including antibiotics. Aim To evaluate community pharmacists' knowledge, practice, and challenges faced in relation to AMS in SSA community pharmacies. Methods The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) framework guided the review. We searched six electronic databases (PubMed, Web of Science, ProQuest Central, Google Scholar, African Journal Online and Wiley Online library) from January 2010 to December 2022. Reference lists of included articles were screened for additional studies. Studies published in English that described AMS interventions, antibiotic dispensing practices, community pharmacists’ knowledge and perceptions of AMS/AMR were included. Literature reviews and systematic reviews were excluded. AMS in hospital pharmacy and animal studies were also excluded. Two reviewers independently screened the abstracts and full texts according to pre-defined inclusion criteria. Disagreements were resolved through discussion. The Mixed Methods Appraisal Tool (MMAT) was employed to assess the quality of the included studies2. Data were extracted using a standardised form in Microsoft excel and double checked for accuracy. Data were synthesised using narrative synthesis. The review protocol was registered with PROSPERO (CRD42023381320). The study did not require ethical approval because it did not involve conducting primary or secondary research involving human participants. Results The review identified 1972 articles, of which 23 studies met the inclusion criteria. Studies varied in settings, design, and data collection methods. Two broad categories were identified from the narrative synthesis. (1) Community pharmacists’ knowledge, attitude, perception, and dispensing practices (n=20). Studies reported that community pharmacists displayed an understanding of how antibiotics work. They also acknowledged threats posed by AMR. Some studies reported misconceptions on clear guidelines about the practical implementation of AMS, other studies described good adherence to antibiotic dispensing practices, including taking medication histories, assessing symptoms, advising on completion of antibiotic courses and making referrals. One study described the perception of community pharmacists of AMS as crucial for improving patient care. (2). Determinants of non-prescription antibiotic sales (n=3). The studies explored factors influencing the sale of antibiotics without prescription. Studies identified pharmacy owners’ expectations (profitability) and lack of public awareness regarding the risks of non-prescription antibiotic use as contributing factors. Limited patient access to doctors and low economic status in SSA were also cited as determinants. Conclusions Community pharmacists have knowledge of antibiotics, and they also acknowledged the importance of AMS. There were also positive dispensing practices despite existing challenges regarding implementation of AMS and sales of antibiotics without prescription. Further research should prioritize well-designed studies that evaluate the effectiveness of AMS in this setting and address the challenges identified. Heterogeneity of study methods limits the generalisability of findings.

Assessing the Efficacy of Gene-Drive Technology in Reducing Malaria Transmission in Sub-Saharan Africa: Current Progress and Future Prospects

Malaria continues to pose a significant public health challenge in Sub-Saharan Africa, necessitating innovative solutions to combat its transmission. This review examined the efficacy of gene-drive technology as a novel approach to reducing malaria transmission through genetic modifications of Anopheles mosquitoes. Utilizing a comprehensive literature review and analysis of experimental studies and pilot projects, we assessed the mechanisms of gene drives, including population suppression and replacement strategies. The findings indicated that gene-drive technology has the potential to significantly alter mosquito populations, thereby diminishing the burden of malaria. However, challenges such as ecological concerns, regulatory complexities, and public acceptance must be addressed for successful implementation. The integration of gene drives with existing malaria control measures, collaborative research efforts, and robust ethical governance is crucial for maximizing effectiveness and ensuring sustainable outcomes. Furthermore, monitoring and evaluation systems are essential for assessing the safety and efficacy of gene-drive initiatives. This review underscored the transformative potential of gene-drive technology in malaria prevention, advocating for continued dialogue among stakeholders to navigate the complexities associated with its application in Sub-Saharan Africa. Keywords: Gene-drive technology, Malaria transmission, Anopheles mosquitoes, Public health, Sub-Saharan Africa.

The Impact of Mobile Health (mHealth) Interventions on Malaria Diagnosis and Treatment Adherence among Pregnant Women: A Comprehensive Review

Malaria in pregnancy (MiP) poses a significant public health threat, particularly in sub-Saharan Africa, contributing to maternal anemia, preterm birth, low birth weight, and maternal and infant mortality. Early diagnosis and strict adherence to antimalarial treatments are essential to reduce these risks, yet access to timely care and consistent treatment adherence remain major challenges. Mobile health (mHealth) interventions, utilizing mobile technologies such as SMS reminders, diagnostic applications, and telemedicine platforms, have emerged as innovative tools to address these barriers. This comprehensive review examined the impact of mHealth interventions on malaria diagnosis and treatment adherence among pregnant women in malaria-endemic regions. Through case studies from Kenya, Nigeria, and Tanzania, we explore the effectiveness of mHealth solutions in improving maternal health outcomes by ensuring timely diagnosis and promoting adherence to treatment. Methodologically, the review drew on empirical studies, program evaluations, and case reports from peer-reviewed literature. Despite promising outcomes, challenges such as technological barriers, cultural resistance, and scalability concerns persist. Future research should focus on integrating emerging technologies like AI and machine learning to enhance mHealth’s effectiveness while prioritizing equitable access to digital health solutions. Policymakers must also prioritize the integration of mHealth into national health systems to ensure long-term sustainability. Keywords: mHealth interventions, Malaria in pregnancy (MiP), Treatment adherence, Malaria diagnosis, Sub-Saharan Africa

Relative Contributions of Mothers, Fathers, and Other Caregivers’ Cognitive and Socioemotional Stimulation on Ghanaian Children’s School Readiness

ABSTRACT This study examined the concurrent contributions of mothers, fathers, and other caregivers’ cognitive and socioemotional home stimulation to children’s school readiness skills in a sample of Ghanaian kindergartners measured at two time-points across one school year (N = 2,975; M age = 5.2 years; 49% female). Research Findings: Multiple regression analyses showed that mothers and other caregivers’ stimulation – but not fathers – predicted child outcomes. Specifically, in lagged models controlling for children’s fall scores, there were small, positive statistically significant associations between mothers’ cognitive stimulation with literacy, numeracy and motor skills, and between other caregivers’ cognitive stimulation and executive function. With regard to socioemotional stimulation, only mothers’ stimulation was significantly associated with one child outcome – literacy. Father’s stimulation practices were not associated with any child outcomes. Practice or Policy: Although our results are small in magnitude, the findings support the growing evidence from sub-Saharan Africa that home stimulation is an important driver of child development and extends this work by examining different domains of stimulation, as well as contributions from various caregivers in the household. Findings highlight the need for interventions to adopt a family-inclusive approach that engages not only mothers but other caregivers to maximize improvements in children’s development.

Simulation-Based Education of Health Workers in Low- and Middle-Income Countries: A Systematic Review.

Simulation-based education (SBE) is increasingly used to improve clinician competency and patient care and has been identified as a priority by the World Health Organization for low- and middle-income countries (LMICs). The primary aim of this review was to investigate the global distribution and effectiveness of SBE for health workers in LMICs. The secondary aim was to determine the learning focus, simulation modalities, and additional evaluation conducted in included studies. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta Analysis guidelines, searching Ovid (Medline, Embase, and Emcare) and the Cochrane Library from January 1, 2002, to March 14, 2022. Primary research studies reporting evaluation at Level 4 of The Kirkpatrick model were included. Studies on simulation-based assessment and validation were excluded. Quality and risk-of-bias assessments were conducted using appropriate tools. Narrative synthesis and descriptive statistics were used to present the results. A total of 97 studies were included. Of these, 54 were in sub-Saharan Africa (56%). Forty-seven studies focused on neonatology (48%), 29 on obstetrics (30%), and 16 on acute care (16%). Forty-nine used mannequins (51%), 46 used scenario-based simulation (47%), and 21 used synthetic part-task trainers (22%), with some studies using more than 1 modality. Sixty studies focused on educational programs (62%), while 37 used SBE as an adjunct to broader interventions and quality improvement initiatives (38%). Most studies that assessed for statistical significance demonstrated at least partial improvement in Level 4 outcomes (75%, n=81). SBE has been widely applied to improve outcomes in a variety of contexts across LMICs. Modalities of simulation are typically low-technology versions. However, there is a lack of standardized reporting of educational activities, particularly relating to essential features of SBE. Further research is required to determine which approaches are effective in specific contexts.

Women's Perspectives on the Unique Benefits and Challenges of Self-Injectable Contraception: A Four-Country In-Depth Interview Study in Sub-Saharan Africa.

Implementing self-injection (SI) of subcutaneous depot-medroxyprogesterone acetate (DMPA-SC) is a key self-care strategy for sexual and reproductive health, but SI uptake remains low, and assertions about the potential of SI to increase women's control over contraceptive use lack evidence. We sought to qualitatively explore how women with diverse contraceptive experiences-including those with and without experience using SI-view the benefits and challenges of SI as compared to other methods. We conducted 241 in-depth interviews with women across four sub-Saharan African countries and found alignment between the perceived and experienced benefits of SI across our diverse sample. Through the benefits of privacy, easier access, and self-management, we found SI can promote greater control over the contraceptive experience by facilitating a woman's ability to act on her preferences and control who is involved in or aware of her contraceptive use. Interviews revealed SI's potential is, however, constrained by inherent limitations in the method; for example, it is often not private or accessible enough and many fear injecting themselves. SI has the most potential when implemented with programmatic solutions that mitigate challenges women experience or anticipate and allow more women to benefit from the privacy, easier access, and self-management that SI offers.

Considerations in planning a controlled human infection model in at-risk groups in sub-Saharan Africa: the case for pneumococcal challenge in people living with HIV in Malawi and a report of stakeholder consultation

Considerations in planning a controlled human infection model in at-risk groups in sub-Saharan Africa: the case for pneumococcal challenge in people living with HIV in Malawi and a report of stakeholder consultation

Uproar against Liberal Majoritarianism: Critiques from African Perspectives

Abstract The article deals with critiques of liberal majoritarianism from an African, chiefly sub-Saharan-African perspective. It explains the central claims African and Africanist critics advance against liberal majoritarianism and indicates potential normative ways of development. The case study of Guinea-Bissau exemplifies our arguments using a qualitative analysis of interviews with local respondents. The article infers that this is an instance of a more general perception of liberal majoritarianism in Africa. The article contributes to critiques that range from empirical and theoretical concerns over the feasibility of this model in sub-Saharan Africa to analyses of cultural, social, and political specificities.

Why anti-corruption projects and programmes fail in some African countries: a case study of an anti-corruption project that drowned in corruption and the lessons learned

Purpose The pandemic of corruption in Africa reflects the more general climate of the lack of both ethical leadership and appropriate anti-corruption systems found throughout most of the continent. The purpose of this study is to examine the manner in which corruption was perpetrated in an anti-corruption project that was intended to produce outcomes to reduce and control said corruption, in a sub-Saharan Africa country, for sustained development outcomes, including progress in meeting the sustainable development goals. Design/methodology/approach Based on a field experience, and drawing on the active participant observation research methodology, buttressed by open-ended interviews, this work provides a qualitative analysis and assessment case study of corruption in the implementation process of the anti-corruption project. Findings It is shown that corruption remains a significant barrier to positive development outcomes, especially in those environments where certain social norms and collectivist behaviour are prominent. In such environments, special systems need to be in place for project implementation success even in cases where a project itself is designed to reduce and control that corruption. Key lessons learned include the imperatives of recruiting qualified and ethical personnel and the importance of country ownership, political will and persistent project monitoring including by the citizen beneficiaries of sustainable development projects. Originality/value The paper’s value is the insights it provides through the mapping of the key lessons learned for successful implementation of projects and systems to control corruption and improve ethical behaviour in Africa and beyond.

FDI, industrialisation and environmental quality in SSA—the role of institutional quality towards environmental sustainability

In light of the quest to achieve economic development without compromising environmental quality, we empirically examine whether institutional quality (INSQY) can help moderate the possible harmful effects of foreign direct investments (FDI) and industrialisation on environmental quality in sub-Saharan Africa (SSA). We utilise the Driscoll and Kraay standard error estimation technique on a panel of 45 SSA countries from 2000 to 2019. The results indicate that FDI and industrialisation generally have a significant harmful effect on the environment. Our findings reveal that INSQY directly promotes environmental quality. Notably, the results confirm that INSQY plays a stimulating role in mitigating the adverse effects of FDI and industrialisation on environmental quality. The results further validate the environmental Kuznets curve (EKC) hypothesis in SSA. These findings contribute to environmental sustainability literature and offer policymakers insights on how INSQY can enhance environmental quality. Our empirical results are also robust to different estimation techniques, such as the two-stage least squares. We recommend SSA leaders strengthen institutional capacities, enforce environmental regulations, and implement strict policies to ensure environmental quality while promoting industrialisation and FDI inflows.

Investigating the mediating role of national governance bundles and institutional ownership on the relationship between risk governance disclosure and market valuation: evidence from Sub-Saharan Africa

Purpose The paper aims to comparatively examine the impact of risk governance disclosure (RGD) on the market valuation of firms in Sub-Saharan Africa (SSA) and the mediating role of institutional investment and national governance bundles (NGB). Design/methodology/approach Using a dynamic system generalized method of moments estimation to control for endogeneity, the data for this research is manually collected from the annual reports of small and large firms in Nigeria (80 firms) and South Africa (100 firms) for the period 2012–2017 (900 firm years). Findings The authors find that firm RGD directly impacts firm valuation positively, but this association is significantly mediated by national governance practices (bundles) and institutional investment. The authors also develop a conceptual framework that shows the direct and indirect impact of RGD on firm market valuation. Originality/value The paper contributes to the comparative corporate governance literature in three ways. First, the authors show that differences in country-level RGD are explained by the maturation of governance regulations and institutions in each country. Second, despite the differences in the level of maturity of governance institutions across countries, stock markets value risk governance information. Finally, the study develops a conceptual framework that addresses prior inconsistent findings by showing that firm-level NGB and institutional investment significantly mediate the association between RGD and market valuation.

Prevalence and factors associated with cerebral malaria among children aged 6 to 59 months with severe malaria in Western Uganda: a hospital-based cross-sectional study

IntroductionCerebral malaria, caused by Plasmodium falciparum, represents the most severe neurologic complication of malaria. Its association with high morbidity and mortality rates, especially among young children, underscores its clinical significance. In sub-Saharan Africa, including Uganda, cerebral malaria remains a major health challenge, contributing significantly to the high child mortality rate. Despite advances in malaria control, the burden of cerebral malaria among children under five is substantial, reflecting the need for targeted interventions and improved management strategies. This study aimed to determine the prevalence of cerebral malaria and identify associated factors among children admitted with severe malaria at a tertiary hospital in western Uganda.MethodsThis was a cross-sectional, descriptive, and analytical study involving children aged 6 to 59 months admitted with severe malaria. The study was conducted from January to March 2023 at Fort Portal Regional Referral Hospital. Severe and cerebral malaria were defined as per the WHO criteria. Sociodemographic, clinical, and laboratory data were collected and analyzed using IBM SPSS version 27. Logistic regression analysis was used to evaluate the factors associated with cerebral malaria. A p-value < 0.05 indicated statistical significance.ResultsA total of 250 children were recruited (mean age 33.1 ± 17.3 months). The prevalence of cerebral malaria was 12.8% (95% CI: 8.9–17.6). Cerebral malaria was independently associated with male sex (aOR: 3.05, 95% CI: 1.20–7.77, p = 0.02), abnormal bleeding (aOR: 13.22, 95% CI: 11.54–15.16, p = 0.001), history of convulsions (aOR 12.20, 95% CI: 10.7–21.69, p = 0.010), acute kidney injury (aOR: 4.50, 95% CI: 1.30–15.53, p = 0.02), and hyponatremia (aOR: 3.47, 95% CI: 1.34–8.96, p = 0.010).Conclusions and recommendationsThe prevalence of cerebral malaria was high among children with severe malaria. Factors associated with cerebral malaria included male gender, history of convulsions, abnormal bleeding, acute kidney injury, and hyponatremia. Targeted interventions and early management are essential to improve clinical outcomes.

What are the main factors of fuzzy inequality in Chad?

The purpose of this study is to identify the effects of multidimensional (fuzzy) inequalities and marginal changes on the Gini coefficients of various factors. This allows a range of social policies to be specifically targeted to reduce broader inequalities, but these policies are focused primarily on health, education, housing, sanitation, energy and drinking water. It is necessary to target policy areas that are unequally distributed, such as those with access to unevenly distributed drinking water policies. The data are from the Household and Consumption Survey of 6695 households in 2003 and 9259 households in 2011. This paper uses Lerman and Yitzhaki’s method. The results revealed that the main contributors to inequalities over the two periods were health and education. These sources have a potentially significant effect on total inequality. Health increases overall inequalities, but sources such as housing, sanitation and energy reduce them. This article provides resources to disadvantaged and vulnerable target groups. Multiple inequalities are analyzed for different subgroups of households, such as place of residence and the gender of the head of household. Analyzing fuzzy poverty inequalities makes it possible to develop targeted measures to combat poverty and inequality. This study is the first to investigate the sources of Gini’s fuzzy inequality in Chad via data analysis techniques, and in general, it is one of the few studies in Saharan Africa to be interested in this subject. Some development policies in sub-Saharan Africa should therefore focus on different sources (negative effect), sources (positive effect) and the equalization effect.

Reaching gender equity in the classroom

The present study explores the impact of the choice of language in tests for girls’ academic performance at monolingual primary and secondary schools in Sub-Saharan Africa. For that purpose, students in grades 3, 6, and 10 (140 girls and 139 boys) from schools in rural Senegal were given a test consisting of three mathematics problem-solving tasks. They were randomly divided into an experimental group if they received the test in a local language, their mother tongue (Sereer for grades 3 and 6, and Joola for grade 10), and into a control group if they received the test in French, the unique language of instruction in the traditional Senegalese public education system. The findings suggest that using a local language familiar to students may contribute to girls’ attainment at school: Girls in the experimental group in grades 3, 6 and 10 outperformed girls in the control group, therefore narrowing the existing gender gap in education. The present study also explores the application of Cummins’ (1979, 2009) theories of language acquisition: The data shows that girls might take advantage of bilingual education systems that promote the transfer of language skills and knowledge. The results presented in this paper show the benefit of introducing local languages familiar to students in the education system of Senegal and other Sub-Saharan countries where only a European language is employed as the language of instruction, especially for girls, by improving their academic performance and contributing to gender equity in education.

Awareness of Family Planning Services among Pregnant Women in Arumeru District, Tanzania: Implications for Public Health Interventions

The demand for health literacy in family planning continues to be a global issue, particularly in developing regions. It is also estimated that over 225 million women in developing countries face challenges accessing and utilizing family planning services. Sub-Saharan Africa has the lowest family planning prevalence, at 24%, with high unmet needs, despite global efforts to improve access and knowledge. This study aimed at assessing the family planning services among pregnant women in Arumeru District, Tanzania. Using a sample size of 269 respondents, data was collected through questionnaires and interviews with healthcare officers between February and March 2024. Data were then analyzed using descriptive statistics techniques for quantitative data whereas qualitative data were analyzed using content analysis approach. Results reveal that 92.9% of respondents were aware of family planning services, with varying levels of understanding. Education and occupation played significant roles in awareness, with younger, educated individuals showing higher knowledge. Improving awareness about maternal and child health can lead to better healthcare practices, timely interventions, and increased utilization of services, ultimately reducing mortality rates and contributing to broader public health goals of improved health equity and universal health coverage. However, cultural, religious, and literacy barriers continue to hinder full understanding. The study concludes that respondents in the study area have high level of awareness regarding family planning, particularly among younger individuals and those with higher education levels. The study recommends targeted awareness programs, especially for underserved populations, and emphasizes the importance of involving men in family planning education to improve reproductive health outcomes.