Practice In Sub-Saharan Africa Research Articles

Maximizing Laboratory Production of Aflatoxins and Fumonisins for Use in Experimental Animal Feeds.

Warm and humid climatic conditions coupled with poor agricultural practices in sub-Saharan Africa favor the contamination of food and feed by Aspergillus flavus and Fusarium verticillioides fungi, which subsequently may produce aflatoxins (AFs) and fumonisins (FBs), respectively. The growth of fungi and the production of mycotoxins are influenced by physical (temperature, pH, water activity, light and aeration), nutritional, and biological factors. This study aimed at optimizing the conditions for the laboratory production of large quantities of AFs and FBs for use in the animal experiments. A. flavus and F. verticillioides strains, previously isolated from maize in Kenya, were used. Levels of AFB1 and total FBs (FB1, FB2, and FB3) in different growth substrates were screened using ELISA methods. Maize kernels inoculated with three different strains of A. flavus simultaneously and incubated at 29 °C for 21 days had the highest AFB1 level of 12,550 ± 3397 μg/kg of substrate. The highest level of total FBs (386,533 ± 153,302 μg/kg of substrate) was detected in cracked maize inoculated with three different strains of F. verticillioides and incubated for 21 days at temperatures of 22-25 °C in a growth chamber fitted with yellow light. These two methods are recommended for the mass production of AFB1 and FBs for animal feeding trials.

Editorial Board Composition Among Pediatric Cardiology Journals: Time to Cast the Net Wider

BackgroundNo data currently exist on the diversity of editorial board members (EBMs) of pediatric cardiology journals. ObjectivesThe objective was to investigate the editorial boards of 5 pediatric cardiology journals to assess the composition of these boards in terms of the geographical, gender, and economic representation of their members. MethodsInformation on EBMs was collected directly from 5 journal websites accessed in February 2022. The following data were collected: country of practice (including World Bank geographical and income classification), institution of practice, role on editorial board, and whether an individual held a role on 1 or more of the boards included. ResultsA total of 455 EBMs were identified. A total of 369 (81%) were male. All editors-in-chief were male, and 4 were from the United States. EBMs practicing in North America accounted for 278 individuals (61%) of the editorial boards reviewed. The next majority of EBMs are practicing within Europe and Central Asia (23%, n = 103), East Asia and Pacific (7%, n = 31), Middle East and North Africa (4%, n = 18), and Latin America and Caribbean (4%, n = 16). Less than 2% (n = 9) practice in Sub-Saharan Africa and South Asia. Over 90% (n = 415) practice in high-income countries. There was no representation from low-income countries. ConclusionsWomen and pediatric cardiologists practicing in countries outside of Europe and North America were underrepresented on the editorial boards of the journals studied. Diversifying composition of editorial boards may provide greater representation of underserved areas and encourage broader avenues of investigation and research.

Sustainable Scaling of Climate-Smart Agricultural Technologies and Practices in Sub-Saharan Africa: The Case of Kenya, Malawi, and Nigeria

In the wake of climate change, climate-smart agriculture has been proposed as an option for mitigation and adaptation to the attendant harsh impacts among smallholder farmers in Africa. The approach has been promoted for nearly two decades in Kenya, Nigeria, and Malawi, but with low adoption among farmers. This study therefore sought to determine the pathways for sustainable scaling of climate-smart agricultural technologies and practices in the three countries. Secondary and primary data were obtained from desk review, field survey, key informant interviews, and focus group discussions. Data was analyzed using descriptive statistics and multivariate probit regression. The multivariate probit regression result showed eight negative correlated coefficients between the climate-smart agriculture technologies and practices adopted, thus implying that the practices are substitutes for each other. It was observed that gender had no significant influence on the adoption of a set of practices (refuse retention, minimum tillage, green manure, and mulching) but influenced significantly the adoption of early maturing varieties. Implicitly, therefore, apart from gender, the adoption of climate-smart agriculture technologies and practices might often be due to other factors.

The reality of managing asthma in sub-Saharan Africa – Priorities and strategies for improving care

Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relative to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.

Telepharmacy in sub-Saharan Africa: A Narrative Review

In light of the COVID-19 pandemic, there have been developments to ensure patient care even with distance as a barrier. In line with this, Telepharmacy has been receiving much focus, however, there is sparse information on its practice in Sub-Saharan Africa, thus, necessitating the study. This study described the trends and dynamics of Telepharmacy in SubSaharan Africa.

Measuring kidney function: the voice of Africa

Measuring kidney function: the voice of Africa

The feasibility of endourological surgery in low-resource settings.

One of the widest variations in contemporary surgical practice between high and low, or low-middle, income countries is the utilisation of endoscopy as a means of treating urological pathology. The endoscopic management of lower urinary tract problems such as benign prostatic hypertrophy, bladder cancer and urethral strictures was established in the UK in the late 1970s, whilst its adoption into everyday practice in sub-Saharan Africa (SSA) has been significantly retarded. It is still neither a major feature of urological training in those countries nor widely available to the patients that established consultants treat. Likewise, the explosion of less invasive technologies for treating upper tract stone disease in the 1980s, particularly the management of renal stone disease, has also lagged behind practice established in the UK over the last 40 years. This is not due to a lack of patients who could be treated endoscopically or restricted by the abilities of the surgeons in SSA. The restraint in assumption of these less-invasive management options is rather due to the physical availability of trained specialist surgeons, their access to basic infrastructure such as electricity and water, access to endoscopes and the peripheral equipment necessary to successfully deploy them, and the ability of patients to afford the disposable items required for less-invasive forms of management. Some endoscopic procedures are viable in resource-poor settings. However, they are largely dependent upon the supply of equipment from non-governmental organisations in high-income countries, frugal innovation to reduce individual procedure costs, adequately skilled mentors, and maintenance and supply chains to make them a durable option in patient management. Urolink and the Medi Tech Trust present their experience of how endoscopic surgery can be taught, and used sustainably, in a resource-poor healthcare environment.

Magnitude and determinants of breastfeeding initiation within one hour among reproductive women in Sub-Saharan Africa; evidence from demographic and health survey data: a multilevel study

BackgroundEarly initiation of breastfeeding is one of the most simple and essential intervention for child development and survival in the world. World Health Organization recommended to begin breast milk with one hour after delivery. The objective of this study was to determine the magnitude of early initiation of breastfeeding in Sub-Saharan Africa using DHS data set.MethodsThis study was carried out within 32 Sub-Saharan African countries from 2010–2020, a pooled study of early initiation of breastfeeding was performed. For assessing model fitness and contrast, intra-class correlation coefficient, median odds ratio, proportional change in variance, and deviance were used. In order to identify possible covariates associated with early initiation of breastfeeding in the study area, the multilevel multivariable logistic regression model was adapted. Adjusted Odds Ratio was used with 95% confidence interval to declare major breastfeeding factors.ResultThe pooled prevalence of early initiation of breastfeeding in Sub-Saharan Africa countries was 57% (95% CI; 56%—61%), the highest prevalence rate of early initiation of breastfeeding was found in Malawi while the lowest prevalence was found in Congo Brazzaville (24%). In multilevel multivariable logistic regression model; wealth index (AOR = 1.20; 95% CI 1.16 – 1.26), place of delivery (AOR = 1.97; 95% CI 1.89 – 2.05), skin-to-skin contact (AOR = 1.51; 95% CI 1.47 – 1.57), mode of delivery (AOR = 0.27; 95% CI 0.25 – 0.29), media exposure (AOR = 1.36; 95% CI 1.31 – 1.41) were significantly correlated with early initiation of breastfeeding in Sub-Saharan Africa.ConclusionThe magnitude of early initiation of breastfeeding rate was low in Sub-Saharan Africa. Covariates significantly associated with early initiation of breastfeeding was wealth index, place of delivery, mode of delivery, women educational status, and media exposure. Structural improvements are required for women with caesarean births to achieve optimal breastfeeding practice in Sub-Saharan Africa.

Maize Yield Estimation in Intercropped Smallholder Fields Using Satellite Data in Southern Malawi

Satellite data provide high potential for estimating crop yield, which is crucial to understanding determinants of yield gaps and therefore improving food production, particularly in sub-Saharan Africa (SSA) regions. However, accurate assessment of crop yield and its spatial variation is challenging in SSA because of small field sizes, widespread intercropping practices, and inadequate field observations. This study aimed to firstly evaluate the potential of satellite data in estimating maize yield in intercropped smallholder fields and secondly assess how factors such as satellite data spatial and temporal resolution, within-field variability, field size, harvest index and intercropping practices affect model performance. Having collected in situ data (field size, yield, intercrops occurrence, harvest index, and leaf area index), statistical models were developed to predict yield from multisource satellite data (i.e., Sentinel-2 and PlanetScope). Model accuracy and residuals were assessed against the above factors. Among 150 investigated fields, our study found that nearly half were intercropped with legumes, with an average plot size of 0.17 ha. Despite mixed pixels resulting from intercrops, the model based on the Sentinel-2 red-edge vegetation index (VI) could estimate maize yield with moderate accuracy (R2 = 0.51, nRMSE = 19.95%), while higher spatial resolution satellite data (e.g., PlanetScope 3 m) only showed a marginal improvement in performance (R2 = 0.52, nRMSE = 19.95%). Seasonal peak VI values provided better accuracy than seasonal mean/median VI, suggesting peak VI values may capture the signal of the dominant upper maize foliage layer and may be less impacted by understory intercrop effects. Still, intercropping practice reduces model accuracy, as the model residuals are lower in fields with pure maize (1 t/ha) compared to intercropped fields (1.3 t/ha). This study provides a reference for operational maize yield estimation in intercropped smallholder fields, using free satellite data in Southern Malawi. It also highlights the difficulties of estimating yield in intercropped fields using satellite imagery, and stresses the importance of sufficient satellite observations for monitoring intercropping practices in SSA.

Male partner involvement in health interventions: A systematic review of best practices in Sub-Saharan Africa

Health promotion programmes aimed at the involvement of men are implemented in a complex cultural and socio-demographic context that reifies persistent unequal gender relations. The explanations and evidence for the mechanisms by which male involvement facilitates health and wellness, are, however, less clear. Drawing on findings from a qualitative systematic review of peer-reviewed studies, this article synthesises the literature on health, social policy, and programme interventions for improving male partner involvement to promote sexual and reproductive health, HIV and AIDS health outcomes in sub-Saharan Africa (SSA). Findings suggest that combining approaches such as mass education campaigns and health and social care programmes, targeting both men and women, improves male participation. Finally, enhancing participation of both men and women in the planning, implementation, and evaluation of health program programmes, can lead to positive gender role transformations and positive health and social care outcomes in Sub-Saharan Africa. Keywords: HIV; AIDS; Male Involvement; Health Interventions; Sub-Saharan Africa

Improving ‘needless’ waits in an obstetric ER: implementing an obstetric triage system in a tertiary hospital in Ghana

Abstract Background Maternal mortality is the bane of obstetric practice in sub-Saharan Africa. The delay in receiving care upon arrival in a hospital is a significant contributor to maternal mortalities. Obstetric triaging allows the prioritization of care based on patient acuity. This allows orderly access to care and reduces delays in the health facility. Methods This study was a quality improvement project that set out to establish an obstetric triaging system in the Department of Obstetrics and Gynaecology of the Korle Bu Teaching Hospital (KBTH) starting in December 2016, and assess its impact primarily on the pre-implementation waiting time of 4.2 h, 1 year on after implementation. The project was scheduled in phases which included training, development of an Obstetric Emergency System, development of process maps, and reorganization of care, infrastructural works all culminating in the establishment of a Triage System. Results Results from data collected 1 year on showed an average reduction in waiting time from 4.2 h (252 min) to an average of 138.8 min. Conclusions Triaging has helped to improve the timeliness and has added a patient-centered approach to care offered in the Obstetric Emergency of the Korle Bu Teaching Hospital.

Effects of maternal education on early initiation and exclusive breastfeeding practices in sub-Saharan Africa: a secondary analysis of Demographic and Health Surveys from 2015 to 2019

BackgroundEarly initiation of breast feeding (EIBF) and exclusive breast feeding (EBF) are the cheapest, feasible and simplest nutritional interventions for infants. Effects of maternal education on EIBF and EBF are...

Phosphorus management strategies to increase lowland rice yields in sub-Saharan Africa: A review

Phosphorus (P) deficiency is one of the major yield-limiting factors for lowland rice production in sub-Saharan Africa (SSA). Therefore, improved P management could be an effective strategy to increase lowland rice yields in SSA. The study reviews on historical and recent efforts for improving P management for lowland rice production in SSA together with their limitations and prospects for future research. Special focuses are on following three aspects: (1) suitable soil tests to assess the indigenous soil P supply and the yield response to P application in lowlands; (2) organic inputs and localized P application to the nursery bed (nursery P) and to the seedling roots at transplanting (P-dipping); (3) the interaction between P application and climate-induced stresses via its impact on phenological development. For the first aspect, we demonstrate the importance of considering the P adsorption and desorption kinetics in SSA soils, where large amounts of insoluble P complexes are bound to iron and aluminum oxides while these insoluble P pools are solubilized under submerged soil culture. We propose using the oxalate-extractable P, which extracts insoluble P pools bound to amorphous iron-oxide minerals, as a reliable test for measuring the indigenous soil P supply for lowland rice production. With respect to the second aspect, the efficient use of organic inputs—an important nutrient resource for smallholder farmers in SSA—can be reconsidered not only as a source of P but also as a substance to accelerate the chemical reaction and P solubilization in soils for lowland rice production. Several studies have demonstrated significant effects of nursery P and P-dipping to increase rice yields and agronomic P use efficiency (AE P ) as the yield gain per unit of P applied. Excess yield gains with a micro-dosing nursery P may have a risk of P mining from soils. The P-dipping retains the P input-output balance and achieves a consistently high AE P at 74–152 kg kg −1 . The third aspect has received little attention in the previous studies, although recent observations indicate that P management affects rice yields via its impact on phenological development. The time to heading under P deficiency can extend beyond three weeks, which allows plants to accumulate more biomass production while increasing the risk of biotic and abiotic stresses at the reproductive and ripening stages. Further attention should be paid to changes in phenological development and their interactions with climate-induced stress to develop improved P management practices in SSA. • Improved P management strategies can increase rice yield in sub-Saharan Africa. • Organic amendment increases effectively available P in soils and rice growth. • Localized P at nursery and transplanting stages increases rice yields with high AE P . • Improved P management should take into account the effect of P on rice phenology.

The 'dozen' elements substantiating sustainable procurement practice in Sub-Saharan Africa: evidence from Ghana

The 'dozen' elements substantiating sustainable procurement practice in Sub-Saharan Africa: evidence from Ghana

Fodder development in sub‐Saharan Africa: An introduction

AbstractLivestock systems play a key role in the sustainability and livelihood of sub‐Saharan Africa (SSA). The human population in SSA is rapidly increasing, resulting in steady growth in the demand for animal‐sourced foods (ASF). Most current agricultural production practices in SSA coupled with poor management, health challenges and indigenous breeds, result in low crop and livestock productivity and often do not meet local demands. To improve productivity, locally adapted technologies and management practices need to be widely adopted. This special issue is a collection of contributions addressing major aspects of crop and livestock systems in SSA. Key topics addressed include the present status of feedstuff availability in SSA, improved fodder production and utilization practices, new cultivars, soil management, forage conservation, use of near infrared reflectance spectroscopy (NIRS) tools to measure forage nutritive value, and social and economic aspects of crop‐livestock systems. The overarching goal of this special issue is to provide insightful information that can be used for the future development and implementation of efficient and sustainable integrated systems. SSA will have a key role in feeding itself and the world in the future, and livestock systems and cropping practices are crucial components of this process.

The expanding movement of primary care physicians operating at the first line of healthcare delivery systems in sub-Saharan Africa: A scoping review.

In sub-Saharan Africa (SSA), the physicians' ratio is increasing. There are clear indications that many of them have opted to work at the first-line of healthcare delivery systems, i.e. providing primary care. This constitutes an important change in African healthcare systems where the first line has been under the responsibility of nurse-practitioners for decades. Previous reviews on primary care physicians (PCPs) in SSA focused on the specific case of family physicians in English-speaking countries. This scoping review provides a broader mapping of the PCPs' practices in SSA, beyond family physicians and including francophone Africa. For this study, we defined PCPs as medical doctors who work at the first-line of healthcare delivery and provide generalist healthcare. We searched five databases and identified additional sources through purposively selected websites, expert recommendations, and citation tracking. Two reviewers independently selected studies and extracted and coded the data. The findings were presented to a range of stakeholders. We included 81 papers, mostly related to the Republic of South Africa. Three categories of PCPs are proposed: family physicians, "médecins généralistes communautaires", and general practitioners. We analysed the functioning of each along four dimensions that emerged from the data analysis: professional identity, governance, roles and activities, and output/outcome. Our analysis highlighted several challenges about the PCPs' governance that could threaten their effective contribution to primary care. More research is needed to investigate better the precise nature and performance of the PCPs' activities. Evidence is particularly needed for PCPs classified in the category of GPs and, more generally, PCPs in African countries other than the Republic of South Africa. This review sheds more light on the institutional, organisational and operational realities of PCPs in SSA. It also highlighted persisting gaps that remain in our understanding of the functioning and the potential of African PCPs.

Does attitude towards wife beating determine infant feeding practices during diarrheal illness\xa0in sub-Saharan Africa?

BackgroundInappropriate feeding practices of children during illness remains a public health problem globally, particularly in sub-Saharan Africa (SSA). One strategy to improve child health outcomes is through women empowerment—measured by wife beating attitude. However, the role of attitude towards wife beating in child feeding practices has not been comprehensively studied. Therefore, we investigated the association between women's attitude towards wife beating and child feeding practices during childhood diarrhea in 28 countries in SSA.MethodsWe analyzed data from the Demographic and Health Survey on 40,720 children under 5 years. Bivariate and multivariate binary logistic regression analyses were applied to assess the association between women's attitude towards wife beating and child feeding practices. The results were presented using adjusted odds ratio (aOR) with 95% confidence intervals (CIs).ResultsThe pooled results showed that appropriate feeding practices during diarrheal illness among under-five children was 9.3% in SSA, varying from 0.4% in Burkina Faso to 21.1% in Kenya. Regarding regional coverage, the highest coverage was observed in Central Africa (9.3%) followed by East Africa (5.5%), Southern Africa (4.8%), and West Africa (4.2%). Women who disagreed with wife-beating practices had higher odds of proper child feeding practices during childhood diarrhea compared to those who justified wife-beating practices (aOR = 2.02, 95% CI; 1.17–3.48).ConclusionThe findings suggest that women’s disagreement with wife beating is strongly associated with proper child feeding practices during diarrheal illness in SSA. Proactive measures and interventions designed to change attitudes towards wife-beating practices are crucial to improving proper feeding practices in SSA.

Associations between women's empowerment and child development, growth, and nurturing care practices in sub-Saharan Africa: A cross-sectional analysis of demographic and health survey data.

Approximately 40% of children 3 to 4 years of age in low- and middle-income countries have suboptimal development and growth. Women's empowerment may help provide inputs of nurturing care for early development and growth by building caregiver capacity and family support. We examined the associations between women's empowerment and child development, growth, early learning, and nutrition in sub-Saharan Africa (SSA). We pooled data on married women (15 to 49 years) and their children (36 to 59 months) from Demographic and Health Surveys that collected data on child development (2011 to 2018) in 9 SSA countries (N = 21,434): Benin, Burundi, Cameroon, Chad, Congo, Rwanda, Senegal, Togo, and Uganda. We constructed a women's empowerment score using factor analysis and assigned women to country-specific quintile categories. The child outcomes included cognitive, socioemotional, literacy-numeracy, and physical development (Early Childhood Development Index), linear growth (height-for-age Z-score (HAZ) and stunting (HAZ <-2). Early learning outcomes were number of parental stimulation activities (range 0 to 6) and learning resources (range 0 to 4). The nutrition outcome was child dietary diversity score (DDS, range 0 to 7). We assessed the relationship between women's empowerment and child development, growth, early learning, and nutrition using multivariate generalized linear models. On average, households in our sample were large (8.5 ± 5.7 members) and primarily living in rural areas (71%). Women were 31 ± 6.6 years on average, 54% had no education, and 31% had completed primary education. Children were 47 ± 7 months old and 49% were female. About 23% of children had suboptimal cognitive development, 31% had suboptimal socioemotional development, and 90% had suboptimal literacy-numeracy development. Only 9% of children had suboptimal physical development, but 35% were stunted. Approximately 14% of mothers and 3% of fathers provided ≥4 stimulation activities. Relative to the lowest quintile category, children of women in the highest empowerment quintile category were less likely to have suboptimal cognitive development (relative risk (RR) 0.89; 95% confidence interval (CI) 0.80, 0.99), had higher HAZ (mean difference (MD) 0.09; 95% CI 0.02, 0.16), lower risk of stunting (RR 0.93; 95% CI 0.87, 1.00), higher DDS (MD 0.17; 95% CI 0.06, 0.29), had 0.07 (95% CI 0.01, 0.13) additional learning resources, and received 0.16 (95% CI 0.06, 0.25) additional stimulation activities from their mothers and 0.23 (95% CI 0.17 to 0.29) additional activities from their fathers. We found no evidence that women's empowerment was associated with socioemotional, literacy-numeracy, or physical development. Study limitations include the possibility of reverse causality and suboptimal assessments of the outcomes and exposure. Women's empowerment was positively associated with early child cognitive development, child growth, early learning, and nutrition outcomes in SSA. Efforts to improve child development and growth should consider women's empowerment as a potential strategy.

Provider Barriers and Facilitators of Breast Cancer Guideline-Concordant Therapy Delivery in Botswana: A Consolidated Framework for Implementation Research Analysis.

IntroductionSystemic treatment for breast cancer in sub‐Saharan Africa (SSA) is cost effective. However, there are limited real‐world data on the translation of breast cancer treatment guidelines into clinical practice in SSA. The study aimed to identify provider factors associated with adherence to breast cancer guideline‐concordant care at Princess Marina Hospital (PMH) in Botswana.Materials and MethodsThe Consolidated Framework for Implementation Research was used to conduct one‐on‐one semistructured interviews with breast cancer providers at PMH. Purposive sampling was used, and sample size was determined by thematic saturation. Transcribed interviews were double‐coded and analyzed in NVivo using an integrated analysis approach.ResultsForty‐one providers across eight departments were interviewed. There were variations in breast cancer guidelines used. Facilitators included a strong tension for change and a government‐funded comprehensive cancer care plan. Common provider and health system barriers were lack of available resources, staff shortages and poor skills retention, lack of relative priority compared with HIV/AIDS, suboptimal interdepartmental communication, and lack of a clearly defined national cancer control policy. Community‐level barriers included accessibility and associated transportation costs. Participants recommended the formal implementation of future guidelines that involved key stakeholders in all phases of planning and implementation, strategic government buy‐in, expansion of multidisciplinary tumor boards, leveraging nongovernmental and academic partnerships, and setting up monitoring, evaluation, and feedback processes.DiscussionThe study identified complex, multilevel factors affecting breast cancer treatment delivery in Botswana. These results and recommendations will inform strategies to overcome specific barriers in order to promote standardized breast cancer care delivery and improve survival outcomes.Implications for PracticeTo address the increasing cancer burden in low‐ and middle‐income countries, resource‐stratified guidelines have been developed by multiple international organizations to promote high‐quality guideline‐concordant care. However, these guidelines still require adaptation in order to be successfully translated into clinical practice in the countries where they are intended to be used. This study highlights a systematic approach of evaluating important contextual factors associated with the successful adaptation and implementation of resource‐stratified guidelines in sub‐Saharan Africa. In Botswana, there is a critical need for local stakeholder input to inform country‐level and facility‐level resources, cancer care accessibility, and community‐level barriers and facilitators.

Protocol for a scoping review of neonatal emollient therapy and massage practices throughout sub-Saharan Africa

Background: Serious infections and other complications from very low birth weight and prematurity are the leading causes of death for neonates worldwide. Infections partly result from the compromised skin barrier function in preterm neonates. Optimal skin care practices for neonates, especially in settings with limited access to adequate hygienic conditions, hold potential to reduce infection and avoid these preventable preterm neonatal deaths. The purpose of this protocol is to support a scoping review of neonatal skin care, emollient therapy and massage practices throughout sub-Saharan Africa. Protocol: The proposed review will follow a methodological framework consisting of the following five steps: (i) identifying the research question, (ii) identifying relevant studies, (iii) selection of eligible studies, (iv) charting the data, and (v) collating and summarizing the results. In addition, we will reflect on the implications of the findings for the feasibility and design of randomized controlled trials to examine the impact of emollient therapy on survival, growth, infection and neurodevelopment of very low birth weight infants in sub-Saharan Africa. We will search domestic and international databases for literature published in English between January 1, 2000, and July 12, 2021. Articles will be chosen based on standardized inclusion criteria. The primary criteria for inclusion will be a report on skin care practices administered to neonates in Africa. Conclusions: Documentation of common neonatal skin care practices throughout Africa has the potential to highlight opportunities for skin care intervention and future research on neonatal skin care practices in sub-Saharan Africa, and support the development of future emollient intervention trials for preterm and low birthweight neonates in low- and middle-income countries.