Research In sub-Saharan Africa Research Articles

Development and Evaluation of Project Management Training for Cancer Research in Sub-Saharan Africa.

Globally, there were 19.3 million new cancer cases and 10 million cancer deaths, with the African continent contributing approximately 1.1 million new cases and over 700,000 deaths to the global cancer burden in 2020. High quality research is required to understand the etiology and risk factors for common cancers in the region to develop context specific strategies aimed at minimizing the future cancer burden in Africa. Our study addresses a significant gap in the knowledge and resources available for training a project management (PM) workforce for cancer research in Africa. We developed and evaluated a training program to strengthen the research capacity of project managers involved in cancer research in Africa. This workshop was held in collaboration with the Men of African Descent and Carcinoma of the Prostate (MADCaP) Consortium. The PM working group of the MADCaP Consortium had previously developed a project manager toolkit to provide a structured approach to PM for cancer research in Africa. We implemented and evaluated this training toolkit in a hybrid workshop in Nigeria. Among 29 participants from 10 African institutions, PM skills improved after training by 16.6% compared with pretraining levels. In a 1-year follow-up survey, training skills remained better (80.8%) than before the training (70.8%). The training program successfully upskilled the trainees with a significant improvement in knowledge of PM practices including planning, execution, monitoring, and evaluation of projects. The majority (80%) reported an excellent training experience. PM skills training can be successfully implemented in Africa with long-term retention of knowledge geared toward developing a workforce critical for the implementation of cancer research in the region.

Private commercial companies sharing health-relevant consumer data with health researchers in sub-Saharan Africa: an ethical exploration

ABSTRACT Sharing large digital-first datasets, including for purposes for which they were not originally intended, is a hallmark of the “big data revolution”. Through their routine operations, private commercial companies collect massive amounts of diverse data from their customers, some of which may interest those working in the public sector, such as health researchers. Researchers and government agencies worldwide have been increasingly using data from commercial entities (such as Google, Microsoft, Apple, Facebook/Meta, Twitter/X and Amazon, among others) to generate health-related insights. This article explores ethical issues raised by the practice of commercial companies sharing consumer data with third parties for the purposes of promoting health in the sub-Saharan African (SSA) context. First, as an illustrative example, it examines some of the ways telecommunication (telecom) companies in SSA shared mobility data from cellphone users with public health researchers during the COVID-19 pandemic. Second, it examines a recent debate about the ethical responsibilities of companies that collect, process and share user-generated data, drawing implications for the SSA context. Finally, since this is a relatively understudied subject, we point out some areas where future conceptual and empirical work could contribute to the development of relevant ethics guidance and regulatory governance in SSA.

The Western psychologization of global development: A cultural and decolonial approach

Euro-American psychology’s strong focus on the individual mind and behavior has become a fundamental part of global development agendas. Concepts like self-regulation, self-actualization, self-efficacy, and behavior change decorate the development discourse. Scholars term this phenomenon the “psychologization of development.” The main driver of this focus is likely rooted in the hegemonic belief that Western psychological theories are universally applicable. Yet, the discipline’s embeddedness in Euro-American imperialism, globalization, and neoliberalism makes its theories particularly un-universal and unfit in many contexts. Nevertheless, people in non-Western societies are increasingly subjected to development interventions targeting their individual behavior. Using examples from research in sub-Saharan Africa of how articulations of harmful witchcraft may increase because of development interventions that promote individualized ways of being and thinking, this article prompts a cultural and decolonial perspective to reimagine other ways of doing development.

Abstract C033: Mapping behavioral research in post-treatment cancer care in Sub-Saharan Africa: A scoping review

Abstract Introduction: In Sub-Saharan Africa (SSA), high cancer incidence is compounded by limited healthcare access and out-of-pocket costs. Additional factors like limited research funding, socioeconomic disparities, and cultural influences further affect cancer survivors' well-being. While some studies identify factors improving psychosocial well-being, there is a gap in understanding SSA-specific contextual and behavioral influences. This study addresses this gap through a scoping review of post-treatment cancer behavioral research, synthesizing current knowledge to inform interventions aimed at enhancing psychosocial support and improving health outcomes for survivors in the region. Methods: Guided by Arksey and O'Malley's 5-step framework, we conducted a scoping review to map cancer-focused behavioral research in Sub-Saharan Africa, aiming to inform policy and identify research gaps. Through comprehensive literature searches and eligibility criteria based on the PICOS framework, we identified relevant studies. Searches were executed from September-October 2023. Our search strategy encompassed multiple databases and supplementary methods to ensure thorough coverage. Screening, extraction, and analysis of the selected articles were conducted independently by at least two reviewers, using Microsoft Excel and Covidence and resolving discrepancies through discussion. Ultimately, seven articles met our inclusion criteria. Data were charted and summarized, covering demographics, study design, barriers, facilitators, cultural factors, support mechanisms, and recommendations. Results: Seven articles from four SSA countries were reviewed, with Nigeria contributing the most studies. The study articles, spanning from 1998 to 2023, used diverse methodologies and theoretical frameworks. The studies covered various cancer types and stages, highlighting significant psychological distress, financial toxicity, and post-traumatic growth among survivors. Cultural influences, including stigma and spiritual beliefs, were prominent. Barriers to care included financial constraints and limited access, while facilitators were social support and positive healthcare relationships. Effective support mechanisms like social and psychological interventions were crucial for enhancing survivors' well-being and promoting long-term follow-up care. Conclusion: This scoping review highlights the significant psychological, financial, and cultural challenges faced by cancer survivors in SSA. Addressing these challenges requires targeted interventions and policies that consider the unique contextual factors of SSA, aiming to enhance psychosocial support and improve overall health outcomes for cancer survivors. Future research should focus on comprehensive and culturally competent approaches to mitigate barriers and leverage facilitators, ultimately fostering a more supportive environment for cancer survivorship in the region. Citation Format: Motolani Ogunsanya, Opeyemi Bolajoko, Jessica Saintibert, Danetta Hooks, Oluwaseyi Toye, Shari Clifton, Folakemi Odedina. Mapping behavioral research in post-treatment cancer care in Sub-Saharan Africa: A scoping review [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C033.

Trust as moral currency: Perspectives of health researchers in sub-Saharan Africa on strategies to promote equitable data sharing.

Groundbreaking data-sharing techniques and quick access to stored research data from the African continent are highly beneficial to create diverse unbiased datasets to inform digital health technologies and artificial intelligence in healthcare. Yet health researchers in sub-Saharan Africa (SSA) experience individual and collective challenges that render them cautious and even hesitant to share data despite acknowledging the public health benefits of sharing. This qualitative study reports on the perspectives of health researchers regarding strategies to mitigate these challenges. In-depth interviews were conducted via Microsoft Teams with 16 researchers from 16 different countries across SSA between July 2022 and April 2023. Purposive and snowball sampling techniques were used to invite participants via email. Recorded interviews were transcribed, cleaned, coded and managed through Atlas.ti.22. Thematic Analysis was used to analyse the data. Three recurrent themes and several subthemes emerged around strategies to improve governance of data sharing. The main themes identified were (1) Strategies for change at a policy level: guideline development, (2) Strengthening data governance to improve data quality and (3) Reciprocity: towards equitable data sharing. Building trust is central to the promotion of data sharing amongst researchers on the African continent and with global partners. This can be achieved by enhancing research integrity and strengthening micro and macro level governance. Substantial resources are required from funders and governments to enhance data governance practices, to improve data literacy and to enhance data quality. High quality data from Africa will afford diversity to global data sets, reducing bias in algorithms built for artificial intelligence technologies in healthcare. Engagement with multiple stakeholders including researchers and research communities is necessary to establish an equitable data sharing approach based on reciprocity and mutual benefit.

Female-specific perspectives in social work research in sub-Saharan Africa: literature review

ABSTRACT In this article, the focus is on social work in sub-Saharan Africa from a female-specific perspective. The article answers the following two questions: what are the most central questions around female-specific perspectives in social work research in sub-Saharan Africa and what kind of emphasis does social work have or recommend for working with women? The aim is to provide international dialogue and new openings for Nordic social work research and practice. The analysis is based on data collected by conducting an integrative literature review. The results show that the importance of women´s perspectives in sub-Saharan Africa is an issue linked to gendered poverty, inequality and gender-based violence. The included studies deal with health issues, including maternal health, sexual health and reproductive health. Social work emphasizes measures based on spirituality and communities, where a female-specific perspective is understood as part of communal structures. An analytical examination of social work in African countries can develop Nordic social work practice and the discipline so that it considers the meaning of female-specific issues as part of communal resources, spiritual practices and global inequality.

The State of Surgical Research in Sub-Saharan Africa: An Urgent Call for Surgical Research Trainers.

Surgery in low- and middle-income countries (LMICs) is poorly developed because of years of neglect. Sustained research on global surgery led to its recognition as an indivisible and indispensable part of primary healthcare in 2015. However, this has had little visible effect on surgical ecosystems within LMICs, especially in sub-Saharan Africa (SSA). SSA surgical research systems strengthening, which includes skills transfer, with local priority setting driving the research agenda, is needed to propel global surgery into the future. The authors performed a literature review of the state of surgical research within SSA and also report the initial efforts of two research training nonprofits to empower young African surgeons with research skills. Surgical research in SSA is disadvantaged even before it is birthed, facing monumental challenges at every stage of development, from research agenda determination to funding, study execution, and publication. Compared with a global output of 17.49 publications per 100,000 population, SSA produces 0.9 (P < 0.0001). The Surgeons in Humanitarian Alliance for Reconstructive, Research, and Education and Enabling Africa Clinical Health Research programs are involved in the longitudinal research mentorship of surgical residents within SSA; the improved quality of research and successful publications by participants suggest nascent steps in growing young surgical scientists. In the absence of an existing surgical research infrastructure within LMICs, global surgery research trainers should link up and collaborate to help develop a surgical research community that will provide the local data required to help transform the SSA surgical ecosystem.

Western Intellectual Hegemony and Academic Research in Sub-Saharan Africa

Western Intellectual Hegemony and Academic Research in Sub-Saharan Africa

Large language models through the lens of ubuntu for health research in sub-Saharan Africa

Large language models through the lens of ubuntu for health research in sub-Saharan Africa

The Africa non-communicable diseases (NCD) Open Lab: Impact of a portfolio of clinical studies to deepen the understanding of NCDs in sub-Saharan Africa.

Clinical research in sub-Saharan Africa (SSA) has often focussed on communicable diseases. However, with the increasing burden of non-communicable diseases (NCDs), there is a need for Africa-specific NCD research. GSK established the Africa NCD Open Lab in 2014. Three calls for proposals were advertised through various media channels. An external independent scientific advisory board, predominantly representing African scientists and NCD experts, reviewed and selected projects to receive funding. An additional programme in the Africa NCD Open Lab was designed to build statistical capability by supporting training initiatives. We assessed the impact of the Africa NCD Open Lab in three ways: scientific quality with impact; research training and professional development; and research environments. We captured metrics through regular reports/interactions with researchers; via a final report; and through exit interviews with principal investigators. Twenty projects in 11 African countries were funded; reports from 18 completed projects are available (data capture is ongoing). Overall, 139 articles have been published in peer-reviewed journals and other data have been presented at conferences and other forums. Most completed projects led to positive outcomes, such as further research, informing policy, or positively impacting clinical care, including three projects that saw changes to regional or national practice guidelines: the CREOLE study in Nigeria; the African Severe Asthma Program in Uganda; and the African Prospective Study on the Early Detection and Identification of Cardiovascular Disease and Hypertension in South Africa. Participation in the Africa NCD Open Lab led to the award of 34 grants related to or influenced by increased research capacity or experience. Significant professional development related to the projects also occurred with higher-level degrees being awarded, including 30 MScs, 30 PhDs, and nine postdoctoral fellowships. Through these projects, research capacity was strengthened across the region by equipping core research facilities, training research staff, strengthening research support services, and supporting the expansion of investigator networks. The completed Africa NCD Open Lab projects demonstrate high-quality research outcomes addressing important health challenges with potential benefits to African populations. Based on the success of the Africa NCD Open Lab, additional funding has been secured to extend the Open Lab initiative.

Measuring Lineage: Implications for Family Violence Research in Sub-Saharan Africa

Previous research on family violence in sub-Saharan Africa highlighted the importance of lineage to women’s experiences of intimate partner violence (IPV). The findings suggest women in patrilineal societies face a greater risk of experiencing IPV than those in matrilineal societies. However, a major critique of this body of work is the operationalization of lineage with ethnicity. This study highlights the weaknesses/strengths of using ethnicity as a proxy for lineage by comparing it to direct measures of lineage. Specifically, we tested the validity of lumping ethnic groups together to create lineage categories against measures that directly ask respondents to self-identify their lineage. We also explored the effects of lineage on different types of IPV. We used representative cross-sectional data collected between May and August 2022 from 1,624 ever-married Ghanaian women aged 18 years and older and residing in three major ecological zones—Coastal, Middle, and Northern Zones—that reflect differences in ecology, culture, and modernity in Ghana. Descriptive and multivariate statistical techniques were used to analyze the data. The findings suggest significant differences in direct (self-identified) and indirect (ethnic) measures of lineage. The majority of respondents who were classified as matrilineal or patrilineal based on their ethnic backgrounds self-reported as belonging to these lineage categories. Both direct and indirect measures of lineage were significantly associated with IPV. However, given the limited operationalization of lineage based on ethnicity, self-identified measures were more useful. While ethnicity remains an important proxy for lineage, self-identified measures of the construct are better if available.

Evaluation of HIV-1 DNA levels among adolescents living with perinatally acquired HIV-1 in Yaounde, Cameroon: A contribution to paediatric HIV cure research in Sub-Saharan Africa

BackgroundWith the advent of antiretroviral therapy (ART), most children living with HIV in sub-Saharan Africa (SSA) are growing toward adolescence, with scarcity of evidence on the size of viral reservoirs to enhance paediatric cure research strategies. This study aims to compare HIV-1 proviral DNA levels according to virological response among adolescents living with perinatally acquired HIV-1 (ALPHIV) and identify associated-factors in the Cameroonian context. MethodsIn this observational cohort study, HIV-1 RNA viremia and CD4+ T-cell count were assessed through RT-PCR and flow cytometry respectively at three time-points over 18 months of observation. At the third time-point, 80 randomly-selected participants were classified as with viremia (≥50 HIV-1 copies/mL; n = 40) or without viremia (<50 HIV-1 copies/mL; n = 40); immune-competent (≥500 CD4+ T cells/mm3) or immunocompromised (<500 CD4+ T cells/mm3). Among these participants, total HIV-1 DNA load was quantified through droplet digital PCR using Bio-Rad QX200. ResultsOf the 80 randomly-selected adolescents, median [IQR] age was 15 (13-17) years, 56.2% were female, duration on ART was 9.3 [5.4–12.2] years. Among the 40 viremic ones (median viremia 7312 [283–71482]) HIV-1 copies/ml, 75.0% (30/40) were in virological failure (≥1000 HIV-1 copies/ml), while median of CD4 T cells were 494 [360–793] cell/mm3 with 48.8% (39/80) immunocompromised. No significant variation in HIV-1 RNA viremia and CD4 T cell count was observed between the three time-points, and 13.7% (11/80) adolescents remained aviremic and immune-competent throughout (stable adolescents). A positive and moderate correlation (r = 0.59; p < 0.001) was found between HIV-1 DNA levels and HIV- 1 RNA viremia. Regarding the CD4 T cell count, a negative and weak correlation (r = −0.28; p = 0.014) was found with HIV-1 DNA loads only among adolescents with viremia. Starting ART within the first year of life, ART for over 9 years and aviremia appear as predictors of low HIV-1 DNA loads. ConclusionAmong ALPHIV, high HIV-1 RNA indicates an elevated viral reservoir size, representing a drawback to cure research. Interestingly, early ART initiation and longer ARTduration lead to sustained viral control and limited HIV-1 reservoir size. As limited size of viral reservoir appears consistent with viral control and immune competence, adolescents with sustained viral control (about 14% of this target population) would be candidates for analytical ART interruptions toward establishing paediatric post-treatment controllers in SSA.

Support for dermatological research in Sub-Saharan Africa: insights from African hair and skin research programs.

The structure and physiology of skin and hair in people of African ancestry are different from other ethnic categories and studies from other continents cannot necessarily be extrapolated to Sub-Saharan Africa (SSA) due to the differences in genetics, lifestyle, climate, cultures, and hair and skin care practices. The aim of this report is to highlight the recent advances in local skin and hair research in SSA from a grant program. African Hair and Skin Research Grants from an industrial sponsor were awarded between 2013 and 2022 on five main topics: acne, hair and scalp, keloid scars, atopic dermatitis, and air pollution. A literature search in Scopus identified publications on these topics in African or black skin in SSA and worldwide to provide insight into the impact of the program. The number of publications from around the world on the skin and hair of people of African ancestry has increased significantly over the past 30 years on all five topics, especially as a result studies conducted in the United States. Fewer studies have been conducted in SSA but there has been an increasing number of publications over the past 10 years, especially from South Africa. Scientific and clinical partnerships between the industry, academia, and public healthcare sectors have contributed to a steady increase in hair and skin publications from SSA, which may be useful for the development of tailored products and public educational campaigns to raise awareness of the risks of using inappropriate products.

Policy Over Practice: A Review of Groundwater Governance Research in Sub-Saharan Africa

Groundwater is increasingly seen as crucial to both agricultural and domestic water supply in sub-Saharan Africa. Citing climate change and growing populations, there is especially a notable shift towards promoting groundwater for irrigation to ensure food security. Increased use of the resource will undoubtedly be accompanied with new questions of governance, with groundwater overexploitation in other parts of the world functioning as a strong cautionary tale. This article provides an overview of the current groundwater governance literature on sub-Saharan Africa. Using a critical water governance lens we analyse how groundwater governance is framed, what terms, categories, and measurements are used to describe and assess groundwater governance, and whose perspectives are considered. We also assess whether groundwater governance research has taken place across sub-Saharan African countries in a balanced way. We find that groundwater governance research in sub-Saharan Africa, even more so than elsewhere, ignores the voices and perspectives of those physically encountering the resource. Instead, it is dominated by the views of formal, technical groundwater experts focusing on the need for more hydrogeological data and formal policies. While the existing contributions to the literature are valuable, the current bias in perspectives calls for others to join the field of groundwater governance and to supplement current conceptualisations and approaches with those of users and others dealing with groundwater management on a daily basis. We argue that groundwater users’ practical governance experiences, locally adapted solutions and knowledges, can add important complementary perspectives and insights towards crafting effective, sustainable and equitable groundwater governance processes across the continent.

Prioritizing post-COVID-19 health research in sub-Saharan Africa: A modified Delphi study for future pandemic

BackgroundThe COVID-19 pandemic exposed weaknesses in healthcare systems and disparities in healthcare access across sub-Saharan Africa (SSA). The insights of frontline healthcare professionals (HCPs), and healthcare researchers involved with the response to COVID in SSA are crucial to ensuring that health systems are optimally prepared for the next pandemic threat. Nonetheless, there is limited consensus as to what are the clinical and public health research priorities necessary to ensure that SSA is optimally prepared and responsive to future pandemics. The aim of this Delphi consensus process was to collate the insights of leading HCPs engaged in research and clinical practice across SSA and prioritize a set of post-COVID-19 pandemic research priorities and determine the investment agenda necessary to address those priorities MethodsA modified Delphi process was designed to prioritize a shared agenda. A group of researchers from the African Forum for Research and Education in Health (AFREhealth) were asked to first list potential research topics. Then, members of the broader AFREhealth community were invited to rate the importance of each topic on a 4-point Likert scale, through two rounds of consensus-seeking. Consensus for inclusion was predefined as ≥70 % of respondents' rating. ResultsHealth professionals, academics, and scientists representing a variety of professions from twenty SSA countries responded to the survey rounds, delivered electronically. An initial subset of researchers suggested 11 initial topics; subsequently, 53 respondents completed round one, and 64 completed round two of the modified Delphi. A final list of 20 topics that met predetermined consensus was grouped into four technical domains: [1] Health workforce and health professions education research; [2] Epidemiology and surveillance; [3] Clinical and health systems research; and [4] and other cross-cutting topics. Across these four domains, the highest-ranking priorities included [1] leveraging digital tools to enhance the health workforce, [2] strengthening genomic surveillance, [3] assessing health system resiliency, and [4] conducting ethical research. ConclusionsPost-pandemic research priorities for pandemic preparedness and response included strategies to determine to leverage digital tools to enhance workforce training and impact, leveraging genomic surveillance capacity to close epidemiologic gaps, and developing strategies to enhance health system resiliency. The priorities outlined in this analysis underscore the need for capacity-building and context-specific research in sub-Saharan Africa to ensure an effective and equitable response to future pandemics.

Enhancing microbiome research in sub-Saharan Africa

While there are lighthouse examples of microbiome research in sub-Saharan Africa (SSA), a significant proportion of local researchers face several challenges. Here, we highlight prevailing issues limiting microbiome research in SSA and suggest potential technological, societal, and research-based solutions. We emphasize the need for considerable investment in infrastructures, training, and appropriate funding to democratize modern technologies with a view to providing useful data to improve human health.

PREDICTING THE FEASIBILITY OF DATA COLLECTION FOR DISABILITY-RELATED RESEARCH IN SUB-SAHARAN AFRICA

This study presents the findings of an investigation into the feasibility of data collection for disability-related research in sub-Saharan Africa. Three research questions were raised and answered in the study. Data were collected from 164 respondents from 8 countries within the sub-Saharan African region. Five respondents were also purposively selected for a semi-structured interview. The qualitative data collected was thematically analysed while the quantitative data was descriptively and inferentially analysed. Findings in the study revealed the possibility of conducting disability-related research seamlessly within sub-Saharan African countries. However, there are a myriad of challenges that face the conducting of disability-related research in the region. Attitude towards disability had the highest likelihood of predicting the availability and accessibility of data for disability research. The study concluded that societal attitude had a strong influence on the conducting and productivity of disability-related research in sub-Saharan Africa. Valuable recommendations were offered based on the findings.

Caregiver Burden and Its Correlates in Caring for Adults With Epilepsy in a Nigerian Tertiary Hospital: A Cross-Sectional Study

Background Epilepsy is a chronic neurological disorder that imposes a substantial burden on caregivers of patients with the condition. There is a lack of research in sub-Saharan Africa assessing the burden of informal caregiving in epilepsy. Aims This study investigated caregiver burden among carers of people with epilepsy, focusing on its patterns, severity, correlates, and impact on caregiver quality of life. Methods A descriptive cross-sectional study was conducted among 246 adult attendees (patients with epilepsy and their caregivers in a 1:1 ratio) at a neurology outpatient clinic. Patients aged 18 to 65, and their caregivers, who were at least 18 years old, were recruited consecutively. A socio-demographic questionnaire and the National Hospital Seizure Severity Scale assessed demographics and illness severity, respectively. The socio-demographic questionnaire, Zarit Burden Interview, and WHO Quality of Life-Bref scale were used to assess the carers’ demographics, burden of care, and quality of life, respectively. Results The mean burden score was 26.5 ± 13.3. Fifty-three caregivers (43.1%) reported a mild-to-moderate burden, while twenty-one (17.0%) reported moderate-to-severe and severe burdens. Caregiver burden was significantly negatively correlated with carers’ quality of life across almost all domains, with the strongest inverse correlation in the psychological domain (r = -0.4, p = 0.01). There was no statistically significant relationship between caregiver burden and respondents’ demographics or clinical variables, except for the epilepsy severity index of the patients (p = 0.01). Conclusion This study provides valuable insights into the burden of care experienced by family members of individuals with epilepsy, highlighting the negative impact on the caregivers' quality of life. Healthcare providers should focus not only on alleviating the suffering of patients with epilepsy but also consider the well-being of caregivers in their treatment plans.

Cancer Research in sub-Saharan Africa: Progress in closing the gap

Cancer presents an escalating challenge in Sub-Saharan Africa (SSA), necessitating strategic interventions grounded in regionally relevant evidence-based medicine. Informed decision-making is critical to formulate effective strategies for cancer prevention, diagnosis, funding, and treatment within the SSA population. The aim of this study is to highlight ongoing clinical trials in SSA, emphasizing the continuous initiatives aimed at filling existing knowledge gaps. Further, the study seeks to assess whether SSA is progressing or stagnating in the global landscape of cancer research. A comprehensive review of research papers and online registries on clinical trials was executed, focusing on English-language journal articles retrieved from the PubMed database. Additionally, a quantitative, web-based, retrospective review was conducted on registered cancer studies in SSA over the past decade (2000-2023) from ClinicalTrials.gov and the Pan African Clinical Trials Registry (PACTR) databases. The review resulted in the inclusion of 71 articles from PubMed, alongside 104 and 140 clinical trials from ClinicalTrials.gov and PACTR databases, respectively. Aggregate findings from PubMed and clinical trial databases revealed that East Africa is the predominant contributor (37%) to cancer clinical trials, whereas Central Africa exhibited the lowest contribution (4%). Notably, PubMed indicated a predominant focus on cervical cancer in clinical trials. Between 2000 and 2015, less than 4% of global cancer clinical trials listed on ClinicalTrials.gov were performed in SSA; in subsequent years, there was an observable increase in the percentage of total trials performed in SSA. Analyses of funding sources revealed that 45% and 32% of clinical trials in SSA were supported by the United States and the United Kingdom, respectively. In the last two decades, the formation of entities like the African Consortium for Cancer Clinical Trials, spearheaded by BIO Ventures for Global Health in partnership with African ministries of health, cancer hospitals, private industry, research institutions, and global oncology experts, contributed to increasing the effective implementation of multicenter clinical trials in Africa. Noteworthy instances, such as the Burkitt's lymphoma and HypoAfrica studies, serve as examples of the results arising from these collaborative initiatives, reflecting substantial progress within SSA’s cancer research landscape.

Developing policy-ready digital dashboards of geospatial access to emergency obstetric care: a survey of policymakers and researchers in sub-Saharan Africa

BackgroundDashboards are increasingly being used in sub-Saharan Africa (SSA) to support health policymaking and governance. However, their use has been mostly limited to routine care, not emergency services like emergency obstetric care (EmOC). To ensure a fit-for-purpose dashboard, we conducted an online survey with policymakers and researchers to understand key considerations needed for developing a policy-ready dashboard of geospatial access to EmOC in SSA.MethodsQuestionnaires targeting both stakeholder groups were pre-tested and disseminated in English, French, and Portuguese across SSA. We collected data on participants’ awareness of concern areas for geographic accessibility of EmOC and existing technological resources used for planning of EmOC services, the dynamic dashboard features preferences, and the dashboard's potential to tackle lack of geographic access to EmOC. Questions were asked as multiple-choice, Likert-scale, or open-ended. Descriptive statistics were used to summarise findings using frequencies or proportions. Free-text responses were recoded into themes where applicable.ResultsAmong the 206 participants (88 policymakers and 118 researchers), 90% reported that rural areas and 23% that urban areas in their countries were affected by issues of geographic accessibility to EmOC. Five percent of policymakers and 38% of researchers were aware of the use of maps of EmOC facilities to guide planning of EmOC facility location. Regarding dashboard design, most visual components such as location of EmOC facilities had almost universal desirability; however, there were some exceptions. Nearly 70% of policymakers considered the socio-economic status of the population and households relevant to the dashboard. The desirability for a heatmap showing travel time to care was lower among policymakers (53%) than researchers (72%). Nearly 90% of participants considered three to four data updates per year or less frequent updates adequate for the dashboard. The potential usability of a dynamic dashboard was high amongst both policymakers (60%) and researchers (82%).ConclusionThis study provides key considerations for developing a policy-ready dashboard for EmOC geographical accessibility in SSA. Efforts should now be targeted at establishing robust estimation of geographical accessibility metrics, integrated with existing health system data, and developing and maintaining the dashboard with up-to-date data to maximise impact in these settings.