Africa Rising Research Articles

Academic partnerships in transforming nursing and midwifery education in Africa: a systematic scoping review protocol

BackgroundIn recent decades, the literature on global partnerships in nursing and midwifery education, to enhance the quality of education and produce competent graduates in the labor market, is on the rise in Africa. However, there is a gap regarding the best practices and barriers in the African context. This systematic scoping review aims to map the evidence on academic partnerships in transforming nursing and midwifery education in Africa.MethodsThe review will be guided by Arksey and O’Malley’s methodology framework through five stages: (1) Identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collecting, summarizing, and reporting the results. A search will be conducted with the use of the following electronic databases: Cumulative Index to Nursing and Applied Health Literature (CINAHL), PubMed, ScienceDirect, and Google Scholar. Additional gray literature will be searched via the World Health Organization’s website to locate relevant policies and guidelines. The search will be limited to work published in English from 2014 to 2023. All located resources will be exported to EndNote X8. All duplicates will be removed during when the abstracts are screened. Two independent reviewers will screen and extract the full text of the selected articles. Thematic analysis will be used to analyze data from this systematic scoping review.DiscussionMapping the evidence on global partnerships in transforming nursing and midwifery education in Africa will outline the best practices and preferences for sustainable collaboration. The review will also highlight knowledge gaps and limitations that could inform future research projects.Systematic review registrationhttps://osf.io/h83cy

Metabolic Syndrome and Its Component Factors Among Corporate Company Employees in Kampala Uganda.

Metabolic syndrome (MetS), a cluster of metabolic dysregulations indicative of increased cardiometabolic risk is on the rise in Sub-Saharan Africa. The study aimed to determine the prevalence of MetS and its components, among corporate employees in Kampala, Uganda. A cross-sectional survey was undertaken among 408 adults who were employees from seven corporate companies in Kampala, using the WHO STEPwise NCD screening approach. Metabolic syndrome was measured using the National Cholesterol Education Program Adult Treatment Panel (ATPIII) and the International Diabetes Federation (IDF) criteria with the waist circumference (WC) cut-off points adapted for Sub-Saharan African populations. The mean population age (standard deviation [SD]) of the respondents was 34years (± 8.87) years and 52% of them were females. The prevalence of MetS was 22.8% (NCEP ATPIII) and 28.4% (IDF). Of the respondents who did not have MetS, 75% had at least one metabolic dysregulation. Of those respondents with MetS, only 31% perceived that they were at risk of this cluster of metabolic dysregulations. In this analysis, we observed that the systolic blood pressure (BP) and the body mass index (BMI) correlated strongly (r = 0.81 and r = 0.71) with the diastolic BP and waist circumference (WC), respectively. Age on the other hand correlated fairly with the WC and BMI (both r values = 0.46). Principal component analysis showed that the greatest loadings in principle factors one, two and three were from central obesity, with low HDL-C explaining 60.8% variance in the population. Age, BMI, family history of having cardiometabolic disorders, and perceived cardiometabolic disease risk (CMR) were associated with an increased risk of MetS by 5, 8.86, 1.55, and 2.73 (all P values were < 0.05) respectively in this group of respondents. These risks remained for age, BMI and perceived CMR after removing the confounding effects of education status, marital status and family history of cardiometabolic disease. Being single on the other hand, was associated with a reduced risk of MetS (0.23, p < 0.009). While the primary contributors to the high prevalence of MetS among corporate employees in Kampala, Uganda were the high BP, high WC and high fasting blood sugar (FBS); age, BMI and perceived CMR were the key determinants of MetS. Future MetS interventions should aim to control and monitor obesity indicators in this population. Additionally, the findings inform targeted screening parameters for cardiometabolic risk assessment and suggest the need for further research into a weighted algorithm for MetS in this population.

Zero Hunger by 2030 - SDG 2 We are off target, AGAIN

According to the just released report, the world is still off target when it comes to meeting SDG 2, zero hunger. Hunger affects 1/5 in Africa, 1/11 globally, is on the rise in Africa, remains the same in Asia, while notable progress is being made in Latin America and the Caribbean. It is noted that fewer and fewer people are able to afford a heathy diet, a diet that is diverse in form and nutrients. Obesity is on the rise globally and in some population groups which did not know of it before, mainly because of poor food choices and also adopting foreign dietary habits, and sedentary lifestyles. Anaemia in women is on the rise, meaning their reproductive health and that of their offsprings are affected. The report does not paint a good picture for Africa as it reveals a slow reduction in stunting and wasting. It shows a continent that has been slow to recover from negative COVID impacts. "Financing to End Hunger, Food Insecurity and Malnutrition in All its Forms" is the theme. It is noted that only 25% of ODA (Overseas Development Assistance) goes towards financing food and nutrition programs. Clearly, this needs to be improved, especially following the many pledges that have been made this far. The realization continues to be that serious political will is needed to be able to achieve this. The question is: who is supposed to demonstrate this political will? As I have written before, we have had many global and regional meetings, all addressing world hunger, malnutrition, and micronutrient deficiency. In this report, there is a call to many to do more: donors, both corporate and individual; Governments need to commit more, why? Sovereign nations need to grow their economies in order to serve their people, in order for their countries to participate equitably in building and promoting the world economy. I have enjoyed watching the 2024 Olympics in Paris. In a short span of three weeks, we have seen the best sports competition ever. We see pure human talent. I was a sports nut in my youth but never heard of the Olympics until I was a lot older. It is one thing to have talent, and it is another to have access to showcase it and use it to God's glory, and to encourage others. The report at hand is on how to find resources to finance food and nutrition and poverty eradication programs. Look, without a fairly decent life, no one can make it to the Olympics. How proud I feel when I see the Kenyan Flag on the podium, and the National anthem played all because a Kenyan has won a bronze, a silver or a gold. This time around there were countries receiving their first medal ever, ever since the Games started in 1776 at Olympia in southern Greece and revived in 1896. Some of the athletes come from fairly disadvantaged environments, practice poorly and do not even have coaches let alone experts on programming or diet. What if they had exactly what is needed to make an excellent athlete? Or even half of it? And diet is huge in this case. An athlete needs to build good muscle and to learn how to release energy depending on the sport. Should we not prioritize and adequately fund food and nutrition programs in order to give everyone an equal chance of achieving a healthy body? This report was emphasizing how far off target we are from meeting SDG 2, Zero hunger. We need political will, at all levels. Let us work on it.

Tapping imaginaries: Guinness, masculinity, and the promise of Africa Rising

ABSTRACT This article interrogates masculinity and the consumer politics of late capitalism in urban Africa. Engaging scholarship on racialized masculinities, branding, and African cities with special attention to the Nigerian context, it conducts a media analysis of three Guinness Africa advertising campaigns: Made of More, Michael Power, and Greatness. Building off of its centuries-long ties between the African male consumer and European capital, in 1998 Guinness created the fictional Michael Power in a marketing coup that was to elevate the brewery to unrivaled dominance over the continent’s beer import market. Subsequent campaigns were to glorify everyday heroes: Greatness declaring a ‘drop of greatness in each man’ and Made of More extolling the sartorial elegance of Congolese dandies. This representational shift reflected the brewery’s recognition of changing models of accumulation in the African urban informal economy and the corresponding aspirations that they ignited in its men. Bypassing scripts of hegemonic masculinity, this new era of Guinness advertising showcased self-made men in a laissez-faire economy, simultaneously celebrating and depoliticizing the racialized global inequalities and gendered politics of contemporary African urbanization. Guinness’s successful appeal to twenty-first-century African male consumers provides a case study of multinational marketing in bottom billion capitalism.

Financial crimes in Africa and economic growth: Implications for achieving sustainable development goals (SDGs)

AbstractThe current review systematically synthesizes existing literature to provide a comprehensive overview of the nature of financial crimes in Africa and their impact on economic growth. We adopted the PRISMA protocol to identify 128 papers from the Scopus database, which were analyzed using MS Excel, VOSviewer, and R‐packages (Bibliometrix). The survey reveals that financial crimes are on the rise in Africa and have gained increasing concern over the years on the part of scholars, governments, and NGOs. The survey also demonstrates that most of the financial crime in Africa emanates from illicit activities such as credit card fraud, cybercrime, mobile money fraud, financial statement fraud, Ponzi scheme, bribery and corruption, public fund mismanagement, terror financing, piracy, identity fraud, tax invasion, drug trafficking, product based‐fraud, burglary, trade‐based money laundering, sex marketing, and gambling; with the majority occurring in specific regions like Western Africa, Southern Africa, and Eastern Africa. Sociopolitical marginalization, poverty, and unemployment, weak institutional and financial regulatory systems and individual selfish interests were the major causes. Overall, the content analysis of the studies indicates that financial crimes have significant negative impacts on the economic growth of the African continent. Implications for future research and practices have been discussed.

Modeling a Caring Approach towards Children with Fallot’s Tetralogy Repair: A Focus on the Child’s Profile

Children with Tetralogy of Fallot (TOF) continue to be on the rise in Africa. More research is needed to improve caring approach towards children with surgically corrected TOF. The consequences of surgical correction of TOF remains an important area of research interest as children with TOF repair run the high risk of increase mortality resulting from acute cardiopulmonary problems. Yet little or no research published focused on investigating which clinical or para-clinical profile of children going in for surgical correction could be the cause of morbidity or mortality amongst children with TOF repair. The aim of the study was to determine the association between the profiles of children visiting the Surgical Heart Center for consultation with Tetralogy of Fallot (TOF) on the healing process after surgical repair. It was a descriptive quantitative study in which 303 nurses were issued questionnaires. Data was collected using convenient sampling technique and analyzed using multiple corresponding analysis in SPSS software version 21.0. The results showed that the clinical symptoms, clinical history, para-clinical characteristics, and postoperative complications identified three groups of children operated on for TOF: children with unstable hemodynamics; children who usually have symptoms such as systolic thrill, oppression in chest, tachycardia, and heart murmur; and finally children with symptoms of failure to thrive and heart murmur.

Wet markets in Southeast Asia and access to healthy diets

Hunger and malnutrition in all forms continues to rise in Africa and Asia. Urban and rural communities’ diets in Southeast Asia (SEA) are increasingly unhealthy, with consumption influenced by affordability and convenience. The cost of a healthy diet is a major barrier to accessing healthy foods in SEA. Wet markets are key places in food environments where people buy and sell a variety of foods. They are especially important for food and nutrition insecure communities. This mini narrative review explores the role that wet markets, in SEA food environments, play in providing local communities with access to healthy foods. Fourteen peer-review papers, published in English between 2017 and 2022, were identified during screening and analysed according to six food environment domains. Findings highlight that convenient access to wet markets facilitates access to fruits and vegetables in peri urban and urban areas. Fresh foods, most notably fruits, were viewed as being more expensive than processed foods which in turn influenced purchasing behavior. Divergent findings were presented in the identified papers regarding affordability of food in wet markets. Concerns about food quality and the use of chemicals and pesticides were raised. This review was constrained by several factors including the lack of consistent and meaningful definitions and typologies of the varied forms of wet markets. Looking ahead, better defined interpretations of wet markets can enhance the development and refinement of appropriate policies and actions and comparison of wet markets, in respect of access to diverse, healthy foods, vendor practices and consumer food choices.

Unraveling the Complexity of Vaso-Occlusive Crises in Sickle Cell Disease: Insights from a Resource-Limited Setting.

Background/Objectives: This study investigated vaso-occlusive crises (VOCs) in sickle cell disease in Lubumbashi, Democratic Republic of Congo, aiming to understand the disease complexities amidst limited resources. With sickle cell hemoglobinopathies on the rise in sub-Saharan Africa, this nine-year study explored factors associated with VOCs and hematological components. Methods: This study comprised 838 patients, analyzing VOCs and hematological changes over time. Demographic characteristics and blood composition changes were carefully categorized. A total of 2910 crises were observed and managed, with analyses conducted on severity, localization, and age groups using statistical methods. Results: The majority of crises were mild or moderate, primarily affecting osteoarticular regions. Statistical analysis revealed significant disparities in crisis intensity based on location and age. The association between blood samples and the number of comorbidities was investigated. Significant positive associations were found for all parameters, except monocytes, indicating a potential link between blood variables and complication burden. Survival analysis using Cox regression was performed to predict the probability of experiencing a second crisis. No significant effects of medication or localization were observed. However, intensity (p < 0.001), age (p < 0.001), and gender (p < 0.001) showed significant effects. Adjusted Hazard Ratios indicated increased risk with age and male gender and reduced risk with mild or severe crisis intensity compared to light. Conclusions: This research sheds light on the complexities of VOCs in resource-limited settings where sickle cell disease is prevalent. The intricate interplay between clinical, laboratory, and treatment factors is highlighted, offering insights for improved patient care. It aims to raise awareness of patient challenges and provide valuable information for targeted interventions to alleviate their burden.

The Rise and Fall of South Africa’s Intelligence Community during Apartheid

The author explores the context that contributed to the evolution of the South African Intelligence Community (SAIC) from political police to an independent security state during the apartheid, nondemocratic regime (1961–1994). It also assesses the circumstances that led to the demise of authoritarian rule and the reform of the intelligence apparatus. It finds that such factors as the security landscape, changes in leadership, and enabling legislation assisted the SAIC’s consolidation of power as political police, morphing it into an independent security state during that period. Subsequently, leadership, liberalization measures, scandals, and inquiries contributed to the demise of the apartheid intelligence apparatus and the slow emergence of a democratically inclined SAIC.

Insulin therapy among diabetic patients in rural communities of Sub-Saharan Africa: a perspective review.

In this perspective review, we describe a brief background on the status quo of diabetes mellitus-related therapies and glycemic control among patients in rural communities in sub-Saharan Africa. The article discusses insulin therapy as well as the difficulties in obtaining insulin and oral hypoglycemic medications for diabetic patients living in sub-Saharan Africa. We wrap up our discussion with suggestions on solutions and opportunities for future research to tackle this health challenge in these impoverished communities. We conducted a literature search from PubMed and Google Scholar up until August 2023. Key words were used to generate search terms used to retrieve the required information. All types of literature with pertinent information on the current topic were included in the study. Diabetes mellitus is on the rise in sub-Saharan Africa. Several studies have reported poor glycemic control, low screening rates for diabetes mellitus, cigarette smoking, high alcohol consumption, prescription of antidiabetic therapy, and associated costs as contributors to the uptake of antidiabetic treatment. Although there is paucity of data on the extent of insulin therapy uptake and its possible modifiable contributors among the diabetic patients in the region, the anticipated increase in the number of people with diabetes on the continent makes it critical for global leaders to address the research gaps in insulin therapy among rural communities of sub-Saharan Africa, thus reducing the burden of diabetes in these populations.

Charity can still begin at home: Examining the drivers and boundary conditions of Africa-to-Africa outward foreign direct investment (OFDI)

Recent studies on ‘Africa Rising’ and ‘Africa-to-Africa Internationalization’ have propelled conversations on how African Small and Medium-Sized Enterprises (SMEs) can continue to internationalize within African countries. From the tenets of the institutional theory and the dynamic capabilities perspectives, this study proposes and tests a framework of how and when dysfunctional competition drives SMEs' outward foreign direct investments within African countries. Analysis of a survey data from 196 Ghanaian SMEs operating across the African continent indicates that cross-border open innovation mediates the relationship between dysfunctional competition and SMEs' intra- Africa OFDI activities. Further analysis revealed that SMEs' strategic agility plays a double-edged sword moderating role in enhancing the effects of dysfunctional competitions and cross-border open innovation on intra-Africa OFDI. These findings have significant implications for the international business and finance literature as well as the management and growth of African SMEs.

A Comparison of the EU and China's Aid Policies in Africa

Since the beginning of the 21st century, the rise of African power has become a major factor influencing the international political situation, but Africa itself is still objectively lagging most parts of the world in terms of its level of development. China and the European Union, in conjunction with the UN's development programme, have become important players in supporting Africa's rise. As a long-established political and economic phenomenon in state relations, foreign aid policy is also an extension of the internal political economy of national alliances or organizations of states and is one of the most important means by which each state can safeguard its economic interests and achieve its strategic objectives. China and the EU differ in their aid policies towards Africa and have many features that can be learned from each other. By starting from the aid policies of China and the EU towards Africa and using comparative regionalism as a theoretical guide, this paper summarizes the strengths and weaknesses of the aid policies of the two parties towards Africa and will propose constructive ideas for the establishment of a new inter-aid international structure and the promotion of closer cooperation between China, the EU and Africa.

Cardiovascular disease prevention: Community Based Asset Mapping within religious networks in a rural Sub-Saharan African neighbourhood.

Prevalence of conditions which raise cardiovascular risk, such as hypertension and type 2 diabetes are seeing a dramatic rise in Sub Saharan Africa. A large proportion of these cases remain undiagnosed and there is limited resource to provide patients with self-management support and education once diagnosed. This study aimed to identify and catalogue community-based assets for the purposes of developing and deploying a screening and education programme for cardiometabolic risk factors (diabetes and hypertension) within religious organisations in a local community in a rural Ghanaian context. We utilised a community-based form of participatory research made up of a number of different components including community-based asset mapping and stakeholder consultation, supplemented by 18 in-depth interviews and 10 focus groups with n = 115 service users, to map existing assets with relevance to cardiometabolic health in this setting and context. Thematic analysis of interview and focus group data was performed to identify themes related to successful implementation of health screening. Two stakeholder workshops with local healthcare professionals, faith leaders and health policy makers were delivered to co-produced a prioritised list of recommendations and 'asset map' to aid deployment of mass screening within faith organisations in this context. The findings of this research highlight a number of 'hidden' community assets and motivational mechanisms at an individual, community and institutional levels; these have informed a list of recommendations which have been co-developed with the stakeholder group and local community to support the development of effective screening strategies for cardiometabolic conditions within faith organisations in this context. We have identified key mechanisms and assets which would support a sustainable screening approach designed to engage an underserved community at high CVD risk to promote general community health and well-being.

The potential of underutilised and biofortified grains, roots, and tubers in Ghana: A nutrition-sensitive approach for improved health

Abstract The prevalence of micronutrient deficiencies and non-communicable diseases are on the rise in Sub-Saharan Africa (SSA) despite the abundance of indigenous nutritious and biofortified crops. Rapid urbanisation and poor dietary habits have resulted in most Ghanaian households frequently consuming highly processed foods, sugar, salt, and unhealthy fats in place of complex carbohydrates such as whole grains, root and tuber crops, fruits, and vegetables. Existing postharvest and food processing practices may also not help consumers to make healthy food choices that would result in optimal nutrition. Applying a food systems approach will enable stakeholders to consider the solutions to these public health concerns through different lenses along the agricultural value chain. This review examines nutritious indigenous crops in Ghana, that include millet, sorghum, soybean, locust bean, aerial yam, taro, and cocoyam, considering how their nutrient composition could aid in disease prevention and health promotion among the populace. In addition, biofortified crops such as yellow and orange maize, high iron bean, yellow cassava, and orange-fleshed sweetpotato are discussed, highlighting the focal nutrients and their relation to health improvement. This review employs the food systems approach to critically examine how nutrition can be maximised along the various steps of the agricultural value chain. It concludes with recommendations at the individual and policy levels that could result in medium- and long-term positive impacts on nutrition and health status.

Pattern of cutaneous neoplasms and associated factors at a tertiary teaching hospital pathology center in Ethiopia: An eight-year histopathological review

Background: Cancer is the leading cause of death globally and is on the rise in Africa. Cutaneous neoplasms are becoming increasingly common worldwide. Understanding the pattern of this disease is essential for developing data-driven preventive, screening, and treatment services. However, there are limited studies in Ethiopia so far. Therefore, the study aimed to assess the pattern and associated factors of cutaneous neoplasm among patients with histopathologically confirmed biopsy results at a tertiary teaching hospital in Ethiopia from March 2014 to October 2022.Methods: A retrospective record review study was conducted among 1006 patients with histopathologically confirmed cutaneous neoplasms from the biopsies that were assessed at St. Paul’s Hospital Millennium Medical College. Data was summarized using frequencies, percentages, median (interquartile range), and graphs. To identify significant factors associated with malignant cutaneous neoplasm, a multivariable binary logistic regression model was fitted, where Adjusted Odds ratio (AOR), 95% CIs for AOR, and p-values were used for interpretation of results.Result: From the 1006 cases, 265 (26.3%, 95%CI=23.5%-29.3%) were malignant, of which sarcoma (26.0%) and squamous cell carcinoma (25.7%) were the most frequent and found to be prevalent in younger (19-29 years) and older (≥60 years) patients, respectively. The trunk was the commonest site (54.2%) for all the malignancies, especially sarcoma (80.4%). Age was found to be a significant exposure that is associated with the development of malignant cutaneous neoplasm for those ≥30 years as compared with those ≤18 years, with the odds increasing with age (AOR=2.66, 95% CI=1.10,6.45 for 30-39 years, AOR=4.98, 95% CI= 2.01,12.36 for 40-49 years, AOR=5.33, 95% CI=2.15,13.22 for 50-59 years and AOR= 6.62, 95% CI=2.79,15.66 for ≥60).Conclusion: The prevalence of malignant cutaneous neoplasm is higher than previously reported in the country and the malignancy pattern and distribution are different from what is known so far. This could signal a shift in disease epidemiology, and the findings should be factored into clinical decision making and program design for disease prevention, screening, and treatment. It also calls for further prospective research to learn more about the conditions in the context of additional relevant personal and clinical characteristics

The Rise of Autocracy in the Sahel of Africa: Insights from Resource Curse Theory

Abstract The countries in the Sahel, aside from being located in the same geopolitical region, also share similar socioeconomic and socio-political challenges. This includes political instability, insecurity, poor governance, climate change and democratic erosion – among others. The corrosion of the democratic gains recorded since the spread of democracy in the 1990s and the rise of autocratic regimes has become prevalent in the last decade. The subversion of the electoral process, limited freedom and military takeovers are an indication of the spread of autocracy in Africa (generally) and the Sahel (specifically). The paper which is anchored on the resource curse theory argues that the Sahel is rich in natural resources that when not properly managed breed corruption and increase the chances of conflict and the likelihood of military takeover. More so, faced with weak institutions, autocrats take advantage of abundant resources to increase patronage networks at the expense of development and democratic growth. The paper found that the rise of illiberal regimes is on the rise in Africa; suggesting a wave of autocracy. This is evident in the spate of autocratic and highly defective democracies in the region; one-party dominance; re-emergence of military coups; and circumvention of term limits. It is therefore concluded that electoral autocracy is on the rise in Africa and is a common phenomenon in the Sahel. This is given impetus by weak institutions which makes it difficult for rulers to utilize resource wealth for human capital development. To this end, the paper adopts a qualitative approach that relies on secondary data sourced from peer-reviewed journal articles, government reports, briefs and internet sources.

Radiation safety in an era of diagnostic radiology growth in Africa: Lessons learned from Tanzania

PurposeAs radiology continues to grow in low- and middle-income countries (LMICs), radiation exposure and risk to patients and staff will concurrently increase. This study aims to assess the knowledge of radiation safety among medical staff in Tanzania. MethodsA survey was distributed to 350 staff members at a national referral hospital in Tanzania over a 7-month period (February–August 2021). This consisted of a structured questionnaire evaluating participants' knowledge and awareness ionizing radiation and radiation safety. Chi-square and Fisher's exact tests were used to determine the association between independent and dependent categorical variables. ResultsA total of 300 surveys were completed (86% response rate). Mean age was 31 and 53% of participants were female. The majority (89%) were clinical staff employed in direct patient care. Most reported having heard of radiation protection (85%) but only 61% reported receiving training in radiation protection. Regarding radiation knowledge, 73% correctly answered how to protect oneself from radiation and 74% knew which medical staff were at greater risk of radiation exposure. However, only 32% correctly answered which imaging tests emit more radiation and only 53% correctly answered which age group was at greatest risk of radiation effects. Non-clinical staff had a significantly lower radiation awareness than clinical staff, with 69.7% reporting having heard about radiation protection, compared to 88.3% of clinical staff (p = 0.004). Female participants were more knowledgeable of radiation risks in pregnancy (p = 0.002). More early career staff reported receiving radiation protection training (64.5%) compared to those with >5 years work experience (53.9%), though this difference was not statistically significant (p = 0.09). When stratifying radiation knowledge by high (score of 80–100%), moderate (60–79.9%) and low (<60%), 20% of participants scored high, 47% moderate, and 33% low. ConclusionMost staff had low to moderate knowledge on radiation safety. Our findings highlight the importance of education on ionizing radiation as medical imaging continues to rise in Africa.

Child-directed marketing on packaged breakfast cereals in South Africa.

Childhood obesity is on the rise in South Africa (SA), and child-directed marketing (CDM) is one of the contributing factors to children's unhealthy food choices. This study assessed CDM on packaged breakfast cereals available in SA supermarkets and their nutritional quality. Photographic images were examined in a descriptive quantitative study. A codebook of definitions of CDM was developed for this purpose. REDCap, an online research database, was used for data capturing, and SPSS was used for data analyses including cross-tabulations and one-way ANOVA. The current study was set in the Western Cape province of SA. Photographic images of all packaged breakfast cereals sold in major retailers in the Western Cape province of SA in 2019 were studied. CDM strategies were classified as direct (to the child) or indirect (through the parent). A total of 222 breakfast cereals were studied, of which 96·9 % had a nutritional or health claim, 95·0 % had illustrations, 75·2 % had product and consumption appeals, 10·8 % had characters, 10·8 % consisted of different appeals, 8·6 % alluded to fantasy and 7·7 % had role models. In breakfast cereals with direct CDM, the protein and fibre content was significantly lower than in breakfast cereals without direct CDM. This study found a significantly higher total carbohydrate and total sugar content in breakfast cereals with direct CDM than those without direct CDM. CDM was highly prevalent in breakfast cereals sold in SA. Regulations to curb the marketing of packaged foods high in nutrients of concern is recommended.

Cost and outcomes of acute cardiovascular disease hospitalizations in a tertiary hospital in Ghana

ABSTRACT Background Cardiovascular diseases (CVDs) are on the rise in Sub-Saharan Africa. The management of these CVDs comes at an exorbitant cost to both individuals and health institutions. However, data on the economic impact of the most common CVDs in Ghana are lacking. Our objective was to describe the in-patient cost and outcomes of acute CVD admissions in a leading teaching hospital in Ghana. Methods We retrospectively reviewed hospital admissions, cost of hospitalization, length of stay, and CVD outcomes following admissions between January 2018 and December 2019. Results A total of 1975 patients with a mean age of 62.2 (±16.1) years were admitted over the study period of which 52.6% were males.The top 3 most prevalent CVDs among admitted patients were stroke(48.5%), hypertensive urgencies/emergencies(42.7%), and heart failure(29.4%). The overall case fatality rate (CFR) was 21.5% (95% CI: 19.7%−23.3%). The CFR for stroke, hypertensive urgencies/emergencies, and heart failure were 28.9%, 17.6%, and 14.1%, respectively. Median (IQR) length of stay and cost of treatment across all CVDs was 5(3–9) days and USD $195.29(137.9–288.9), respectively. The highest median cost for admission was for stroke (USD $211.19). Conclusion The average cost of CVD hospitalization is over a hundred times the daily minimum wage of the average Ghanaian. A greater emphasis on primordial and primary prevention is warranted to curtail the economic burden of CVDs in developing economies such as Ghana.

Research for development approaches in mixed crop-livestock systems of the Ethiopian highlands

This study presents processes and success stories that emerged from Africa RISING's Research for Development project in the Ethiopian Highlands. The project has tested a combination of participatory tools at multiple levels, with systems thinking and concern for sustainable and diversified livelihoods. Bottom-up approaches guided the selection of technological interventions that could address the priority farming system challenges of the communities, leading to higher uptake levels and increased impact. Joint learning, appropriate technology selection, and the creation of an enabling environment such as the formation of farmer research groups, the establishment of innovation platforms, and capacity development for institutional and technical innovations were key to this study. The study concludes by identifying key lessons that focus more on matching innovations to community needs and geographies, systems orientation/integration of innovations, stepwise approaches to enhance the adoption of innovations, documenting farmers' capacity to modify innovations, building successful partnerships, and facilitating wider scaling of innovations for future implementation of agricultural research for development projects.