sub-Saharan African Countries Research Articles

Schistosomiasis diagnosis: Challenges and opportunities for elimination.

The roadmap adopted by the World Health Organization (WHO) for eliminating neglected tropical diseases aims to eliminate schistosomiasis, as a public health concern, by 2030. While progress has been made towards reducing schistosomiasis morbidity control in several sub-Saharan African countries, there is still more that needs to be done. Proper surveillance using accurate diagnostics with acceptable sensitivity and specificity is essential for evaluating the success of all efforts against schistosomiasis. Microscopy, despite its low sensitivity, remains the gold standard approach for diagnosing the disease. Although many efforts have been made to develop new diagnostics based on circulating parasite proteins, genetic markers, schistosome egg morphology, and their paramagnetic properties, none has been robust enough to replace microscopy. This review highlights common diagnostic approaches for detecting schistosomiasis in field and clinical settings, major challenges, and provides new and novel opportunities and diagnosis pathways that will be critical in supporting elimination of schistosomiasis. We searched for relevant and reliable published literature from PubMed, Scopus, google scholar, and Web of science. The search strategies were primarily determined by subtopic, and hence the following words were used (schistosom*, diagnosis, Kato-Katz, antibody test, circulating antigen, POC-CCA, UCP-LF-CAA, molecular diagnostics, nucleic acid amplification test, microfluidics, lab-on a disk, lab-on chip, recombinase polymerase amplification (RPA), LAMP, portable sequencer, nanobody test, identical multi-repeat sequences, diagnostic TPPs, REASSURED, extraction free), and Boolean operators AND and/OR were used to refine the searching capacity. Due to the global public health nature of schistosomiasis, we also searched for reliable documents, reports, and research papers published by international health organizations, World Health Organization (WHO), and Center for Disease control and Elimination.

Self-Reported Physical Activity and Mental Health Among Asylum Seekers in a Refugee Camp.

Global forced displacement has been rising steeply since 2015 as a result of wars and human rights abuses. Forcibly displaced people are often exposed to physical and mental strain, which can cause traumatic experiences and poor mental health. Physical activity has been linked with better mental health, although such evidence is scarce among those populations. The purpose of the study was to examine the relationships of self-reported physical activity and fitness with mental health indices among people residing in a refugee camp in Greece as asylum seekers. Participants were 151 individuals (76 women, 75 men; mean age 28.90y) displaced from their homes for an average of 32.03months. Among them, 67% were from Afghanistan and countries from southwest Asia, and 33% from sub-Saharan African countries. Participants completed self-report measures assessing physical activity, fitness, symptoms of post-traumatic stress disorder, depression, anxiety, and well-being. High prevalence of mental health disorder symptoms and poor well-being were identified, with women and Asians showing poorer mental health. Symptoms of post-traumatic stress disorder, depression, and anxiety were related to perceived fitness, but not to self-reported physical activity. Regression analysis showed that perceived fitness (β: 0.34; 95% CI, 0.43 to 1.52) and low-intensity physical activity (β: 0.24; 95% CI, 0.001 to 0.009) significantly positively predicted well-being, showing small to medium effect. The findings provide useful insights regarding the link between physical activity and well-being; nevertheless, further research examining objectively measured physical activity is warranted to complement these data and further explore the associations between physical activity and mental health.

Commonalities and differences in injured patient experiences of accessing and receiving quality injury care: a qualitative study in three sub-Saharan African countries

ObjectivesTo understand commonalities and differences in injured patient experiences of accessing and receiving quality injury care across three lower-income and middle-income countries.DesignA qualitative interview study. The interviews were audiorecorded, transcribed...

Investigating the impact of credit channels, energy production and oil revenues on agricultural development in sub-Saharan Africa

Development of the agricultural sector can numerously gift the economy by ensuring food security and rural livelihoods, fostering economic growth, reducing poverty, promoting social stability, and achieving sustainable development goals. But agricultural activities especially in Sub-Saharan Africa are faced with numerous challenges like lack of required credits to the farmers, unavailability of needed energy for powering the farm machinery and transportation of farm produce, and fluctuation of crude oil prices which serve as the main source of energy in Sub-Saharan Africa. However, the sequel to these highlighted challenges that face agricultural activities, this study examines the impact of credit channels, energy production, and oil revenue on agricultural development in sub-Saharan Africa using an annual time series covering 21 years (2001–2021) drawn from selected sub-Saharan African countries under study. Using the panel autoregressive distributed lag model (ARDL) as the baseline model and the generalized method of moment (GMM) as the robustness check, we made the following findings. From the ARDL perspective, we found that credit channels have a negative impact on agricultural development. In contrast, energy production and oil revenue have positive and negative significant impacts on the agricultural development of sub-Saharan Africa. Further, results of the Generalized Method of Moment (GMM) revealed that while credit channels have both negative and positive long-run relationships with agricultural development, energy production, and oil revenues have positive and significant long-run relationships with agricultural development in sub-Saharan Africa. The study concludes that credit channels have both negative and positive long-run relationships with agricultural development. In contrast, energy production and oil revenue have negative and significant long-run relationships with agricultural development in sub-Saharan Africa. We recommended effective agricultural credit provision and a mechanized farming system to increase the quality and quantity of food supplies in sub-Saharan Africa.

Prevalence and correlates of female genital mutilation among young women in selected sub-Saharan African countries: A pooled analysis.

A deeper understanding of the factors associated with female genital mutilation remains important in the fight against this practice, particularly in developing countries. This study focused on young women (15-35 years) and pooled analysis using DHS data (2015-2019) for selected sub-Saharan African countries was done. The weighted study sample was 26289 and the data were analysed using univariate, bivariate and multivariate regression analysis. The results are based on information at the time of the survey. The overall prevalence of FGM among young women from the selected countries was 71.5%. Sierra Leone had the highest prevalence (83.7%), followed by Tanzania (80.8%), Ethiopia (73.0%), and Gambia (72.4%). The prevalence in Senegal and Guinea were both below 60%. We found that age, level of education, age at first marriage, parity, employment status, media exposure, and type of place of residence were statistically associated with FGM. This calls for targeted interventions focusing on increasing awareness, education, and empowerment for young women with low socio-economic status.

Foreign direct investment, Green Technological Innovation and Energy Poverty: Empirical evidences from Sub-Saharan African countries

This study investigates the unconditional and conditional effects of Foreign Direct Investment (FDI) and Green Technology Innovation (GTI) on Energy Poverty (EP) in 11 Sub-Saharan African (SSA) countries from 2000 to 2020. Given that EP captures the share of the population without access to energy, it includes electricity, clean fuel and technology for cooking (CFTP), renewable energy consumption (RECP), and the multidimensional energy poverty index (MEPI) which is computed using the PCA method. Furthermore, this study considere the overall, urban and rural supsamples, and the data from the World Bank and OECD databases. This study employs the FGLS and the Driscoll- Kraay approaches. The findings reveal that FDI and GTI negatively affect both electricity poverty and CFT poverty, whereas these effects are significantly positives for both REC poverty and MEPI. This means that, in the long term, FDI and GTI allow the alleviation of both electricity and CFT poverty; conversely, FDI and GTI strengthen renewable energy and MEPI irrespectively of the residential area. However, FDI-EP nexus is significanty affected through GTI development. Moreover, FDI and GTI contribute to strengthening the rural-urban poverty gap in access to both electricity and CFT. In light of these findings, policy implications are presented.

Minimum milk feeding frequency and its associated factors among non-breastfed children aged 6–23 months in sub-saharan Africa: a multilevel analysis of the recent demographic and health survey data

BackgroundPoor infant and child feeding practices, in combination with increased rates of infectious diseases, are the main immediate causes of malnutrition during the first two years of life. Non-breastfed children require milk and other dairy products, as they are rich sources of calcium and other nutrients. As far as our search is concerned, there is no evidence on the pooled magnitude and determinants of minimum milk feeding frequency among non-breastfed children in sub-Saharan Africa conducted using the most recent indicators for assessing infant and young child feeding practices published in 2021. Therefore, this study is intended to determine the magnitude and associated factors of minimum milk feeding frequency among non-breastfed children aged 6–23 months in sub-Saharan Africa using the most recent guideline and demographic and health survey dataset.MethodsData from the most recent health and demographic surveys, which were carried out between 2015 and 2022 in 20 sub-Saharan African countries, were used. The study comprised a weighted sample consisting of 13,315 non-breastfed children between the ages of 6 and 23 months. STATA/SE version 14.0 statistical software was used to clean, recode, and analyze data that had been taken from DHS data sets. Utilizing multilevel mixed-effects logistic regression, the factors associated with the outcome variable were identified. Model comparison and fitness were assessed using deviance (-2LLR), likelihood ratio test, median odds ratio, and intra-class correlation coefficient. Finally, variables with a p-value < 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant.ResultsThe pooled magnitude of minimum milk feeding frequency among non-breastfed children aged 6–23 months in sub-Saharan African countries was 12.39% (95% CI: 11.85%, 12.97%). Factors like maternal educational level [AOR = 1.61; 95% CI (1.35, 1.91)], marital status of the mother [AOR = 0.77; 95% CI (0.67, 0.89)], maternal working status [AOR = 0.80; 95% CI (0.71, 0.91)], media exposure [AOR = 1.50; 95% CI (1.27, 1.77)], wealth index [AOR = 1.21; 95% CI (1.03, 1.42)], place of delivery [AOR = 1.45; 95% CI (1.22, 1.72)], ANC visit attended during pregnancy [AOR = 0.49; 95% CI (0.39, 0.62)], PNC checkup [AOR = 1.57; 95% CI (1.40, 1.76)], child’s age [AOR = 0.70; 95% CI (0.53, 0.93)], and residence [AOR = 2.15; 95% CI (1.87, 2.46)] were significantly associated with minimum milk feeding frequency.ConclusionsIn sub-Saharan Africa, the proportion of minimum milk feeding frequency among non-breastfed children aged between 6 and 23 months was low. The likelihood of minimum milk feeding frequency increases with high levels of education, unemployment, media exposure, rich wealth status, being unmarried, having a child born in a health facility, getting PNC checks, being between 6 and 8 months old, and living in an urban area. Hence, promoting women’s education, increasing the economic status of the household, disseminating nutrition information through media, strengthening maternal health service utilization like health facility delivery and PNC services, and giving prior attention to mothers with older children and from rural areas are strongly recommended.

Documenting Community Health Worker Compensation Schemes and Their Perceived Effectiveness in Seven sub-Saharan African Countries: A Qualitative Study.

Community health worker (CHW) incentives and remuneration are core issues affecting the performance of CHWs and health programs. There is limited documentation on the implementation details of CHW financial compensation schemes used in sub-Saharan African countries, including their mechanisms of delivery and effectiveness. We aimed to document CHW financial compensation schemes and understand CHW, government, and other stakeholder perceptions of their effectiveness. A total of 68 semistructured interviews were conducted with a range of purposefully selected key informants in 7 countries: Benin, Burkina Faso, Ghana, Malawi, Mali, Niger, and Zambia. Thematic analysis of coded interview data was conducted, and relevant country documentation was reviewed, including any documents referenced by key informants, to provide contextual background for qualitative interpretation. Key informants described compensation schemes as effective when payments are regular, distributions are consistent, and amounts are sufficient to support health worker performance and continuity of service delivery. CHW compensation schemes associated with an employed worker status and government payroll mechanisms were most often perceived as effective by stakeholders. Compensation schemes associated with a volunteer status were found to vary widely in their delivery mechanisms (e.g., cash or mobile phone distribution) and were perceived as less effective. Lessons learned in implementing CHW compensation schemes involved the need for government leadership, ministerial coordination, community engagement, partner harmonization, and realistic transitional financing plans. Policymakers should consider these findings in designing compensation schemes for CHWs engaged in routine, continuous health service delivery within the context of their country's health service delivery model. Systematic documentation of the tasks and time commitment of volunteer status CHWs could support more recognition of their health system contributions and better determination of commensurate compensation as recommended by the 2018 World Health Organization Guidelines on Health Policy and System Support to Optimize Community Health Worker Programs.

Determinants of preterm birth among reproductive age women in sub-Saharan Africa: Evidence from the most recent Demographic and Health Survey data-2019-2022.

Preterm birth is the leading cause of both infant and neonatal mortality. It also had long-term consequences for the physical and neurological development of a growing child. The majority of these and related problems occur in low- and middle-income countries, particularly in sub-Saharan Africa, due to resource scarcity to sustain the lives of premature babies. Despite this, there is a paucity of recent information on the pooled prevalence and factors associated with preterm birth in sub-Saharan Africa. Therefore, this study aimed to update the pooled prevalence and determinants of preterm birth in sub-Saharan Africa based on the most recent Demographic and Health Survey data. A cross-sectional study design using the most recent demographic and health survey data from eight sub-Saharan African countries was used. We included a total weighted sample of 74,871 reproductive-aged women who gave birth in the five years preceding the survey. We used a multilevel logistic regression model to identify associated factors of preterm birth in sub-Saharan Africa. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of <0.05 are declared statistically significant. In this study, the pooled prevalence of preterm birth among reproductive-aged women in eight sub-Saharan African countries was 3.11% (95% CI: 2.98-3.25). Working mothers (AOR = 0.61; 95% CI: 0.38-0.97), being married (AOR = 0.63; 95% CI: 0.40-0.99), and having media exposure (AOR = 0.59; 95% CI: 0.36-0.96) decrease the odds of preterm birth. On the other hand, being low birth weight (AOR = 17.7; 95% CI: 10.7-29.3), having multiple pregnancies (AOR = 3.43; 95% CI: 1.82-6.45), having a history of terminated pregnancies (AOR = 1.56; 95% CI: 1.01-2.41), being un-educated (AOR = 3.16; 95% CI: 1.12-8.93), being of a maternal age above 35 (AOR = 1.63; 95% CI: 1.08-2.45), maternal alcohol use (AOR = 19.18; 95% CI: 13.6-38.8), and being in the low socio-economic status (AOR = 1.85; 95% CI: 1.11-3.07) of the community increase the odds of preterm birth. The burden of preterm birth among reproductive-age women in sub-Saharan Africa showed improvements as compared to previous findings. To further lessen the burden, policymakers and other pertinent organizations must prioritize maternal health, expand media access, educate and empower women, and promote a healthy lifestyle for reproductive-age women.

Editorial: Transforming teacher education in Sub-Saharan African countries towards the achievement of Sustainable Development Goal 4 by 2030: new opportunities, challenges, problems and prospects

Editorial: Transforming teacher education in Sub-Saharan African countries towards the achievement of Sustainable Development Goal 4 by 2030: new opportunities, challenges, problems and prospects

External Debt and Economic Growth Nexus in Sub-Saharan Africa: the Role of Institutional Quality

Sub-Saharan African (SSA) countries have recently embarked on an economic growth trajectory which is characterized by ambitious national development aspirations. The ability of the SSA economies to generate sufficient domestic revenues to spur their desired economic growth is limited resulting into fiscal deficits. External Debt has provided alternatives to the fiscal deficits prevalent in SSA economies. Dividends from external debt investments have been unevenly witnessed among the SSA countries. Regions with better institutional quality continue to reap considerable dividends from external debt investments while SSA economies continue to accumulate external debt with sluggish economic performance. This study made use of the Generalized Method of Moments (GMM) to examine the role played by institutional quality on the nexus between external debt and economic growth on a panel of 28 SSA countries over the period 2005 - 2021. Empirical results indicate that institutional quality influences a positive and significant relation between external debt and economic growth. Policy makers in SSA countries should therefore strive to improve on institutional quality in regard to external debt management in order to reap more economic benefits from external debt

The effect of continuous electronic fetal monitoring on mode of delivery and neonatal outcome among low-risk laboring mothers at Debre Markos comprehensive specialized hospital, Northwest Ethiopia.

Electronic fetal heart rate monitoring (EFM) has been widely used in obstetric practice for over 40 years to improve perinatal outcomes. Its popularity is growing in Ethiopia and other sub-Saharan African countries to reduce high perinatal morbidity and mortality rates. However, its impact on delivery mode and perinatal outcomes in low-risk pregnancies remains controversial. This study aimed to assess the effect of continuous EFM on delivery mode and neonatal outcomes among low-risk laboring mothers at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia. A prospective follow-up study was conducted from November 20, 2023, to January 10, 2024. All low-risk laboring mothers meeting the inclusion criteria were included. Data were collected via pretested structured questionnaires and observation, then analyzed using Epi-data 4.6 and SPSS. The incidences of cesarean delivery and continuous EFM were compared using the chi-squared test and Fisher's exact test. The study found higher rates of instrumental-assisted vaginal delivery (7% vs. 2.4%) and cesarean sections (16% vs. 2%) due to unsettling fetal heart rate patterns in the continuous EFM group compared to the intermittent auscultation group. However, there were no differences in immediate neonatal outcomes between the groups. When compared to intermittent auscultation with a Pinard fetoscope, the routine use of continuous EFM among low-risk laboring mothers was associated with an increased risk of cesarean sections and instrumental vaginal deliveries, without significantly improving immediate newborn outcomes. However, it is important to note that our study faced significant logistical constraints due to the limited availability of EFM devices, which influenced our ability to use EFM comprehensively. Given these limitations, we recommend avoiding the routine use of continuous EFM for low-risk laboring mothers to help reduce the rising number of operative deliveries, particularly cesarean sections. Our findings should be interpreted with caution, and further research with adequate resources is needed to draw definitive conclusions.

Economic Complexity and Good Governance in Sub-Saharan Africa: A Cross Country Analysis

The underlying problems of Sub-Saharan African development are a result of a crisis in governance. Over the years, issues of governance and economic development have been the focus of debate in academia. However, the existing literature has not adequately explored the association between good governance and economic complexity. The purpose of this study is therefore to investigate the short-run and long-run relationships between economic complexity and good governance in 27 Sub-Saharan African countries for the period 1996–2019 using the PMG-ARDL model. The findings reveal that economic complexity, foreign aid, and the Gini coefficient have a positive and statistically significant long-run impact on good governance in Sub-Saharan Africa. Thus, the null hypothesis that economic complexity has a significantly positive impact on good governance is accepted by these findings. The short-run dynamics results reveal that economic complexity and foreign aid have a negative and insignificant impact on good governance, while foreign direct investment, the Gini coefficient, and unemployment have a positive and insignificant impact on good governance in Sub-Saharan Africa. Based on the findings, it is recommended that policymakers in the region place more emphasis on structural transformations to transform their productive structures, which will ultimately lead to higher economic growth in Sub-Saharan Africa. Policies geared towards the diversification of exports (i.e., economic complexity) in the region for economic growth and development are also recommended.

The impact of COVID-19 on non-communicable disease patients in sub-Saharan African countries: A systematic review.

COVID-19 and its prevention measures have had a significant impact on patients with non-communicable diseases (NCDs) by disrupting routine healthcare service and increasing risk factors. These challenges were expected to be more severe in sub-Saharan Africa due to the lack of physical infrastructure and inadequate resources. The quantity of studies conducted was limited, and there was a lack of published systematic reviews in the specified region. This systematic review aimed to assess the indirect impacts of the COVID-19 pandemic and associated lockdown measures on individuals with non-communicable diseases (NCDs) in sub-Saharan African countries. This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and is registered with PROSPERO (ID CRD42023387755). Extensive searches were conducted in MEDLINE, EMBASE, and CINAHL databases in December 2023, supplemented by a manual search of references, grey literature, and the WHO COVID-19 database. Inclusion criteria encompassed studies that reported on the impact of COVID-19 on NCD patients in sub-Saharan African countries, focusing on access to care, health outcomes, and factors related to NCDs. Critical appraisal of study quality was performed using the Joanna Briggs Institute (JBI) analytical cross-sectional studies critical appraisal tool. Data were extracted and synthesized, highlighting the main findings and relevant limitations. This review included 30 primary studies with a cumulative sample size of 25634 participants, conducted in seven sub-Saharan African countries. These studies demonstrated that the COVID-19 pandemic significantly disrupted regular NCD patient care provision, with regional variations. The studies also identified a reduction in patient health-seeking behavior and reduced medication adherence, leading to poor treatment outcome. Furthermore, the pandemic and related lockdowns have been implicated in the increased prevalence of substance use, decreased physical exercise, and increased mental health problems. This systematic review identified the complex challenges faced by NCD patients in sub-Saharan Africa during the COVID-19 pandemic. It also underlines the need to consider the indirect impact on vulnerable populations while developing pandemic prevention and control strategies for the future. The current NCD management strategies should prioritize the restoration of access to essential healthcare services while considering the multifaceted risks posed by decreased physical activity, poor dietary practices, and increased substance use. The main limitation of this review was the study design and setting. All of the studies included in this review employed a cross-sectional design, which may result in a low quality of evidence. This study identified research conducted in only seven countries among the 46 UN-classified sub-Saharan nations, which may impair the generalizability of the result.

Green Finance and Sustainable Development Nexus in Sub-Saharan Africa

This study comprehensively assesses the influence of green finance on sustainabledevelopment in sub-Saharan African countries from 1999-2023. The sub-Saharan Africancountries are considered most vulnerable to climate change due to their individual countries’ geographical location, economic structure, population density, limited adaptive capacitytoclimate change, and social vulnerability. By examining the intricate linkages between greenfinance measured by financial development indicators, and institutional frameworks, technology, urbanization, and educational levels, the study aims to address environmental, social, and economic challenges and the trajectory of green development in sub-SaharanAfrican countries. The pool mean group autoregressive distributed lags (PMG/ARDL) method was employed for its ability to rheostat endogeneity and serial autocorrelation, neglected by previous studies. The findings underscore the pivotal role of green finance, proxied by bank credit to the private sector, in promoting sustainable practices, throughtechnological advancements and educational levels to increase investment in industries that prioritize sustainability, conservation, and biodiversity preservation. The negative nexusbetween foreign direct investment and the potential adverse consequences is associatedwiththe influx of multinational corporations to sub-Saharan African countries, particularly duetolax environmental regulations linked to weak regulatory frameworks. In light of thesefindings, this study recommends aligning investments with sustainable development goals, enhancing regulatory oversight to improve environmental quality, and balancing economicgrowth and environmental stewardship through sustainable development strategies, giventheir countries' vulnerability to climate change.

The influence of democracy, corruption, economic growth and ICT on carbon emissions in Sub-Saharan African countries: Does FDI matter?

The study analyses empirically the role of FDI as an interactive factor in the democracy, corruption, economic growth, ICT and carbon emissions nexus in sub-Saharan Africa (SSA). We use the Method of Moments Quantile Regression (MMQR) technique with data from 37 SSA countries covering the period 1970–2019. We find evidence that corruption and democracy create a significantly negative association with carbon emissions across most quantiles for the SSA countries. Conversely, economic growth, ICT and FDI develops a significantly positive relationship with environmental quality. Thus, the paper confirms validity of the Pollution Haven Hypothesis in SSA countries. More results demonstrate that the interaction variables, corruption × FDI, democracy × FDI, economic development × FDI also produces positive and significant links with carbon emissions, but the link between ICT × FDI and emissions is insignificantly negative. In conclusion, our findings indicate the need for a targeted approach towards improving FDI to fight corruption, enhance democracy, ICT and economic growth in pursuit of green economy and sustainable development in SSA.

Impact of COVID-19 on the management of hypertension: a perspective on disease severity, service use patterns and expenditures from Ghana's health insurance claims data.

Hypertension is a leading cause of morbidity in Ghana and other sub-Saharan African countries, but management has historically suffered from the fragility of health systems in these countries. This has been exacerbated by the COVID-19 pandemic and its associated measures. Our study examines and quantifies the effect of the pandemic on the management of hypertension in Ghana by determining changes in disease severity and presentation, as well as changes in health service use patterns and expenditures. We used cross-sectional data to perform an impact evaluation of COVID-19 on hypertension management before and during the pandemic. We employed statistical tests including t-tests, z-tests, and exact Poisson tests to estimate and compare hypertension episode intensity and related claim expenditures before and during the pandemic using medical claims data from Ghana's National Health Insurance Authority database. The study duration includes a 12-month reference/pre-pandemic period (March 2019-February 2020) relative to the target/pandemic period (March 2020-February 2021). We observed that although there was a 20% reduction in the number of hypertension claimants in the pandemic year, there was an increase in hypertension severity as measured by the number of hypertension episodes per claimant. There was also an 18.64% or $22.88 (95% CI: $21-$25, p = 0.01042) increase in the average cost per hypertension claimant in the pandemic year. The increase in episodes per claimant had the largest financial impact on the average cost per claimant. The findings from our studies are relevant for future policymaking and strategy implementation for hypertension control in Ghana.

Exploration of family caregivers’ experiences on coping in dementia care in Ghana: a phenomenological study

BackgroundDementia is an important public health and geriatric concern for sub-Saharan African countries, including Ghana. Evidence shows that persons living with dementia are often supported and cared for by family caregivers in the community. In the execution of these services to the persons living with dementia, family caregivers are overwhelmed and experience heightened stress that results in serious repercussions. Therefore, the aim of this study was to explore family caregivers’ experiences on coping in dementia care in Ghana.MethodsAdopting a descriptive phenomenological design, individual face-to-face interviews were conducted among thirty unpaid family caregivers of persons living with dementia in Ghana. Semi-structured interview guides were used. The data analysis process followed Clarke and Braun’s framework analysis.ResultsSix themes were generated from the textual data. These themes were captioned as: (1) empathy and perspective-taking; (2) family support and cohesion; (3) coaxing and pampering of persons living with dementia; (4) humour and positive communication; (5) spiritual support; and (6) ethical/moral consideration in dementia caregiving.ConclusionWe conclude that unpaid family caregivers of persons living with dementia in Ghana adopt varied strategies to cope with the strains of caregiving. Healthcare facilities that provide services to persons living with dementia could incorporate caregiver preparatory training or education for family caregivers. This training should focus on briefing family caregivers about the potential strains that they are likely to encounter. Also, the training could focus on equipping family caregivers with the knowledge and skills to effectively communicate and care for the persons living with dementia using person-centered approaches. Key stakeholders such as the Ghana Health Service and Alzheimer’s Ghana must raise awareness about the dangers of caregivers’ violation of the autonomy and freedom of persons living with dementia as they navigate through the challenges of caregiving. Lastly, faith-based institutions need to be considered as key stakeholders in dementia interventions since they could play a critical role.

Rethinking of Government Institutions and Governance Quality Indicators on Economic Growth in Sub-Saharan African Countries

AbstractThe study aims to investigate the effect of governance quality on economic growth and government consumption in Sub-Saharan African countries. Balanced dynamic panel data for 36 Sub-Saharan African countries from 2011 to 2022 were analyzed using GMM and Driscoll-Kraay regressions. In addition to the fact that there is no study in the literature that examines the effect of state governance indicators on economic growth in SSA countries, the addition of government consumption variable as a second dependent variable adds originality to the study. The empirical analysis revealed that government institutions have a positive effect and are significant in SSA countries’ economic growth. In addition, according to the Driscoll-Kraay regression, it is seen that governments’ development of institutions increases government consumptions. The governance indicators threshold that strengthens the government institution in Sub-Sahara Africa must be reached to increase the economic growth of Sub-Sahara Africa. For economic growth, effective government institutions and governance quality policies should be practiced and maintained among the Sub-Saharan African countries. Graphical Abstract

Machine learning algorithms to predict healthcare-seeking behaviors of mothers for acute respiratory infections and their determinants among children under five in sub-Saharan Africa.

Acute respiratory infections (ARIs) are the leading cause of death in children under the age of 5 globally. Maternal healthcare-seeking behavior may help minimize mortality associated with ARIs since they make decisions about the kind and frequency of healthcare services for their children. Therefore, this study aimed to predict the absence of maternal healthcare-seeking behavior and identify its associated factors among children under the age 5 in sub-Saharan Africa (SSA) using machine learning models. The sub-Saharan African countries' demographic health survey was the source of the dataset. We used a weighted sample of 16,832 under-five children in this study. The data were processed using Python (version 3.9), and machine learning models such as extreme gradient boosting (XGB), random forest, decision tree, logistic regression, and Naïve Bayes were applied. In this study, we used evaluation metrics, including the AUC ROC curve, accuracy, precision, recall, and F-measure, to assess the performance of the predictive models. In this study, a weighted sample of 16,832 under-five children was used in the final analysis. Among the proposed machine learning models, the random forest (RF) was the best-predicted model with an accuracy of 88.89%, a precision of 89.5%, an F-measure of 83%, an AUC ROC curve of 95.8%, and a recall of 77.6% in predicting the absence of mothers' healthcare-seeking behavior for ARIs. The accuracy for Naïve Bayes was the lowest (66.41%) when compared to other proposed models. No media exposure, living in rural areas, not breastfeeding, poor wealth status, home delivery, no ANC visit, no maternal education, mothers' age group of 35-49 years, and distance to health facilities were significant predictors for the absence of mothers' healthcare-seeking behaviors for ARIs. On the other hand, undernourished children with stunting, underweight, and wasting status, diarrhea, birth size, married women, being a male or female sex child, and having a maternal occupation were significantly associated with good maternal healthcare-seeking behaviors for ARIs among under-five children. The RF model provides greater predictive power for estimating mothers' healthcare-seeking behaviors based on ARI risk factors. Machine learning could help achieve early prediction and intervention in children with high-risk ARIs. This leads to a recommendation for policy direction to reduce child mortality due to ARIs in sub-Saharan countries.