Systems In sub-Saharan Africa Research Articles

Paediatric airway foreign-body removal equipment availability in sub-Saharan Africa

Sub-Saharan Africa (SSA), home to over 1 billion people, has only one paediatric otolaryngology fellowship program and nine fellowship-trained paediatric Otolaryngology Head and Neck Surgery (OHNS) specialists covering seven countries. Seven of these specialists estimated an average of 40+ patients per month are in need of critical surgical airway management in their respective countries and that 2–25 deaths per year (mainly paediatric) occur in their country from lack of access to foreign body removal equipment. Investing in paediatric airway infrastructure and capacity would largely benefit the health system in SSA, where the current lack of equipment alone leads to unmeasured morbidity and mortality. As a region of the world with the largest paediatric populations, sub-Saharan Africa’s need is all the more pressing given the disproportionately low number of medical specialists, institutions and resources. Collaborative approaches in procurement and maintenance of high-quality, cost-effective equipment are crucially desirable factors in both low- and middle-income countries (LMICs) and high-income countries (HICs). We, as the Global OHNS Initiative, urge for multi-stakeholder engagement and collaboration to forge lasting change.

Genomic loci associated with grain yield under well-watered and water-stressed conditions in multiple bi-parental maize populations

Smallholder maize farming systems in sub-Saharan Africa (SSA) are vulnerable to drought-induced yield losses, which significantly impact food security and livelihoods within these communities. Mapping and characterizing genomic regions associated with water stress tolerance in tropical maize is essential for future breeding initiatives targeting this region. In this study, three biparental F3 populations composed of 753 families were evaluated in Kenya and Zimbabwe and genotyped with high-density single nucleotide polymorphism (SNP) markers. Quantitative trait loci maping was performed on these genotypes to dissect the genetic architecture for grain yield (GY), plant height (PH), ear height (EH) and anthesis-silking interval (ASI) under well-watered (WW) and water-stressed (WS) conditions. Across the studied maize populations, mean GY exhibited a range of 4.55–8.55 t/ha under WW and 1.29–5.59 t/ha under WS, reflecting a 31–59% reduction range under WS conditions. Genotypic and genotype-by-environment (G × E) variances were significant for all traits except ASI. Overall broad sense heritabilities for GY were low to high (0.25–0.60). For GY, these genetic parameters were decreased under WS conditions. Linkage mapping revealed a significant difference in the number of QTLs detected, with 93 identified under WW conditions and 41 under WS conditions. These QTLs were distributed across all maize chromosomes. For GY, eight and two major effect QTLs (>10% phenotypic variation explained) were detected under WW and WS conditions, respectively. Under WS conditions, Joint Linkage Association Mapping (JLAM) identified several QTLs with minor effects for GY and revealed genomic region overlaps in the studied populations. Across the studied water regimes, five-fold cross-validation showed moderate to high prediction accuracies (−0.15–0.90) for GY and other agronomic traits. Our findings demonstrate the polygenic nature of WS tolerance and highlights the immense potential of using genomic selection in improving genetic gain in maize breeding.

Crop yields fail to rise in smallholder farming systems in sub-Saharan Africa

Drawing on a harmonized longitudinal dataset covering more than 55,000 smallholder farms in six African countries, we analyze changes in crop productivity from 2008 to 2019. Because smallholder farmers represent a significant fraction of the world's poorest people, agricultural productivity in this context matters for poverty reduction and for the broader achievement of the UN Sustainable Development Goals. Our analysis measures productivity trends for nationally representative samples of smallholder crop farmers, using detailed data on agricultural inputs and outputs which we integrate with detailed data on local weather and environmental conditions. In spite of government commitments and international efforts to strengthen African agriculture, we find no evidence that smallholder crop productivity improved over this 12-y period. Our preferred statistical specification of total factor productivity (TFP) suggests an overall decline in productivity of -3.5% per year. Various other models we test also find declining productivity in the overall sample, and none of them finds productivity growth. However, the different countries in our sample experienced varying trends, with some instances of growth in some regions. The results suggest that major challenges remain for agricultural development in sub-Saharan Africa. They complement previous analyses that relied primarily on aggregate national statistics to measure agricultural productivity, rather than detailed microdata.

Editorial: Sustainable intensification of smallholder farming systems in Sub-Saharan Africa and South Asia

Editorial: Sustainable intensification of smallholder farming systems in Sub-Saharan Africa and South Asia

Management of traumatic brain injury in Africa: Challenges and opportunities.

Traumatic brain injury (TBI) is a major public health concern globally, with significant implications for morbidity, mortality, and long-term disability. While extensive research has been conducted on TBI management in high-income countries, limited attention has been given to the specific challenges and opportunities faced by healthcare systems in Sub-Saharan Africa (SSA). This perspective study aims to provide a comprehensive overview of the current status of TBI management in SSA, focusing on the unique challenges and potential opportunities for improvement. The findings highlight several key challenges faced by SSA healthcare systems in managing TBIs, including limited resources, inadequate infrastructure, and a shortage of trained healthcare professionals. Furthermore, social and cultural factors, such as ignorance of driving laws, financial constraints, and limited access to modern technology services. However, the study also identifies potential opportunities for improving TBI management in SSA. These include strengthening healthcare infrastructure, enhancing pre-hospital care and transportation systems, and increasing public awareness and education about TBI. This perspective study emphasizes the urgent need for tailored interventions and strategies to address the unique challenges faced by SSA in managing TBIs. Addressing the challenges and opportunities in brain injury management in sub-Saharan Africa requires a comprehensive approach which can be through investing in health infrastructure, addressing socioeconomic inequalities, implementing prevention strategies, and fostering evidence-based research collaboration. Through this, the region can significantly improve TBI care and outcomes, thereby improving the well-being of people affected by TBI in sub-Saharan Africa.

How are health systems in sub-Saharan Africa adapting to protect human health from climate change threats? A scoping review and case study

BackgroundSub-Saharan Africa stands out as one of the regions most affected by the climate crisis, while it has contributed to the problem only marginally. The foreseen negative effect on health adds great stress to the already overburdened health systems. Health systems' adaptation to climate change is, therefore, urgently needed to better protect human health. There is, however, scant evidence on how adaption is being planned and implemented in Africa. The aim of this study was to review the literature on health system adaptation in sub-Saharan Africa. MethodsIn this scoping review and case study, we first carried out the scoping review, searching for publications on adaptation measures using the PubMed, Science Direct, and Web of Science databases on July 1, 2023. We included papers in English and French that addressed the adaptation of health systems in countries in sub-Saharan Africa without time limit. Second, we did a case study of the design and implementation of the National Adaptation Plan of Benin, with a specific focus on the policy-making process underlying the plan, whereby we used the health policy triangle as a policy analysis framework. Data were collected through a document review of national policy plans, reports, and evaluations. FindingsA total of 14 papers met the inclusion criteria, showing that climate change adaptation remains a niche in the literature for sub-Saharan Africa. Most included papers were authored by individuals from high-income countries. Health system adaptation measures cover seven domains: health systems strengthening; policy and planning; financing and implementation; information and capacity building; societal resilience; disaster risk prevention, preparedness, response, and recovery; and mitigation. The review found that the dominant role of global agencies in supporting or steering health system adaptation planning contributes to policy mimicry across countries, as confirmed by the case study of the adaptation plan in Benin. Benin's National Adaptation Plan prioritised three climate hazards: heat, drought, and flooding. Although the financial and technical inputs of international agencies effectively support Benin's adaptation planning, these inputs might induce a more narrow focus that does not fully respond to Benin's needs in terms of climate shocks and adaptation priorities. InterpretationHealth systems in sub-Saharan Africa are already adapting to climate change. Future research could focus on how national governments could develop adaptation plans that are responsive to local needs by making the needs analysis and priority-setting processes more inclusive of local stakeholders. FundingThe Belgian Directorate-General for Development Cooperation and Humanitarian Aid.

Assessment of the Barriers and Enablers of the Use of mHealth Systems in Sub-Saharan Africa According to the Perceptions of Patients, Physicians, and Health Care Executives in Ethiopia: Qualitative Study.

Digital technologies are increasingly being used to deliver health care services and promote public health. Mobile wireless technologies or mobile health (mHealth) technologies are particularly relevant owing to their ease of use, broad reach, and wide acceptance. Unlike developed countries, Sub-Saharan Africa experiences more challenges and obstacles when it comes to deploying, using, and expanding mHealth systems. In addition to barriers, there are enabling factors that could be exploited for the design, implementation, and scaling up of mHealth systems. Sub-Saharan Africa may require tailored solutions that address the specific challenges facing the region. The overall aim of this study was to identify the barriers and enablers for using mHealth systems in Sub-Saharan Africa from the perspectives of patients, physicians, and health care executives. Multi-level and multi-actor in-depth semistructured interviews were employed to qualitatively explore the barriers and enablers of the use of mHealth systems. Data were collected from patients, physicians, and health care executives. The interviews were audio recorded, transcribed verbatim, translated, and coded. Thematic analysis methodology was adopted, and NVivo software was used for the data analysis. Through this rigorous study, a total of 137 determinants were identified. Of these determinants, 68 were identified as barriers and 69 were identified as enablers. Perceived barriers in patients included lack of awareness about mHealth systems and language barriers. Perceived enablers in patients included need for automated tools for health monitoring and an increasing literacy level of the society. According to physicians, barriers included lack of available digital health systems in the local context and concern about patients' mHealth capabilities, while enablers included the perceived usefulness in reducing workload and improving health care service quality, as well as the availability of mobile devices and the internet. As perceived by health care executives, barriers included competing priorities alongside digitalization in the health sector and lack of interoperability and complete digitalization of implemented digital health systems, while enablers included the perceived usefulness of digitalization for the survival of the highly overloaded health care system and the abundance of educated manpower specializing in technology. mHealth systems in Sub-Saharan Africa are hindered and facilitated by various factors. Common barriers and enablers were identified by patients, physicians, and health care executives. To promote uptake, all relevant stakeholders must actively mitigate the barriers. This study identified a promising outlook for mHealth in Sub-Saharan Africa, despite the present barriers. Opportunities exist for successful integration into health care systems, and a user-centered design is crucial for maximum uptake.

Linkage mapping and genomic prediction of grain quality traits in tropical maize (Zea mays L.).

The suboptimal productivity of maize systems in sub-Saharan Africa (SSA) is a pressing issue, with far-reaching implications for food security, nutrition, and livelihood sustainability within the affected smallholder farming communities. Dissecting the genetic basis of grain protein, starch and oil content can increase our understanding of the governing genetic systems, improve the efficacy of future breeding schemes and optimize the end-use quality of tropical maize. Here, four bi-parental maize populations were evaluated in field trials in Kenya and genotyped with mid-density single nucleotide polymorphism (SNP) markers. Genotypic (G), environmental (E) and G×E variations were found to be significant for all grain quality traits. Broad sense heritabilities exhibited substantial variation (0.18-0.68). Linkage mapping identified multiple quantitative trait loci (QTLs) for the studied grain quality traits: 13, 7, 33, 8 and 2 QTLs for oil content, protein content, starch content, grain texture and kernel weight, respectively. The co-localization of QTLs identified in our research suggests the presence of shared genetic factors or pleiotropic effects, implying that specific genomic regions influence the expression of multiple grain quality traits simultaneously. Genomic prediction accuracies were moderate to high for the studied traits. Our findings highlight the polygenic nature of grain quality traits and demonstrate the potential of genomic selection to enhance genetic gains in maize breeding. Furthermore, the identified genomic regions and single nucleotide polymorphism markers can serve as the groundwork for investigating candidate genes that regulate grain quality traits in tropical maize. This, in turn, can facilitate the implementation of marker-assisted selection (MAS) in breeding programs focused on improving grain nutrient levels.

DOES WOODFUEL PRICE DISTORTION INHIBIT ECO-EFFICIENCY IN WOODFUEL EXPLOITATION SYSTEMS IN SUB-SAHARAN AFRICA? EVIDENCE FROM CAMEROON

The aim of this study is to assess the impacts of woodfuel prices distortion on the eco-efficiency of woodfuel exploitation systems. The study, conducted in Cameroon, involved 415 randomly selected woodfuel operators. To achieve this, the marginal opportunity cost approach and the stochastic specification of the production technology were used to assess the price distortion degree and the eco-efficiency indices, respectively. In doing so, the 2SLS allowed to evaluate the impacts of woodfuel prices distortion on eco-efficiency of woodfuel exploitation systems. From this study, we conclude that the woodfuel prices distortion does not encourage eco-efficient exploitation of this resource. A 1% increase in the degree of distortion results in a reduction in eco-efficiency of −0.019 points. Including the optimal price in the woodfuel pricing system will improve eco-efficiency by 0.030 points. In view of these results, a marginal opportunity cost pricing system that takes into account all the exploitation costs ignored by the market price like user costs associated with resource depletion and the external costs associated with CO2 emissions will encourage producers to adopt a sustainable woodfuel exploitation path.

Time to bring female genital schistosomiasis out of neglect.

Female genital schistosomiasis (FGS) is a chronic gynaecological disease affecting girls and women in sub-Saharan Africa (SSA), caused by the parasite Schistosoma (S.) haematobium. FGS is associated with sexual dysfunction, reproductive tract morbidity and increased prevalence of HIV and cervical precancer lesions. Key peer-reviewed published literature. FGS screening and diagnosis require costly equipment and specialized training, seldom available in resource-limited settings. FGS surveillance is not included in wider schistosomiasis control strategies. The interplay of FGS with other SRH infections is not fully understood. Integration of FGS within sexual and reproductive health (SRH) control programmes needs to be explored. There are no standardized methods for individual or population-based FGS screening and diagnosis, hindering accurate disease burden estimates and targeted resource allocation. Treatment recommendations rely on public health guidelines, without rigorous clinical evidence on efficacy. Integrating FGS screening with SRH programmes offers an opportunity to reach at-risk women with limited access to healthcare services. Home-based self-sampling coupled with handheld colposcopes operated by primary healthcare workers show promise for FGS diagnosis and surveillance at scale. There is growing interest in decentralizing strategies for FGS screening and diagnosis. The accurate predictions on the 'cost-effectiveness' of these approaches will determine their affordability and feasibility within the overburdened health systems in SSA. Clinical trials are needed to optimize FGS treatment. Longitudinal studies can expand on the epidemiological knowledge on co-morbidities and integration within other SRH interventions.

A participatory framework for prioritizing climate-smart agriculture innovations in rice-based systems: A case study of Mali

Alleviating the climate-related constraints faced by agri-food systems in sub-Saharan Africa requires an accelerated adoption of climate-smart agriculture (CSA) innovations by farmers. However, little is known about the best-bet (most appropriate) CSA innovations, and the enabling conditions for their widespread adoption in a given biophysical and socioeconomic context. The objectives of this study were to identify the best-bet CSA innovations and the barriers, incentive mechanisms, and roles of institutions in widespread adoption in the four rice growing environments in Mali (irrigated lowlands, rainfed lowlands, rainfed uplands, and submergence systems). Data were collected from stakeholder's consultations to assess CSA innovations using four climate-smart performance indicators (productivity, income, adaptation, and mitigation) and four implementation feasibility indicators (technology cost, technical feasibility, gender inclusivity, and market demand). The best-bet CSA innovations included drought- and submergence-tolerant rice varieties, perennial rice, and rice-vegetable rotation in irrigated lowlands; drought-tolerant rice varieties, rice-tuber, rice-vegetable, and rice-legume rotations in rainfed lowlands; drought-tolerant rice varieties and mulching in rainfed uplands; and submergence-tolerant rice varieties, perennial rice, and integrated rice-fish in submergence systems. The average perceived adoption level of CSA innovations by farmers in the rice-growing environments was low, ranging from 7 to 19 % due to the lack of finance, technical knowledge, machinery, fertilizer, and quality seeds. Governments, farmers’ organizations, and research and academic institutions were identified as critical actors in the wide spread adoption of CSA innovations. The framework used in this study can be used to identify and invest into locally relevant best-bet CSA innovation packages.

Understanding drought risk management in vulnerable communities in dryland farming systems: Evidence from northwest Ghana

Drought intensity and associated risks are increasing in sub-Saharan Africa (SSA) with dire implications for sustainable livelihood. Yet, there is a limited comprehensive understanding of the severity of drought risks in dryland farming systems in sub-Saharan Africa including Ghana, where climate change has multiple effects on farming operations. Monitoring episodic droughts is particularly important for developing local-based adaptive interventions to sustainably improve livelihood and food systems. Drawing evidence from Northwest Ghana, this study used a Rainfall Anomaly Index (RAI), Principal Component Analysis (PCA) and Binary Logistic Regression (BLR) to understand drought indices and risks of 40 years (1981–2020), and assess prioritized coping measures and determinants in rural farming communities. The study revealed that farmers in Northwest Ghana have been experiencing severe intermittent drought risks in the last four decades, with extreme episodes observed in 1983 and 1984. Results show that northern Ghanaian households are coping with drought risks using several strategies such as picking edible wild fruit, migration for labour work, remittances from family members and friends, livestock rearing and sale, petty trading, and basket weaving as the key coping measures by households to counteract drought risk. The BLR estimates show that socio-economic variables such as marital status, household size, market access, and farmland size are significant factors that can predict farmers’ coping interventions. The sale of livestock as a buffer to support households rebound from a climate disaster is critical. We suggest that decision-makers and policy-makers mainstream access to social safety schemes in drought-affected locations to sustain local food systems, agricultural biodiversity and livelihoods.

Strategic Framework for Development of Typology-based Fertilizer Policy and Regulatory Systems in Sub-Saharan Africa

Strategic Framework for Development of Typology-based Fertilizer Policy and Regulatory Systems in Sub-Saharan Africa

Insecticide contamination in organic agriculture: Evidence from a long-term farming systems comparisons trial

Synthetic pesticides applied in conventional agriculture to control pests tend to compromise ecosystem services, and their residues may contaminate organic agriculture. To understand the significance of this contamination, also in small-scale farming systems in sub-Saharan Africa, quantitative data is required. Therefore, we compared synthetic insecticide and botanical/biopesticide residues in conventional and organic agricultural production systems after nine years of continuous cultivation of a maize-based crop rotation system at two sites in Kenya. Our results show high detectable concentrations of synthetic insecticide residues (imidacloprid, acetamiprid, chlorpyrifos, and chlorantraniliprole) in conventional plant produce and soil. Furthermore, the organophosphate chlorpyrifos was detected at concentrations above European Union Maximum Residue Limits (MRL) for plant produce, indicating potential risks for human health. Additionally, we detected imidacloprid, acetamiprid, chlorpyrifos, and chlorantraniliprole concentrations in the soil, indicating potential environmental harm. No residues of biopesticide/botanicals were detected in any of the production systems. However, we detected imidacloprid and chlorantraniliprole in organic plots. The findings indicate that the MRLs can be crossed even if synthetic insecticides are applied according to or below the recommended rates on the conventional plots. Thus, synthetic insecticides potentially risk human health and the environment, while botanicals and bio-pesticides represent a safe alternative.

Rheumatology in Cameroon: History, Challenges, and Future.

Rheumatology is a medical specialty that deals with diseases of bones, joints, tendons, and muscles. It is a relatively young specialty in sub-Saharan Africa, particularly in Cameroon. We believe that current and future generations need to know the history and challenges of rheumatology in Cameroon, which not only is a mainstay of Central Africa but also reflects many other health systems in sub-Saharan Africa, to properly identify the challenges facing this specialty and define appropriate strategies for developing countries in sub-Saharan Africa.

Sustainable intensification of sorghum-based cropping systems in semi-arid sub-Saharan Africa: The role of improved varieties, mineral fertilizer, and legume integration

ProblemSustainable intensification of cereal cropping systems can contribute to reducing food insecurity while mitigating biodiversity losses thanks to land sparing. Yet, intensifying crop production with more nutrient inputs often increases sensitivity to climate hazards and yields inter-annual variability. How different options for sustainable intensification interact and how they could help achieve greater and less variable yields is not well known for key cereal cropping systems of sub-Saharan Africa. ObjectiveHere, we aim to assess the impact on productivity and its interannual variation of three contrasted strategies of crop intensification, namely i) the integration of cowpea intercropped with sorghum or as sole crop, ii) improved varieties with high harvest index and greater nitrogen use efficiency, and iii) the use of more mineral fertilizer. MethodsWe did this assessment using a calibrated soil-crop model for a case study of sorghum-based cropping systems of semi-arid southern Mali, using a historical weather series from 1980 to 2010. ResultsWe found that the incremental combinations of two or three strategies helped increase productivity in terms of energy and protein. However, greater productivity went hand in hand with greater inter-annual variability. Intercropping sorghum with cowpea helped to reduce the inter-annual variability of productivity, but only when mineral fertilizer was not added. With mineral fertilizer input, sorghum contributed the largest share of the intercrop productivity, and sorghum yield was more variable from a year to another than cowpea yield. The overall productivity of intercropping sorghum with cowpea was always greater than having the two sole crops on separate plots. This was possible thanks to the facilitation of light, water and N acquisition by the two crops in the intercropping, regardless of the specificities of the growing season with regard to water and nitrogen stress. However, the variability of productivity was smaller for the cultivation of the two sole crops on separate plots, regardless of fertilizer input. ConclusionThe often-claimed benefit of intercropping on reducing the inter-annual variability of production does not hold when the three strategies are combined. ImplicationsOur results suggest that the integration of legumes does not help cushion farmers against the risk related to the intensification of cropping systems with more nutrients and improved seeds. Careful gross margin analysis that accounts for price variability and uncertainty would be required to refine this risk assessment for specific farm contexts. We discuss the implication of these findings in light of the current research agenda for the sustainable intensification of cropping systems in sub-Saharan Africa.

Implementing Clinical Information Systems in Sub-Saharan Africa: Report and Lessons Learned From the MatLook Project in Cameroon.

Yaoundé Central Hospital (YCH), located in the capital of Cameroon, is one of the leading referral hospitals in Cameroon. The hospital has several departments, including the Department of Gynecology-Obstetrics (hereinafter referred to as "the Maternity"). This clinical department has faced numerous problems with clinical information management, including the lack of high-quality and reliable clinical information, lack of access to this information, and poor use of this information. We aim to improve the management of clinical information generated at the Maternity at YCH and to describe the challenges, success factors, and lessons learned during its implementation and use. Based on an open-source hospital information system (HIS), this intervention implemented a clinical information system (CIS) at the Maternity at YCH and was carried out using the HERMES model-the first part aimed to cover outpatient consultations, billing, and cash management of the Maternity. Geneva University Hospitals supported this project, and several outcomes were measured at the end. The following outcomes were assessed: project management, technical and organizational aspects, leadership, change management, user training, and system use. The first part of the project was completed, and the CIS was deployed in the Maternity at YCH. The main technical activities were adapting the open-source HIS to manage outpatient consultations and develop integrated billing and cash management software. In addition to technical aspects, we implemented several other activities. They consisted of the implementation of appropriate project governance or management, improvement of the organizational processes at the Maternity, promotion of the local digital health leadership and performance of change management, and implementation of the training and support of users. Despite barriers encountered during the project, the 6-month evaluation showed that the CIS was effectively used during the first 6 months. Implementation of the HIS or CIS is feasible in a resource-limited setting such as Cameroon. The CIS was implemented based on good practices at the Maternity at YCH. This project had successes but also many challenges. Beyond project management and technical and financial aspects, the other main problems of implementing health information systems or HISs in Africa lie in digital health leadership, governance, and change management. This digital health leadership, governance, and change management should prioritize data as a tool for improving productivity and managing health institutions, and promote a data culture among health professionals to support a change in mindset and the acquisition of information management skills. Moreover, in countries with a highly centralized political system like ours, a high-level strategic and political anchor for such projects is often necessary to guarantee their success.

Toward smallholder bamboo-integrated agro-silvopastoral systems in sub-Saharan Africa: assessing the impact of bamboo leaves on consumption pattern, growth performance and manure characteristics of West African dwarf goats

IntroductionThe selection of appropriate plant species, particularly those tailored to supplement ruminants raised under agrosilvopastoral systems, remains a persistent challenge.ObjectiveIn a 30-day study, the feed intake, growth performance, and manure characteristics of West African dwarf (WAD) goats fed bamboo leaf supplement were evaluated. Materials and methodsA total of 30 animals with an average weight of 9.9 ± 0.21 kg were divided into a control group, and four bamboo-supplemented groups, following a 2 x 2 factorial arrangement within a completely randomized design. Each group had six animal replicates and received the following dietary treatments: T1 (control) – 400g of basal diet composed of 60% Megathyrsus maximus and 40% Bridelia ferruginea leaves per day; T2—basal diet composed of the T1 diet supplemented with 400 g of Oxytenanthera abyssinica (A. Rich.) Munro leaves per day; T3—basal diet composed of the T1 diet supplemented with 400 g of Bambusa balcooa (Beema) leaves per day; T4—basal diet composed of the T1 diet supplemented with 600 g of O. abyssinica (A. Rich.) leaves per day; and T5—basal diet composed of the T1 diet supplemented with 600 g of B. balcooa leaves per day. The data were analyzed using generalized linear model procedures in Minitab Statistical Software at a 5% significance level. ResultsThe results showed varied (p < 0.05) dry matter compositions spanning from 894.3 to 910 g/kg with the highest contents of crude protein (194 g/kg), nitrogen (31 g/kg), crude fibre (302 g/kg), ash (156 g/kg), acid detergent fibre (429 g/kg), and acid detergent lignin (3.6 g/kg) recorded for B. ferruginea. The leaves of Bambusa balcooa contained the highest neutral detergent fibre (481 g/kg) while M. maximus had the highest organic matter content (911 g/kg). Significant interaction effect (p < 0.05) was observed between the supplement type and the supplementation level, impacting various parameters including feed intake ranging from 398 g (T1) to 469 g (T3) per day, weight gain from 27 g (T1) to 72 g (T2) per day, feed conversion efficiency from 6% (T1) to 15% (T2), manure output from 241 g (T2) to 260 g (T5) per day, carbon- nitrogen (C: N) ratio from 9 (T2) to 20 (T5), faecal acidity levels from 4 (T1) to 5 (T4). Comparatively, higher daily dry matter intake was recorded for the animal groups fed the B. balcooa supplement than their counterparts fed the O. abyssinica supplement. However, the O. abyssinica supplemented groups were more efficient in converting feed to body weight, with feed conversion efficiency approximately 9% higher than the B. balcooa-supplemented groups. Furthermore, in general, the animal groups that received a daily supplement of 400 g gave higher feed efficiency, with performance approximately 3.2% higher compared to the groups receiving 600 g. Likewise, these groups displayed higher faecal N output while concurrently achieving a reduced C: N ratio, indicative of enhanced nutrient utilization and potential environmental benefits. ConclusionTo conclude, integrating 400 grams of bamboo leaves into animal diet can enhance basal diet consumption, accelerate animal growth, and yield manure akin to chemical fertilizers, making it a valuable strategy for bamboo-integrated agro-silvopastoral systems practitioners.

One Hundred Priority Questions for the Development of Sustainable Food Systems in Sub-Saharan Africa

Sub-Saharan Africa is facing an expected doubling of human population and tripling of food demand over the next quarter century, posing a range of severe environmental, political, and socio-economic challenges. In some cases, key Sustainable Development Goals (SDGs) are in direct conflict, raising difficult policy and funding decisions, particularly in relation to trade-offs between food production, social inequality, and ecosystem health. In this study, we used a horizon-scanning approach to identify 100 practical or research-focused questions that, if answered, would have the greatest positive impact on addressing these trade-offs and ensuring future productivity and resilience of food-production systems across sub-Saharan Africa. Through direct canvassing of opinions, we obtained 1339 questions from 331 experts based in 55 countries. We then used online voting and participatory workshops to produce a final list of 100 questions divided into 12 thematic sections spanning topics from gender inequality to technological adoption and climate change. Using data on the background of respondents, we show that perspectives and priorities can vary, but they are largely consistent across different professional and geographical contexts. We hope these questions provide a template for establishing new research directions and prioritising funding decisions in sub-Saharan Africa.

The HIV/AIDS responses pre and during the COVID-19 pandemic in sub-Saharan Africa: A basis for sustainable health system strengthening post–COVID-19

In May 2023, the World Health Organization announced that COVID-19 was no longer a global emergency. The impact of COVID-19 on the provision of HIV/AIDS services was not that severe due to the reprogramming of key resources. For health systems in sub-Saharan Africa to become resilient to future pandemics, lessons should be learned from the successful HIV/AIDS response in the region, and how the HIV/AIDS services were successfully adapted to the COVID-19 pandemic. In this article, we reviewed the 6 World Health Organization health system building blocks on how the best practices from the provision of HIV/AIDS services and the services’ response to the COVID-19 pandemic can be used as a basis for restoring and strengthening health systems to offer universal access to quality essential health services. The success of the leadership and governance for universal access to anti-retroviral therapy can be a blueprint for the realization of universal health coverage. Significant efficiencies that resulted in the reduction in anti-retroviral therapy costs can be leveraged to ensure cheaper essential drugs while differentiated service delivery models can be used to improve health service accessibility. New technologies that have proven to be successful in HIV/AIDS care can also be used in the care of other diseases, including disease outbreaks. The strong health information systems developed for HIV programs can be used as a foundation for developing health information systems for the whole health sector while the healthcare professionals trained for the provision of HIV/AIDS services can be trained to provide services for a variety of other conditions.