Journal of Public Health in Africa最新文献

Background: Landfills are globally recognised as significant environmental and public health risks. Their emissions contribute to air and water contamination. However, research in the South African context remains limited.

Aim: To assess community perceptions of air quality and health impacts of living near a landfill site.

Setting: The study was conducted in Durban, South Africa.

Methods: The study employed a cross-sectional survey design. A structured survey questionnaire was used to collect data from a sample of residents (n = 154). Survey interviews were administered in English and isiZulu. Survey data were captured on Microsoft^® Excel for descriptive statistical analysis.

Results: The analysis revealed that 72% of respondents rated air quality as poor or very poor, with the landfill site identified as the primary contributor (77%). Seasonal variations were evident, with summer perceived as the season of worst air quality (45%). Awareness of environmental rights and engagement in formal environmental activities were low, with 93% of respondents not participating in any environmental group. Common behavioural responses included shutting windows (60%) and limiting outdoor activities (17%), while 75% of respondents advocated relocation of either the landfill site or the community to address these concerns.

Conclusion: The findings underscore the urgent need for stronger community engagement, targeted awareness campaigns and interventions to address environmental and health challenges near landfill sites.

Contribution: This study advances public health in Africa by highlighting the environmental and health risks of landfill sites and highlighting the need for targeted interventions in affected communities.

Background: Teenage mothers face significant challenges, including social stigma, a lack of support and inadequate healthcare services, which adversely affect their well-being and parenting capacities. These challenges are compounded by a lack of youth-friendly healthcare services tailored to their unique needs.

Aim: This study aimed to explore the lived experiences of teenage mothers regarding the youth-friendliness of support services in primary healthcare facilities in the Enoch Mgijima district in the Eastern Cape.

Setting: The study was conducted in primary healthcare facilities in the Enoch Mgijima district, focusing on teenage mothers aged 10-19.

Methods: An exploratory qualitative research design was employed. Data were collected through in-depth interviews with 10 teenage mothers selected using convenience and snowball sampling techniques. Data analysis followed Braun and Clarke's reflective thematic analysis framework.

Results: From the data, four main themes and ten subthemes were identified. The findings emphasise the need for more inclusive, confidential and accessible healthcare services tailored to the unique needs of teenage mothers, particularly those balancing school and caregiving or living in remote locations.

Conclusion: Enhancing healthcare worker training, promoting comprehensive sexual and reproductive health education, and tailoring services to meet the needs of teenage mothers are essential to improving health outcomes.

Contribution: The study highlights gaps in youth-friendly healthcare services and proposes actionable recommendations to foster supportive, inclusive and accessible healthcare for teenage mothers in rural South Africa.

Background: Mortality data are critical for understanding changes in population health, detecting and monitoring diseases, guiding public health responses and evaluating interventions like human immunodeficiency viruses (HIV) prevention and treatment programmes. However, in low- and middle-income countries (LMICs), comprehensive mortality data are often hindered by a high incidence of deaths occurring outside healthcare facilities and the lack of robust data systems, creating a significant knowledge gap.

Aim: This article presents methodologies for collecting mortality data, particularly in LMICs, to provide accurate and reliable information on overall and cause-specific mortality, including HIV-related deaths.

Setting: This study explore methods that may be useful in LMICs, where mortality data systems are often ad-hoc, sub-national and incomplete.

Method: Available methods were examined for collecting mortality data and report on the strengths, weaknesses and resource considerations for each method.

Results: The analysis shows that while Civil Registration and Vital Statistics is the gold standard for mortality data collection, its implementation is challenging because of differing priorities of stakeholders, infrastructural and legal barriers. Alternative methods may provide valuable data but may have limitations in coverage and resource allocation. Integrating these methods can enhance understanding of mortality data, including for HIV-related deaths.

Conclusion: Implementing a combination of mortality data-collection methods could address gaps in mortality data in LMICs. Tailoring interventions based on these data may improve health outcomes and support HIV epidemic control efforts.

Contribution: This study could be used as a resource to ministries of health, national and international public health organisations, researchers and funding bodies as it can assist countries in selecting the mortality surveillance strategy that best fits their HIV epidemic, and available infrastructure and financial resources.

Respiratory syncytial virus (RSV) is a leading cause of severe lower respiratory tract infections (LRTIs) in young children, accounting for an estimated 94 600 to 149 400 deaths annually and over 33 million cases of LRTI. The burden is particularly acute in Africa, where limited healthcare access, malnutrition, and co-infections exacerbate outcomes. Despite the introduction of maternal vaccines, such as RSVpreF (respiratory syncytial virus prefusion F protein vaccine), and monoclonal antibodies (mAbs), such as nirsevimab, barriers including high costs, infrastructure limitations, and vaccine hesitancy hinder implementation in African settings. This article examines the challenges of RSV prophylaxis in Africa, including the economic burden of interventions, cold chain requirements, and the scarcity of robust epidemiological and surveillance data. It highlights the need for expanded molecular surveillance and localised clinical trials to ensure the safety and efficacy of these interventions. Vaccine hesitancy, rooted in historical failures such as the formalin-inactivated RSV vaccine, underscores the importance of culturally sensitive community engagement. Opportunities for advancing RSV prevention in Africa include integrating maternal vaccines into antenatal care systems, aligning vaccination schedules with RSV seasonality, and leveraging private sector partnerships. Advocacy for WHO prequalification is essential to enable global procurement and secure international funding. A dual approach combining maternal vaccines with mAbs offers comprehensive protection, particularly for high-risk infants. By addressing these challenges and leveraging available opportunities, Africa can lead efforts to reduce RSV-associated morbidity and mortality, improving outcomes for its most vulnerable populations.

Background: During health emergencies, continuity of care for non-communicable diseases (NCDs) and mental health (MH), informed by robust surveillance, is required. The COVID-19 pandemic revealed that many countries were ill-prepared in this respect.

Aim: This study assesses the effect of COVID-19 on the continuity of care and surveillance of NCDs and MH in 10 African Union (AU) member states (MS) from the onset of the COVID-19 pandemic.

Setting: The study was conducted in 10 AU MS, with two MS from each AU region.

Methods: An online cross-sectional survey was developed. Member states were selected using stratified random sampling, and individual participants were selected from the ministries of health as national NCD and MH focal persons. Responses were analysed using descriptive statistics and thematic analysis.

Results: All 10 MS responded. In two-thirds and half of participating MS, routine surveillance for NCDs and MH took place, respectively. During the COVID-19 pandemic, where data were available, several MS observed increases in NCD and MH risk factors and NCD mortality and MH morbidity. Half of the MS integrated NCDs and MH into emergency preparedness and response plans and activities.

Conclusion: The MS had varied levels of national NCD and MH surveillance practices. Where data were available, most observed negative effects on NCDs and MH during the COVID-19 pandemic. Though the integration of NCDs and MH in emergency preparedness and response planning was limited, some countries responded with innovative measures to ensure continuity of care.

Contribution: The study provides insights for improving public health surveillance and emergency response systems.

Background: Most children from low- and middle-income countries (LMICs) are at risk of poor development. Poor developmental outcomes are associated with later poor schooling and labour outcomes. Previous literature has documented a range of factors that influence children's development. However, these factors are not well established in rural settings.

Aim: The current study aims at assessing the determinants of developmental outcomes among children under 3 years.

Setting: Siaya County, Kenya.

Methods: A cross-sectional study of children under 3 years and their caregivers, attending Child Welfare Clinic (CWC) at tier 3 health facilities in a rural setting in Kenya, was conducted. A total of 149 children were randomly selected to participate in the study and had their development assessed using the third version of the Ages and Stages Questionnaire (ASQ-3). We assessed the association between ASQ-3 scores and environmental, cultural and individual-level factors in crude and adjusted linear regression models.

Results: Being married and being employed showed the strongest positive associations with child development while earning less than $100.00 per month has a negative association with children's development for individual-level factors. In addition, exposing children to opportunities for early learning had a greater effect on the child's outcomes. Also, responsive caregiving showed higher scores for children's developmental outcomes.

Conclusion: The study suggests a positive association between child development outcomes and caregivers' socio-demographic characteristics. There is also an association between responsive caregiver-child interactions and child development outcomes. Programmes that create an enabling environment for caregivers to provide a stimulating environment for their children may help children to thrive, improving their development outcomes.

Contribution: This study contributes to the body of knowledge on the important roles of caregivers in enhancing their children's optimal development.

Background: Neonatal mortality is still a significant global public health issue and most of these deaths occur in sub-Saharan Africa. Despite extensive government and nongovernment campaigns, the neonatal fatality rate in this region remains unacceptable.

Aim: This review evaluates the efficacy of educational resuscitation interventions on the knowledge and skills of nurses and midwives about newborns resuscitation.

Setting: Knowledge and skills of nurses and midwives about newborns resuscitation in sub-Saharan Africa.

Method: The review followed Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) standards and used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system to evaluate the quality of evidence from the included studies. A search was conducted across seven databases from 2000 to 2024. A cumulative number of 912 studies were retrieved. The review protocol was registered in PROSPERO (CRD42022332734).

Result: The final selection comprised 16 articles. An average grading score of 2.4, suggesting low to moderate evidence. The programmes included the Basic Emergency Obstetrics and Newborn Care training, the Helping Babies Breathe (HBB), the UK Resuscitation Guidelines, the American Heart Council Guidelines, the American Neonatal Resuscitation Program and the Safe Delivery Application. The intervention resulted in considerable improvements in resuscitation knowledge and skills.Conclusion: This review has demonstrated the importance of providing nurses and midwives with training in neonatal resuscitations, as well as the substantial impact it has on the reduction of neonatal mortality rates.

Contribution: This study highlights the need for high-quality data and prioritise locally and culturally acceptable interventions to reduce neonatal mortality in sub-Saharan Africa.