Water, sanitation and hygiene (WASH) in sub-Saharan Africa and associations with undernutrition, and governance in children under five years of age: a systematic review

Abstract Associations between different forms of malnutrition and environmental conditions, including water, sanitation and hygiene (WASH), may contribute towards persistently poor child health, growth and cognitive development. Experiencing poor nutrition in utero or during early childhood is furthermore associated with chronic diseases later in life. The primary responsibility for provision of water and sanitation, as a basic service and human right, lies with the State; however, a number of stakeholders are involved. The situation is most critical in sub-Saharan Africa (SSA), where, in 2015, 311 million people lacked a safe water source, and >70% of SSA populations were living without adequate sanitation. The aim of this paper was to conduct a systematic review to investigate the state of literature concerned with WASH and its association with nutritional status, and governance in children from birth to 5 years of age in SSA. Articles were sourced from PubMed Central, Science Direct and ProQuest Social Science databases published between 1990 and 2017. The PRISMA Statement was utilised and this systematic review is registered with PROSPERO (CRD42017071700). The search terms returned 15,351 articles for screening, with 46 articles included. This is indicative of a limited body of knowledge; however, the number of publications on this topic has been increasing, suggesting burgeoning field of interest. Targeted research on the governance of WASH through the identification of the various role players and stakeholders at various levels, while understanding the policy environment in relation to particular health-related outcomes is imperative to address the burden of child undernutrition.

Download Full-text

Access to water, sanitation and hygiene services in health facilities in sub-Saharan Africa 2013–2018: Results of health facility surveys and implications for COVID-19 transmission

BMC Health Services Research ◽

10.1186/s12913-021-06515-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mufaro Kanyangarara ◽

Savannah Allen ◽

Safia S Jiwani ◽

David Fuente

Keyword(s):

Health Facility ◽

Infection Prevention ◽

Water Source ◽

Health Facilities ◽

Sub Saharan Africa ◽

Standard Precautions ◽

Running Water ◽

Sanitation And Hygiene ◽

Access To Water ◽

Sub Saharan

Abstract Background The COVID-19 pandemic has highlighted important needs in water, sanitation and hygiene (WASH) services and standard practices for infection prevention and control in sub-Saharan Africa. We assessed the availability of WASH and standard precautions for infection prevention in health facilities across 18 countries in sub-Saharan Africa, as well as inequalities by location (rural/urban) and managing authority (public/private). Data from health facility surveys conducted between 2013 and 2018 in 18 sub-Saharan African countries were used to estimate the access to an improved water source within 500 m, an improved toilet, soap and running water or alcohol-based hand rub, and standard precautions for infection prevention at health facilities. Rural-urban differences and public-private differences in access to services were calculated. We also compared population level access to health facility access to services. Result Overall, 16,456 health facilities from 18 countries were included. Across countries, an estimated 88 % had an improved water source, 94 % had an improved toilet, 74 % had soap and running water or alcohol-based hand rub, and 17 % had standard precautions for infection prevention available. There was wide variability in access to water, sanitation and hygiene services between rural and urban health facilities and between public and private facilities, with consistently lower access in both rural and public facilities. In both rural and urban areas, access to water, sanitation and hygiene services was ubiquitously better at health facilities than households. Conclusions Availability of WASH services in health facilities in sub-Saharan Africa has improved but remains below the global target of 80 % in many countries. Ensuring adequate access to WASH services and enforcing adherence to safety and hygiene practices in health facilities will be essential to minimize the risk of COVID-19 transmission.

Download Full-text

Models of engagement between the state and the faith sector in sub-Saharan Africa – a systematic review

Development in Practice ◽

10.1080/09614524.2017.1327030 ◽

2017 ◽

Vol 27 (5) ◽

pp. 684-697 ◽

Cited By ~ 5

Author(s):

Eleanor Whyle ◽

Jill Olivier

Keyword(s):

Systematic Review ◽

The State ◽

Sub Saharan Africa ◽

Sub Saharan

Download Full-text

Health-related interventions for youth living with perinatally-acquired HIV in sub-Saharan Africa: A systematic review of the evidence

Journal of HIV/AIDS & Social Services ◽

10.1080/15381501.2021.1900975 ◽

2021 ◽

pp. 1-32

Author(s):

Sadandaula Rose Muheriwa Matemba ◽

Rosina Cianelli ◽

Brian E. McCabe ◽

Evelyn Chilemba

Keyword(s):

Systematic Review ◽

Sub Saharan Africa ◽

Health Related ◽

Perinatally Acquired ◽

Sub Saharan

Download Full-text

Khat chewing and risky sexual behavior in Sub-Saharan Africa: a systematic review protocol

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/jbisrir-2013-877 ◽

2013 ◽

Vol 11 (12) ◽

pp. 59-67 ◽

Cited By ~ 4

Author(s):

Amanuel Tesfay Gebremedhin ◽

Hailay Abrha Gesesew ◽

Tariku Dejene Demissie ◽

Mirkuzie Woldie Kerie ◽

Morankar Sudhakar

Keyword(s):

Systematic Review ◽

Sexual Behavior ◽

Risky Sexual Behavior ◽

Sub Saharan Africa ◽

Systematic Review Protocol ◽

Khat Chewing ◽

Review Protocol ◽

Sub Saharan

Download Full-text

Gambling Patterns and Problem Gambling Among Youth in Sub-Saharan Africa: A Systematic Review

Journal of Gambling Studies ◽

10.1007/s10899-021-10001-w ◽

2021 ◽

Author(s):

Byron K. Y. Bitanihirwe ◽

Derrick Ssewanyana

Keyword(s):

Systematic Review ◽

Problem Gambling ◽

Sub Saharan Africa ◽

Sub Saharan ◽

Gambling Patterns

Download Full-text

Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00822-7 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Hafte Kahsay Kebede ◽

Lillian Mwanri ◽

Paul Ward ◽

Hailay Abrha Gesesew

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Hiv Care ◽

Care Services ◽

Validity Assessment ◽

Sub Saharan ◽

Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

Download Full-text

Behavioural interventions promoting condom use among female sex workers in sub-Saharan Africa: a systematic review

African Journal of AIDS Research ◽

10.2989/16085906.2017.1358753 ◽

2017 ◽

Vol 16 (3) ◽

pp. 257-268 ◽

Cited By ~ 7

Author(s):

Uchenna O Okafor ◽

Rik Crutzen ◽

Yauri Aduak ◽

Sylvia Adebajo ◽

Hubertus W Van den Borne

Keyword(s):

Systematic Review ◽

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Sub Saharan Africa ◽

Behavioural Interventions ◽

Female Sex ◽

Sub Saharan

Download Full-text

Interventions to Improve Adherence to Antiretroviral Therapy (ART) in Sub-Saharan Africa: An Updated Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052477 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2477

Author(s):

Panmial Priscilla Damulak ◽

Suriani Ismail ◽

Rosliza Abdul Manaf ◽

Salmiah Mohd Said ◽

Oche Agbaji

Keyword(s):

Systematic Review ◽

Antiretroviral Therapy ◽

Behavioral Interventions ◽

Controlled Trial ◽

Self Report ◽

Sub Saharan Africa ◽

Art Adherence ◽

Study Characteristics ◽

Combination Study ◽

Sub Saharan

Optimal adherence to antiretroviral therapy (ART) remains the bedrock of effective therapy and management of human immunodeficiency virus (HIV). This systematic review examines the effect of interventions in improving ART adherence in sub-Saharan Africa (SSA), which bears the largest global burden of HIV infection. In accordance with PRISMA guidelines, and based on our inclusion and exclusion criteria, PUBMED, MEDLINE, and Google Scholar databases were searched for published studies on ART adherence interventions from 2010 to 2019. Thirty-one eligible studies published between 2010 to 2019 were identified, the categories of interventions were structural, behavioral, biological, cognitive, and combination. Study characteristics varied across design, intervention type, intervention setting, country, and outcome measurements. Many of the studies were behavioral interventions conducted in hospitals with more studies being randomized controlled trial (RCT) interventions. Despite the study variations, twenty-four studies recorded improvements. Notwithstanding, more quality studies such as RCTs should be conducted, especially among key affected populations (KAPs) to control transmission of resistant strains of the virus. Reliable objective measures of adherence should replace the conventional subjective self-report. Furthermore, long-term interventions with longer duration should be considered when evaluating the effectiveness of interventions.

Download Full-text