scholarly journals Community-orientated primary care: a scoping review of different models, and their effectiveness and feasibility in sub-Saharan Africa

2019 ◽  
Vol 4 (Suppl 8) ◽  
pp. e001489 ◽  
Author(s):  
Bob Mash ◽  
Sunanda Ray ◽  
Akye Essuman ◽  
Edu Burgueño
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Scoping Review ◽  
Health Workers ◽  
Historical Analysis ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Scoping Reviews ◽  
Study Characteristics ◽  
Sub Saharan

IntroductionCommunity-orientated primary care (COPC) is an approach to primary healthcare (PHC) that originated in South Africa and contributed to the formulation of the Declaration of Alma-Ata 40 years ago. Despite this, PHC remains poorly developed in sub-Saharan African countries. There has been a resurgence of interest in strengthening PHC systems in the last few years and identifying key knowledge gaps. COPC has been an effective strategy elsewhere, most notably Brazil. This scoping review investigated COPC in the sub-Saharan African context and looked for evidence of different models, effectiveness and feasibility.MethodsDatabases were systematically searched using a comprehensive search strategy to identify studies from the last 10 years. A methodological guideline for conducting scoping reviews was followed. A standardised template was used to extract data and compare study characteristics and findings. Studies were grouped into five categories: historical analysis, models, implementation, educational studies and effectiveness.ResultsA total of 1997 publications were identified and 39 included in the review. Most publications were from the last 5 years (n = 32), research (n = 27), from South Africa (n = 27), focused on implementation (n = 25) and involving case studies (n = 9), programme evaluation (n = 6) or qualitative methods (n = 10). Nine principles of COPC were identified from different models. Factors related to the implementation of COPC were identified in terms of governance, finances, community health workers, primary care facilities, community participation, health information and training. There was very little evidence of effectiveness of COPC.ConclusionsThere is a need for further research to describe models of COPC in Africa, investigate the appropriate skills mix to integrate public health and primary care in these models, evaluate the effectiveness of COPC and whether it is included in training of healthcare workers and government policy.

scholarly journals 1673. Gendered Patterns of HIV, TB, and Other Primary Care Referrals in Rural South Africa

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S612-S613
Author(s):  
Koeun Choi ◽  
Anthony Moll ◽  
Sheela Shenoi
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Health Care ◽  
Community Health ◽  
Health Workers ◽  
Hazardous Drinking ◽  
Sub Saharan Africa ◽  
Running Water ◽  
Health Concerns ◽  
Sub Saharan

Abstract Background Men’s lack of engagement in healthcare hinders HIV efforts in sub-Saharan Africa. Masculine norms and lack of accessibility in a female-dominated healthcare system deter male health-seeking behavior. Community interventions combat the gender gap. In South Africa (SA), alcohol-based venues (ABV) are common locales for men. We created an ABV community health screening to determine the need. Methods Community Health Workers targeted ABV in rural SA, offering screenings for HIV, TB, Isoniazid Preventive Therapy, STI, hypertension, diabetes, circumcision, with referral to primary care services (PCS) for any positive screenings. Participants completed questionnaires, including socioeconomic (SE), healthcare use, and alcohol use evaluated by AUDIT scores. Multivariable logistic regression identified factors associated with referral to PCS. Results From July 2018 to March 2019, 1356 were screened, 74% were men, median age was 30 (IQR 22–46), 26% employed and 30% had running water. Men are more likely to have never gone to a PCS compared with women (15.9% vs. 9.7%, P = 0.004) and have lengthier time since the last clinic visit (1.4 years vs. 0.6 years, P < 0.001). Men are significantly more likely than women to report hazardous drinking (49% vs. 28%, P < 0.001) Overall, positive screenings were noted in 537 (53.9%) community members, and χ 2 analysis show men more likely to require referrals after screening (P = 0.08). Multivariate analysis shows among men, referrals were associated with older age, hazardous drinking, any health concerns; while higher SE was protective. For women, only age and health concerns were associated with referral. Similarly, alcohol contributed to HIV and TB referrals for men, while higher SE was protective of TB referrals for men (Table 1). Conclusion ABV males in this rural community, although disengaged from health care, required more referrals than women. HIV, TB, and any referrals for men screened at ABV in rural SA were associated with lower SE and hazardous drinking, highlighting the challenges that this population faces in seeking health care. Differentiated and targeted community-based services may facilitate care for these hard to reach men in sub-Saharan Africa. Next steps include determining clinical outcomes of referrals. Disclosures All authors: No reported disclosures.

scholarly journals Intersectional stigma and its impact on HIV prevention and care among MSM and WSW in sub-Saharan African countries: a protocol for a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047280
Author(s):  
Gamji M’Rabiu Abubakari ◽  
Debbie Dada ◽  
Jemal Nur ◽  
DeAnne Turner ◽  
Amma Otchere ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Data Extraction ◽  
Grey Literature ◽  
Secondary Data ◽  
Well Being ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Scoping Reviews ◽  
Sub Saharan ◽  
Meta Analyses

IntroductionResearch has established that various forms of stigma (HIV stigma, gender non-conforming stigma and same-gender sex stigma) exist across Sub-Saharan Africa and have consequences for the utilisation of HIV prevention and care services. Stigmas are typically investigated in HIV literature individually or through investigating individual populations and the various stigmas they may face. The concept of intersectionality highlights the interconnected nature of social categorisations and their ability to create interdependent systems of discrimination based on gender, race, sexuality and so on. Drawing from perspectives on intersectionality, intersectional stigma denotes the convergence of multiple marginalised identities within an individual or a group, the experiences of stigma associated with these identities as well as the synergistic impact of these experiences on health and well-being. With respect to HIV, public health scholars can examine the impacts of intersectional stigmas on HIV prevention and care utilisation.Methods and analysisReviewers will search systematically through MEDLINE, Global Health, Embase, Scopus, Web of Science Core Collection and Africa Index Medicus and citations for quantitative studies, qualitative studies and grey literature that include data on stigma and HIV among men who have sex with men and women who have sex with women in Sub-Saharan Africa. Eligible studies will include primary or secondary data on stigma related to HIV risk factors experienced by this population. Studies will be written in French or English and be published between January 1991 and November 2020. All screening and data extraction will be performed in duplicate, and if discrepancies arise, they will be settled by GM’RA, LEN, DD or AO. Findings from this study will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.Ethics and disseminationEthics approval is not required as there will be no human participants and no protected data will be used in this study. We will disseminate findings through peer-reviewed manuscripts, conferences and webinars.

scholarly journals The inverse primary care law in sub-Saharan Africa: a qualitative study of the views of migrant health workers

2014 ◽  
Vol 64 (623) ◽  
pp. e321-e328 ◽  
Author(s):  
Shabir Moosa ◽  
Silvia Wojczewski ◽  
Kathryn Hoffmann ◽  
Annelien Poppe ◽  
Oathokwa Nkomazana ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Health Workers ◽  
Migrant Health ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals South-South migration and elections: evidence from post-apartheid South Africa

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Biniam E. Bedasso ◽  
Pascal Jaupart
Keyword(s):  
South Africa ◽  
Ethnic Diversity ◽  
Negative Impact ◽  
African National Congress ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Single Issue ◽  
Local Public Services ◽  
Sub Saharan ◽  
Election Results

AbstractLittle is known about the political consequences of immigration in Sub-Saharan Africa. In this paper, we estimate the effect of exposure to immigration on election outcomes in South Africa. Our analysis is based on municipality panel data and an instrumental variable (IV) strategy exploiting historical migrant settlement patterns. We find that local immigration concentration has a negative impact on the performance of the incumbent African National Congress, whereas support for the main opposition party, the Democratic Alliance, is found to increase in municipalities with a larger immigrant presence. These effects hold regardless of the skill levels of immigrants in a municipality. In terms of mechanisms, competition over jobs and local public services as well as ethnic diversity and cultural factors influence how immigration affects election outcomes. These findings are robust to a broad range of sensitivity checks. They provide evidence that immigration can be a politically salient issue in migrant-destination Sub-Saharan African countries. They also show that immigration can affect election results even in contexts where there is no single issue anti-migrant party.

scholarly journals Mapping Evidence of Mobile Health Technologies for Disease Diagnosis and Treatment Support by Health Workers in Sub-Saharan Africa: A Scoping Review

2019 ◽  
Author(s):  
Ernest Osei ◽  
Desmond Kuupiel ◽  
Portia Nelisiwe Vezi ◽  
Tivani P. Mashamba-Thompson
Keyword(s):  
Mobile Health ◽  
Scoping Review ◽  
Full Text ◽  
Methodological Quality ◽  
Health Workers ◽  
Disease Diagnosis ◽  
Sub Saharan Africa ◽  
Diagnosis And Treatment ◽  
Treatment Support ◽  
Sub Saharan

Abstract Background: The rapid growth of mobile technology has given rise to the development of mobile health programmes aimed at treating and preventing a wide range of health conditions. However, evidence on the use of mHealth in high disease burdened settings such as SSA is not clear. We systematically mapped evidence on mHealth for disease diagnosis and treatment support by health workers in SSA. Methods: We conducted a scoping review study guided by the Arksey and O’Malley’s framework, Levac et al recommendations, and Joanna Briggs Institute guidelines. We thoroughly searched the following databases: MEDLINE and CINAHL with full-text via EBSCOhost; PubMed; Science Direct and Google Scholar for relevant articles from inception to July 2019. Two independent reviewers screened abstracts and full-text articles using the eligibility criteria as reference. This study employed the mixed methods appraisal tool version 2018 to assess the methodological quality of the included studies. Results: Out of the 572 articles identified , only 10 published articles presented evidence on mHealth for treatment support by health workers in SSA since 2010. No studies reported evidence on mHealth for disease diagnosis by health workers in SSA. Of the 10 studies, four studies were conducted in Kenya; one in South Africa; one in Malawi; one in Zimbabwe; one in Mozambique; one in Nigeria and one in Lesotho. Of the 10 studies: three reported the use of mHealth to manage HIV; two on the management of HIV/TB; two on treatment of malaria; one each on the management of hypertension; cervical cancer; and one was not specific on any disease condition. All the 10 included studies underwent methodological quality appraisal with a scored between 70 and 100%. Conclusions: The study shows that there is limited research on the availability and use of mHealth by health workers for treatment support in SSA. This study also shows there is no literature on the availability and use of mHealth by health workers for disease diagnosis in SSA. We, therefore, recommend primary studies focusing on the use of mHealth by health workers for disease diagnosis in SSA. Keywords: Mobile Health; Disease diagnosis; Treatment support; sub-Saharan Africa

scholarly journals Angola - an Oil Dependant Country in Sub-Saharan Africa

2016 ◽  
Vol 9 (35) ◽  
pp. 233-242
Author(s):  
Boris Baumgartner
Keyword(s):  
South Africa ◽  
World Economy ◽  
Sub Saharan Africa ◽  
African Countries ◽  
The Third ◽  
The World ◽  
Sub Saharan ◽  
The One ◽  
Rich Countries ◽  
Essential Problem

Abstract The Sub-Saharan Africa belongs to the most underdeveloped regions in the world economy. This region consists of forty nine countries but it’s world GDP share is only a small percentage. There are some very resource rich countries in this region. One of them is Angola. This former Portuguese colony has one of the largest inventories of oil among all African countries. Angola recorded one of the highest growth of GDP between 2004-2008 from all countries in the world economy and nowadays is the third biggest economy in Sub-Saharan Africa after Nigeria and South Africa. The essential problem of Angola is the one-way oriented economy on oil and general on natural resources. Angola will be forced to change their one-way oriented economy to be more diversified and competitive in the future.

scholarly journals Factors influencing uptake of schistosomiasis research findings in ingwavuma area, uMkhanyakude District, Kwazulu-Natal, South Africa

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Tafadzwa Mindu ◽  
Moses J. Chimbari
Keyword(s):  
South Africa ◽  
Rural Areas ◽  
Health Workers ◽  
Sub Saharan Africa ◽  
Primary School Children ◽  
Factors Influencing ◽  
Kwazulu Natal ◽  
Research Uptake ◽  
Research Findings ◽  
Sub Saharan

Background: Research uptake is concerned with spreading ideas across multiple levels of the community. Barriers such as poverty, lack of infrastructure, illiteracy and culture prevent information sharing in arid rural areas of sub-Saharan Africa. Objective: This study explores the factors influencing schistosomiasis research uptake and the available channels for the uptake of research findings from a transdisciplinary and eco-health research project on schistosomiasis in Ingwavuma area, uMkhanyakude district, KwaZulu-Natal province in South Africa. Methods: This case study conducted in 2017 involved 78 primary school children and 73 heads of household recruited through convenience and purposive sampling. Data were collected through focus group discussions, then transcribed and analysed by the researcher using thematic analysis. Results: Factors such as poor knowledge, water and sanitation problems, and lack of sufficient health workers hindered the uptake of schistosomiasis research findings. Participants recommended several platforms to share schistosomiasis research findings with the community, including: door to door visits; social gatherings such as sports events, talent shows, and religious gatherings; mass media platforms such as radio and television; social media platforms such as WhatsApp, Facebook and Twitter; and printed media such as posters, booklets and pamphlets. Conclusions: There is a need to train health workers and peer educators in this area of South Africa to educate people about schistosomiasis infection, screening and treatment through home visits or social events. Schistosomiasis research findings must be synthesised and packaged in different forms for dissemination via multimedia media-based communication channels.

scholarly journals Knowledge, attitude, perception, and preventative practices towards COVID-19 in sub-Saharan Africa: A scoping review

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249853
Author(s):  
Ugochinyere Ijeoma Nwagbara ◽  
Emmanuella Chinonso Osual ◽  
Rumbidzai Chireshe ◽  
Obasanjo Afolabi Bolarinwa ◽  
Balsam Qubais Saeed ◽  
...  
Keyword(s):  
Scoping Review ◽  
Positive Attitude ◽  
Grey Literature ◽  
Further Education ◽  
Sub Saharan Africa ◽  
World Health ◽  
African Countries ◽  
Preventive Practices ◽  
Adequate Knowledge ◽  
Sub Saharan

Background Knowledge, attitudes, perception, and preventative practices regarding coronavirus- 2019 (COVID-19) are crucial in its prevention and control. Several studies have noted that the majority of people in sub-Saharan African are noncompliant with proposed health and safety measures recommended by the World Health Organization (WHO) and respective country health departments. In most sub-Saharan African countries, noncompliance is attributable to ignorance and misinformation, thereby raising questions about people’s knowledge, attitudes, perception, and practices towards COVID-19 in these settings. This situation is particularly of concern for governments and public health experts. Thus, this scoping review is aimed at mapping evidence on the knowledge, attitudes, perceptions, and preventive practices (KAP) towards COVID-19 in sub-Saharan Africa (SSA). Methods Systematic searches of relevant articles were performed using databases such as the EBSCOhost, PubMed, Science Direct, Google Scholar, the WHO library and grey literature. Arksey and O’Malley’s framework guided the study. The risk of bias for included primary studies was assessed using the Mixed Method Appraisal Tool (MMAT). NVIVO version 10 was used to analyse the data and a thematic content analysis was used to present the review’s narrative account. Results A total of 3037 eligible studies were identified after the database search. Only 28 studies met the inclusion criteria after full article screening and were included for data extraction. Studies included populations from the following SSA countries: Ethiopia, Nigeria, Cameroon, Uganda, Rwanda, Ghana, Democratic Republic of Congo, Sudan, and Sierra Leone. All the included studies showed evidence of knowledge related to COVID-19. Eleven studies showed that participants had a positive attitude towards COVID-19, and fifteen studies showed that participants had good practices towards COVID-19. Conclusions Most of the participants had adequate knowledge related to COVID-19. Despite adequate knowledge, the attitude was not always positive, thereby necessitating further education to convey the importance of forming a positive attitude and continuous preventive practice towards reducing contraction and transmission of COVID‐19.

African states hope the Gulf crisis will end soon

2017 ◽  
Keyword(s):  
South Africa ◽  
Saudi Arabia ◽  
Sub Saharan Africa ◽  
African Union ◽  
African Countries ◽  
Content Type ◽  
Gulf Countries ◽  
Political Effects ◽  
Gulf Crisis ◽  
Sub Saharan

Significance The split between Qatar and its neighbours has pushed a few small African countries to side with Saudi Arabia, but leaves the continent’s leading powers and several conflict-afflicted nations eager to stay neutral -- for now. In sub-Saharan Africa (SSA) -- where Gulf countries have strong diplomatic ties and major economic investments -- the crisis has had significant political effects. Impacts The withdrawal of Qatari peacekeepers from the Djibouti-Eritrea border will become a pressing concern for the African Union. Ongoing expulsions of African migrants from Saudi Arabia will complicate Saudi and Emirati efforts to find African partners against Qatar. Countries such as South Africa and Nigeria may begin to act more assertively in calling for neutrality.

5. HIV AND WOMEN: THE AFRICAN EXPERIENCE

Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 286
Author(s):  
D. A. Lewis
Keyword(s):  
South Africa ◽  
Cervical Screening ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Hormonal Contraceptives ◽  
First Line ◽  
African Countries ◽  
Incidence Studies ◽  
Seroprevalence Data ◽  
Sub Saharan

Africa as a continent has been devastated by the acquired immunodeficiency syndrome epidemic caused by the human immunodeficiency virus (HIV). Women are more likely to acquire HIV/AIDS for a number of reasons and incidence studies show that younger women are particularly at risk of HIV acquisition. Biologically, they are more vulnerable and the acquisition of HIV can be influenced by hormonal contraceptives as well as sexually transmitted infections, which are often more asymptomatic than is the case for men. Women in Africa are also more vulnerable because of cultural issues; in some countries polygamy is accepted practice. Women are often economically disadvantaged and disempowered. It is often hard for them to insist on the use of condoms with husbands and regular partners. Physical and sexual abuse of women, including rape, remains a major problem on the continent, particularly in times of civil war. Many women are forced to work as sex workers or be involved in transactional sex in order to survive. Most countries rely on anonymous antenatal surveys to generate HIV seroprevalence data for women of reproductive age. These data is often used as surrogate markers for HIV prevalence rates in men of a similar age. The seroprevalence of HIV among pregnant women differs remarkably around the continent, with the highest rates being seen in Southern Africa, as high as 30%, and much lower rates being seen in West Africa. These reasons underlying these differences are complex and not completely understood. UNAIDS estimated in 2005 that 470�000 (87%) of the world's 540�000 newly infected children (<15 years old) reside in Sub-Saharan Africa. Prevention of mother to child transmission (PMTCT) of HIV is thus a national priority in many Sub-Saharan African countries. Despite policies, treatment is sometimes not given at the clinic level for several reasons, and when it is, most commonly it is with single dose Nevirapine. Data from South Africa has shown that both mothers and infected babies rapidly acquire nevirapine resistance. It is likely that this will lead to early failure of first line antiretroviral (ARV) therapy among these mothers once they start their ARVs. In South Africa, for example, either efavirenz or nevirapine form the backbone of the first-line ARV regimens. AIDS defining illnesses (ADIs) in women living in Africa are similar to those observed in men. Tuberculosis is the most common ADI but other life-threatening illnesses such as cryptococcal meningitis are relatively common compared to other parts of the world. Cervical cancer and cervical intra-epithelial neoplasia (CIN) lesions are more common in HIV-infected than in non-infected women. Most countries in Africa do not have cervical screening programmes and, even in richer countries such as South Africa, the national policy is to screen women three times in their life at 30, 40 and 50 years of age. Many HIV specialist centres, with additional donor funds, are now attempting to perform annual cervical screening, at least in South Africa.

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