scholarly journals Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa

2021 ◽  
Vol 6 (5) ◽  
pp. e004669
Author(s):  
Olukemi Adeyemi ◽  
Mary Lyons ◽  
Tsi Njim ◽  
Joseph Okebe ◽  
Josephine Birungi ◽  
...  

BackgroundLow-income and middle-income countries are struggling to manage growing numbers of patients with chronic non-communicable diseases (NCDs), while services for patients with HIV infection are well established. There have been calls for integration of HIV and NCD services to increase efficiency and improve coverage of NCD care, although evidence of effectiveness remains unclear. In this review, we assess the extent to which National HIV and NCD policies in East Africa reflect the calls for HIV-NCD service integration.MethodsBetween April 2018 and December 2020, we searched for policies, strategies and guidelines associated with HIV and NCDs programmes in Burundi, Kenya, Rwanda, South Sudan, Tanzania and Uganda. Documents were searched manually for plans for integration of HIV and NCD services. Data were analysed qualitatively using document analysis.ResultsThirty-one documents were screened, and 13 contained action plans for HIV and NCDs service integration. Integrated delivery of HIV and NCD care is recommended in high level health policies and treatment guidelines in four countries in the East African region; Kenya, Rwanda, Tanzania and Uganda, mostly relating to integrating NCD care into HIV programmes. The increasing burden of NCDs, as well as a move towards person-centred differentiated delivery of services for people living with HIV, is a factor in the recent adoption of integrated HIV and NCD service delivery plans. Both South Sudan and Burundi report a focus on building their healthcare infrastructure and improving coverage and quality of healthcare provision, with no reported plans for HIV and NCD care integration.ConclusionDespite the limited evidence of effectiveness, some East African countries have already taken steps towards HIV and NCD service integration. Close monitoring and evaluation of the integrated HIV and NCD programmes is necessary to provide insight into the associated benefits and risks, and to inform future service developments.

1973 ◽  
Vol 17 (1) ◽  
pp. 66-93 ◽  
Author(s):  
R. W. Hodgin

The purpose of this article is to review the application of the English law of defamation in the East African countries (Uganda, Kenya, Tanzania) and to assess the possible contribution of the Kenya Defamation Act, 1970.


2020 ◽  
Vol 20 (1) ◽  
pp. 248-256
Author(s):  
Lenka Mařincová ◽  
Simona Šafaříková ◽  
Radka Cahlíková

Background: Over a few decades obesity has become a major global health problem. Its prevalence worldwide has more than doubled since 1980. The situation is expected to worsen in the future, especially in the developing countries that experience nutrition transition due to economic growth. It contributes to reduction in malnutrition which supports an increase in obesity prevalence. Objectives: The aim of this study was to analyse the predictors of obesity in the region of East Africa. Methods: Meta-analysis of existing studies was used in order to find the different risk factors and their significance in obesity development. Data extracted from 16 published academic research articles described the situation in East African countries. The significance of the effect of each variable was tested by means of an asymptotic chi-square test, or Fisher's exact (factorial) test and the risk ratios were calculated. Results: Based on the chi-square test and the risk ratios of the aggregated data, three risk factors were found to be significant in the development of obesity – gender, type of residence and socio-economic status. In East African countries, women are significantly more likely to be obese. Living in an urban area and socioeconomic status are also positively associated with obesity. Because of insufficient data three other risk factors did not prove to be of any significance – alcohol consumption, smoking and education level. Conclusion: Conclusions of this meta-analysis confirm world trends but we also found results that are not in line with them (e.g. education). This meta-analysis confirms the huge existing research gap concerning obesity predictors in the East African region. Keywords: Obesity; meta-analysis; East Africa. 


Author(s):  
Herman O. Kiriama

The countries of Burundi, Kenya, Tanzania, Uganda, Rwanda, and South Sudan geographically lie on the eastern part of the African continent and are member states of the East African Community (EAC), a regional economic bloc. These countries, as many other countries in the world, have important heritage places that are significant to their communities. As a result, these countries have developed various methods of managing this heritage. Heritage management should be understood as caring for a heritage site without compromising its significance so that present and future generations can continue enjoying it. Consequently, countries around the world have put in place various legal regimes that enable them to manage and protect their heritage. Though the East African countries listed belong to the same geographical region and economic bloc, they had differing colonial experiences and, therefore, their legislation regimes, including that governing heritage, may not be exactly the same. Kenya and Uganda, for instance, were British colonies, whereas Tanzania started as a Germany colony but later ended up as a British Protectorate. Rwanda and Burundi also started as Germany colonies but ended up as Belgian colonies. South Sudan, once part of the larger Republic of Sudan, was a British colony. Common to all these countries, however, is the fact that the colonial management system laid more emphasis on the protection of tangible as opposed to intangible heritage, and it also ignored and in most cases destroyed the indigenous management systems that local communities had hitherto used to manage their heritage. Despite gaining their independence from the colonial governments in the early 1960s, these countries, have however, apart from Rwanda, continued to use the inherited colonial legal systems. It is now widely accepted within heritage management circles that unless indigenous heritage management systems are embraced, the local communities tend to feel alienated from their heritage and thus in most cases tend to disregard, ignore, or in some cases destroy the heritage site as it no longer belongs to them but to the state; the end result is that pressure is put on the heritage as the national government institutions do not have adequate financial and human capacity to manage all the heritage resources in their jurisdiction.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Getayeneh Antehunegn Tesema ◽  
Zemenu Tadesse Tessema ◽  
Koku Sisay Tamirat ◽  
Achamyeleh Birhanu Teshale

Abstract Background Complete childhood vaccination remains poor in Sub-Saharan Africa, despite major improvement in childhood vaccination coverage worldwide. Globally, an estimated 2.5 million children die annually from vaccine-preventable diseases. While studies are being conducted in different East African countries, there is limited evidence of complete basic childhood vaccinations and associated factors in East Africa among children aged 12–23 months. Therefore, this study aimed to investigate complete basic childhood vaccinations and associated factors among children aged 12–23 months in East Africa. Methods Based on the Demographic and Health Surveys (DHSs) of 12 East African countries (Burundi, Ethiopia, Comoros, Uganda, Rwanda, Tanzania, Mozambique, Madagascar, Zimbabwe, Kenya, Zambia, and Malawi), secondary data analysis was performed. The study included a total weighted sample of 18,811 children aged 12–23 months. The basic childhood vaccination coverage was presented using a bar graph. Multilevel binary logistic regression analysis was fitted for identifying significantly associated factors because the DHS has a hierarchical nature. The Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance (−2LLR) were used for checking model fitness, and for model comparison. Variable with p-value ≤0.2 in the bi-variable multilevel analysis were considered for the multivariable analysis. In the multivariable multilevel analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the significance and strength of association with full vaccination. Results Complete basic childhood vaccination in East Africa was 69.21% (95% CI, 69.20, 69.21%). In the multivariable multilevel analysis; Mothers aged 25–34 years (AOR = 1.21, 95% CI: 1.10, 1.32), mothers aged 35 years and above (AOR = 1.50, 95% CI: 1.31, 1.71), maternal primary education (AOR = 1.26, 95% CI: 1.15, 1.38), maternal secondary education and above (AOR = 1.54, 95% CI: 1.36, 1.75), husband primary education (AOR = 1.25, 95% CI: 1.13, 1.39), husband secondary education and above (AOR = 1.24, 95% CI: 1.11, 1.40), media exposure (AOR = 1.23, 95% CI: 1.13, 1.33), birth interval of 24–48 months (AOR = 1.28, 95% CI: 1.15, 1.42), birth interval greater than 48 months (AOR = 1.35, 95% CI: 1.21, 1.50), having 1–3 ANC visit (AOR = 3.24, 95% CI: 2.78, 3.77), four and above ANC visit (AOR = 3.68, 95% CI: 3.17, 4.28), PNC visit (AOR = 1.34, 95% CI: 1.23, 1.47), health facility delivery (AOR = 1.48, 95% CI: 1.35, 1.62), large size at birth 1.09 (AOR = 1.09, 95% CI: 1.01, 1.19), being 4–6 births (AOR = 0.83, 95% CI: 0.75, 0.91), being above the sixth birth (AOR = 0.60, 95% CI: 0.52, 0.70), middle wealth index (AOR = 1.16, 95% CI: 1.06, 1.28), rich wealth index (AOR = 1.20, 95% CI: 1.09, 1.33), community poverty (AOR = 1.21, 95% CI: 1.11, 1.32) and country were significantly associated with complete childhood vaccination. Conclusions In East Africa, full basic childhood vaccine coverage remains a major public health concern with substantial differences across countries. Complete basic childhood vaccination was significantly associated with maternal age, maternal education, husband education, media exposure, preceding birth interval, number of ANC visits, PNC visits, place of delivery, child-size at birth, parity, wealth index, country, and community poverty. Public health interventions should therefore target children born to uneducated mothers and fathers, poor families, and those who have not used maternal health services to enhance full childhood vaccination to reduce the incidence of child mortality from vaccine-preventable diseases.


LOGOS ◽  
2015 ◽  
Vol 26 (3) ◽  
pp. 23-30 ◽  
Author(s):  
Kiarie Kamau

The main aim of this paper is to examine the state of publishing in East Africa. It also attempts to review the situation in Malawi and Zambia, where the author has had practical experience in publishing and marketing. The paper focuses on the growth of the publishing industry in the East African region and how this growth has impacted on access to textbooks and trade publications. It demonstrates that there has been significant growth in the industry, especially in Kenya and Uganda. However, this growth has largely been in the area of publishing of textbooks. Funding for the rollout of curricula in the East African countries has been a blessing to publishers because the funding includes allocations for textbook purchases for both primary and secondary schools. However, this kind of publishing has sounded something of a death knell for the publication of general books such as novels and biographies. The paper also demonstrates that indigenous book-publishing firms have gained a stronger foothold in East Africa in the last ten years and edged out the multinationals. It concludes by indicating that unless the publishing model changes, general publishing will continue to be relegated to the back-burner. At the same time, publishers are challenged to embrace digital publishing, since that is where the future of publishing lies.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253736
Author(s):  
Koku Sisay Tamirat ◽  
Getayeneh Antehunegn Tesema ◽  
Zemenu Tadesse Tessema

Background In low-income nations, high-risk fertility behavior is a prevalent public health concern that can be ascribed to unmet family planning needs, child marriage, and a weak health system. As a result, this study aimed to determine the factors that influence high-risk fertility behavior and its impact on child stunting and anemia. Method This study relied on secondary data sources from recent demography and health surveys of nine east African countries. Relevant data were extracted from Kids Record (KR) files and appended for the final analysis; 31,873 mother-child pairs were included in the final analysis. The mixed-effect logistic regression model (fixed and random effects) was used to describe the determinants of high-risk fertility behavior (HRFB) and its correlation with child stunting and anemia. Result According to the pooled study about 57.6% (95% CI: 57.7 to 58.2) of women had at least one high-risk fertility behavior, with major disparities found across countries and women’s residences. Women who lived in rural areas, had healthcare access challenges, had a history of abortion, lived in better socio-economic conditions, and had antenatal care follow-up were more likely to engage in high-risk fertility practices. Consequently, Young maternal age at first birth (<18), narrow birth intervals, and high birth orders were HRFBs associated with an increased occurrences of child stunting and anemia. Conclusion This study revealed that the magnitude of high-risk fertility behavior was higher in east Africa region. The finding of this study underscores that interventions focused on health education and behavioral change of women, and improvement of maternal healthcare access would be helpful to avert risky fertility behaviors. In brief, encouraging contraceptive utilization and creating awareness about birth spacing among reproductive-age women would be more helpful. Meanwhile, frequent nutritional screening and early intervention of children born from women who had high-risk fertility characteristics are mandatory to reduce the burden of chronic malnutrition.


2020 ◽  
Author(s):  
Kahabi Isangula ◽  
Grace Edwards ◽  
Tumbwene Mwansisya ◽  
Columba Mbekenga ◽  
Eunice Pallangyo ◽  
...  

BACKGROUND In the face of growing modernity and the coronavirus disease 2019 (COVID-19) pandemic, open and distance learning (ODL) is considered to play an important role in increasing access to education worldwide. There is a robust evidence base demonstrating its cost effectiveness in comparison with conventional class-based teaching; however, the transition to this new paradigm of learning for nursing and midwifery courses has been difficult in low-income countries. While there are notable efforts to increase internet and education access to health care professionals, not much is known about ODL for nurses and midwives in East African countries. OBJECTIVE The objective of this scoping review is to understand whether ODL programs for nursing and midwifery education exist, the drivers of their adoption, their implementation, the topics/courses covered, their acceptability, and their impacts in East African countries. METHODS The scoping review methodology employs the framework developed by Arksey and O’Malley. Using an exploratory approach, a two-stage screening process consisting of a title and abstract scan and a full-text review will be used to determine the eligibility of articles. To be included, articles must report on an existing ODL initiative for nurses and midwives in Uganda, Tanzania, and Kenya. All articles will be independently assessed for eligibility by pairs of reviewers, and all eligible articles will be abstracted and charted in duplicate using a standardized form. RESULTS Details of ODL for nursing and midwifery education initiatives and study outcomes will be summarized in a table. The extracted data will undergo exploratory descriptive analysis, and the results will be classified into learner and clinical outcomes. CONCLUSIONS Evidence on ODL for nursing and midwifery education will inform the ongoing development and restructuring of health care professional education in East Africa amidst the COVID-19 pandemic. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/17765


PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248637
Author(s):  
Getayeneh Antehunegn Tesema ◽  
Yigizie Yeshaw ◽  
Misganaw Gebrie Worku ◽  
Zemenu Tadesse Tessema ◽  
Achamyeleh Birhanu Teshale

Background Childhood undernutrition is the leading cause of under-five mortality and morbidity in the world particularly in East African countries. Although there are studies on child undernutrition in different East African countries, our search of the literature revealed that there is limited evidence of a pooled analysis of these studies. Therefore, this study aimed to investigate the pooled prevalence and associated factors of chronic undernutrition (i.e. stunting) among under-five children in East Africa. Methods A pooled analysis of the Demographic and Health Surveys (DHSs) in 12 East African countries was conducted. A total weighted sample of 79744 under-five children was included in the study. Mixed-effect logistic regression analysis was used to identify significant factors associated with chronic undernutrition since the DHS data has a hierarchical structure. The intra-class correlation coefficient (ICC), Median Odds Ratio (MOR), Likelihood Ratio (LR)-test, and deviance was used for model comparison. Variables with p-value <0.2 in the bivariable mixed-effect logistic regression analysis were considered for the multivariable analysis. In the multivariable multilevel analysis model, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) were reported for significant factors. Results The pooled prevalence of chronic undernutrition among underfive children in East Africa was 33.3% (95% CI: 32.9%, 35.6%) ranging from 21.9% in Kenya to 53% in Burundi. Children whose mothers lived in rural area (AOR = 1.11, 95% CI: 1.06, 1.16), born to mother who had no formal education (AOR = 1.42, 95% CI: 1.34, 1.50) and primary education (AOR = 1.37, 95% CI: 1.31, 1.44), being in poor household (AOR = 1.66, 95% CI: 1.58, 1.74), and middle household (AOR = 1.42, 95% CI: 1.35, 1.49), child aged 36–48 months (AOR = 1.09, 95% CI: 1.04, 1.14), being male (AOR = 1.19, 95% CI: 1.15, 1.23), 2nd - 4th birth order (AOR = 1.08, 95% CI: 1.03, 1.13), and above 4th 1.27 (AOR = 1.27, 95% CI: 1.19, 1.35), home delivery 1.09 (AOR = 1.09, 95% CI: 1.05, 1.13), small size at birth (AOR = 1.35, 95% CI: 1.29, 1.40) and being multiple births (AOR = 1.98, 95% CI: 1.81, 2.17) were associated with increased odds of stunting. While, antenatal care visit (AOR = 0.89, 95% CI: 0.86, 0.93), mothers aged 25–34 (AOR = 0.83, 95% CI: 0.79, 0.86) and ≥ 35 years (AOR = 0.76, 95% CI: 0.72, 0.81), large size at birth (AOR = 0.85, 95% CI: 0.81, 0.88), and family size >8 (AOR = 0.92, 95% CI: 0.87, 0.98) were associated with decreased odds of stunting. Conclusion The study revealed that stunting among under-five children remains a major public health problem in East Africa. Therefore, to improve child nutrition status the governmental and non-governmental organizations should design public health interventions targeting rural residents, and the poorest households. Furthermore, enhancing health facility delivery, ANC visit, and maternal health education is vital for reducing child chronic undernutrition.


2020 ◽  
Author(s):  
Eunice Wambui Ndirangu ◽  
Ahmed Sarki ◽  
Columba Mbekenga ◽  
Grace Edwards

Abstract Background: Evidence suggests that there is a negative image of nursing and midwifery that does not promote nursing and midwifery as attractive career options. Furthermore, there is a paucity of studies documenting how nursing and midwifery is perceived in East Africa, and where such studies exist they are country-specific. The aim of this study was to explore views regarding the image of nursing and midwifery among nurses and midwives in three East African countries, Kenya, Tanzania and Uganda.Methods: An exploratory descriptive cross-sectional study administered online using Survey Monkey Questionnaires assessed the views and perceptions of nurses, midwives and doctors regarding the image of nursing and midwifery professions. Descriptive statistics and Pearson’s Chi square tests were used to analyse the data. All analyses were performed using SPSS version 24.Results: A total of 551 participants took part in the study. The majority were females (61.8%), registered nurses/midwives (45.8%), and aged 30-39 years (34.2%). The majority of the respondents were from Kenya (39.7%) and Uganda (32.9%). About two-thirds of the nurses and midwives in this study perceived nursing/midwifery as both trusted and respected professions and expressed having a level of control over how their image was portrayed. Conversely, the nurses and midwives were conscious that the public had mixed responses about the nursing/midwifery professions specifically, some members of the public described nurses/midwives as professionals, knowledgeable and caring, others perceived nurses/midwives to be rude, cruel, unkind, lazy, unkempt, and maids.Conclusion: This study offers an interesting insight about the image of nursing/midwifery in East Africa. Findings from this study will inform policy makers and educators about key concepts that affect the image of nursing and midwifery in East Africa. The findings will be used to design marketing materials to help improve the image of nursing and midwifery in the region and other African countries.


2020 ◽  
Author(s):  
FIRDISA BIRRU GOSHU

Abstract Self-employment plays a major role in the economic growth of Africa in general and East African countries in particular. It is a major source of new jobs and a way of employing the entrepreneurial abilities of the population. Moreover, self-employment allows people to do what they want and to follow their passion. However, populations in East Africa face various barriers that hinder their ability to start their own business and/or to become self-employed. Thus, the aim of this study is to examine the effects of government quality and economic indicators on self-employment. Data was taken for this study from World Bank’s World Development Indicators, Worldwide Governance Indicators, African development Bank and United Nations Development Program for eight East African countries for 2010-2018. The countries were selected based on the availability of panel data. The fixed effects result indicated that political Stability, control of corruption indices and Voice and accountability, natural logarithm of electricity access, mobile phone subscriptions, people living below income poverty line and primary education enrolment are favorably affecting self-employment in East Africa. The result also shows that the natural logarithm of employment in industry and real GDP growth have negative coefficients. . These findings suggest that in addition to economic and social indicators government quality have greater effect on self-employment in East Africa.


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