scholarly journals Participants’ experiences of engagement in community-centred mental health and psychosocial support programmes in conflict-affected communities within sub-Saharan Africa: a qualitative systematic review

2021 ◽  
Vol 6 (12) ◽  
pp. e005388
Author(s):  
Cleothia Caroline Alford ◽  
Yuko Otake
Keyword(s):  
Mental Health ◽  
Sierra Leone ◽  
Low Income ◽  
Psychosocial Support ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Policy And Practice ◽  
Middle Income ◽  
Republic Of The Congo ◽  
Sub Saharan

BackgroundSub-Saharan Africa (SSA) experienced a burden of organised violence within 18 low-income and middle-income countries and hosted over 33 million displaced persons in 2019. Community-centred mental health and psychosocial support (cc-MHPSS) programmes may provide insights to address the psychosocial well-being of conflict-affected individuals, though literature is mixed on community impact. This review aimed to synthesise qualitative evidence to understand the kind of experiences conflict-affected participants have and how these experiences occur during cc-MHPSS programme engagement in SSA.MethodsWe searched Global Health, MEDLINE, Psychological Information Database, Embase Classic+Embase, Social Policy and Practice, Web of Science, Africa-Wide Information, PubMed and Global Index Medicus databases. Eligible publications qualitatively reported on conflict-affected participants’ experiences of engagement in cc-MHPSS programmes. Data were extracted to summarise publication characteristics. The results were synthesised using a thematic synthesis analysis.ResultsThe search yielded 953 records, of which 20 publications were included in the review. Included publications were located in Rwanda (n=8), the Democratic Republic of the Congo (n=3), Mozambique (n=3), Sierra Leone (n=1), Ghana (n=1), Uganda (n=1), Zimbabwe (n=1) and South Sudan (n=1); one publication included three countries (Sierra Leone, Liberia and Uganda). Findings include the themes of (1) the experience of change in time and space, and (2) the sharing and silence of participants’ experiences. Findings demonstrate that elements transferred by participants from a cc-MHPSS programme to a natural community, and vice versa, contribute to participants’ healing. Elements’ transfer, or non-transfer, was often related to participants’ disclosure, or non-disclosure, of experiences.DiscussionFindings suggest that there are elements from a cc-MHPSS programme and a wider community which aid participant engagement and work therapeutically. More rigorous research is needed concerning how participants experience change during cc-MHPSS programme engagement in proximity to their relationship with the wider community.PROSPERO registration numberCRD42020197300.

scholarly journals Adolescent Well-Being Gap Maps: What We Know and Opportunities for Future Research

2021 ◽  
Vol 16 (2-3) ◽  
pp. 124-158
Author(s):  
Prerna Banati ◽  
Christina Bacalso
Keyword(s):  
Youth Development ◽  
Research Policy ◽  
Emotional Health ◽  
Research Priorities ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Policy And Practice ◽  
Middle Income ◽  
Sub Saharan

Designing and delivering effective programs for adolescents and youth requires high-quality evidence that is easily available to decision makers. Yet while adolescence as a unique development period has gained policy attention in recent years, and there has been a growth in research, priorities for research investment remain unclear. This paper provides a panoramic view of adolescent development research to review what evidence exists and how evidence is mapped. Our approach interrogated studies mapped by evidence maps (including the subset evidence gap maps or EGMs). Our findings have implications for future directions of research on positive youth development (PYD) in low- and middle-income countries (LMICs): The analysis showed that while most evidence maps exist in the adolescent protection, safety, and security domain, most studies focus on outcomes related to well-being and social and emotional health. There are gaps in demographic groupings and contexts studied. For example, while gender and sex inequities were the most prevalent in the studies identified, though seen in less than 1/5 of the studies analyzed, disability appears in only 3%. Housing, participation, and information communication technologies are researched relatively rarely. Rigorous research in conflict or humanitarian settings is absent. Additionally, while most impact evaluations are conducted in sub-Saharan Africa, followed by Latin America, the Middle East and North America were poorly represented regions. This article reflects on the state of the evidence, argues for a more thoughtful approach to equity in adolescent research, and calls for a stronger link between research, policy, and practice in LMICs.

scholarly journals Mental Health and Psychosocial Support During COVID-19: A Review of Health Guidelines in Sub-Saharan Africa

2021 ◽  
Vol 12 ◽  
Author(s):  
Keneilwe Molebatsi ◽  
Otsetswe Musindo ◽  
Vuyokazi Ntlantsana ◽  
Grace Nduku Wambua
Keyword(s):  
Mental Health ◽  
Psychosocial Support ◽  
Well Being ◽  
Health Needs ◽  
Sub Saharan Africa ◽  
World Health ◽  
Mental Health Needs ◽  
Sub Saharan ◽  
The Impact ◽  
Ssa Countries

The COVID-19 pandemic brought in its wake an unforeseen mental health crisis. The World Health Organization published a guideline as a way of supporting mental health and psychosocial well-being of different groups during this pandemic. The impact of the pandemic has pushed governments to put measures in place to curb not only the physical health of individuals but their mental health and psychosocial well-being as well. The aim of our paper was to review mental health guidelines of some Sub Saharan African (SSA) countries: (i) to assess their appropriateness for the immediate mental health needs at this time, (ii) to form as a basis for ongoing reflection as the current pandemic evolves. Guidelines were retrieved openly from internet search and some were requested from mental health practitioners in various SSA countries. The authors designed a semi structured questionnaire, as a self-interview guide to gain insight on the experience of COVID-19 from experts in the mental health sector in the various countries. While we used a document analysis approach to analyze the data, we made use of the Mental Health Preparedness and Action Framework to discuss our findings. We received health or mental health guidelines from 10 SSA countries. Cameroon, Kenya, South Africa, Tanzania, and Uganda all had mental health guidelines or mental health component in their health guidelines. Our experts highlight that the mental health needs of the people are of concern during this pandemic but have not been given priority. They go further to suggest that the mental health needs are slightly different during this time and requiring a different approach especially considering the measures taken to curb the spread of disease. We conclude that despite the provision of Mental Health and Psychosocial Support guidelines, gaps still exist making them inadequate to meet the mental health needs of their communities.

scholarly journals Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

2020 ◽  
Vol 5 (11) ◽  
pp. e003423
Author(s):  
Dongqing Wang ◽  
Molin Wang ◽  
Anne Marie Darling ◽  
Nandita Perumal ◽  
Enju Liu ◽  
...  
Keyword(s):  
Weight Gain ◽  
North Africa ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Weight ◽  
Latin America And Caribbean ◽  
Nationally Representative ◽  
Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

scholarly journals Understanding cause of stillbirth: a prospective observational multi-country study from sub-Saharan Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mamuda Aminu ◽  
Sarah Bar-Zeev ◽  
Sarah White ◽  
Matthews Mathai ◽  
Nynke van den Broek
Keyword(s):  
Sierra Leone ◽  
Cause Of Death ◽  
Expert Panel ◽  
Healthcare Providers ◽  
Sub Saharan Africa ◽  
Primary Data ◽  
Middle Income ◽  
Computer Based ◽  
Sub Saharan ◽  
Low And Middle Income

Abstract Background Every year, an estimated 2.6 million stillbirths occur worldwide, with up to 98% occurring in low- and middle-income countries (LMIC). There is a paucity of primary data on cause of stillbirth from LMIC, and particularly from sub-Saharan Africa to inform effective interventions. This study aimed to identify the cause of stillbirths in low- and middle-income settings and compare methods of assessment. Methods This was a prospective, observational study in 12 hospitals in Kenya, Malawi, Sierra Leone and Zimbabwe. Stillbirths (28 weeks or more) were reviewed to assign the cause of death by healthcare providers, an expert panel and by using computer-based algorithms. Agreement between the three methods was compared using Kappa (κ) analysis. Cause of stillbirth and level of agreement between the methods used to assign cause of death. Results One thousand five hundred sixty-three stillbirths were studied. The stillbirth rate (per 1000 births) was 20.3 in Malawi, 34.7 in Zimbabwe, 38.8 in Kenya and 118.1 in Sierra Leone. Half (50.7%) of all stillbirths occurred during the intrapartum period. Cause of death (range) overall varied by method of assessment and included: asphyxia (18.5–37.4%), placental disorders (8.4–15.1%), maternal hypertensive disorders (5.1–13.6%), infections (4.3–9.0%), cord problems (3.3–6.5%), and ruptured uterus due to obstructed labour (2.6–6.1%). Cause of stillbirth was unknown in 17.9–26.0% of cases. Moderate agreement was observed for cause of stillbirth as assigned by the expert panel and by hospital-based healthcare providers who conducted perinatal death review (κ = 0.69; p < 0.0005). There was only minimal agreement between expert panel review or healthcare provider review and computer-based algorithms (κ = 0.34; 0.31 respectively p < 0.0005). Conclusions For the majority of stillbirths, an underlying likely cause of death could be determined despite limited diagnostic capacity. In these settings, more diagnostic information is, however, needed to establish a more specific cause of death for the majority of stillbirths. Existing computer-based algorithms used to assign cause of death require revision.

Financial well-being of customer-to-customer co-creation experience: a comparative qualitative focus group study of savings/credit groups

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nkosinathi Sithole ◽  
Gillian Sullivan Mort ◽  
Clare D'Souza
Keyword(s):  
Low Income ◽  
Financial Services ◽  
Well Being ◽  
Social Experiences ◽  
Sub Saharan Africa ◽  
Focus Group Study ◽  
Financial Capability ◽  
Content Type ◽  
Self Confidence ◽  
Sub Saharan

PurposeThis paper aims to explore the effects of the customer-to-customer co-creation experiences of savings/credit groups in the African context and how savings/credit groups influence financial capability and enhance financial well-being.Design/methodology/approachUsing purposive sampling, a study of a total of 18 focus groups was conducted in sub-Saharan Africa. Nine urban-based savings/credit groups were drawn from across South Africa and additional nine, rural-based savings/credit groups were studied in the Monduli district of Tanzania.FindingsFindings demonstrate that the African philosophy of Ubuntu, which promotes customer-to-customer interaction, is the cornerstone of the customer-to-customer co-creation experience. Ubuntu philosophical principles were found to influence the dialogue, access, risk and transparency model of co-creation and customer-dominant logic. The results show further that customer-to-customer co-creation experience positively influences the cognitive, financial, personal and social experiences of members. Specifically, it was found that cognitive and financial experiences positively influence financial satisfaction, financial self-esteem, financial self-efficacy and financial capability, all of which enhance financial well-being. In addition, personal and social experiences positively influence equality, self-confidence, entrepreneurial skills and motivation that in turn enhance social well-being.Research limitations/implicationsThis study has implications for many different stakeholders concerned with the financial inclusion of low-income consumers, particularly in the southern part of Africa.Originality/valueTo the authors’ knowledge, this is the first study to explore the effects of customer-to-customer co-creation experiences in traditional financial services settings in order to understand how these indigenous financial services influence the financial capability and financial well-being of co-creation members.

P1586Research network in Africa (RNA): antihypertensive drugs strategies in 12 African countries

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kane ◽  
P Cavagna ◽  
I B Diop ◽  
B Gaye ◽  
J B Mipinda ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Low Income ◽  
Democratic Republic ◽  
Antihypertensive Drugs ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Sub Saharan

Abstract Background High Blood Pressure is the worldwide leading global burden of disease risk factor. In Sub-Saharan Africa, the number of adults with raised blood pressure has alarmingly increased from 0.59 to 1.13 billion between 1975 and 2015. Blood pressure-lowering medicines are cornerstone of cardiovascular risk reduction. Data on management of anti-hypertensive drugs in sub-Saharan Africa are squarce. Purpose Our study aims to describe antihypertensive drugs strategies in Africa. Methods We conducted a cross-sectional survey in urban clinics during outpatient consultation specialized in hypertension cardiology departments of 29 medical centers from 17 cities across 12 African countries (Benin, Cameroon, Congo, Democratic Republic of Congo, Gabon, Guinea, Ivory Coast, Mauritania, Mozambic, Niger, Senegal, Togo). Data were collected on demographics, treatment and standardized BP measures were made among the hypertensive patients attending the clinics. Country income was retrieved from the World Bank database. All analyses were performed through scripts developed in the R software (3.4.1 (2017–06–30)). Results A total of 2198 hypertensive patients (58.4±11.8 years; 39.9% male) were included. Among whom 2123 (96.6%) had at least one antihypertensive drug. Overall, 30.8% (n=653) received monotherapy and calcium-channel blockers (49.6%) were the most common monotherapy prescribed follow by diuretics (18.7%). Two-drug strategies were prescribed for 927 patients (43.6%). Diuretics and Angiotensin-converting enzyme inhibitors was the combination most frequently prescribed (33.7%). Combination of three drugs or more was used in 25.6% (n=543) of patients. The proportion of drugs strategies differed significantly according to countries (p<0.001), monotherapy ranged from 12.7% in Niger to 47.1% in Democratic Republic of the Congo (figure). Furthermore we observed a significantly difference of strategies between low and middle income countries (55.3% and 44.7% of monotherapy respectively) (p<0.001). According to hypertension grades 1, 2 and 3, the proportion of three-drugs or more combination was 25%, 28% and 34% in middle-income and lower in low-income countries (18%, 19% and 25%). Furthermore, Grade 3 hypertension in low income countries was still treated with monotherapy (36%) instead of 19% in middle income countries (p<0.01). Antihypertensive strategies by country Conclusion Our study described antihypertensive drugs use across 12 sub-Saharan countries, and identified disparities specific to the income context. Inequity in access to drugs combination is a serious barrier to tackle the burden of hypertension in Africa.

Educational Psychology in Sub-Saharan Africa

2020 ◽  
Author(s):  
Irma Eloff
Keyword(s):  
Mental Health ◽  
Educational Psychology ◽  
Policy Development ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Theoretical Development ◽  
Strength Based ◽  
Global Goal ◽  
Sub Saharan ◽  
Educational Psychological

Educational psychology in Africa has a rich and colorful history. In sub-Saharan Africa educational psychology, as both a profession and a scientific field, is particularly vibrant. The emergence of educational psychology in sub-Saharan Africa shows how the science and the profession has pirouetted in ways that could support mental health and learning in African contexts in innovative ways. While emanating within Western cultures, educational psychology has been adapted and, perhaps, been deeply enriched in the African context. After the initial establishment of educational psychology in sub-Saharan Africa, three broad eras of theoretical development are evident: (a) the era of ecosystems and community, (b) the era of inclusion, and (c) the era of strength-based and positive approaches. During the era of ecosystems and community, emergent theories challenged the dominance of the individualist paradigms in educational psychology and provided broadened conceptualizations of the factors that impact mental health and effective learning. The role of communities was also given prominence. During the era of inclusion, the medical model was challenged as the primary foundation for legitimizing educational psychological assessments and interventions. Educational psychologists moved toward rights-based approaches that championed the rights of vulnerable populations and the creation of inclusive learning environments. The inclusion of children with disabilities influenced policy development in multiple sub-Saharan countries and expanded the dialogues on how best to support learning for all children. During the era of strength-based and positive approaches, theoretical and pragmatic approaches that forefront strengths, capacities, and possibilities started to develop. This era signified yet another departure from previous hegemonic paradigms in that educational psychology moved beyond the individual level, toward more systemic approaches, but then also used approaches that focused more on strengths and the mobilization of resources within these systems to address challenges and to optimize educational psychological support. These eras in the development of educational psychology in sub-Saharan Africa created optimal opportunities to respond to the United Nation’s Sustainable Development Goals (SDGs). In terms of SDGs, educational psychology responds primarily to Global Goal 3 (health and well-being) and Global Goal 4 (quality education). At the same time it supports the Global Goals of no poverty (1), gender equality (5), decent work and economic growth (8), reduced inequalities (10), sustainable cities and communities (11), and building partnerships for the goals (17).

scholarly journals Is overseas volunteering beneficial to the NHS? The analysis of volunteers’ responses to a feedback questionnaire following experiences in low-income and middle-income countries

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017517 ◽  
Author(s):  
Daniel Yeomans ◽  
Grace Le ◽  
Hemant Pandit ◽  
Chris Lavy
Keyword(s):  
Professional Development ◽  
Low Income ◽  
Personal Development ◽  
Positive Impact ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Feedback Questionnaire ◽  
Sub Saharan ◽  
The Uk

IntroductionLocally requested and planned overseas volunteering in low-income and middle-income countries by National Health Service (NHS) staff can have benefits for the host or receiving nation, but its impact on the professional development of NHS staff is not proven. The Knowledge and Skills Framework (KSF) and Leadership Framework (LF) are two tools used by employers as a measure of individuals' development. We have used dimensions from both tools as a method of evaluating the benefit to NHS doctors who volunteer overseas.Methods88 NHS volunteers participating with local colleagues in Primary Trauma Care and orthopaedic surgical training courses in sub-Saharan Africa were asked to complete an online self-assessment questionnaire 6 months following their return to the UK. The survey consisted of questions based on qualities outlined in both the KSF and LF.Results85 completed responses to the questionnaire were received. In every KSF domain assessed, the majority of volunteers agreed that their overseas volunteering experience improved their practice within the NHS. Self-assessed pre-course and post-course scores evaluating the LF also saw a universal increase, notably in the ‘working with others’ domain.DiscussionThere is a growing body of literature outlining the positive impact of overseas volunteering on NHS staff. Despite increasing evidence that such experiences can develop volunteers’ essential skills, individuals often find it difficult to gain support of their employers. Our study, in line with the current literature, shows that overseas volunteering by NHS staff can provide an opportunity to enhance professional and personal development. Skills gained from volunteering within international links match many of the qualities outlined in both KSF and LF, directly contributing to volunteers’ continued professional development.

scholarly journals The Causal Relationship Between China-Africa Trade, China OFDI, and Economic Growth of African Countries

SAGE Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 215824402110648
Author(s):  
Emma Serwaa Obobisa ◽  
Haibo Chen ◽  
Emmanuel Caesar Ayamba ◽  
Claudia Nyarko Mensah
Keyword(s):  
Economic Growth ◽  
Low Income ◽  
Negative Impact ◽  
Empirical Studies ◽  
Generalized Least Squares ◽  
Causal Link ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Middle Income ◽  
Sub Saharan

Recently, China has emerged as the largest trading partner and a significant source of investment in the African continent. Although there is consent on the increasing importance of China and Africa’s economic partnership, there are many controversies on how it affects African countries. Debates on China in Africa have, however, relied on grandiloquence rather than empirical studies. This study explores the causal link between China-Africa trade, China’s outward foreign direct (OFDI), and economic growth of 24 Sub-Saharan Africa countries from 1999 to 2018. The aggregated panel is classified into upper-middle-income, low-middle income, and low-income Sub-Saharan African countries. In the long run, key findings from the feasible generalized least squares (FGLS) estimator unveiled that; (i) China-Africa trade negatively contributes to economic growth among all panels. (ii) China’s OFDI improves economic growth in the low middle and low-income African countries whereas a significant negative liaison is evidenced in the upper-middle-income African countries. (iii) Labor force have a negative impact on economic growth whiles gross capital formation is evidenced to positively impact economic growth at all the panels. The Dumitrescu and Hurlin Granger causality unveiled a one-sided causal link from China-Africa trade to economic growth at all panels. The study proposes policy recommendations based on the results.

scholarly journals Delivering mental health and psychosocial support interventions to women and children in conflict settings: a systematic review

2020 ◽  
Vol 5 (3) ◽  
pp. e002014
Author(s):  
Mahdis Kamali ◽  
Mariella Munyuzangabo ◽  
Fahad J Siddiqui ◽  
Michelle F Gaffey ◽  
Sarah Meteke ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Low Income ◽  
Psychosocial Support ◽  
Grey Literature ◽  
Sub Saharan Africa ◽  
Observational Research ◽  
Intervention Coverage ◽  
Conflict Settings ◽  
Women And Children

BackgroundOver 240 million children live in countries affected by conflict or fragility, and such settings are known to be linked to increased psychological distress and risk of mental disorders. While guidelines are in place, high-quality evidence to inform mental health and psychosocial support (MHPSS) interventions in conflict settings is lacking. This systematic review aimed to synthesise existing information on the delivery, coverage and effectiveness of MHPSS for conflict-affected women and children in low-income and middle-income countries (LMICs).MethodsWe searched Medline, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Psychological Information Database (PsycINFO)databases for indexed literature published from January 1990 to March 2018. Grey literature was searched on the websites of 10 major humanitarian organisations. Eligible publications reported on an MHPSS intervention delivered to conflict-affected women or children in LMICs. We extracted and synthesised information on intervention delivery characteristics, including delivery site and personnel involved, as well as delivery barriers and facilitators, and we tabulated reported intervention coverage and effectiveness data.ResultsThe search yielded 37 854 unique records, of which 157 were included in the review. Most publications were situated in Sub-Saharan Africa (n=65) and Middle East and North Africa (n=36), and many reported on observational research studies (n=57) or were non-research reports (n=53). Almost half described MHPSS interventions targeted at children and adolescents (n=68). Psychosocial support was the most frequently reported intervention delivered, followed by training interventions and screening for referral or treatment. Only 19 publications reported on MHPSS intervention coverage or effectiveness.DiscussionDespite the growing literature, more efforts are needed to further establish and better document MHPSS intervention research and practice in conflict settings. Multisectoral collaboration and better use of existing social support networks are encouraged to increase reach and sustainability of MHPSS interventions.PROSPERO registration numberCRD42019125221.

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