scholarly journals The impact of the COVID-19 pandemic on hospital utilisation in Sierra Leone

2021 ◽  
Vol 6 (10) ◽  
pp. e005988
Author(s):  
Stephen Sevalie ◽  
Daniel Youkee ◽  
A J van Duinen ◽  
Emma Bailey ◽  
Thaimu Bangura ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Health Systems ◽  
Hospital Admissions ◽  
Qualitative Interviews ◽  
Sub Saharan Africa ◽  
Hospital Data ◽  
Sub Saharan ◽  
Hospital Utilisation ◽  
Student’S T ◽  
The Impact

IntroductionThe COVID-19 pandemic has adversely affected health systems in many countries, but little is known about effects on health systems in sub-Saharan Africa. This study examines the effects of COVID-19 on hospital utilisation in a sub-Saharan country, Sierra Leone.MethodsMixed-methods study using longitudinal nationwide hospital data (admissions, operations, deliveries and referrals) and qualitative interviews with healthcare workers and patients. Hospital data were compared across quarters (Q) in 2020, with day 1 of Q2 representing the start of the pandemic in Sierra Leone. Admissions are reported in total and disaggregated by sex, service (surgical, medical, maternity and paediatric) and hospital type (government or private non-profit). Referrals in 2020 were compared with 2019 to assess whether any changes were the result of seasonality. Comparisons were performed using Student’s t-test. Qualitative data were analysed using thematic analysis.ResultsFrom Q1 to Q2, weekly mean hospital admissions decreased by 14.7% (p=0.005). Larger decreases were seen in male 18.8% than female 12.5% admissions. The largest decreases were in surgical admissions, a 49.8% decrease (p<0.001) and medical admissions, a 28.7% decrease (p=0.002). Paediatric and maternity admissions did not significantly change. Total operations decreased by 13.9% (p<0.001), while caesarean sections and facility-based deliveries showed significant increases: 12.7% (p=0.014) and 7.5% (p=0.03), respectively. In Q3, total admissions remained 13.2% lower (p<0.001) than Q1. Mean weekly referrals were lower in Q2 and Q3 of 2020 compared with 2019, suggesting findings were unlikely to be seasonal. Qualitative analysis identified both supply-side factors, prioritisation of essential services, introduction of COVID-19 services and pausing elective care, and demand-side factors, fear of nosocomial infection and financial hardship.ConclusionThe study demonstrated a decrease in hospital utilisation during COVID-19, the decrease is less than reported in other countries during COVID-19 and less than reported during the Ebola epidemic.

scholarly journals The impact of the COVID-19 pandemic on health service utilisation in Sierra Leone

2021 ◽  
Author(s):  
Stephen Sevalie ◽  
Daniel Youkee ◽  
Alex J van Duinen ◽  
Emma Bailey ◽  
Thaimu Bangura ◽  
...  
Keyword(s):  
Health Service ◽  
Sierra Leone ◽  
Health Systems ◽  
Hospital Admissions ◽  
Health Service Utilisation ◽  
Sub Saharan Africa ◽  
Service Utilisation ◽  
Hospital Data ◽  
Sub Saharan ◽  
The Impact

Introduction: The COVID-19 pandemic has adversely affected health systems in many countries, but little is known about effects on health systems in sub-Saharan Africa. This study examines the effects of COVID-19 on health service utilisation in a sub-Saharan country, Sierra Leone. Methods: Mixed-methods study using longitudinal nationwide hospital data (admissions, operations, deliveries and referrals), and qualitative interviews with healthcare workers and patients. Hospital data were compared across Quarters (Q) in 2020, with day 1 of Q2 representing the start of the pandemic in Sierra Leone. Admissions are reported in total and disaggregated by sex, service (surgical, medical, maternity, paediatric), and hospital type (government or private not for profit). Referrals in 2020 were compared with 2019, to assess whether any changes were the result of seasonality. Comparisons were performed using students t test. Qualitative data were analysed using thematic analysis. Results: From Q1-Q2, weekly mean hospital admissions decreased by 14.7% (p=0.005). Larger decreases were seen in male 18.8%, than female 12.5% admissions. The largest decreases were in surgical admissions, a 49.8 % decrease (p<0.001) and medical admissions, a 28.7% decrease (p=0.002). Paediatric and maternity admissions did not significantly change. Total operations decreased by 13.9% (p<0.001), whilst caesarean sections and facility-based deliveries showed significant increases, 12.7 % (p=0.014) and 7.5% (p=0.03) respectively. In Q3 total admissions remained 13.2% lower (p<0.001) than Q1. Mean weekly referrals were lower in Q2 and Q3 of 2020 compared to 2019, suggesting findings were unlikely to be seasonal. Qualitative analysis identified both supply-side factors, prioritisation of essential services, introduction of COVID-19 services and pausing elective care, and demand-side factors, fear of nosocomial infection and financial hardship. Conclusion: The study demonstrated a decrease in health service utilisation during Covid-19, the decrease is less than in other countries during COVID-19 and less than reported during the Ebola epidemic.

scholarly journals Les petits exploitants agricoles à l’école inclusive : cas de l’apprentissage collectif par la vidéo et la radio sur la post-récolte du riz local au Bénin

2021 ◽  
Vol 15 (4) ◽  
pp. 1678-1697
Author(s):  
Espérance Zossou ◽  
Seth Graham-Acquaah ◽  
John Manful ◽  
Simplice D. Vodouhe ◽  
Rigobert C. Tossou
Keyword(s):  
Smallholder Farmers ◽  
Laboratory Data ◽  
Innovation System ◽  
Collective Learning ◽  
Sub Saharan Africa ◽  
Quality Analysis ◽  
Afrique Subsaharienne ◽  
Sub Saharan ◽  
Student’S T ◽  
The Impact

En Afrique subsaharienne, les petits exploitants agricoles ruraux ont difficilement accès aux connaissances et informations actualisées afin d’améliorer leur revenu. Pour renforcer l’apprentissage collectif au sein des acteurs des chaînes de valeur du riz local blanc et étuvé, la vidéo et la radio ont été utilisées de façon participative. La présente étude visait à comprendre l’influence de cet apprentissage collectif sur (i) le changement des pratiques des transformations et (ii) la qualité du riz local. Des interviews et suivis hebdomadaires ont été réalisés entre 2009 et 2018 au sud et nord du Bénin auprès de 240 transformateurs choisis aléatoirement. Des échantillons de riz ont été également collectés pour des analyses de qualité au laboratoire. L’analyse des données a été faite avec les tests t de Student, Wilcoxon, ANOVA, et le modèle de régression de Poisson. Les résultats ont montré une amélioration des pratiques de 14% ; 23% et 58% respectivement dans les villages contrôles, radio et vidéo. Dans le processus d’amélioration des pratiques, les transformateurs ont renforcé leur créativité en développant des technologies appropriées à leur environnement ; ce qui a eu un impact positif sur les qualités physiques et de cuisson du riz. Dans un contexte de pauvreté, d’insécurité alimentaire, de ruralité et d’analphabétisme, l’apprentissage collectif par la vidéo et la radio locale se révèle être une opportunité pour le renforcement du système d’innovation agricole.   English title: Smallholder farmers at inclusive school: Lessons learnt from collective  learning through video and radio on local rice processing in Benin In sub-Saharan Africa, rural smallholder farmers have limited access to timely and up-to-date knowledge and information to improve their incomes. To strengthen collective learning among rice sector’ stakeholders, videos and radio were participatory used. This study aims to assess the impact of this collective learning on (i) changing rice processors practices and (ii) the quality of local rice. Interviews and weekly follow-ups were conducted between 2009 and 2018 in southern and northern Benin with 240 randomly selected rice processors. Rice samples were also collected for quality analysis in the laboratory. Data analysis was done with Student's t-tests, Wilcoxon, one-way ANOVA, and the Poisson regression model. The results showed an improvement in rice processors practices of 14%; 23% and 58% respectively in control, video and radio villages. During the improvement of their practices, rice processors have increased their creativity by developing appropriate technologies to their environment; and this has positively impact on the physical and cooking qualities of the rice. In a context of poverty, food insecurity, rurality and illiteracy, collective learning through video and radio seems to be an opportunity to strengthen the agricultural innovation system, and a booster for change through adoption and adaptation of innovation.

scholarly journals Psychiatric comorbidity in African patients with epilepsy – Experience from Sierra Leone

2017 ◽  
Vol 04 (01) ◽  
pp. 026-030 ◽  
Author(s):  
Tenema M’bayo ◽  
Michal Tomek ◽  
Clifford Kamara ◽  
Durodami Lisk
Keyword(s):  
Sierra Leone ◽  
Primary Healthcare ◽  
Psychiatric Comorbidity ◽  
Sub Saharan Africa ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Screening Programs ◽  
Sub Saharan ◽  
The Impact

Abstract Objective Epilepsy is associated with a significant burden of psychiatric comorbidity, including depression and anxiety disorders. However, paucity of data exists regarding the impact of epilepsy on mental health of patients in the setting of sub-Saharan Africa, where these comorbidities are under-recognized and under-treated. We carried out a cross-sectional descriptive study to investigate the prevalence and determinants of depression and anxiety among people with epilepsy in Sierra Leone. Method A screening tool previously validated in the primary healthcare setting in Zambia was administered to adult patients in our epilepsy clinics in Freetown and Kenema, Sierra Leone. In addition, various socio-demographic and clinical characteristics were recorded for each patient. Results A total of 142 patients were included. The mean screening score was 16.3 out of 40, with 39 (27.5%) patients scoring above the diagnostic cut-off point for anxiety and/or depression. Variables showing a significant association with the presence of psychiatric comorbidity included female gender (p = 0.015), seizure frequency of >2 per month (p = 0.001), and self-reporting of sedation and/or dizziness as side effects of anti-epileptic medications (p = 0.006). Conclusion Symptoms of anxiety and depression are common in epilepsy patients in Sierra Leone. Given the significant negative impacts of such comorbidity on those affected, primary healthcare workers in sub-Saharan countries should be trained to inquire about anxiety and depression symptoms in epilepsy patients, and implementation of screening programs should be considered.

scholarly journals Delivery of nutrition services in health systems in sub-Saharan Africa: opportunities in Burkina Faso, Mozambique and Niger

2004 ◽  
Vol 7 (8) ◽  
pp. 1047-1053 ◽  
Author(s):  
Rachel D Hampshire ◽  
Victor M Aguayo ◽  
Hamani Harouna ◽  
Julie A Roley ◽  
Ann Tarini ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Health Systems ◽  
National Health ◽  
Sub Saharan Africa ◽  
Nutrition Services ◽  
Nutrition Training ◽  
Women And Children ◽  
Sub Saharan ◽  
The Impact

AbstractBackground:In sub-Saharan Africa, underweight and micronutrient deficiencies account for an estimated 25% of the burden of disease. As the coverage of national health systems expands, increased opportunities exist to address the needs of children and women, the most vulnerable to these deficiencies, through high-quality nutrition services.Objectives:To assess health providers' knowledge and practice with regard to essential nutrition services for women and children in Burkina Faso, Mozambique and Niger, in order to assist the development of a standard guide and tools to assess and monitor the quality of the nutrition services delivered through national health systems.Findings:The three surveys reveal the extent of missed opportunities to deliver nutrition services during routine prenatal, postnatal and child-care consultations for the prevention and treatment of highly prevalent nutritional deficiencies.Conclusion:A commitment to improving the quality of facility-based nutrition services is necessary to impact on the health outcomes of women and children ‘covered’ by national health systems. Rigorous assessment and monitoring of the quality of nutrition services should inform health programme and policy development. Building on the lessons learned in these three assessments, Helen Keller International has developed a standard Guide and Tools to assess the quality of the nutrition services delivered through national health systems. These tools can be adapted to assess ongoing nutrition services in health facilities, provide a framework for nutrition programming, inform the development of pre-service as well as in-service nutrition training curricula for providers, and evaluate the impact of nutrition training on providers' practices.

Conflicts in Biafra, Katanga and Cabinda as a result of the geopolitical legacy of colonialism

2020 ◽  
Vol 2020 (10-3) ◽  
pp. 238-246
Author(s):  
Olga Dzhenchakova
Keyword(s):  
Democratic Republic ◽  
Economic Factor ◽  
Colonial Period ◽  
Sub Saharan Africa ◽  
Negative Consequences ◽  
Post Colonial ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
The Republic ◽  
The Impact

The article considers the impact of the colonial past of some countries in sub-Saharan Africa and its effect on their development during the post-colonial period. The negative consequences of the geopolitical legacy of colonialism are shown on the example of three countries: Nigeria, the Democratic Republic of the Congo and the Republic of Angola, expressed in the emergence of conflicts in these countries based on ethno-cultural, religious and socio-economic contradictions. At the same time, the focus is made on the economic factor and the consequences of the consumer policy of the former metropolises pursuing their mercantile interests were mixed.

scholarly journals The impact and cost‐effectiveness of community‐basedHIVself‐testing in sub‐Saharan Africa: a health economic and modelling analysis

2019 ◽  
Vol 22 (S1) ◽  
pp. e25243 ◽  
Author(s):  
Valentina Cambiano ◽  
Cheryl C Johnson ◽  
Karin Hatzold ◽  
Fern Terris‐Prestholt ◽  
Hendy Maheswaran ◽  
...  
Keyword(s):  
Health Economic ◽  
Cost Effectiveness ◽  
Sub Saharan Africa ◽  
Modelling Analysis ◽  
Sub Saharan ◽  
The Impact

scholarly journals Financial Inclusion, Income Inequality and Sustainable Economic Growth in Sub-Saharan African Countries

2021 ◽  
Vol 13 (4) ◽  
pp. 1780
Author(s):  
Chima M. Menyelim ◽  
Abiola A. Babajide ◽  
Alexander E. Omankhanlen ◽  
Benjamin I. Ehikioya
Keyword(s):  
Economic Growth ◽  
Income Inequality ◽  
Financial Services ◽  
Sub Saharan Africa ◽  
Kuznets Curve ◽  
African Countries ◽  
Financial Access ◽  
Sub Saharan ◽  
Sustainable Economic Growth ◽  
The Impact

This study evaluates the relevance of inclusive financial access in moderating the effect of income inequality on economic growth in 48 countries in Sub-Saharan Africa (SSA) for the period 1995 to 2017. The findings using the Generalised Method of Moments (sys-GMM) technique show that inclusive financial access contributes to reducing inequality in the short run, contrary to the Kuznets curve. The result reveals a negative effect of financial access on the relationship between income inequality and economic growth. There is a positive net effect of inclusive financial access in moderating the impact of income inequality on economic growth. Given the need to achieve the Sustainable Development Targets in the sub-region, policymakers and other stakeholders of the economy must design policies and programmes that would enhance access to financial services as an essential mechanism to reduce income disparity and enhance sustainable economic growth.

scholarly journals Mapping 20 Years of Urban Expansion in 45 Urban Areas of Sub-Saharan Africa

2021 ◽  
Vol 13 (3) ◽  
pp. 525
Author(s):  
Yann Forget ◽  
Michal Shimoni ◽  
Marius Gilbert ◽  
Catherine Linard
Keyword(s):  
Case Studies ◽  
Urban Areas ◽  
Urban Expansion ◽  
Local Population ◽  
Sub Saharan Africa ◽  
Annual Growth Rate ◽  
Urban Dynamics ◽  
Mapping Approach ◽  
Sub Saharan ◽  
The Impact

By 2050, half of the net increase in the world’s population is expected to reside in sub-Saharan Africa (SSA), driving high urbanization rates and drastic land cover changes. However, the data-scarce environment of SSA limits our understanding of the urban dynamics in the region. In this context, Earth Observation (EO) is an opportunity to gather accurate and up-to-date spatial information on urban extents. During the last decade, the adoption of open-access policies by major EO programs (CBERS, Landsat, Sentinel) has allowed the production of several global high resolution (10–30 m) maps of human settlements. However, mapping accuracies in SSA are usually lower, limited by the lack of reference datasets to support the training and the validation of the classification models. Here we propose a mapping approach based on multi-sensor satellite imagery (Landsat, Sentinel-1, Envisat, ERS) and volunteered geographic information (OpenStreetMap) to solve the challenges of urban remote sensing in SSA. The proposed mapping approach is assessed in 17 case studies for an average F1-score of 0.93, and applied in 45 urban areas of SSA to produce a dataset of urban expansion from 1995 to 2015. Across the case studies, built-up areas averaged a compound annual growth rate of 5.5% between 1995 and 2015. The comparison with local population dynamics reveals the heterogeneity of urban dynamics in SSA. Overall, population densities in built-up areas are decreasing. However, the impact of population growth on urban expansion differs depending on the size of the urban area and its income class.

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