scholarly journals The Crucial Role of Mothers and Siblings in Child Survival: Evidence From 29 Health and Demographic Surveillance Systems in Sub-Saharan Africa

Demography ◽  
2021 ◽  
Vol 58 (5) ◽  
pp. 1687-1713
Author(s):  
Philippe Bocquier ◽  
Carren Ginsburg ◽  
Ashira Menashe-Oren ◽  
Yacouba Compaoré ◽  
Mark Collinson
Keyword(s):  
Child Mortality ◽  
Birth Interval ◽  
Child Survival ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Birth Intervals ◽  
Sub Saharan ◽  
Demographic Surveillance Systems ◽  
Older Sibling

Abstract A considerable body of research has studied the effects of siblings on child mortality through birth intervals. This research has commonly focused on older siblings. We argue that birth intervals with younger siblings may have equal or stronger effects on child mortality, even during a mother's pregnancy. Moreover, we contend that birth interval effects need to be considered only when siblings are coresident. Using longitudinal data from 29 Health and Demographic Surveillance Systems across sub-Saharan Africa, covering more than 560,000 children, we examine the proximate role of siblings and mothers in child mortality. We find that a birth interval of 24 months or more is advantageous for both older and younger siblings. The effect of a younger sibling on child mortality is more pronounced than that of an older sibling and adds to the effect of an older sibling. Moreover, child mortality is particularly low during a mother's subsequent pregnancy, contrasting the shock resulting from a younger sibling's birth. Further, we find that a mother's or sibling's absence from the household results in a higher risk of mortality, and the death of either reduces child survival up to six months before the death.

scholarly journals Geographic coverage of demographic surveillance systems for characterising the drivers of childhood mortality in sub-Saharan Africa

2018 ◽  
Vol 3 (2) ◽  
pp. e000611 ◽  
Author(s):  
C Edson Utazi ◽  
Sujit K Sahu ◽  
Peter M Atkinson ◽  
Natalia Tejedor-Garavito ◽  
Christopher T Lloyd ◽  
...  
Keyword(s):  
International Health ◽  
Childhood Mortality ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
African Countries ◽  
Factors Associated ◽  
Development Goals ◽  
Sub Saharan ◽  
Reduction Of Mortality ◽  
Demographic Surveillance Systems

A major focus of international health and development goals is the reduction of mortality rates in children under 5 years of age. Achieving this requires understanding the drivers of mortality and how they vary geographically to facilitate the targeting and prioritisation of appropriate interventions. Much of our knowledge on the causes of, and trends in, childhood mortality come from longitudinal demographic surveillance sites, with a renewed focus recently on the establishment and growth of networks of sites from which standardised outputs can facilitate broader understanding of processes. To ensure that the collective outputs from surveillance sites can be used to derive a comprehensive understanding and monitoring system for driving policy on tackling childhood mortality, confidence is needed that existing and planned networks of sites are providing a reliable and representative picture of the geographical variation in factors associated with mortality. Here, we assembled subnational data on childhood mortality as well as key factors known to be associated with it from household surveys in 27 sub-Saharan African countries. We then mapped the locations of existing longitudinal demographic surveillance sites to assess the extent of current coverage of the range of factors, identifying where gaps exist. The results highlight regions with unique combinations of factors associated with childhood mortality that are poorly represented by the current distribution of sites, such as southern Mali, central Nigeria and southern Zambia. Finally, we determined where the establishment of new surveillance systems could improve coverage.

scholarly journals Towards an appropriate ethics framework for Health and Demographic Surveillance Systems (HDSS): learning from issues faced in diverse HDSS in sub-Saharan Africa

2021 ◽  
Vol 6 (1) ◽  
pp. e004008
Author(s):  
Alex Nginyo Hinga ◽  
Sassy Molyneux ◽  
Vicki Marsh
Keyword(s):  
Ethical Issues ◽  
A Priori ◽  
Public Health Practice ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Science Literature ◽  
Ethics Framework ◽  
Sub Saharan ◽  
Demographic Surveillance Systems ◽  
And Migration

IntroductionHealth and Demographic Surveillance Systems (HDSS) collect data on births, deaths and migration from relatively small, geographically defined populations primarily in Africa and Asia. HDSS occupy a grey area between research, healthcare and public health practice and it is unclear how ethics guidance that rely on a research-practice distinction apply to HDSS. This topic has received little attention in the literature. In this paper, based on empirical research across sub-Saharan Africa, we map out key ethical issues for HDSS and assess the relevance of current ethics guidance in relation to these findings.MethodsWe conducted a qualitative study across seven HDSS sites in sub-Saharan Africa, including individual in-depth interviews and informal discussions with 68 research staff, document reviews and non-participant observations of surveillance activities. Qualitative data analysis drew on a framework approach led by a priori and emergent themes, drawing on the wider ethics and social science literature.ResultsThere were diverse views on core ethical issues in HDSS, including regarding the strengths and challenges of community engagement, informed consent and data sharing processes. A key emerging issue was unfairness in the overall balance of benefits and burdens for residents and front-line staff when compared with other stakeholders, particularly given the socioeconomic contexts in which HDSS are generally conducted.ConclusionWe argue that HDSS operate as non-traditional epidemiologic research projects but are often governed using ethics guidance developed for traditional forms of health research. There is a need for specific ethics guidance for HDSS which prioritises considerations around fairness, cost-effectiveness, ancillary care responsibilities, longitudinality and obligations of the global community to HDSS residents.

scholarly journals Vitamin A Deficiency and Child Survival in Sub-Saharan Africa: A Reappraisal of Challenges and Opportunities

2005 ◽  
Vol 26 (4) ◽  
pp. 348-355 ◽  
Author(s):  
Victor M. Aguayo ◽  
Shawn K. Baker
Keyword(s):  
At Risk ◽  
Vitamin A ◽  
Child Mortality ◽  
Vitamin A Deficiency ◽  
Child Survival ◽  
Sub Saharan Africa ◽  
Children At Risk ◽  
Potential Child ◽  
Sub Saharan ◽  
Policies And Programs

Background Children with vitamin A deficiency have higher risk of morbidity and mortality than vitamin A–sufficient children. Estimates on the potential child survival benefits of vitamin A deficiency control are needed for policy and program advocacy. Objective To determine the current prevalence of children at risk for vitamin A deficiency in sub-Saharan Africa in order to estimate the potential child-survival benefits of effective and sustained policies and programs for the control of vitamin A deficiency in this region. Methods Estimates of the prevalence of vitamin A deficiency generated in 1998, data from 11 nationally representative vitamin A deficiency surveys conducted in sub-Saharan Africa between 1997 and 2003, and the measured effects of vitamin A deficiency on child mortality were combined to estimate the prevalence of children at risk for vitamin A deficiency in sub-Saharan Africa and the potential child-survival benefits of effective and sustained policies and programs for the control of vitamin A deficiency in this region. Results Our analysis shows that in the absence of effective and sustained policies and programs for the control of vitamin A deficiency, an estimated 42.4% of children 0 to 59 months of age in sub-Saharan Africa (43.2 million children) are at risk for vitamin A deficiency. Such effective and sustained policy and program action for the control of vitamin A deficiency can bring about a potential 25% reduction in mortality in children 0 to 59 months with respect to 1995 mortality levels (i.e., before the onset of large-scale vitamin A supplementation programs in sub-Saharan Africa). Conclusions Effective and sustained control of vitamin A deficiency has the potential to be among the most cost-effective and high-impact child-survival interventions in sub-Saharan Africa. A stronger political commitment and a more appropriate level of investment in the effective control of vitamin A deficiency could make a large contribution toward the attainment of the Millennium Development Goal for the reduction of child mortality rates by two-thirds between 1990 and 2015. Among the many challenges that Africa will need to face in the coming years, vitamin A deficiency is one that can be overcome. The need is urgent, and the solutions are known, effective, and affordable.

scholarly journals Pursuing the limits of child survival in the most and least developed countries

2019 ◽  
Author(s):  
Iván Mejía-Guevara ◽  
Wenyun Zuo ◽  
Laust H. Mortensen ◽  
Shripad Tuljapurkar
Keyword(s):  
Child Mortality ◽  
Child Survival ◽  
National Income ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Least Developed Countries ◽  
Life Expectancy At Birth ◽  
The Usa ◽  
Age Patterns ◽  
Sub Saharan

Summary paragraphThe epidemiological transition from young to old deaths in high-income countries reduced mortality at all ages, but a major role was played by a decline of infant and child mortality from infectious diseases1,2 that greatly increased life expectancy at birth2,3. Over time, declines in infectious disease continue but chronic and degenerative causes persist4,5, so we might expect under-5 deaths to be concentrated in the first month of life. However, little is known about the age-pattern of this transition in early mortality or its potential limits. Here we first describe the limit using detailed data on Denmark, Japan, France, and the USA— developed countries with low under-5 mortality. The limiting pattern of under-5 deaths concentrates in the first month, but is surprisingly dispersed over later ages: we call this the early rectangularization of mortality. Then we examine the progress towards this limit of 31 developing countries from sub-Saharan Africa (SSA)—the region with the highest under-5 mortality6. In these countries, we find that early deaths have large age-heterogeneities; and that the age patterns of death is an important marker of progress in the mortality transition at early ages. But a negative association between national income and under-5 mortality levels, confirmed here, does not help explain reductions in child mortality during the transition.

Islam and Economic Development in Sub-Saharan Africa

2021 ◽  
Author(s):  
Melina R. Platas
Keyword(s):  
Social Services ◽  
Child Mortality ◽  
Sub Saharan Africa ◽  
Colonial Legacies ◽  
Historical Role ◽  
Sub Saharan ◽  
Development Outcomes ◽  
Development Trajectories

The world’s fastest-growing Muslim population resides in sub-Saharan Africa, a region that experiences the lowest levels of economic and human development globally. This chapter shows that Muslims in Africa often experience worse development outcomes than Christians. Across countries, Muslim majority countries are on average poorer, with higher levels of child mortality and lower levels of education, than countries where Muslims are a minority. Within countries, Muslims have fewer years of education than Christians, and experience higher rates of child mortality in a number of countries as well. The chapter discusses three channels through which religion may matter in explaining these divergent development trajectories: institutions, norms and beliefs, and geography. There is evidence of a role for both institutions and norms and beliefs in explaining gaps in development outcomes between Christians and Muslims. However, it is not necessarily the religious content of institutions or beliefs that matters. Colonial legacies that differ across Muslim and non-Muslim areas and the historical role of Christian missionaries in providing social services in Africa are among the factors that also appear to affect long-term development trajectories.

Crowdsourcing Covid-19 signals in sub-Saharan Africa: Leveraging digital contributor networks for participatory surveillance of Covid-19 symptoms and deaths (Preprint)

2020 ◽  
Author(s):  
Ngozi A Erondu ◽  
Sagal A Ali ◽  
Mohamed Ali ◽  
Schadrac C Agbla
Keyword(s):  
Public Health ◽  
Sub Saharan Africa ◽  
Specific Information ◽  
Surveillance Systems ◽  
Health Seeking ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Local Networks ◽  
The World ◽  
Sub Saharan

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.

Financing Energy Access in Africa

2018 ◽  
Author(s):  
Peter Kayode Oniemola ◽  
Jane Ezirigwe
Keyword(s):  
Oil And Gas ◽  
Sub Saharan Africa ◽  
Capital Investments ◽  
Energy Access ◽  
African Countries ◽  
Sustainable Technologies ◽  
Energy Technologies ◽  
Sub Saharan ◽  
Diesel Motors

To achieve universal energy access will attract huge capital investments. If sub-Saharan Africa is to realize anything close to the ambitious goals set for its energy access, then new actors, innovative funding mechanisms and sustainable technologies will have to be attracted. Finance is needed for activities such as rural electrification, clean cooking facilities, diesel motors and generators, other renewable energy technologies, oil and gas infrastructures, etc. Finance is also needed in research and development of suitable technologies and funding options as well as investment in the capacity to formulate and implement sound energy policies. This chapter examines the varied financing options for energy access in sub-Saharan Africa. It argues that with appropriate laws in place and effective mechanism for implementation, African countries can significantly engage private sector financing, international financial institutions and foreign donors. The role of the law here will be in creating an enabling environment for financing.

Human Development Paradigm for South Asia

2018 ◽  
Keyword(s):  
South Asia ◽  
Human Development ◽  
Sub Saharan Africa ◽  
Health And Nutrition ◽  
The People ◽  
Sub Saharan ◽  
Development Paradigm

In the chapter, Haq gives a snapshot of the human progress of South Asia, comparing it with other regions. He was worried about the region beginning to lag behind all other regions, including Sub-Saharan Africa. He highlights the role of the two largest economies in the region, India and Pakistan, in financing the major investment in education, health and nutrition for the people. Haq advocates some fiscal and monetary reforms are suggested to invest in human development.

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