scholarly journals Factors influencing COVID-19 vaccines hesitancy in rural and urban West Africa: Implications for vaccination strategies

2021 ◽  
Author(s):  
Sylvain Faye ◽  
Ralf Krumkamp ◽  
Seydou Doumbia ◽  
Moctar Tounkara ◽  
Ricardo Strauss ◽  
...  
Keyword(s):  
Social Media ◽  
West Africa ◽  
Sierra Leone ◽  
Adult Population ◽  
Sub Saharan Africa ◽  
Vaccine Hesitancy ◽  
Sources Of Information ◽  
Factors Influencing ◽  
Rural And Urban ◽  
Sub Saharan

Abstract Background: Raising immunization coverage against COVID-19, in particular in low- and middle-income countries (LMICs), is crucial in addressing the current pandemic. Additionally, in Africa reaching the necessary herd immunity threshold is jeopardized by factors, such as vaccine hesitancy. To build confidence in COVID-19 vaccines, it is important to understand and address the reasons for vaccine hesitancy. Yet, few studies for rural and urban Sub-Saharan Africa exist, which have analyzed these factors. Methods: This study reports on a cross-sectional survey in five West African countries (Burkina Faso, Guinea, Mali, Senegal, and Sierra Leone) to identify and describe factors influencing COVID-19 vaccine hesitancy in rural and urban settings. The survey was conducted at a time when in these countries the roll-out of COVID-19 vaccines had not yet or only just begun. Data were analyzed using descriptive statistics and Poisson regression models, with robust standard errors. The general protocol is registered on clinicaltrial.gov (protocol number: NCT04912284)Results: Findings show that in West Africa COVID-19 adult vaccine acceptance ranges from 60% in Guinea and 50% in Sierra Leone to 11% in Senegal. This is largely congruent with acceptance levels of COVID-19 vaccinations for children. Multivariable regression analysis shows that perceived effectiveness and safety of COVID-19 vaccines increased the willingness to get vaccinated, rather than socio-demographic factors, such as educational attainment and rural/urban residence. Primary sources of information about COVID-19 vaccines, include television, radio, and social media. Conclusions: Communication strategies addressed at the adult population using mass and social media, which emphasize COVID-19 vaccine effectiveness and safety, could encourage greater acceptance also of COVID-19 child vaccinations in Sub-Saharan countries.

scholarly journals Perceptions of Cannabis in sub-Saharan Africa: Findings from a general population survey in six African countries with different Cannabis policies.

2022 ◽  
Author(s):  
Chenai Kitchen ◽  
John Alimamy Kabba ◽  
Tonny Ssekamatte ◽  
Ediomo-Ubong Nelson ◽  
Samuel Adu-Gyamfi ◽  
...  
Keyword(s):  
South Africa ◽  
Sierra Leone ◽  
Online Survey ◽  
Adult Population ◽  
Sub Saharan Africa ◽  
Policy Position ◽  
Categorical Variables ◽  
African Countries ◽  
Country Level ◽  
Sub Saharan

Abstract Background Recently, legislative shifts in cannabis regulation away from exclusively prohibitionist controls have been seen in sub-Saharan African countries. However, the extent to which public perceptions are aligned with policy trends is unclear. Given that views concerning cannabis may be influenced by associated legislation we aimed to compare public opinion towards cannabis amongst countries with legislatively different cannabis policies. Methods We conducted an online survey of the general adult population in six purposively selected countries representative of maximum policy variation across sub-Saharan Africa i.e., Ghana, Nigeria, Sierra Leone, South Africa and Zimbabwe. Survey questions covered perceptions towards users, risks and benefits, regulations and public health impacts as well as sociodemographic characteristics. Chi square tests were used to analyse the association between categorical variables and explore country level differences. Results Totally 1216 responses were received. Large variations were noted in responses towards user stereotypes, risks and preferred legislation. In relation to users being honest (X2=43.316, P<0.0001), most in Sierra Leone(52.9%), Nigeria (45.6%) and Uganda(48.6%) disagreed whereas in Ghana(39.4%), South Africa(43.3%) and Zimbabwe(40.1%) most agreed. Differences in smoking cannabis and smoking tobacco products(X2= 27.712, P=0.002) saw respondents from Ghana(51.4%), Nigeria(58.8%), Uganda(50.9%) and Zimbabwe(46.8%) agreeing that smoking cannabis is more harmful to health, whereas majorities in Sierra Leone(45.7%) and South Africa(49.8%) disagreed. Apart from South Africa were the greater proportion opted to allow cannabis for all purposes(28.8%), majorities in other countries supported only medicinal legalisation(X2= 96.631, P<0.0001). Conclusion Dependent upon the question of focus, at the liberal end of the policy spectrum are Ghana, South Africa and Zimbabwe whilst Nigeria, Sierra Leone and Uganda were more conservative. Responses tended to reflect the policy position of respective countries, however our findings suggest overall increasing medicinal cannabis support. Greater understanding of policy dynamics may help create frameworks for countries contemplating reforms.

Faith Tabernacle Congregation, the 1918–19 Influenza Pandemic and Classical Pentecostalism in Colonial West Africa

2020 ◽  
Vol 26 (3) ◽  
pp. 219-238
Author(s):  
Adam Mohr
Keyword(s):  
West Africa ◽  
Influenza Pandemic ◽  
Assemblies Of God ◽  
Sub Saharan Africa ◽  
Orthodox Medicine ◽  
Massive Growth ◽  
Small Branch ◽  
Pentecostal Churches ◽  
Sub Saharan ◽  
Apostolic Church

The 1918–19 influenza pandemic killed between 30 and 50 million people worldwide. In Sub-Saharan Africa, as Terence Ranger points out, the pandemic left an indelible mark, including the unforeseen emergence of anti-medical religious movements. None were as significant as Faith Tabernacle Congregation, the Philadelphia-based divine-healing church that spurred a massive revival in West Africa – and a network stretching from Ivory Coast to Nigeria – without ever sending missionaries. They evangelised through personal letters exchanged across the Atlantic, and Faith Tabernacle literature sent from Philadelphia to various leaders in West Africa. The 1918–19 influenza pandemic was the spark that led to the church's massive growth, from one small branch before the pandemic began in 1918 to 10,500 members and nearly 250 branches of Faith Tabernacle in West Africa at its zenith in 1926. After the church's rapid demise between 1926 and 1929, leaders of Faith Tabernacle established most of the oldest Pentecostal Churches in the Gold Coast and Nigeria – such as the Apostolic Faith, the Apostolic Church, the Christ Apostolic Church and the Assemblies of God (Nigeria). Classical Pentecostalism, therefore, is Faith Tabernacle's legacy in West Africa, while abstinence from orthodox medicine continued to be debated within these Pentecostal circles.

scholarly journals Decomposing the rural–urban gap in factors associated with childhood immunisation in sub-Saharan Africa: evidence from surveys in 23 countries

2021 ◽  
Vol 6 (1) ◽  
pp. e003773
Author(s):  
Edward Kwabena Ameyaw ◽  
Yusuf Olushola Kareem ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Sanni Yaya
Keyword(s):  
Decomposition Analysis ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Childhood Immunisation ◽  
Urban Settings ◽  
Factors Associated ◽  
Rural And Urban ◽  
Full Immunisation ◽  
Sub Saharan

BackgroundAbout 31 million children in sub-Saharan Africa (SSA) suffer from immunisation preventable diseases yearly and more than half a million children die because of lack of access to immunisation. Immunisation coverage has stagnated at 72% in SSA over the past 6 years. Due to evidence that full immunisation of children may be determined by place of residence, this study aimed at investigating the rural–urban differential in full childhood immunisation in SSA.MethodsThe data used for this study consisted of 26 241 children pooled from 23 Demographic and Health Surveys conducted between 2010 and 2018 in SSA. We performed a Poisson regression analysis with robust Standard Errors (SEs) to determine the factors associated with full immunisation status for rural and urban children. Likewise, a multivariate decomposition analysis for non-linear response model was used to examine the contribution of the covariates to the observed rural and urban differential in full childhood immunisation. All analyses were performed using Stata software V.15.0 and associations with a p<0.05 were considered statistically significant.ResultsMore than half of children in urban settings were fully immunised (52.8%) while 59.3% of rural residents were not fully immunised. In all, 76.5% of rural–urban variation in full immunisation was attributable to differences in child and maternal characteristics. Household wealth was an important component contributing to the rural–urban gap. Specifically, richest wealth status substantially accounted for immunisation disparity (35.7%). First and sixth birth orders contributed 7.3% and 14.9%, respectively, towards the disparity while 7.9% of the disparity was attributable to distance to health facility.ConclusionThis study has emphasised the rural–urban disparity in childhood immunisation, with children in the urban settings more likely to complete immunisation. Subregional, national and community-level interventions to obviate this disparity should target children in rural settings, those from poor households and women who have difficulties in accessing healthcare facilities due to distance.

scholarly journals Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Lesley Rose Ninsiima ◽  
Isabel Kazanga Chiumia ◽  
Rawlance Ndejjo
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Health Workers ◽  
Sub Saharan Africa ◽  
Inclusion Criteria ◽  
Reproductive Health Services ◽  
Factors Influencing ◽  
Sub Saharan ◽  
Youth Friendly

Abstract Background Despite the global agreements on adolescents’ sexual and reproductive health and rights, access to and utilisation of these services among the youth/adolescents remain unsatisfactory in low- and middle-income countries which are a significant barrier to progress in this area. This review established factors influencing access and utilisation of youth-friendly sexual and reproductive health services (YFSRHS) among the youth in sub-Saharan Africa to inform programmatic interventions. Methodology A systematic review of studies published between January 2009 and April 2019 using PubMed, Web of Science, EMBASE, Medline, and Cochrane Library, and Google Scholar databases was conducted. Studies were screened based on the inclusion criteria of barriers and facilitators of implementation of YFSRHS, existing national policies on provision of YFSRHS, and youth’s perspectives on these services. Findings A total of 23,400 studies were identified through database search and additional 5 studies from other sources. After the full-text screening, 20 studies from 7 countries met the inclusion criteria and were included in the final review. Structural barriers were the negative attitude of health workers and their being unskilled and individual barriers included lack of knowledge among youth regarding YFSRHS. Facilitators of utilisation of the services were mostly structural in nature which included community outreaches, health education, and policy recommendations to improve implementation of the quality of health services and clinics for adolescents/youth to fit their needs and preferences. Conclusion Stakeholder interventions focusing on implementing YFSRHS should aim at intensive training of health workers and put in place quality implementation standard guidelines in clinics to offer services according to youth’s needs and preferences. In addition, educating the youth through community outreaches and health education programs for those in schools can facilitate utilisation and scale up of the service.

scholarly journals Community-driven citizen science approach to explore cardiovascular disease risk perception, and develop prevention advocacy strategies in sub-Saharan Africa: a programme protocol

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kufre Joseph Okop ◽  
Kathy Murphy ◽  
Estelle Victoria Lambert ◽  
Kiya Kedir ◽  
Hailemichael Getachew ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Citizen Science ◽  
Risk Perceptions ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Data Gathering ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Rural And Urban ◽  
Sub Saharan

Abstract Background In sub-Saharan Africa (SSA), which experiences a disproportionately high cardiovascular disease (CVD) burden, population-based screening and prevention measures are hampered by low levels of knowledge about CVD and associated risk factors, and inaccurate perceptions of severity of risk. Methods This protocol describes the planned processes for implementing community-driven participatory research, using a citizen science method to explore CVD risk perceptions and to develop community-specific advocacy and prevention strategies in the rural and urban SSA settings. Multi-disciplinary research teams in four selected African countries will engage with and train community members living in rural and urban communities as citizen scientists to facilitate conceptualization, co-designing of research, data gathering, and co-creation of knowledge that can lead to a shared agenda to support collaborative participation in community-engaged science. The emphasis is on robust community engagement, using mobile technology to support data gathering, participatory learning, and co-creation of knowledge and disease prevention advocacy. Discussion Contextual processes applied and lessons learned in specific settings will support redefining or disassembling boundaries in participatory science to foster effective implementation of sustainable prevention intervention programmes in Low- and Middle-income countries.

scholarly journals Wealth-related inequalities in demand for family planning satisfied among married and unmarried adolescent girls and young women in sub-Saharan Africa

2021 ◽  
Vol 18 (S1) ◽  
Author(s):  
Martin K. Mutua ◽  
Yohannes D. Wado ◽  
Monica Malata ◽  
Caroline W. Kabiru ◽  
Elsie Akwara ◽  
...  
Keyword(s):  
Family Planning ◽  
West Africa ◽  
Adolescent Girls ◽  
Young Women ◽  
Rate Of Change ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sexually Active ◽  
Sub Saharan ◽  
Over Time

Abstract Background The use of modern contraception has increased in much of sub-Saharan Africa (SSA). However, the extent to which changes have occurred across the wealth spectrum among adolescents is not well known. We examine poor-rich gaps in demand for family planning satisfied by modern methods (DFPSm) among sexually active adolescent girls and young women (AGYW) using data from national household surveys. Methods We used recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys to describe levels of wealth-related inequalities in DFPSm among sexually active AGYW using an asset index as an indicator of wealth. Further, we used data from countries with more than one survey conducted from 2000 to assess DFPSm trends. We fitted linear models to estimate annual average rate of change (AARC) by country. We fitted random effects regression models to estimate regional AARC in DFPSm. All analysis were stratified by marital status. Results Overall, there was significant wealth-related disparities in DFPSm in West Africa only (17.8 percentage points (pp)) among married AGYW. The disparities were significant in 5 out of 10 countries in Eastern, 2 out of 6 in Central, and 7 out of 12 in West among married AGYW and in 2 out of 6 in Central and 2 out of 9 in West Africa among unmarried AGYW. Overall, DFPSm among married AGYW increased over time in both poorest (AARC = 1.6%, p < 0.001) and richest (AARC = 1.4%, p < 0.001) households and among unmarried AGYW from poorest households (AARC = 0.8%, p = 0.045). DPFSm increased over time among married and unmarried AGYW from poorest households in Eastern (AARC = 2.4%, p < 0.001) and Southern sub-regions (AARC = 2.1%, p = 0.030) respectively. Rwanda and Liberia had the largest increases in DPFSm among married AGYW from poorest (AARC = 5.2%, p < 0.001) and richest (AARC = 5.3%, p < 0.001) households respectively. There were decreasing DFPSm trends among both married (AARC = − 1.7%, p < 0.001) and unmarried (AARC = − 4.7%, p < 0.001) AGYW from poorest households in Mozambique. Conclusion Despite rapid improvements in DFPSm among married AGYW from the poorest households in many SSA countries there have been only modest reductions in wealth-related inequalities. Significant inequalities remain, especially among married AGYW. DFPSm stalled in most sub-regions among unmarried AGYW.

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.

Factors Influencing Contraceptive Use in Sub-Saharan Africa: A Systematic Review

2017 ◽  
Vol 37 (2) ◽  
pp. 79-91 ◽  
Author(s):  
Sarah R. Blackstone ◽  
Ucheoma Nwaozuru ◽  
Juliet Iwelunmor
Keyword(s):  
Contraceptive Use ◽  
Male Partner ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
African Countries ◽  
Factors Influencing ◽  
Contraceptive Side Effects ◽  
Modern Contraceptive Use ◽  
Negative Perceptions ◽  
Sub Saharan

The purpose of this study was to systematically review the literature regarding factors influencing contraceptive use in sub-Saharan Africa between 2005 and 2015. A total of 58 studies from twelve Sub-Saharan African countries were reviewed. Keywords were grouped using the PEN-3 cultural model. Negative factors prohibiting or reducing contraceptive use were women’s misconceptions of contraceptive side–effects, male partner disapproval, and social/cultural norms surrounding fertility. Positive factors included education, employment, and communication with male partner. Increasing modern contraceptive use in Sub-Saharan Africa is a multi-faceted problem that will require community and systems wide interventions that aim to counteract negative perceptions and misinformation.

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