Dietary Patterns as Characterized by Food Processing Levels and Their Association with the Health Outcomes of Rural Women in East Africa

Overweight and obesity are rapidly rising in Sub-Saharan Africa including in rural areas. However, most studies focus on urban centers, and have attributed this epidemic to the consumption of processed foods without their clear characterization. This study investigated food intake patterns defined by food processing levels and their association with overweight/obesity in rural areas. Four 24-h dietary recalls, anthropometric measurements, and socio-demographic characteristics were collected from 1152 women in Kenya, Tanzania, and Uganda. The PCA method was used to extract patterns characterized by food processing levels. The association between patterns and overweight/obesity was ascertained with regression models. The overweight/obesity rate was 47%, 42%, 26%, and 38% in Kenya, Tanzania, Uganda, and East Africa (as pooled data), respectively. Several patterns were identified, yet a “plant-based pattern” largely characterized by unprocessed and minimally processed foods and a “purchase pattern” mainly distinguished by highly processed foods were dominant. The “plant-based pattern” was inversely or not associated with overweight/obesity, while the “purchase pattern” had a positive association or no association. A clear distinction on processed foods as healthy and unhealthy should be made based on their nutrient provision to avoid their mischaracterization as unhealthy. Policies to reverse consumption of unhealthy processed foods while promoting healthy ones should be pursued.

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A multilevel analysis of individual and contextual factors associated with the practice of safe disposal of children’s faeces in sub-Saharan Africa

PLoS ONE ◽

10.1371/journal.pone.0254774 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0254774

Author(s):

Abdul-Aziz Seidu ◽

Bright Opoku Ahinkorah ◽

Kwaku Kissah-Korsah ◽

Ebenezer Agbaglo ◽

Louis Kobina Dadzie ◽

...

Keyword(s):

Rural Women ◽

Rural Areas ◽

Contextual Factors ◽

Statistical Significance ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Safe Disposal ◽

Factors Associated ◽

Sub Saharan ◽

The Individual

Background Over the years, sanitation programs over the world have focused more on household sanitation, with limited attention towards the disposal of children’s stools. This lack of attention could be due to the misconception that children’s stools are harmless. The current study examined the individual and contextual predictors of safe disposal of children’s faeces among women in sub-Saharan Africa (SSA). Methods The study used secondary data involving 128,096 mother-child pairs of under-five children from the current Demographic and Health Surveys (DHS) in 15 sub-Saharan African countries from 2015 to 2018. Multilevel logistic analysis was used to assess the individual and contextual factors associated with the practice of safe disposal of children’s faeces. We presented the results as adjusted odds ratios (aOR) at a statistical significance of p< 0.05. Results The results show that 58.73% (57.79–59.68) of childbearing women in the 15 countries in SSA included in our study safely disposed off their children’s stools. This varied from as high as 85.90% (84.57–87.14) in Rwanda to as low as 26.38% (24.01–28.91) in Chad. At the individual level, the practice of safe disposal of children’s stools was more likely to occur among children aged 1, compared to those aged 0 [aOR = 1.74; 95% CI: 1.68–1.80] and those with diarrhoea compared to those without diarrhoea [aOR = 1.17, 95% CI: 1.13–1.21]. Mothers with primary level of education [aOR = 1.42, 95% CI: 1.30–1.5], those aged 35–39 [aOR = 1.20, 95% CI: 1.12–1.28], and those exposed to radio [aOR = 1.23, 95% CI: 1.20–1.27] were more likely to practice safe disposal of children’s stools. Conversely, the odds of safe disposal of children’s stool were lower among mothers who were married [aOR = 0.74, 95% CI: 0.69–0.80] and those who belonged to the Traditional African Religion [aOR = 0.64, 95% CI: 0.51–0.80]. With the contextual factors, women with improved water [aOR = 1.13, 95% CI: 1.10–1.16] and improved toilet facility [aOR = 5.75 95% CI: 5.55–5.95] had higher odds of safe disposal of children’s stool. On the other hand, mothers who lived in households with 5 or more children [aOR = 0.89, 95% CI: 0.86–0.93], those in rural areas [aOR = 0.86, 95% CI: 0.82–0.89], and those who lived in Central Africa [aOR = 0.19, 95% CI: 0.18–0.21] were less likely to practice safe disposal of children’s stools. Conclusion The findings indicate that between- and within-country contextual variations and commonalities need to be acknowledged in designing interventions to enhance safe disposal of children’s faeces. Audio-visual education on safe faecal disposal among rural women and large households can help enhance safe disposal. In light of the strong association between safe stool disposal and improved latrine use in SSA, governments need to develop feasible and cost-effective strategies to increase the number of households with access to improved toilet facilities.

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Sociodemographic Inequalities in Health Insurance Ownership among Women in Selected Francophone Countries in Sub-Saharan Africa

BioMed Research International ◽

10.1155/2021/6516202 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Yiting Wang ◽

Xuhui Wang ◽

Lu Ji ◽

Rui Huang

Keyword(s):

Health Insurance ◽

Rural Women ◽

Rural Areas ◽

Household Wealth ◽

Access To Healthcare ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Universal Healthcare ◽

Explanatory Factors ◽

Sub Saharan

In sub-Saharan Africa, improving equitable access to healthcare remains a major challenge for public health systems. Health policymakers encourage the adoption of health insurance schemes to promote universal healthcare. Nonetheless, progress towards this goal remains suboptimal due to inequalities health insurance ownership especially among women. In this study, we aimed to explore the sociodemographic factors contributing to health insurance ownership among women in selected francophone countries in sub-Saharan Africa. Methods. This study is based on cross-sectional data obtained from Demographic and Health Surveys on five countries including Benin ( n = 13,407 ), Madagascar ( n = 12,448 ), Mali ( n = 10,326 ), Niger ( n = 12,558 ), and Togo ( n = 6,979 ). The explanatory factors included participant age, marital status, type of residency, education, household wealth quantile, employment stats, and access to electronic media. Associations between health insurance ownership and the explanatory factors were analyzed using multivariate regression analysis, and effect sizes were reported in terms in average marginal effects (AMEs). Results. The highest percentage of insurance ownership was observed for Togo (3.31%), followed by Madagascar (2.23%) and Mali (2.2%). After stratifying by place of residency, the percentages were found to be significantly lower in the rural areas for all countries, with the most noticeable difference observed for Niger (7.73% in urban vs. 0.54% in rural women). Higher levels of education and wealth quantile were positively associated with insurance ownership in all five countries. In the pooled sample, women in the higher education category had higher likelihood of having an insurance: Benin ( AME = 1.18 ; 95% CI = 1.10 , 1.27), Madagascar ( AME = 1.10 ; 95% CI = 1.05 , 1.15), Mali ( AME = 1.14 ; 95% CI = 1.04 , 1.24), Niger ( AME = 1.13 ; 95% CI = 1.07 , 1.21), and Togo ( AME = 1.17 ; 95% CI = 1.09 , 1.26). Regarding wealth status, women from the households in the highest wealth quantile had 4% higher likelihood of having insurance in Benin and Mali and 6% higher likelihood in Madagascar and Togo. Conclusions. Percentage of women who reported having health insurance was noticeably low in all five countries. As indicated by the multivariate analyses, the actual situation is likely to be even worse due to significant socioeconomic inequalities in the distribution of women having an insurance plan. Increasing women’s access to healthcare is an urgent priority for population health promotion in these countries, and therefore, addressing the entrenched sociodemographic disparities should be given urgent policy attention in an effort to strengthen universal healthcare-related goals.

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Source-sink dynamics could sustain HIV epidemics in rural communities in sub-Saharan Africa: the case of Malawi

10.1101/468298 ◽

2018 ◽

Author(s):

Justin T. Okano ◽

Katie Sharp ◽

Laurence Palk ◽

Sally Blower

Keyword(s):

Rural Communities ◽

Geographic Variation ◽

Rural Areas ◽

Population Level ◽

Hiv Prevalence ◽

Sub Saharan Africa ◽

Heterosexual Transmission ◽

Urban Centers ◽

Mobility Data ◽

Sub Saharan

AbstractBackground:Approximately 25.5 million individuals are infected with HIV in sub-Saharan Africa (SSA). Epidemics in this region are generalized, show substantial geographic variation in prevalence, and are driven by heterosexual transmission; populations are highly mobile. We propose that generalized HIV epidemics should be viewed as a series of micro-epidemics occurring in multiple connected communities. Using a mathematical model, we test the hypothesis that travel can sustain HIV micro-epidemics in communities where transmission is too low to be self-sustaining. We use Malawi as a case study.Methods:We first conduct a mapping exercise to visualize geographic variation in HIV prevalence and population-level mobility. We construct maps by spatially interpolating georeferenced HIV-testing and mobility data from a nationally representative population-level survey: the 2015-16 Malawi Demographic and Health Survey. To test our hypothesis, we construct a novel HIV epidemic model that includes three transmission pathways: resident-to-resident, visitor-caused and travel-related. The model consists of communities functioning as “sources” and “sinks”. A community is a source if transmission is high enough to be self-sustaining, and a sink if it is not.Results:HIV prevalence ranges from zero to 27%. Mobility is high, 27% of the population took a trip lasting at least a month in the previous year. Prevalence is higher in urban centers than rural areas, but long-duration travel is higher in rural areas than urban centers. We show that a source-community can sustain a micro-epidemic in a sink-community, but only if specific epidemiological and demographic threshold conditions are met. The threshold depends upon the level of transmission in the source- and sink-communities, as well as the relative sizes of the two communities. The larger the source than the sink, the lower transmission in the source-community needs to be for sustainability.Discussion:Our results support our hypothesis, and suggest that it may be rather easy for large urban communities to sustain HIV micro-epidemics in small rural communities; this may be occurring in northern Malawi. Visitor-generated and travel-related transmission may also be sustaining micro-epidemics in rural communities in other SSA countries with highly-mobile populations. It is essential to consider mobility when developing HIV elimination strategies.

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How Women Entrepreneurs Impact

10.4018/978-1-7998-4646-8.ch009 ◽

2022 ◽

pp. 217-236

Keyword(s):

Rural Women ◽

Rural Areas ◽

Women Entrepreneurs ◽

Poverty Reduction ◽

Local Level ◽

Sub Saharan Africa ◽

Rural Setting ◽

Economic Role ◽

Sub Saharan

In this chapter, a case study of women entrepreneurs provides the avenue to understand the challenges of poverty reduction and social change at the grassroots level, particularly in rural areas. This case is first among three cases that are worth noting in this book because this case exemplifies women entrepreneurs in a rural setting, where they mobilize groups of women to transform their household and community, to help impoverished Tanzanian rural women increase earnings and autonomy through nonfarm business. From these perspectives and lessons garnered, there is a tacit but general agreement that women's economic role at the local level is critical for development and that women entrepreneurs are a great resource in the Sub-Saharan Africa region.

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Women's Income-Generating Activities and Gender Roles in Rural Households in Mayo Danay Division, Northern Cameroon

Journal of Social and Political Sciences ◽

10.31014/aior.1991.04.03.298 ◽

2021 ◽

Vol 4 (3) ◽

Author(s):

Julie Jasmine SILIKAM ◽

◽

Angeline Raymonde NGO ESSOUNGA

Keyword(s):

Gender Roles ◽

Rural Women ◽

Rural Areas ◽

Urban Areas ◽

Domestic Work ◽

Sub Saharan Africa ◽

Economic Activities ◽

Northern Cameroon ◽

Income Generating Activities ◽

Sub Saharan

In sub-Saharan Africa, women participate in the rural labor market where they are present in subsistence agro-pastoral activities, which are more domestic work and, in other income-generating rural activities such as trading. Within the studies carried out on women’s status in communities, those on women's access to income-generating activities in certain contexts such as Ghanaian urban areas, have revealed that, income-generating activities contribute to a redistribution of gender roles in households. This paper by questioning the impacts of women's economic activities on gender relations within households in rural areas of Northern Cameroon, aims to analyse the realities faced by women involved in income-generating activities in a particular rural area to assess if the changes mentioned above happened in all communities. The data used for this work are empirical data from a qualitative survey of 48 women living in 8 villages in Mayo Danay, an administrative territory in Northern Cameroon. The results of this survey reveal that rural women involved in income-generating activities are both breadwinners and domestic workers. Contrary to what was observed in Ghana, the status of female breadwinners does not participate in the emancipation of women. Indeed, even with their means of production, women are still dependent on men and are still alone to bear the burden of the domestic work. Access of women to income-generating activities and their participation in household expenditures have surely reduced poverty in households but have not contributed to gender roles changes.

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Women's Income-Generating Activities and Gender Roles in Rural Households in Mayo Danay Division, Northern Cameroon

10.31219/osf.io/9z6n8 ◽

2021 ◽

Author(s):

Julie Jasmine SILIKAM ◽

Angeline Raymonde NGO ESSOUNGA

Keyword(s):

Gender Roles ◽

Rural Women ◽

Rural Areas ◽

Urban Areas ◽

Domestic Work ◽

Sub Saharan Africa ◽

Economic Activities ◽

Northern Cameroon ◽

Income Generating Activities ◽

Sub Saharan

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Chronic Poverty in Sub-Saharan Africa and South Asia: A Select Annotated Bibliography with Special Reference to Remote Rural Areas

SSRN Electronic Journal ◽

10.2139/ssrn.1754547 ◽

2001 ◽

Cited By ~ 1

Author(s):

Sam Hickey ◽

Karen Moore

Keyword(s):

Special Reference ◽

South Asia ◽

Rural Areas ◽

Annotated Bibliography ◽

Sub Saharan Africa ◽

Chronic Poverty ◽

Sub Saharan

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Plasmodium vivax from Duffy-Negative and Duffy-Positive Individuals Shares Similar Gene Pool in East Africa

The Journal of Infectious Diseases ◽

10.1093/infdis/jiab063 ◽

2021 ◽

Author(s):

Daniel Kepple ◽

Alfred Hubbard ◽

Musab M Ali ◽

Beka R Abargero ◽

Karen Lopez ◽

...

Keyword(s):

Plasmodium Vivax ◽

East Africa ◽

Sub Saharan Africa ◽

Road Density ◽

Genetic Characteristics ◽

Plasmodium Vivax Malaria ◽

Genetic Clusters ◽

Sub Saharan ◽

The Impact ◽

Duffy Negative

Abstract Plasmodium vivax malaria was thought to be rare in Africa, but an increasing number of P. vivax cases reported across Africa and in Duffy-negative individuals challenges this conventional dogma. The genetic characteristics of P. vivax in Duffy-negative infections, the transmission of P. vivax in East Africa, and the impact of environments on transmission remain largely unknown. This study examined genetic and transmission features of P. vivax from 107 Duffy-negative and 305 Duffy-positive individuals in Ethiopia and Sudan. No clear genetic differentiation was found in P. vivax between the two Duffy groups, indicating between-host transmission. P. vivax from Ethiopia and Sudan showed similar genetic clusters, except samples from Khartoum, possibly due to distance and road density that inhibited parasite gene flow. This study is the first to show that P. vivax can transmit to and from Duffy-negative individuals and provides critical insights into the spread of P. vivax in sub-Saharan Africa.

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Malarial Infection in HIV Infected Pregnant Women Attending a Rural Antenatal Clinic in Nigeria

Advances in Epidemiology ◽

10.1155/2014/694213 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

R. S. Houmsou ◽

B. E. Wama ◽

S. O. Elkanah ◽

L. C. Garba ◽

T. D. Hile ◽

...

Keyword(s):

Risk Factors ◽

Haemoglobin Level ◽

Pregnant Women ◽

Rural Areas ◽

First Trimester ◽

Antenatal Clinic ◽

Severe Anaemia ◽

Sub Saharan Africa ◽

Malarial Infection ◽

Sub Saharan

Malaria still remains a challenging infection affecting the lives of several HIV infected pregnant women in sub-Saharan Africa. This study was undertaken to determine malarial infection in HIV infected pregnant women in relation to sociodemographic and obstetrical factors. The study also assessed relationship between malarial infection and haemoglobin level, CD4+ counts, and ART regimen, as well as predisposing risk factors that influenced occurrence of malarial infection in the women. Thick and thin blood smears were prepared and stained with Giemsa. Haemoglobin level was determined using a hematology analyzer, while the flow cytometry was used to measure CD4+ counts. Sociodemographic and obstetrical parameters were obtained through the administration of questionnaires. Of the 159 HIV infected pregnant women examined, 33.3% (59/159) had malarial infection. Malarial infection was significantly higher in pregnant women who were divorced, 40.24% (33/82) (χ2=5.72; P=0.05), were at their first trimester (4–12 weeks), 54.8% (17/31) (χ2=14.85; P=0.01), had CD4+ = [201–500 cells/μL], 42.42% (42/99) (χ2=10.13; P=0.00), and those that had severe anaemia (<8 dg/L), 100.00% (χ2= 45.75; P=0.00). However, risk factors that influenced the occurrence of malarial infection in the pregnant women were occupation (farming) (AOR=0.226; P=0.03), marital status (divorced) (AOR=2.80; P=0.02), gestation (first trimester) (AOR=0.33; P=0.00), haemoglobin level (Hb < 8 dg/L) (AOR=0.02; P=0.00), and CD4+ counts (low CD4+) (OR=0.40; P=0.05). The study reported endemicity of malaria in HIV infected pregnant women living in rural areas of Benue State, Nigeria. Malarial infection was higher in women that were divorced, and at their first trimester, had low CD4+ count, and had severe anaemia. Farming, divorce, gestation, severe anaemia, and low CD4+ counts were predisposing risk factors that influenced malaria occurrence in the HIV infected pregnant women. It is advocated that HIV infected pregnant women should be properly and thoroughly educated on malaria preventive measures in rural areas so as to avoid unpleasant effect of malaria during their pregnancies.

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Mitigation of the Water Crisis in Sub-Saharan Africa: Construction of Delocalized Water Collection and Retention Systems

Sustainability ◽

10.3390/su13041673 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1673

Author(s):

Adolfo F. L. Baratta ◽

Laura Calcagnini ◽

Abdoulaye Deyoko ◽

Fabrizio Finucci ◽

Antonio Magarò ◽

...

Keyword(s):

Rural Areas ◽

Water Shortage ◽

Sub Saharan Africa ◽

Economic Activities ◽

Research Project ◽

Water Utility ◽

Research Areas ◽

Emilia Romagna Region ◽

Sub Saharan ◽

Surrounding Areas

This paper presents the results of a three-year research project aimed at addressing the issue of water shortage and retention/collection in drought-affected rural areas of Sub-Saharan Africa. The project consisted in the design, construction, and the upgrade of existing barrages near Kita, the regional capital of Kayes in Mali. The effort was led by the Department of Architecture of Roma Tre University in partnership with the Onlus Gente d’Africa (who handled the on-the-ground logistics), the Department of Architecture of the University of Florence and the École Supérieure d’Ingénierie, d’Architecture et d’Urbanisme of Bamako, Mali. The practical realization of the project was made possible by Romagna Acque Società delle Fonti Ltd., a water utility supplying drinking water in the Emilia-Romagna region (Italy) that provided the financing as well as the operational contribution of AES Architettura Emergenza Sviluppo, a nonprofit association operating in the depressed areas of the world. The completion of the research project resulted in the replenishment of reservoirs and renewed presence of water in the subsoil of the surrounding areas. Several economic activities such as fishing and rice cultivation have spawned from the availability of water. The monitoring of these results is still ongoing; however, it is already possible to assess some critical issues highlighted, especially with the progress of the COVID-19 pandemic in the research areas.

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