Prevention of Adolescent Pregnancy in Anglophone Sub-Saharan Africa: A Scoping Review of National Policies

Background: Despite the existence of preventive policies across sub-Saharan Africa, countries within the sub-region lead global rankings for rates of adolescent pregnancy. The aim of this scoping review was to identify and review national policies on the prevention of adolescent pregnancy in Anglophone sub-Saharan Africa. Methods: Relevant policies were identified from searches of national government websites and the search engine Google. Recognised screening and data extraction processes were used; data were subjected to content analysis using a published Framework for Evaluating Program and Policy Design on Adolescent Reproductive Health. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews guidelines was used in reporting the review. Results: In line with the inclusion criteria that guided the selection of relevant policies in this study, 17 of 75 national policies were suitable for the analysis. All were backed by political recognition, were government and public initiatives, acknowledged a range of determinants of adolescent pregnancy and allocated human resources to policy activities. Few specified financial resourcing. Most policies acknowledged the importance of coordination and collaboration among public and private actors. All policies had objectives that addressed adolescent pregnancy but none were measurable or included timeframes. Provision of comprehensive sexuality education and adolescent reproductive health services were the most common recommendations. Monitoring and evaluation plans were present in all the policies. However, youth involvement in policy formulation, and plans for implementation, monitoring and evaluation was scarce. Conclusion: Overall, national policy strengths were seen in relation to their political recognition, and all aspects of policy formulation. Policy implementation strengths and weaknesses were identified, the latter in relation to clear descriptions of financial resources. Importantly, the absence of measurable and time-bound objectives or formal evaluation of policy effectiveness confounds demonstration of what has been delivered and achieved. Youth involvement was notably absent in many policies. For future policy-setting, governments and policy-makers should make efforts to engage young people in policy development and to be transparent, realistic and address the necessary financial resourcing. They should set quantifiable policy objectives that provide a basis for assessing the adoption, uptake and effectiveness of policies in relation to measurable objectives.

Download Full-text

National Policies and Older People’s Healthcare in Sub-Saharan Africa: A Scoping Review

Annals of Global Health ◽

10.5334/aogh.2401 ◽

2019 ◽

Vol 85 (1) ◽

pp. 91 ◽

Cited By ~ 1

Author(s):

Sule Saka ◽

Frasia Oosthuizen ◽

Manimbulu Nlooto

Keyword(s):

Scoping Review ◽

Sub Saharan Africa ◽

National Policies ◽

Sub Saharan

Download Full-text

Male Participation in Reproductive Health Interventions in Sub-Saharan Africa: A Scoping Review

International Perspectives on Sexual and Reproductive Health ◽

10.1363/45e8119 ◽

2019 ◽

Vol 45 ◽

pp. 71

Author(s):

Nkwonta ◽

Messias

Keyword(s):

Reproductive Health ◽

Scoping Review ◽

Health Interventions ◽

Sub Saharan Africa ◽

Male Participation ◽

Sub Saharan

Download Full-text

Nature of, and responses to key sexual and reproductive health challenges for adolescents in urban slums in sub-Saharan Africa: a scoping review

Reproductive Health ◽

10.1186/s12978-020-00998-5 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Yohannes Dibaba Wado ◽

Martin Bangha ◽

Caroline W. Kabiru ◽

Garumma T. Feyissa

Keyword(s):

Young People ◽

Reproductive Health ◽

Urban Space ◽

Scoping Review ◽

Sexual And Reproductive Health ◽

Urban Slums ◽

Sub Saharan Africa ◽

Gender Based Violence ◽

Scoping Reviews ◽

Sub Saharan

Abstract Background Addressing adolescents’ sexual and reproductive health and rights (SRHR) requires an understanding of the socio-cultural and spatial settings within which they live. One setting of particular importance is the informal settlements or ‘slums’ that are gradually dominating the urban space. We undertook a scoping review and synthesis of existing evidence on adolescent SRHR in slums in sub-Saharan Africa (SSA) focusing on the characteristics and nature of existing evidence. Methods The scoping review was conducted based on Arksey and O’Malley framework and in accordance with the guidance on scoping reviews from the Joanna Briggs Institute (JBI) and using PRISMA reporting guidelines for scoping reviews. A comprehensive search was undertaken in PubMed, POPLINE, African Journals Online (AJOL), Bioline International and Google Scholar. The search was confined to studies published in peer reviewed journals and reports published online between January 2000 and May 2019. Studies were included in the review if they addressed SRHR issues among adolescents living in urban slums in SSA. Results The review included a total of 54 studies. The majority (79.5%) of studies were quantitative. The bulk of studies (85.2%) were observational studies with only eight intervention studies. While half (27) of the studies focused exclusively on adolescents (10–19 years), 12 studies combined adolescents with other young people (10–24 years). The studies were skewed towards sexual behavior (44%) and HIV/AIDS (43%) with very few studies focusing on other SRHR issues such as contraception, abortion, gender-based violence and sexually transmitted infections (STIs) other than HIV. Most of the studies highlighted the significantly higher risks for poor SRHR outcomes among adolescents in slums as compared to their peers in other settlements. Conclusion Young people growing up in slums face tremendous challenges in relation to their SRHR needs resulting in poor outcomes such as early and unintended pregnancy, STIs, and sexual violence. The results of this review point to several potential target areas for programming, policy, and research aimed at improved adolescent SRHR in slums in SSA.

Download Full-text

Mapping adolescent sexual and reproductive health research in sub-Saharan Africa: protocol for a scoping review

BMJ Open ◽

10.1136/bmjopen-2019-035335 ◽

2020 ◽

Vol 10 (7) ◽

pp. e035335

Author(s):

Anthony Idowu Ajayi ◽

Boniface Ayanbekongshie Ushie ◽

Meggie Mwoka ◽

Emmy Kageha Igonya ◽

Ramatou Ouedraogo ◽

...

Keyword(s):

Reproductive Health ◽

Scoping Review ◽

Sexual And Reproductive Health ◽

Grey Literature ◽

The Body ◽

Sub Saharan Africa ◽

Future Research ◽

Scoping Reviews ◽

Sub Saharan ◽

Full Search

IntroductionPrevious studies have attempted to review the vast body of evidence on adolescent sexual and reproductive health (ASRH), but none has focused on a complete mapping and synthesis of the body of inquiry and evidence on ASRH in sub-Saharan Africa (SSA). Such a comprehensive scoping is needed, however, to offer direction to policy, programming and future research. We aim to undertake a scoping review of studies on ASRH in SSA to capture the landscape of extant research and findings and identify gaps for future research.Methods and analysisThis protocol is designed using the framework for scoping reviews developed by the Joanna Briggs Institute. We will include English and French language peer-reviewed publications and grey literature on ASRH (aged 10–19) in SSA published between January 2010 and June 2019. A three-step search strategy involving an initial search of three databases to refine the keywords, a full search of all databases and screening of references of previous review studies for relevant articles missing from our full search will be employed. We will search AJOL, JSTOR, HINARI, Scopus, Science Direct, Google Scholar and the websites for the WHO, UNICEF, UNFPA, UNESCO and Guttmacher Institute. Two reviewers will screen the titles, abstracts and full texts of publications for eligibility and inclusion—using Covidence (an online software). We will then extract relevant information from studies that meet the inclusion criteria using a tailored extraction frame and template. Extracted data will be analysed using descriptive statistics and thematic analysis. Results will be presented using tables and charts and summaries of key themes arising from available research findings.Ethics and disseminationEthical approval is not required for a scoping review as it synthesises publicly available publications. Dissemination will be through publication in a peer-review journal and presentation at relevant conferences and convening of policymakers and civil society organisations working on ASRH in SSA.

Download Full-text

Adolescent sexual and reproductive health research in sub-Saharan Africa: a scoping review of substantive focus, research volume, geographic distribution and Africa-led inquiry

BMJ Global Health ◽

10.1136/bmjgh-2020-004129 ◽

2021 ◽

Vol 6 (2) ◽

pp. e004129

Author(s):

Anthony Idowu Ajayi ◽

Emmanuel Oloche Otukpa ◽

Meggie Mwoka ◽

Caroline W. Kabiru ◽

Boniface Ayanbekongshie Ushie

Keyword(s):

Reproductive Health ◽

Scoping Review ◽

Sexual And Reproductive Health ◽

Grey Literature ◽

The Body ◽

Sub Saharan Africa ◽

Ethical Review ◽

Future Research ◽

Sub Saharan ◽

Ssa Countries

BackgroundPrevious review studies have not systematically mapped the existing body of knowledge on adolescent sexual and reproductive health (ASRH) in sub-Saharan Africa (SSA). Our scoping review addresses this gap by examining how the body of research on ASRH in SSA has evolved over the past decade, and its present profile, in terms of trends in volume, geographic and substantive focus, and Africa-led inquiry.MethodsWe used a three-step search strategy to identify English and French peer-reviewed publications and relevant grey literature on ASRH in SSA published between January 2010 and December 2019. Two reviewers screened the titles, abstracts and full texts of publications for eligibility and inclusion.ResultsA total of 1302 articles were published over the period, rising from 91 in 2010 to 183 in 2015. However, the bulk of the studies (63.9%) focused on six (South Africa, Kenya, Nigeria, Tanzania, Uganda and Ethiopia) of the 46 SSA countries. Ten countries had no ASRH papers, while five others each had only one publication. While issues like HIV (17.2%), sexual behaviours (17.4%) and access to sexual and reproductive health services (13.0%) received substantial attention, only a few studies focused on early adolescence (10–14 years), programme interventions, scaling up of interventions and policy evaluation. Just over half of publications had authors with African institutional affiliations as first authors (51.1%) or last author (53.0%). Sixteen per cent of papers did not include any authors from institutions in Africa.ConclusionsOur review demonstrated that research on ASRH is limited in focus and is unevenly distributed across SSA countries. The identified gaps can guide future research and funding to advance ASRH policies and programmes. It is also vital for stakeholders in the research enterprise, including researchers, donors, ethical review boards, and journal editors and reviewers, to implement measures that foster national investigators’ inclusion.

Download Full-text

Protocol for a scoping review to identify and map in-service education and training materials for midwifery care in sub-Saharan Africa from 2000 to 2020

BMJ Open ◽

10.1136/bmjopen-2020-047118 ◽

2021 ◽

Vol 11 (3) ◽

pp. e047118

Author(s):

Joanne Welsh ◽

Mechthild M Gross ◽

Claudia Hanson ◽

Hashim Hounkpatin ◽

Ann-Beth Moller

Keyword(s):

Scoping Review ◽

Maternal Mortality Ratio ◽

Newborn Care ◽

Education And Training ◽

Sub Saharan Africa ◽

Midwifery Care ◽

Training Materials ◽

Service Training ◽

Sub Saharan ◽

And Training

IntroductionMaternal and neonatal mortality are disproportionally high in low-and middle-income countries. In 2017 the global maternal mortality ratio was estimated to be 211 per 100 000 live births. An estimated 66% of these deaths occurred in sub-Saharan Africa. Training programmes that aim to prepare providers of midwifery care vary considerably across sub-Saharan Africa in terms of length, content and quality. To overcome the shortfalls of pre-service training and support the provision of quality care, in-service training packages for providers of midwifery care have been developed and implemented in many countries in sub-Saharan Africa. We aim to identify what in-service education and training materials have been used for providers of midwifery care between 2000 and 2020 and map their content to the International Confederation of Midwives’ Essential Competencies for Midwifery Practice (ICM Competencies), and the Lancet Midwifery Series Quality Maternal and Newborn Care (QMNC) framework.Methods and analysisA search will be conducted for the years 2000–2020 in Cumulative Index of Nursing and Allied Health Literature, PubMed/MEDLINE, Social Sciences Citation Index, African Index Medicus and Google Scholar. A manual search of reference lists from identified studies and a hand search of literature from international partner organisations will be performed. Information retrieved will include study context, providers trained, focus of training and design of training. Original content of identified education and training materials will be obtained and mapped to the ICM Competencies and the Lancet Series QMNC.Ethics and disseminationA scoping review is a secondary analysis of published literature and does not require ethical approval. This scoping review will give an overview of the education and training materials used for in-service training for providers of midwifery care in sub-Saharan Africa. Mapping the content of these education and training materials to the ICM Competencies and The Lancet Series QMNC will allow us to assess their appropriateness. Findings from the review will be reflected to stakeholders involved in the design and implementation of such materials. Additionally, findings will be published in a peer-reviewed journal, and used to inform the design and content of an in-service training package for providers of midwifery care as part of the Action Leveraging Evidence to Reduce perinatal morTality and morbidity (ALERT) study, (https://alert.ki.se/) a multi-country study in Benin, Malawi, Tanzania and Uganda.Trial registration numberPACTR202006793783148; Post-results.

Download Full-text

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

Reproductive Health ◽

10.1186/s12978-021-01183-y ◽

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.

Download Full-text

Mapping evidence on the distribution of the costs associated with cancer of prostate, cervix, and female breast in the sub-Saharan Africa: protocol for a scoping review

Systematic Reviews ◽

10.1186/s13643-021-01672-y ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Cebisile Ngcamphalala ◽

Ellinor Ostensson ◽

Mbuzeleni Hlongwa ◽

Themba G. Ginindza

Keyword(s):

Systematic Reviews ◽

Scoping Review ◽

Economic Burden ◽

Indirect Costs ◽

Economic Consequences ◽

Sub Saharan Africa ◽

Breast Cancers ◽

Direct And Indirect Costs ◽

Female Breast ◽

Sub Saharan

Abstract Background Despite the well-documented information on cancer prevention and management, among noncommunicable diseases (NCDs), globally, cancer continues to be the second leading cause of morbidity and mortality with devastating economic consequences. The burden is disproportionately more among developing countries and the extent of evidence available on the economic consequences (direct and indirect costs) of cancer remains unknown in low-income countries particularly in the sub-Saharan region. Understanding the costs of illness is important to inform decision-making on setting up health care policies and informing economic evaluation of interventions. This study aims to map evidence on the distribution of the economic burden (direct and indirect costs) associated with prevention, diagnosis, and treatment of three predominant cancers: prostate, cervix, and female breast in the sub-Saharan Africa. Methods This scoping review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR), and will be conducted following Arksey and O’Malley’s framework. We will search PubMed/MEDLINE, Web of Science, CINHAL (via EBSCOhost platform), Science Direct, Cochrane Database of Systematic Reviews, Africa-Wide Information, Google Scholar, and WHO Library. We will perform hand-searching of the reference lists of included studies and other relevant documents. Two reviewers will independently screen all citations, full-text articles, and abstract data. We will include primary studies from all study designs reporting costs associated with prevention, diagnosis and treatment of prostate, cervical, and breast cancers in the sub-Saharan region. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., thematic analysis) methods. A narrative summary of findings will be presented. Discussion This review will map the extent of information available on the economic burden (direct and indirect costs) of prostate, cervical, and breast cancers in the sub-Saharan region. Further guidance for future research in the subject area will be discussed. Systematic review registration Open Science Framework

Download Full-text