scholarly journals Training for Rural Radiology and Imaging in Sub-Saharan Africa: Addressing the Mismatch Between Services and Population

2012 ◽  
Vol 2 ◽  
pp. 37 ◽  
Author(s):  
Michael G. Kawooya

The objectives of this review are to outline the needs, challenges, and training interventions for rural radiology (RR) training in Sub-Saharan Africa (SSA). Rural radiology may be defined as imaging requirements of the rural communities. In SSA, over 80% of the population is rural. The literature was reviewed to determine the need for imaging in rural Africa, the challenges, and training interventions. Up to 50% of the patients in the rural health facilities in Uganda may require imaging, largely ultrasound and plain radiography. In Uganda, imaging is performed, on an average, in 50% of the deserving patients in the urban areas, compared to 10–13 % in the rural areas. Imaging has been shown to increase the utilization of facility-based rural health services and to impact management decisions. The challenges in the rural areas are different from those in the urban areas. These are related to disease spectrum, human resource, and socio-economic, socio-cultural, infrastructural, and academic disparities. Countries in Sub-Saharan Africa, for which information on training intervention was available, included: Uganda, Kenya, Tanzania, Rwanda, Zambia, Ghana, Malawi, and Sudan. Favorable national policies had been instrumental in implementing these interventions. The interventions had been made by public, private-for-profit (PFP), private-not-for profit (PNFP), local, and international academic institutions, personal initiatives, and professional societies. Ultrasound and plain radiography were the main focus. Despite these efforts, there were still gross disparities in the RR services for SSA. In conclusion, there have been training interventions targeted toward RR in Africa. However, gross disparities in RR provision persist, requiring an effective policy, plus a more organized, focused, and sustainable approach, by the stakeholders.

Africa ◽  
2011 ◽  
Vol 81 (4) ◽  
pp. 606-627 ◽  
Author(s):  
Clemens Greiner

ABSTRACTRural–urban migration and networks are fundamental for many livelihoods in sub-Saharan Africa. Remittances in cash and kind provide additional income, enhance food security and offer access to viable resources in both rural and urban areas. Migration allows the involved households to benefit from price differences between rural and urban areas. In this contribution, I demonstrate that rural–urban networks not only contribute to poverty alleviation and security, but also further socio-economic stratification. This aspect has been ignored or neglected by most scholars and development planners. Using ethnographic data from Namibia, I have adopted a translocal perspective on migration and stratification, focusing on the resulting impact in rural areas where modern urban forms of stratification, induced by education and income from wage labour, are on the increase.


2021 ◽  
Author(s):  
Collins Adu ◽  
Aliu Mohammed ◽  
Eugene Budu ◽  
James Boadu Frimpong ◽  
Justice Kannor Tetteh ◽  
...  

Abstract Background Sexually transmitted infections (STIs) remain a major public health challenge worldwide. Despite the importance of sexual autonomy in the prevention and control of sexual and reproductive health disorders such as STIs, there are limited studies on the possible relationship between women’s sexual autonomy and self-reported STIs, especially in sub-Saharan Africa (SSA). This study, therefore, examined the association between sexual autonomy and self-reported STIs among women in sexual unions in SSA.Methods Data from the Demographic and Health Survey (DHS) of 31 countries in SSA conducted between 2010 and 2019 were analysed. A total of 234,310 women in sexual unions were included in the study. Data were analysed using binary logistic regression models and the results were presented as crude odds ratios (cORs) and adjusted odds ratios (aORs) at 95% confidence interval (CI). Results The prevalence of self-reported STIs among women in sexual unions in SSA was 5.8%. Approximately 83.0% of the women surveyed had sexual autonomy. Women who had no sexual autonomy were less likely to have self-reported STIs (cOR=0.52, CI: 0.46-0.54), compared to those who had sexual autonomy. Additionally, higher odds of self-reported STIs were found among women aged 25-29, compared to those aged 15-19 (aOR= 1.21, CI: 1.09-1.35); those who reside in urban areas, compared to those who reside in rural areas (aOR= 1.51, CI: 1.37-1.66) and those who were cohabiting, compared to those who were married (aOR= 1.65, CI: 1.52-1.79). On the other hand, lower odds of self-reported STIs were found among women who were exposed to newspapers (aOR= 0.89, CI: 0.82-0.95), those whose partners had primary education (aOR= 0.84, CI: 0.78-0.91), those who were not exposed to radio (aOR= 0.84, CI: 0.79-0.89), and working women (aOR= 0.86, CI: 0.80-0.93). Conclusion Findings from this study suggest that sexual autonomy is a significant predictor of self-reported STIs among women in sexual unions in SSA. Thus, instituting policies and programs that empower women and improve their levels of sexual autonomy may result in increased self-reporting of symptoms associated with STIs which subsequently help in minimising STI-related complications. Also, policies aimed at enhancing women’s sexual autonomy may reduce the burden of STIs in SSA, especially among women in sexual unions.


2014 ◽  
Vol 4 (1) ◽  
pp. 23-28
Author(s):  
Souhaibou Ndongo ◽  
Abdoulaye Pouye ◽  
Emeric Azankpan ◽  
Mourtalla M. Ka ◽  
Thérèse Moreira Diop

Background: Rheumatoid arthritis, formerly rare in sub-Saharan Africa, is becoming increasingly reported. The objective study determines the epidemiological, clinical and biological features of rheumatoid arthritis at diagnosis. Methods: A cross-sectional study conducted at the rheumatology outpatient department of Aristide Le Dantec Teaching Hospital of Dakar in Senegal. Results: Three hundred eight patients with rheumatoid arthritis according, to American College of Rheumatology 1987 criteria, were included: 273 women and 35 men (ratio of 7:8). Median age was 41 years (Q1: 31; Q3: 53 years); predominant age group was 30-40 years. Ninety-three percent resided in urban areas and 7% in rural areas. Family history of chronic inflammatory arthritis was reported by 35.1% of patients. Thirty-nine percent of patients initially consulted a traditional healer. On admission, the median Disease Activity Score 28 was 6.5 (Q1: 5.5; Q3: 7.3). Rheumatoid arthritis was very active in 81.1% and a positive factor in 84% of patients. Cyclic citrullinated peptide antibodies assessed in 116 patients; 95 reported positive (81.9%). Of 169 patients, at least one extra-articular manifestation was presented; the most common, anemia and sicca syndrome. Conclusion: Rheumatoid arthritis was characterized by an important delay in diagnosis, a polyarticular presentation, and a high positivity of immunological markers. Extra-articular manifestations included mainly anemia and sicca syndrome. Early management and a better understanding of rheumatoid arthritis in sub-Saharan Africa are required.


2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
William Agyemang ◽  
Emmanuel Kofi Adanu ◽  
Steven Jones

Like many countries in sub-Saharan Africa, Ghana has witnessed an increase in the use of motorcycles for both commercial transport and private transport of people and goods. The rapid rise in commercial motorcycle activities has been attributed to the problem of urban traffic congestion and the general lack of reliable and affordable public transport in rural areas. This study investigates and compares factors that are associated with motorcycle crash injury outcomes in rural and urban areas of Ghana. This comparison is particularly important because the commercial use of motorcycles and their rapid growth in urban areas are a new phenomenon, in contrast to rural areas where people have long relied on motorcycles for their transportation needs. Preliminary analysis of the crash data revealed that more of the rural area crashes occurred under dark and unlit roadway conditions, while urban areas recorded more intersection-related crashes. Additionally, it was found that more pedestrian collisions happened in urban areas, while head-on collisions happened more in rural areas. The model estimation results show that collisions with a pedestrian, run-off-road, and collisions that occur under dark and unlit roadway conditions were more likely to result in fatal injury. Findings from this study are expected to help in crafting and targeting appropriate countermeasures to effectively reduce the occurrence and severity of motorcycle crashes throughout the country and, indeed, sub-Saharan Africa.


Author(s):  
Nigel McKelvey ◽  
Adam Crossan ◽  
Kevin Curran

Mobile technology today is increasingly being used to help improve underdeveloped and developing areas such as sub-Saharan Africa. With the statistics showing the number of adults in Africa owning mobile devices steadily increasing, mobile technology has been a popular area of interest to use to help improve areas such as healthcare and education throughout African cities and rural areas. Common that ways mobile technology is being used to help the residents of sub-Saharan Africa are in the sectors of health care and education. Mobile technologies being used in these areas whilst simple are incredibly effective and successful in helping to better the quality of health in education in sub-Saharan Africa. Many of the projects and systems developed using mobile technology focus mainly on urban areas. While reports state the huge increase in the number of those using mobile devices in Africa, along with the large estimated increase in the coming years, the difference between rural African countries and countries which contain urban cities is substantial.


2014 ◽  
Vol 4 (1) ◽  
pp. 23-28
Author(s):  
Souhaibou Ndongo ◽  
Abdoulaye Pouye ◽  
Emeric Azankpan ◽  
Mourtalla M. Ka ◽  
Thérèse Moreira Diop

Background: Rheumatoid arthritis, formerly rare in sub-Saharan Africa, is becoming increasingly reported. The objective study determines the epidemiological, clinical and biological features of rheumatoid arthritis at diagnosis. Methods: A cross-sectional study conducted at the rheumatology outpatient department of Aristide Le Dantec Teaching Hospital of Dakar in Senegal. Results: Three hundred eight patients with rheumatoid arthritis according, to American College of Rheumatology 1987 criteria, were included: 273 women and 35 men (ratio of 7:8). Median age was 41 years (Q1: 31; Q3: 53 years); predominant age group was 30-40 years. Ninety-three percent resided in urban areas and 7% in rural areas. Family history of chronic inflammatory arthritis was reported by 35.1% of patients. Thirty-nine percent of patients initially consulted a traditional healer. On admission, the median Disease Activity Score 28 was 6.5 (Q1: 5.5; Q3: 7.3). Rheumatoid arthritis was very active in 81.1% and a positive factor in 84% of patients. Cyclic citrullinated peptide antibodies assessed in 116 patients; 95 reported positive (81.9%). Of 169 patients, at least one extra-articular manifestation was presented; the most common, anemia and sicca syndrome. Conclusion: Rheumatoid arthritis was characterized by an important delay in diagnosis, a polyarticular presentation, and a high positivity of immunological markers. Extra-articular manifestations included mainly anemia and sicca syndrome. Early management and a better understanding of rheumatoid arthritis in sub-Saharan Africa are required.


2020 ◽  
Vol 20 (1) ◽  
pp. 498-508
Author(s):  
Linda A Winkler ◽  
Agnes Stypulkowski ◽  
Shana Noon ◽  
Theophila Babwanga ◽  
Jesca Lutahoire

Background: Kangaroo Mother Care (KMC) requires few specialized resources, reduces mortality, and can be implemented in low resource environments. It is now recommended for implementation around the globe. Objectives: This paper discusses KMC use with low birth weight newborns at a Tanzania hospital providing valuable outcomes assessment of KMC use in rural areas of sub-Saharan Africa. Methods: The research used retrospective records (136 Low Birth Weight (LBW) and 33 Very Low Birth Weight (VLBW) ne- onates) supplemented by observations. Data included weights (longitudinal), survival period, and cause of death if it occurred. This hospital’s KMC use and study data began when the mother-baby dyad was referred, usually birth day. Results: This KMC group demonstrated 70% survival, but 77% of deaths occur within 24 hours. After the first 24 hours, KMC survival rate was 92%. Even VLBW neonates (<1000 g) had 37.5% survival among the KMC program. Prematurity and respi- ratory distress caused nearly half of the deaths, but hypothermia (19% of deaths) and infection were factors also. Conclusion: Our study indicates the value of KMC in rural low resource environments. Results are comparable to KMC pro- grams in urban areas where newborns begin KMC after stabilization and better than outcomes reported for comparable popu- lations not practicing KMC in rural sub-Saharan Africa. Keywords: Kangaroo mother care; low birth weight; neonatal mortality; premature infant. 


2018 ◽  
Author(s):  
Justin T. Okano ◽  
Katie Sharp ◽  
Laurence Palk ◽  
Sally Blower

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.


2021 ◽  
Vol 4 ◽  
pp. 44
Author(s):  
Fidelia A. A. Dake

Food security has been a global development agenda for several decades, and rightly so: nearly 945 million people were food insecure in 2005 and a decade later, this number declined to 784 million in 2014, only to rise to 821 million three years later in 2017. These global figures, however, mask variations in the extent of progress in different regions of the world. Progress towards achieving food security has been much slower in sub-Saharan Africa, and the region continues to be the worst hit by food insecurity. Furthermore, it is increasingly being recognised that food insecurity is prevalent in urban, and not just rural areas, and that the urban poor rather than the rural poor are particularly vulnerable, and at increased risk of being food insecure. Additionally, nutrition insecurity, a closely related component of food insecurity, is common among the urban poor and contributes to malnutrition. While several factors have been explored in trying to address the issue of food security, the potential role of foodscapes in urban spaces of Africa has been less researched. Recent evidence, however, indicates that foodscapes in urban areas of sub-Saharan Africa potentially contribute to food and nutrition insecurity, particularly among the urban poor. Addressing food and nutrition insecurity in sub-Saharan Africa will thus first require reframing the discourse about these issues from solely a rural to also an urban problem, and secondly improving access, especially availability of healthy and nutritious options that are also economically accessible, for vulnerable and at-risk groups; in particularly, the urban poor.


2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Prathiba M. De Silva ◽  
John M. Marshall

Sub-Saharan Africa suffers by far the greatest malaria burden worldwide and is currently undergoing a profound demographic change, with a growing proportion of its population moving to urban areas. Urbanisation is generally expected to reduce malaria transmission; however the disease still persists in African cities, in some cases at higher levels than in nearby rural areas.Objective. This paper aims to collate and analyse risk factors for urban malaria transmission throughout sub-Saharan Africa and to discuss their implications for control.Methods. A systematic search on malaria and urbanisation was carried out focusing on sub-Saharan Africa. Particular interest was taken in vector breeding sites in urban and periurban areas.Results. A variety of urban vector breeding sites were catalogued, the majority of which were artificial, including urban agriculture, tyre tracks, and ditches. Natural breeding sites varied according to location. Low socioeconomic status was a significant risk factor for malaria, often present in peri-urban areas. A worrying trend was seen in the adaptation of malaria vector species to the urban environment. Urban malaria is highly focused and control programs should reflect this.Conclusion. As urbanisation continues and vector species adapt, continued monitoring and control of urban malaria in sub-Saharan Africa is essential.


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