Biomass burning decline causes large reductions in NO2 burden over north equatorial Africa in spite of growing fossil fuel use

2020 ◽  
Author(s):  
Jonathan Hickman ◽  
Niels Andela ◽  
Money Ossohou ◽  
Corinne Galy-Lacaux ◽  
Kostas Tsigaridis ◽  
...  
Keyword(s):  
Economic Development ◽  
Air Quality ◽  
Biomass Burning ◽  
Fossil Fuel ◽  
Sub Saharan Africa ◽  
Burned Area ◽  
Fuel Use ◽  
Middle Income ◽  
Socio Economic Development ◽  
Low And Middle Income

<p>Socio-economic development in low and middle-income countries has been accompanied by increased emissions of air pollutants such as nitrogen oxides (NO<sub>x</sub>: nitrogen dioxide (NO<sub>2</sub>) + nitric oxide (NO)), which affect human health.  In sub-Saharan Africa, fossil fuel combustion has nearly doubled since 2000.  At the same time, biomass burning—another important NO<sub>x</sub> source—has declined in Africa’s northern biomass burning region, attributed to changes in climate and anthropogenic fire management associated with agricultural development. Here we use satellite observations of tropospheric NO<sub>2</sub> vertical column densities (VCDs) and burned area to identify NO<sub>2</sub> trends and drivers over Africa. Across the northern ecosystems where biomass burning occurs—home to over 350 million people—mean annual tropospheric NO<sub>2 </sub>VCDs decreased by 4.5% from 2005 through 2017 during the biomass burning season of November through February. Reductions in burned area explained the majority of these change in NO<sub>2</sub> VCDs, but there were also weaker relationships between changes in NO<sub>2</sub> VCDs and fossil fuel emissions over parts of West Africa, which were stronger during rainy season. Over Africa’s biomass burning regions, NO<sub>2</sub> VCDs tended to decrease with increasing population density up to a threshold of approximately 180 people per km<sup>2</sup>, suggesting that anthropogenic activity causes a net reduction in NO<sub>2</sub> emissions across roughly 90% of the continent’s biomass burning regions. In contrast to the widely-held perception that socio-economic development worsens air quality in low and middle-income nations, our results suggest that countries in Africa’s northern biomass burning region are following a different pathway, resulting in regional air quality benefits. However, these benefits may be lost with increasing fossil fuel use.</p>

scholarly journals Reductions in NO2 burden over north equatorial Africa from decline in biomass burning in spite of growing fossil fuel use, 2005 to 2017

2021 ◽  
Vol 118 (7) ◽  
pp. e2002579118
Author(s):  
Jonathan E. Hickman ◽  
Niels Andela ◽  
Kostas Tsigaridis ◽  
Corinne Galy-Lacaux ◽  
Money Ossohou ◽  
...  
Keyword(s):  
Biomass Burning ◽  
Socioeconomic Development ◽  
Fossil Fuel ◽  
Dry Season ◽  
Sub Saharan Africa ◽  
Burned Area ◽  
Fuel Use ◽  
Middle Income ◽  
Equatorial Africa ◽  
Low And Middle Income

Socioeconomic development in low- and middle-income countries has been accompanied by increased emissions of air pollutants, such as nitrogen oxides [NOx: nitrogen dioxide (NO2) + nitric oxide (NO)], which affect human health. In sub-Saharan Africa, fossil fuel combustion has nearly doubled since 2000. At the same time, landscape biomass burning—another important NOx source—has declined in north equatorial Africa, attributed to changes in climate and anthropogenic fire management. Here, we use satellite observations of tropospheric NO2 vertical column densities (VCDs) and burned area to identify NO2 trends and drivers over Africa. Across the northern ecosystems where biomass burning occurs—home to hundreds of millions of people—mean annual tropospheric NO2 VCDs decreased by 4.5% from 2005 through 2017 during the dry season of November through February. Reductions in burned area explained the majority of variation in NO2 VCDs, though changes in fossil fuel emissions also explained some variation. Over Africa’s biomass burning regions, raising mean GDP density (USD⋅km−2) above its lowest levels is associated with lower NO2 VCDs during the dry season, suggesting that economic development mitigates net NO2 emissions during these highly polluted months. In contrast to the traditional notion that socioeconomic development increases air pollutant concentrations in low- and middle-income nations, our results suggest that countries in Africa’s northern biomass-burning region are following a different pathway during the fire season, resulting in potential air quality benefits. However, these benefits may be lost with increasing fossil fuel use and are absent during the rainy season.

scholarly journals Are low and middle-income countries prioritising high-value healthcare interventions?

2020 ◽  
Vol 5 (2) ◽  
pp. e001850
Author(s):  
Ashley A Leech ◽  
David D Kim ◽  
Joshua T Cohen ◽  
Peter J Neumann
Keyword(s):  
Cost Effectiveness ◽  
Cost Saving ◽  
National Health ◽  
Sub Saharan Africa ◽  
Health Plans ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Priority ◽  
Sub Saharan ◽  
Low And Middle Income

IntroductionSince resources are finite, investing in services that produce the highest health gain ‘return on investment’ is critical. We assessed the extent to which low and middle-income countries (LMIC) have included cost-saving interventions in their national strategic health plans.MethodsWe used the Tufts Medical Center Global Health Cost-Effectiveness Analysis Registry, an open-source database of English-language cost-per-disability-adjusted life year (DALY) studies, to identify analyses published in the last 10 years (2008–2017) of cost-saving health interventions in LMICs. To assess whether countries prioritised cost-saving interventions within their latest national health strategic plans, we identified 10 countries, all in sub-Saharan Africa, with the highest measures on the global burden of disease scale and reviewed their national health priority plans.ResultsWe identified 392 studies (63%) targeting LMICs that reported 3315 cost-per-DALY ratios, of which 207 ratios (6%) represented interventions reported to be cost saving. Over half (53%) of these targeted sub-Saharan Africa. For the 10 countries we investigated in sub-Saharan Africa, 58% (79/137) of cost-saving interventions correspond with priorities identified in country plans. Alignment ranged from 95% (21/22 prioritised cost-saving ratios) in South Africa to 17% (2/12 prioritised cost-saving ratios) in Cameroon. Human papillomavirus vaccination was a noted priority in 70% (7/10) of national health prioritisation plans, while 40% (4/10) of countries explicitly included prenatal serological screening for syphilis. HIV prevention and treatment were stated priorities in most country health plans, whereas 40% (2/5) of countries principally outlined efforts for lymphatic filariasis. From our sample of 45 unique interventions, 36% of interventions (16/45) included costs associated directly with the implementation of the intervention.ConclusionOur findings indicate substantial variation across country and disease area in incorporating economic evidence into national health priority plans in a sample of sub-Saharan African countries. To make health economic data more salient, the authors of cost-effectiveness analyses must do more to reflect implementation costs and other factors that could limit healthcare delivery.

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.

scholarly journals ‘I should be disease free, healthy and be happy in whatever I do’: a cross-country analysis of drivers of adolescent diet and physical activity in different low- and middle-income contexts

2020 ◽  
pp. 1-11 ◽  
Author(s):  
Susie Weller ◽  
Polly Hardy-Johnson ◽  
Sofia Strommer ◽  
Caroline Fall ◽  
Ulka Banavali ◽  
...  
Keyword(s):  
Physical Activity ◽  
Nutrition Education ◽  
Urban Areas ◽  
Economic Transition ◽  
Cultural Influences ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Adolescent Diet ◽  
Diet And Physical Activity ◽  
Low And Middle Income

Abstract Objective: To explore perceptions of how context shapes adolescent diet and physical activity in eight low- and middle-income (LMIC) sites at different stages of societal and economic transition. Design: Novel qualitative secondary analysis of eight data sets generated as part of the international Transforming Adolescent Lives through Nutrition (TALENT) collaboration. Setting: Diverse sites in India and Sub-Saharan Africa. Participants: Fifty-two focus group discussions with 491 participants (303 adolescents aged 10–17 years; 188 caregivers). Results: Analysis of pooled qualitative data identified three themes: (1) transitions in generational nutrition education and knowledge; (2) transition in caregiver–adolescent power balance and (3) the implications of societal and economic transition for diet and physical activity. Adolescents in urban and peri-urban areas could readily access ‘junk’ food. Diets in rural settings were determined by tradition, seasonality and affordability. Physical activity was inhibited by site-specific factors including lack of space and crime in urban settings, and the prioritisation of academic performance. Gender influenced physical activity across all sites, with girls afforded fewer opportunities. Conclusions: Interventions to improve adolescent diet and physical activity in LMIC need to be complex, context-specific and responsive to transitions at the individual, economic and societal levels. Moreover, solutions need to acknowledge gender inequalities in different contexts, as well as structural and cultural influences on diet and physical activity in resource-limited settings. Programmes need to be effective in engaging and reconciling adolescents’ and caregivers’ perspectives. Consequently, there is a need for action at both the community-household level and also through policy.

Strategies used to establish palliative care in rural low- and middle-income countries: an integrative review

2020 ◽  
Vol 35 (8) ◽  
pp. 1110-1129
Author(s):  
Atsede Aregay ◽  
Margaret O’Connor ◽  
Jill Stow ◽  
Nicola Ayers ◽  
Susan Lee
Keyword(s):  
Palliative Care ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Care Home ◽  
Sub Saharan Africa ◽  
Integrative Review ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Globally, 40 million people need palliative care; about 69% are people over 60 years of age. The highest proportion (78%) of adults are from low- and middle-income countries (LMICs), where palliative care still developing and is primarily limited to urban areas. This integrative review describes strategies used by LMICs to establish palliative care in rural areas. A rigorous integrative review methodology was utilized using four electronic databases (Ovid MEDLINE, Ovid Emcare, Embase classic+Embase and CINAHL). The search terms were: ‘palliative care’, ‘hospice care’, ‘end of life care’, ‘home-based care’, ‘volunteer’, ‘rural’, ‘regional’, ‘remote’ and ‘developing countries’ identified by the United Nations (UN) as ‘Africa’, ‘Sub-Saharan Africa’, ‘low-income’ and ‘middle- income countries’. Thirty papers published in English from 1990 to 2019 were included. Papers were appraised for quality and extracted data subjected to analysis using a public health model (policy, drug availability, education and implementation) as a framework to describe strategies for establishing palliative care in rural areas. The methodological quality of the reviewed papers was low, with 7 of the 30 being simple programme descriptions. Despite the inclusion of palliative care in national health policy in some countries, implementation in the community was often reliant on advocacy and financial support from non-government organizations. Networking to coordinate care and medication availability near-patient homes were essential features of implementation. Training, role play, education and mentorship were strategies used to support health providers and volunteers. Home- and community-based palliative care services for rural LMICs communities may best be delivered using a networked service among health professionals, community volunteers, religious leaders and technology.

THE ENERGY–POLLUTION–HEALTH NEXUS: A PANEL DATA ANALYSIS OF LOW- AND MIDDLE-INCOME ASIAN COUNTRIES

2020 ◽  
pp. 1-21 ◽  
Author(s):  
FARHAD TAGHIZADEH-HESARY ◽  
EHSAN RASOULINEZHAD ◽  
NAOYUKI YOSHINO ◽  
YOUNGHO CHANG ◽  
FARZAD TAGHIZADEH-HESARY ◽  
...  
Keyword(s):  
Energy Consumption ◽  
Fossil Fuel ◽  
Renewable Energy Sources ◽  
Generalized Method Of Moments ◽  
Energy Sources ◽  
Asian Countries ◽  
Middle Income ◽  
Fossil Fuel Energy ◽  
Fossil Fuel Energy Consumption ◽  
Low And Middle Income

Increased consumption of nonrenewable energy sources may lead to more air pollution, resulting in negative health impacts in a society. The main purpose of this study is to investigate the relationship between fossil fuel energy consumption and health issues using generalized method of moments estimation technique for data from 18 Asian countries (both low- and middle-income) over the period 1991–2018. The findings demonstrate that fossil fuel energy consumption increases the risk of lung and respiratory diseases. In addition, the results demonstrate the significant effect of CO2 emissions and fossil fuel consumption on undernourishment and death rates. Furthermore, we find that increases in the gross domestic product per capita and healthcare expenditure may help reduce undernourishment and death ratio. The conclusion recommends that diversification of energy in low- and middle-income countries from too much reliance on fossil fuels to more renewable energy sources can improve energy insecurity, at the same time reduce greenhouse gas emissions and minimize the negative impacts on human health.

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