Coronavirus awareness, prevention, and household hardship survey data for the CHAMPS HDSS network: Data collected between August and September of 2022 from the Bamako HDSS, Mali.

Data were gathered through a collaborative initiative to investigate impacts of the COVID-19 pandemic and related lockdowns on child and maternal health, economic hardships, and access to care for children and pregnant women by the Child Health and Mortality Prevention Surveillance (CHAMPS) Network. The data were gathered in Bamako, the capital city of Mali (population ∼2.9 million) between August and September of 2022 through a Health and Demographic Surveillance System (HDSS). Data collectors used a survey instrument specifically designed to measure household awareness, knowledge, and prevalence of COVID-19, as well as hardships that households experienced since the onset of the pandemic in March of 2020. The data are from two neighborhoods of Bamako, Banconi and Djicoroni; the Health and Demographic Surveillance System (HDSS) operating in these neighborhoods tracks the health of approximately 235,000 inhabitants. The data were collected using a stratified random sample of 454 households.

Effectiveness of lifestyle interventions for glycaemic control among adults with type 2 diabetes in West Africa: a systematic review and meta-analysis protocol.

BACKGROUND: Lifestyle interventions are key to the control of diabetes and the prevention of complications, especially when used with pharmacological interventions. This protocol aims to review the effectiveness of lifestyle interventions in relation to nutrition and physical activity within the West African region. This systematic review and meta-analysis seeks to understand which interventions for lifestyle modification are implemented for the control of diabetes in West Africa at the individual and community level, what evidence is available on their effectiveness in improving glycaemic control and why these interventions were effective. METHODS: We will review randomised control trials and quasi-experimental designs on interventions relating to physical activity and nutrition in West Africa. Language will be restricted to English and French as these are the most widely spoken languages in the region. No other filters will be applied. Searching will involve four electronic databases - PubMed, Scopus, Africa Journals Online and Cairn.info using natural-language phrases plus reference/citation checking. Two reviewers will independently screen results according to titles and abstracts against the inclusion and exclusion criteria to identify eligible studies. Upon full-text review, all selected studies will be assessed using Cochrane's Collaboration tool for assessing the risk of bias of a study and the ROBINS-I tool before data extraction. Evidence will be synthesised narratively and statistically where appropriate. We will conduct a meta-analysis when the interventions and contexts are similar enough for pooling and compare the treatment effects of the interventions in rural to urban settings and short term to long term wherever possible. DISCUSSION: We anticipate finding a number of studies missed by previous reviews and providing evidence of the effectiveness of different nutrition and physical activity interventions within the context of West Africa. This knowledge will support practitioners and policymakers in the design of interventions that are fit for context and purpose within the West African region. SYSTEMATIC REVIEW REGISTRATION: This systematic review has been registered in the International Prospective Register for Systematic Reviews - PROSPERO, with registration number CRD42023435116. All amendments to this protocol during the process of the review will be explained accordingly.

On the partial impact of uncertainties on the nexus between macroeconomic fundamentals in West Africa.

We investigate the degree of interconnectedness between stock returns and exchange rate returns, and the influence of some selected global uncertainty indices on such a relationship within a time-frequency domain in West Africa through the bi and partial wavelet approaches. The analysis was based on monthly observations from February 2013 to June 2023. The results highlight a negative correlation between stock return and exchange rates. The partial wavelet analysis evidence a significant effect of the global economic policy uncertainty, the implied oil market volatility, and the United States volatility index in driving the co-movements observed in the currency and stock markets. We also find a significant impact of the stock market on the currency market, underscoring the need for robust stock market policies. It is recommended that policymakers prioritize strategies aimed at boosting stock market stability and depth which can positively affect the currency markets. The significant influence of global uncertainties or shocks should not be disregarded in the formulation of policies regarding exchange rates and stock return integration at various investment horizons.

Microplastic dynamics and risk projections in West African coastal areas: Developing a vulnerability index, adverse ecological pathways, and mitigation framework using remote-sensed oceanographic profiles.

Microplastic pollution threatens marine ecosystems globally, particularly in West Africa, prompting this study to identify key variables influencing microplastic dynamics in the region. Using NASA's Giovanni system, we analyzed key environmental variables from 2019 to 2024 to understand microplastic dynamics. The key findings include homogenous offshore air temperatures due to turbulence (25.22-45.62 K) with significant nearshore variation and generally homogeneous salinity levels (4 PSU) with slight decreases in southern-southern Nigeria. The surface wind speed increased from 4.206 to 5.026 m/s in Nigeria to >5.848 m/s off Mauritania, whereas the eastward stress exhibited hotspots in Nigeria and from Sierra Leone to Senegal. The photosynthetically available radiation (PAR) beam values are highest off Mauritania and lowest off Nigeria to Sierra Leone, with the PAR diffuse values showing the opposite trend. High absorption and particulate backscattering hotspots, along with elevated aerosol optical depth and remote sensing reflectance, indicate the presence of substantial particulate matter. The Microplastic Vulnerability Index (MVI) identifies Nigeria to the Guinea-Bissau coastal stretch as the most vulnerable area due to conditions that favor microplastic accumulation; moderate vulnerability was observed from Guinea-Bissau to Senegal and in Mauritania. Air temperature and turbulence variations influence microplastic dispersion, with higher offshore temperatures promoting widespread suspension, whereas cooler nearshore temperatures lead to sedimentation and localized accumulation. In regions such as Senegal and Mauritania, increased turbulence and higher temperatures could facilitate greater mixing and transport of microplastics, impacting marine life through ingestion and bioaccumulation. Conversely, stable conditions off Nigeria increase microplastic persistence and accumulation, particularly in sensitive coastal habitats such as mangroves and coral reefs. Variations in salinity, wind speed, aerosol optical depth, and photosynthetically available radiation further complicate microplastic dynamics, affecting transport, degradation, and ecological risks. These findings highlight the need for region-specific management strategies to address microplastic pollution and effectively protect marine ecosystems.

Assessing greywater characteristics in the sahel region and perception of the local population on its reuse in agriculture.

Research on greywater reuse in water stressed areas is in full swing. However, the perception of greywater reuse is one of the least researched areas in West Africa, particularly in Sahelian countries. This study aimed to fills a significant gap in the existing literature, which has largely ignored the specific socio-demographic contexts of developing countries in the Sahelian regions. The study involved in-depth interviews with 240 rural households and the collection of 40 greywater samples in four locations for laboratory analysis. The survey focused on greywater management and household perceptions of greywater reuse in agriculture. The analyses focused on determining the physico-chemical and microbiological parameters of greywater collected from households. The results showed that over 80 % of households discharged greywater into the natural environment without prior treatment. The majority of respondents were aware that poor greywater management poses a health risk. The results also showed an association between locality, gender, education level and perceptions of poor grey water management. Respondents were willing to accept the reuse of greywater in agriculture, to consume irrigated vegetables and to install a greywater treatment system. The quality analysis showed that the greywater was not in compliance with the legal discharge limits. This study highlights that in order to promote sustainable greywater management practices within households, it is important to design effective greywater treatment systems that meet the needs of the target population. Awareness campaigns, education and training programmes on wastewater management could also be established.

Prevalence of hepatitis and HIV infection among 18-months old children in Guinea-Bissau before vaccination.

OBJECTIVES: This study reports on the prevalence of hepatitis B virus (HBV) in children in Guinea-Bissau before the hepatitis B vaccine was introduced. METHODS: Cross-sectional study. From 2005 to 2008, 187 children aged 18 months were enrolled in a vaccine trial and had blood samples taken to test for HBV (HbsAg, anti-HBs and anti-HBc), hepatitis C virus (HCV) and HIV. RESULTS: HBsAg prevalence was 11.2% and prevalence of any HBV serological marker was 16.0%. No children were positive for HCV. One was positive for HIV-1. CONCLUSIONS: The prevalence of HBsAg was high compared to other sub-Saharan African countries pre-immunisation, underscoring the importance of broad and sustained HBV vaccination. This study indicates that the majority of HBV transmission is horizontal during childhood in Guinea-Bissau.

The Impact of Climate Change on Road Traffic Crashes in Ghana.

Despite the substantial injuries and fatalities from Road Traffic Crashes (RTCs), evidence of climate change's impact on RTCs in Ghana is lacking. This study assessed the impact of climate change on RTCs in Ghana by combining quantitative (Mann-Kendall trend tests, Continuous Wavelet Transform analysis, causal inference analysis) and qualitative (15 key stakeholder interviews) methods. The quantitative analysis employed monthly rainfall and temperature data (1991-2021) alongside RTC data (1998-2021) across 10 regions. While rainfall trends varied regionally, the wet season (April through mid-October) showed a strong link to crash severity for all regions across Ghana. Wavelet analysis showed higher crash severity in the wet season within every 2-8 months period in a particular annual year during the study period. Causal inference analysis revealed rainfall's stronger influence (3.59%) on fatal crashes during the wet season compared to temperature (0.04%). Key stakeholder interviews highlighted perceived changes in temperature and intense rainfall patterns affecting RTCs, especially during rainy seasons suggesting an association between increased rainfall and crash severity. These findings emphasize the multifaceted role of climate change on road safety and the need to address weather-specific risks.

In Silico Screening of Phytocompounds from West African Traditional Medicine and Molecular Docking Targeting Dengue Virus Protein NS2B/NS3.

Traditional medicine offers a wide range of application for in silico study techniques. This drug research and development strategy is embryonic in the West African context, particularly in Burkina Faso, which is increasingly faced with emerging diseases such as dengue fever. Circulation of the 4 serotypes of this virus has been documented in the country. This study aims to evaluate the therapeutic potential of phytocompounds contained in the West African pharmacopoeia against dengue virus NS2B/NS3 protein, using computational methods integrating several software packages and databases. Based on a literature review, we identified 191 molecules from 30 plants known for their antiviral effects. Five met the inclusion criteria for molecular docking: patulin from calotropis procera, resiniferonol from Euphorbia poissonii, Securinol A from Flueggea virosa, Shikimic acid and Methyl gallate from Terminalia macroptera. The best binding scores were observed between resiniferonol and the serotypes 1, 2 and 4 NS2B/NS3 protease, with binding energies of -7.4 Kcal/mol, -6.8 Kcal/mol and -7.3 Kcal/mol respectively; while the NS2B/NS3 protease of serotype 3 had the best affinity for securinol A (-7 Kcal/mol). This study points the way to further research in computer aided drug design field and calls for multidisciplinary collaboration to promote West African medicinal plants against health challenges.

Climate change and health in the Sahel: a systematic review.

The Sahel region is projected to be highly impacted by the more frequent hazards associated with climate change, including increased temperature, drought and flooding. This systematic review examined the evidence for climate change-related health consequences in the Sahel. The databases used were Medline (PubMed), Embase (Ovid), Web of Science (Clarivate) and CABI Global Health. Hand searches were also conducted, which included directly engaging Sahelian researchers and hand-searching in the African Journals Online database. Of the 4153 studies found, 893 were identified as duplicates and the remaining 3260 studies were screened (title and abstract only) and then assessed for eligibility. A total of 81 studies were included in the systematic review. Most studies focused on vector-borne diseases, food security, nutrition and heat-related stress. Findings suggest that mosquito distribution will shift under different climate scenarios, but this relationship will not be linear with temperature, as there are other variables to consider. Food insecurity, stunting (chronic malnutrition) and heat-related mortality are likely to increase if no action is taken owing to the projected impact of climate change on environmental factors and agriculture. Seventy-one per cent of manuscripts (n = 58) had first authors from institutions in North America or Europe, of which 39.7% (n = 23) included co-authors from African institutions.

Erratum: Livestock feed resources used as alternatives during feed shortages and their impact on the environment and ruminant performance in West Africa: a systematic review.

[This corrects the article DOI: 10.3389/fvets.2024.1352235.].

Differences in neutralizing antibody sensitivities and envelope characteristics indicate distinct antigenic properties of Nigerian HIV-1 subtype G and CRF02_AG.

The magnitude of the HIV-1 epidemic in Nigeria is second only to the subtype C epidemic in South Africa, yet the subtypes prevalent in Nigeria require further characterization. A panel of 50 subtype G and 18 CRF02_AG Nigerian HIV-1 pseudoviruses (PSV) was developed and envelope coreceptor usage, neutralization sensitivity and cross-clade reactivity were characterized. These PSV were neutralized by some antibodies targeting major neutralizing determinants, but potentially important differences were observed in specific sensitivities (eg. to sCD4, MPER and V2/V3 monoclonal antibodies), as well as in properties such as variable loop lengths, number of potential N-linked glycans and charge, demonstrating distinct antigenic characteristics of CRF02_AG and subtype G. There was preferential neutralization of the matched CRF/subtype when PSV from subtype G or CRF02_AG were tested using pooled plasma. These novel Nigerian PSV will be useful to study HIV-1 CRF- or subtype-specific humoral immune responses for subtype G and CRF02_AG.

Surveillance of Antimicrobial Resistance in the ECOWAS Region: Setting the Scene for Critical Interventions Needed.

Antimicrobial resistance poses a significant challenge to public health globally, leading to increased morbidity and mortality. AMR surveillance involves the systematic collection, analysis, and interpretation of data on the occurrence and distribution of AMR in humans, animals, and the environment for action. The West African Health Organization, part of the Economic Community of West African States (ECOWAS), is committed to addressing AMR in the region. This paper examines the status of AMR surveillance in ECOWAS countries using available WHO data from the TrACSS survey and GLASS enrollments. The analysis reveals that while progress has been made, significant challenges remain. Twelve of the fifteen ECOWAS countries are enrolled in GLASS, and ten have developed national action plans (NAPs) for AMR. However, there is a need to ensure all countries fully implement their NAPs, continue reporting to GLASS, and use the data for evidence-based actions and decision making. Surveillance systems for AMR and antimicrobial consumption/use vary across countries with some demonstrating limited capacity. All countries, except Cabo Verde, reported having a reference laboratory for AMR testing. Strengthening laboratory capabilities, data management and use, and multisectoral coordination are crucial for effective AMR surveillance and response. Based on the findings and the regional context, it is essential to prioritize capacity building, data utilization, and the adoption of standardized guidelines for AMR surveillance. Collaboration among ECOWAS countries, the WAHO, and international partners is essential to address AMR comprehensively. Ensuring a consistent supply of essential antimicrobial medications and reagents is vital.

Cellular immune response to SARS-CoV-2 and clinical presentation in individuals exposed to endemic malaria.

Ghana and other parts of West Africa have experienced lower COVID-19 mortality rates than other regions. This phenomenon has been hypothesized to be associated with previous exposure to infections such as malaria. This study investigated the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the influence of previous malaria exposure. Blood samples were collected from individuals with asymptomatic or symptomatic COVID-19 (n = 217). A variety of assays were used to characterize the SARS-CoV-2-specific immune response, and malaria exposure was quantified using Plasmodium falciparum ELISA. The study found evidence of attenuated immune responses to COVID-19 among asymptomatic individuals, with elevated proportions of non-classical monocytes and greater memory B cell activation. Symptomatic patients displayed higher P. falciparum-specific T cell recall immune responses, whereas asymptomatic individuals demonstrated elevated P. falciparum antibody levels. Summarily, this study suggests that P. falciparum exposure-associated immune modulation may contribute to reduced severity of SARS-CoV-2 infection among people living in malaria-endemic regions.

Livestock feed resources used as alternatives during feed shortages and their impact on the environment and ruminant performance in West Africa: a systematic review.

Ruminant feed is a major problem for the livestock sector in West African developing countries causing animal nutritional diseases, reducing ruminant production, and creating a massive ecological crisis through greenhouse gas emissions. Alternative feeds, which include agro-industrial by-products, fodder trees, crop residues, insects, fodder legumes, algae, and pulses, constitute enormous feed resources for livestock in Africa. This study was conducted in accordance with the methodological recommendations of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We conducted a literature search using Google Scholar, Web of Science, and Scopus to identify documents related to alternative ruminant feeds using the following keywords: alternative feeds, ruminant products, environmental impacts, and West Africa. Those that met the inclusion criteria were included, resulting in 44 articles published between 2013 and 2023. These studies included 45 alternative feeds divided into six groups, including agro-industrial by-products (48.89%), followed by fodder trees (17.78%), crop residues (13.33%), insects (8.89%), fodder legumes (6.67%) and seaweeds (4.44%). Our results revealed that alternative feed resources and their effects on ruminant's performances and environment are poorly known in West Africa, which limits their inclusion in rations and sometimes leads to their misuse. Future research should focus on these aspects in order to make efficient use of these resources to improve ruminant milk and meat production.

Opinion review of drug resistant tuberculosis in West Africa: tackling the challenges for effective control.

Drug-resistant (DR) tuberculosis (TB) is a major public health concern globally, complicating TB control and management efforts. West Africa has historically faced difficulty in combating DR-TB due to limited diagnostic skills, insufficient access to excellent healthcare, and ineffective healthcare systems. This has aided in the emergence and dissemination of DR Mycobacterium tuberculosis complex (MTBC) strains in the region. In the past, DR-TB patients faced insufficient resources, fragmented efforts, and suboptimal treatment outcomes. However, current efforts to combat DR-TB in the region are promising. These efforts include strengthening diagnostic capacities, improving access to quality healthcare services, and implementing evidence-based treatment regimens for DR-TB. Additionally, many West African National TB control programs are collaborating with international partners to scale up laboratory infrastructure, enhance surveillance systems, and promote infection control measures. Moreso, novel TB drugs and regimens, such as bedaquiline and delamanid, are being introduced to improve treatment outcomes for DR-TB cases. Despite these obstacles, there is optimism for the future of DR-TB control in West Africa. Investments are being made to improve healthcare systems, expand laboratory capacity, and support TB research and innovation. West African institutions are now supporting knowledge sharing, capacity building, and resource mobilization through collaborative initiatives such as the West African Network for TB, AIDS, and Malaria (WANETAM), the West African Health Organization (WAHO), and other regional or global partners. These efforts hold promise for improved diagnostics, optimized treatment regimens, and provide better patient outcomes in the future where drug-resistant TB in WA can be effectively controlled, reducing the burden of the disease, and improving the health outcomes of affected individuals.

Modeled impacts of bouillon fortification with micronutrients on child mortality in Senegal, Burkina Faso, and Nigeria.

Micronutrient interventions can reduce child mortality. By applying Micronutrient Intervention Modeling methods in Senegal, Burkina Faso, and Nigeria, we estimated the impacts of bouillon fortification on apparent dietary adequacy of vitamin A and zinc among children and folate among women. We then used the Lives Saved Tool to predict the impacts of bouillon fortification with ranges of vitamin A, zinc, and folic acid concentrations on lives saved among children 6-59 months of age. Fortification at 250 µg vitamin A/g and 120 µg folic acid/g was predicted to substantially reduce vitamin A- and folate-attributable deaths: 65% for vitamin A and 92% for folate (Senegal), 36% for vitamin A and 74% for folate (Burkina Faso), and >95% for both (Nigeria). Zinc fortification at 5 mg/g would avert 48% (Senegal), 31% (Burkina Faso), and 63% (Nigeria) of zinc-attributable deaths. The addition of all three nutrients at 30% of Codex nutrient reference values in 2.5 g bouillon was predicted to save an annual average of 293 child lives in Senegal (3.5% of deaths from all causes among children 6-59 months of age), 933 (2.1%) in Burkina Faso, and 18,362 (3.7%) in Nigeria. These results, along with evidence on program feasibility and costs, can help inform fortification program design discussions.

Next-generation phenotyping in Nigerian children with Cornelia de Lange syndrome.

Next-generation phenotyping (NGP) can be used to compute the similarity of dysmorphic patients to known syndromic diseases. So far, the technology has been evaluated in variant prioritization and classification, providing evidence for pathogenicity if the phenotype matched with other patients with a confirmed molecular diagnosis. In a Nigerian cohort of individuals with facial dysmorphism, we used the NGP tool GestaltMatcher to screen portraits prior to genetic testing and subjected individuals with high similarity scores to exome sequencing (ES). Here, we report on two individuals with global developmental delay, pulmonary artery stenosis, and genital and limb malformations for whom GestaltMatcher yielded Cornelia de Lange syndrome (CdLS) as the top hit. ES revealed a known pathogenic nonsense variant, NM_133433.4: c.598C>T; p.(Gln200*), as well as a novel frameshift variant c.7948dup; p.(Ile2650Asnfs*11) in NIPBL. Our results suggest that NGP can be used as a screening tool and thresholds could be defined for achieving high diagnostic yields in ES. Training the artificial intelligence (AI) with additional cases of the same ethnicity might further increase the positive predictive value of GestaltMatcher.

Screening for hepatitis B in the Bronx West African community with a blood pressure cuff: a cohort study.

Background: Hepatitis B (HBV) and hypertension (HTN) are prevalent in West Africa (WA). Inadequate control is common, and evaluation and management are challenging among immigrants due to unfamiliarity with the United States (US) healthcare system. While HBV is stigmatised, HTN is recognised as an important condition. We describe how a HTN screening program can facilitate HBV screening in the Bronx WA community. Methods: Thirty-minute HTN educational programs were delivered in collaboration with faith-based organisations, and 5-min presentations were presented upon request at community gatherings. Arrangements were made for those interested in a clinic visit where a questionnaire was completed, blood pressure (BP) measured, a free BP cuff provided, HBV testing performed, and referrals made. For those without ongoing care, insurance was arranged, and linkage to care provided. Findings: Seven 30-min and five 5-min presentations were conducted. After the 30-min presentation, 204 of 445 attendees (45.8%) requested a visit, and 68 (33.3%) attended the visit. After the 5-min presentation, 80 requested a visit and 51 (63.8%) attended the visit. A BP >140/90 mmHg was present in 122 individuals (48.4%), including 43 (17.1%) without a history of HTN and 39 (15.5%) with BP >160/90 mmHg. All except two who reported previous testing agreed to HBV testing. 19 (7.5%) were hepatitis B surface antigen positive. Transition into ongoing care was provided for 60 (33.9%) with HTN who were not integrated into the US healthcare system. Interpretation: HTN screening with a free BP cuff promotes HBV screening and US healthcare integration. Funding: No funding.

Field sensitivity and specificity of the SD BIOLINE onchocerciasis IgG4 Rapid Diagnostic Test in children <10 years old from endemic areas in Burkina Faso.

Skin biopsies (Skin snips) have historically been the gold standard for the diagnosis of onchocerciasis. However, in low prevalence areas and in areas with successful ivermectin mass drug administration (MDA) programs, skin snips are not sensitive enough to decide when to stop MDA; thus, serological diagnostic tools have been recommended for this purpose. This study assessed the sensitivity and specificity of the Ov16 Rapid Diagnostic Test (SD BIOLINE Onchocerciasis RDT) compared to skin snip in endemic areas undergoing ivermectin mass distribution using Community Directed Treatment with Ivermectin (CDTI) strategy. A cross-sectional study was conducted between September and November 2016 in five endemic villages in the Cascades region in Burkina Faso. Children aged 2 to 9-years were examined during the impact epidemiological survey using both the skin snip and Ov16 Rapid Diagnostic Test. The Ov16 Rapid Diagnostic Test sensitivity and specificity were determined with reference to the skin biopsy. Skin snip positivity was 1.25% in this population, while seroprevalence was 6.5%. When compared to the skin snip as the gold standard, the sensitivity of the Ov16 Rapid Diagnostic Test was 60% and the specificity 94%. When the Ov16 Rapid Diagnostic Test was considered as the gold standard, the skin snip exhibited a sensitivity of 11.5% and a specificity of 99.5%. These results are similar to other studies comparing the performance of the Ov16 ELISA to skin snips, suggesting that the Ov16 RDT may be a useful tool for ivermectin STOP MDA and post transmission surveys, assuming that the prevalence of infection is low or close to zero, and the Ov16 RDT detected also pre patent infections.

Mobilizing stakeholders for implant removals in Burkina Faso using landscape assessment data.

BACKGROUND: Successful efforts to encourage uptake of subdermal contraceptive implants, with a lifespan of three to five years, necessitate planning to ensure that quality removal services are available when desired. In Burkina Faso, implant use has tripled over the past 8 years and now comprises almost half of the contraceptive method mix. Population Monitoring for Action (PMA) surveys identified barriers to obtaining quality removal when desired, particularly when the implant is not palpable, or providers lack needed skills or supplies. The Expanding Family Planning Choices (EFPC) project supported ministries of health in four countries with evaluation and strengthening of implant removal services. METHODS: An implant removal landscape assessment was conducted at 24 health facilities in three regions of Burkina Faso with high implant use that included provider observations of implant removal, interviews with providers and health facility managers, and facility readiness surveys. The project used landscape data to mobilize stakeholders through a series of participatory workshops to develop a collaborative roadmap and commit to actions supporting quality implant removals. RESULTS: Landscape findings revealed key gaps in provision of quality removal services, including high levels of provider confidence for implant insertion and removal (82% and 71%, respectively), low competence performing simple and difficult removals (19.2% and 11.1%, respectively), inadequate supplies and equipment (no facilities had all necessary materials for removal), lack of difficult removal management systems, and a lack of standard data collection tools for removal. Exposure to the data convinced stakeholders to focus on removals rather than expanding insertion services. While not all roadmap commitments were achieved, the process led to critical investments in quality implant removals. CONCLUSION: Landscape data revealed that facilities lack needed supplies and equipment, and providers lack skills needed to perform quality implant removals, limiting client reproductive choice. Disseminating this data enabled stakeholders to identify and commit to evidence-based priority actions. Stakeholders have since capitalized on program learnings and the roadmap, including following MOH guidance for implant removal supplies and health provider training. Our experience in Burkina Faso offers a replicable model of how data can direct collective action to improve quality of contraceptive implant removals.