Psychosocial interventions for depression among young people in Sub-Saharan Africa: a systematic review and meta-analysis.

BACKGROUND: Depression among young people is a global health problem due to its rising prevalence and negative physical and social outcomes. The prevalence of depression and the treatment gap among young people in Sub-Saharan Africa (SSA) is higher than global estimates. Most psychosocial interventions for adolescent and youth depression were developed in high-income countries and less is known about their effectiveness in SSA. Due to contextual differences, findings from High-Income Countries (HICs) are less applicable to SSA. Yet, no systematic review of psychosocial interventions for depression among young people in SSA has been conducted. METHODS: A systematic literature search of four databases (Medline, Web of Science, PsycInfo, and Cochrane library) was conducted. Experimental studies published before May 2024 that evaluated the effect of psychosocial interventions on depressive symptoms among young people (aged 10-24 years) in SSA were included in the systematic review. Effect sizes (Hedge's g (g)) indicating differences between intervention and control groups were calculated using a random effects model. RESULTS: Twenty-two eligible studies were identified for the systematic review, of which eighteen randomized control trials (RCTs) involving 2338 participants were included in the meta-analysis. The findings revealed that psychosocial interventions significantly reduced depressive symptoms (g = -1.55, 95% CI -2.48, -0.63), although heterogeneity was high (I2 = 98.8%). Subgroup analysis revealed that efficacy differed significantly by intervention type, with Cognitive Behavioural Therapy (9 studies) showing the strongest effect (g = -2.84, 95% CI -4.29; -1.38). While Wise Interventions (a form of positive psychology interventions; 2 studies) had a moderate effect (g = -0.46, 95% C.I -0.53, -0.39), Interpersonal Psychotherapy (2 studies; g = -0.08, 95% CI -1.05, 0.88) and Creative Psychological Interventions (3 studies; g = -0.29, 95% CI -1.38, 0.79) showed smaller, non-significant effects. Sensitivity analysis excluding studies at high risk of bias strengthened the effect size. Few studies assessed factors affecting intervention efficacy and showed mixed effects of age, gender, and adherence levels. CONCLUSION: Psychosocial interventions, particularly CBT, significantly reduced depressive symptoms among young people in SSA. However, it is crucial to acknowledge the high heterogeneity which likely stems from variations in study populations and intervention delivery modalities. This highlights the need for further research to identify the specific intervention components and delivery methods that work best for distinct subpopulations. Future research should also explore how long intervention effects are maintained and factors affecting efficacy.

The Pandemic Treaty, the Pandemic Fund, and the Global Commons: our scepticism.

The call to strengthen global health governance against future outbreaks through a binding treaty on pandemics has attracted global attention and opinion. Yet, few of these perspectives have reflected the voices from early career global health professionals in Africa. We share our perspectives on the Pandemic Treaty, and specifically our scepticism on the limitations of the current top-down approach of the treaty, and the need for the treaty to centre equity, transparency and fairness to ensure equitable and effective cooperation in response to global health emergencies. We also highlight the challenges intergovernmental organisations for health faced in coordinating nation states during the COVID-19 crisis and how a Pandemic Treaty would address these challenges. We argue that lessons from the COVID-19 pandemic provide a critical opportunity to strengthen regional institutions in Africa-particularly in a multipolar world with huge disparities in power and resources. However, addressing these challenges and achieving this transformation may not be easy. Fiscal space in many countries remains constrained now more than ever. New tools such as the Pandemic Fund should be designed in ways that consider the specific needs and capacities of countries. Therefore, strengthening countries' capacities overall requires an increase in domestic investment. This paper calls for wider structural reforms such as debt restructuring among other tools to strengthen countries' capacities.

Institutionalizing Open Science in Africa: Limitations and Prospects.

The advancement of scientific research and raising the next-generation scientists in Africa depend largely on science access. The COVID-19 pandemic has caused discussions around open science (OS) to reemerge globally, especially in resource-poor settings like Africa, where the practice of OS is low. The authors highlighted the elements, benefits, and existing initiatives of OS in Africa. More importantly, the article critically appraised the challenges, opportunities, and future considerations of OS in Africa. Addressing challenges of funding and leadership at different levels of educational, research, and government parastatals may be pivotal in charting a new course for OS in Africa. This review serves as an advocacy strategy and an informative guide to policymaking and institutionalization of OS in Africa.

A health policy analysis of the implementation of the National Tobacco Control Act in Nigeria.

Non-communicable diseases (NCDs) have emerged as a public health issue of concern in Nigeria. The massive increase in tobacco use amongst different population groups is a common NCDs risk factor. To this effect, the National Tobacco Control Act (NTCA) was enacted following the WHO Framework Convention on Tobacco Control (FCTC). This article conducts a health policy agenda-setting analysis of the NTCA using the Kingdon's multiple streams model and analyses its implementation using the Principal-Agent theory. The purposive and snowballing sampling methods were used to select and review relevant peer-review literature. Other data sources included gray literature, government reports, Non-Governmental Organization briefs and media resources. Though NTCA conforms to WHO FCTC, Nigeria only domesticated her obligation to this framework legislatively while the executive and administrative measures were found lacking. The challenges and gaps identified in the NTCA implementation include; revision of textual health warnings and lack of pictorial health warnings on cigarette packs, poor taxation, and the National Tobacco Control Commission's (NTCC) lack of regulatory autonomy, hence, the poor policy implementation reported in this article. To effectively implement NTCA, a review of textual warnings, enforcement of pictorial warnings, regulatory autonomy of the NTCC and review of the tobacco taxation are suggested to help in the prevention and control of NCDs.