An integrative literature review on the impact of COVID-19 on maternal and child health in Africa.

Africa has the highest rates of maternal deaths globally which have been linked to poorly functioning health care systems. The pandemic revealed already known weaknesses in the health systems in Africa, such as workforce shortages, lack of equipment and resources. The aim of this paper is to review the published literature on the impact of the COVID-19 pandemic on maternal and child health in Africa. The integrative review process delineated by Whittemore and Knafl (2005) was used to meet the study aims. The literature search of Ovid Medline, CINAHL, PubMed, WHO, Google and Google scholar, Africa journals online, MIDIRS was limited to publications between March 2020 and May 2022. All the studies went through the PRISMA stages, and 179 full text papers screened for eligibility, 36 papers met inclusion criteria. Of the studies, 6 were qualitative, 25 quantitative studies, and 5 mixed methods. Thematic analysis according to the methods of Braun and Clark (2006) were used to synthesize the data. From the search the six themes that emerged include: effects of lockdown measures, COVID concerns and psychological stress, reduced attendance at antenatal care, childhood vaccination, reduced facility-based births, and increase maternal and child mortality. A review of the literature revealed the following policy issues: The need for government to develop robust response mechanism to public health emergencies that negatively affect maternal and child health issues and devise health policies to mitigate negative effects of lockdown. In times of pandemic there is need to maintain special access for both antenatal care and child delivery services and limit a shift to use of untrained birth attendants to reduce maternal and neonatal deaths. These could be achieved by soliciting investments from various sectors to provide high-quality care that ensures sustainability to all layers of the population.

Female participation in agriculture and economic development in 33 African Countries.

Women occupy a crucial position in the agricultural sector because; they participate in different forms, as entrepreneurs, labourers, and marketers among others. Despite the various responsibilities' women are involved in, such as family and child-care among others; they contribute up to 40% of agricultural GDP. Against this background, this study examined how female participation in agriculture contributes to economic development in selected African countries, which is in line with the United Nations (UN) 2030 Sustainable Development Goals (SDGs 5 & 8; to ensure gender equality, decent work and economic growth respectively). The study engaged a panel data of selected 33 African countries sourced from the World Development Indicators (WDI) and the Human Development Index (HDI) for the period of 2000 - 2018. The study applied the Pooled Ordinary Least Squares (POLS) and the fixed effects method based on Hausman specification result. Findings from the POLS and fixed effect were consistent across sub-regions, showing that, female participation in agriculture, though statistically significant, was negatively related to economic development. This means that a 1% increase in female participation in agriculture may reduce economic development by between 0.06% and 2.7%. On the other hand, across model, female education was found to be statistically significant and positively related to economic development. On the average, increased level of female education may increase economic development by 1.71%. The implication of this is that an increase in female participation in agriculture without the required level of education and training and access to agricultural materials may have a negative impact on economic development. Therefore, the study recommended that female education and training are required to improve economic development in Africa.

Determinants of perceived quality of health care among pregnant women in Ifo, Ogun State, Nigeria.

Nigeria's health system is among the weakest globally, characterized by doctors' and nurses' concentration in a few tertiary facilities in the cities. Simultaneously, rural areas that constitute over 70% of the population suffer from acute health personnel and inadequate health facilities. Whether Nigeria can achieve the Sustainable Development Goal 3 (SDG 3) of access to quality essential health care by 2030 if this situation continues. Therefore, this study provides unique insights on socio-demographic and environmental determinants of quality of health care and treatment choice among women in the Ifo Local Government Area (LGA), a predominantly rural area, in Ogun State, Nigeria. It employed the 2018 cross-sectional survey data collected using a multi-stage sampling technique. A total of 1350 pregnant women aged 20-44 who attended antenatal care during the study period were interviewed. Multicollinearity diagnostics of explanatory variables showed that variance inflation factor, eigenvalues, and the condition index values were within accepted thresholds. Findings showed that the predictors of perceived quality of care were the age of respondents, level of education, type of house lived in, the number of persons in the house, type of toilet facility, primary source of water supply, waste disposal practices, and husband's level of education. Statistically significant predictors of treatment choice included husband's occupation, number of living children, type of house respondent lived in, type of toilet facility, and primary water supply source. These predictors are useful for designing policies and program activities for achieving improved quality of maternal health care at the community level and the attainment of SDG 3 for the country by 2030.

Variations in preference for family care support among the elderly in Southwestern Nigeria.

Preference for family care support among the elderly has become a prominent issue in Nigeria. Hence, the study explored variations in preference for family care support among the elderly in South-western Nigeria (Lagos and Oyo states). Data were extracted from a 2012 elderly survey dataset, and analyzed using quantitative techniques (univariate and bivariate). The results showed that study locations, marriage-type, educational attainment, employment status, religious affiliation, means of livelihood and usual place of residence have little and apparent variations in preferences for family care support in Southwestern Nigeria. We recommend that in order to keep on sustaining high-preferences for family care support, elderly people should be given all-round communal supports by family caregivers in the Nigerian extended family system.

Socio-demographic and environmental determinants of child mortality in rural communities of Ogun State, Nigeria.

Nigeria's under five-mortality was 132 per 1000 in 2018. The statistic makes Nigeria the country with the third-highest under-five mortality globally. It implies that the government may not achieve the Sustainable Development Goal (SDG) of 25 per 1000 births by 2030. This situation is of grave concern to policymakers and other stakeholders interested in the country's development. This study provides unique community micro-level information on child mortality determinants in rural communities where the country's health system is weakest. The study used a sample of 1350 pregnant women aged 20-44 who attended antenatal care in22 health facilities in selected rural communities of Ogun State, South-west Nigeria. The multicollinearity diagnostics tests conducted between the dependent variable and predictors showed no abnormality in the values of the variance inflation factor, eigenvalues, and condition indexes. Logistics regression results showed that the socio-demographic characteristics such as the respondent's age, educational level, number of living children, and husband's education directly affected child mortality. In contrast, the husband has another wife had an indirect effect on child mortality. Environmental factors that directly impacted child mortality included the type of household toilet facility, source of water supply, and household waste disposal practices. These findings indicate that policies and programs to reduce child mortality in rural Nigeria must address socio-demographic and context-specific factors, especially at the community level.

Factors associated with child mortality among antenatal care attendees in Ado-Odo/Ota, Ogun State, Nigeria.

The study examined the determinants of child mortality among attendees at a government health care facility in Ado-Odo/Ota in Ogun State, Nigeria. The study, based on a descriptive cross-sectional study, used a mixed-methods research approach and utilized an interviewer-administered structured pretested questionnaire. A total of 1350 respondents constituted the sample size. Data analysis consisted of descriptive and regression analysis with STATA Version 12. Furthermore, the study employed focus group discussions to reinforce the quantitative results of the investigation. Results showed the place of delivery (P = 0.000), distance from house to health facility (P = 0.022), immunization status (P = 0.000), duration of breastfeeding (P = 0.000), cost of treatment at the health facility (P = 0.627), household waste disposal practice (P = 0.000), and ever used oral rehydration solution (P = 0.000) as being significantly associated with child mortality. The study created awareness of behavioral practices affecting child mortality and insights on possible interventions for reducing child mortality. We conclude that community-based educational strategies and the improvement of health facilities will reduce child mortality.

Nigeria and Italy Divergences in Coronavirus Experience: Impact of Population Density.

BACKGROUND: The reports and information on coronavirus are not conspicuously emphasising the possible impact of population density on the explanation of difference in rapid spread and fatality due to the disease and not much has been done on bicountry comparisons. OBJECTIVE: The study examined the impact of population density on the spread of COVID-19 pandemic in two sociodemographic divergent countries. METHODS: The study conducted a scoping review of published and unpublished articles including blogs on incidences and fatalities of COVID-19. The analysis followed qualitative description and quantitative presentation of the findings using only frequency distribution, percentages, and graphs. RESULTS: The two countries shared similar experience of "importation" of COVID-19, but while different states ordered partial lockdown in Nigeria, it was an immediate total lockdown in Italy. The physician/patient ratio is high in Italy (1 : 328) but low in Nigeria (1 : 2500), while population density is 221 in Nigeria and 206 in Italy. Daily change in incidence rate reduced to below 20% after 51 and 30 days of COVID-19 first incidence in Italy and Nigeria, respectively. Fatality rate has plummeted to below 10% after the 66th day in Italy but has not been stabilised in Nigeria. CONCLUSION: The authors upheld both governments' recommending measures that tilted towards personal hand-hygienic practices and social distancing. Authors suggested that if Italy with its high physician/patient ratio and lower population density compared to Nigeria could suffer high fatality from COVID-19 pandemic under four weeks, then Nigeria with its low physician/patient ratio and higher population density should prepare to face harder time if the pandemic persists.

The burden of road traffic crashes, injuries and deaths in Africa: a systematic review and meta-analysis.

OBJECTIVE: To estimate the burden of road traffic injuries and deaths for all road users and among different road user groups in Africa. METHODS: We searched MEDLINE, EMBASE, Global Health, Google Scholar, websites of African road safety agencies and organizations for registry- and population-based studies and reports on road traffic injury and death estimates in Africa, published between 1980 and 2015. Available data for all road users and by road user group were extracted and analysed. We conducted a random-effects meta-analysis and estimated pooled rates of road traffic injuries and deaths. FINDINGS: We identified 39 studies from 15 African countries. The estimated pooled rate for road traffic injury was 65.2 per 100 000 population (95% confidence interval, CI: 60.8-69.5) and the death rate was 16.6 per 100 000 population (95% CI: 15.2-18.0). Road traffic injury rates increased from 40.7 per 100 000 population in the 1990s to 92.9 per 100 000 population between 2010 and 2015, while death rates decreased from 19.9 per 100 000 population in the 1990s to 9.3 per 100 000 population between 2010 and 2015. The highest road traffic death rate was among motorized four-wheeler occupants at 5.9 per 100 000 population (95% CI: 4.4-7.4), closely followed by pedestrians at 3.4 per 100 000 population (95% CI: 2.5-4.2). CONCLUSION: The burden of road traffic injury and death is high in Africa. Since registry-based reports underestimate the burden, a systematic collation of road traffic injury and death data is needed to determine the true burden.

Exposure to Sex Education and Its Effects on Adolescent Sexual Behavior in Nigeria.

Sexual behavior during adolescence fundamentally steers the future life of both girls and boys, and it should be guided with appropriate education, especially as it also represents a key factor to be considered in attainment of sustainable developmental goals. The study assessed the effect of exposure to sex education on adolescents' sexual behavior. The primary and cross-sectional survey data used for this study were analyzed using basic descriptive statistics and binary logistic regression analytical technique. The results, among others, highlighted that the most common sources of first sex education among the respondents are school (54.6%), family (21.6%), social media (9.5%), and others like television (7.6%) and books or magazines (4.9%). Frequency of discussion on sexual matters is positively associated with the use of protection such as condom (ß = 0.261; p ≤ 0.01). The study gave support to the increasing pursuit of sexuality education. However, since adolescents' needs could vary by demographics, streamlining sex education need by age and sex characteristics could enhance its effectiveness.

Factors influencing maternal mortality among rural communities in southwestern Nigeria.

BACKGROUND: Maternal mortality and morbidity reflect the status of population health and quality of life across nations. Poor understanding of the interplay of many antecedent factors, including sociocultural, economic and logistic factors, combined with an overwhelming poor health services delivery, is a basic challenge in several countries, particularly in rural settings where functional health care services are relatively scarce. There are still uncertainties as to the extent of this burden, owing to current challenges with information and data collation. This study aimed at identifying nonmedical factors associated with maternal mortality in rural and semiurban communities of southwestern Nigeria. METHODOLOGY: The study was carried out in Ado-Odo/Ota Local Government Area of Ogun State. A multistage sampling technique and an informant survey approach were used in the study. A total sample of 360 eligible respondents were selected randomly from 11 out of 16 political wards in the study area and interviewed through the administration of questionnaires. The data were processed using descriptive statistics and regression analyses. RESULTS: Place of consultation (P=0.000), who pays the treatment costs (P=0.000), awareness of pregnancy complications (P=0.002) and knowledge of the place of antenatal care treatment (P=0.000) significantly influenced maternal mortality (proxy by place of delivery of last birth). The F-statistic (15.100) confirmed the hypothesis that nonmedical factors influence maternal mortality. The correlation of predictor variables was significant at both the 0.01 level and the 0.05 level (2-tailed). CONCLUSION: Our findings suggest that in a rural community setting with a depleted health care system, health education tailored toward community culture, subsidized maternal health care services by the government and operators of private clinics, as well as empowering and improving the status of women may reduce maternal mortality and prompt better utilization and survival chances of women in the study area as well as in all of Nigeria.

The interplay of post-translational modification and gene therapy.

Several proteins interact either to activate or repress the expression of other genes during transcription. Based on the impact of these activities, the proteins can be classified into readers, modifier writers, and modifier erasers depending on whether histone marks are read, added, or removed, respectively, from a specific amino acid. Transcription is controlled by dynamic epigenetic marks with serious health implications in certain complex diseases, whose understanding may be useful in gene therapy. This work highlights traditional and current advances in post-translational modifications with relevance to gene therapy delivery. We report that enhanced understanding of epigenetic machinery provides clues to functional implication of certain genes/gene products and may facilitate transition toward revision of our clinical treatment procedure with effective fortification of gene therapy delivery.

Correlation between body mass index and waist circumference in nigerian adults: implication as indicators of health status.

BACKGROUND: Anthropometric measures have been widely used for body weight classification in humans. Waist circumference has been advanced as a useful parameter for measuring adiposity. This study evaluated the correlation between body mass index (BMI) and waist circumference and examined their significance as indicators of health status in adults. DESIGN AND METHODS: The subject included 489 healthy adults from Ota, Nigeria, aged between 20 and 75 years, grouped into early adulthood (20-39 years), middle adulthood (40-59 years) and advanced adulthood (60 years and above). Weight, height and abdominal circumference were measured. BMI was calculated as weight kg/height2 (m2) and World Health Organization cut-offs were used to categorize them into normal, underweight, overweight and obese. RESULTS: Abnormal weight categories accounted for 60 % of the subjects (underweight 11 %, overweight 31%, and obese 18%). The waist circumference of overweight and obese categories were significantly (P<0.05) higher than the normal weight category. There was no significant difference between waist circumference of underweight and normal subjects. The correlation coefficient values of BMI with waist circumference (r=0.63), body weight (r=0.76) and height (r=-0.31) were significant (P<0.01) for the total subjects. CONCLUSIONS: The study indicates that waist circumference can serve as a positive indicator of overweight and obesity in the selected communities; however, it may not be used to determine underweight in adults. Regular BMI and waist circumference screening is recommended as an easy and effective means of assessing body weight and in the prevention of weight related diseases in adults. Significance for public healthThis manuscript describes the correlation between body mass index, waist circumference and body weight of two communities in Ota, Ogun State, Nigeria and the use of these anthropometric measures for body weight classification in human populations of the selected communities. This was carried out to evaluate the health status of the indigenes of the two communities for proper health awareness and public health intervention programmes.