Health-care seeking for childhood diseases by parental age in Western and Central Africa between 1995 and 2017: A descriptive analysis using DHS and MICS from 23 low- and middle-income countries.

Background: Globally, health care seeking for childhood diseases seems to be on the rise. However, progress is slow and still, many cases of infectious diseases in children remain untreated, leading to preventable child mortality. A better understanding of care seeking behaviour may help to further increase the probability that a sick child is taken to a health facility for care.

The wealth gradient in diarrhoea, acute respiratory infections, and malaria in childhood over time: A descriptive analysis using DHS and MICS from Western and Central Africa between 1995 and 2017.

Background: While the prevalence of childhood diseases and related mortality have been decreasing over the past decades, progress has been unequally distributed. The poorest households often carry the highest disease burden. As morbidity and mortality also decline most slowly among children of the poorest households, socioeconomic status may become a more relevant risk factor for childhood diseases.

Prevalence of diarrhoea, acute respiratory infections, and malaria over time (1995-2017): A regional analysis of 23 countries in West and Central Africa.

Backgound: The global community recognizes the urgent need to end preventable child deaths, making it an essential part of the third Sustainable Development Goal. Pneumonia, diarrhoea, and malaria still remain the leading causes of deaths among children under five years, especially in one of the poorest geographic regions of the world - West and Central Africa. This region carries a disproportionately high share of the global burden, both in terms of morbidity and mortality.

Socio-economic predictors of undernutrition and anaemia in adolescent mothers in West and Central Africa.

Background: Adolescence is a formative period when an individual acquires physical, cognitive, emotional, and social resources that are the foundation for later life, health, and well-being [1]. However, in West and Central African region, this trajectory is curtailed by early childbearing associated with an increased risk of undernutrition and anemia. Evidence on socio-economic determinants of anemia and undernutrition in adolescent mothers is limited.

Socio-economic predictors of adolescent marriage and maternity in West and Central Africa between 1986 and 2017.

Background: Early marriage and maternity prevalence rates among adolescent girls remain alarmingly high in West and Central Africa (WCA). This study aims to explore the associations between socio-economic factors and the prevalence of early marriage and maternity, thus contributing to the identification of girls at risk of early pregnancy or marriage.

Methods: We pooled data from national representative surveys (1986 - 2017) for 23 countries in WCA to examine associations between wealth, educational attainment, religious affiliation, and place of residence with adolescent marriage and maternity.

Strengthening the community health program in Liberia: Lessons learned from a health system approach to inform program design and better prepare for future shocks.

Background: Arising from the Ebola virus disease (EVD) outbreak, the 2015-2021 Investment Plan aimed to improve the health status of the Liberian population through building a resilient health system that contributes to achieving equitable health outcomes. Recognizing the significance of community participation in overcoming the EVD outbreak, strengthening community systems emerged as one of the most important strategies for bridging the gap in accessing primary health care (PHC) services. This study reviewed the community health policy development process in order to draw lessons from the health system strengthening efforts in Liberia post-EVD crisis.

Galvanizing Action on Primary Health Care: Analyzing Bottlenecks and Strategies to Strengthen Community Health Systems in West and Central Africa.

Introduction: The renewed commitment to primary health care (PHC) presents an opportunity to strengthen health systems in West and Central Africa (WCA). Though evidence-based cost-effective interventions that are predicted to prevent up to one-third of maternal, newborn, and child health complications and deaths with universal coverage have been identified, more than 50% of people living in rural areas or from poor families still do not have access to these interventions in resource-constrained settings.

Methods: We conducted a multicountry systematic analysis of bottlenecks and proposed solutions to strengthen community health systems through a series of collaborative workshops in 22 countries in WCA.

Basic maternal health care coverage among adolescents in 22 sub-Saharan African countries with high adolescent birth rate.

Background: In the sub-Saharan Africa region, the adolescent birth rate is the highest in the world, estimated at 100.5 births per 1000 women aged 15 to 19 years, and 2.4 times greater than the global average.

Consensus building around nutrition lessons from the 2014-16 Ebola virus disease outbreak in Guinea and Sierra Leone.

There are important lessons learned from the 2014-16 Ebola virus disease outbreak in West Africa. However, there has not been a systematic documentation of nutrition lessons specifically. Therefore, this study sought to generate multiple stakeholder perspectives for understanding the nutrition challenges faced during the Ebola virus disease outbreak, as well as for consensus building around improved response strategies.

Community health workers during the Ebola outbreak in Guinea, Liberia, and Sierra Leone.

Background: The role of community health workers (CHWs) in the West Africa Ebola outbreak has been highlighted to advocate for increasing numbers of CHWs globally to build resilience, strengthen health systems, and provide emergency response capacity. However, the roles CHWs played, the challenges they faced, and their effectiveness during the outbreak are not well documented. This study assessed the impact of Ebola on community-based maternal, newborn, and child health (MNCH) services, documented the contribution of CHWs and other community-based actors to the Ebola response, and identified lessons learned to strengthen resilience in future emergencies.

Innovative approaches for improving maternal and newborn health--A landscape analysis.

Background: Essential interventions can improve maternal and newborn health (MNH) outcomes in low- and middle-income countries, but their implementation has been challenging. Innovative MNH approaches have the potential to accelerate progress and to lead to better health outcomes for women and newborns, but their added value to health systems remains incompletely understood. This study's aim was to analyze the landscape of innovative MNH approaches and related published evidence.

Inpatient care of small and sick newborns: a multi-country analysis of health system bottlenecks and potential solutions.

Background: Preterm birth is the leading cause of child death worldwide. Small and sick newborns require timely, high-quality inpatient care to survive. This includes provision of warmth, feeding support, safe oxygen therapy and effective phototherapy with prevention and treatment of infections.

Treatment of neonatal infections: a multi-country analysis of health system bottlenecks and potential solutions.

Background: Around one-third of the world's 2.8 million neonatal deaths are caused by infections. Most of these deaths are preventable, but occur due to delays in care-seeking, and access to effective antibiotic treatment with supportive care.

Basic newborn care and neonatal resuscitation: a multi-country analysis of health system bottlenecks and potential solutions.

Background: An estimated two-thirds of the world's 2.7 million newborn deaths could be prevented with quality care at birth and during the postnatal period. Basic Newborn Care (BNC) is part of the solution and includes hygienic birth and newborn care practices including cord care, thermal care, and early and exclusive breastfeeding.

Antenatal corticosteroids for management of preterm birth: a multi-country analysis of health system bottlenecks and potential solutions.

Background: Preterm birth complications are the leading cause of deaths for children under five years. Antenatal corticosteroids (ACS) are effective at reducing mortality and serious morbidity amongst infants born at <34 weeks gestation. WHO guidelines strongly recommend use of ACS for women at risk of imminent preterm birth where gestational age, imminent preterm birth, and risk of maternal infection can be assessed, and appropriate maternal/newborn care provided.

Quality care during labour and birth: a multi-country analysis of health system bottlenecks and potential solutions.

Background: Good outcomes during pregnancy and childbirth are related to availability, utilisation and effective implementation of essential interventions for labour and childbirth. The majority of the estimated 289,000 maternal deaths, 2.8 million neonatal deaths and 2.

Scaling up quality care for mothers and newborns around the time of birth: an overview of methods and analyses of intervention-specific bottlenecks and solutions.

Background: The Every Newborn Action Plan (ENAP) and Ending Preventable Maternal Mortality targets cannot be achieved without high quality, equitable coverage of interventions at and around the time of birth. This paper provides an overview of the methodology and findings of a nine paper series of in-depth analyses which focus on the specific challenges to scaling up high-impact interventions and improving quality of care for mothers and newborns around the time of birth, including babies born small and sick.

Methods: The bottleneck analysis tool was applied in 12 countries in Africa and Asia as part of the ENAP process.

Impact of smoking on the quantity and quality of antibodies induced by human papillomavirus type 16 and 18 AS04-adjuvanted virus-like-particle vaccine - a pilot study.

Background: The AS04-adjuvanted bivalent L1 virus-like-particle (VLP) vaccine (Cervarix™) against infection with human papillomavirus (HPV) types 16/18 holds great promise to prevent HPV16/18 infections and associated neoplasias, but it is important to rule out significant co-factors of the neoplasias like smoking.

Methods: We conducted a pilot study to compare the quantity and quality of HPV16/18 antibody response at baseline and 7 months post vaccination in 104 non-smoking and 112 smoking female participants vaccinated at 0, 1 and 6 months with Cervarix™ (55 and 48 study participants) or with Hepatitis A vaccine (HAVRIX™) (48 and 64 participants, respectively). These 216 women were a sub-sample of 4808 baseline 16- to 17-year old Finnish women initially enrolled in the double-blind, randomized controlled phase III PATRICIA trial.

Every Newborn: health-systems bottlenecks and strategies to accelerate scale-up in countries.

Universal coverage of essential interventions would reduce neonatal deaths by an estimated 71%, benefit women and children after the first month, and reduce stillbirths. However, the packages with the greatest effect (care around birth, care of small and ill newborn babies), have low and inequitable coverage and are the most sensitive markers of health system function. In eight of the 13 countries with the most neonatal deaths (55% worldwide), we undertook a systematic assessment of bottlenecks to essential maternal and newborn health care, involving more than 600 experts.

The importance of parental beliefs and support for physical activity and body weights of children: a population-based analysis.

Objective: To determine whether parental beliefs and support for physical activity (PA) are associated with normal-weight and overweight children's self-reported PA and body weight using a population-based approach.

Methods: We analyzed cross-sectional survey data from 6,585 students and their parents in Alberta, Canada, collected in 2008 and 2010. Parental beliefs and support were collected through questions on "care about staying fit", "encourage PA" and "engage in PA with their child".

Do improvements in outreach, clinical, and family and community-based services predict improvements in child survival? An analysis of serial cross-sectional national surveys.

Background: There are three main service delivery channels: clinical services, outreach, and family and community. To determine which delivery channels are associated with the greatest reductions in under-5 mortality rates (U5MR), we used data from sequential population-based surveys to examine the correlation between changes in coverage of clinical, outreach, and family and community services and in U5MR for 27 high-burden countries.

Methods: Household survey data were abstracted from serial surveys in 27 countries.

Socio-economic gradients in health behaviours and overweight among children in distinct economic settings.

Background: The socio-economic gradient in health does not seem to apply to overweight among Canadians adults. In the present study, we sought to determine the socio-economic gradient in overweight among Canadian children in distinct economic settings. We further examined socio-economic gradients in underlying behaviours, healthy eating and active living, as well as parental support for these behaviours.

Lack of association between human papillomavirus type 16 and 18 infections and female lung cancer.

Background: A carcinogenic role of human papillomavirus (HPV) in lung cancer development has been suggested through both clinical and laboratory research during the last two decades.

Methods: We did a population-based case-control study nested within the Finnish Maternity Cohort to assess the role of HPV16/18 infections in female lung carcinogenesis. The Finnish Maternity Cohort containing samples from more than 600,000 subjects were linked with nationwide cancer registries (1973-2006).

Should public health interventions aimed at reducing childhood overweight and obesity be gender-focused?

Background: Overweight in childhood is a major public health concern that calls for immediate preventative action. An increasing number of reports suggest that gender specific approaches to prevention may be more effective. However, there is a paucity of information to guide gender-sensitive health promotion and population health interventions for the prevention of overweight in childhood.