Associations of financial inclusion with physical activity participation in later life.

Background: Physical activity (PA) is a vital modifiable psychosocial intervention for promoting healthy longevity but problematically decreases with age. Innovative community-based strategies are recommended by the World Health Organization (WHO) to improve PA but prior research has seldom considered the interactive effect of financial inclusion, social networks, and sex differences on PA. In this study, we examine the role of sex differences and resourceful social networks in relation to the association of financial inclusion with PA among older Ghanaian people.

Availability, accessibility and activation of mental health services among university students in Africa: a protocol of a mixed-methods systematic review with meta-analysis and meta-synthesis.

Introduction: In Africa, the prevalence of mental health problems is higher among university students than in the general population. A number of systematic reviews and recent prevalence studies have focused on prevalence of mental health issues among college. This mixed-methods systematic review, including meta-analysis and meta-synthesis, will explore: what mental health services are available to university students; the extent to which students access available services and factors associated with service access; and the degree to which students activate (use) accessible services and factors associated with service activation.

Prevalence and Social Risk Factors of Functional Limitations Among Slum-Dwelling Older Adults: Findings From the Nairobi Urban Health and Demographic Surveillance System.

: In this study, we investigate the patterns and the risk factors of functional limitations in a sample of 1323 slum-dwelling older adults in Kenya who participated in the Nairobi Urban Health and Demographic Surveillance Systems. : We conducted crude and adjusted logistic regression analyses to evaluate the associations. : The prevalence of activities of daily living (ADL) and instrumental ADL (IADL) limitations were approximately 5% and 8%, respectively; some 4.

Perspectives on returning individual and aggregate genomic research results to study participants and communities in Kenya: a qualitative study.

Background: A fundamental ethical challenge in conducting genomics research is the question of what and how individual level genetic findings and aggregate genomic results should be conveyed to research participants and communities. This is within the context of minimal guidance, policies, and experiences, particularly in Africa. The aim of this study was to explore the perspectives of key stakeholders' on returning genomics research results to participants in Kenya.

Health-related quality of life among Ebola survivors in Sierra Leone: the role of socio-demographic, health-related and psycho-social factors.

Background: Evidence of how social factors affect the health-related quality of life (HRQoL) of Ebola virus disease (EVD) survivors is limited. Our study explores the association between socio-demographic, health-related and psycho-social (stigma) factors and EVD survivors' health-related quality of life (HRQoL) in Sierra Leone.

Methods: We conducted a nationwide cross-sectional study among 358 EVD survivors between January and August 2018.

Influence of contextual socioeconomic position on hypertension risk in low- and middle-income countries: disentangling context from composition.

Background: Hypertension has emerged as the single most significant modifiable risk factor for cardiovascular disease and death worldwide. Resource-limited settings are currently experiencing the epidemiological transition from infectious diseases to chronic non-communicable diseases, primarily due to modifications in diet and lifestyle behaviour. The objective of this study was to examine the influence of individual-, community- and country-level factors associated with hypertension in low- and middle-income countries (LMICs).

The wicked problem of waste management: An attention-based analysis of stakeholder behaviours.

Surging amounts of waste are reported globally and especially in lower-income countries, with negative consequences for health and the environment. Increasing concern has been raised for the limited progress achieved in practice by diverse sets of policies and programmes. Waste management is a wicked problem characterised by multilayered interdependencies, complex social dynamics and webs of stakeholders.

Willingness and ability to pay for healthcare insurance: A cross-sectional study of Seven Communities in East and West Africa (SevenCEWA).

Willingness and ability to pay for insurance that would cover primary healthcare services has not been evaluated consistently in different African communities. We conducted a cross-sectional community health survey and examined willingness and ability to pay in 3676 adults in seven communities in four countries: Nigeria, Tanzania, Uganda and Kenya. We used an open-ended contingency valuation method to estimate willingness to pay and examined ability to pay indirectly by calculating the ratio of healthcare expenditure to total household income.

Effect of disclosure of HIV status on patient representation and adherence to clinic visits in eastern Uganda: A propensity-score matched analysis.

Background: Disclosure of human immunodeficiency virus (HIV) status improves adherence to antiretroviral therapy (ART) and increases the chance of virological suppression and retention in care. However, information on the effect of disclosure of HIV status on adherence to clinic visits and patient representation is limited. We evaluated the effects of disclosure of HIV status on adherence to clinic visits and patient representation among people living with HIV in eastern Uganda.

Inequalities in Access and Utilization of Maternal, Newborn and Child Health Services in sub-Saharan Africa: A Special Focus on Urban Settings.

Objectives: The aim of this paper is to share the results of a systematic review on the state of inequalities in access to and utilization of maternal, newborn and child health (MNCH) services in the sub-Saharan African region. The focus of the review was on urban settings where growing needs and challenges have been registered over the past few years due to rapid increase in urban populations and urban slums.

Methods: The review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.

Psychosocial challenges and individual strategies for coping with mental stress among pregnant and postpartum adolescents in Nairobi informal settlements: a qualitative investigation.

Background: This study was part of a project funded under the Grand Challenges Explorations initiative to engage adolescent girls living in the main slums of Nairobi. This involved an innovative co-creation initiative through jointly designing and testing the feasibility of a toolkit of information, skill, and confidence-building, and coping mechanisms that can effectively shield them and their peers against the risks of mental stress during pregnancy and early motherhood.

Methods: Qualitative interviews and discussions from visual methodologies including Photovoice, digital storytelling, and public service announcements were conducted with 30 pregnant and adolescent mothers aged 14-19 years in four informal settlements either pregnant or having a child less than 2 years.

Whither are we bound? Rethinking the gendered frailty during COVID-19 pandemic.

The outbreak of the novel coronavirus disease 2019 (COVID-19) has demonstrated the urgency to reconsider social behavior and the health system quality to efficiently support and improve global health. Diverse global and country-specific mechanisms to fight COVID-19 have been displyed, but the gendered analysis of these efforts still remain too little too late. A critical consideration of the brunt of health and socioeconomic crises through gender lenses can improve understanding and direction of our efforts during pandemics.

Public opinion regarding government response to COVID-19: case study of a large commercial city in Nigeria.

Introduction: government measures to contain the COVID-19 pandemic cannot be effective without widespread compliance by the public. A greater understanding of citizens' perceptions of these measures can help government agencies adapt their strategies to boost compliance. We examined citizens' perceptions of government's measures to contain the COVID-19 pandemic and its implications on compliance using data from Onitsha city, Anambra State Nigeria.

Financial inclusion and physical health functioning among aging adults in the sub-Saharan African context: Exploring social networks and gender roles.

Background: It remains poorly understood how financial inclusion influences physical health functioning in later life in sub-Saharan African context and whether the association differs by gender and social relationships. We aim 1) to examine the associations of financial inclusion with functional impairment during older age in Ghana; and 2) to evaluate whether gender and social networks modify this association.

Methods: The cross-sectional analyses are based on a sample (N = 1,201) of study participants aged 50 years and over (M = 66.

Association between physical activity participation and perceived social isolation at older ages: Do social participation, age and sex differences matter?

Background: Physical inactivity is a major risk factor for poor health. However, it is unclear how physical activity (PA) is associated with perceived social isolation (PSI) in older age. This study aims to explore 1) association between PA and PSI among older people in Ghana and 2) if social participation (SP), age and sex modify any associations.

A qualitative inquiry of access to and quality of primary healthcare in seven communities in East and West Africa (SevenCEWA): perspectives of stakeholders, healthcare providers and users.

Background: Universal health coverage is one of the Sustainable Development Goal targets known to improve population health and reduce financial burden. There is little qualitative data on access to and quality of primary healthcare in East and West Africa. The aim of this study was to describe the viewpoints of healthcare users, healthcare providers and other stakeholders on health-seeking behaviour, access to and quality of healthcare in seven communities in East and West Africa.

Policy Action Within Urban African Food Systems to Promote Healthy Food Consumption: A Realist Synthesis in Ghana and Kenya.

Background: Obesity and nutrition-related non-communicable diseases (NR-NCDs) are increasing throughout Africa, driven by urbanisation and changing food environments. Policy action has been limited - and influenced by high income countries. Socio-economic/political environments of African food systems must be considered in order to understand what policy might work to prevent NR-NCDs, for whom, and under what circumstances.

Multimorbidity from Chronic Conditions among Adults in Urban Slums: The AWI-Gen Nairobi Site Study Findings.

Background: In the era of double burden of infectious and non-communicable diseases in sub-Saharan Africa, the burden of multimorbidity is likely to be common. However, there is limited evidence on the burden and its associated factors in the sub-Saharan African context.

Objective: The aim of this study was to determine the levels and identify determinants of multimorbidity from chronic conditions in two urban slums in Nairobi.

Research priorities to support evidence-informed policies and advocacy for access to safe abortion care in sub-Saharan Africa.

A key obstacle to advocacy efforts to promote legal and policy reforms that ensure women's and girls' access to comprehensive abortion care (CAC) is the lack of relevant and timely evidence. This commentary outlines a research agenda-setting initiative that identified research priorities to support evidence-informed policy and advocacy for CAC access in sub-Saharan Africa (SSA). It involved three phases: 1) a landscape analysis; 2) research agenda co-creation with stakeholders, and 3) a validation exercise on research priorities.

Unhealthy eating practices of city-dwelling Africans in deprived neighbourhoods: Evidence for policy action from Ghana and Kenya.

Growing urbanisation in Africa is accompanied by rapid changes in food environments, with potential shifts towards unhealthy food/beverage consumption, including in socio-economically disadvantaged populations. This study investigated how unhealthy food and beverages are embedded in everyday life in deprived areas of two African countries, to identify levers for context relevant policy. Deprived neighbourhoods (Ghana: 2 cities, Kenya: 1 city) were investigated (total = 459 female/male, adolescents/adults aged ≥13 y).

Physical activity and predictors of loneliness in community-dwelling older adults: The role of social connectedness.

This study sought to examine whether and how social connectedness impacts the association between physical activity and loneliness among older people in Ghana. Data for the analysis were obtained from the 2016-2017 Aging, Health, Psychological Wellbeing and Health-seeking Behavior Study (AgeHeaPsyWel-HeaSeeB) (N = 1200; mean age 66±12 years; women = 63%). Loneliness was assessed with the Short Form Revised UCLA Loneliness Scale.

Hypertension prevalence, awareness, treatment, and control and predicted 10-year CVD risk: a cross-sectional study of seven communities in East and West Africa (SevenCEWA).

Background: Few studies have characterized the epidemiology and management of hypertension across several communities with comparable methodologies in sub-Saharan Africa. We assessed prevalence, awareness, treatment, and control of hypertension and predicted 10-year cardiovascular disease risk across seven sites in East and West Africa.

Methods: Between June and August 2018, we conducted household surveys among adults aged 18 years and above in 7 communities in Kenya, Nigeria, Tanzania, and Uganda.