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Objective To estimate the direct costs of treating women with maternal near misses and potentially life- threatening conditions in Kenya and the factors associated with catastrophic health expenditure for these women and their households. Methods As part of a prospective, nationally representative study of all women with near misses during pregnancy and childbirth or within 42 days of delivery or termination of pregnancy, we compared the cost of treating maternal near-miss cases admitted to referral facilities with that of women with potentially life-threatening conditions. We used logistic regression analysis to assess clinical, demographic and household factors associated with catastrophic health expenditure. Findings Of 3025 women, 1180 (39.0%) had maternal near misses and 1845 (61.0%) had potentially life-threatening conditions. The median cost of treating maternal near misses was 7135 Kenyan shillings (71 United States dollars, US$) compared with 2690 Kenyan shillings (US$ 27) for potentially life-threatening conditions. Of the women who made out-of- pocket payments, 26.4% (122/462) experienced catastrophic expenditure. The highest median costs for treatment of near misses were in Nairobi and Central region (22 220 Kenyan shillings; US$ 222). Women with ectopic pregnancy complications and pregnancy-related infections had the highest median costs of treatment, at 7800 Kenyan shillings (US$ 78) and 3000 Kenyan shillings (US$ 30), respectively. Pregnancy-related infections, abortion, ectopic pregnancy, and treatment in secondary and tertiary facilities were significantly associated with catastrophic expenditure. Conclusion The cost of treating maternal near misses is high and leads to catastrophic spending through out-of- pocket payments. Universal health coverage needs to be expanded to guarantee financial protection for vulnerable women. Objectif Estimer les couts directs engendres par la prise en charge des meres ayant evite un deces de justesse et par les maladies potentiellement mortelles au Kenya, ainsi que les facteurs lies aux depenses de sante catastrophiques pour ces femmes et leur foyer. Methodes Une etude prospective et representative a l'echelle nationale a ete menee aupres de l'ensemble des femmes ayant evite un deces de justesse durant la grossesse et l'accouchement, ou dans les 42 jours suivant l'accouchement ou l'interruption de grossesse. C'est dans ce contexte que nous avons compare le cout du traitement des deces maternels evites de justesse avec celui des femmes souffrant de maladies potentiellement mortelles. Nous avons procede a une analyse de regression logistique afin d'evaluer les facteurs cliniques, demographiques et domestiques lies aux depenses de sante catastrophiques. Resultats Sur un total de 3025 femmes, 1180 (39,0%) avaient evite un deces de justesse et 1845 (61,0%) presentaient des maladies potentiellement mortelles. La prise en charge des deces maternels evites de justesse coutait en moyenne 7135 shillings kenyans (71 dollars americains), tandis que les maladies potentiellement mortelles revenaient a 2690 shillings kenyans (27 dollars americains). Parmi les femmes contraintes de payer elles-memes ces frais, 26,4% (122/462) ont fait face a des depenses catastrophiques. C'est a Nairobi et dans la Province centrale que la prise en charge des deces evites de justesse s'est averee la plus onereuse (22 220 shillings kenyans; 222 dollars americains). Les couts moyens les plus eleves etaient assumes par les femmes ayant subi des complications a cause d'une grossesse ectopique (7800 shillings kenyans; 78 dollars americains) et des infections liees a la grossesse (3000 shillings kenyans; 30 dollars americains). Les infections liees a la grossesse, l'avortement, les grossesses ectopiques et les traitements dans des etablissements secondaires et tertiaires etaient frequemment synonymes de depenses catastrophiques. Conclusion Le montant que represente la prise en charge des deces maternels evites de justesse est considerable et entraine des depenses catastrophiques lorsqu'il doit etre debourse par la patiente elle-meme. Il est imperatif d'etendre la couverture maladie universelle afin d'assurer la protection financiere des femmes vulnerables. Objetivo Estimar los costes directos del tratamiento de las mujeres con morbilidad materna extrema y con enfermedades potencialmente mortales en Kenia, asi como los factores asociados a los gastos sanitarios catastroficos para estas mujeres y sus hogares. Metodos Como parte de un estudio de cohortes y representativo a nivel nacional de todas las mujeres con morbilidad extrema durante el embarazo y el parto o dentro de los 42 dias posteriores al parto o a la interrupcion del embarazo, se comparo el coste del tratamiento de los casos de morbilidad extrema ingresados en centros de referencia con el de las mujeres con enfermedades potencialmente mortales. Se utilizo un analisis de regresion logistica para evaluar los factores clinicos, demograficos y domesticos asociados a los gastos sanitarios catastroficos. Resultados De 3025 mujeres, 1180 (39,0 %) tuvieron morbilidad materna extrema y 1845 (61,0 %) padecieron enfermedades potencialmente mortales. El coste medio del tratamiento de los casos de morbilidad materna extrema fue de 7135 chelines kenianos (71 dolares estadounidenses, USD), en comparacion con los 2690 chelines kenianos (27 USD) de las enfermedades potencialmente mortales. De las mujeres que pagaron de su bolsillo, el 26,4 % (122/462) tuvo gastos catastroficos. La mediana de los costes mas elevados para el tratamiento de la morbilidad materna extrema se registro en Nairobi y en la region central (22 220 chelines kenianos; 222 USD). Las mujeres con problemas de embarazo ectopico y con infecciones causadas por el embarazo tuvieron los costes medios de tratamiento mas elevados, 7800 chelines kenianos (78 USD) y 3000 chelines kenianos (30 USD), respectivamente. Las infecciones causadas por el embarazo, el aborto, el embarazo ectopico y el tratamiento en centros de atencion secundaria y terciaria se asociaron de manera significativa con los gastos catastroficos. Conclusion El coste del tratamiento de la morbilidad materna extrema es alto y genera un gasto catastrofico mediante los pagos de bolsillo. Se debe ampliar la cobertura sanitaria universal para garantizar la proteccion financiera de las mujeres vulnerables. [phrase omitted], Introduction Many countries in sub-Saharan Africa have increasingly committed to tackling maternal illnesses and deaths through a mix of interventions. For instance, in the past 15 years, the Kenyan government [...]

Advocacy actors play a unique role in promoting changes in policy, legal, and social environments for sexual and gender minorities in sub-Saharan Africa (SSA). However, their efforts may be hampered by limited incorporation of evidence because there is a massive gulf between what researchers focus on and what evidence users need. Together with fifty key stakeholders across SSA, we—a team of researchers and policy engagement specialists—co-created a research agenda and identified policy goals and research priorities to support evidence-informed policy and advocacy that can foster social inclusion of sexual and gender minorities in the region. We identified six research priority areas: (1) The history of lesbian, gay, bisexual and trans people and people whose identities do not conform to typical binary notions of male and female, or identify themselves using other categories to describe sexuality (LGBT+) in Africa and their lived realities; (2) Cost of non-inclusion and benefits of inclusion; (3) Strategies fostering inclusion; (4) Challenges and needs of LGBT + people; and (5) Implementation science on the effectiveness of provisions in sexual and reproductive health and HIV strategies or guidelines; and (6) Understanding the existing policy and legal architecture. This co-created research agenda can guide the generation of policy-relevant evidence, increase collaboration between researchers and policy actors, and increase research uptake to support efforts toward inclusion. [ABSTRACT FROM AUTHOR]

Introduction: Unsafe abortion is a leading cause of maternal mortality, and access to safe abortion services remains a public health priority in sub-Saharan Africa (SSA). A considerable amount of abortion research exists in the region; however, the spread of existing evidence is uneven such that some countries have an acute shortage of data with others over-researched. The imbalance reflects the complexities in prioritization among researchers, academics, and funders, and undeniably impedes effective policy and advocacy efforts. This scoping review aims to identify and map the landscape of abortion research in SSA, summarize existing knowledge, and pinpoint significant gaps, both substantive and geographic, requiring further investigation. This review will provide direction for future research, investments, and offer guidance for policy and programming on safe abortion. Materials and methods: We utilize the Joanna Briggs Institute's methodology for conducting scoping reviews. We will perform the search for articles in 8 electronic databases (i.e., PubMed, AJOL, Science Direct, SCOPUS, HINARI, Web of Knowledge, CINAHL, and WHO Regional Databases). We will include studies written in English or French language, produced or published between January 1, 2011, and July 31, 2021, and pertain directly to the subject of abortion in SSA. Using a tailored extraction frame, we will extract relevant information from publications that meet the inclusion criteria. Data will be analyzed using descriptive statistics and thematic analysis in response to key review questions. Ethics and dissemination: Formal ethical approval is not required, as no primary data will be collected. The findings of this study will be disseminated through peer-reviewed publications and conference presentations. [ABSTRACT FROM AUTHOR]

Introduction Previous studies have attempted to review the vast body of evidence on adolescent sexual and reproductive health (ASRH), but none has focused on a complete mapping and synthesis of the body of inquiry and evidence on ASRH in sub-Saharan Africa (SSA). Such a comprehensive scoping is needed, however, to offer direction to policy, programming and future research. We aim to undertake a scoping review of studies on ASRH in SSA to capture the landscape of extant research and findings and identify gaps for future research. Methods and analysis This protocol is designed using the framework for scoping reviews developed by the Joanna Briggs Institute. We will include English and French language peer-reviewed publications and grey literature on ASRH (aged 10–19) in SSA published between January 2010 and June 2019. A three-step search strategy involving an initial search of three databases to refine the keywords, a full search of all databases and screening of references of previous review studies for relevant articles missing from our full search will be employed. We will search AJOL, JSTOR, HINARI, Scopus, Science Direct, Google Scholar and the websites for the WHO, UNICEF, UNFPA, UNESCO and Guttmacher Institute. Two reviewers will screen the titles, abstracts and full texts of publications for eligibility and inclusion—using Covidence (an online software). We will then extract relevant information from studies that meet the inclusion criteria using a tailored extraction frame and template. Extracted data will be analysed using descriptive statistics and thematic analysis. Results will be presented using tables and charts and summaries of key themes arising from available research findings. Ethics and dissemination Ethical approval is not required for a scoping review as it synthesises publicly available publications. Dissemination will be through publication in a peer-review journal and presentation at relevant conferences and convening of policymakers and civil society organisations working on ASRH in SSA. [ABSTRACT FROM AUTHOR]

Background: Abortion draws varied emotions based on individual and societal beliefs. Often, women known to have sought or those seeking abortion services experience stigma and social exclusion within their communities. Understanding community perception of abortion is critical in informing the design and delivery of interventions that reduce the gaps in access to safe abortion for women. Objective: We explored community perceptions and beliefs relating to abortion, clients of abortion services, and abortifacients in Kenya. Methods: We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) in Kisumu and Nairobi counties in Kenya among a mix of adult men and women, pharmacists, nurses, and community health volunteers. Results: Community perspectives around abortion were heterogeneous, reflecting a myriad of opinions ranging from total anti-abortion to more pro-choice positions, and with rural-urban differences. Notably, negative views on abortion became more nuanced and tempered, especially among young women in urban areas, as details of factors that motivate women to seek abortion became apparent. Participants were mostly aware of the pathways through which women and girls access abortion services. Whereas abortion is commonplace, multiple structural and socioeconomic barriers, as well as stigma, are prevalent, thus impeding access to safe and quality services. Conclusion: Community perceptions on abortion are heterogeneous, varying by gender, occupation, level of education, residence, and position in society. Stigma and the hostile abortion environment limit access to safe abortion services, with several negative consequences. There is urgent need to strengthen community-based approaches to mitigate predisposing and enabling factors for unsafe abortions. [ABSTRACT FROM AUTHOR]

Non-communicable diseases (NCDs) prevalence is rising fastest in lower income settings, and with more devastating outcomes compared to High Income Countries (HICs). While evidence is consistent on the growing health and economic consequences of NCDs in sub-Saharan Africa (SSA), specific efforts aimed at addressing NCD prevention and control remain less than optimum and country level progress of implementing evidence backed cost-effective NCD prevention approaches such as tobacco taxation and restrictions on marketing of unhealthy food and drinks is slow. Similarly, increasing interest to employ multi-sectoral approaches (MSA) in NCD prevention and policy is impeded by scarce knowledge on the mechanisms of MSA application in NCD prevention, their coordination, and potential successes in SSA. In recognition of the above gaps in NCD programming and interventions in Africa, the East Africa NCD alliance (EANCDA) in partnership with the African Population and Health Research Center (APHRC) organized a three-day NCDs conference in Nairobi. The conference entitled "First Africa Non-Communicable Disease Research Conference 2017: Sharing Evidence and Identifying Research Priorities" drew more than one hundred fifty participants and researchers from several institutions in Kenya, South Africa, Nigeria, Cameroon, Uganda, Tanzania, Rwanda, Burundi, Malawi, Belgium, USA and Canada. The sections that follow provide detailed overview of the conference, its objectives, a summary of the proceedings and recommendations on the African NCD research agenda to address NCD prevention efforts in Africa. [ABSTRACT FROM AUTHOR]

Introduction: Anaemia and malnutrition are common health problems in developing countries with children being the most vulnerable. They have negative impacts on human performance, growth and development, in children, both as cause and consequences of disease. Although annual mass deworming and nutrition supplement strategies have been implemented in the Tiko Health District (THD), no study has been carried out to determine the prevalence of anaemia and malnutrition. The aim of this study was therefore designed to determine the prevalence of anaemia and malnutrition among primary school children aged 5-15 years in the Tiko Health District. Methods: A cross-sectional study was carried out in 10 randomly selected schools in the THD and a total of 400 school children were enrolled in the study. Body weight and height were measured using an electronic weighing scale and stadiometer respectively. Anthropometric indices: Height-for-Age Z scores (HAZ), Weight-for-Age Z scores (WAZ) and Body Mass Index-for-Age Z scores (BMIAZ) were analyzed and compared with WHO Growth Reference Standards using WHO Anthroplus software. Hemoglobin levels were determined using Urit-12 Haemoglobinometer and anaemia defined as Hemoglobin (Hb) < 11g/dl. Data analysis was done using the SPSS software. Results: The overall prevalence of malnutrition was 9.25%, prevalence of stunting 7.5% with 0.8% being severely stunted. The prevalence of wasting was 1% and underweight 0.7%. The overall prevalence of anaemia was 5%. Parents occupation and the absence of toilet were statistically associated with anaemia (P = 0.04 and P = 0.003). Age, floor type, absence of toilet and BMI were significantly associated with malnutrition (P = 0.00, P = 0.01, P = 0.02 and P = 0.003). Conclusion: This study revealed a low prevalence of malnutrition and anaemia which could be attributed to the deworming and nutrition supplement strategies which have been implemented. [ABSTRACT FROM AUTHOR]