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Violence against women (VAW) and violence against the Earth (VAE) have always shared a unique and complex associa- tion yet to be explored. The fields of VAW and VAE have evolved in separate routes, with divergent theoretical foundations but with little integration. While the impact of VAW has received much attention over the years, relatively little thought has gone into the intersections. Drawing parallels between society’s treatment of the physical and natural environment and its treatment of women, this paper will pull in insights to broaden and clarify the way VAW has been conceptualized, its association with the physical and natural environment (Mother Earth), and the constructs and the commitments that flow from them. In this paper, we formulate, cast, and present an expanded understanding of the relationship between violence against the physical and the natural environment and VAW. The article, an offshoot of our conceptualization on the inter-linkages between VAW and VAE, is being submitted for interpretation and application. [ABSTRACT FROM AUTHOR]

This study presents an in-depth analysis of vaccine clinical trials in Africa, emphasising the significance of local investments to address the continent's healthcare requirements. The research scrutinises vaccine trials across various African nations, focusing on trial distribution, phases, funding sources, recruitment sites, recruitment statuses, and age group participation. The findings suggest substantial trial activity in countries like Kenya, Ghana, and Gambia, whereas nations like the Democratic Republic of the Congo and Tunisia exhibit minimal representation. Notably, COVID-19, HIV, and Yellow Fever vaccines prominently feature in the trials, with Phase 3 trials being the most prevalent. The presence of "Not Applicable" trials indicates adopting adaptive trial designs. Analysis of funding patterns reveals substantial international and local support, reflecting an escalating commitment to vaccine research in Africa. Nevertheless, concerns persist regarding disparities in trial distribution and age group participation, underscoring the necessity for robust regulatory frameworks and augmented local R&D capacity. Addressing these disparities can enhance the efficacy of vaccine research and elevate health outcomes across the African continent., Competing Interests: Declaration of competing interest We, the undersigned authors, declare that Lindi Mathebula, Thobile Malinga, Chinwe Iwu-Jaja, and Duduzile Ndwandwe have equally contributed to the conceptualisation, writing, and reviewing of the original draft of the manuscript. Additionally, we declare that we have nothing to disclose and no conflicts of interest to report., (Copyright © 2024. Published by Elsevier Inc.)

Cholera has been one of the world's biggest public health challenges for centuries. The presence of this disease brings into focus the social determinants of health in different parts of the world. Research and development efforts to find safe and effective Cholera vaccines are critical to decreasing the disease burden from Vibrio cholerae . We searched the International Clinical Trials Registry Platform (ICTRP) and Cochrane Central Register of Controlled Trials (CENTRAL) on 5 March 2023. We included all registered randomized trials studying Cholera vaccines. We used Microsoft Excel to perform a descriptive analysis of the source registry, geographic distribution, recruitment status, phase of trials, and type of trial sponsor and presented the findings using tables and graphs. The search of ICTRP yielded 84 trials, and 315 trials were identified from CENTRAL. Seventy-four trials were included in the analysis. Most of the trials (66%, n  = 49) were registered in ClinicalTrials.gov, followed by Clinical Trials Registry - India (9%, n  = 7) and the Cuban Public Registry of Clinical Trials (8%, n  = 6). The geographical distribution of the trials indicates that 48% ( n  = 36) of the trials were conducted in Asia, followed by 23% ( n  = 17) in North America, 15% ( n  = 11) in Africa, and 11% ( n  = 8) in Europe. Results further indicate that 81% ( n  = 60) of trials have a recruitment status "Not recruiting," followed by 12% ( n  = 9) with a status "recruiting." With the recent surge in Cholera cases and the limited supply of Cholera vaccines, research indicates the need for Cholera vaccine trials to ensure the availability of vaccines, especially in populations affected.

Universal health coverage (UHC) is defined as people having access to quality healthcare services (e.g., treatment, rehabilitation, and palliative care) they need, irrespective of their financial status. Access to quality healthcare services continues to be a challenge for many people in low- and middle-income countries (LMICs). The aim of this study was to conduct a scoping review to map out the health system strengthening strategies that can be used to attain universal health coverage in Africa. We conducted a scoping review and qualitatively synthesized existing evidence from studies carried out in Africa. We included studies that reported interventions to strengthen the health system, e.g., financial support, increasing work force, improving leadership capacity in health facilities, and developing and upgrading infrastructure of primary healthcare facilities. Outcome measures included health facility infrastructures, access to medicines, and sources of financial support. A total of 34 studies conducted met our inclusion criteria. Health financing and developing health infrastructure were the most reported interventions toward achieving UHC. Our results suggest that strengthening the health system, namely, through health financing, developing, and improving the health infrastructure, can play an important role in reaching UHC in the African context.

Despite overwhelming evidence of the effectiveness and safety of vaccinations, a growing number of people are reluctant to receive recommended vaccinations or refuse them altogether. Vaccination currently prevents 2-3 million deaths a year and a further 1.5 million deaths could be avoided if global coverage of vaccinations improved. However, recently vaccine hesitancy has led to a resurgence of preventable diseases. There is heterogeneity in vaccine hesitant individuals and a diversity of situations in which vaccine hesitancy can arise, thus requiring that interventions to address vaccine hesitancy be context-specific and problem-specific., (Copyright © 2021. Published by Elsevier Ltd.)

Background: Implementation research has emerged as part of evidence-based decision-making efforts to plug current gaps in the translation of research evidence into health policy and practice. While there has been a growing number of initiatives promoting the uptake of implementation research in Africa, its role and effectiveness remain unclear, particularly in the context of universal health coverage (UHC). Hence, this scoping review aimed to identify and characterise the use of implementation research initiatives for assessing UHC-related interventions or programmes in Africa., Methods: The review protocol was developed based on the methodological framework proposed by Arksey and O'Malley, as enhanced by the Joanna Briggs Institute. The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). MEDLINE, Scopus and the Cochrane Library were searched. The search also included a hand search of relevant grey literature and reference lists. Literature sources involving the application of implementation research in the context of UHC in Africa were eligible for inclusion., Results: The database search yielded 2153 records. We identified 12 additional records from hand search of reference lists. After the removal of duplicates, we had 2051 unique records, of which 26 studies were included in the review. Implementation research was used within ten distinct UHC-related contexts, including HIV; maternal and child health; voluntary male medical circumcision; healthcare financing; immunisation; healthcare data quality; malaria diagnosis; primary healthcare quality improvement; surgery and typhoid fever control. The consolidated framework for implementation research (CFIR) was the most frequently used framework. Qualitative and mixed-methods study designs were the commonest methods used. Implementation research was mostly used to guide post-implementation evaluation of health programmes and the contextualisation of findings to improve future implementation outcomes. The most commonly reported contextual facilitators were political support, funding, sustained collaboration and effective programme leadership. Reported barriers included inadequate human and other resources; lack of incentives; perception of implementation as additional work burden; and socio-cultural barriers., Conclusions: This review demonstrates that implementation research can be used to achieve UHC-related outcomes in Africa. It has identified important facilitators and barriers to the use of implementation research for promoting UHC in the region.

Introduction: Implementation research has emerged as part of evidence-based decision-making efforts to plug current gaps in the translation of research evidence into health policy and practice. While there has been a growing number of institutions and initiatives promoting the uptake of implementation research in Africa, their role and effectiveness remain unclear, particularly in the context of universal health coverage (UHC). This review aims to extensively identify and characterise the nature, facilitators and barriers to the use of implementation research for assessing or evaluating UHC-related interventions or programmes in Africa., Methods and Analysis: This scoping review will be developed based on the methodological framework proposed by Arksey and O'Malley and enhanced by the Joanna Briggs Institute. It will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search of the following electronic databases will be conducted: Medline (via PubMed), Scopus and the Cochrane Library. Relevant grey literature and reference lists will also be searched. All publications describing the application of implementation research in the context of UHC will be considered for inclusion. Findings will be narratively synthesised and analysed using a predefined conceptual framework. Where applicable, quantitative evidence will be aggregated using summary statistics. There will be consultation of stakeholders, including UHC-oriented health professionals, programme managers, implementation researchers and policy-makers; to provide methodological, conceptual and practical insights., Ethics and Dissemination: The data used in this review will be sourced from publicly available literature; hence, this study will not require ethical approval. Findings and recommendations will be disseminated to reach a diverse audience, including UHC advocates, implementation researchers and key health system stakeholders within the African region. Additionally, findings will be disseminated through an open-access publication in a relevant peer-reviewed journal., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)

Introduction: long-distance truck drivers have been identified as a high-risk group for coronavirus disease (COVID-19) infection. Thus, the aim of this scoping review is to map out the existing evidence on the impact of long-distance truck drivers on the spread of COVID-19 and measures that countries can implement to mitigate this route of spread in the African region., Methods: we searched the PubMed database and the website of the World Health Organization (WHO) in March 2020 for eligible studies., Results: the search strategy identified 669 citations, of which six met the inclusion criteria. The most frequently reported interventions were maintaining hand hygiene, social distance, testing truck drivers, regulation of trade and transport e.g. only trucks with the food, medical supplies, fuels, agricultural supplies will be allowed to operate in interstate operations and regulating and controlling trucks carrying essential goods and services e.g. truck drivers are required to declare their final destination and are urged to stop only at designated points. Two studies from the African region reported about border closures and entry and exit screening, two studies from the US reported about the threat for public safety and risks and mitigation plans and 2 guidelines reported about harmonisation and facilitation of cross border in the context of the COVID-19 outbreak., Conclusion: this review highlights the countries response to mitigate the impact of the pandemic by implementing measures to facilitate safe cross-border trade and adopting regional harmonization of trucking regulations., Competing Interests: The authors declare no competing interests., (Copyright: Thobile Malinga et al.)

The occurrence of social isolation and loneliness has increased with the implementation of social distancing measures in multiple countries to contain the COVID-19 pandemic. Social isolation and loneliness are associated with considerable morbidity and mortality. Numerous interventions addressing social isolation and loneliness have been studied, including social facilitation using video calls. A Cochrane review, published in May 2020, assessed the effectiveness of video calls for preventing social isolation and loneliness in the elderly. The authors conducted a comprehensive electronic search and found three eligible studies, none of which was conducted during the COVID-19 pandemic. The review provides limited and uncertain evidence regarding the effectiveness of video call interventions to reduce loneliness in the elderly. Given the need for social distancing among the elderly, even when social distancing measures are lifted in African countries, there is a need for further research on the effectiveness of video calls in reducing social isolation and loneliness among older people., Competing Interests: The authors declare no competing interests., (© Thobile Malinga et al.)

Background: Perinatal tobacco smoking remains a public health concern and is associated with smoking related morbidity and mortality. This study aims to report the prevalence and correlates of smoking during pregnancy among low-income women., Methods: The study sample comprised 729 pregnant women who were enrolled in a perinatal depression registry in a public health WIC program between 2013 and 2015. Smoking risks were obtained from the clinical USDA Risk Assessment. STATA 14.2 was used for analyses., Results: 15.1% of women reported smoking during pregnancy. Compared to White women, Black women were less likely to smoke odds ratio (OR 0.45 [95% CI 0.25-0.81]). Foreign-born women and women living in non-smoking homes remained at a lower risk for smoking during pregnancy., Implications: Smoking during pregnancy is prevalent among low-income women. In addition to prenatal education on smoking cessation, supportive measures to help deliver smoking cessation interventions should be provided to household members.

Background: Suicidal ideation (SI) during pregnancy is a major maternal health concern, however few examinations report findings on the burden of SI among low-income women. The aim of this study is to estimate the prevalence and correlates of suicidal ideation among a sample of low-income women., Methods: A cross-sectional analysis of 736 low-income pregnant women enrolled in a Women Infant and Children supplemental nutrition program and a perinatal depression registry between 2013 and 2015. All participants provided informed consent. SI was captured from Edinburgh Postnatal Depression Scale (EPDS) screens administered during standard clinic visits., Results: The prevalence of suicidal ideation was 4.6%. After adjusting for smoking, women with depression were 13 times as likely to report SI., Limitations: SI was measured using a single item from the EPDS during pregnancy., Conclusions: This study indicates that most, but not all, women with SI reported elevated depressive symptoms., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background : Disparities in birth outcomes remain a problem in the United States. This study examined whether pre-pregnancy weight and gestational weight gain moderate the association between nativity and birth outcomes in the United States. Methods : We conducted a systematic review using Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. We searched PubMED, CINAHL, PsychInfo, and Cochrane Database of Systematic Reviews for relevant articles published before May 27, 2016. Results : Four articles met the eligibility criteria by adjusting for pre-pregnancy or gestational weight gain when examining birth outcomes by nativity. Results : Results from these studies show statistically significant differences in the risk of delivering low birth weight babies between foreign-born and U.S.-born women. These differences remained after adjusting for pre-pregnancy weight or gestational weight gain. However, results stratified by nativity still vary significantly by race/ethnicity. Conclusion : Few investigations include pre-pregnancy weight and gestational weight gain when examining differences in birth outcomes by nativity. Additional studies are needed to examine possible effect modification of these weight variables on the association between nativity and birth outcomes., Competing Interests: The authors declare no conflict of interest.

Background: WHO recommends a male circumcision (MC) prevalence rate higher than 80% to have a substantial impact on the HIV-AIDS epidemic in Eastern and Southern Africa. Orange Farm, a township in South Africa, has a free-for-service voluntary medical male circumcision (VMMC) clinic in operation since 2008. Following an intense campaign from 2008 to 2010, MC prevalence rate increased to 55.4% (ANRS-12126). Ongoing and past VMMC campaigns focused on youths, through school talks, and adults at a community level. The main objective of the study was to assess the change in MC prevalence rate among adults aged 18-19 and 18-49 years in the past 5 years., Methods: A cross-sectional survey (ANRS-12285) was conducted among a random sample of 522 adult men in 2015. MC status and characteristics of participants were collected through a genital examination and a face-to-face questionnaire., Results: MC prevalence rate among young adult men aged 18-19 years increased markedly from 61.2% (95%CI: 57.4% to 65.0%) in 2010 to 87.5% (76.0% to 94.6%) in 2015 (p<0.001). In the same period, among men aged 18-49 years, MC prevalence rate varied slightly from 55.4% (53.6% to 57.1%) to 56.7% (52.4% to 60.9%). In 2015, 84.9% (79.2% to 89.5%) of uncircumcised adult men reported that they were willing to be circumcised. However, we estimated that only 4.6% (11/237; 2.5% to 7.9%) of the uncircumcised men underwent circumcision in 2015, despite 117/185 (63.2%; 95%CI: 56.1% to 69.9%) who reported that they were definitely willing to become circumcised., Conclusions: In Orange Farm, VMMC campaigns were successful among the youth and led to a sufficiently high MC prevalence rate to have a substantial impact in the future on the HIV-AIDS epidemic. However, despite high acceptability and a free VMMC service, VMMC campaigns since 2010 have failed to increase MC prevalence rate among adults to above 80%. These campaigns should be revisited.

Culture and tradition influences behaviour. Multiple partner and concurrent relationships are made responsible for the increase of HIV infection in Sub-Saharan Africa. A contextualized "Theory of Planned Behaviour" was used to identify predictors of intention to practice monogamy. A mixed method design using qualitative data from focus groups, stories and a survey were analyzed for quantitative data. The qualitative data added to the behavioural beliefs a socio-cultural belief domain as well as attitudes, subjective norms, and perceived behavioural control predicted the intention to practice monogamy. The adolescents showed a tendency towards having more than one sexual partner. The normative beliefs and the socio cultural beliefs also predicted intentions while hedonistic belief and partner reaction did not. In contextualizing theory-based interventions, it is important to draw from stories and the langauage that circulate in a community about a given behaviour. More studies are needed on ways to combine qualitative approaches with quantitative approaches to inform the development of theory based culturally appropriate and context specific intervention strategies to reduce the risk of HIV.

Introduction and Hypothesis: World Health Organisation data suggest that two million women live with the physical and psychosocial effects of obstetric fistula. As part of an expanded fistula programme in Tanzania, Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) introduced an evaluation strategy to include impact of surgery on psychosocial aspects of obstetric fistula. This is an initial report documenting morbidity on admission., Methods: A questionnaire assessing the impact of obstetric fistula was developed taking into account literature in the field including sections on: patient contact information, transport costs and a set of statements regarding the effects of fistula. The effects were spread across five domains: the physical consequences of obstetric fistula, the effects of a difficult delivery and possible stillbirth, the experience of isolation, the inability to undertake daily living activities and feelings of depression. The questionnaire was administered in Kiswahili by Tanzanian counsellors shortly after admission of patients onto the fistula ward., Results: A total of 100 fistula patients reported high rates of physical and psychosocial morbidity. Over half of the patients said they would not have been able to access treatment without the transport costs being covered., Conclusions: Fistula patients are affected by extremely high rates of physical and psychosocial morbidity. Further work is required to confirm these findings, validate assessment tools and assess contributing factors in greater detail over time, such as the effect of stillbirth, as well as the impact of surgery.