How Zambia reduced inequalities in under-five mortality rates over the last two decades: a mixed-methods study
Background: Zambia experienced a major decline in under-five mortality rates (U5MR), with one of the fastest declines in socio-economic disparities in sub-Saharan Africa in the last two decades. We aimed to understand the extent to which, and how, Zambia has reduced socio-economic inequalities in U5MR since 2000. Methods: Using nationally-representative data from Zambia Demographic Health […]
Trends of inequalities in childhood immunization coverage among children aged 12-23 months in Kenya, Ghana, and Côte d’Ivoire
Background: Immunization is one of the most cost-effective health intervention to halt the spread of childhood diseases, and improve child health. Yet, there is a substantial disparity in childhood immunization coverage. The overall objective of the study is to investigate the trends of within-country inequalities in childhood immunization coverage among children aged 12-23 months in […]
Working with what you have: How the East Africa Preterm Birth Initiative used gestational age data from facility maternity registers
Objective Preterm birth is the primary driver of neonatal mortality worldwide, but it is defined by gestational age (GA) which is challenging to accurately assess in low-resource settings. In a commitment to reducing preterm birth while reinforcing and strengthening facility data sources, the East Africa Preterm Birth Initiative (PTBi-EA) chose eligibility criteria that combined GA […]
Antiretroviral therapy use during pregnancy and adverse birth outcomes in South African women
Background: Studies of antiretroviral therapy (ART) use during pregnancy in HIVinfected women have suggested that ART exposure may be associated with adverse birth outcomes. However, there are few data from sub-Saharan Africa where HIV is most common, and few studies involving the World Health Organization’s (WHO’s) recommended first-line regimens. Methods: We enrolled consecutive HIV-infected pregnant […]
‘We allwork together to vaccinate the child’: A formative evaluation of a community-engagement strategy aimed at closing the immunization gap in North-West Ethiopia
The role of community engagement (CE) in improving demand for immunization merits investigation. The International Rescue Committee developed a CE strategy to implement a vaccine defaulter-tracing tool and a color-coded health calendar aimed at increasing uptake of immunization services in north-west Ethiopia (‘The Fifth Child Project’). We report findings from a formative evaluation of this […]
Stakeholder perceptions and context of the implementation of performance-based financing in district hospitals in Mali
Background: To improve the performance of the healthcare system, Mali’s government implemented a pilot project of performance-based financing (PBF) in the field of reproductive health. It was established in the Koulikoro region. This research analyses the process of implementing PBF at district hospital (DH) level, something which has rarely been done in Africa. Methods: This […]
Interruptions to HIV Care Delivery During Pandemics and Natural Disasters: A Qualitative Study of Challenges and Opportunities From Frontline Healthcare Providers in Western Kenya
During public health crises, people living with HIV (PLWH) may become disengaged from care. The goal of this study was to understand the impact of the COVID-19 pandemic and recent flooding disasters on HIV care delivery in western Kenya. We conducted ten individual in-depth interviews with HIV providers across four health facilities. We used an […]
Factors influencing full immunization coverage among 12-23 months of age children in Ethiopia: Evidence from the national demographic and health survey in 2011
Background: Immunization remains one of the most important public health interventions to reduce child morbidity and mortality. The 2011 national demographic and health survey (DHS) indicated low full immunization coverage among children aged 12-23 months in Ethiopia. Factors contributing to the low coverage of immunization have been poorly understood. The aim of this study was […]
Neonatal, infant and under-five mortalities in Nigeria: An examination of trends and drivers (2003-2013)
Neonatal (NMR), infant (IMR) and under-five (U5M) mortality rates remain high in Nigeria. Evidence-based knowledge of trends and drivers of child mortality will aid proper interventions needed to combat the menace. Therefore, this study assessed the trends and drivers of NMR, IMR, and U5M over a decade in Nigeria. A nationally representative data from three […]
Risk factors for obstetric fistula in western uganda: A case control study
Introduction: Two million women worldwide are living with genital fistula with an annual incidence of 50,000-100,000 women. Risk factors for obstetric fistula are context bound. Studies from other countries show variation in the risk factors for obstetric fistula. This study was conducted to identify risk factors for obstetric fistula in western Ugandan context. The study […]
