Same sex relationships and HIV/AIDS in Africa: Need for Research and programmatic focus

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Prévention et contrôle du cancer du col en Afrique: Appel à l'action

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Editorial - Promoting Youth Sexual and Reproductive Health in Africa: The Need for a Paradigm Shift

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EDITORIAL: Revamping the Reproductive Health Agenda in Africa After 2014

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Editorial: Defining a New Pathway for Family Planning in Africa After 2014

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What Africa can do to accelerate and sustain progress against malaria

After a longstanding global presence, malaria is now largely non-existent or suppressed in most parts of the world. Today, cases and deaths are primarily concentrated in sub-Saharan Africa. According to many experts, this persistence on the African continent reflects factors such as resistance to insecticides and drugs as well as insufficient access to essential commodities such as insecticide-treated nets and effective drugs. Crucially, however, this narrative ignores many central weaknesses in the fight against malaria and instead reinforces a narrow, commodity-driven vision of disease control. This paper therefore describes the core challenges hindering malaria programs in Africa and highlights key opportunities to rethink current strategies for sustainable control and elimination. The epidemiology of malaria in Africa presents far greater challenges than elsewhere and requires context-specific initiatives tailored to national and sub-national targets. To sustain progress, African countries must systematically address key weaknesses in its health systems, improve the quality and use of data for surveillance-responses, improve both technical and leadership competencies for malaria control, and gradually reduce overreliance on commodities while expanding multisectoral initiatives such as improved housing and environmental sanitation. They must also leverage increased funding from both domestic and international sources, and support pivotal research and development efforts locally. Effective vaccines and drugs, or other potentially transformative technologies such as genedrive modified mosquitoes, could further accelerate malaria control by complementing current tools. However, our underlying strategies remain insufficient and must be expanded to include more holistic and context-specific approaches critical to achieve and sustain effective malaria control

Rethinking human resources and capacity building needs for malaria control and elimination in Africa

Despite considerable success in controlling malaria worldwide, progress toward achieving malaria elimination has largely stalled. In particular, strategies to overcome roadblocks in malaria control and elimination in Africa are critical to achieving worldwide malaria elimination goals-this continent carries 94% of the global malaria case burden. To identify key areas for targeted efforts, we combined a comprehensive review of current literature with direct feedback gathered from frontline malaria workers, leaders, and scholars from Africa. Our analysis identified deficiencies in human resources, training, and capacity building at all levels, from research and development to community involvement. Addressing these needs will require active and coordinated engagement of stakeholders as well as implementation of effective strategies, with malaria-endemic countries owning the relevant processes. This paper reports those valuable identified needs and their concomitant opportunities to accelerate progress toward the goals of the World Health Organization's Global Technical Strategy for Malaria 2016-2030. Ultimately, we underscore the critical need to re-think current approaches and expand concerted efforts toward increasing relevant human resources for health and capacity building at all levels if we are to develop the relevant competencies necessary to maintain current gains while accelerating momentum toward malaria control and elimination

Where do delays occur when women receive antenatal care? A client flow multi-site study in four health facilities in Nigeria

Objectives: The objective of the study was to identify where delays occur when women present for antenatal care in four Nigerian referral hospitals, and to make recommendations on ways to reduce delays in the course of provision of antenatal care in the hospitals.Design: Prospective observational studySetting: Four Nigerian (1 tertiary and 3 secondary) HospitalsParticipants: Women who presented for antenatal care.Interventions: A process mapping. The National Health Service (NHS) Institute Quality and Service Improvement Tool was used for the assessment.Main outcome measures: The time women spent in waiting and receiving antenatal care in various departments of the hospitals.Results: Waiting and total times spent varied significantly within and between the hospitals surveyed. Mean waiting and total times spent were longest in the outpatients’ departments and shortest in the Pharmacy Departments. Total time spent was an average of 237.6 minutes. χ2= 21.074; p= 0.0001Conclusion: There was substantial delay in time spent to receive care by women seeking routine antenatal health services in the four secondary and tertiary care hospitals. We recommend managers in health facilities include the reduction of waiting times in the strategic plans for improving the quality of antenatal care in the hospitals. This should include the use of innovative payment systems that excludes payment at time of service delivery, adoption of a fast-track system such as pre-packing of frequently used commodities and the use of new tech informational materials for the provision of health education.Funding: The Alliance for Health Policy and Systems Research, World Health Organization, Geneva; Protocol IDA65869.Keywords: Delays; Waiting time; antenatal; Hospitals; Women; Maternity care; Process mapping; Nigeria

Prevalence and risk factors for maternal mortality in referral hospitals in Nigeria : a multicenter study

This study determines maternal mortality ratios (MMR) and identifies risk factors for maternal deaths in referral health facilities in Nigeria. Results show an MMR of 2,085 per 100,000 live births in hospital facilities. Efforts to reduce MMR requires the improvement of emergency obstetric care; public health education so that women can seek appropriate and immediate evidence-based pregnancy care; the socioeconomic empowerment of women; and the strengthening of the health care system. In the past ten years contraceptive prevalence rates have remained low at 10%; antenatal attendance has remained at 64%, skilled birth attendance of 33% is one of the lowest in sub-Saharan Africa.World Health Organizatio