Les données démographiques Africaines sont-elles capables de bien informer les décideurs sur les besoins de la population âgée Africaine?

It is unclear whether adequate data exist to assess accurately the numbers of older Africans, let alone provide the detailed information needed to inform policy decision making. We examine the quality of data on older Africans produced by the Demographic and Health surveys and censuses for 17 African countries in order to evaluate the quality of age reporting and the extent to which the older population is captured by these major data collection exercises. Our analyses show (1) that the quality of age data is rough or very rough for most countries outside Southern Africa (2) that in a number of Sahelian countries DHS surveys seem to omit a considerable proportion of older women and (3) the data on older people produced by the DHS and the census are inconsistent and contradictory. We then analyse in-depth interviews with data producers and users in Burkina Faso, Tanzania and Uganda on the available and required data in these countries on older people. We demonstrate a virtuous circle in Uganda where new policies for provision of services and resources for older people are generating new demands for data on older peoples’ situations and needs. This contrasts with the situations in Tanzania and Burkina Faso where there is little recognition of older people as a vulnerable population with specific needs and no widespread perception that better quality data are required

Bushmeat consumption in large urban centres in West Africa

Bushmeat consumption in large Sub-Saharan African cities is perceived as a major threat to the conservation of many species because their considerable population sizes can generate a significant demand for bushmeat. The study of the effect of age, sex and geographic location in bushmeat eating in African cities may offer valuable insights on which population groups to target in behaviour change campaigns. Using 2,040 interviews in six West African cities from four countries, in forest and savannah settings, we analysed the differences between age and sex in people’s frequency of bushmeat consumption. Overall, we found similar patterns in all sampled cities. As many as 62.2 % males and 72.1% females replied that they ‘would not eat bushmeat at all’, though only 12.8% males and 8.8% females mentioned they regularly ate bushmeat. Younger generations of both sexes answered that they ‘would never eat bushmeat’ more often than older age groups, independently of their city of origin. These trends are encouraging though further research needs to be undertaken to find out whether bushmeat volumes consumed in cities are unsustainable and having a serious impact of prey populations

Bushmeat consumption in large urban centres in West Africa

Bushmeat consumption in large Sub-Saharan African cities is perceived as a major threat to the conservation of many species because their considerable population sizes can generate a significant demand for bushmeat. The study of the effect of age, sex and geographic location in bushmeat eating in African cities may offer valuable insights on which population groups to target in behaviour change campaigns. Using 2,040 interviews in six West African cities from four countries, in forest and savannah settings, we analysed the differences between age and sex in people’s frequency of bushmeat consumption. Overall, we found similar patterns in all sampled cities. As many as 62.2 % males and 72.1% females replied that they ‘would not eat bushmeat at all’, though only 12.8% males and 8.8% females mentioned they regularly ate bushmeat. Younger generations of both sexes answered that they ‘would never eat bushmeat’ more often than older age groups, independently of their city of origin. These trends are encouraging though further research needs to be undertaken to find out whether bushmeat volumes consumed in cities are unsustainable and having a serious impact of prey populations

UN census households and local interpretations in Africa since independence

Abstract Since the 1950s, the UN Statistical Division has encouraged nations to standardize the definitions used in data collection. A key concept in censuses and surveys is the household: This is the unit for which information is collected and analyzed, and is thus an important dimension of data that are the basis for many policies. We aim to understand the tensions between conformity with UN guidelines and national priorities. We analyze the documentation around the UN household definition over this period. Using detailed census and survey documentary data for several African countries, especially Burkina Faso, Senegal, Uganda, and Tanzania, we examine the disparities between national census definitions of "household" and the UN definition. Perspectives from interviews with key informants within national statistical offices demonstrate the variability in the importance accorded to the UN harmonization aims and the problems that arise when these standardized approaches interact with local norms and living arrangements

Profile: The Ouagadougou Health and Demographic Surveillance System

The Ouagadougou Health and Demographic Surveillance System (Ouaga HDSS), located in five neighbourhoods at the northern periphery of the capital of Burkina Faso, was established in 2008. Data on vital events (births, deaths, unions, migration events) are collected during household visits that have taken place every 10 months. The areas were selected to contrast informal neighbourhoods (∼40 000 residents) with formal areas (40 000 residents), with the aims of understanding the problems of the urban poor, and testing innovative programmes that promote the well-being of this population. People living in informal areas tend to be marginalized in several ways: they are younger, poorer, less educated, farther from public services and more often migrants. Half of the residents live in the Sanitary District of Kossodo and the other half in the District of Sig-Nonghin. The Ouaga HDSS has been used to study health inequalities, conduct a surveillance of typhoid fever, measure water quality in informal areas, study the link between fertility and school investments, test a non-governmental organization (NGO)-led programme of poverty alleviation and test a community-led targeting of the poor eligible for benefits in the urban context. Key informants help maintain a good rapport with the community. The Ouaga HDSS data are available to researchers under certain conditions

The Role of Food Insecurity and Dietary Diversity on Recovery from Wasting among Hospitalized Children Aged 6-23 Months in Sub-Saharan Africa and South Asia

BACKGROUND: Current guidelines for the management of childhood wasting primarily focus on the provision of therapeutic foods and the treatment of medical complications. However, many children with wasting live in food-secure households, and multiple studies have demonstrated that the etiology of wasting is complex, including social, nutritional, and biological causes. We evaluated the contribution of household food insecurity, dietary diversity, and the consumption of specific food groups to the time to recovery from wasting after hospital discharge. METHODS: We conducted a secondary analysis of the Childhood Acute Illness Network (CHAIN) cohort, a multicenter prospective study conducted in six low- or lower-middle-income countries. We included children aged 6-23 months with wasting (mid-upper arm circumference [MUAC] ≤ 12.5 cm) or kwashiorkor (bipedal edema) at the time of hospital discharge. The primary outcome was time to nutritional recovery, defined as a MUAC > 12.5 cm without edema. Using Cox proportional hazards models adjusted for age, sex, study site, HIV status, duration of hospitalization, enrollment MUAC, referral to a nutritional program, caregiver education, caregiver depression, the season of enrollment, residence, and household wealth status, we evaluated the role of reported food insecurity, dietary diversity, and specific food groups prior to hospitalization on time to recovery from wasting during the 6 months of posthospital discharge. FINDINGS: Of 1286 included children, most participants (806, 63%) came from food-insecure households, including 170 (13%) with severe food insecurity, and 664 (52%) participants had insufficient dietary diversity. The median time to recovery was 96 days (18/100 child-months (95% CI: 17.0, 19.0)). Moderate (aHR 1.17 [0.96, 1.43]) and severe food insecurity (aHR 1.14 [0.88, 1.48]), and insufficient dietary diversity (aHR 1.07 [0.91, 1.25]) were not significantly associated with time to recovery. Children who had consumed legumes and nuts prior to diagnosis had a quicker recovery than those who did not (adjusted hazard ratio (aHR): 1.21 [1.01,1.44]). Consumption of dairy products (aHR 1.13 [0.96, 1.34], p = 0.14) and meat (aHR 1.11 [0.93, 1.33]), p = 0.23) were not statistically significantly associated with time to recovery. Consumption of fruits and vegetables (aHR 0.78 [0.65,0.94]) and breastfeeding (aHR 0.84 [0.71, 0.99]) before diagnosis were associated with longer time to recovery. CONCLUSION: Among wasted children discharged from hospital and managed in compliance with wasting guidelines, food insecurity and dietary diversity were not major determinants of recovery

Childhood mortality during and after acute illness in Africa and south Asia: a prospective cohort study

Background: Mortality among children with acute illness in low-income and middle-income settings remains unacceptably high and the importance of post-discharge mortality is increasingly recognised. We aimed to explore the epidemiology of deaths among young children with acute illness across sub-Saharan Africa and south Asia to inform the development of interventions and improved guidelines. Methods: In this prospective cohort study, we enrolled children aged 2–23 months with acute illness, stratified by nutritional status defined by anthropometry (ie, no wasting, moderate wasting, or severe wasting or kwashiorkor), who were admitted to one of nine hospitals in six countries across sub-Saharan Africa and south Asia between Nov 20, 2016, and Jan 31, 2019. We assisted sites to comply with national guidelines. Co-primary outcomes were mortality within 30 days of hospital admission and post-discharge mortality within 180 days of hospital discharge. A priori exposure domains, including demographic, clinical, and anthropometric characteristics at hospital admission and discharge, as well as child, caregiver, and household-level characteristics, were examined in regression and survival structural equation models. Findings: Of 3101 children (median age 11 months [IQR 7–16]), 1120 (36·1%) had no wasting, 763 (24·6%) had moderate wasting, and 1218 (39·3%) had severe wasting or kwashiorkor. Of 350 (11·3%) deaths overall, 234 (66·9%) occurred within 30 days of hospital admission and 168 (48·0%) within 180 days of hospital discharge. 90 (53·6%) post-discharge deaths occurred at home. The proportion of children who died following discharge was relatively preserved across nutritional strata. Numerically large high-risk and low-risk groups could be disaggregated for early mortality and post-discharge mortality. Structural equation models identified direct pathways to mortality and multiple socioeconomic, clinical, and nutritional domains acting indirectly through anthropometric status. Interpretation: Among diverse sites in Africa and south Asia, almost half of mortality occurs following hospital discharge. Despite being highly predictable, these deaths are not addressed in current guidelines. A fundamental shift to a child-centred, risk-based approach to inpatient and post-discharge management is needed to further reduce childhood mortality, and clinical trials of these approaches with outcomes of mortality, readmission, and cost are warranted. Funding: The Bill & Melinda Gates Foundation