Malawi's Future Human Capital: Is the Country on Track to Meeting the MDGs on Education?

This study uses demographic and multi-state population projections to estimate the future population structure by age, sex and educational attainment in Malawi, and importantly, to assess the likelihood of meeting the Millennium Development Goals (MDG) related to universal primary education and gender disparity no later than 2015. Data from the 1998 and 1987 censuses, and from the 1992 and 2000 Malawi Demographic and Health Surveys (DHS) are used. First, we examine school enrollment ratios, repetition and dropout rates, and educational attainment, as well as differentials in infant and child mortality by level of the mother's education. Second, we estimate fertility, mortality, and educational transition rates from the DHS. Third, we estimate the population structure in 2000 and then perform forward projections to 2015. Finally, we examine the percentage distribution of the projected population by level of education. Malawi is one of the poorest countries in sub-Saharan Africa, with a population close to 10 million as of 2000. Less than 80 percent of the 6-14 year old children are still in school, and only 15 percent of those aged 14-17 have completed primary school

Anthelmintic activity and cytotoxic effects of compounds isolated from the fruits of Ozoroa insignis del. (Anacardiaceae)

Ozoroa insignis Del. is an ethnobotanical plant widely used in traditional medicine for various ailments, including schistosomiasis, tapeworm, and hookworm infections. From the so far not investigated fruits of Ozoroa insignis, the anthelmintic principles could be isolated through bioassay-guided isolation using Caenorhabditis elegans and identified by NMR spectroscopic analysis and mass spectrometric studies. Isolated 6-[8(Z)-pentadecenyl] anacardic (1), 6-[10(Z)-heptadecenyl] anacardic acid (2), and 3-[7(Z)-pentadecenyl] phenol (3) were evaluated against the 5 parasitic organisms Schistosoma mansoni (adult and newly transformed schistosomula), Strongyloides ratti, Heligmosomoides polygyrus, Necator americanus, and Ancylostoma ceylanicum, which mainly infect humans and other mammals. Compounds 1-3 showed good activity against Schistosoma mansoni, with compound 1 showing the best activity against newly transformed schistosomula with 50% activity at 1microM. The isolated compounds were also evaluated for their cytotoxic properties against PC-3 (human prostate adenocarcinoma) and HT-29 (human colorectal adenocarcinoma) cell lines, whereby compounds 2 and 3 showed antiproliferative activity in both cancer cell lines, while compound 1 exhibited antiproliferative activity only on PC-3 cells. With an IC50 value of 43.2 microM, compound 3 was found to be the most active of the 3 investigated compounds

Overview of migration, poverty and health dynamics in Nairobi City's slum settlements

The Urbanization, Poverty, and Health Dynamics research program was designed to generate and provide the evidence base that would help governments, development partners, and other stakeholders understand how the urban slum context affects health outcomes in order to stimulate policy and action for uplifting the wellbeing of slum residents. The program was nested into the Nairobi Urban Health and Demographic Surveillance System, a uniquely rich longitudinal research platform, set up in Korogocho and Viwandani slum settlements in Nairobi city, Kenya. Findings provide rich insights on the context in which slum dwellers live and how poverty and migration status interacts with health issues over the life course. Contrary to popular opinions and beliefs that see slums as homogenous residential entities, the findings paint a picture of a highly dynamic and heterogeneous setting. While slum populations are highly mobile, about half of the population comprises relatively well doing long-term dwellers who have lived in slum settlements for over 10 years. The poor health outcomes that slum residents exhibit at all stages of the life course are rooted in three key characteristics of slum settlements: poor environmental conditions and infrastructure; limited access to services due to lack of income to pay for treatment and preventive services; and reliance on poor quality and mostly informal and unregulated health services that are not well suited to meeting the unique realities and health needs of slum dwellers. Consequently, policies and programs aimed at improving the wellbeing of slum dwellers should address comprehensively the underlying structural, economic, behavioral, and service-oriented barriers to good health and productive lives among slum residents

Factors influencing place of delivery for women in Kenya: an analysis of the Kenya Demographic and Health Survey, 2008/2009

Background Maternal mortality in Kenya increased from 380/100000 live births to 530/100000 live births between 1990 and 2008. Skilled assistance during childbirth is central to reducing maternal mortality yet the proportion of deliveries taking place in health facilities where such assistance can reliably be provided has remained below 50% since the early 1990s. We use the 2008/2009 Kenya Demographic and Health Survey data to describe the factors that determine where women deliver in Kenya and to explore reasons given for home delivery. Methods Data on place of delivery, reasons for home delivery, and a range of potential explanatory factors were collected by interviewer-led questionnaire on 3977 women and augmented with distance from the nearest health facility estimated using health facility Global Positioning System (GPS) co-ordinates. Predictors of whether the woman’s most recent delivery was in a health facility were explored in an exploratory risk factor analysis using multiple logistic regression. The main reasons given by the woman for home delivery were also examined. Results Living in urban areas, being wealthy, more educated, using antenatal care services optimally and lower parity strongly predicted where women delivered, and so did region, ethnicity, and type of facilities used. Wealth and rural/urban residence were independently related. The effect of distance from a health facility was not significant after controlling for other variables. Women most commonly cited distance and/or lack of transport as reasons for not delivering in a health facility but over 60% gave other reasons including 20.5% who considered health facility delivery unnecessary, 18% who cited abrupt delivery as the main reason and 11% who cited high cost. Conclusion Physical access to health facilities through distance and/or lack of transport, and economic considerations are important barriers for women to delivering in a health facility in Kenya. Some women do not perceive a need to deliver in a health facility and may value health facility delivery less with subsequent deliveries. Access to appropriate transport for mothers in labour and improving the experiences and outcomes for mothers using health facilities at childbirth augmented by health education may increase uptake of health facility delivery in Kenya

Examining the “Urban Advantage” in Maternal Health Care in Developing Countries

Andrew Channon and colleagues outline the complexities of urban advantage in maternal health where the urban poor often have worse access to health care than women in rural areas

Consumer preferences and socioeconomic factors decided on plantain and plantain-based products in the central region of Cameroon and Oyo state, Nigeria

Open Access Journal; Published online: 22 Aug 2021Plantain is a key staple food in Central and West Africa, but there is limited understanding of its market in Africa. In addition, the cooking methods for enhancing the nutritional value, consumer preference, and willingness to pay for plantain and plantain-based products are not well understood. The knowledge gaps in the market and consumer dimension of the food chain need to be known to increase plantain utilization and guide breeding efforts. This research contributes by examining the cooking methods, consumer preference, and willingness to pay for plantain and plantain-based products in Cameroon and Nigeria. A household survey sample of 454 Cameroonian consumers in four divisions of Central Region and 418 Nigerian consumers in seven government areas of Oyo State in southwest Nigeria was the basis for the analysis. The results showed some levels of similarity and difference in the consumption and cooking of boiled, roasted, and fried plantain in both countries. The trend in consumption of all plantain-based products was constant in Cameroon but increased in Nigeria. The most important factor influencing Cameroonian consumers’ choice of plantain and its products was taste, while the nutrition trait influenced Nigerian consumers. Both Cameroonian and Nigerian consumers considered packaging, location of produce, and size and quantity as the least important factors. In addition, socioeconomic characteristics were significant determinants of consumers’ choices to consume plantain and its products. Gender significantly influenced (p < 0.05) taste, while nutrition was significantly driven (p < 0.05) by education and annual income. Household size played a significant role (p < 0.05) in consumers’ choices when the price was considered. These findings serve as a guideline to improve existing products to match the needs of consumers in each country and develop products for different consumer segments and potentially increase production

How Mistimed and Unwanted Pregnancies Affect Timing of Antenatal Care Initiation in three Districts in Tanzania

Early antenatal care (ANC) initiation is a doorway to early detection and management of potential complications associated with pregnancy. Although the literature reports various factors associated with ANC initiation such as parity and age, pregnancy intentions is yet to be recognized as a possible predictor of timing of ANC initiation. Data originate from a cross-sectional household survey on health behaviour and service utilization patterns. The survey was conducted in 2011 in Rufiji, Kilombero and Ulanga districts in Tanzania on 910 women of reproductive age who had given birth in the past two years. ANC initiation was considered to be early only if it occurred in the first trimester of pregnancy gestation. A recently completed pregnancy was defined as mistimed if a woman wanted it later, and if she did not want it at all the pregnancy was termed as unwanted. Chisquare was used to test for associations and multinomial logistic regression was conducted to examine how mistimed and unwanted pregnancies affect timing of ANC initiation. Although 49.3% of the women intended to become pregnant, 50.7% (34.9% mistimed and 15.8% unwanted) became pregnant unintentionally. While ANC initiation in the 1st trimester was 18.5%, so was 71.7% and 9.9% in the 2nd and 3rd trimesters respectively. Multivariate analysis revealed that ANC initiation in the 2nd trimester was 1.68 (95% CI 1.10‒2.58) and 2.00 (95% CI 1.05‒3.82) times more likely for mistimed and unwanted pregnancies respectively compared to intended pregnancies. These estimates rose to 2.81 (95% CI 1.41‒5.59) and 4.10 (95% CI 1.68‒10.00) respectively in the 3rd trimester. We controlled for gravidity, age, education, household wealth, marital status, religion, district of residence and travel time to a health facility. Late ANC initiation is a significant maternal and child health consequence of mistimed and unwanted pregnancies in Tanzania. Women should be empowered to delay or avoid pregnancies whenever they need to do so. Appropriate counseling to women, especially those who happen to conceive unintentionally is needed to minimize the possibility of delaying ANC initiation.\u

Variability of provitamin A carotenoids in plantain: influence of cultivar, bunch type, maturation stage, and location

Open Access Article; Published online: 01 Sept 2020In this study, the effect of ripening stage (R), cultivar (C), bunch type (T), and location (L) on the variability of provitamin A carotenoids (pVACs) in 16 plantain cultivars grown in Cameroon and Gabon was investigated. For the sixteen plantain cultivars, fruits were collected at stages 1 (unripe), 5 (ripe), and 7 (overripe) from three different bunch types (French, False Horn, and True Horn) across 13 locations in Cameroon and Gabon. For all cultivars, the highest concentration of carotenoids was found in ripe pulp (p < 0.05). For bunch type, a higher level of pVACs was observed in the French type compared with the False Horn and True Horn types at all ripening stages. In addition, the concentration of pVACs at each ripening stage varied greatly across locations. In both countries, the interaction between the four factors, particularly between R × C, R × T, R × L, R × C × L, and R × T × L, contributed significantly (p < 0.05) to the variability of pVACs in plantain. Daily consumption of 100 g of ripe plantain could meet 36.2–101.7 % of the dietary reference intakes (DRIs) for children 1–5 years old, 20.7–58.1 % for adult women, and 16.1–45.2 % for adult men. These findings can serve as a guide to reducing vitamin A deficiency (VAD) in Africa

Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya

BackgroundThe World Health Organisation (WHO) recommends exclusive breastfeeding during the first six months of life for optimal growth, development and health. Breastfeeding should continue up to two years or more and nutritionally adequate, safe, and appropriately-fed complementary foods should be introduced at the age of six months to meet the evolving needs of the growing infant. Little evidence exists on breastfeeding and infant feeding practices in urban slums in sub-Saharan Africa. Our aim was to assess breastfeeding and infant feeding practices in Nairobi slums with reference to WHO recommendations. MethodsData from a longitudinal study conducted in two Nairobi slums are used. The study used information on the first year of life of 4299 children born between September 2006 and January 2010. All women who gave birth during this period were interviewed on breastfeeding and complementary feeding practices at recruitment and this information was updated twice, at four-monthly intervals. Cox proportional hazard analysis was used to determine factors associated with cessation of breastfeeding in infancy and early introduction of complementary foods. ResultsThere was universal breastfeeding with almost all children (99%) having ever been breastfed. However, more than a third (37%) were not breastfed in the first hour following delivery, and 40% were given something to drink other than the mothers' breast milk within 3 days after delivery. About 85% of infants were still breastfeeding by the end of the 11th month. Exclusive breastfeeding for the first six months was rare as only about 2% of infants were exclusively breastfed for six months. Factors associated with sub-optimal infant breastfeeding and feeding practices in these settings include child's sex; perceived size at birth; mother's marital status, ethnicity; education level; family planning (pregnancy desirability); health seeking behaviour (place of delivery) and; neighbourhood (slum of residence). ConclusionsThe study indicates poor adherence to WHO recommendations for breastfeeding and infant feeding practices. Interventions and further research should pay attention to factors such as cultural practices, access to and utilization of health care facilities, child feeding education, and family planning. <br/