Challenges of being a researcher in Africa: A narrative synthesis of literature

Background: The importance of research in the development agenda of Africa has received better recognition in recent years, with an increasing number of publications by African researchers. However, the number and quality of the research outputs are not on a par with the health problems and population size of the continent. This review was carried out with the aim of identifying the challenges researchers face in Africa. Materials and Methods: We conducted a narrative synthesis of the available literature. We searched for relevant articles on PubMed, Hinari and Google Scholar databases. We searched for additional articles from the reference lists of studies identified through the search. The date of the last search was 05 April 2018. We thematically synthesized the results in terms of individual, institutional and policy challenges. Results: We retrieved 610 articles, of which 12 were eligible for inclusion. Limited institutional research capacity, including a shortage of local funds, shortage of skilled researchers and weak infrastructure, were the prevailing challenges. A lack of technical capacity in scientific writing, including lack of English language writing skills, were the common individual-level challenges. A further finding was that research evidence generated in Africa was not generally used to inform the policy-making process. Conclusions: The challenge for researchers in Africa is primarily the weak capacity of research institutes that are not well equipped to produce the next generation of researchers. Efforts should be made to strengthen their capacity to improve the production of skilled scientists and visibility of research work in Africa. Ethiop. J. Health Dev. 2019; 33(4):229-238] Key words: Scientist, research, researcher, challenge, Africa, narrative, systematic revie

Balanced Energy Protein Supplementation in Pregnancy: Adherence and Acceptability among Pregnant Women in Rural Ethiopia.

BACKGROUND: Balanced energy protein (BEP) supplementation in pregnant women in low-and middle-income countries may reduce the risk of stillbirth and low birth weight. OBJECTIVES: The objective of this study was to assess the adherence to and acceptability of a corn-soy blend (CSB) BEP product among pregnant women in rural Ethiopia. METHODS: This formative study was conducted from October to November 2018 among pregnant women in the rural Amhara region of Ethiopia prior to initiation of a clinical effectiveness study (ISRCTN: 15116516). We assessed adherence and acceptability of a micronutrient-fortified CSB BEP supplement among 40 pregnant women during a 4-wk utilization period. Acceptability was assessed using a 7-point Likert-style scale about the hedonic characteristics of the BEP product at 2 wk and 4 wk. Adherence was assessed by weekly monitoring and empty sachet counts for BEP consumption over 4 wk. RESULTS: Adherence to the BEP was, on average, 89% over the month-long pilot. The BEP product was rated favorably (mean Likert score >6 of 7) for the following domains: color, taste, odor, and likeability at mid and endpoints. Women found the product convenient to eat [mean (standard deviation [SD] = 5.9 (1.0))] and filling (mean (SD) = 6.1 (1.5) out of 7). Scores on acceptability and perception of the product remained stable throughout the duration of use. A majority of women (63%) reported consuming the BEP as a snack to supplement meals and splitting the serving over 2 or more sessions (68%). A quarter of respondents reported sharing the supplement with family members. CONCLUSIONS: Adherence and acceptability of the CSB BEP product were high among this population in rural Amhara, Ethiopia. This formative data was important to select the final product and shape the counseling and delivery of BEP in the parent study

Effect of birthweight measurement quality improvement on low birthweight prevalence in rural Ethiopia.

BACKGROUND: Low birthweight (LBW) (< 2500 g) is a significant determinant of infant morbidity and mortality worldwide. In low-income settings, the quality of birthweight data suffers from measurement and recording errors, inconsistent data reporting systems, and missing data from non-facility births. This paper describes birthweight data quality and the prevalence of LBW before and after implementation of a birthweight quality improvement (QI) initiative in Amhara region, Ethiopia. METHODS: A comparative pre-post study was performed in selected rural health facilities located in West Gojjam and South Gondar zones. At baseline, a retrospective review of delivery records from February to May 2018 was performed in 14 health centers to collect birthweight data. A birthweight QI initiative was introduced in August 2019, which included provision of high-quality digital infant weight scales (precision 5 g), routine calibration, training in birth weighing and data recording, and routine field supervision. After the QI implementation, birthweight data were prospectively collected from late August to early September 2019, and December 2019 to June 2020. Data quality, as measured by heaping (weights at exact multiples of 500 g) and rounding to the nearest 100 g, and the prevalence of LBW were calculated before and after QI implementation. RESULTS: We retrospectively reviewed 1383 delivery records before the QI implementation and prospectively measured 1371 newborn weights after QI implementation. Heaping was most frequently observed at 3000 g and declined from 26% pre-initiative to 6.7% post-initiative. Heaping at 2500 g decreased from 5.4% pre-QI to 2.2% post-QI. The percentage of rounding to the nearest 100 g was reduced from 100% pre-initiative to 36.5% post-initiative. Before the QI initiative, the prevalence of recognized LBW was 2.2% (95% confidence interval [CI]: 1.5-3.1) and after the QI initiative increased to 11.7% (95% CI: 10.1-13.5). CONCLUSIONS: A QI intervention can improve the quality of birthweight measurements, and data measurement quality may substantially affect estimates of LBW prevalence

Mid-upper arm circumference for identifying adult overweight in large-scale population-based surveys : empirical evaluation using data of the EAT Addis study, Ethiopia

Objectives The present study evaluates body circumferences as a nutrition screening tool for women of reproductive age with children less than 5 years of age to improve the detection of overweight and obesity in a community setting. Design This study draws data from a community-based cross-sectional study conducted between July–August 2017 and January–February 2018 to account for seasonality in Addis Ababa, Ethiopia. Setting One hundred and sixteen districts were included in Addis Ababa, Ethiopia. Participants A total of 4914 women of reproductive age with children less than 5 years of age were participated in this study. Primary and secondary outcome measures Primary outcome measures included anthropometric indices. There were no secondary outcomes. Results The optimal cut-off points to identify overweight women of reproductive age were &gt;87.5 cm for waist circumference (WC), &gt;31.7 cm for neck circumference (NC) and &gt;28.0 cm for mid-upper arm circumference (MUAC) based on the highest corresponding Youden index. The area under the receiver operating characteristics curve was 0.92 (95% CI: 0.91 to 0.93) for WC, 0.83 (95% CI: 0.82 to 0.84) for NC and 0.91 (95% CI: 0.89 to 0.92) for MUAC. Conclusions Our result shows that WC and MUAC are alternative tools to body mass index. Both WC and MUAC are effective in identifying overweight women. We recommend using MUAC in large-scale population-based assessments to identify overweight and obesity in low-income settings as it is logistically simpler and operationally feasible

Additional file 1 of Targeting strategies of antenatal balanced energy and protein supplementation in Addis Ababa, Ethiopia: study protocol for a randomized effectiveness study

Supplementary Material 1