Ghana coastal fisheries governance dialogue: Presentations, discussions and outcomes from a stakeholder forum on issues for reforming governance of Ghana’s coastal fisheries

This meeting, the second national Fisheries Governance Dialogue, aimed to help stakeholders in the fisheries sector generate a shared understanding of critical lessons and pathways for fisheries co-management success in Ghana. This was a direct response to the call from both fisheries communities and the government of Ghana for a radical change from the way fisheries resources are currently being managed. The meeting was attended by 60 men and women from stakeholder organizations and communities, and commenced with presentations on co-management experiences from local, regional and international participants. This was followed by panel discussions to extract lessons that specifically related to successfully implementing co-management in Ghana’s fisheries. Finally, breakout groups addressed in greater detail some issues of importance to fisheries governance reform in Ghana. While fisheries co-management is not a new concept in Ghana, participants heard that previous attempts to initiate these systems proved unsustainable. A number of lessons were drawn from these past experiences

Ghana coastal fisheries governance dialogue: developing options for a legal framework for fisheries co-management in Ghana

The Third National Fisheries Governance Dialogue was a direct follow up on the Second National Fisheries Governance Dialogue held in Elmina in April 2012. It was agreed at the Second dialogue that co-management was the way forward for sustaining Ghana’s fisheries and that its success would depend on a supportive legal framework. The two day dialogue meeting consisted of four key presentations focusing on: the current status of fisheries in Ghana; co-management as a fresh approach to fisheries; outcomes from the regional stakeholder consultations on co-management structure; and outcomes from the research on the legal framework. The presentations were followed by four breakout groups that generated ideas for co-management structures for different species namely pelagic fish or Sardinella, near shore demersal, Volta lake, and lagoons and estuaries. Key elements for co-management structures and elements of a co-management legal framework were later identified during plenary discussions

Women empowerment and uptake of antenatal care services : A meta-analysis of Demographic and Health Surveys from 33 Sub-Saharan African countries

Background: Women empowerment has been linked to increased skilled antenatal care (ANC) service use. However, there is no evidence on the net effect of women empowerment on ANC in the Sub-saharan African (SSA) region. We aim to address the knowledge gap on whether or not women empowerment positively influences the uptake of ANC at the SSA regional level. Methods: We analyzed the Demographic Health Survey (DHS) datasets from 33 SSA countries. Following the DHS data analysis guideline, we measured women empowerment using two indicators. The first indicator is an index, which comprises decision-making on women’s own health, household purchase and visit to family or relatives whilst disagreeing statements that husband is justified in beating his wife constitutes the second indictor. We performed confounder-adjusted logistic regression analysis for the two indicators with ANC attendance in each of the 33 countries. Then, we pooled the adjusted Odds Ratios (OR) using the random effect model through the two-stage Individual Participant Data meta-analysis technique. Summary findings are reported in OR and corresponding 95 %CI and are presented in a forest plot. Results: Moderately empowered women had marginally higher odd of skilled ANC service across the SSA region (aOR = 1.19; 95 %CI: 1.03, 1.38, with a prediction interval of 0.58, 2.45). Conversely, being involved in the three decisions (aOR = 1.15; 95 %CI: 0.99, 1.33, with prediction interval 0.57, 2.31), and attitude towards wife-beating (aOR = 0.97; 95 %CI: 0.88, 1.06, with prediction interval of 0.63, 1.48) had no statistically significant relationship with ANC. Conclusions: Women empowerment did not predict the use of skilled ANC in the context of the SSA region. We recommend that further studies be conducted in order to understand how women empowerment affects skilled ANC service utilization in the region

Summary measures of socioeconomic and area-based inequalities in fertility rates among adolescents: evidence from Ethiopian demographic and health surveys 2000–2016

Background One of the highest rates of adolescent pregnancies in the world is in sub-Saharan Africa. Most adolescent pregnancies in the region are unintended or unwanted, due to poor access to information and services on sexual and reproductive health for adolescents. Ethiopia has high adolescent fertility rates (AFR) with disparities across socioeconomic subgroups and regions. This study assessed the magnitude and trends of socioeconomic and area-based AFR inequalities in Ethiopia. Methods The 2000 and 2016 Ethiopia Demographic and Health surveys (EDHS) was analyzed using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software. Adolescent fertility rates were disaggregated using three equity stratifiers (economic status, education and residence) and analyzed through four summary measures (Difference (D), Population Attributable Risk (PAR), Ratio (R) and Population Attributable Fraction (PAF)) to assess inequality. To measure statistical significance, point estimates were constructed using a 95% Uncertainty Interval (UI). Results Large socio-economic and urban-rural inequalities were observed within the 16-year period. Adolescents in less well-off socio-economic groups (PAF: -62.9 [95% UI; − 64.3, − 61.4], D: 96.4 [95% UI; 47.7, 145.1]), uneducated (R: 8.5 [95% UI; 4.8, 12.2], PAR: -76.4 [95% UI;-77.7, − 75.0]) and those from rural areas (D: 81.2 [95% UI; 67.9, 94.6], PAF: -74.2 [95% UI, − 75.7, − 72.7]) had a higher chance of pregnancy and more births than their counterparts. Conclusions Socioeconomic (education and economic status) and place of residence determine adolescents’ pregnancy and childbearing. Policies and programs should be directed at preventing child marriage and early fertility so that adolescents continue to access education, sexual and reproductive health care as well as access employment opportunities. More emphasis should be placed on subpopulations with disproportionately higher adolescent pregnancy and childbirth

Time trends, geographical, socio-economic, and gender disparities in neonatal mortality in Burundi: evidence from the demographic and health surveys, 2010-2016.

BackgroundProgrammatic and research agendas surrounding neonatal mortality are important to help countries attain the child health related 2030 Sustainable Development Goal (SDG). In Burundi, the Neonatal Mortality Rate (NMR) is 25 per 1000 live births. However, high quality evidence on the over time evolution of inequality in NMR is lacking. This study aims to address the knowledge gap by systematically and comprehensively investigating inequalities in NMR in Burundi with the intent to help the country attain SDG 3.2 which aims to reduce neonatal mortality to at least as low as 12 per 1000 live births by 2030.MethodsThe Burundi Demographic and Health Survey (BDHS) data for the periods of 2010 and 2016 were used for the analyses. The analyses were carried out using the WHO's HEAT version 3.1 software. Five equity stratifiers: economic status, education, residence, sex and subnational region were used as benchmark for measuring NMR inequality with time over 6 years. To understand inequalities from a broader perspective, absolute and relative inequality measures, namely Difference, Population Attributable Risk (PAR), Ratio, and Population Attributable Fraction (PAF) were calculated. Statistical significance was measured by computing corresponding 95% Confidence Intervals (CIs).ResultsNMR in Burundi in 2010 and 2016 were 36.7 and 25.0 deaths per 1000 live births, respectively. We recorded large wealth-driven (PAR = -3.99, 95% CI; - 5.11, - 2.87, PAF = -15.95, 95% CI; - 20.42, - 11.48), education related (PAF = -6.64, 95% CI; - 13.27, - 0.02), sex based (PAR = -1.74, 95% CI; - 2.27, - 1.21, PAF = -6.97, 95% CI; - 9.09, - 4.86), urban-rural (D = 15.44, 95% CI; 7.59, 23.29, PAF = -38.78, 95% CI; - 45.24, - 32.32) and regional (PAR = -12.60, 95% CI; - 14.30, - 10.90, R = 3.05, 95% CI; 1.30, 4.80) disparity in NMR in both survey years, except that urban-rural disparity was not detected in 2016. We found both absolute and relative inequalities and significant reduction in these inequalities over time - except at the regional level, where the disparity remained constant during the study period.ConclusionLarge survival advantage remains to neonates of women who are rich, educated, residents of urban areas and some regions. Females had higher chance of surviving their 28th birthday than male neonates. More extensive work is required to battle the NMR gap between different subgroups in the country

Predictors of skilled birth attendance among married women in Cameroon: further analysis of 2018 Cameroon Demographic and Health Survey

Background In Cameroon, maternal deaths remain high. The high maternal deaths in the country have been attributed to the low utilization of maternal healthcare services, including skilled birth attendance. This study examined the predictors of skilled birth services utilization among married women in Cameroon. Methods Data from the 2018 Cameroon Demographic and Health Survey was analyzed on 7881 married women of reproductive age (15–49 years). Both bivariate and multivariable logistic regression analyses were carried out to determine the predictors of skilled childbirth services. The results were presented with crude odds ratio (cOR) and adjusted odds ratio (aOR) and 95% confidence interval (CI). Results The coverage of skilled birth attendance among married women of reproductive age in Cameroon was 66.2%. After adjusting for potential confounders, media exposure (aOR = 1.46, 95% CI: 1.11–1.91), higher decision making (aOR = 1.88, 95% CI: 1.36–2.59), maternal education (aOR = 2.38, 95% CI; 1.65–3.42), place of residence (aOR = 0.50, 95% CI; 0.33–0.74), religion (aOR = 0.55, 95% CI; 0.35–0.87), economic status (aOR = 5.16, 95% CI; 2.58–10.30), wife beating attitude (aOR = 1.32, 95% CI; 1.05–1.65), parity (aOR = 0.62, 95% CI; 0.41–0.93) and skilled antenatal care (aOR = 14.46, 95% CI; 10.01–20.89) were found to be significant predictors of skilled birth attendance. Conclusions This study demonstrates that social, economic, regional, and cultural factors can act as barriers to skilled childbirth services utilization in Cameroon. Interventions that target women empowerment, antenatal care awareness and strengthening are needed, especially among the rural poor, to reduce barriers to care seeking. Maternal healthcare services utilization interventions and policies in Cameroon need to focus on specific equity gaps that relate to socio-economic status, maternal education, and the economic empowerment of women. Such policies and interventions should also aim at reducing geographical barriers to access to maternal healthcare services, including skilled birth attendance. Due to the presence of inequities in the use of skilled birth attendance services, programs aimed at social protection and empowerment of economically disadvantaged women are necessary for the achievement of the post-2015 targets and the Sustainable Development Goals

Trends in socio-economic, sex and geographic disparities in childhood underweight in Mauritania: evidence from Multiple Indicator Cluster Surveys (2007-2015).

BackgroundUnderweight is one of the largest contributors to child morbidity and mortality and is considered to be the largest contributor to the global burden of diseases in low-and middle-income countries. In Mauritania, where one-fifth of children are underweight, there is a dearth of evidence on socio-economic, sex and geographic disparities in childhood underweight. As a result, this study aimed at investigating the socio-economic, sex and geographic disparities in childhood underweight in Mauritania.MethodsUsing the World Health Organization's (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the Mauritania Multiple Indicator Cluster Surveys (MICSs) conducted between 2007 and 2015 were analysed. Childhood underweight was disaggregated by five equity stratifiers: education, wealth, residence, region and sex. In addition, absolute and relative inequality measures, namely difference (D), population attributable risk (PAR), ratio (R) and population attributable fraction (PAF) were calculated to understand inequalities from wider perspectives. Corresponding 95% confidence intervals (CIs) were computed to measure statistical significance.ResultsSubstantial absolute and relative socio-economic, sex and geographic disparities in underweight were observed from 2007 to 2015. Children from the poorest households (PAR=-12.66 [95% CI -14.15 to -11.16]), those whose mothers were uneducated (PAF=-9.11 [95% CI -13.41 to -4.81]), those whose mothers were rural residents (R=1.52 [95% CI 1.37 to 1.68]), residents of HodhCharghy (PAF=-66.51 [95% CI -79.25 to -53.76]) and males (D=4.30 [95% CI 2.09 to 6.52]) experienced a higher burden of underweight. Education-related disparities decreased from 2007 to 2015. The urban-rural gap in underweight similarly decreased over time with the different measures showing slightly different reductions. Wealth-driven disparities decreased marginally from 2011 to 2015. The sex-based and regional disparities increased, at least on average, over the 8-y intersurvey period.ConclusionsThe burden of underweight was significantly higher among children from disadvantaged subpopulations, those with uneducated and poorest/poor mothers, those living in rural areas and those living in HodhCharghy. Special nutrition intervention and efforts focused on these deprived subpopulations are required to reduce childhood morbidity and mortality associated with underweight and help achieve the Sustainable Development Goals

Undernutrition, polygynous context and family structure: a multilevel analysis of cross-sectional surveys of 350 000 mother-child pairs from 32 countries.

BACKGROUND:Contextual factors, especially where people live, has been linked to various health outcomes, therefore, there is an increasing focus on its implication for policies and implementation of health interventions. Polygyny is a widespread practice in sub-Saharan Africa that also reflects socioeconomic and sociocultural features. This study investigated the association between polygynous context and risk of undernutrition. METHODS:Recent Demographic and Health Surveys involving 350 000 mother-child pairs from 32 sub-Saharan African countries conducted between 2010 and 2018 as of March 2020, were analysed using relevant descriptive and 3-level multilevel logistic regression modelling. Undernutrition among under-5 was defined as underweight, stunting and wasting using the WHO Multicentre Growth Reference Study. Odd Ratio (OR) at 95% credible interval was used to report the associations. RESULTS:The prevalence of contextual polygyny varied widely across the 32 sub-Saharan African countries, the lowest (0%) found in one of the regions in South Africa and the highest (52%) in one of the regions in Uganda. Underweight, stunting and wasting were lowest in Uganda (3.5%, 9.3%-1.27%, respectively), stunting was highest in Mozambique (37.1%) while wasting was highest in Niger (7.7%). Furthermore, the results showed that the contextual prevalence of polygynous practice exacerbates the risk of underweight (1.003 (0.997-1.008)) and wasting (1.014 (1.007-1.021)) among under-5 children, even when gender inequality and sociodemographic indicators were adjusted for. Polygyny was negatively associated with stunting though not significant; multiple births had the strongest and positive association with the risk of undernutrition among under-5 children in sub-Saharan Africa. CONCLUSIONS:This study further corroborates the strong influence of contextual factors on health outcomes-which is undernutrition in this study. In addition to specific interventions aimed at reducing the prevalence of undernutrition, broader strategies that will address contextual issues are required

Effect of xylopic acid on alloxan-induced diabetic neuropathy in rats

Background: Neuropathic pain is a very disturbing condition commonly found in diabetic patients. This study investigated xylopic acid (XA), the major constituent of Xylopia aethiopica in diabetic neuropathy as well as established possible toxicity of the compound on some selected tissues.Methods: Diabetes was induced in six groups of male rats with 120 mg/kg alloxan monohydrate. Diabetes was confirmed as a blood glucose level >15 mmol/dl. Neuropathic pain was confirmed on day three post-diabetes induction and treatment with 10 mg/kg, 30 mg/kg or 100 mg/kg xylopic acid, 10 mg/kg glibenclamide, 10 mg/kg morphine, and 10 ml/kg normal saline were initiated and continued for the next 15 days. The effects of the treatments on cold allodynia (cold water at 4°C) and thermal hyperalgesia (hot water at 55 ± 1°C) were evaluated within the duration of treatments. Histology of the liver and kidney, as well as haematological, serum biochemical, and semen analyses, were done after the fifteenth day of the experiment.Results: Xylopic acid produced significant anti-hyperglycaemic and analgesic effects in the cold allodynia and thermal hyperalgesia tests. Sperm motility, viability and count were significantly restored at 10 mg/kg XA as compared higher doses and negative control. The outcome of haematological analysis revealed a protective effect of XA although histological damage liver and kidney due to alloxan treatment was observable.Conclusions: Xylopic acid ameliorates diabetic neuropathy in rats and does not exert detrimental effects at low doses