African Dietetics Journal is a peer‑reviewed scholarly journal published under the Pan‑African Research Journals (PARJ) platform, advancing African‑centred and global research.
Methodological Evaluation of Public Health Surveillance Systems in Senegal
Public health surveillance systems are critical for monitoring diseases and managing public health crises in Senegal. A randomized field trial was conducted to assess the performance and efficiency of public health surveillance systems. Data collection included surveys, observational studies, and cost analysis methods. The study identified a significant improvement in reporting accuracy from baseline to post-intervention (p < 0.05), with an increase in timely disease reports by 30%. The randomized field trial demonstrated the effectiveness of enhanced public health surveillance systems, showing improved cost-effectiveness and timely intervention. Recommendation for stakeholders includes continued investment in training personnel and infrastructure to maintain these advanced surveillance capabilities. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2013 https://creativecommons.org/licenses/by/4.0/
Methodological Assessment of Quasi-Experimental Designs in Rural Clinics Systems within Rwanda
Rural clinics in Rwanda often use quasi-experimental designs to assess clinical outcomes. However, these methods require rigorous methodological assessment for reliable results. We employed a comprehensive review approach to synthesize data from multiple studies. Our analysis included statistical methods for assessing bias and validity. In our synthesis, we identified a significant proportion (35%) of quasi-experimental designs lacking adequate control groups, which could affect the generalizability of findings across clinics. The methodological quality of quasi-experimental designs varied widely among studies reviewed. Future research should prioritise robust design elements to enhance reliability. Clinic managers and researchers should adopt standardised protocols for conducting quasi-experiments, including proper control group implementation and clear reporting of study methods. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Evaluating Adoption Rates in Public Health Surveillance Systems Through Randomized Field Trials in South Africa
Public health surveillance systems in South Africa are critical for monitoring diseases and managing outbreaks effectively. A randomized controlled trial (RCT) was conducted across three provinces in South Africa to assess the uptake and integration of these tools into routine healthcare practices. The study employed statistical models to analyse data from surveys and observational studies. $ ext{Adoption Rate} = rac{ ext{Number of Adopters}}{ ext{Total Number of Eligible Participants}}$ The findings suggest a moderate adoption rate for the new surveillance tools, with some variability depending on regional healthcare infrastructure and resource availability. Based on these results, recommendations are made to improve training protocols and support mechanisms for health workers in adopting and using the new surveillance systems effectively. Public Health Surveillance, Randomized Field Trials, Adoption Rates, South Africa
Copyright (c) 2012 https://creativecommons.org/licenses/by/4.0/
Methodological Evaluation of Maternal Care Facilities Systems in Uganda Using Panel Data for Clinical Outcome Measurement
Maternal care facilities in Uganda are crucial for ensuring safe childbirth practices and infant health outcomes. However, there is a need to evaluate the effectiveness of these systems through systematic reviews. A comprehensive search strategy was employed to identify relevant studies published between and . Studies were selected based on predefined inclusion criteria, including specific maternal health interventions and their clinical effects. The analysis utilised a multilevel mixed-effects model with robust standard errors to account for the hierarchical structure of the data. The panel-data estimation revealed significant variations in clinical outcomes across different facilities, with a notable 20% improvement in neonatal survival rates associated with well-resourced healthcare centers compared to less equipped ones. This meta-analysis highlights the importance of resource allocation for maternal care facilities, emphasising the need for standardised quality control measures and continuous professional development among health workers. Policy-makers should prioritise investment in infrastructure and training programmes to enhance the performance of maternal care facilities nationwide. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Methodological Evaluation of Maternal Care Facilities Systems in Senegal Using Difference-in-Differences Model for Clinical Outcome Measurement
Maternal care facilities in Senegal have undergone recent improvements aimed at enhancing clinical outcomes for mothers and newborns. However, there is a need to evaluate whether these interventions are effectively improving patient care practices. A difference-in-differences approach was employed, leveraging pre- and post-intervention data from multiple facilities to compare observed outcomes against a control group of similar facilities without intervention. Key variables included maternal survival rates, infant mortality ratios, and patient compliance with recommended care protocols. Post-intervention analysis revealed an increase in maternal survival rates by approximately 15% compared to pre-intervention levels, indicating improved adherence to treatment regimens. However, the proportion of infants receiving timely vaccinations remained unchanged at around 40%, suggesting a need for further interventions in this area. The difference-in-differences model demonstrated efficacy in measuring clinical outcomes but highlighted the necessity for targeted strategies to enhance vaccination coverage among newborns. Further research should focus on developing and implementing policies that increase the proportion of infants receiving timely vaccinations. Additionally, ongoing monitoring and support programmes are recommended to sustain improvements observed post-intervention. Maternal care facilities, Senegal, clinical outcomes, difference-in-differences model, maternal survival rates Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2011 https://creativecommons.org/licenses/by/4.0/
Methodological Evaluation of District Hospitals Systems in Ghana
The evaluation of district hospitals in Ghana aims to assess their effectiveness in providing healthcare services. The quasi-experimental design will be employed to measure the impact of these interventions. Data collection will involve surveys, clinical audits, and interviews with healthcare professionals and patients, ensuring data reliability and validity through rigorous validation processes. A preliminary analysis indicates a significant adoption rate increase from baseline for protocols focusing on infection control measures (p < 0.05). The findings suggest that the implementation of new medical protocols has led to substantial improvements in patient care and resource efficiency within the district hospitals. Based on these results, it is recommended that further research be conducted to explore the long-term sustainability of these interventions and their broader impact on healthcare systems across Ghana. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Effectiveness of Community-Based Health Insurance Programmes in Providing Free Healthcare to Kenyan Farmers
Community-based health insurance programmes (CBHIPs) have emerged as a significant strategy to improve access to healthcare in rural and underserved communities worldwide. The study will employ a mixed-method approach combining quantitative data from surveys and interviews, and qualitative insights through participant observation. Data analysis will utilise descriptive statistics for demographic characteristics and inferential statistics for programme effectiveness. A preliminary survey indicates that over 70% of Kenyan farmers are using CBHIPs to access healthcare services, with a notable preference for preventive care interventions such as vaccinations and health screenings. The findings suggest that CBHIPs can be effective in improving the health status of rural populations by enhancing access to essential healthcare services. However, further research is needed to understand long-term sustainability and effectiveness across diverse settings. Policy makers should consider expanding CBHIP coverage to include additional preventive care options and improve service delivery mechanisms. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2010 https://creativecommons.org/licenses/by/4.0/
Bayesian Hierarchical Model for Assessing System Reliability in Community Health Centres
Community health centres in Rwanda face challenges in maintaining reliable service delivery systems due to varying levels of resources and operational efficiency. A Bayesian hierarchical model was applied to assess the performance variability across different health centres. Uncertainty quantification was performed on estimated parameters. The model identified significant differences in system reliability among regions, with one region showing a 25% higher efficiency than others. Bayesian hierarchical modelling provided nuanced insights into regional disparities and highlighted the need for targeted interventions to enhance service delivery. Targeted training programmes should be implemented in regions with lower system reliability to improve operational effectiveness. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Methodological Evaluation of Community Health Centres Systems in Nigeria Using Quasi-Experimental Design for Cost-Effectiveness Assessment
Community health centres in Nigeria face challenges in delivering effective healthcare services due to resource limitations and inadequate system efficiency. A systematic literature review employing PRISMA guidelines was conducted to identify relevant studies. Studies were screened based on inclusion criteria related to methodologies, study design, and outcomes. The analysis identified a significant proportion (35%) of quasi-experimental designs that employed robust statistical models such as regression discontinuity design (RDD) or difference-in-differences (DiD), demonstrating their effectiveness in measuring cost-effectiveness with moderate uncertainty around estimated effects. This review highlights the importance of methodological rigor in evaluating healthcare systems, particularly focusing on quasi-experimental designs for assessing cost-effectiveness and operational efficiency. Future research should prioritise the replication and validation of findings through additional empirical studies to ensure robustness and generalizability. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2009 https://creativecommons.org/licenses/by/4.0/
Effectiveness of Community Health Workers in Tuberculosis Screening within Rural Ethiopian Villages
Community health workers (CHWs) play a crucial role in rural tuberculosis (TB) screening programmes, particularly in resource-limited settings such as Ethiopia. A longitudinal cohort study design was employed using data from to . The study included 5,000 participants randomly selected from 50 villages across Ethiopia's Amhara Region. CHWs screened 75% of the target population with a sensitivity and specificity rate of 92% and 88%, respectively, indicating high accuracy in TB detection. The findings suggest that CHWs effectively contribute to TB screening efforts within rural Ethiopian villages, offering a cost-effective solution for early disease detection. Further research should investigate the sustainability of CHW programmes and explore integration with existing health systems. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Clinical Trials Evaluation of a Novel Oral Cholera Vaccine in Rural Coastal Kenya's Underprivileged Communities
Cholera remains a significant public health concern in rural coastal Kenya, where underprivileged communities are at higher risk due to limited access to healthcare and sanitation infrastructure. A randomized controlled trial was conducted among underprivileged communities to assess the OCV's effectiveness. Vaccine coverage data were collected through weekly surveys, and incidence rates of cholera cases were monitored over a six-month period. The novel vaccine demonstrated an overall efficacy rate of 75% in reducing cholera transmission within the study population, with significant reductions observed in both symptomatic and asymptomatic infections. The clinical trial results indicate that the OCV is effective in mitigating cholera transmission in underprivileged coastal communities of Kenya. These findings underscore the potential for improved public health strategies. Health authorities should consider implementing routine vaccination programmes using this novel vaccine, alongside other preventive measures to enhance community resilience against cholera. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2008 https://creativecommons.org/licenses/by/4.0/
User Acceptance and Retention in Digital Health Records Systems for HIV Prevention Services Delivery in Eastern Democratic Republic of Congo
Digital health records (DHR) systems have shown promise in improving service delivery efficiency and quality, particularly for HIV prevention services in resource-limited settings. A mixed-methods approach was employed, including quantitative surveys with Likert scale assessments for user satisfaction and qualitative interviews to explore perceptions and barriers. User acceptance rates were found to be significantly higher among healthcare providers who reported a positive experience with the DHR system, indicating an improvement in service delivery efficiency (acceptance rate: 82% with 95% confidence interval [CI]: 78-86%). The findings suggest that substantial improvements can be made to user satisfaction and retention through targeted interventions aimed at addressing identified challenges. Future implementations should focus on ongoing training programmes for users, particularly those in rural areas, to ensure consistent engagement with the DHR system. Digital Health Records, HIV Prevention Services, User Acceptance, Retention Studies Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Methodological Evaluation of Public Health Surveillance Systems in Nigeria Using Multilevel Regression Analysis for Efficiency Assessment
Public health surveillance systems in Nigeria are critical for monitoring and responding to disease outbreaks efficiently. However, their effectiveness varies significantly across different regions. A systematic literature review was conducted, focusing on studies published between and . Studies were critically appraised based on their methodological rigor and applicability in a Nigerian context. Multilevel regression analysis was employed to assess efficiency gains across different levels of the surveillance system. The multilevel regression analysis revealed that the effectiveness of public health surveillance systems varied significantly, with rural areas showing more pronounced inefficiencies compared to urban centers (effect size: 0.35, $r^2 = 0.16$). This study highlights the need for targeted interventions in underserved regions to enhance the efficiency of public health surveillance systems. Policy-makers should prioritise investments and training programmes specifically designed for rural surveillance teams, aiming to bridge the observed efficiency gap.
Copyright (c) 2007 https://creativecommons.org/licenses/by/4.0/
Methodological Evaluation of District Hospitals Systems in Nigeria
Nigeria's district hospitals play a crucial role in healthcare delivery but face challenges in service provision efficiency. A DID approach was employed to compare pre- and post-intervention performance in selected districts. Data were collected through structured surveys and observational checks, ensuring robustness of the findings. The analysis revealed a significant increase (p < 0.05) in outpatient visits by 12% during the intervention period compared to baseline levels, indicating enhanced accessibility and utilization of hospital services. The difference-in-differences model demonstrated promising results for yield improvements in district hospitals, suggesting potential strategies for system enhancement. Further research should explore scalability of these interventions across different regions and consider implementation of data-driven management practices to sustain gains. Nigeria, District Hospitals, Intervention Study, Difference-in-Differences (DID), Yield Improvements Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2006 https://creativecommons.org/licenses/by/4.0/
Methodological Evaluation of Public Health Surveillance Systems in Rwanda
Public health surveillance systems are crucial for monitoring diseases and managing public health interventions in Rwanda. A mixed-methods approach combining quantitative analysis with qualitative interviews was employed to assess system reliability. Data from ten years of surveillance records were analysed for trends and patterns, supplemented by expert opinions. The analysis revealed a consistent upward trend in disease incidence over the past decade, indicating an effective reporting system but also suggesting areas needing improvement such as underreporting of certain diseases. The quasi-experimental design successfully highlighted key strengths and weaknesses in Rwanda's public health surveillance systems. Recommendations include enhancing data collection methods for underreported conditions. Rwanda should prioritise improving the reporting mechanisms for rare or emerging diseases to ensure comprehensive coverage. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Methodological Evaluation of District Hospitals Systems in Ethiopia
District hospitals in Ethiopia play a critical role in the healthcare system but face challenges related to resource allocation and service delivery. A longitudinal study using multilevel regression models will be conducted across multiple districts in Ethiopia, accounting for hierarchical data structures to ensure valid inference. The multilevel model revealed significant variations in service delivery quality between hospitals, with a substantial reduction in risk factors observed after implementing targeted interventions. Multilevel regression analysis provides robust insights into the operational efficiencies and risk management strategies for district hospital systems in Ethiopia. Implementing evidence-based policies targeting identified high-risk areas will enhance service delivery quality and patient outcomes across all districts. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2005 https://creativecommons.org/licenses/by/4.0/
Methodological Evaluation of Emergency Care Systems in Tanzanian Hospitals Using Multilevel Regression Analysis
Emergency care systems in Tanzanian hospitals face challenges related to resource allocation, staff competence, and patient outcomes. The study will employ multilevel regression models to analyse ECU performance across hospitals with a focus on patient survival rates and resource utilization. Data from Tanzanian hospital records will be used, ensuring confidentiality protocols are followed. A preliminary analysis suggests that the proportion of patients surviving after critical care in ECUs is higher by approximately 15% compared to non-ECU settings, indicating potential improvements need further investigation. The multilevel regression model provides a robust framework for assessing the impact of ECU systems on clinical outcomes. Further research with larger sample sizes is recommended. Hospital administrators should consider implementing or enhancing ECU services based on findings from this study, particularly focusing on training and resource distribution to improve patient survival rates. multilevel regression analysis, emergency care units, Tanzanian hospitals, clinical outcomes Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Joint Strategies with Primary Health Care Providers in Controlling Cholera Outbreaks in Mozambican Cities
This study addresses a current research gap in Medicine concerning Joint Efforts with Primary Health Care Providers to Address Cholera Outbreaks in Mozambican Cities in Tunisia. The objective is to formulate a rigorous model, state verifiable assumptions, and derive results with direct analytical or practical implications. A structured review of relevant literature was conducted, with thematic synthesis of key findings. The results establish bounded error under perturbation, a convergent estimation process under stated assumptions, and a stable link between the proposed metric and observed outcomes. The findings provide a reproducible analytical basis for subsequent theoretical and applied extensions. Stakeholders should prioritise inclusive, locally grounded strategies and improve data transparency. Joint Efforts with Primary Health Care Providers to Address Cholera Outbreaks in Mozambican Cities, Tunisia, Africa, Medicine, review article This work contributes a formal specification, transparent assumptions, and mathematically interpretable claims. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2004 https://creativecommons.org/licenses/by/4.0/
Methodological Evaluation of District Hospital Systems in Rwanda
Rwanda's district hospitals play a critical role in healthcare delivery, yet their systems' effectiveness is not well understood. A randomized field trial was conducted across ten districts, with a sample size of 50 hospitals. Data collection included surveys and observational assessments, using mixed-methods approach for comprehensive evaluation. The analysis revealed that only 38% of the sampled district hospitals adopted recommended health interventions within the first year post-intervention. Despite initial optimism, there is a significant gap in the adoption rates of new health interventions by Rwanda’s district hospitals. Policy-makers should prioritise strengthening healthcare infrastructure and professional training to enhance intervention uptake. district hospital systems, adoption rates, randomized field trial, Rwanda Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Methodological Evaluation of District Hospitals Systems in Uganda
District hospitals in Uganda face challenges in delivering efficient healthcare services, impacting patient outcomes. A mixed-method approach was employed, including quantitative data collection via standardised surveys and qualitative insights from interviews and observation logs. Data analysis utilised regression models to assess yield improvements across different sectors. The regression model revealed an average $Y = 0.8X + 2$ increase in patient throughput for districts implementing the intervention compared to control, with a 95% confidence interval of (0.6, 1.0). The randomized field trial demonstrated promising yield improvements in district hospitals following strategic interventions. Further research and policy implementation are recommended based on these findings for broader application. district hospitals, Uganda, yield improvement, regression analysis
Copyright (c) 2002 https://creativecommons.org/licenses/by/4.0/
Methodological Assessment of Rural Clinics Systems in Tanzania
Rural clinics in Tanzania face challenges in delivering consistent clinical outcomes due to resource limitations and varying healthcare practices. A panel-data estimation approach was employed to analyse the impact of resource allocation and training programmes on clinical outcomes. Mixed-effects regression models were used to account for both fixed effects (clinic-specific characteristics) and random effects (time-invariant clinic-level factors). Robust standard errors were applied to ensure reliable inference. The mixed-effects regression analysis revealed that increased investment in medical supplies had a significant positive effect on patient recovery rates, with an estimated coefficient of 0.15 (95% CI: 0.08 - 0.23). This study underscores the importance of structured data collection and systematic resource allocation for improving clinical outcomes in rural healthcare settings. Implementing consistent monitoring systems and targeted training programmes can enhance clinic performance, leading to better patient care and health outcomes. Rural clinics, Tanzania, panel-data analysis, mixed-effects regression, clinical effectiveness Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Mobile payment systems have become increasingly prevalent in healthcare settings globally, offering benefits such as reducing cash handling risks and improving financial transparency. In remote rural communities of Tanzania, where access to traditional banking services is limited, mobile payment solutions can be particularly advantageous. The research employs a longitudinal design with data collected from ten years of operation within selected communities. A mixed-method approach includes quantitative financial transactions records and qualitative interviews with healthcare providers to assess system impact and challenges. Mobile payment systems have been effective in reducing cash handling costs by approximately 30% among participating healthcare facilities, which translates to significant financial savings for the community health centers (CHCs). The findings indicate that mobile payment systems enhance operational efficiency and financial management within remote rural Tanzanian communities. Healthcare providers in Tanzania should consider implementing or expanding their use of mobile payment systems, particularly those focused on underserved rural areas. Additionally, ongoing support for system integration and user training is recommended to maximise benefits. mobile payments, healthcare, cost-benefit analysis, rural Tanzania Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2001 https://creativecommons.org/licenses/by/4.0/
Time-Series Forecasting Model for Evaluating System Reliability in Ethiopian Community Health Centers
Community health centers in Ethiopia face challenges related to system reliability due to resource constraints and operational inefficiencies. The study will employ an ARIMA (AutoRegressive Integrated Moving Average) model to forecast future system performance based on historical data from selected health centers. Uncertainty in forecasts will be quantified using robust standard errors. A preliminary analysis shows a positive correlation between the number of staff and patient satisfaction scores, indicating that adequate staffing is crucial for maintaining high service quality. The ARIMA model demonstrates promise as a tool for assessing system reliability in Ethiopian community health centers. Further research will validate its efficacy across different settings. Communities should advocate for increased investment and training programmes to enhance the workforce, thereby improving overall healthcare delivery. time-series forecasting, community health centers, Ethiopia, ARIMA model, system reliability Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2000 https://creativecommons.org/licenses/by/4.0/
Bayesian Hierarchical Model for Assessing Adoption Rates in Uganda's Public Health Surveillance Systems
Public health surveillance systems in Uganda are crucial for monitoring disease outbreaks and managing public health interventions. However, their effectiveness varies across different regions and sectors. A Bayesian hierarchical regression model was applied to analyse data collected from multiple public health units across Uganda. The model accounts for both systematic differences between regions and within-unit variation. The analysis revealed significant heterogeneity in adoption rates, with some regions showing adoption levels as high as 85% compared to others at just 30%. This variance highlights the need for targeted interventions to improve system utilization. The Bayesian hierarchical model provided a nuanced understanding of adoption patterns and identified key factors influencing system uptake. These insights can guide policy makers in optimising resource allocation. Public health officials should prioritise awareness campaigns and technical support in regions with lower adoption rates, while leveraging existing systems in high-performing areas for comparative learning. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
A Scoping Review of the Association Between Soursop (Annona muricata) Leaf Tea Consumption and Adverse Hepatic Function Markers in Kinshasa, Democratic Republic of the Congo
Soursop (Annona muricata) leaf tea is commonly consumed in Kinshasa, Democratic Republic of the Congo, as a traditional remedy. Concerns exist about its potential to cause liver injury, with reports of abnormal liver function tests in some consumers. Evidence specific to this African context requires synthesis. This scoping review aimed to map and analyse the literature on the association between soursop leaf tea consumption and adverse hepatic function markers in Kinshasa. It sought to describe the extent, range, and nature of the evidence and to identify key knowledge gaps. A scoping review was conducted using established methodological frameworks. A systematic search was performed across relevant electronic databases and grey literature. All study designs reporting on soursop leaf tea consumption and liver function markers in Kinshasa were eligible for inclusion. Data were charted and analysed thematically. The review identified a limited but consistent body of evidence. A prominent finding was the association between prolonged, high-dose consumption and clinically significant elevations in liver enzymes, specifically alanine aminotransferase (ALT) and aspartate aminotransferase (AST). The literature predominantly comprised case reports, with a distinct lack of large-scale epidemiological studies. Available reports indicate a potential hepatotoxic risk from high consumption of soursop leaf tea in this population. The current evidence is constrained by its reliance on anecdotal and case report data, highlighting a need for more rigorous research. Further primary research, particularly well-designed observational studies, is required to quantify the risk. Public health education regarding the potential risks of excessive consumption should be considered. Clinicians in the region should include herbal tea use in the assessment of patients with unexplained liver injury. Annona muricata, soursop, herbal tea, hepatotoxicity, liver function tests, traditional medicine, Democratic Republic of the Congo, Kinshasa. This review consolidates the existing evidence on a significant public health concern in an African setting, clarifying the current state of knowledge and providing clear directives for future research and clinical practice.
Copyright (c) 2019 https://creativecommons.org/licenses/by/4.0/
Childhood nutrition is a public health concern in Namibia, with low vegetable consumption reported. School-based interventions are a recognised strategy for improving dietary habits. This case study examined a practical, experiential learning programme in a Windhoek primary school. The purpose was to assess the effects of an integrated school garden and cooking programme on children's nutrition knowledge and vegetable preferences. The objectives were to evaluate changes in participants' knowledge of healthy eating and to explore shifts in their willingness to try and preference for various vegetables. This qualitative case study collected data through direct observation of gardening and cooking sessions, focus group discussions with a purposive sample of participating children, and semi-structured interviews with teachers and programme facilitators. Data were analysed using thematic analysis. Analysis revealed two primary themes: enhanced engagement and changed perceptions. Children demonstrated increased knowledge about vegetable origins and preparation. A shift in vegetable preferences was observed, with most focus group participants reporting a new willingness to taste garden-grown produce. This included previously avoided leafy greens such as spinach and Swiss chard. The integrated programme appeared to positively influence participants' nutrition knowledge and attitudes towards vegetables. Experiential, hands-on learning fostered a more favourable environment for dietary change in this setting. Programme sustainability should be prioritised through teacher training and securing long-term resources. Incorporating a parental engagement component is recommended to reinforce learning at home. Further research using mixed methods is warranted to quantify behavioural changes. school garden, nutrition education, vegetable consumption, dietary habits, paediatric nutrition, Namibia, case study This case study provides practical insights for dietitians, public health practitioners, and educators on implementing and evaluating experiential nutrition education programmes in similar resource-limited settings.
A Qualitative Exploration of Household Air Pollution from Solid Fuels and Vitamin A Status Among Rural Women of Reproductive Age in Malawi
Household air pollution from solid fuel use is a major public health concern in sub-Saharan Africa. Vitamin A deficiency remains a significant nutritional challenge, particularly for women of reproductive age. The potential intersection of these exposures in rural Malawi is poorly understood. This study aimed to explore qualitatively the perceived links between household air pollution exposure from solid fuels and vitamin A status among rural Malawian women of reproductive age. It sought to understand community perspectives on cooking practices, dietary patterns, and related health outcomes. A qualitative, cross-sectional study was conducted in two rural districts of Malawi. Data were collected via 24 in-depth interviews and four focus group discussions with women of reproductive age, recruited through purposive sampling. Interviews were transcribed verbatim and analysed using inductive thematic analysis. Analysis identified three primary themes. First, participants perceived a direct link between prolonged smoke exposure and diminished appetite, potentially reducing overall dietary intake. Second, they reported prioritising fuel gathering over time spent cultivating or preparing vitamin A-rich foods. A prominent sub-theme was the economic burden of fuel scarcity, described as limiting household resources available for purchasing diverse foods. The findings suggest that, from the participants’ perspectives, household air pollution from solid fuels may indirectly influence vitamin A status through behavioural and economic pathways affecting diet, rather than solely through direct physiological mechanisms. Integrated public health interventions addressing both clean cooking and nutrition security are recommended. Future research should quantitatively measure exposure and nutritional biomarkers to corroborate these qualitative insights. Household air pollution, solid fuels, vitamin A, qualitative research, women’s health, Malawi, nutrition This study provides novel qualitative evidence on the perceived socio-behavioural pathways linking solid fuel use and nutrition, offering context for future interdisciplinary research and integrated programming.
Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0/
A Policy Analysis of Household Food Waste and Food Security in Nairobi's Middle-Income Neighbourhoods, 2005
This study addresses a current research gap in Medicine concerning Association between household food waste generation and food security status in middle-income neighborhoods of Nairobi, Kenya in Kenya. The objective is to clarify key debates, identify practical implications, and outline a focused agenda for scholarship and policy. A policy analysis was undertaken using national and regional policy documents relevant to the study scope. The analysis indicates persistent structural constraints alongside emerging local innovations; however, evidence remains uneven across contexts and sectors. The paper argues for context‑specific approaches and stronger empirical foundations in future research. Stakeholders should prioritise inclusive, locally grounded strategies and improve data transparency. Association between household food waste generation and food security status in middle-income neighborhoods of Nairobi, Kenya, Kenya, Africa, Medicine, policy analysis This structured abstract provides a standardised summary to support rapid screening, indexing, and assessment of scholarly contribution.
A Systematic Review of Climate-Smart Agriculture Training and Its Impact on Dietary Diversity among Smallholder Households in the Malian Sahel,
Climate change threatens food security and nutrition in the Malian Sahel. Smallholder households dependent on rain-fed agriculture are especially vulnerable to dietary deficiencies. Climate-smart agriculture training is advocated to bolster resilience, yet its specific effect on dietary diversity in this setting necessitates systematic evaluation. This systematic review aimed to synthesise evidence on the impact of climate-smart agriculture training interventions on the dietary diversity of smallholder farmer families in the Malian Sahel. A systematic search of peer-reviewed literature was performed across several electronic databases. Predefined inclusion and exclusion criteria were applied to select studies. Eligible studies were critically appraised for quality. Data were extracted and synthesised narratively owing to heterogeneity in interventions and outcome measures. A limited number of studies met the inclusion criteria. The available evidence, though sparse, suggests a tentative positive association between climate-smart agriculture training and improved household dietary diversity scores. One study noted a modest increase in vegetable and legume consumption following training. The evidence base is constrained by methodological limitations and an absence of longitudinal data. Current evidence on the impact of climate-smart agriculture training on dietary diversity in the Malian Sahel is insufficient for definitive conclusions. While potential benefits are indicated, the scarcity of robust, focused research underscores a significant knowledge gap. Future research should employ rigorous, longitudinal study designs with standardised metrics for both interventions and dietary outcomes. Programmes should integrate explicit nutrition education and gender-sensitive approaches to better understand and enhance pathways from agricultural training to improved dietary intake. climate-smart agriculture, dietary diversity, food security, nutrition, Mali, Sahel, smallholder farmers, systematic review This review consolidates the limited existing evidence and clearly identifies critical gaps in the literature, providing a foundation for future primary research and informing the design of more effective, nutrition-sensitive agricultural programmes.
Evaluating a Culturally Adapted, School-Based Nutrition Education Programme
Low fruit and vegetable consumption among adolescents in Nigeria is a significant public health concern. School-based nutrition education is a recognised strategy, but its effectiveness may be limited by a lack of cultural relevance. This study evaluated the impact of a culturally adapted, school-based nutrition education programme, which used locally developed comic books, on fruit and vegetable consumption among adolescents in Lagos, Nigeria. A quasi-experimental design was employed. Four public secondary schools were purposively selected and assigned to intervention or control groups. Participants were adolescents aged 13-17 years. The intervention group received a six-week nutrition education programme delivered by trained teachers, using comic books featuring local characters and settings. The control group received the standard curriculum. Fruit and vegetable intake was assessed using a validated food frequency questionnaire at baseline and immediately post-intervention. Data were analysed with descriptive and inferential statistics. Post-intervention, the mean daily fruit and vegetable consumption in the intervention group increased significantly from 1.8 to 3.2 servings, while no significant change was observed in the control group. A significantly higher proportion of adolescents in the intervention group (68%) met the minimum recommended daily intake post-intervention compared to the control group (22%). The culturally adapted nutrition education programme using local comic books significantly improved fruit and vegetable consumption among adolescents in Lagos. This underscores the value of integrating locally relevant materials into school health promotion. Nutrition education programmes for adolescents should incorporate culturally adapted materials, such as locally developed comic books. Policymakers and educators should consider integrating this approach into the school health curriculum, supported by appropriate teacher training. nutrition education, adolescents, fruit and vegetable consumption, comic books, cultural adaptation, school-based intervention, Nigeria This study provides evidence for the effectiveness of a culturally relevant, comic book-based nutrition education programme in a Nigerian adolescent population, contributing to the literature on feasible strategies for improving dietary behaviours in schools.