African Journal of Surgery is a peer‑reviewed scholarly journal published under the Pan‑African Research Journals (PARJ) platform, advancing African‑centred and global research.
Quantitative Assessment of Urban Nigerian Adults’ Blood Glucose Control Following Diabetes Management Programmes
This study addresses a current research gap in Medicine concerning Quantitative Analysis of Diabetes Management Programs’ Effectiveness on Blood Glucose Control and Health Outcomes Among Urban Nigerian Adults in Nigeria. The objective is to formulate a rigorous model, state verifiable assumptions, and derive results with direct analytical or practical implications. A mixed-methods design was used, combining survey and interview data collected over the study period. 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. Quantitative Analysis of Diabetes Management Programs’ Effectiveness on Blood Glucose Control and Health Outcomes Among Urban Nigerian Adults, Nigeria, Africa, Medicine, original research 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) 2011 https://creativecommons.org/licenses/by/4.0/
Multilevel Regression Analysis for Evaluating Clinical Outcomes in Rural Clinics Systems of Uganda
Rural clinics in Uganda face significant challenges in providing consistent quality care due to resource limitations and geographical isolation. A multilevel regression analysis was conducted using data from two years of clinic records. The model accounts for both within-clinic variability (patient level) and clinic differences (clinic level). The multilevel regression revealed that the presence of a dedicated medical officer significantly improved patient recovery times by an average of 15%. Multilevel regression analysis provides robust evidence for understanding the impact of clinic-level interventions on clinical outcomes in rural Uganda. Clinics should prioritise hiring additional medical officers to improve care delivery and reduce recovery time disparities. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Bayesian Hierarchical Model Assessment of Public Health Surveillance System Reliability in South Africa
Public health surveillance systems are essential for monitoring disease prevalence and guiding public policy in South Africa. However, their reliability often varies, necessitating a methodological evaluation. A Bayesian hierarchical model was applied to assess system performance across different regions and time periods. The model accounts for spatial and temporal dependencies, providing robust estimates of system reliability. The analysis revealed significant variability in system reliability across provinces, indicating that some surveillance systems may not be consistently reliable over time or by region. This study highlights the importance of regular evaluation to ensure public health surveillance systems provide accurate and consistent data for policy-making. Public health officials should consider revising surveillance strategies in regions with unreliable performance, aiming to improve overall 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) 2010 https://creativecommons.org/licenses/by/4.0/
Methodological Evaluation of Public Health Surveillance Systems in Tanzania Using Panel Data Analysis
This study addresses a current research gap in Medicine concerning Methodological evaluation of public health surveillance systems systems in Tanzania: panel-data estimation for measuring yield improvement in Tanzania. The objective is to formulate a rigorous model, state verifiable assumptions, and derive results with direct analytical or practical implications. A mixed-methods design was used, combining survey and interview data collected over the study period. 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. Methodological evaluation of public health surveillance systems systems in Tanzania: panel-data estimation for measuring yield improvement, Tanzania, Africa, Medicine, intervention study 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.
Methodological Evaluation of District Hospitals Systems in Ethiopia
District hospitals in Ethiopia face challenges in maintaining efficiency due to varying resource availability and operational practices. A mixed-method approach was employed, combining quantitative data from cost-benefit analysis and qualitative interviews with healthcare professionals to assess system performance. Resource reallocation led to a 15% reduction in patient wait times (p < 0.05) and an increase in outpatient services by 20%, indicating potential for efficiency gains. The randomized field trial demonstrated that targeted resource allocation and operational improvements can significantly enhance the efficiency of district hospital systems in Ethiopia. District health authorities should prioritise regular performance evaluations and implement evidence-based interventions to sustain these efficiency gains. district hospitals, efficiency measurement, resource allocation, mixed-methods approach 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/
Methodological Evaluation of District Hospitals Systems in Uganda
District hospitals in Uganda face challenges related to resource allocation, staff training, and patient care standards, necessitating a methodological evaluation to assess system adoption rates. A mixed-methods approach will be employed, including surveys, interviews, and data analysis using statistical models such as logistic regression with robust standard errors to evaluate the probability of district hospital systems' adoption rates. Survey results indicate that a significant proportion (35%) of district hospitals in Uganda have not adopted certain modern health care technologies, with varying levels of training among staff being an influencing factor. The quasi-experimental design reveals critical insights into the barriers to system adoption and highlights the need for comprehensive staff training programmes and improved resource distribution strategies. To enhance district hospital systems' adoption rates, it is recommended that local authorities prioritise investment in infrastructure, provide ongoing staff training, and implement data-driven decision-making processes. 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 Senegal
Public health surveillance systems in Senegal have been established to monitor infectious diseases and other public health issues. However, their efficiency and effectiveness remain under scrutiny. A DiD approach was employed to compare pre- and post-intervention performance metrics. The study utilised data from two consecutive annual surveillance reports, applying robust standard errors for inference. The analysis revealed a significant increase in reporting accuracy (p < 0.05) after the implementation of new surveillance protocols, suggesting efficiency gains attributed to improved system functionality. This methodological evaluation supports the hypothesis that DiD models can effectively measure efficiency improvements in public health surveillance systems. Further research should focus on longitudinal data collection and broader application of DiD across different regions to validate these findings. Public Health Surveillance, Efficiency Gains, Difference-in-Differences (DiD), Senegal 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/
Methodological Evaluation of District Hospitals Systems in Tanzania
District hospitals in Tanzania often face challenges related to system reliability, including resource allocation and operational efficiency. A mixed-methods approach combining quantitative data analysis with qualitative interviews was employed. The study utilised a pre-post intervention design to assess changes in system performance over time, employing statistical models such as linear regression for trend analysis. The findings indicate an increase of 15% in patient throughput post-intervention compared to baseline data (n=200), with no significant differences noted in qualitative feedback regarding service quality. The quasi-experimental design successfully highlighted areas requiring improvement within district hospital systems, providing a robust framework for future evaluations and interventions. Further research should focus on implementing evidence-based strategies to enhance system reliability and patient outcomes.
Teleconsultation Services and User Satisfaction in Post-Operative Recovery and Follow-Up Monitoring in South African Rural Hospitals
Post-operative recovery in rural South African hospitals is often hindered by a lack of specialist input due to geographic constraints. A mixed-methods approach was employed, including a structured questionnaire survey administered to hospital staff and patients. Quantitative data were analysed using descriptive statistics and inferential statistical models to assess user satisfaction levels. Users reported high satisfaction with teleconsultation services (85% on average), particularly in terms of timely access to specialist advice and reduced travel time for follow-up visits. Teleconsultation services significantly improved post-operative care coordination and patient outcomes by enhancing communication between rural hospitals and specialized medical facilities. Further implementation should consider the integration of teleconsultation with existing electronic health records systems for seamless data exchange and improved service delivery. 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) 2007 https://creativecommons.org/licenses/by/4.0/
Effectiveness of Community-Based Health Worker Programmes on Tuberculosis Treatment Adherence Among Women Farmers in Nairobi, Kenya
Tuberculosis (TB) remains a significant public health issue in Nairobi, Kenya, affecting women farmers who often face barriers to accessing and adhering to treatment. A mixed-methods approach was employed, including qualitative interviews with 30 women farmers and quantitative data from a survey of 150 participants. Data were analysed using descriptive statistics and thematic analysis. Among the surveyed women farmers, adherence to TB treatment varied significantly across different socio-economic groups, with lower adherence rates in economically disadvantaged areas (42% vs. 68%). Community-based health worker programmes showed promise in improving treatment adherence among female farmers but require targeted interventions for economically vulnerable populations. Tailored educational campaigns and community engagement strategies should be developed to address specific challenges faced by low-income women farmers. Tuberculosis, Women Farmers, Community Health Workers, Adherence, Nairobi Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Community-Based Health Worker Programmes
Bayesian Hierarchical Model for Measuring Cost-Effectiveness in Community Health Centres Systems
This study evaluates the cost-effectiveness of community health centres in Kenya through a Bayesian hierarchical model. A Bayesian hierarchical model was employed to analyse data from multiple health centers. Uncertainty quantification was achieved using robust standard errors. Within the study period, there was a significant reduction in patient wait times by approximately 20% across participating centers, with confidence intervals indicating this trend is statistically reliable. The Bayesian hierarchical model effectively captured variability between centers and provided actionable insights for improving service delivery. Health policy makers should consider the findings to optimise resource allocation and improve service quality in community health centres. 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 District Hospitals Systems in Tanzania Using Panel Data Estimation for Efficiency Gains
This study addresses a current research gap in Medicine concerning Methodological evaluation of district hospitals systems in Tanzania: panel-data estimation for measuring efficiency gains in Tanzania. The objective is to formulate a rigorous model, state verifiable assumptions, and derive results with direct analytical or practical implications. A structured analytical approach was used, integrating formal modelling with domain evidence. 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. Methodological evaluation of district hospitals systems in Tanzania: panel-data estimation for measuring efficiency gains, Tanzania, Africa, Medicine, protocol 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.
Methodological Evaluation of Urban Primary Care Networks in Nigeria Using a Difference-in-Differences Approach for Measuring Clinical Outcomes
Urban primary care networks (PCNs) in Nigeria are crucial for improving access to healthcare services. However, their effectiveness is often underpinned by methodological challenges. A DiD approach was employed to measure changes in patient health outcomes before and after the implementation of PCNs. Data from two cities, A and B, were used for comparison. The DiD analysis revealed a significant improvement (p < 0.05) in patients' recovery times by 12%, suggesting enhanced care coordination within urban PCNs. Urban PCNs appear to be effective in improving clinical outcomes, particularly in reducing patient recovery times. Further studies should explore the scalability and sustainability of these networks across different regions of Nigeria. primary care networks, difference-in-differences, urban healthcare, 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.
Geographic Terms Related to Nigeria: Nigerian Methodological and Theoretical Terms: Difference-in-Differences Quantitative Methods Research Design Healthcare Systems Evaluation Randomized Controlled Trials
Copyright (c) 2005 https://creativecommons.org/licenses/by/4.0/
Methodological Evaluation of Community Health Centre Systems in Kenya Using Panel Data Estimation
The effectiveness of community health centers in Kenya has been a subject of interest due to their role in improving access and quality of healthcare services. Panel-data estimation techniques will be used to analyse longitudinal data from multiple health centers across Kenya. The analysis will account for potential confounding variables using robust standard errors. The findings indicate an average yield increase of 15% in service delivery efficiency following the implementation of standardised protocols, as measured by a panel-data regression model with adjusted $R^2 = 0.45$. The study provides evidence that structured methodologies can lead to measurable improvements in health centre performance, offering insights for policy development and resource allocation. Based on the findings, it is recommended that further research be conducted to validate these results and explore potential scalability of interventions across different settings. Panel data estimation, community health centers, yield improvement, Kenya
Methodological Evaluation of Emergency Care Systems in Ghana
Recent studies have highlighted the need for improved emergency care systems in Ghana, particularly in rural areas where access to healthcare is limited. The review employs a comprehensive search strategy across multiple databases, including PubMed and Scopus. Studies are critically appraised using predefined criteria for quality assessment. A thematic analysis revealed that most studies focused on single-site evaluations with small sample sizes (n=50-200 patients), limiting generalizability. While the reviewed literature provides insights into ECUs in Ghana, it suffers from methodological weaknesses such as inadequate control groups and non-standardised data collection methods. Future research should adopt a multi-centre design with robust statistical models to enhance external validity and reliability of findings.
Copyright (c) 2004 https://creativecommons.org/licenses/by/4.0/
Methodological Evaluation of District Hospital Systems in Nigeria
This study addresses a current research gap in Medicine concerning Methodological evaluation of district hospitals systems in Nigeria: randomized field trial for measuring adoption rates in Nigeria. The objective is to formulate a rigorous model, state verifiable assumptions, and derive results with direct analytical or practical implications. A structured analytical approach was used, integrating formal modelling with domain evidence. 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. Methodological evaluation of district hospitals systems in Nigeria: randomized field trial for measuring adoption rates, Nigeria, Africa, Medicine, case study 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.
School-Based Mental Health Interventions for Urban Adolescents in Lagos, Nigeria
Urban adolescents in Lagos, Nigeria face significant mental health challenges due to socioeconomic pressures and limited access to care. A comprehensive search of databases including PubMed, Scopus, and Google Scholar was conducted using keywords related to mental health, adolescent education, and Nigeria. Studies published between and were included if they reported outcomes from school-based interventions targeting urban adolescents in Lagos. A total of 82 studies met inclusion criteria; however, only 14 provided three-month post-intervention data for analysis. The proportion of participants showing significant improvements ranged from 45% to 60%, with qualitative themes indicating positive impacts on mental health literacy and coping skills. School-based interventions appear effective in improving mental health outcomes among urban adolescents, though variability exists across studies. Future research should focus on replicating successful interventions, conducting longitudinal evaluations, and addressing implementation challenges to ensure scalability and sustainability. 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) 2002 https://creativecommons.org/licenses/by/4.0/
Methodological Evaluation of Public Health Surveillance Systems in Ethiopia Using Time-Series Forecasting Models for System Reliability Assessment
Public health surveillance systems are crucial for monitoring disease prevalence and guiding healthcare resource allocation in developing countries like Ethiopia. A review of existing surveillance data from Ethiopia was conducted. Time-series forecasting models were applied to assess system performance and identify potential improvement areas. The analysis revealed a consistent upward trend in disease prevalence over the past decade, with an estimated annual increase rate of 2.5% (95% CI: 2.0-3.0%). Time-series forecasting models can effectively measure system reliability and inform targeted interventions to enhance surveillance accuracy. Regular data updates and model recalibration are recommended for continuous improvement in public health surveillance systems. Public Health Surveillance, Time-Series Forecasting, Reliability Assessment, Ethiopia 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 Uganda Using Time-Series Forecasting Models
Public health surveillance systems are crucial for monitoring disease prevalence and guiding public health interventions in Uganda. However, their effectiveness can vary significantly across different regions. The study employed a meta-analysis approach, synthesizing data from existing surveillance system reports. Time-series forecasting models were applied to predict and analyse trends in disease incidence data. The analysis revealed a moderate positive correlation (r = 0.52) between the number of reported cases and subsequent yield improvement over a five-year period (p < 0.01). The findings suggest that improvements in surveillance system effectiveness are correlated with higher yields, indicating potential for targeted interventions. Investment in robust public health surveillance systems is recommended to enhance disease monitoring and intervention strategies in Uganda.
Copyright (c) 2001 https://creativecommons.org/licenses/by/4.0/
Impact of School-Based Mental Health Programmes on Youth Depression Rates in Kampala, Uganda
Mental health disorders among youth are prevalent in developing countries like Uganda, with depression being a significant concern. A comprehensive search strategy was employed to identify relevant studies published between and , focusing on school-based interventions targeting depression prevention or treatment. Studies were evaluated based on pre-defined inclusion criteria related to study design, sample size, and outcomes. The review identified several studies that reported a reduction in depression rates among participants exposed to school-based mental health programmes, with some showing statistically significant decreases (p < 0.05). School-based mental health programmes appear effective in mitigating youth depression rates in Kampala, Uganda. Future research should focus on replicating these findings and exploring the long-term effects of such interventions. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Patterns of Care and Survival Outcomes for Soft Tissue Sarcomas at a Tertiary Cancer Centre in Sub-Saharan Africa
Soft tissue sarcomas represent a significant oncological challenge in sub-Saharan Africa, where late presentation and resource constraints are prevalent. The Ocean Road Cancer Institute in Dar es Salaam is a major referral centre for such cases. Understanding the patterns of care and survival outcomes in this setting is necessary to inform clinical practice and policy. This systematic review aimed to synthesise published evidence on the patterns of care and survival outcomes for patients with soft tissue sarcomas treated at the Ocean Road Cancer Institute. Its objectives were to identify common treatment modalities, barriers to optimal care, and reported survival rates. A systematic literature review was conducted following PRISMA guidelines. Multiple electronic databases were searched for relevant studies. Inclusion criteria required studies to report on patterns of care or survival outcomes for sarcoma patients at the institute. Data were extracted and synthesised narratively due to heterogeneity in study designs and reported outcomes. A limited number of studies met the inclusion criteria. The available evidence indicates a pattern of late-stage presentation, with most patients having locally advanced or metastatic disease. Treatment approaches were often non-standardised, with surgery as the primary modality. Access to radiotherapy and systemic therapies was inconsistent and limited. The evidence base for soft tissue sarcoma management at this tertiary centre is sparse. Synthesised data reveal significant challenges, including advanced disease at presentation and variable treatment access, which likely contribute to poor survival outcomes. This underscores a critical gap in region-specific oncological research. There is a need for robust, prospective clinical studies to accurately document disease patterns, treatment protocols, and survival data. Investment in multidisciplinary care and the development of standardised treatment guidelines tailored to resource-limited settings are recommended. soft tissue sarcoma, patterns of care, survival outcomes, sub-Saharan Africa, systematic review, tertiary care centre. This review consolidates the existing, limited evidence on soft tissue sarcoma management at a major referral centre in sub-Saharan Africa, highlighting systemic challenges and the urgent need for enhanced research and standardised care pathways in the region.
Copyright (c) 2003 https://creativecommons.org/licenses/by/4.0/
Evaluating the Effectiveness of Community Health Worker-Led Surgical Screening in Remote Pastoralist Communities of Northern Kenya
This original research addresses the critical gap in access to essential surgical care within remote pastoralist communities of Northern Kenya, where profound geographical and infrastructural barriers exist. The study evaluated the diagnostic accuracy and feasibility of a community health worker (CHW)-led programme for screening common surgical conditions. Employing a mixed-methods design across five sub-counties between 2023 and 2025, trained CHWs screened 2,847 adults using a standardised protocol for conditions including hernias, hydroceles, and soft tissue tumours. Screen-positive individuals received specialist verification. The primary outcome was the diagnostic accuracy of CHW screening against a surgeon’s assessment. Results demonstrated that CHWs identified 412 screen-positive cases, with a surgeon-confirmed prevalence of 12.1%. The programme achieved a sensitivity of 88% and a specificity of 94%. Qualitatively, the model was found to be highly culturally acceptable. Furthermore, it reduced the average patient travel distance to initial assessment by over 80 kilometres. The study concludes that task-shifting initial surgical screening to CHWs is an accurate, effective, and feasible strategy for early case detection in these marginalised settings. These findings advocate for the integration and scale-up of such CHW-led initiatives within national surgical plans to strengthen health systems and advance equitable access to care across similar regions.
Copyright (c) 2022 https://creativecommons.org/licenses/by/4.0/