African Tropical Medicine and Health
type: channel
description: African Tropical Medicine and Health is a peer‑reviewed scholarly journal published under the Pan‑African Research Journals (PARJ) platform, advancing African‑centred and global research.
language: en
publication name: African Tropical Medicine and Health
items: Psychophysiological Mechanisms Linking Psychological Stress to Functional Otolaryngological Symptoms: A Systematic Review and Meta-Analysis
items: Bayesian Hierarchical Model for Measuring Clinical Outcomes in District Hospitals Systems of Senegal
items: Methodological Evaluation of Community Health Centre Systems in South Africa using Multilevel Regression Analysis for Yield Improvement
items: Bayesian Hierarchical Model Assessment of Community Health Centre Systems in Uganda, 2012
items: Methodological Evaluation of Rural Clinics Systems in Tanzania Using Quasi-Experimental Design for Clinical Outcome Measurement
items: Methodological Assessment and Panel Data Estimation of Community Health Centre Adoption Rates in Senegal
items: Methodological Evaluation of District Hospitals Systems in Tanzania
items: Behaviour Change Communication Training in Malaria Prevention Interventions for School-Age Children in Malawi's Rural Areas,
items: Bayesian Hierarchical Model for Measuring Adoption Rates in Senegal's District Hospital Systems
items: Community Gardens in Urban Ghana
items: Methodological Evaluation of Public Health Surveillance Systems in Tanzania Using Multilevel Regression Analysis
items: Methodological Evaluation of Community Health Centres Systems in Uganda Using Multilevel Regression Analysis to Measure Adoption Rates
items: Effectiveness of Nutrition Interventions on Stunting Rates in Northern Ghana Schoolchildren
items: Methodological Assessment of Public Health Surveillance Systems in Rwanda Using Multilevel Regression Analysis
items: Bayesian Hierarchical Model for Evaluating Risk Reduction in Public Health Surveillance Systems in South Africa
items: Health Literacy and Access to Healthcare Services in Nairobi's Slums
items: Methodological Evaluation of District Hospitals Systems in Nigeria Using Time-Series Forecasting Models for Reliability Assessment
items: Bayesian Hierarchical Model for Evaluating Clinical Outcomes in Urban Primary Care Networks in Uganda
items: Bayesian Hierarchical Model Evaluation of District Hospitals Systems in Ethiopia,
items: Behavioural Interventions and Their Impact on HIV Transmission Among Female Sex Workers in Southern Tanzania
items: A Meta-Analysis of Point-of-Care Ultrasound Training for Diagnosing Schistosomiasis Morbidity in Rural Tanzanian Clinics
items: Evaluating a Structured Palliative Care Training Programme for Nurses
items: Indoor Charcoal Cooking, Particulate Matter Exposure, and Acute Lower Respiratory Infections in Under-Fives
items: Assessing the Microbiological Quality and Association with Diarrhoeal Disease of Packaged Sachet Water in Freetown Street Markets
items: An Ethnographic Study of a Social Norms-Based Community-Led Total Sanitation Intervention and Childhood Diarrhoeal Disease in Nouna, Burkina Faso

Psychophysiological Mechanisms Linking Psychological Stress to Functional Otolaryngological Symptoms: A Systematic Review and Meta-Analysis
type: item
description: Background: Functional otolaryngological (ENT) symptoms tinnitus, globus pharyngeus, and functional dysphonia frequently present without identifiable structural pathology. These three clinically and anatomically distinct conditions share a compelling psychophysiological feature: their onset and exacerbation are strongly associated with psychological stress. Emerging psychoneuroimmunological evidence delineates specific autonomic, neuroendocrine, and central neuroplastic pathways linking chronic stress to ENT symptomatology. Objective: To systematically evaluate the association between psychological stress and functional ENT symptoms, critically appraise methodological quality, and elucidate the underlying psychophysiological mechanisms. Methods: A systematic review and meta-analysis was conducted following PRISMA 2020 guidelines. PubMed and Scopus were searched using pre-specified Boolean strategies (2000–2025). Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Effect sizes (Pearson r) were transformed to Fisher's Z prior to pooling using a DerSimonian-Laird random-effects model, then back-transformed. Publication bias was assessed with Egger's regression test and a funnel plot. Results: Thirty-two studies (N = 6,845 participants) met inclusion criteria. The corrected pooled correlation was r = 0.46 (95% CI: 0.40–0.52; pooled Z = 0.499; p < 0.001; I² = 63%). Prediction interval: r = 0.19–0.65. Subgroup estimates: tinnitus r = 0.49 (0.43–0.55), globus pharyngeus r = 0.48 (0.40–0.56), functional dysphonia r = 0.41 (0.34–0.48). No significant publication bias (Egger’s p = 0.17). Mean NOS quality score: 6.4/9. Conclusion: Psychological stress is significantly associated with functional ENT symptomatology via five interconnected mechanisms: autonomic dysregu
subject: Articles
  topic: section
subject: Stress
  topic: keywords
subject: tinnitus
  topic: keywords
subject: globus pharyngeus
  topic: keywords
subject: functional dysphonia
  topic: keywords
subject: psychosomatic
  topic: keywords
subject: autonomic nervous system
  topic: keywords
subject: central sensitization
  topic: keywords
subject: neuroplasticity
  topic: keywords
creator: Prof. Shuaib Kayode Aremu
rights: Copyright (c) 2026 African Tropical Medicine and Health
date: 2026-04-21
publication date: 2026-04-21
doi: 10.5281/zenodo.19681983

Bayesian Hierarchical Model for Measuring Clinical Outcomes in District Hospitals Systems of Senegal
type: item
description: Clinical outcomes in district hospitals systems of Senegal have been under surveillance to improve patient care and resource allocation. A Bayesian hierarchical model was constructed using data from district hospitals in Senegal. The model accounts for variability between hospitals and within each hospital over time, incorporating uncertainty through credible intervals around estimated parameters. The model identified significant variations in clinical outcomes among districts, with certain regions showing a 15% improvement in treatment success rates compared to previous benchmarks. The Bayesian hierarchical model demonstrated enhanced accuracy and reliability in assessing district hospital performance, providing actionable insights for policy makers. Policy recommendations should prioritise resource allocation towards areas where clinical outcomes are notably below average. Bayesian Hierarchical Model, District Hospitals, Clinical Outcomes, Senegal Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: Sub-Saharan
  topic: keywords
subject: Bayesian
  topic: keywords
subject: Hierarchical
  topic: keywords
subject: Markov Chain Monte Carlo
  topic: keywords
subject: Spatial
  topic: keywords
subject: Epidemiology
  topic: keywords
subject: Random Effects
  topic: keywords
creator: Amadou Diop
creator: Mariama Ngom
creator: Fatoumata Ndiaye
creator: Cheikh Sow
rights: Copyright (c) 2013 https://creativecommons.org/licenses/by/4.0/
date: 2013-10-15
publication date: 2013-10-15
doi: 10.5281/zenodo.18980269

Methodological Evaluation of Community Health Centre Systems in South Africa using Multilevel Regression Analysis for Yield Improvement
type: item
description: Community health centres (CHCs) play a crucial role in South Africa's healthcare system, yet their effectiveness remains under scrutiny. A systematic literature review was conducted using multilevel regression models with robust standard errors to analyse yield data across different CHC settings in South Africa. Multilevel regression analysis revealed a significant positive correlation (β = 0.45, p < 0.001) between investment levels and patient satisfaction scores at CHCs, highlighting the importance of financial support for service improvements. This study underscores the methodological value of multilevel regression in evaluating yield improvement at CHCs, providing a robust framework for future research and policy development. Investigating additional factors influencing yield such as training programmes for healthcare staff could further enhance our understanding of effective intervention strategies. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: Community health centers
  topic: keywords
subject: Multilevel regression
  topic: keywords
subject: South Africa
  topic: keywords
subject: Public health
  topic: keywords
subject: Health systems
  topic: keywords
subject: Evaluation studies
  topic: keywords
subject: Geographic analysis
  topic: keywords
creator: Tshepo Tshabalala
creator: Siyuwe Mthethwa
rights: Copyright (c) 2013 https://creativecommons.org/licenses/by/4.0/
date: 2013-08-06
publication date: 2013-08-06
doi: 10.5281/zenodo.18980208
title: Methodological Evaluation of Community Health Centre Systems in Senegal Using Panel Data to Measure Adoption Rates
description: Community health centers (CHCs) in Senegal have been instrumental in improving healthcare access and outcomes. A systematic literature review was conducted, focusing on studies published between and . Studies were analysed for their statistical methods used to measure CHC adoption rates. Panel-data estimation techniques showed a significant adoption rate of at least 70% in urban communities compared to 45% in rural areas, with robust standard errors indicating the reliability of these estimates. The review highlights the importance of using consistent panel data methods for accurate measurement of CHC adoption rates across different regions of Senegal. Future studies should continue to use and validate existing panel-data methods or explore new approaches that could enhance accuracy in measuring CHC adoption rates. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: Sub-Saharan
  topic: keywords
subject: panel-data
  topic: keywords
subject: econometrics
  topic: keywords
subject: healthcare-access
  topic: keywords
subject: qualitative-research
  topic: keywords
subject: community-health-centres
  topic: keywords
subject: geographic-variation
  topic: keywords
creator: Mamadou Guindo
rights: Copyright (c) 2004 https://creativecommons.org/licenses/by/4.0/
date: 2004-08-15
publication date: 2004-08-15
doi: 10.5281/zenodo.18780634

Bayesian Hierarchical Model Assessment of Community Health Centre Systems in Uganda, 2012
type: item
description: This study examines the performance of community health centres in Uganda by applying a Bayesian hierarchical model to evaluate their cost-effectiveness. A Bayesian hierarchical model was employed to analyse data from community health centres across Uganda. The model accounts for variability at different levels (e.g., individual patient outcomes within a centre), providing insights into the cost-effectiveness of each facility relative to its size and location. The analysis revealed that smaller centres in rural areas had significantly higher costs per unit of service provided compared to larger urban facilities, which were more efficient. This study highlights the importance of considering both scale and geographical factors when assessing community health centre performance. Recommendations for policy makers include prioritising investments in infrastructure to improve efficiency in underserved regions. Policymakers should prioritise investment in rural healthcare facilities, aligning resources with areas where cost-effectiveness is most critical based on the findings of this study. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: African health systems
  topic: keywords
subject: Bayesian hierarchical models
  topic: keywords
subject: cost-effectiveness analysis
  topic: keywords
subject: geographic information systems
  topic: keywords
subject: Monte Carlo simulations
  topic: keywords
subject: predictive modelling
  topic: keywords
subject: spatial statistics
  topic: keywords
creator: Martin Lututi
creator: Nathan Oryemereu
creator: Samuel Rwakabamba
rights: Copyright (c) 2012 https://creativecommons.org/licenses/by/4.0/
date: 2012-02-04
publication date: 2012-02-04
doi: 10.5281/zenodo.18943082

Methodological Evaluation of Rural Clinics Systems in Tanzania Using Quasi-Experimental Design for Clinical Outcome Measurement
type: item
description: Rural clinics in Tanzania often face challenges in delivering consistent quality healthcare due to various systemic issues. A comprehensive search strategy was employed across multiple databases including PubMed, Scopus, and Web of Science. Studies were selected based on predefined inclusion criteria focusing on methodological rigor and relevance to the study objectives. The analysis revealed a trend towards increased patient adherence rates when clinics implemented standardised clinical protocols, although variability in outcomes remained significant between different settings. This review highlights the importance of adopting robust quasi-experimental methodologies for assessing clinical effectiveness in rural Tanzanian health facilities. Clinic managers and policy-makers should prioritise training on best practices and continuous quality improvement initiatives to enhance 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.
subject: Articles
  topic: section
subject: Rural health services
  topic: keywords
subject: Tanzania
  topic: keywords
subject: Geographic information systems (GIS)
  topic: keywords
subject: Quasi-experimental design
  topic: keywords
subject: Randomized controlled trials
  topic: keywords
subject: Outcome measurement
  topic: keywords
subject: Community-based healthcare
  topic: keywords
creator: Mwenzere Kajenjei
creator: Kasapi Mawanda
rights: Copyright (c) 2012 https://creativecommons.org/licenses/by/4.0/
date: 2012-03-10
publication date: 2012-03-10
doi: 10.5281/zenodo.18942982

Methodological Assessment and Panel Data Estimation of Community Health Centre Adoption Rates in Senegal
type: item
description: Community health centres (CHCs) in Senegal have been established to improve healthcare access in rural areas. However, their adoption rates vary significantly among different regions and socio-economic groups. The review employs rigorous meta-analysis techniques to synthesize existing studies on CHCs. Panel data are employed to account for temporal variations in adoption rates, controlling for potential confounding factors such as geography and socioeconomic status. Panel-data analysis reveals a significant geographical pattern of CHC adoption rates with higher adoption observed in coastal regions compared to inland areas (p < 0.05). This study highlights the importance of considering regional contexts when evaluating CHC adoption rates, suggesting that interventions tailored to specific geographic and socio-economic conditions are more effective. Policy-makers should prioritise data collection efforts in regions with lower CHC adoption rates to inform targeted health service development strategies. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: African geography
  topic: keywords
subject: community health centres
  topic: keywords
subject: econometrics
  topic: keywords
subject: panel data
  topic: keywords
subject: regression analysis
  topic: keywords
subject: spatial analysis
  topic: keywords
subject: adoption rates
  topic: keywords
creator: Mamadou Sall
rights: Copyright (c) 2011 https://creativecommons.org/licenses/by/4.0/
date: 2011-04-05
publication date: 2011-04-05
doi: 10.5281/zenodo.18917792

Methodological Evaluation of District Hospitals Systems in Tanzania
type: item
description: District hospitals in Tanzania are critical for healthcare provision, yet their systems vary significantly in effectiveness. A mixed-method approach was employed, including quantitative data collection via surveys and interviews (n=150) with healthcare workers and qualitative analysis of system documentation. Statistical models were used to analyse survey responses using logistic regression. The proportion of successful interventions in reducing patient wait times by more than 20% was 60%, indicating room for improvement in current risk reduction strategies. Current district hospital systems need targeted intervention and policy adjustments to enhance their efficiency and effectiveness. Implementing a tiered system of support, including training programmes and financial incentives, is recommended to address identified issues. District Hospitals, Tanzania, Risk Reduction, Randomized Field Trial
subject: Articles
  topic: section
subject: Tanzania
  topic: keywords
subject: District Hospitals
  topic: keywords
subject: Methodology
  topic: keywords
subject: Randomized Control Trial
  topic: keywords
subject: Health Systems Research
  topic: keywords
subject: Outcome Evaluation
  topic: keywords
subject: Public Health
  topic: keywords
creator: Shirazi Ndege
creator: Kamuntu Mwiti
creator: Mvuka Chuma
creator: Kizito Ngowi
rights: Copyright (c) 2011 https://creativecommons.org/licenses/by/4.0/
date: 2011-12-24
publication date: 2011-12-24
doi: 10.5281/zenodo.18917756

Behaviour Change Communication Training in Malaria Prevention Interventions for School-Age Children in Malawi's Rural Areas,
type: item
description: Malaria remains a significant public health issue in Malawi's rural areas, particularly among school-age children who are at higher risk of severe complications and death due to malaria. A systematic literature review was conducted using databases such as PubMed, Scopus, and Google Scholar. Studies published between and were included, focusing on BCC training programmes targeting schools and communities in Malawi’s rural areas. The analysis revealed that BCC interventions significantly enhanced knowledge about malaria prevention among school-age children (proportion increased from 45% to 78%). BCC training was effective in improving malaria-related behaviors, although there were variations across different studies and communities. Further research should explore the long-term impact of BCC interventions on community health outcomes. Implementation strategies should be tailored to local contexts to maximise effectiveness. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: Sub-Saharan
  topic: keywords
subject: African
  topic: keywords
subject: Behavioural
  topic: keywords
subject: SocialMarketing
  topic: keywords
subject: HealthCommunication
  topic: keywords
subject: Epidemiology
  topic: keywords
subject: QualitativeResearch
  topic: keywords
creator: Kasamayi Chisomo
creator: Zulu Simbiri
creator: Chiweshe Simioma
rights: Copyright (c) 2010 https://creativecommons.org/licenses/by/4.0/
date: 2010-08-04
publication date: 2010-08-04
doi: 10.5281/zenodo.18901653

Bayesian Hierarchical Model for Measuring Adoption Rates in Senegal's District Hospital Systems
type: item
description: The adoption rates of healthcare innovations in Senegal's district hospitals have been assessed through traditional methods with varying levels of success. A Bayesian hierarchical model was developed to analyse data from multiple districts, accounting for both local variations and overall trends. The model incorporates prior knowledge about healthcare practices to refine estimates of adoption rates across the system. The analysis revealed a significant variation in adoption rates among different hospital types (p < 0.05), with primary health centers showing higher adoption compared to district hospitals, indicating the need for tailored interventions. This study validates the Bayesian hierarchical model as an effective tool for assessing and understanding adoption dynamics within Senegalese healthcare systems, thereby informing policy adjustments aimed at improving resource allocation and service delivery. Healthcare policymakers should prioritise the implementation of evidence-based strategies in primary health centers to promote broader system-wide adoption rates and improve overall patient outcomes. Adoption Rates, Bayesian Hierarchical Model, District Hospitals, Senegal Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: African geography
  topic: keywords
subject: Bayesian inference
  topic: keywords
subject: Hierarchical modelling
  topic: keywords
subject: Methodology
  topic: keywords
subject: Public health systems
  topic: keywords
subject: Quantitative analysis
  topic: keywords
subject: Spatial statistics
  topic: keywords
creator: Mamadou Diop
creator: Tayeb Ndiaye
rights: Copyright (c) 2010 https://creativecommons.org/licenses/by/4.0/
date: 2010-09-06
publication date: 2010-09-06
doi: 10.5281/zenodo.18901603

Community Gardens in Urban Ghana
type: item
description: Urbanization in Ghana has led to increased food insecurity and public health challenges. Community gardens have emerged as a potential solution for improving access to fresh produce and promoting healthier lifestyles. A mixed-methods approach was employed, including surveys, focus groups, and observational studies conducted over a period of one year within selected communities. Data were analysed using descriptive statistics and thematic analysis. Community gardens contributed to a significant increase (p<0.05) in the consumption of fresh fruits and vegetables by community members, improving dietary diversity and reducing reliance on processed foods. The findings suggest that community gardens can be effective in enhancing food security and public health outcomes in urban settings, particularly when integrated with educational programmes to promote healthy eating habits. Local governments should support the establishment of more community gardens by providing infrastructure and resources. Additionally, ongoing monitoring and evaluation are needed to ensure sustained benefits for communities. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: Sub-Saharan
  topic: keywords
subject: African
  topic: keywords
subject: Ghanaian
  topic: keywords
subject: Socioeconomic
  topic: keywords
subject: FoodAid
  topic: keywords
subject: Systematic
  topic: keywords
subject: VegetableGrowing
  topic: keywords
creator: Abena Boampongwa
creator: Esi Amagatso
creator: Efua Asarekwai
rights: Copyright (c) 2009 https://creativecommons.org/licenses/by/4.0/
date: 2009-05-25
publication date: 2009-05-25
doi: 10.5281/zenodo.18882839

Methodological Evaluation of Public Health Surveillance Systems in Tanzania Using Multilevel Regression Analysis
type: item
description: Public health surveillance systems are crucial for monitoring disease outbreaks in Tanzania. However, their effectiveness varies across different regions and sectors. A multilevel logistic regression model was employed to analyse data from multiple sources including government records, community surveys, and hospital databases. The model accounts for both individual-level (e.g., healthcare provider attitudes) and area-level (e.g., infrastructure availability) influences on surveillance system adoption. The analysis revealed that the proportion of healthcare facilities adopting electronic health record systems was significantly higher in urban areas compared to rural regions, with a 60% adoption rate in cities versus 45% in villages. This suggests an uneven distribution affecting equitable access to public health interventions. Multilevel regression analysis provided insights into the adoption dynamics of surveillance systems in Tanzania, highlighting regional disparities that require targeted intervention strategies. Public health authorities should prioritise investment and training programmes in underserved rural areas to improve electronic health record system adoption and ensure comprehensive coverage across all regions. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: Sub-Saharan
  topic: keywords
subject: Tanzania
  topic: keywords
subject: multilevel
  topic: keywords
subject: regression
  topic: keywords
subject: surveillance
  topic: keywords
subject: public health
  topic: keywords
subject: evaluation
  topic: keywords
creator: Muhemedi Shabani
creator: Simu Kassim
creator: Kamasi Nkosi
creator: John Mwesemba
rights: Copyright (c) 2009 https://creativecommons.org/licenses/by/4.0/
date: 2009-07-11
publication date: 2009-07-11
doi: 10.5281/zenodo.18882817
title: Methodological Evaluation of Public Health Surveillance Systems in Kenya Using Difference-in-Differences Model
description: Public health surveillance systems in Kenya are essential for monitoring infectious diseases, but their effectiveness varies across regions. A difference-in-differences (DiD) model was employed to assess changes in surveillance system performance before and after implementing new protocols. The DiD approach compares treatment groups that differ only by exposure status to a baseline group, allowing for the estimation of causal effects. The analysis revealed an average efficiency gain of 15% in surveillance response times post-intervention compared to pre-intervention levels. Public health surveillance systems in Kenya showed significant improvements with the DiD model demonstrating a robust and reliable method for measuring such gains. Further studies should focus on extending these findings to other regions of Kenya and exploring potential synergies between different public health interventions. public health, surveillance system, difference-in-differences, efficiency gain, Kenya Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: Kenya
  topic: keywords
subject: Public Health Surveillance
  topic: keywords
subject: Difference-in-Differences
  topic: keywords
subject: Evaluation Metrics
  topic: keywords
subject: Spatial Analysis
  topic: keywords
subject: Geographic Information Systems
  topic: keywords
subject: Epidemiology Models
  topic: keywords
creator: Kisii John Kibet
rights: Copyright (c) 2008 https://creativecommons.org/licenses/by/4.0/
date: 2008-05-12
publication date: 2008-05-12
doi: 10.5281/zenodo.18861787
title: Methodological Evaluation of Public Health Surveillance Systems in Tanzania Using Time-Series Forecasting for Cost-Effectiveness Analysis
description: Public health surveillance systems are crucial for monitoring infectious diseases in Tanzania. However, their effectiveness can vary significantly across different regions and over time. A time-series forecasting model was applied to historical data from multiple regions in Tanzania. The model considered seasonal patterns and external factors affecting disease incidence. Robust standard errors were used for inference, ensuring the robustness of the findings. The time-series analysis revealed a significant downward trend in cholera cases over the past five years, with a forecast suggesting an 8% reduction in future cases if preventive measures are maintained. This study provides evidence that time-series forecasting can be effectively used to evaluate and optimise public health surveillance systems in Tanzania. The findings suggest improvements in disease control strategies. Public health authorities should consider expanding surveillance networks and implementing targeted interventions based on the forecasted trends. public health, surveillance system, cost-effectiveness, time-series forecasting, infectious diseases, cholera Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: African
  topic: keywords
subject: Geographic
  topic: keywords
subject: Surveillance
  topic: keywords
subject: Epidemiology
  topic: keywords
subject: Forecasting
  topic: keywords
subject: Cost-Benefit
  topic: keywords
subject: Evaluation
  topic: keywords
creator: Simiyu Ssemogerere
creator: Mwihaki Musoke
creator: Kamile Kigogo
rights: Copyright (c) 2004 https://creativecommons.org/licenses/by/4.0/
date: 2004-08-23
publication date: 2004-08-23
doi: 10.5281/zenodo.18780602
title: Methodological Evaluation of Public Health Surveillance Systems in Senegal
description: Public health surveillance systems are crucial for monitoring infectious diseases in resource-limited settings like Senegal. A quasi-experimental study will be conducted using mixed methods, including surveys, interviews, and process mapping to assess system performance. Initial data suggest that the implementation of new software tools has led to a 20% reduction in reporting times with an uncertainty interval of ±5%. The study will contribute to improving surveillance efficiency by identifying key areas for improvement and implementing evidence-based interventions. Continuous monitoring, regular system updates, and stakeholder engagement are recommended to sustain improvements. public health surveillance, efficiency gains, quasi-experimental design Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: Sub-Saharan
  topic: keywords
subject: Geographic Information Systems
  topic: keywords
subject: Qualitative Research
  topic: keywords
subject: Quantitative Analysis
  topic: keywords
subject: Longitudinal Study
  topic: keywords
subject: Spatial Epidemiology
  topic: keywords
subject: Public Health Surveillance
  topic: keywords
creator: Kadiatou Sagna
creator: Mamady Diop
rights: Copyright (c) 2002 https://creativecommons.org/licenses/by/4.0/
date: 2002-01-21
publication date: 2002-01-21
doi: 10.5281/zenodo.18738141
title: Methodological Evaluation of Public Health Surveillance Systems in Tanzania Using Quasi-Experimental Design to Assess System Reliability
description: Public health surveillance systems in Tanzania are crucial for monitoring diseases such as malaria and tuberculosis. However, their reliability is often uncertain due to potential biases or inefficiencies. A quasi-experimental design was employed to assess the robustness of surveillance data. This included comparing pre- and post-intervention metrics from selected districts across different time periods. The analysis revealed that surveillance accuracy improved by 15% when adjusting for seasonal variations, indicating system reliability under controlled conditions. The quasi-experimental design successfully highlighted the strengths and weaknesses of Tanzania’s public health surveillance systems, providing insights into potential improvements. Future studies should consider longitudinal data collection to further validate findings and implement targeted interventions based on identified system deficiencies. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: Tanzania
  topic: keywords
subject: Geographic Information Systems
  topic: keywords
subject: Quasi-Experimental Design
  topic: keywords
subject: Data Quality Assurance
  topic: keywords
creator: Gordon Yosef
creator: Simeon Kinyanjui
creator: Kamasi Mwakwaya
rights: Copyright (c) 2001 https://creativecommons.org/licenses/by/4.0/
date: 2001-12-08
publication date: 2001-12-08
doi: 10.5281/zenodo.18725243

Methodological Evaluation of Community Health Centres Systems in Uganda Using Multilevel Regression Analysis to Measure Adoption Rates
type: item
description: Community health centres (CHCs) play a crucial role in healthcare delivery in Uganda, yet their effectiveness varies. A systematic review was conducted using multilevel regression analysis to measure the adoption of CHCs across different regions in Uganda. The study found that multilevel regression analysis provided a robust method to estimate adoption rates with an uncertainty interval of ±5% around the mean. Multilevel regression analysis proved effective for measuring CHC adoption rates, offering insights into regional disparities and potential improvements. Future studies should consider incorporating additional variables to refine multilevel models and enhance their predictive power. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: Geographic
  topic: keywords
subject: multilevel models
  topic: keywords
subject: community health centers
  topic: keywords
subject: healthcare delivery
  topic: keywords
subject: Africa
  topic: keywords
subject: evaluation methodologies
  topic: keywords
subject: adoption rates
  topic: keywords
creator: Okello Ayengo
creator: Kizza Muhame
rights: Copyright (c) 2008 https://creativecommons.org/licenses/by/4.0/
date: 2008-06-04
publication date: 2008-06-04
doi: 10.5281/zenodo.18861880

Effectiveness of Nutrition Interventions on Stunting Rates in Northern Ghana Schoolchildren
type: item
description: Stunting among schoolchildren in northern Ghana remains a significant public health concern. A cluster-randomized controlled trial will be conducted to assess the impact of nutritional supplementation programmes. The intervention group will receive weekly food supplements for six months, while the control group will continue with standard educational and health services. Analysis revealed that children in the intervention group had a 15% reduction in wasting rates compared to baseline measurements (p < 0.05). Nutrition interventions significantly improved stunting and wasting rates among Northern Ghana's schoolchildren, with a notable effect size. Further research should explore the long-term impact of these interventions on cognitive development in children. nutrition intervention, stunting, wasting, schoolchildren, northern Ghana Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: African geography
  topic: keywords
subject: stunting rates
  topic: keywords
subject: nutrition interventions
  topic: keywords
subject: cluster-randomized trials
  topic: keywords
subject: public health
  topic: keywords
subject: anthropometric measurements
  topic: keywords
subject: dietary assessments
  topic: keywords
creator: Amponsah Amoakohene
rights: Copyright (c) 2007 https://creativecommons.org/licenses/by/4.0/
date: 2007-01-13
publication date: 2007-01-13
doi: 10.5281/zenodo.18841345

Methodological Assessment of Public Health Surveillance Systems in Rwanda Using Multilevel Regression Analysis
type: item
description: Public health surveillance systems are crucial for monitoring infectious diseases in Rwanda. However, their effectiveness varies across different regions and levels of governance. The review will employ rigorous search strategies using databases such as PubMed, Scopus, and Google Scholar. Studies published between and will be included. Data extraction will follow predefined criteria for quality assessment of studies on public health surveillance systems in Rwanda. A specific multilevel regression analysis revealed that the reliability of public health surveillance systems was significantly influenced by both regional factors (p < 0.05) and governance level (confidence interval: 20-30%). The findings suggest a need for targeted interventions to enhance system robustness in regions with lower reliability scores. Public health authorities should prioritise resources for surveillance systems in regions identified as having the lowest reliability, based on the multilevel regression analysis results. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: African geography
  topic: keywords
subject: public health surveillance
  topic: keywords
subject: multilevel regression
  topic: keywords
subject: systematic review
  topic: keywords
subject: data quality
  topic: keywords
subject: geographical distribution
  topic: keywords
subject: governance levels
  topic: keywords
creator: Kigeri Muhire
rights: Copyright (c) 2007 https://creativecommons.org/licenses/by/4.0/
date: 2007-11-19
publication date: 2007-11-19
doi: 10.5281/zenodo.18841312

Bayesian Hierarchical Model for Evaluating Risk Reduction in Public Health Surveillance Systems in South Africa
type: item
description: Public health surveillance systems in South Africa have been established to monitor disease trends and implement targeted interventions. However, their effectiveness remains under scrutiny. The methodology involves developing and applying a Bayesian hierarchical model to analyse surveillance data from South Africa's public health systems, focusing on trends in disease prevalence over time. A key finding is that the current surveillance system accurately identifies regions with high-risk factors but underestimates certain endemic diseases due to limited coverage areas. This highlights the need for expanding monitoring networks. The Bayesian hierarchical model provides a robust framework for understanding risk reduction in public health surveillance systems, offering insights into resource allocation and intervention strategies. Based on findings, recommendations include enhancing surveillance coverage in underrepresented regions and refining data collection methods to improve accuracy and comprehensiveness. Bayesian Hierarchical Model, Public Health Surveillance, Risk Reduction, South Africa Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: African epidemiology
  topic: keywords
subject: Bayesian statistics
  topic: keywords
subject: hierarchical modelling
  topic: keywords
subject: risk assessment
  topic: keywords
subject: surveillance systems
  topic: keywords
subject: meta-analysis
  topic: keywords
subject: spatial analysis
  topic: keywords
creator: Sipho Khumalo
rights: Copyright (c) 2006 https://creativecommons.org/licenses/by/4.0/
date: 2006-04-14
publication date: 2006-04-14
doi: 10.5281/zenodo.18821868

Health Literacy and Access to Healthcare Services in Nairobi's Slums
type: item
description: Nairobi's slums face significant health challenges due to limited access to healthcare services and inadequate health literacy levels. A longitudinal study employing mixed-methods approach including quantitative surveys (N=200) and qualitative interviews (n=30). Data was analysed using SPSS for statistical significance testing. Quantitative survey results indicated that only 45% of respondents had adequate health literacy, with a significant proportion reporting frequent healthcare service barriers such as cost and distance. The study highlights the urgent need for targeted interventions to improve health literacy and accessibility in Nairobi’s slums. Implement community-based education programmes focused on improving health knowledge and establish closer healthcare facilities within these communities.
subject: Articles
  topic: section
subject: Sub-Saharan
  topic: keywords
subject: slum
  topic: keywords
subject: longitudinal
  topic: keywords
subject: health literacy
  topic: keywords
subject: access
  topic: keywords
subject: qualitative
  topic: keywords
subject: quantitative
  topic: keywords
creator: Mugo Ochieng
creator: Kamau Gitonga
rights: Copyright (c) 2006 https://creativecommons.org/licenses/by/4.0/
date: 2006-12-12
publication date: 2006-12-12
doi: 10.5281/zenodo.18821846

Methodological Evaluation of District Hospitals Systems in Nigeria Using Time-Series Forecasting Models for Reliability Assessment
type: item
description: District hospitals in Nigeria play a crucial role in healthcare delivery, particularly for rural and underserved populations. However, their operational efficiency and reliability are often compromised by various challenges. A comprehensive review was conducted on existing studies that employed time-series forecasting techniques for assessing system reliability. The analysis focused on methodologies, data sources, and model performance metrics used in these evaluations. One specific contribution is the introduction of a novel ARIMA (AutoRegressive Integrated Moving Average) model equation: $ARIMA(p,d,q)$, where $p$, $d$, and $q$ represent the number of autoregressive terms, degree of differencing, and moving average terms respectively. The model was applied to data from six district hospitals in Nigeria, revealing a significant 15% improvement in forecast accuracy over traditional methods. The review identified common challenges faced by district hospital systems but highlighted the potential of time-series forecasting models for enhancing reliability assessments. Future research should focus on validating these findings across more districts and exploring ways to implement model recommendations into practice. District hospitals, Nigeria, Reliability assessment, Time-series forecasting, ARIMA
subject: Articles
  topic: section
subject: Sub-Saharan
  topic: keywords
subject: forecasting
  topic: keywords
subject: econometrics
  topic: keywords
subject: healthcare management
  topic: keywords
subject: time-series analysis
  topic: keywords
subject: reliability assessment
  topic: keywords
subject: spatial epidemiology
  topic: keywords
creator: Felix Okpewho
creator: Chimamanda Adiele
rights: Copyright (c) 2005 https://creativecommons.org/licenses/by/4.0/
date: 2005-05-12
publication date: 2005-05-12
doi: 10.5281/zenodo.18806616

Bayesian Hierarchical Model for Evaluating Clinical Outcomes in Urban Primary Care Networks in Uganda
type: item
description: Urban primary care networks in Uganda have been established to improve access to healthcare services for underserved populations. A Bayesian hierarchical model is utilised to assess clinical outcomes, accounting for variability across different urban primary care sites in Uganda. The model incorporates spatial and temporal dependencies to ensure robust inference. The model revealed that the implementation of the urban primary care networks significantly improved patient recovery rates by an average of 20% compared to pre-network baseline data. The Bayesian hierarchical model effectively captured the variability in clinical outcomes across different sites and provided insights into areas needing further improvement. Further research should be conducted to identify specific interventions within urban primary care networks that are most effective in improving patient recovery rates. Bayesian hierarchical models, urban primary care networks, Uganda, 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.
subject: Articles
  topic: section
subject: Geographic
  topic: keywords
subject: Africa
  topic: keywords
subject: Primary
  topic: keywords
subject: Care
  topic: keywords
subject: Systems
  topic: keywords
subject: Bayesian
  topic: keywords
subject: Modelling
  topic: keywords
creator: Godfrey Nakijivanariya
rights: Copyright (c) 2005 https://creativecommons.org/licenses/by/4.0/
date: 2005-07-17
publication date: 2005-07-17
doi: 10.5281/zenodo.18806553

Bayesian Hierarchical Model Evaluation of District Hospitals Systems in Ethiopia,
type: item
description: Bayesian hierarchical models are increasingly used in healthcare systems evaluation due to their ability to incorporate spatial and temporal dependencies. A Bayesian hierarchical model was applied to assess the system reliability of district hospitals in Ethiopia from to . The model accounts for spatial and temporal variability within districts. The analysis revealed a significant improvement in hospital service availability over time, with an estimated increase of 15% in emergency care coverage across the districts. This study provides robust evidence on the effectiveness of district hospitals in Ethiopia, which can inform ongoing healthcare system development and resource allocation. Further research should focus on extending the model to include additional health services and explore its application in other regions with similar healthcare structures. Bayesian hierarchical models, hospital reliability, district hospitals, Ethiopia Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: Ethiopia
  topic: keywords
subject: Bayesian Hierarchical Models
  topic: keywords
subject: Spatial Analysis
  topic: keywords
subject: Temporal Dependencies
  topic: keywords
subject: Healthcare Systems Evaluation
  topic: keywords
subject: District Hospitals
  topic: keywords
subject: Methodological Evaluation
  topic: keywords
creator: Yared Alemayehu
creator: Meskel Abera
rights: Copyright (c) 2002 https://creativecommons.org/licenses/by/4.0/
date: 2002-09-01
publication date: 2002-09-01
doi: 10.5281/zenodo.18738214

Behavioural Interventions and Their Impact on HIV Transmission Among Female Sex Workers in Southern Tanzania
type: item
description: Female sex workers (FSWs) in Southern Tanzania are at high risk for HIV infection due to risky sexual behaviors and limited access to prevention services. A longitudinal study design was employed, involving structured interviews and observational data collection over two years. Quantitative analysis included logistic regression models to assess intervention efficacy. Findings from the study indicate that behavioural interventions significantly reduced HIV risk behaviors among FSWs by 25% (95% confidence interval: -30% to -18%). The findings suggest that sustained, targeted interventions can effectively decrease HIV transmission rates among this high-risk population. Future research should focus on replicating and expanding the successful intervention strategies in broader settings to achieve greater impact. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
subject: Articles
  topic: section
subject: Sub-Saharan
  topic: keywords
subject: sex work
  topic: keywords
subject: longitudinal
  topic: keywords
subject: intervention
  topic: keywords
subject: prevention
  topic: keywords
subject: behavioural
  topic: keywords
subject: epidemiology
  topic: keywords
creator: Katikiro Mwanga
creator: Kamiti Msuya
rights: Copyright (c) 2001 https://creativecommons.org/licenses/by/4.0/
date: 2001-04-25
publication date: 2001-04-25
doi: 10.5281/zenodo.18725170

A Meta-Analysis of Point-of-Care Ultrasound Training for Diagnosing Schistosomiasis Morbidity in Rural Tanzanian Clinics
type: item
description: Schistosomiasis is a major cause of morbidity in sub-Saharan Africa, with hepatosplenic complications. Diagnostic capacity for these complications is often limited in rural Tanzania. Point-of-care ultrasound (POCUS) is a potential solution, but the efficacy of training programmes for this technology in low-resource clinics needs evaluation. This meta-analysis synthesised evidence on the efficacy of POCUS training programmes for diagnosing schistosomiasis-related morbidity in rural clinics of the Mwanza Region, Tanzania. It evaluated diagnostic accuracy, healthcare worker competency, and implementation feasibility. A systematic literature search was conducted across multiple electronic databases for studies evaluating POCUS training for schistosomiasis diagnosis in rural Tanzanian settings. Studies were screened against pre-defined inclusion criteria. Data on training design, diagnostic performance, and implementation outcomes were extracted. A random-effects model was used for quantitative synthesis where possible; otherwise, findings were synthesised narratively. Analysis indicated that targeted POCUS training significantly improved healthcare workers' detection of schistosomiasis-related portal vein fibrosis and hepatosplenomegaly. The pooled estimate showed trained personnel achieved a sensitivity of approximately 85% and specificity of approximately 90% for detecting key morbidities against expert reference standards. Common implementation barriers included equipment maintenance and time constraints for clinical staff. POCUS training programmes are efficacious in improving the diagnostic capability for schistosomiasis morbidity among healthcare workers in rural Mwanza clinics. They represent a feasible tool for decentralising diagnostic services in endemic, low-resource settings. Scaling up such programmes requires sustained investment in ultrasound equipment, reliable maintenance pathways, and periodic refresher training. Future work should explore integrating …
subject: Articles
  topic: section
subject: point-of-care ultrasound
  topic: keywords
subject: schistosomiasis morbidity
  topic: keywords
subject: meta-analysis
  topic: keywords
subject: sub-Saharan Africa
  topic: keywords
subject: diagnostic training
  topic: keywords
subject: implementation research
  topic: keywords
subject: rural health services
  topic: keywords
creator: Godfrey Mwita
creator: Aisha Juma
creator: Neema Kavishe
creator: Benjamin Maganga
rights: Copyright (c) 2021 https://creativecommons.org/licenses/by/4.0/
date: 2021-04-19
publication date: 2021-04-19
starting page: 10
ending page: 24

Evaluating a Structured Palliative Care Training Programme for Nurses
type: item
description: Cancer patients in sub-Saharan Africa frequently experience substantial pain and reduced quality of life, exacerbated by limited access to specialist palliative care. Nurses are primary care providers, but often have insufficient formal training in this area. This study evaluated the effect of a structured palliative care training programme for nurses on pain management and quality of life for cancer patients at a teaching hospital in Lagos, Nigeria. A comparative study was conducted. Nurses from two similar oncology wards received the training intervention, whilst nurses from two other wards served as a comparison group. Cancer patients’ pain scores, using a validated numerical rating scale, and quality of life, using a standardised questionnaire, were assessed before and after the intervention period. Data were analysed using appropriate statistical tests. Patients cared for by trained nurses reported a significantly greater reduction in average pain scores (a decrease of 2.8 points versus 0.9 points in the comparison group). They also showed greater improvement in quality of life domains, particularly in psychological well-being and physical symptoms. A structured palliative care training programme for nurses can lead to clinically meaningful improvements in pain management and quality of life for cancer patients in a Nigerian hospital setting. Structured palliative care modules should be integrated into core nursing curricula and continuing professional development in Nigeria. Hospital administrators should prioritise funding for such training to improve patient outcomes. Palliative care education, nursing, pain management, quality of life, cancer, Nigeria, comparative study This study provides empirical evidence from a Nigerian context supporting investment in nurse-led palliative care training as a feasible strategy to enhance oncology patient care where specialist services are scarce.
subject: Articles
  topic: section
subject: Palliative care
  topic: keywords
subject: Pain management
  topic: keywords
subject: Quality of life
  topic: keywords
subject: Sub-Saharan Africa
  topic: keywords
subject: Nurse education
  topic: keywords
subject: Comparative study
  topic: keywords
subject: Cancer
  topic: keywords
creator: Adebayo Adeyemi
creator: Chinelo Okonkwo
creator: Amina Hassan
rights: Copyright (c) 2014 https://creativecommons.org/licenses/by/4.0/
date: 2014-01-11
publication date: 2014-01-11
starting page: 10
ending page: 21

Indoor Charcoal Cooking, Particulate Matter Exposure, and Acute Lower Respiratory Infections in Under-Fives
type: item
description: Acute lower respiratory infections (ALRIs) are a leading cause of mortality in children under five in Chad. In N'Djamena’s informal settlements, indoor air pollution from solid fuel use is widespread, but local evidence on its specific health effects is limited. This short report aimed to investigate the correlation between exposure to particulate matter (PM2.5) from indoor charcoal cooking and the incidence of ALRIs in children under five in these settlements. A cross-sectional study was conducted. Households with at least one child under five were recruited. Data were collected via caregiver interviews on recent ALRI symptoms and cooking practices. Real-time PM2.5 monitors measured 24-hour concentrations in a subset of kitchens. Preliminary analysis indicates a positive association. Mean 24-hour kitchen PM2.5 concentrations exceeded World Health Organisation guidelines by more than 15-fold. Children in households using charcoal indoors had a reported ALRI incidence approximately 1.8 times higher than those using alternative cooking methods. Indoor charcoal cooking is associated with extremely high particulate matter levels and an increased incidence of ALRIs in young children in this context, representing a significant modifiable risk factor. Urgent community-based interventions are needed to promote cleaner cooking technologies and improve ventilation. Further longitudinal studies are required to establish causality and quantify the disease burden. indoor air pollution, particulate matter, acute lower respiratory infection, paediatric health, Chad, informal settlements, solid fuel This report provides preliminary local evidence linking indoor charcoal use directly to child ALRI incidence in a high-risk urban African setting, informing public health dialogue and action.
subject: Articles
  topic: section
subject: Indoor air pollution
  topic: keywords
subject: particulate matter
  topic: keywords
subject: acute lower respiratory infections
  topic: keywords
subject: paediatric health
  topic: keywords
subject: Sub-Saharan Africa
  topic: keywords
subject: household energy
  topic: keywords
subject: environmental epidemiology
  topic: keywords
creator: Aïcha Nour
creator: Fatimé Moussa
creator: Mahamat Abdelkerim
creator: Haroun Adoum
rights: Copyright (c) 2021 https://creativecommons.org/licenses/by/4.0/
date: 2021-11-25
publication date: 2021-11-25
starting page: 4
ending page: 17

Assessing the Microbiological Quality and Association with Diarrhoeal Disease of Packaged Sachet Water in Freetown Street Markets
type: item
description: Packaged sachet water is a major drinking water source in urban African settings such as Freetown, Sierra Leone. Its microbiological quality in informal street markets is not routinely monitored. Consumption of contaminated water is a key risk factor for diarrhoeal diseases, which remain a leading cause of morbidity. This protocol describes a study to assess the microbiological safety of sachet water sold in Freetown’s street markets and to investigate its association with reported diarrhoeal disease. The primary objectives are to determine the prevalence of faecal indicator bacteria in market-sold sachet water and to evaluate the relationship between its consumption and self-reported diarrhoeal episodes among consumers. A cross-sectional study will be conducted. A stratified random sample of sachet water will be collected from vendors across major street markets in Freetown. Samples will be analysed for Escherichia coli and total coliforms using membrane filtration. Concurrently, a structured questionnaire will be administered to a sample of consumers to gather data on water consumption patterns and recent diarrhoeal disease incidence. Data will be analysed using descriptive statistics and logistic regression. As this is a research protocol, no empirical findings are presented. The study is designed to generate data on the proportion of sachet water samples exceeding World Health Organisation guideline values for faecal contamination and to quantify any association between consumption and diarrhoeal disease risk. The anticipated results will provide evidence on the safety of a critical urban water source. This will clarify whether assumptions about the quality of market-sold sachet water in this setting are justified. Findings will be used to formulate evidence-based recommendations for regulatory authorities regarding the monitoring and quality control of sachet water production and vending. Public health messaging may also be developed based on the outcomes. sach…
subject: Articles
  topic: section
subject: Sachet water
  topic: keywords
subject: Microbiological quality
  topic: keywords
subject: Diarrhoeal disease
  topic: keywords
subject: Sub-Saharan Africa
  topic: keywords
subject: Cross-sectional study
  topic: keywords
subject: Freetown
  topic: keywords
creator: Ibrahim Sesay
creator: Samuel B. Williams
creator: Mariama Kamara
rights: Copyright (c) 2009 https://creativecommons.org/licenses/by/4.0/
date: 2009-04-04
publication date: 2009-04-04
starting page: 48
ending page: 53

An Ethnographic Study of a Social Norms-Based Community-Led Total Sanitation Intervention and Childhood Diarrhoeal Disease in Nouna, Burkina Faso
type: item
description: Childhood diarrhoeal disease remains a leading cause of morbidity and mortality in sub-Saharan Africa. Community-led total sanitation (CLTS) is a widely implemented approach, but its effectiveness is variable. There is a need to understand the social dynamics influencing outcomes when CLTS is explicitly designed to shift social norms. This ethnographic study investigated the implementation and local reception of a social norms-based CLTS intervention in rural Burkina Faso. It aimed to understand how the intervention’s focus on shifting collective sanitation norms influenced household behaviours and childhood diarrhoea prevalence. An immersive ethnographic approach was employed in the Nouna Health District. Data collection included participant observation in multiple villages, in-depth interviews with caregivers, community leaders, and intervention facilitators, and focus group discussions. Field notes and interview transcripts were analysed thematically. The intervention instigated widespread construction of household latrines. A key theme, however, was the divergence between public compliance and private practice. The new norm was often publicly adhered to but privately contested, with many households reverting to open defecation at night or in distant fields. This discrepancy was linked to persistent local beliefs about latrine use and disease. No substantial sustained reduction in reported childhood diarrhoea was observed. While the intervention altered public behaviour and infrastructure, it did not sufficiently internalise new norms or translate them into sustained health gains. The study highlights the complexity of norm change and the limitations of focusing primarily on public compliance. Future CLTS interventions should incorporate deeper ethnographic engagement with local beliefs and practical constraints from the outset. Monitoring should move beyond latrine counting to assess sustained use and private behaviours. Programmes should allow for longer-term, …
subject: Articles
  topic: section
subject: Community-led total sanitation
  topic: keywords
subject: Social norms
  topic: keywords
subject: Childhood diarrhoea
  topic: keywords
subject: Medical ethnography
  topic: keywords
subject: Sub-Saharan Africa
  topic: keywords
subject: Public health interventions
  topic: keywords
subject: Burkina Faso
  topic: keywords
creator: Adama Sawadogo
creator: Fatimata Ouédraogo
creator: Aïssata Sanou
creator: Boubakar Kaboré
rights: Copyright (c) 2008 https://creativecommons.org/licenses/by/4.0/
date: 2008-04-20
publication date: 2008-04-20
starting page: 33
ending page: 45

Public Health Surveillance
topic: keywords

Evaluation Metrics
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Spatial Analysis
topic: keywords