At the core of the conclusions reached by the Lancet Commission on the future of health in sub-Saharan Africa published last September is a sense of possibility for what Africans can and must accomplish to level their populations' health with the rest of the world's by 2030. Among the key requirements are the home-bred, tailored solutions that a greater local research capacity and leadership would produce to respond to the challenges ahead. At the first Epicentre Niger Scientific Day held in Niamey on January 25, there were signs that the message is on point and the optimism justified.
In The Lancet Global Health, Sophie Sarrassat and colleagues report on the first cluster randomised controlled trial of a radio intervention to reduce child mortality. The study is exceptional in its design and ambition: a systematic review of 111 mass media interventions to improve child survival found that only 32 used moderate to strong evaluation designs and only one measured an actual health outcome.2This elegant Burkinabé trial bucks all trends.
Background: Media campaigns can potentially reach a large audience at relatively low cost but, to our knowledge, no randomised controlled trials have assessed their effect on a health outcome in a low-income country. We aimed to assess the effect of a radio campaign addressing family behaviours on all-cause post-neonatal under-5 child mortality in rural Burkina Faso.
Building upon the successes of Countdown to 2015, Countdown to 2030 aims to support the monitoring and measurement of women's, children's, and adolescents' health in the 81 countries that account for 95% of maternal and 90% of all child deaths worldwide. To achieve the Sustainable Development Goals by 2030, the rate of decline in prevalence of maternal and child mortality, stillbirths, and stunting among children younger than 5 years of age needs to accelerate considerably compared with progress since 2000.
Mobile phones have the potential to improve access to healthcare information and services in low-resourced settings. This study investigated the use of mobile phones among patients with chronic diseases, pregnant women, and health workers to enhance primary healthcare in rural South Africa. Qualitative research was undertaken in Mpumalanga in 2014. Semi structured in-depth interviews were conducted with 113 patients and 43 health workers from seven primary healthcare clinics and one district hospital. Data were thematically analysed.
In agonising, crippling pain from lung cancer, Mr S came to the palliative care service in Calicut, Kerala, from an adjoining district a couple of hours away by bus. His body language revealed the depth of the suffering. We put Mr S on morphine, among other things. A couple of hours later, he surveyed himself with disbelief. He had neither hoped nor conceived of the possibility that this kind of relief was possible. Mr S returned the next month. Yet, common tragedy befell patient and caregivers in the form of a stock-out of morphine.
Sub-Saharan Africa's health challenges are numerous and wide-ranging. Most sub-Saharan countries face a double burden of traditional, persisting health challenges, such as infectious diseases, malnutrition, and child and maternal mortality, and emerging challenges from an increasing prevalence of chronic conditions, mental health disorders, injuries, and health problems related to climate change and environmental degradation.
SUMMARY: Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer.
Subject: [hifa] Evidence-informed country-level policymaking (28) Moving towards universal health coverage: lessons from 11 country studies