Research Articles
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A research article reports the results of original research, assesses its contribution to the body of knowledge in a given area, and is published in a peer-reviewed scholarly journal. The faculty publications through published and on-going articles/researches are captured in this community
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Item Craniosynostosis in Africa: Insights from 8 Countries—A Systematic Review and Meta-Analysis.(Elsevier Inc., 2025-02) Darko, K.; Tenkorang, P.; Pulido, S.; et al.OBJECTIVE: Craniosynostosis is a congenital skull deformity that impacts development and quality of life of children if left untreated. This study aimed to evaluate literature regarding presentation, treatment, and outcomes of cranio synostosis in Africa. - METHODS: A systematic review of the literature using PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar databases was conducted ac cording to the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. - RESULTS: Fourteen retrospective/prospective studies with 620 patients and 14 case reports involving 27 cases (8 countries) were included. In 12 articles, 56.6% of patients (317/560) were males, with a mean age of 2.4 years (confidence in terval [CI]: 1.1e3.7). Abnormal head shape was the most reported presentation in 77.8% of cases (332/427, 8 articles). Syndromic craniosynostosis was seen in 25.2% (CI: 13.7%e36.6%). Common phenotypes were trigonocephaly in 31.5% (CI: 3.6%e59.4%), anterior plagiocephaly in 23.2% (CI: 5.1%e41.3%), and scaphoce phaly in 22.1% (CI: 13.5%e30.8%). Five hundred seventy eight patients, 99.5% (CI: 99.0%e100.0%), underwent surgical treatment. Vault remodeling was performed in 72.9% patients (CI: 47.4%e98.6%). Postoperative complications included ce rebrospinal fluid leaks 5.4% (CI: 0.0%e11.6%) and surgical site infections 4.5% (CI: 0.0%e10.8%). Follow-up ranged between 0.2 and 40.9 months; 95.6% of cases (CI: 90.1%e100.0%) exhibited improved deformity and neurological deficits at last follow-up. The mortality rate was 3.1% (CI: 0.0%e6.9%, 2 articles). - CONCLUSIONS: Few studies on craniosynostosis in Africa highlight the need for more research. Treatment with open techniques yields few complications and a low mortality rate. Early diagnosis and collaborative data reporting will enhance understanding of its burden and variations across Africa.Item The Africa Food Environment Research Network (FERN): from concept to practice(Global Health Promotion, 2022) Tandoh, A.; Aryeetey, R.; Agyemang, C.; et al.Background: Africa is contending with unhealthy food environments that are, in part, driving increasing rates of overweight, obesity, and diet-related non-communicable diseases, alongside persistent undernutrition. This current paradigm requires expanded efforts – both in the volume and nature of empirical research, as well as the tools and capacity of those who conduct it. High-quality and context-relevant research supports the development and implementation of policies that create healthy food environments. Aim and approach: This paper sets out the concept of the Africa Food Environment Research Network (FERN) initiative recently established by the Measurement, Evaluation, Accountability, and Leadership Support for non-communicable diseases (NCDs) (MEALS4NCDs) prevention project. Central to the Africa FERN initiatives are: 1) building research capacity for innovative food environment research in Africa; 2) improving South-South, and South-North partnerships to stimulate a robust food environment research and monitoring in Africa and 3) sustaining dialogue and focusing priorities on current and future needs for enhanced food environment research and monitoring in Africa. Conclusion: The FERN initiative presents an opportune platform for researchers in Africa and the global North to weave the threads of experience and expertise for research capacity building, collaboration and advocacy, to advance food environment research.Item Prevalence and management of ectopic and molar pregnancies in 17 countries in Africa and Latin America and the Caribbean: a secondary analysis of the WHO multi-country cross-sectional survey on abortion(BMJ Open, 2024) Cavalar, C. A.A.; Mehrtash, H.; Govule, P.; et al.Introduction There are limited global data on ectopic pregnancy (EP) and molar pregnancy (MP), making it important to understand their epidemiology and management across different regions. Our study aimed to describe their prevalence for both conditions, severity of their complications and management among women in selected health facilities across 17 countries in Africa and Latin America and the Caribbean (LAC). Methods This is a secondary analysis of the WHO multi country survey on abortion. Data were collected from 280 healthcare facilities across 11 countries in Africa and 6 in LAC. Sociodemographic information, signs and symptoms, management and clinical outcomes were extracted from medical records. Facility-level data on post-abortion care (PAC) capabilities were also collected, and facilities were classified accordingly. χ2 or Fisher’s exact tests were used to compare categorical data. Results The total number of women with EP and MP across both regions was 9.9% (2 415/24 424) where EP accounted for 7.8% (1 904/24 424) and MP for 2.1% (511/24 424). EP presented a higher severity of complications than MP. At admission, 49.8% of EP had signs of peritoneal irritation. The most common surgical management for EP was laparotomy (87.2%) and for MP, uterine evacuation (89.8%). Facilities with higher scores in infrastructure and capability to provide PAC more frequently provided minimal invasive management using methotrexate/other medical treatment (34.9%) and laparoscopy (5.1%). Conclusion In Africa and LAC, EP and MP cause significant maternal morbidity and mortality. The disparity in the provision of good quality care highlights the need to strengthen the implementation of evidence-based recommendations in the clinical and surgical management of EP and MPItem Community perceptions on the factors in the social food environment that influence dietary behaviour in cities of Kenya and Ghana: A Photovoice study(Public Health Nutrition, 2022) Wanjohi, M.N.; Laar, A.; Aryeteey, R.; et al.Objective To explore communities’ perspectives on the factors in the social food environment that influence dietary behaviours in African cities. Design A qualitative study using participatory photography (Photovoice). Participants took and discussed photographs representing factors in the social food environment that influence their dietary behaviours. Follow-up in-depth interviews allowed participants to tell the ‘stories’ of their photographs. Thematic analysis was conducted, using data-driven and theory-driven (based on the socio-ecological model) approaches. Setting Three low-income areas of Nairobi (n=48) in Kenya, and Accra (n=62) and Ho (n=32) in Ghana. Participants Adolescents and adults, male and female aged ≥13 years. Results The ‘people’ who were the most commonly reported as influencers of dietary behaviours within the social food environment included family members, friends, health workers and food vendors. They mainly influenced food purchase, preparation and consumption, through 1) considerations for family members’ food preferences, 2) considerations for family members’ health and nutrition needs, 3) social support by family and friends, 4) provision of nutritional advice and modelling food behaviour by parents and health professionals, 5) food vendors’ services and social qualities. Conclusions The family presents an opportunity for promoting healthy dietary behaviours between family members. Peer groups could be harnessed to promote healthy dietary behaviours among adolescents and youth. Empowering food vendors to provide healthier and safer food options could enhance healthier food sourcing, purchasing and consumption in African low-income urban communities.Item Conference on ‘Nutrition dynamics in Africa opportunities and challenges for meeting the sustainable development goals’(Proceedings of the Nutrition Society, 2017) Aryeetey, R.; Colecraft, E.; Holdsworth, M.; et al.Although a substantial amount of nutrition research is conducted in Africa, the research agenda is mainly donor-driven. There is a clear need for a revised research agenda in Africa which is both driven by and responding to local priorities. The present paper summarises the proceedings of a symposium on how evidence can guide decision-makers towards context-appropriate priorities and decisions in nutrition. The paper focuses on lessons learned from case studies by the Evidence Informed Decision Making in Nutrition and Health Network implemented between 2015 and 2016 in Benin, Ghana, and South Africa. Activities within these countries were organised around problem-oriented evidence-informed decision-making (EIDM), capacity strengthening and leadership, and horizontal collaboration. Using a combination of desk-reviews, stakeholder influence-mapping, semi-structured interviews and convening platforms, these country-level studies demonstrated a strong interest in partnership between researchers and decision-makers, and the use of research evidence for prioritization and decision-making in nutrition. Identified capacity gaps were addressed through training workshops on EIDM, systematic reviews, cost-benefit evaluations, and evidence contextualization. Investing in knowledge partnerships and the development of capacity and leadership are key to driving the appropriate use of evidence in nutrition policy and programming in Africa.Item Digital Platforms in Climate Information Service Delivery for Farming in Ghana(African Handbook of Climate Change Adaptation, 2021) Sarku, R.; Adiku, P.; Appiah, D.O.; et al.Phone-based applications, Internet connectivity, and big data are enabling climate change adaptations. From ICT for development and agriculture perspectives, great interest exists in how digital platforms support climate information provision for smallholder farmers in Africa. The vast majority of these platforms both private and public are for delivering climate information services and for data collection. The sheer number of digital platforms in the climate information sector has created a complex information landscape for potential information users, with platforms differing in information type, technology, geographic coverage, financing structures, and infrastructure. This chapter mapped the existing climate information services and examined their impact on policy and practices in smallholder farming development in Africa, with a focus on Ghana. Specifically, the chapter provides highlights of digital platforms available to smallholder farmers and agricultural extension agents, analyzes the public and/or private governance arrangements that underpin the implementation of digital climate information delivery, and assesses the potential of these platforms in scaling up the use of climate information. The chapter contributes to understanding the dynamics of climate information delivery with digital tools in Africa and suggests a future research agenda.Item Foreign aid-Economic Growth Nexus in Africa: Does Financial Development Matter?(International Economic Journal, 2022) Appiah-Otoo, I.; Appiah, I.K.; Acheampong, A.O.; et al.This study explored the role of financial development in foreign aid (measured by agriculture, humanitarian, health, economic infrastructure and services, and education aid) and economic growth relationships for 37 African countries spanning the 2002–2018 period. Using the instrumental variable generalized method of moments model, our findings indicated that while foreign aid impedes Africa’s growth, financial development spurs economic growth. The conditional effect analysis showed that financial development conditions foreign aid to spur economic growth. The country-specific analysis further showed that foreign aid has a higher growth elasticity in countries with relatively better financial systems, such as Mauritius, South Africa, Gabon, Tunisia, and Botswana, whilst the growth elasticity of aid is smaller in countries with a relatively weak financial system, such as Malawi, Guinea-Bissau, Sierra Leone, and the Democratic Republic of Congo. The study recommended the need for for policymakers in Africa to implement innovative ways to improve domestic revenue mobilization. The study also recommended that policymakers in Africa should create an enabling environment that will enhance the development of Africa’s financial system to mitigate the adverse effect of aid on economic growth.Item Mineralized Urbanization In Africa In The Twenty-First Century: Becoming Urban Through Mining Extraction(International Journal Of Urban And Regional Research, 2022) Bryceson, D.F.; Yankson, P.W.K.; Gough, K.V.; et al.This article focuses on the urbanizing impact of the post-millennial mineral boom at artisanal and small-scale (ASM) or large-scale (LSM) mining sites in three mineral-rich countries, involving gold in Ghana, diamonds in Angola, and both minerals in Tanzania. The focus is on comparing the agency of miners and other residents migrating to settling in and making the mining site habitable. Their mobility and settlement patterns reveal an urbanization trend marked by population agglomeration and expansion. labour complexity, taking distinct forms at the rush and mature stages of gold and diamond ASM and LSM sites. Citing data from household surveys conducted at 12 mining sites, we trace how ‘mineralized urbanization’ propels in-migration, rising localized purchasing power, and proliferating service sector and trade activities, fueling both urban demographic and economic change along the mining extraction trajectory. LSM and ASM generate synergies as well as detractive forces, depending on the size, age and history of the mining settlement development. What emerges is the differential development of households and settlements through strategic economic manoeuvring and the rough and tumble of happenstance, underlined by a compelling, albeit fluctuating, trajectory of non-renewable mineralized urbanizationItem Biodiversity and ecosystem services on the African continent – What is changing, and what are our options?(Environmental Development, 2021) Archer, E.; Dziba, L.E.; Gordon, C.; et al.Throughout the world, biodiversity and nature’s contributions to people are under threat, with clear changes evident. Biodiversity and ecosystem services have particular value in Africa– yet they are negatively impacted by a range of drivers, including land use and climate change. In this communication, we show evidence of changing biodiversity and ecosystem services in Africa, as well as the current most significant drivers of change. We then consider five plausible futures for the African continent, each underlain by differing assumptions. In three out of the five futures under consideration, negative impacts on biodiversity and ecosystem services are likely to persist. Those two plausible futures prioritizing environment and sustainability, however, are shown as the most likely paths to achieving long term development objectives without compromising the continent’s biodiversity and ecosystem services. Such a finding shows clearly that achievement of such objectives cannot be separated from full recognition of the value of such services.Item Different pathways of social protection reforms: An analysis of long-term institutional change in Kenya(World Development, 2021) Bender, K.; Rohregger, B.; Adamba, C.; et al.The potential of social protection to contribute to inclusive growth has been increasingly recognized throughout the last two decades. Social protection reforms involve comprehensive processes of long-term institutional change. Dynamics differ not only across but also within countries across social protection pillars reflecting multiple institutional trajectories and equilibria ranging from rapid and com prehensive shifts over processes of gradual change to situations of blocked reforms or reform reversals. This paper seeks to understand why reforms aiming at extending social protection coverage to the poor might differ across different pillars of social protection within the same country. Being embedded within comparative institutional analysis the paper aims at providing a systematic framework for defining and explaining variations in reform dynamics highlighting the role of uncertainty. The framework is applied to the Kenyan case. The empirical methodology employs a process tracing approach including primary and secondary data covering the time period between 2001 and 2017. The case of Kenya is one example for multiple institutional trajectories within a country: Whereas cash transfer reforms follow a pattern of cumulative incremental change, social health protection reforms reflect patterns of non-cumulative change including blocked reforms and reform reversals. The results suggest that those differences are partly explained by differences in preferences among agents or the institutional legacies within each domain. In addition, behavioral responses to uncertainty matter: Stronger information asymmetries within the cash transfer and fee waiver reform domains opened space for discretionary decision making. Interpretations of the concept of social protection and complexity of ’insurance’ facilitated pro cesses related to cash transfers whereas providing impediments to social health insurance. Lastly, the international and socio-economic context provided focal points facilitating coordination on targeted or vertical interventions such as cash transfers or fee waivers.