Salt intake is associated with hypertension, the leading risk factor for cardiovascular disease. To promote population-level salt reduction, the World Health Organization recommends intervention ...around three core pillars: Reformulation of processed foods, consumer awareness, and environmental changes to increase availability and affordability of healthy food. This review investigates salt reduction interventions implemented and evaluated in sub-Saharan Africa (SSA).
MEDLINE and google scholar electronic databases were searched for articles meeting inclusion criteria. Studies that reported evaluation results of a salt intervention in SSA were identified. Titles and abstracts were screened, and articles selected for full-text review. Quality of included articles was assessed, and a narrative synthesis of the findings undertaken. PROSPERO registration number CRD42015019055.
Seven studies representing four countries-South Africa, Nigeria, Ghana, and Tanzania-were included. Two examined product reformulation, one in hypertensive patients and the other in normotensive volunteers. Four examined consumer awareness interventions, including individualised counselling and advisory health sessions delivered to whole villages. One study used an environmental approach by offering discounts on healthy food purchases. All the interventions resulted in at least one significantly improved outcome measure including reduction in systolic blood pressure (BP), 24 hour urinary sodium excretion, or mean arterial BP.
More high quality studies on salt reduction interventions in the region are needed, particularly focused on consumer awareness and education in urban populations given the context of rapid urbanisation; and essentially, targeting product reformulation and environmental change, for greater promise for propagation across a vast, diverse continent.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In the era of double burden of infectious and non-communicable diseases in sub-Saharan Africa, the burden of multimorbidity is likely to be common. However, there is limited evidence on the burden ...and its associated factors in the sub-Saharan African context.
The aim of this study was to determine the levels and identify determinants of multimorbidity from chronic conditions in two urban slums in Nairobi.
Data collected from 2003 study participants aged 40-60 years in two urban slums of the Nairobi Urban Health and Demographic Surveillance System in 2015 were used. Using self-report, anthropometry and key biomarkers, data on 16 conditions including chronic diseases, behavioral disorders and metabolic abnormalities were gathered. Lifetime multimorbidity defined by the occurrence of at least two chronic conditions in an individual at any time during their life course was computed. Factors associated with lifetime multimorbidity were identified using multiple logistic regression.
A total of 2,081 chronic conditions were identified among 1,302 individuals. While 701 (35.0%) had no chronic condition, single morbidity was reported in 726 (36.2%) of the study population. The overall prevalence of lifetime multimorbidity was 28.7%. The prevalence of dyads and triads of simultaneous occurrences of conditions (episodic multimorbidity) was 20.8% and 6.1%, respectively. Single morbidity was positively associated with gender and alcohol consumption; and negatively associated with employment. Women, older people, the unemployed, current smokers and current alcohol consumers had higher levels of lifetime multimorbidity in the study population.
The findings of this study indicate that a considerable proportion of adults living in urban slums experience multimorbidity from chronic conditions. Further studies with a better rigor to establish temporal associations between socio-demographic factors and the occurrence of chronic conditions are needed to explore the impacts and implications on health status and health system.
Background: Normal-weight central obesity is associated with higher mortality than general obesity as defined by body mass index, particularly in the absence of central fat distribution.
Objective: ...The aim of this study was to examine the magnitude and predictors of normal-weight central obesity in an urban informal settlement setting in Kenya.
Methods: We used data from the AWI-Gen study, a cross-sectional survey targeting randomly selected consenting adults between the ages of 40-60 in two urban informal settlements of Nairobi between 2014 and 2016. Central obesity was determined using waist circumference, waist to hip ratio, visceral fat thickness, and subcutaneous fat thickness. General obesity was determined using body mass index (BMI).
Results: About 20.0% of participants in the study had general obesity. The prevalence of central obesity as measured by waist circumference was 52.0%, by waist-to-hip ratio was 53.5%, by visceral fat thickness was 32.4% and by subcutaneous fat thickness was 49.2%. The prevalence of normal-weight central obesity in the study population was highest when measured by waist to hip ratio (38.1%) and lowest when measured by visceral fat thickness (18.1%). Factors associated with normal-weight central obesity as assesses by waist circumference were being female, of older age, and in full-time employment. Older age was associated with normal-weight central obesity as assessed by waist to hip ratio.
Conclusion: The findings highlight a significant prevalence of normal-weight central obesity among adults in a poor urban setting in Kenya, pointing to women as a key target group for focused interventions. Longitudinal studies are needed to establish whether there is a link between normal-weight central obesity and mortality in such settings as has been found in other settings.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
In humanitarian settings, timely access to care is essential for survivors of gender-based violence (GBV). Despite the existence of GBV support services, challenges still exist in maximising benefits ...for survivors. This study aimed to understand the characteristics of violence against women and explore barriers and facilitators to care-seeking for GBV by women in two camps within the Dadaab refugee complex in Kenya. A mixed-methods design was used to study women accessing comprehensive GBV services between February 2016 and February 2017. Women were recruited into a cohort study (n = 209) and some purposively selected for qualitative in-depth interviews (n = 34). Survivor characteristics were descriptively analysed from baseline measures, and interview data thematically assessed. A majority of women were Muslim, of Somali origin, had been residents in the camp for more than five years, with little or no formal education, and meagre or no monthly income. From the survey, 60.3% and 66.7% of women had experienced non-partner violence or intimate partner violence in their lifetime respectively. Facilitators to accessing GBV services by survivors included awareness of GBV services and self-perceived high severity of acts of violence. Barriers included stigma by family and the community, fear of further violence from perpetrators, feelings of helplessness and insecurity, and being denied entry to service provision premises by guards. Women in the Dadaab refugee camps face violence from intimate partners, family, and other refugees. There is an urgent need to address drivers of GBV and the barriers to disclosure and access to services for all survivors of GBV.
In humanitarian settings, timely access to care is essential for survivors of gender-based violence (GBV). Despite the existence of GBV support services, challenges still exist in maximising benefits ...for survivors. This study aimed to understand the characteristics of violence against women and explore barriers and facilitators to care-seeking for GBV by women in two camps within the Dadaab refugee complex in Kenya. A mixed-methods design was used to study women accessing comprehensive GBV services between February 2016 and February 2017. Women were recruited into a cohort study (n = 209) and some purposively selected for qualitative in-depth interviews (n = 34). Survivor characteristics were descriptively analysed from baseline measures, and interview data thematically assessed. A majority of women were Muslim, of Somali origin, had been residents in the camp for more than five years, with little or no formal education, and meagre or no monthly income. From the survey, 60.3% and 66.7% of women had experienced non-partner violence or intimate partner violence in their lifetime respectively. Facilitators to accessing GBV services by survivors included awareness of GBV services and self-perceived high severity of acts of violence. Barriers included stigma by family and the community, fear of further violence from perpetrators, feelings of helplessness and insecurity, and being denied entry to service provision premises by guards. Women in the Dadaab refugee camps face violence from intimate partners, family, and other refugees. There is an urgent need to address drivers of GBV and the barriers to disclosure and access to services for all survivors of GBV.
Dans les contextes humanitaires, l’accès ponctuel aux soins est essentiel pour les victimes des violences sexistes. En dépit de l’existence de services de soutien, des obstacles persistent pour que les victimes en retirent tous les avantages. Cette étude souhaitait comprendre les caractéristiques de la violence contre les femmes tout en explorant les obstacles et les facteurs qui facilitent la demande de soins des femmes victimes de violences sexistes dans deux camps situés dans le complexe de réfugiés de Dadaab au Kenya. Des méthodes mixtes ont été choisies pour étudier les femmes ayant eu accès à des services complets en cas de violences sexistes entre février 2016 et février 2017. Les femmes ont été recrutées dans une étude de cohorte (n = 209) et certaines sélectionnées pour des entretiens qualitatifs approfondis (n = 34). Les caractéristiques des victimes ont été analysées de manière descriptive à partir de mesures de référence et les données des entretiens évaluées de manière thématique. Une majorité de femmes étaient musulmanes, d’origine somalienne, résidaient dans le camp depuis plus de cinq ans, étaient peu ou pas instruites et disposaient d’un revenu mensuel modeste ou inexistant. D’après l’enquête, 60,3% et 66,7% des femmes avaient déjà connu des violences infligées par une personne autre que leur partenaire ou des violences conjugales respectivement. Les facteurs facilitant l’accès des victimes aux services de soutien comprenaient la connaissance des services et la perception personnelle de la gravité des actes de violence. Les obstacles incluaient la stigmatisation par la famille et la communauté, la crainte de nouvelles violences de la part des coupables, les sentiments d’impuissance et d’insécurité et le refus d’entrée dans les locaux par des gardes. Les femmes dans les camps de réfugiés de Dadaab font face à des violences conjugales, familiales et de la part d’autres réfugiés. Il est urgent de s’attaquer aux facteurs des violences sexistes et aux obstacles qui contrarient la révélation de ces actes et l’accès aux services pour toutes les victimes.
En entornos humanitarios, el acceso oportuno a los servicios de salud es esencial para sobrevivientes de violencia de género (VG). Pese a la existencia de servicios de apoyo a sobrevivientes de VG, aún existen retos para maximizar los beneficios para sobrevivientes. El objetivo de este estudio era entender las características de la violencia contra las mujeres y explorar las barreras y los facilitadores de la búsqueda de atención por VG por mujeres en dos campos dentro del complejo de refugiados de Dadaab, en Kenia. Se utilizó un diseño de combinación de métodos para estudiar a las mujeres que acceden a servicios integrales relacionados con VG, entre febrero de 2016 y febrero de 2017. Se reclutaron mujeres para que participaran en un estudio de cohortes (n = 209) y algunas fueron seleccionadas intencionalmente para que participaran en entrevistas cualitativas a profundidad (n = 34). Las características de las sobrevivientes fueron analizadas de manera descriptiva según las medidas de referencia, y los datos de las entrevistas fueron evaluados por temática. La mayoría de las mujeres eran musulmanas, de origen somalí, residían en el campo desde hace más de cinco años, tenían poca o ninguna formación académica y escaso o ningún ingreso mensual. Según la encuesta, el 60.3% y el 66.7% de las mujeres habían sufrido violencia infligida por una persona que no era su pareja o violencia infligida por su pareja, a lo largo de su vida respectivamente. Ejemplos de facilitadores para acceder a los servicios de atención a sobrevivientes de VG eran: conocimiento de los servicios y autopercepción de la gravedad de los actos de violencia. Ejemplos de barreras eran: estigma por la familia y la comunidad, temor de continuar sufriendo violencia por los perpetradores, sentimientos de impotencia e inseguridad, y negación de entrada a las instalaciones de prestación de servicios por los guardias. Las mujeres en los campos de refugiados en Dadaab enfrentan violencia infligida por sus parejas, familia y otros refugiados. Existe una necesidad urgente de abordar los impulsores de VG y las barreras para denunciar la violencia y acceder a los servicios para todas las sobrevivientes de VG.
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