Authors:Quentin T. Wodon Pages: 6 - 9 Abstract: While research on faith-based healthcare in Africa covers a rich array of topics, we still need to better understand some of the basic features of the sector, including its size. This editorial provides a brief discussion of the size of the faith-based healthcare sector globally and in Africa and some of its characteristics based on data on the number of facilities operated by the Catholic Church in Africa, the largest provider of faith-based healtcare globally and on the continent. Africa is the region of the world where the number of Catholic health facilities operated by the Church has increased the most in the last 40 years, but there is a lot of heterogeneity between countries in terms of the number of Catholic facilities in operation. PubDate: 2024-02-25 DOI: 10.15566/cjgh.v11i1.933 Issue No:Vol. 11, No. 1 (2024)
Authors:Dennis Kinyoki, Ruth Gemi, Gertrude Guveya, James Mukabi, Jaya Shreedhar, Fifi Manuel, Alex Anderson, Cougar P Hall, Josh West, Benjamin Crookston Pages: 10 - 26 Abstract: Background & Aims. The COVID-19 pandemic had a significant impact on health in countries of every income level. While much is known about risk factors for COVID-19 severity, less is known about the relationship between COVID related risk perceptions and behaviors, particularly in low-income settings. The purpose of this study is to investigate the relationship between existing health status and COVID-19 risk perceptions and behaviors in Sierra Leone and Zimbabwe. Methods. Data for this study came from a cross-sectional survey conducted simultaneously among 1158 adults in Sierra Leone and 1154 in Zimbabwe during July and August of 2022. Respondents were recruited from among communities served by the Christian Health Association of Sierra Leone (CHASL) and Zimbabwe Association of Church-Related Hospitals (ZACH), both members of the Africa Christian Health Associations Network (ACHAP). Results. The relationship between health status and COVID-19 risk perceptions and behaviors varied significantly by health condition. Cardiovascular disease was significantly associated with heightened perceptions of COVID-19 risk, heightened perceived safety of COVID vaccines, and subsequent greater vaccine acceptance while cancer was likewise statistically significant in each of lower perceived susceptibility, perceived safety, and vaccination uptake. Similarly, obesity was associated with both lower perceived susceptibility of COVID-19 and decreased perceived safety of COVID vaccines. Conclusion. Results suggest that the association between health conditions and COVID perceptions and behaviors is neither clear nor consistent across a variety of NCDs. Hence, findings from this study may inform public health interventions aimed at reducing COVID-19 morbidity and mortality, including increasing vaccine acceptance and uptake in Sierra Leone and Zimbabwe. Further, findings potentially have broader implications for understanding how health status is associated with COVID-19 risk perceptions in other LMICs. PubDate: 2024-02-25 DOI: 10.15566/cjgh.v11i1.815 Issue No:Vol. 11, No. 1 (2024)
Authors:Simon Ssentongo, Dennis Kinyoki, Ruth Gemi, Alex Muhereza, Fifi Manuel, Rebecca Waugh, Mary Linehan, Jared Saxton, Cougar P Hall, Josh West, Benjamin Crookston Pages: 27 - 45 Abstract: Background & Aims. The coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide, making the uptake of effective vaccines critical to saving lives. In Sierra Leone and Zimbabwe, both supply- and demand-side challenges have made high rates of vaccination difficult to achieve. The current study seeks to describe vaccination rates and reasons for vaccine hesitancy in both Sierra Leone and Zimbabwe. Methods. The current study uses data that came from a cross sectional survey that was conducted face to face in Sierra Leone and Zimbabwe. This study uses frequency statistics, chi-square test statistics, and multivariate regression analysis to describe and explore differences between the two countries. The Health Belief Model was used as a framework for sorting and understanding findings. Results and Conclusions. This study reveals that vaccine uptake was much lower in Sierra Leone than in Zimbabwe. Zimbabweans were almost twice as likely as Sierra Leoneans to be vaccinated while Sierra Leoneans were significantly more likely to believe the vaccine was risky. Individuals who were older, from Zimbabwe, and were healthcare workers or community leaders were more likely to be vaccinated. Those who were from Zimbabwe, had secondary or tertiary education, and were community leaders were more likely to be concerned about catching COVID-19 than community members. Faith leaders were less likely to be concerned about catching COVID-19 in public. These findings add to our understanding of attitudes that lead to vaccine hesitancy and uptake. PubDate: 2024-02-25 DOI: 10.15566/cjgh.v11i1.813 Issue No:Vol. 11, No. 1 (2024)
Authors:Wiktoria Tafesse, Martin Chalkley Pages: 46 - 63 Abstract: Empirical evidence concerning differences in the quality of service offered by faith-based and public healthcare facilities in low- and middle-income countries is limited. This study contributes by examining the difference in clinical knowledge of staff based at faith-based and government facilities in Malawi. Using vignette data for individual healthcare workers from the 2018/2019 Malawi Harmonised Health Facility Assessment we undertake regression analysis of the relationship between ownership and the probability of respondents making the correct diagnosis, treatment and management choices for eight childhood, adult and pregnancy-related cases after accounting for differences across healthcare workers, facilities and geography. Staff employed at faith-based facilities, compared to staff at public facilities, are found to be less likely to correctly diagnose and treat children presenting with diarrhoea with severe dehydration but are better at diagnosing and treating adults presenting with diabetes. We do not find any differences in the diagnosis and treatment of the remaining six cases. Hence, we do not find compelling evidence of an overall difference in clinical knowledge across staff at faith-based compared to public facilities in Malawi. PubDate: 2024-02-25 DOI: 10.15566/cjgh.v11i1.853 Issue No:Vol. 11, No. 1 (2024)
Authors:Valerie Oji, Bailey Powell Pages: 64 - 83 Abstract: Background: Religious/Spiritual (R/S) care is often desirable by mental health clients for culturally sensitive, patient-focused treatment; yet providers may experience hesitancy or overlook this need and treatment guidelines are limited. The aim of this qualitative study was to explore existing R/S care, as well as perspectives on what support care would be considered for patients choosing BFC. This is part of a project to collaboratively extend population-based mental health care access in resource–constrained communities of both the US, a High-Income Country (HIC) and Low-to-Middle Income Countries (LMICs) in Africa. Methods: A qualitative literature synthesis, then an online survey was conducted with 54 multidisciplinary participants recruited via snowballing. Survey participants were asked to review a case as described by a BFC provider and respond anonymously to an open-ended questionnaire. The data collected was distilled with qualitative coding and thematic analysis. Results: Literature synthesis identified multidisciplinary health professional provision of R/S, medical and/or psychological interventions as monotherapy or integrated strategies. There was a paucity of medical education guidelines. Qualitative themes included willingness to coordinate care for BFC clients, to what capacity should care be provided, and perceptions of BFC efficacy. R/S care was often integrated as part of a holistic treatment approach. Scheduled BFC patient follow-ups, ethical hand-offs or referrals were considered important for majority of survey respondents based on comfort-level with biblical counseling and perceived relapse potential. Spiritual growth and maintenance, medication management, and individual psychotherapy were recommended by survey respondents. There were contrasts in BFC and non-R/S provider perspectives on pertinent mental health history and inferences from the case. Significant information for patient support included symptoms and confirmatory diagnosis, medical comorbidities, relevant childhood issues, faith-health beliefs, family history and genetics, medication and therapy adherence, and substance use. Faith-health belief congruence of providers with BFC patients and ethical decision-making should be considered. Graduate Medical Education (GME) and other health professional programs may incorporate these considerations, existing R/S interventions, and multidisciplinary provider scope of practice as options for clinician training. Future research steps should include growing the body of anecdotal case reports, evidence-based case series and implementation science studies across a broader range of mental disorders. PubDate: 2024-02-25 DOI: 10.15566/cjgh.v11i1.845 Issue No:Vol. 11, No. 1 (2024)
Authors:Ekomobong Okpo, Iniobong E Andy, Godwin E John, Rosemary C Chinyeaka Pages: 84 - 90 Abstract: Background & Aims: Children are more susceptible to dermatophytes due to different predisposing factors, such as under developed immune system and high sensitivity of their skin to infection. This study investigated the epidemiology of dermatophyte infection among primary school children in Calabar municipality, Nigeria. Methods: Students attending two primary schools, DPS and PCNPS in Calabar Municipality, were clinically screened. Samples were collected from children with physical signs of dermatophytes on skin, scalp, and nails, and who were present on the day of sample collection. Affected areas were scraped and swabbed. Cultures were done on SDA, and Lactophenol cotton blue was used to prepare isolates for microscopy. Results: A total of 779 children aged 4-17 years were screened. 202(25.9%) were mycologically positive by culture. The occurrence of dermatophyte infection was significantly higher in young children aged 4-6 years than in older children. Male children were more frequently infected (17.6%) than females (8.3%). Trichophyton spp. was the most prevalent etiological agent (35.6%), followed by Microsporum spp. (31.7%), and Epidemophyton spp. (19.3%). Plates with mixed colonies constituted 13.4% of the entire culture. Dermatophytes were mostly isolated from the scalp (63.9%), followed by Skin (32.2%), and Nails (4%). The prevalence of dermatophyte infection among the two schools’ children was 32.0% and 21.9% in DPS and PCNPS, respectively. Conclusion: Dermatophyte infection is still prevalent among primary school children. Regular screening and use of educational health awareness of dermatophyte infection are recommended. PubDate: 2024-02-25 DOI: 10.15566/cjgh.v11i1.851 Issue No:Vol. 11, No. 1 (2024)
Authors:Femi Awotokun, Oluyomi Abayomi Sowemimo, Ruqayah Olawoyin, Ashiat Alaba Adeleke Pages: 91 - 98 Abstract: This cross-sectional study was conducted to determine the prevalence and intensity of infection of soil-transmitted helminths among school-aged children in Ife Central and Ife East Local Government Areas, Osun State, Nigeria, and the level of awareness of the school children on the disease. Fresh stool samples were collected from 324 pupils, comprising 162 males and 162 females (aged 5-12 years), from March to June 2021 and were preserved in 2 ml of 10% formalin. The preserved fecal samples were processed using a modified Kato-Katz technique. Of the 324 fecal samples examined, 79 (24.4%) tested positive for helminth eggs. The eggs were identified as Ascaris lumbricoides, with a prevalence of 22.2%, and hookworm with a prevalence of 3.7%. Double infections were observed in 5 (1.5%) pupils. Private schools had a slightly higher prevalence (24.7%) than did public schools (24.1%). Sex-related prevalence was higher among males (25.9%) than females (22.8%), and no significant difference existed in the prevalence level between the sexes (p > 0.05). Data were analyzed using the chi-square test and multivariate logistic regression using the Statistical Package for Social Sciences (SPSS) version 20. This study concluded that STH infection remains a public health risk among children in the study area. PubDate: 2024-02-25 DOI: 10.15566/cjgh.v11i1.833 Issue No:Vol. 11, No. 1 (2024)
Authors:Thomas Kollars, Mustapha Debboun, Mark Carder, Lee P. McPhatter; JR Pages: 99 - 110 Abstract: Background: The threat posed by mosquito-borne diseases continues to increase globally. The increase of pesticide resistance is impacting vector control and public health globally. The development and testing of new pesticides faces several challenges, e.g., time for development, high cost, and regulatory hurdles. Adapting pesticides that are currently used within integrated vector management can help alleviate these challenges. Methoprene has demonstrated reduction of larval populations and fecundity in adult mosquitoes. The objective of the study was to demonstrate the efficacy of ProVector Entobac with methoprene (Entobac M) on mosquito populations in rural sites in Southeastern Georgia. Methods: ProVector® Military Camouflage Tubes with ProVector Entobac M pesticide were placed in a grid at test sites. A positive control test site and a negative control site were used to compare results statistically. Mosquito diversity and evenness among sites were measured using Shannon Diversity Index and Equitability. Results: Deployment of ProVector® Military Camouflage Tubes with ProVector Entobac M pesticide was effective in reducing total mosquito populations. The mosquito species shared among the test sites and positive control site were similar, and the negative control site was least similar in diversity and evenness. There was variation of control within Aedes, Anopheles, and Culex genera. Discussion: The aim of the study was to demonstrate the efficacy of the ProVector Military Camouflage Tube delivery of Entobac with methoprene (Entobac M) on mosquito populations. Mosquito-borne diseases are an increasing threat to communities around the world due to invasive species and global warming. In previous studies, ProVector® Entobac™ has been validated in laboratory and field studies to control both adult and larval mosquitoes in the United States and several other countries. Application of ecofriendly and target specific pesticides with no-resistance is critical in reducing mosquito populations and the risk of vector-borne diseases. Our study demonstrated a significant decrease in adult mosquito populations due to the utilization of a target specific mosquito larvicide that has been adapted to kill adult mosquitoes. PubDate: 2024-02-25 DOI: 10.15566/cjgh.v11i1.729 Issue No:Vol. 11, No. 1 (2024)
Authors:Dennis Cherian, Fifi Manuel, Rebecca Waugh, Nkatha Njeru, Cornelia Mukandi, Chikari Wedze, Gregory Hooke, Benjamin Crookston, Joshua West, Cougar P Hall Pages: 111 - 120 Abstract: Faith-based organizations (FBOs) and faith-based service providers play a critical role in public health prevention, promotion, treatment, and community development. Effective capacity strengthening efforts through FBO partnerships can make a vital contribution toward effective localization. This case study details the efforts and results of a writing and publishing workshop provided in partnership with Corus International (IMA World Health) and the Africa Christian Health Associations Platform (ACHAP) in March of 2023. This case study also reports on workshop participants’ perceptions of the partnership's approach to capacity strengthening. Three major and related themes emerged from the workshop’s informal Focus Group Discussion transcription: 1) a safe and nurturing environment, 2) openness and shared decision-making, and 3) organizational humility. PubDate: 2024-02-25 DOI: 10.15566/cjgh.v11i1.805 Issue No:Vol. 11, No. 1 (2024)
Authors:Isatu Jalloh, Jill Olivier, Eleanor Beth Whyle Pages: 121 - 147 Abstract: For the health system to function well, the population must have equitable access to quality, affordable pharmaceutical supplies; however, pharmaceutical systems in Africa are challenged by inadequate funding, drug stock outs and irregular supplies, a shortage of trained pharmacy personnel, and a lack of systems for drug regulation and quality. Faith-based health providers, as private, not-for-profit actors, have long complemented public sector efforts in the supply of pharmaceuticals in Africa. However, the contribution of faith-based health providers in pharmaceutical systems has not been formally studied. This study examines the nature and function of faith-based healthcare providers in improving access to pharmaceutical supplies in Africa. To do so, we conducted an exploratory qualitative systematic review to identify documents that contain information on faith-based involvement in pharmaceutical supply in Africa. The review identified 20 articles for inclusion. These articles were analyzed using thematic, narrative analysis. The analysis revealed a significant evidence gap relating to the contribution of private-not-for-profit, faith-based providers to African pharmaceutical systems. The review suggests that while faith-based drug supply organizations have existed for a long time and contribute significantly to national pharmaceutical systems, there is very little known about the nature of faith-based pharmaceutical providers and how they complement public sector pharmaceutical systems. In many contexts, faith-based involvement in pharmaceutical systems improved access for the general population and increased the supply of pharmaceuticals in national systems. Faith-based drug supply organizations also often provide pharmaceutical supplies to both rural and urban areas, often targeting rural and remote areas particularly. The review also indicates that faith-based drug supply organizations improved access to medicines and related commodities and, despite a lack of regulation in many contexts, have the potential to make a positive contribution to quality assurance of pharmaceuticals. In summary, the analysis confirmed that faith-based involvement in pharmaceutical supply chains contributes to strengthening the national health system by complementing the public pharmaceutical system through improved access to medicines and related commodities in Africa. These conclusions corroborate the need to continually document and acknowledge faith-based healthcare providers efforts which could guide the formulation of stringent, evidence-based strategies. PubDate: 2024-02-25 DOI: 10.15566/cjgh.v11i1.793 Issue No:Vol. 11, No. 1 (2024)
Authors:Nadine Nanji, Jill Olivier Pages: 148 - 176 Abstract: Background: Psychological disturbances and mental illnesses are prevalent on the continent of Africa. There are shortages of mental health services and a lack of quality providers with limited training and supervision. It is perceived that faith-based entities for psycho-emotional health and wellbeing are filling the gap with positive impact. However, the risks associated with unconventional or extreme spiritual practices will be evaluated. The contributions of these entities, their roles in the global and African health system, and their implications for community development and policy making are highlighted. Methods: A mixed-methods systematic review was conducted in two phases to synthesise qualitative and quantitative data. The review sought evidence on faith-based health providers of mental health services in Africa looking at types, magnitude, and quality, and included both peer-reviewed and grey literature, published between 2007 and 2024, in English. A narrative thematic analysis was used for the qualitative part and meta-analyses was used for the quantitative part to back up the narrative element of this study. Results: This review identified 55 relevant items from 13 African countries. The results showed that faith-based mental health providers deliver a range of six types of alternative mental health care, faith-based home care and faith-based biomedical mental health care. The magnitude of these faith-based mental health services was considered according to frequency of use and availability (accessibility, affordability, and acceptability), but evidence was limited. When the quality of these mental health care was assessed, some studies showed positive mental health outcomes from the utilisation of faith-based mental health care, but some studies revealed bad quality practices due to inhumane treatments. Conclusion: There are limitations regarding the vast array of faith-based health providers and the mental health care as they provide which include harmful practices used in Africa. Training interventions are needed to avoid some of the inhumane treatments. Faith-based mental health care offers culturally influenced practices for mental health which should be leveraged. Integration of faith-based mental health care into primary health system is advised in order to attain universal health coverage. Finally, possible regulation of traditional and faith healing methods for emotional struggles could be implemented at a policy level. PubDate: 2024-02-25 DOI: 10.15566/cjgh.v11i1.795 Issue No:Vol. 11, No. 1 (2024)
Authors:Kaleab Tegegne, Jemberu Chane Fetene, Tadele Kassahun Wudu , Yosef Aragaw Gonete, Abebe Tadesse Tibebu, Yideg Abinew Kebedes, Moges Tadesse Abebe Pages: 177 - 192 Abstract: Background: Clinical practice competence is affected by different factors in clinical setting like Skill of the educator, staff–student interaction, a clear assessment guideline; Effective mentoring and constructive feedback will also influence learning. Poor performance is caused by low competence and improving competency would improve performance. Therefore, the purpose of this systematic review and meta-analysis's is to asses’ factors affecting clinical practice competency of medical and health science students in Ethiopia. Methods: We conducted a related literature search (February up to March 2023 ) of PubMed, and Web of Science databases for studies describing the factors associated with clinical practice competency among medical and health science students in Ethiopia. The quality of studies was independently assessed by the Newcastle–Ottawa quality scale (NOS), which was guided by the PRISMA checklist. The Q test and I2 statistics were used to evaluate the heterogeneity among selected studies. If the heterogeneity was obvious (I2 >50%), the random effects model (REM) was used. If the heterogeneity was low (I2≤50%), the fixed effects model (FEM) was used. Results: There were 1613 participants in four (4) investigations. The pooled effect size of clinical practice competency among students in the form of odds ratio (OR) with the presence of a checklist 3.40 (95% CI 2.50–4.62), p<0.00001, I2=0%), with the orientation of objective 3.84 (95% CI 2.29–6.43), p<0.00001, I2=57%) ,students having receptor in clinical practice 2.42, (95% CI 1.68–3.48), p=0.00001, I2=47%) ,having confidence during performing the procedure 2.16, (95% CI 1.17–3.99), p=0.01, I2=53%) The final pooled effect size after trim and fill analysis in the random effect model was found to be 1.27 (95%CI: -0.19, -2.73) for the association between staff encourage to do practice and clinical practice competency. This indicated that absence of a significant association between staff encourage to do practice and clinical practice competency among medical and health science students in Ethiopia. Conclusions: The presence of a checklist, the orientation of objective, having receptor in clinical practice and students having confidence during performing the procedure are factors associated with clinical practice competency among medical and health science students in Ethiopia. PubDate: 2024-02-25 DOI: 10.15566/cjgh.v11i1.787 Issue No:Vol. 11, No. 1 (2024)
Authors:Laurie Elit, Rick Bardin , Debbie Bardin, Caroline Brown, Jim Brown, Jackie Griffin, Denis Palmer, Mark Snell, Kaye Streatfeild, Keith Streatfeild, Julie Stone Pages: 193 - 197 Abstract: Jesus' self confessed mandate was to proclaim good news to the poor and validate this message through miracles like healing. He sent out his followers to do likewise. Mission hospitals are the penultimate example of restoring health in the name of a Saviour who loves them. As a group of healthcare missionaries at Mbingo Hospital, Cameroon, we see the role for mission hospitals/systems for the following reasons: compassionate care, competence, an opportunity to reflect our faith, humility, vision, perseverance, social justice, integrity and accountability. We provide examples for each. Missionary hospitals/systems in sub-Saharan Africa are a training group for the principles all of us need to mature in during our Christ-centered journey of life. PubDate: 2024-02-25 DOI: 10.15566/cjgh.v11i1.737 Issue No:Vol. 11, No. 1 (2024)
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