Introduction: Anemia, defined as a low level of hemoglobin in the blood, is a sign of inadequate nutrition as well as poor health in children. It affects about 269 million (39.8%) children under the age of five worldwide and it is a significant risk factor for poor health and nutrition in children. The main aim of this study was to assess the prevalence and contributing factors of anemia among children aged 6–59 months in Eastern Africa. Methods: The research was conducted between 2010 and 2023 across ten East African countries. To identify potential factors associated with anemia, a multilevel logistic regression model was used. Results: The prevalence of anemia in Eastern Africa was 54.26%, with the highest in Tanzania (70.32%) and the lowest in Rwanda (36.64%). A multilevel multivariable logistic regression model revealed that factors like child age in months 12-23 (AOR = 0.623; 95% CI: 0.581-0.669), female (AOR = 0.914; 95% CI: 0.880-0.949), stunted (AOR =1.289; 95% CI: 1.234-1.347), underweight (AOR = 1.232; 95% CI: 1.163-1.306), two under-five children (AOR=1.068; 95% CI: 1.023- 1.116), 2-3 birth order (AOR=1.096; 95% CI:1.034-1.162), having fever (AOR=1.410; 95% CI: 1.343-1.481), having diarrhea (AOR=1.066; 95% CI: 1.009-1.125), vitamin A supplementation (AOR =0.899; 95% CI: 0.863-0.937), primary educated mother (AOR=0.819; 95% CI: 0.775-0.865), anemic mother (AOR =1.844; 95% CI: 1.768-1.923), toilet facility (AOR = 0.879; 95% CI = 0.835-0.926), middle wealth index (AOR =0.876; 95% CI: 0.830-0.925), mother had occupation (AOR=0.930;95%CI: 0.892-0.971) and high community poverty (AOR = 1.047; 95% CI: 1.006-1.089) were significantly associated with anemia in Eastern Africa. Conclusion: The prevalence of anemia among children aged 6–59 months was still high in the region, indicating a continuing public health concern. Child age, sex, nutritional status (stunting and underweight), recent illness (feverand diarrhea), maternal education, anemia status, and occupation, household wealth, toilet facilities, vitamin A supplementation, and community poverty levels have statistically significant association with anemia. These findings underscore the urgent need for comprehensive interventions targeting both child nutrition and broader socio-economic and environmental determinants to effectively reduce the burden of anemia in the region.
Denekew Bitew Belay, Nigussie Adam Birhan, Tilahun Yemanu Birhan et al.
ABSTRACT Infant undernutrition is linked to cognitive deficits and reduced future economic productivity. This makes mitigating its effects on neurodevelopment an important health priority. The gut microbiome is hypothesised to influence host physiology, including brain function, through the production of microbial metabolites such as the short-chain fatty acids (SCFAs). However, direct epidemiological evidence linking SCFAs to infants’ cognitive development remains scarce in low-resourced settings. This study aimed to assess the association between SCFA concentrations and infants’ (6 to 23 months) cognitive development at a tertiary hospital in Northern Ghana. This age- and sex-matched case-control study included 132 infants admitted with severe acute malnutrition and 132 healthy counterparts. Cognitive development was assessed using the Ages and Stages Questionnaire-3. Infant faecal SCFAs (acetate, propionate, butyrate) were quantified via Gas Chromatography-Mass Spectrometry. Associations between SCFAs and atypical cognitive development were analysed using conditional logistic regression, adjusting for covariates. The prevalence of atypical cognitive development was 18.2%. The mean age of infants was 14.92 ± 5.13 months. In the adjusted models, each unit increase in acetate (AOR = 0.88, 95% CI: 0.82-0.95), propionate (AOR = 0.75, 95% CI: 0.63-0.87), and butyrate (AOR = 0.72, 95% CI: 0.60-0.87) was associated with 12%, 25% and 28% significantly reduced likelihood of atypical cognitive development, respectively (p < 0.001 for all). This study provides evidence that SCFAs may influence cognitive development among infants. Effective strategies are urgently needed to specifically enhance SCFA production among undernourished infants. Such strategies may include continued breastfeeding, diversified dietary intake, or targeted prebiotic supplementation.
Hammond Yaw Addae, Charles Apprey, Alexander Kwarteng
Introduction: In Tanzania, prevalence exceeds 30% and is unevenly distributed across geographical areas. The observed distribution may reflect unobserved contextual factors; however, little literature applies Bayesian multilevel generalised linear mixed (B-MGLM) models, which can account for them. This study aimed to model the determinants of stunting, controlling for contextual factors at both the region and enumeration area levels. Methods: This was a secondary data analysis using four recent Tanzania Demographic and Health Surveys (TDHS) datasets. We studied 7,492, 6,806, 8,929, and 4,797 under-five children in TDHS 2004/5, 2010, 2015/16, and 2022, respectively. We used B-MGLM models to evaluate the determinants of stunting. We used the deviance information criterion to compare the models. Results: About 41.4%, 34.1%, and 28.96% of under-five children were stunted in 2010, 2015/16, and 2022, respectively. Controlling for other factors in the model, a unit increase in MPI increased the odds of stunting by 10% [AOR = 1.1; 95% CI: 1.1, 1.2], while a unit increase in WAMI reduced the odds of stunting by 64% [AOR=0.36; 95% CI: 0.3, 0.4] in 2015/16 and 2010, respectively. Other interesting results were that children with multiple births had 17% [AOR=0.83; 95% CI: 0.7, 0.9] lower odds and 68% [AOR=1.68; 95% CI: 1.5, 1.9] higher odds of stunting in 2004/5 and 2010, respectively. Conclusion: Stunting is associated with individual and contextual factors. Critical efforts should focus on the availability of items that form WAMI and MPI, with greater emphasis on elements that form WAMI because of its consistent negative relationship with stunting across the two surveys. Nutrition education should target working mothers and households with food insecurity.
Edwin Musheiguza, Tukae Mbegalo, Justine N. Mbukwa
Background: Routine childhood immunisation is central to child survival in Nigeria, yet coverage and completion vary across settings and over time. Facility-level evidence is needed to assess programme performance during disruption and recovery. Objectives: This study reviewed routine childhood immunisation coverage and dropout rates at the University of Port Harcourt Teaching Hospital (UPTH), a tertiary hospital in South-South Nigeria, from 2022 to 2025, identified vaccines with consistently high uptake, and assessed schedule completion between Penta1-Penta3 and BCG-measles. Methods: A retrospective descriptive analysis was conducted using routine immunisation registers from the Family Health Clinic, UPTH. All children aged 0-23 months vaccinated between January 2022 and December 2025 were included. Administrative coverage rates were calculated for each antigen, and monthly dropout rates were estimated for Penta1-Penta3 and BCG-measles. Results: A total of 37,685 immunisation visit records were reviewed. Male children accounted for 17,570 (46.6%) visit records, while female children accounted for 20,115 (53.4%). Administrative coverage estimates were generally high but varied over time, with a decline in 2023, an increase in 2024, and a subsequent reduction in 2025. Vaccines administered at birth and at 6 weeks of age, including BCG, OPV0, HBV0, Penta1, and PCV1, consistently had the highest uptake. In contrast, vaccines administered later in infancy, including rotavirus vaccine, inactivated polio vaccine (IPV), measles vaccine, yellow fever vaccine, and meningococcal A conjugate vaccine (MenA), showed greater variability. Penta1–Penta3 dropout rates were slightly above the recommended threshold in 2022, improved in 2023, and increased in 2024, while BCG–measles dropout rates remained high and fluctuated throughout the study period. Conclusion: Facility administrative immunisation coverage estimates at UPTH remained generally high, although completion across the schedule was inconsistent, particularly for rotavirus, inactivated polio, measles, yellow fever, and meningococcal A conjugate vaccines. Strengthening follow-up systems and defaulter-tracking may improve completion rates.
Introduction Household food security and food preparation practices are shaped by social roles, caregiving responsibilities, and economic conditions. We examined everyday household food practices in Timor-Leste within systems of caregiving, authority, and resource constraints, and their implications for household food security and child feeding. Methods We conducted an exploratory qualitative study from August to October 2025 using semi-structured, in-depth interviews with mothers who had caregiving responsibilities for children in their households across urban Dili and the rural municipalities of Ainaro and Ermera. Data were analysed using a hybrid deductive–inductive thematic approach. A total of 34 mothers participated in the study. Results Food practices were organised through women’s caregiving roles, household decision-making, and economic constraints. Women coordinated everyday food work and maintained food adequacy even under financial strain. Food allocation followed a hierarchy but remained flexible, with children prioritised during periods of scarcity. Neighbourhood sharing functioned as an informal redistribution system shaped by reciprocity and social obligation. Ceremonial obligations reinforced social cohesion but introduced financial pressure. Meal frequency and food choices were shaped by income stability, while caregiving authority determined the prioritisation of limited resources. Food knowledge was transmitted intergenerationally, and diets combined traditional staples with selected market foods. Discussion Household food practices in Timor-Leste are shaped by caregiving roles, social relationships, and economic constraints, with implications for household food security and child feeding. These findings identify caregiving, food allocation, and adaptive responses to resource constraints as household processes potentially relevant to child nutrition vulnerability. Interventions that recognise women’s central roles in everyday food management, stabilise income, and build on reciprocal systems may support household food security and child feeding.
Md Abu Sayeed, Lesy Careca Atok, Salvador Amaral et al.
This study examines emergent gender issues in the analysis of newspaper coverage of maternal and child healthcare (MCH) in Nigeria over a one-year period. MCH is a major challenge in Nigeria as the country is among the highest contributors to maternal and child mortalities globally. Even though this pattern has wider implication to society at large, it may be regarded as being more relevant to women. Premised on gender bias and journalistic norms hypotheses, the study combines content analysis and in-depth interviews (IDI) to determine the dominant gender leading in the newspaper coverage of such a womencentred issue, and underlying reasons for the dominance. The study thus examines the dominant gender of journalists, and other voices projected in the newspaper reports on the issues. It also compares views of male and female health journalists for possible differences of opinion regarding media coverage of MCH. The study finds male dominance amongst journalists and voices quoted in the coverage of MCH issues and related stories, though there was minimal influence of gender in the overall coverage of issues. The study thus deviates from the media gender studies attributing underrepresentation of women in the media to gender bias; noting that gender imbalance is often rooted in journalistic norms pervading media operations.
Abstract Introduction: Despite the determination to succeed in eliminating neglected tropical diseases, these have been increasing within certain endemicities, particularly in depriving region. Objective: This study aimed to assess the relative burden of neglected tropical diseases in rural and urban slum settings in Eastern Ethiopia. Methods: A comparative cross-sectional study was conducted from February 25 to April 30, 2024 with a multistage random sampling technique used. A survey tool with the integration of the spectrum was employed. Data were entered using Epi-Data version 3.1 and analyzed using STATA 16. Descriptive statistics and multivariable logistic regression analysis was used to identify the risk factors and the level for statistical significance was declared at p-value < 0.05 with 95 % CI. Result: The response rate was 93 % and the mean age of house heads was 31.6 (Range; 18. 63) with 5.7 average family size. The overall prevalence of NTDs among study participants was 22.6 % (95% CI; 20.2, 25.2); urban slum it was 15 % (95% CI; 12.2, 18.4) while it was 29.8 % (95% CI; 26, 33.9) in rural. Though there is no statistically significant difference, the relative prevalence of NTDs in rural to urban was two. The multivariable analysis provided that the risk factors associated with NTDs were government employment (AOR: 12.5 (1.17, 132.4)), good income (AOR: 0.13 (.03, 0.57)), Child playing with soil (AOR: 5.8 (1.52, 22.0)); child hand washing at critical times ( AOR: 11.2 (1.7, 74.9)), presence of flies in the child faces (AOR: 20.3 (4.7, 88.6)) and type of drinking water sources (AOR: 0.11 (0.02, 0.73)). Conclusion: the burden of NTDs was moderate in the study area dominated by STH, Trachoma, and scabies. Socio economic and WASH factors were found to be associated with NTDs. Collaborated efforts among stakeholders are crucial to prevent and control NTDs.
Getachew Kabew Mekonnen, Fitsum Weldegebreal, Assefa Desalew et al.
BackgroundDespite progress, sub-Saharan African countries (SSA) face immunisation disparities. Rwanda has high rates, but the drivers of success are unclear. There's a gap in understanding inequalities and a lack of comparative equity analyses with other SSA countries.MethodsThis study analysed population-based survey data from 17 SSA countries, including Rwanda, among two-year-old children. Full immunisation included all recommended vaccines, according to age and the national immunisation schedule. For Rwanda, the coverage was assessed across six inequality dimensions using frequencies, percentages, and 95% CIs. Absolute (Difference, SII) and relative (Ratio, RCI) measures of inequalities were plotted over time. Population Attributable Risk (PAR) and Fraction (PAF) were estimated for public health impact. Equiplots visualised inequalities across countries.ResultsBetween 2000 and 2019, Rwanda’s full immunisation coverage rose from 76% to 96%. Despite substantial reductions in inequalities in full immunisation coverage in Rwanda between 2000 and 2019, subnational disparities remained the most pronounced, with PAR decreasing from 15.40% to 3.10%, while wealth and place of residence inequalities persisted at low levels (wealth PAR 1.53%; residence PAR 1.43% in 2019). Equiplots highlight that, while Rwanda made significant progress in narrowing gaps across all the equity dimensions, other SSA countries showed wide socioeconomic, educational, and geographic gaps.ConclusionRwanda’s experience with full child immunisation highlights the importance of strong primary healthcare systems and equity-focused delivery strategies, offering transferable lessons for reducing immunisation inequalities across sub-Saharan Africa.
Albert NDAGIJIMANA, Michael Habtu, Theoneste Mutsindashyaka et al.
Effective complementary feeding is essential for infant growth, development, and prevention of malnutrition. This study assessed the attitude and practice of effective weaning techniques and identified factors influencing these practices among breastfeeding mothers attending the antenatal clinic at General Hospital Koko, Koko/Besse Local Government Area, Kebbi State, Nigeria. A descriptive cross-sectional design was adopted. The target population comprised 90 eligible breastfeeding mothers with children aged 6–24 months, from which a sample of 73 respondents was obtained using Taro Yamane’s formula. A self-structured 25-item questionnaire covering demographic characteristics, attitude, practice, and influencing factors was used for data collection. The instrument was subjected to face and content validity and test-retest reliability, yielding a reliability coefficient of 0.81. Data were analyzed using descriptive statistics with SPSS version 25. All 73 questionnaires were retrieved. Respondents demonstrated a generally positive attitude toward effective weaning techniques, with a grand mean of 3.0. They also reported positive weaning practices, with a grand mean of 3.0, particularly in hygienic preparation of foods, hand hygiene, introduction of complementary foods at six months, and avoidance of harmful foods. Financial status was the most strongly identified influencing factor (mean = 3.3), followed by lack of knowledge and health workers’ advice (mean = 3.0 each). The study concludes that although mothers demonstrated favourable attitudes and reported appropriate practices, economic constraints, knowledge gaps, family influence, and other contextual factors may affect effective weaning. Strengthening nutrition education and counselling through antenatal and community-based services is recommended.
Almustapha Lawal Ahmad, Danjuma Aishatu, Sani Gaddafi Wasagu et al.
Child mortality and morbidity remain significant public health concerns in sub-Saharan Africa, with universal health coverage (UHC) for children under five identified as a critical strategy for addressing these issues. This study explored professional nurses’ perspectives on the engagement of caregivers in community- and home-based care practices as a pathway to advancing UHC in Vhembe District, South Africa. A qualitative descriptive explorative design was employed. It involved 15 purposefully selected professional nurses from two primary healthcare centres. Data were collected through semi-structured individual interviews conducted between March and June 2022 and analysed using Braun and Clarke’s thematic analysis framework. Three overarching themes and seven sub-themes emerged. The first theme highlighted the empowerment of caregivers through knowledge dissemination and enhanced decision-making capacity. The second theme emphasised active parental participation in child health, including involvement in assessments, recognition of danger signs, and utilisation of the Road to Health booklet (RtHB). The third theme addressed barriers to effective caregiver engagement, notably the influence of traditional health beliefs and literacy challenges among grandmothers. Findings revealed the pivotal role of nurses in facilitating caregiver involvement and suggest that strengthening community-based strategies may contribute significantly to achieving UHC for children under five, particularly in low- resource settings. Tailored interventions addressing cultural and educational barriers are essential to optimise caregiver participation and improvement of child health outcomes.
