Abstract In the fight against malnutrition, Burkina Faso has developed a Multisectoral Nutrition Strategic Plan (MNSP). This study was conducted to assess the plan’s potential impact on reducing mortality and chronic malnutrition among children under five, using mathematical modeling through the Lives Saved Tool (LiST). Two projections were developed. The first, MNSP, included the strategic plan interventions, namely complementary feeding, age-appropriate breastfeeding practices, and prevention of malaria in pregnancy. The second, MNSP +, included the MNSP interventions, along with additional interventions such as zinc supplementation for children and WASH interventions. The results showed that under-five mortality would decline from 85.4 to 80.6 deaths per 1000 live births under MNSP, and from 85.4 to 73.6 deaths per 1000 live births under MNSP + . The findings also showed that complementary feeding under the MNSP projection would prevent 80% of chronic malnutrition cases, while zinc supplementation under the MNSP + projection would prevent 46% of cases. The projected cost of the interventions modeled in LiST for this study is estimated at $447,431,001 for MNSP and $557,768,209 for MNSP + over the five-year implementation period. Overall, the LiST analysis showed that both MNSP and MNSP + interventions would have a significant impact on chronic malnutrition and under-five mortality in Burkina Faso, with a greater impact observed under MNSP + .
Natacha Kere, Youssouf Keita, Ella W. R. Compaore et al.
Objectives: The study aims to determine socio-demographic characteristics and assess awareness of risk factors of severe acute malnutrition (SAM) among parents of children admitted to stabilisation centres in Northern Nigeria. Material and Methods: A descriptive cross-sectional study was conducted between September and December 2025 across Federal Medical Centre Nguru (Yobe State) and three centres in Zamfara State (Talata Mafara, Gusau, Shinkafi). Structured questionnaires were administered to 408 parents of children aged 6–59 months diagnosed with SAM. Socio-demographic data, parental awareness of SAM risk factors and anthropometric measurements were collected. Data were analysed using the Statistical Package for the Social Sciences version 25, with Chi-square and logistic regression applied to test associations, and a p < 0.05 was considered statistically significant. Results: The mean age of the children with SAM recruited was 23.9 ± 10.8 months; More than half (56.6%) were male. Nearly three-fifths of the mothers of the children were aged 14–29 years (57.6%), while fathers were older (mean 44.0 ± 11.0 years). Polygamous families predominated (71.3%), with the majority (71.3%) residing in rural areas. Nearly half (48.5%) reported displacement due to insecurity. Fathers were predominantly peasant farmers (75%), while 87.1% of mothers were housewives. Formal education was lacking in 55.4% of fathers and 55.5% of mothers. Socio-economic classification revealed 96.3% belonged to the lower class. Awareness of the link between antenatal care and SAM prevention was significantly higher among urban parents (odds ratio = 13.9; 95% confidence interval [CI]: 8.3–23.3; p < 0.001). Parents of children with chronic illnesses demonstrated greater awareness of SAM risk compared to those with recent illnesses ( p < 0.001). Conclusion: Parents of children admitted with SAM in Northern Nigeria are predominantly of low socioeconomic status, rural residence and limited formal education. Awareness of risk factors associated with SAM is significantly influenced by the place of abode and type of illness. Strengthening maternal education, improving antenatal care utilisation and targeted community-based awareness programs are essential to reduce the SAM burden.
Mikailu Abubakar Jangebe, Abdulhakeem Hamza, Sunday Ochapa Onazi et al.
Anchored in Grossman’s health production framework, this study examines how socioeconomic, institutional, environmental, and demographic conditions are associated with population health in developing countries. Population health is measured through three complementary indicators—life expectancy, infant mortality, and maternal mortality—to capture broader survival conditions, early-life vulnerability, and maternal health risks. Using panel data for 90 developing countries from 2002 to 2018, the study estimates country fixed-effects models and uses Driscoll–Kraay standard errors to strengthen inference in the presence of heteroskedasticity, autocorrelation, and cross-sectional dependence. Additional robustness checks are conducted using Panel-Corrected Standard Errors, Feasible Generalized Least Squares, and winsorized specifications. The results show that human capital, government effectiveness, and population density are consistently associated with higher life expectancy and lower infant and maternal mortality, and that these coefficient signs remain stable across robustness checks. Economic misery is associated with lower life expectancy and higher mortality in the baseline models, although its significance weakens in some sensitivity tests. Government health expenditure and educational attainment are generally associated with more favorable health outcomes, but their estimates are less stable after winsorization. Ecological footprint yields mixed associations across the three health indicators, while political stability produces unstable and, in some cases, counterintuitive coefficients. Overall, the findings suggest that population health in developing countries is associated more consistently with human capability and institutional effectiveness than with health expenditure alone.
Tahsin Tabassum Ahmed, Md. Golam Kibria, Mohammad Ridwan et al.
We examine the effect of racial diversity on child stunting and underweight in post-apartheid South Africa, which has a strong history of systemic racial segregation. Using five waves of longitudinal data from the National Income Dynamics Survey (NIDS), and employing instrumental variable and propensity score matching methods, we find that racial diversity significantly reduces child stunting and underweight. This result is consistent across alternative measures of racial diversity, child stunting and underweight, and is also robust to different endogeneity-correction methods. The negative effect of racial diversity on child stunting and underweight is more pronounced among children under 5 years of age. Further analyses highlight increased employment opportunities, food expenditure per capita and financial inclusion as important channels through which racial diversity decreases stunting and underweight. We discuss the policy implications of these findings.
Isaac Koomson, Clifford Afoakwah, Martinson Ankrah Twumasi
Seasonal malaria chemoprevention (SMC) is an important malaria-control intervention designed to protect children living in areas where malaria transmission is highly seasonal. The effectiveness of SMC depends not only on the pharmacological efficacy of the medicines but also on community acceptance, caregiver adherence, trust in medicine distributors, and the quality of programme communication. This paper examines community acceptance of SMC for malaria prevention in Kano State, Nigeria. The study adopts a qualitative empirical research perspective and synthesizes evidence concerning caregivers' attitudes, knowledge, perceived effectiveness, concerns about adverse effects, trust in community drug distributors (CDDs), delivery preferences, and the role of community-based actors. Evidence indicates that SMC is generally well accepted in Kano communities and is perceived by many caregivers as beneficial in reducing malaria episodes and household expenditure on malaria treatment. However, acceptance is not universal. Concerns about side effects, inadequate understanding of the preventive purpose of SMC, doubts about free medicines, medicine shortages, and occasional negative interactions with distributors may reduce uptake. Evidence from Kano also indicates that community-based actors, including lead mothers, can facilitate acceptance by strengthening communication and trust between households and SMC implementers. The paper concludes that sustained community acceptance requires culturally appropriate health education, reliable medicine supplies, respectful door-to-door delivery, stronger involvement of community leaders and local women, and continuous monitoring of adverse events and caregiver concerns.
Abstract Background The co-occurrence of anaemia and stunting (CAS) presents acute development and morbidity challenges to children particularly in sub-Saharan Africa (SSA). Evidence on the effect of child feeding recommendations on CAS is scarce. Methods We used data from 22 recent Demographic and Health Surveys in SSA countries to examine the association between caregivers’ implementation of recommendations on infant and young child feeding and the CAS in their 6- to 23-mo-old children. Results Overall, in multiple logistic regression models, child feed index score, high wealth of household, increasing household size, household head with at least secondary school education, improved sanitation of household, an increase in caregiver’s age and caregiver’s with at least secondary education were associated with lower odds of CAS (i.e., AOR: 0.86; 95% CI; 0.84 – 0.88: 0.75; 0.69 – 0.82: 0.98, 0.98 – 0.99: 0.76, 0.70 – 0.83: 0.81, 0.74 – 0.87: 0.87, 0.81 – 0.94: 0.69, 0.62 – 0.77 respectively). Having a diarrhoea in the past 2 weeks and having fever in the past month were associated with higher odds of CAS (AOR:1.1, 95% CI; 1.0 – 1.2: 1.1, 1.0 – 1.2, respectively). Results from the decision tree analysis showed that the educational level of women was the most important predictor of CAS, followed by child feeding score, the level of education of the family head and state of drinking water. Conclusion The results buttress the importance of interventions aimed at improving feeding practices and parental educational as a vehicle to improve children’s nutritional status.
Aaron Kobina Christian, Eric Afful-Dadzie, Grace S. Marquis
Abstract This study assessed parental attitudes toward routine childhood vaccination in five Arab countries (Egypt, Jordan, Saudi Arabia, Syria, and Libya) and explored factors associated with vaccine hesitancy in the post-coronavirus disease 2019 (COVID-19) pandemic period. Using a cross-sectional design, 2095 parents or guardians of children aged ≤ 4 years were surveyed via online and face-to-face interviews. The Arabic version of the Parent Attitudes about Childhood Vaccines Scale was used to measure parental vaccine hesitancy. Overall, 18.8% of parents were classified as vaccine hesitant. In multivariable modified Poisson regression analysis, residing in Libya was associated with a significantly lower prevalence of vaccine hesitancy compared with Egypt (adjusted prevalence ratio (aPR): 0.14, 95% CI 0.07–0.28; p <0.001), whereas rural residence (aPR: 1.28, 95% CI 1.03–1.58; p = 0.024), unemployment (aPR: 1.26, 95% CI 1.01–1.56; p = 0.040), having a child born after the COVID-19 pandemic (aPR: 1.54, 95% CI 1.22–1.94; p <0.001), family history of COVID-19-related death (aPR: 1.34, 95% CI 1.08–1.65; p = 0.007), lack of parental COVID-19 vaccination (aPR: 1.56, 95% CI 1.26–1.92; p <0.001), and lower confidence in vaccinations provided by the health system (aPR: 2.24, 95% CI 1.77–2.83; p < 0.001) were independently associated with higher parental vaccine hesitancy. Mediation analyses found no significant indirect associations through parental vaccine hesitancy on the relationships between education, country income, parental COVID-19 vaccination or infection history, and childhood vaccination. However, education, country income, and parental COVID-19 infection demonstrated significant direct effects on childhood vaccination status. These findings emphasize the importance of strengthening confidence in health systems and addressing socioeconomic disparities to reduce parental vaccine hesitancy and support childhood immunization programs in the post-pandemic era.
Ehab Elrewany, Ayat Diaa Eldeen Ashour, Hoda Ali Ahmed Shiba et al.
Abstract Gut microbiome composition has been suggested as a factor in the development of malnutrition, which affects one fifth of all children. The microbiome is dependent on environmental and dietary factors, therefore studies on the gut microbiota diversity and relative abundance of bacteria in children with and without malnutrition in different geographical regions are needed. In this study, rectal swabs were collected from 134 Rwandan children 1–36 months of age with (n = 66) or without (n = 68) malnutrition. DNA was extracted from rectal swabs and the full 16S rRNA gene deep sequenced using Nanopore sequencing for analysis of the gut microbiota. Gut microbiota alpha diversity correlated positively with age ( P < 0.0001). Neither alpha nor beta diversity differed between the study-defined malnourished and non-malnourished groups, however, participants with WAZ ≥ − 2 and < − 2 differed in beta diversity analysis ( P = 0.02). The most abundant species, Peptostreptococcaceae bacterium oral taxon 929, showed an association with WAZ, in mean 18% and 9% relative abundance among those with WAZ ≥ − 2 and < − 2, respectively ( p = 0.04). Results suggested that the gut microbiota might be associated with being underweight (WAZ < − 2), highlighting the need for future, larger studies of the gut microbiota in malnourished children.
Johan Ringlander, Maria E. Andersson, Albert Ndagijimana et al.
Although the implementation of free senior high school (SHS) policy which has expanded access to secondary education in Ghana, girls from low-income households in Bolgatanga Municipality continue to battle with socio-cultural, economic and structural barriers which posed a significant threat to their education. This descriptive, perception-based explanatory sequential mixed-methods study was therefore conducted to examine SHS girls' perceptions of gender-sensitive leadership practices; identify the perceived barriers affecting the education of girls from low-income households; and explored strategies for improving their retention and perceived educational achievement. The study integrates survey and interview evidence from SHS girls and educational stakeholders. Out of 5634 girls, criterion-based purposive sampling identified 322 SHS girls from low-income households, after which simple random sampling was used to select 270 participants for the quantitative survey, while the qualitative phase purposively recruited 3 heads of SHSs, 3 teachers, 1 Girls Education Officer, 1 NGO staff, and 30 girls from low income households for interview. Four-points Likert scale questionnaires and semi-structured interviews were employed for data collection. Piloting was conducted to test for reliability and validity of the instruments using Cronbach's alpha reliability reporting, member checking, content validity Index reporting, and the triangulation of survey with interview data. IBM SPSS statistics version 27 was employed to analyse the survey data using descriptive statistics such as frequencies, percentages, mean and standard deviation. The qualitative data from interviews were analyse by means of narration, anecdotes and thematic analysis to triangulate the quantitative results. The findings revealed that girls perceived gender-sensitive leadership practices as moderately supportive of their schooling, although structural and socio-cultural barriers continued to constrain their educational experiences. The study recommends strengthening gender-responsive leadership capacity, improving school WASH infrastructure, and enforcing sexual harassment policies to create safe and gender inclusive learning environments for young girls in SHSs.
This study examines the impact of climate change on children's health in Tajikistan, focusing on key indicators such as under-five mortality (U5M), infant mortality rate (IMR), and extreme weather conditions (EWC) by employing the Autoregressive Distributed Lag (ARDL), granger causality and impulse response Techniques using a time-series data from 1986 to 2023, the analysis explores the dynamic relationships between climate variables (CO2 emissions and extreme weather conditions), health outcomes (under five mortality and infant mortality), and economic performance (GDP). The ARDL and granger causality estimated result suggests that extreme weather conditions and CO2 emissions significantly aggravates under five and infant mortality rates, whereas economic growth reduces it. Also, results from the impulse response analysis highlights the detrimental effects of emissions and extreme weather on health, with GDP shocks improving life expectancy and reducing mortality. The study underscores Tajikistan's vulnerability to climate-induced health risks, particularly among children, due to its geographic and socioeconomic conditions. Policy recommendations include prioritizing investments in healthcare, enhancing climate resilience through sustainable development, and addressing the indirect effects of environmental degradation on health. This research contributes to understanding the health-environment nexus in vulnerable regions and provides insights for targeted interventions in Central Asia.
HAMMAYO ABUBAKAR HAMMAYO, MUHAMMAD SALIM HAMISU, SULAIMAN TOLBA MAGAJI
