ABSTRACT This study examines the impact of ethnic diversity on child health in Ghana using nationally representative panel data. We assess whether greater community‐level ethnic heterogeneity is associated with poorer child health outcomes and explore poverty and access to prenatal care as potential mechanisms. To address endogeneity, we employ an instrumental variable strategy using historical regional ethnic diversity. The results show that higher ethnic heterogeneity is significantly associated with worse child health, particularly in rural areas, with poverty and limited prenatal care access identified as key mediating channels. These findings underscore the importance of poverty reduction and improved maternal healthcare provision in ethnically diverse communities.
BACKGROUND: Children with sickle cell anemia (SCA) in low-income settings are at risk of severe malnutrition, but optimal nutritional management has not been established. We evaluated an intensified ready-to-use therapeutic food (RUTF) regimen in children with persistent severe malnutrition after initial treatment and assessed whether early change in body mass index z-score (BMIZ) was prognostic of later resolution of severe malnutrition. PROCEDURE: Children aged 5-12 years with SCA and BMIZ less than -3.0 after 12 weeks of supplemental RUTF received higher intensity, weight-based RUTF plus hydroxyurea through Week 24. We examined whether the change in BMIZ from baseline to Week 4 was associated with the resolution of severe malnutrition (BMIZ ≥-3.0) by Week 12 or, among extension participants, by Week 24. RESULTS: Of 108 children, 66 (61%) entered the extension. During Weeks 12-24, 11 of 66 (17%) achieved resolution, increasing the cumulative proportion with BMIZ ≥-3.0 from 39% (42/108) at Week 12 to 49% (53/108) by Week 24. Greater improvement in BMIZ from baseline to Week 4 was associated with higher odds of resolution by Week 12 or, among extension participants, by Week 24 (OR 12.38; p < 0.001), whereas older age was associated with lower odds of resolution (OR 0.72; p = 0.006). Among extension participants, higher Week-12 BMIZ was associated with higher odds of Week-24 resolution (OR 14.44; p = 0.039). CONCLUSIONS: In children with SCA and severe malnutrition, early BMIZ improvement in this small, single-arm extension was associated with later resolution of severe malnutrition, and may help risk-stratify children who need earlier reassessment or alternative management, a prognostic signal that warrants prospective testing rather than an immediate change in practice.
Safiya Gambo, Shehu Umar Abdullahi, Hassan Adam Murtala et al.
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.
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.
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
Nigeria is undergoing a demographic transition characterized by a rapidly growing older population, while healthcare systems historically oriented toward maternal and child health remain insufficiently equipped to address the complex needs of older adults. Although aging in place has emerged as a sustainable model of eldercare, Nigeria’s reliance on family-centered caregiving often imposes substantial financial, emotional, and physical burdens on caregivers in the absence of structured support. This study investigates the feasibility, outcomes, and challenges of Home-Based Primary Care (HBPC) in Nigeria and evaluates its potential to advance aging in place by 2026, with particular attention to health outcomes, caregiver burden, hospital utilization, healthcare expenditure, cultural acceptance, and policy implications. A mixed-methods design was employed from January 2024 to December 2025. Quantitative surveys involved 500 adults aged 60 years and above from urban communities in Lagos and Abuja and rural communities in Oyo and Benue, while qualitative interviews were conducted with 50 older adults, caregivers, and healthcare providers. A pilot HBPC program provided routine medical check-ups, medication delivery, physiotherapy, and psychosocial support. Quantitative data were analyzed using descriptive statistics, chi-square tests, and logistic regression, whereas qualitative data were examined through thematic analysis using NVivo. The findings show that 68% of participants reported improved chronic disease management, while hospital readmissions decreased by 32%. Functional independence scores increased by 15 points in urban areas and 10 points in rural areas, while psychological well-being and social relationship indicators improved by 21% and 18%, respectively. Caregiver strain decreased by 40%, and household healthcare expenditure declined by 27%. Qualitative findings further revealed strong cultural acceptance of HBPC, trust in community health workers, and reduced caregiver burden, although workforce shortages, funding constraints, and supply-chain inefficiencies remained significant barriers. The study concludes that HBPC represents a viable approach to advancing aging in place in Nigeria by improving health outcomes, reducing caregiver burden and healthcare costs, and supporting the dignity and independence of older adults. The findings contribute to geriatric and primary healthcare policy by demonstrating the potential value of integrating structured home-based services into Nigeria’s health system and highlight the need for strategic investment, workforce development, and institutional support, including through the National Senior Citizens Centre, to facilitate broader implementation.
Atabo Amodu, Isaac John Umaru, Chakfa Nanmar et al.
Malnutrition and anaemia among school-aged children, particularly in developing nations, are serious public health issues linked to soil-transmitted helminths (STHs). This study aimed to investigate STHs and their impact on the nutritional and anaemia status among school-aged children in some schools in Dutsin-Ma, Katsina State, Nigeria. A cross- sectional study involving 400 randomly selected school-aged children was conducted. All stool samples collected were examined for the presence of STHs using the formal-ether concentration technique. Anthropometric measurements were taken according to World Health Organisation (WHO) standards and haematocrit packed cell volume (PCV), respectively were used to determine the nutritional and anaemia condition of the sampled children. Questionnaire was administered to gather information on socio-demographic factors. The overall prevalence of STHs was 49.0% (196) in which three types of STHs were identified, Ascaris lumbricoides most dominant (50.5%) than hookworm (26.5%) and Trichuris trichiura (5.1%). A statistically significant association was observed between age group (χ² = 9.409, p = 0.009). Residing close to dumpsite, walking barefoot, and playing with sand, were not significantly associated with SHTs(p>0.05). However, washing hands with soap after toilet use was significantly associated with STHs(OR = 0.607, p = 0.017) provides a protective effect against STHs. The BMI for age shown that 26.3% were underweight and 2.8% overweight. Infected children were more anaemic though not statistically significant. Soil-Transmitted Helminthiases remains a public health concern among children and negatively affect children’s nutritional and anaemia status. Therefore, an integrated approach to STH management, nutrition, initiatives, iron supplementation and implementation of WASH are encouraged.
Maryam Yusuf, Adamu Isa, Esther Samuel Danjuma et al.
The phenomenon of broken families resulting from parental separation or divorce has emerged as a serious concern due to its substantial influence on children’s psychological and educational development, particularly among students in primary and secondary schools. Students experiencing family disruption may face various emotional and psychological challenges, including anxiety, depression, diminished self-confidence, and reduced motivation to learn, all of which can negatively affect their academic performance. This study examines the psychological dynamics of students from broken home backgrounds and investigates the role of Islamic Education in providing intervention and support to facilitate their academic achievement. Employing a qualitative approach with a case study design, the findings reveal that students from broken families frequently encounter internal emotional conflicts that interfere with their concentration, classroom engagement, and learning processes. Nevertheless, the internalization of Islamic educational values, including tawakkal (reliance on God), patience, sincerity, and character formation through consistent religious practices, can contribute to strengthening students’ psychological resilience. Islamic Education therefore extends beyond the transmission of religious knowledge and serves as a spiritual and moral support system that enables students to respond to difficult family circumstances with greater emotional stability and inner peace. Furthermore, Islamic value-based learning can help students reinterpret their family experiences positively and transform adversity into motivation for academic improvement. Islamic Education teachers also serve as significant others by offering emotional support, moral direction, and encouragement, thereby helping students manage stress and maintain their commitment to educational goals. The study concludes that integrating psychological support with Islamic educational values is essential for mitigating the adverse effects of family disruption and fostering students’ resilience and academic success despite challenging family circumstances.
