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
AbstractCovid-19 posed little danger to children. Nevertheless, the South African government imposed lockdown measures that impeded children’s education, play and food. Schools were closed, feeding schemes were halted and organised sports were banned. In this study of South African children’s experience during the 2020–22 pandemic, we use the capabilities approach, particularly Nussbaum’s ten capabilities, to assess how the lockdown measures affected their development. The one-dimensional nature of the government response was evident in its focus on physical health and safeguarding adults and the health system, at the expense of children’s well-being. Children were masked and their voices were not heard. Despite being far less at risk of illness or death than adults, children and young people were disproportionately affected by government regulations. Children from low-income environments were particularly severely affected.
Lochner Marais, Abraham Matamanda, Frances Gbadegesin et al.
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.
Kenyan youth increasingly seek psychosocial support through digital environments, yet little Kenya-specific evidence explains how online help-seeking unfolds as an ecosystem rather than as use of a single platform or intervention. This study adopts an exploratory, ecosystem-mapping approach to examine digital help-seeking pathways, trust dynamics, and ethical risks shaping youth psychosocial wellbeing in Kenya. The study triangulated three evidence streams: (i) a structured scan of commonly accessed digital platforms and web resources used by youth (including Google Search, YouTube, TikTok, Instagram, Facebook, WhatsApp communities, X/Twitter spaces, and institutional/NGO websites), (ii) rapid qualitative interviews with youth and mental health stakeholders (n = 28), and (iii) structured expert forum discussions involving practitioners and programme leads engaged in youth mental health and digital support. Findings show that youth help-seeking occurs within a distributed online support ecosystem dominated by mainstream commercial platforms rather than purpose-built mental health services. Five pathway typologies were identified: search-first self-triage, feed-based discovery and identity framing, peer-first confidential disclosure, influencer-guided meaning-making, and crisis-to-professional referral. Trust emerged as the primary determinant of sustained engagement, structured around confidentiality, relatability, non-judgment tone, responsiveness, cultural alignment, and community endorsement, often outweighing formal professional credentials or institutional affiliation. Ethical risks were pervasive and ecosystem-level, including privacy leakage (especially via forwarding and screenshots), misinformation and diagnostic confusion, unregulated counselling, exploitation through direct messaging, cyberstigma, algorithmic amplification of distress content, and safeguarding gaps for minors. Rather than evaluating intervention effectiveness, the study maps everyday digital practices and governance gaps, and proposes ecosystem governance priorities including credibility cues, moderation and peer-group norms, boundary standards for semi-formal counselling, and platform-integrated referral pathways. These findings reposition youth digital help-seeking in Kenya as both a psychosocial coping infrastructure and a risk environment, underscoring the need for youth-centred, ethics-informed governance rather than reliance on standalone digital mental health applications.
