scholarly journals Public health and research funding for childhood neurodevelopmental disorders in Sub-Saharan Africa: a time to balance priorities

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Muideen O. Bakare ◽  
Kerim M. Munir ◽  
Mashudat A. Bello-Mojeed
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Neurodevelopmental Disorders ◽  
Research Funding ◽  
Mental Health Problems ◽  
Policy Formulation ◽  
Sub Saharan Africa ◽  
Under Five ◽  
Mortality Index ◽  
Sub Saharan

Sub-Saharan African (SSA) population consists of about 45% children, while in Europe and North America children population is 10- 15%. Lately, attention has been directed at mitigating childhood infectious and communicable diseases to reduce under-five mortality. As the under-five mortality index in Sub-Saharan Africa has relatively improved over the last two decades, more Sub-Saharan African children are surviving beyond the age of five and, apparently, a sizeable percentage of this population would be living with one or more childhood neurodevelopmental disorders (NDD). The distribution of child mental health service resources across the world is unequal. This manifests in the treatment gap of major childhood onset mental health problems in SSA, with the gap being more pronounced for childhood NDD. It is important to balance the public health focus and research funding priorities in Sub-Saharan Africa. We urgently need to define the burden of childhood NDD in the region for healthcare planning and policy formulation.

scholarly journals Relationships with caregivers and mental health outcomes among adolescents living with HIV: a prospective cohort study in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yulia Shenderovich ◽  
Mark Boyes ◽  
Michelle Degli Esposti ◽  
Marisa Casale ◽  
Elona Toska ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Cohort Study ◽  
Mental Health Problems ◽  
Health Problems ◽  
Sub Saharan Africa ◽  
Depression Symptoms ◽  
Sub Saharan ◽  
Positive Caregiving ◽  
Living With Hiv

Abstract Background Mental health problems may impact adherence to anti-retroviral treatment, retention in care, and consequently the survival of adolescents living with HIV. The adolescent-caregiver relationship is an important potential source of resilience. However, there is a lack of longitudinal research in sub-Saharan Africa on which aspects of adolescent-caregiver relationships can promote mental health among adolescents living with HIV. We draw on a prospective longitudinal cohort study undertaken in South Africa to address this question. Methods The study traced adolescents aged 10–19 initiated on antiretroviral treatment in government health facilities (n = 53) within a health district of the Eastern Cape province. The adolescents completed standardised questionnaires during three data collection waves between 2014 and 2018. We used within-between multilevel regressions to examine the links between three aspects of adolescent-caregiver relationships (caregiver supervision, positive caregiving, and adolescent-caregiver communication) and adolescent mental health (depression symptoms and anxiety symptoms), controlling for potential confounders (age, sex, rural/urban residence, mode of infection, household resources), n=926 adolescents. Results Improvements in caregiver supervision were associated with reductions in anxiety (0.98, 95% CI 0.97–0.99, p=0.0002) but not depression symptoms (0.99, 95% CI 0.98–1.00, p=.151), while changes in positive caregiving were not associated with changes in mental health symptoms reported by adolescents. Improvements in adolescent-caregiver communication over time were associated with reductions in both depression (IRR=0.94, 95% CI 0.92–0.97, p<.0001) and anxiety (0.91, 95% CI 0.89–0.94, p<.0001) symptoms reported by adolescents. Conclusions Findings highlight open and supportive adolescent-caregiver communication and good caregiver supervision as potential factors for guarding against mental health problems among adolescents living with HIV in South Africa. Several evidence-informed parenting programmes aim to improve adolescent-caregiver communication and caregiver supervision, and their effect on depression and anxiety among adolescents living with HIV should be rigorously tested in sub-Saharan Africa. How to improve communication in other settings, such as schools and clinics, and provide communication support for caregivers, adolescents, and service providers through these existing services should also be considered.

MATERNAL HEALTH-SEEKING BEHAVIOUR AND UNDER-FIVE MORTALITY IN ZIMBABWE

2016 ◽  
Vol 49 (3) ◽  
pp. 408-421 ◽  
Author(s):  
Nyasha Chadoka-Mutanda ◽  
Clifford O. Odimegwu
Keyword(s):  
Public Health ◽  
Maternal Health ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Cross Sectional ◽  
Under Five ◽  
Sub Saharan ◽  
Cox Proportional Hazard Regression

SummaryUnder-five mortality remains a major public health challenge in sub-Saharan Africa. Zimbabwe is one of the countries in the region that failed to achieve Millennium Developmental Goal 4 in 2015. The objective of this study was to examine the extent to which maternal health-seeking behaviour prior to and during pregnancy and post-delivery influences the likelihood of under-five mortality among Zimbabwean children. The study was cross-sectional and data were extracted from the 2010/11 Zimbabwe Demographic and Health Survey (ZDHS). The study sample comprised 5155 children who were born five years preceding the 2010/11 ZDHS to a sample of 4128 women of reproductive age (15–49 years). Cox Proportional Hazard regression modelling was used to examine the relationship between maternal health-seeking behaviour and under-five mortality. The results showed that maternal health-seeking behaviour factors are associated with the risk of dying during childhood. Children born to mothers who had ever used contraceptives (HR: 0.38, CI 0.28–0.51) had a lower risk of dying during childhood compared with children born to mothers who had never used any contraceptive method. The risk of under-five mortality among children who had a postnatal check-up within two months after birth (HR: 0.36, CI 0.23–0.56) was lower than that of children who did not receive postnatal care. Small birth size (HR: 1.70, CI 1.20–2.41) and higher birth order (2+) increased the risk of under-five mortality. Good maternal health-seeking behaviour practices at the three critical stages around childbirth have the potential to reduce under-five mortality. Therefore, public health programmes should focus on influencing health-seeking behaviour among women and removing obstacles to effective maternal health-seeking behaviour in Zimbabwe.

Working with vulnerable populations

2015 ◽  
Author(s):  
Theresa S. Betancourt ◽  
William Beardslee ◽  
Catherine Kirk ◽  
Katrina Hann ◽  
Moses Zombo ◽  
...  
Keyword(s):  
Mental Health ◽  
Vulnerable Populations ◽  
Mental Health Problems ◽  
Community Based Participatory Research ◽  
Sub Saharan Africa ◽  
Vulnerable Groups ◽  
Ethical Practices ◽  
Research Attention ◽  
Referral Networks ◽  
Sub Saharan

We discuss key issues to consider when conducting clinical trials with vulnerable children, youths, and families, with particular attention to groups affected by communal violence/war and families affected by HIV/AIDS. Across these settings, there is an overlap of several forms of adversity and vulnerability which require careful research attention. We also discuss ethical practices with vulnerable groups, including the use of qualitative methods to enhance understanding of local perspectives and language around mental health problems and resilience, planning for risk of harm referral networks, and applications of community-based participatory research (CBPR) techniques.  Such approaches can raise community awareness and increase engagement for addressing mental health in vulnerable populations while also informing and promoting practice and policy change. Drawing from examples of work in Sub-Saharan Africa and with refugees in the US, we conclude with a series of recommendations for advancing sensitive research practices with vulnerable populations.

scholarly journals Risk and protective factors for suicidal ideation and behaviour in Rwandan children

2015 ◽  
Vol 207 (3) ◽  
pp. 262-268 ◽  
Author(s):  
Lauren C. Ng ◽  
Catherine M. Kirk ◽  
Frederick Kanyanganzi ◽  
Mary C. Smith Fawzi ◽  
Vincent Sezibera ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Problems ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Hiv Status ◽  
Increased Risk ◽  
Matched Case ◽  
Sub Saharan ◽  
Control Study

BackgroundSuicide is a leading cause of death for young people. Children living in sub-Saharan Africa, where HIV rates are disproportionately high, may be at increased risk.AimsTo identify predictors, including HIV status, of suicidal ideation and behaviour in Rwandan children aged 10–17.MethodMatched case–control study of 683 HIV-positive, HIV-affected (seronegative children with an HIV-positive caregiver), and unaffected children and their caregivers.ResultsOver 20% of HIV-positive and affected children engaged in suicidal behaviour in the previous 6 months, compared with 13% of unaffected children. Children were at increased risk if they met criteria for depression, were at high-risk for conduct disorder, reported poor parenting or had caregivers with mental health problems.ConclusionsPolicies and programmes that address mental health concerns and support positive parenting may prevent suicidal ideation and behaviour in children at increased risk related to HIV.

scholarly journals The prevalence of mental health problems in sub-Saharan adolescents living with HIV: a systematic review

2020 ◽  
Vol 7 ◽  
Author(s):  
A.S. Dessauvagie ◽  
A. Jörns-Presentati ◽  
A.-K. Napp ◽  
D.J. Stein ◽  
D. Jonker ◽  
...  
Keyword(s):  
Mental Health ◽  
Associated Factors ◽  
Mental Health Problems ◽  
Health Problems ◽  
Hiv Treatment ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Hiv Positive ◽  
Hand Search ◽  
Sub Saharan

Abstract Despite the progress made in HIV treatment and prevention, HIV remains a major cause of adolescent morbidity and mortality in sub-Saharan Africa. As perinatally infected children increasingly survive into adulthood, the quality of life and mental health of this population has increased in importance. This review provides a synthesis of the prevalence of mental health problems in this population and explores associated factors. A systematic database search (Medline, PsycINFO, Scopus) with an additional hand search was conducted. Peer-reviewed studies on adolescents (aged 10–19), published between 2008 and 2019, assessing mental health symptoms or psychiatric disorders, either by standardized questionnaires or by diagnostic interviews, were included. The search identified 1461 articles, of which 301 were eligible for full-text analysis. Fourteen of these, concerning HIV-positive adolescents, met the inclusion criteria and were critically appraised. Mental health problems were highly prevalent among this group, with around 25% scoring positive for any psychiatric disorder and 30–50% showing emotional or behavioral difficulties or significant psychological distress. Associated factors found by regression analysis were older age, not being in school, impaired family functioning, HIV-related stigma and bullying, and poverty. Social support and parental competence were protective factors. Mental health problems among HIV-positive adolescents are highly prevalent and should be addressed as part of regular HIV care.

scholarly journals Adolescent-Caregiver Relationships and Mental Health Outcomes Among Adolescents Living with HIV: A Prospective Cohort Study in South Africa

2020 ◽  
Author(s):  
Yulia Shenderovich ◽  
Mark Boyes ◽  
Michelle Degli Esposti ◽  
Marisa Casale ◽  
Elona Toska ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Cohort Study ◽  
Mental Health Problems ◽  
Health Problems ◽  
Sub Saharan Africa ◽  
Depression Symptoms ◽  
Sub Saharan ◽  
Positive Caregiving ◽  
Living With Hiv

Abstract Background Mental health problems may impact adherence to anti-retroviral treatment, retention in care, and consequently the survival of adolescents living with HIV. The adolescent-caregiver relationship is an important potential source of resilience. However, there is a lack of longitudinal research in sub-Saharan Africa on which aspects of adolescent-caregiver relationships can promote mental health among adolescents living with HIV. We draw on a prospective longitudinal cohort study undertaken in South Africa to address this question.Methods The study traced adolescents aged 10-19 initiated on antiretroviral treatment in government health facilities (n = 53) within a health district of the Eastern Cape province. The adolescents completed standardised questionnaires during three data collection waves between 2014 and 2018. We used within-between multilevel regressions to examine the links between three aspects of adolescent-caregiver relationships (caregiver supervision, positive caregiving, and adolescent-caregiver communication) and adolescent mental health (depression symptoms and anxiety symptoms), controlling for potential confounders (age, sex, rural/urban residence, mode of infection, household resources), n=926 adolescents. Results Improvements in caregiver supervision were associated with reductions in anxiety (0.98, 95% CI 0.97-0.99, p=0.0002) but not depression symptoms (0.99, 95% CI 0.98-1.00, p=.151), while changes in positive caregiving were not associated with changes in mental health symptoms reported by adolescents. Improvements in adolescent-caregiver communication over time were associated with reductions in both depression (IRR=0.94, 95% CI 0.92-0.97, p<.0001) and anxiety (0.91, 95% CI 0.89-0.94, p<.0001) symptoms reported by adolescents. Conclusions Findings highlight open and supportive adolescent-caregiver communication and good caregiver supervision as potential factors for guarding against mental health problems among adolescents living with HIV in South Africa. Several evidence-informed parenting programmes aim to improve adolescent-caregiver communication and caregiver supervision, and their effect on depression and anxiety among adolescents living with HIV should be rigorously tested in sub-Saharan Africa. How to improve communication in other settings, such as schools and clinics, and provide communication support for caregivers, adolescents, and service providers through these existing services should also be considered.

scholarly journals Late-life depression in sub-Saharan Africa: lessons from the Ibadan Study of Ageing

2020 ◽  
Vol 29 ◽  
Author(s):  
A. Ojagbemi ◽  
T. Bello ◽  
O. Gureje
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Late Life ◽  
Sub Saharan Africa ◽  
Social Changes ◽  
Late Life Depression ◽  
Treatment Of Depression ◽  
The World ◽  
Sub Saharan ◽  
Health Service Challenges

Abstract The population surviving to old age in sub-Saharan Africa (SSA) is increasing rapidly in consonance with the rest of the world. Nevertheless, the sub-region offers unique challenges to survival across the lifespan. The determinants of health and ageing in SSA are thus likely different from those in higher income countries. The need to explore pressing epidemiological and health service challenges of older people living in SSA in the context of multiple social changes and rapid ageing of the population provided the rationale for the Ibadan Study of Ageing (ISA). This article appraises ISA findings in relation to late-life depression. It concludes that healthcare policies in SSA need to deliberately prioritise the treatment of depression and other mental health problems in late-life in order to stem the neglect of older people's mental health in the region.

scholarly journals Simple, Stigma-free, Scalable, and School-based: A Four-step Approach to Developing Adolescent Mental Health Treatments in Sub Saharan Africa

2020 ◽  
Author(s):  
Tom L Osborn ◽  
Christine Wasanga
Keyword(s):  
Mental Health ◽  
Low Income ◽  
Mental Health Problems ◽  
Healthcare Access ◽  
Intervention Development ◽  
Mental Healthcare ◽  
Adolescent Mental Health ◽  
Sub Saharan Africa ◽  
School Based ◽  
Sub Saharan

-Adolescent mental health problems—which are associated with many negative life outcomes—are prevalent in low-income regions such as those in Sub Saharan Africa (SSA) yet many youths suffering from these problems never get treatment.-Existing treatments are inaccessible to SSA youths because they are long, costly, and require expert delivery in a setting where incomes are low, and a paucity of caregivers exist and where social stigma limits help-seeking.-Most of the efforts to develop interventions for youth mental have been led by researchers from Western high-income countries and can be criticized as socio-culturally inappropriate and costly. -To guide intervention development efforts, we propose a four-step approach that encourages researchers to develop mental health interventions that are simple, stigma-free, scalable and school-based. Through this four-step approach, researchers can expand mental healthcare access in SSA by developing interventions that circumvent existing barriers.

Mental Health in Africa: I. the Extent of Mental Health Problems in Africa Today

1987 ◽  
Vol 151 (4) ◽  
pp. 435-439 ◽  
Author(s):  
G. Allen German
Keyword(s):  
Mental Health ◽  
Psychiatric Disorder ◽  
Mental Health Problems ◽  
Psychiatric Morbidity ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Diverse Populations ◽  
Hospital Data ◽  
Black Africa ◽  
Sub Saharan

This paper is concerned with steadily developing knowledge of the epidemiology of some psychiatric disorders in sub-Saharan Africa. The diversity of ‘Black Africa’ is noted, and preconceptions about African psychiatry briefly discussed. Problems of sociological versus clinical philosophies are also mentioned. Early estimates of prevalence of psychiatric disorder in black Africa were universally low, being based on hospital data. More recent studies, sampling diverse populations, suggest a burden of psychiatric morbidity in black Africa which is not dissimilar to that found in more developed countries, and some studies suggest that rates in Africa may even be higher than in developed countries.

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