Mapping access to basic hygiene services in low- and middle-income countries: A cross-sectional case study of geospatial disparities

Abstract Handwashing with water and soap is among the most a cost-effective interventions to improve public health. Yet billions of people globally lacking handwashing facilities with water and soap on premises, with gaps particularly found in low- and middle-income countries. Targeted efforts to expand access to basic hygiene services require data at geospatially explicit scales. Drawing on country-specific cross-sectional Demographic and Health Surveys with georeferenced hygiene data, we developed an ensemble machine learning model to predict the prevalence of basic hygiene facilities in Malawi, Nepal, Nigeria, Pakistan and Uganda.

Prevalence and factors associated with overweight and obesity in selected health areas in a rural health district in Cameroon: a cross-sectional analysis

Abstract Background: Overweight and obesity are major public health problems worldwide, with projections suggesting a proportional increase in the number of affected individuals in developing countries by the year 2030. Evidence-based preventive strategies are needed to reduce the burden of overweight and obesity in developing countries. We assessed the prevalence of, and factors associated with overweight and obesity in selected health areas in West Cameroon. Methods Data were collected from a community-based cross-sectional study, involving the consecutive recruitment of participants aged 18 years or older.

Variation in SARS-CoV-2 outbreaks across sub-Saharan Africa

Abstract A surprising feature of the SARS-CoV-2 pandemic to date is the low burdens reported in sub-Saharan Africa (SSA) countries relative to other global regions. Potential explanations (for example, warmer environments1, younger populations2,3,4) have yet to be framed within a comprehensive analysis. We synthesized factors hypothesized to drive the pace and burden of this pandemic in SSA during the period from 25 February to 20 December 2020, encompassing demographic, comorbidity, climatic, healthcare capacity, intervention efforts and human mobility dimensions.

District-level estimation of vaccination coverage: Discrete vs continuous spatial models

Abstract Health and development indicators (HDIs) such as vaccination coverage are regularly measured in many low- and middle-income countries using household surveys, often due to the unreliability or incompleteness of routine data collection systems. Recently, the development of model-based approaches for producing subnational estimates of HDIs using survey data, particularly cluster-level data, has been an active area of research. This is mostly driven by the increasing demand for estimates at certain administrative levels, for example, districts, at which many development goals are set and evaluated.

The influence of travel time to health facilities on stillbirths: A geospatial case-control analysis of facility-based data in Gombe, Nigeria

Abstract Access to quality emergency obstetric and newborn care (EmONC); having a skilled attendant at birth (SBA); adequate antenatal care; and efficient referral systems are considered the most effective interventions in preventing stillbirths. We determined the influence of travel time from mother’s area of residence to a tertiary health facility where women sought care on the likelihood of delivering a stillbirth. We carried out a prospective matched case-control study between 1st January 2019 and 31st December 2019 at the Federal Teaching Hospital Gombe (FTHG), Nigeria.

Healthcare-seeking behaviour in reporting of scabies and skin infections in Ghana: A review of reported cases

Abstract Background: Scabies is a neglected tropical disease. In resource-poor settings, scabies and other skin infections are often unreported to a health centre, or misdiagnosed. Dermatological expertise and training are often lacking. Little is known about patient healthcare-seeking behaviour. This study reviewed diagnosed skin infections reported to urban (Greater Accra) and rural (Oti region) study health centres in Ghana over six months in 2019. Methods Study staff received classroom and clinical dermatology training.

Spatial inequalities in skilled attendance at birth in Ghana: a multilevel analysis integrating health facility databases with household survey data

Abstract Objective: This study aimed at using survey data to predict skilled attendance at birth (SBA) across Ghana from healthcare quality and health facility accessibility. Methods Through a cross-sectional, observational study, we used a random intercept mixed effects multilevel logistic modelling approach to estimate the odds of having SBA and then applied model estimates to spatial layers to assess the probability of SBA at high-spatial resolution across Ghana.

Characteristics of packaged water production facilities in Greater Accra, Ghana: implications for water safety and associated environmental impacts

Abstract Packaged water (sold in bags or bottles) is widely consumed in many countries and is the main drinking-water source for most urban Ghanaian households. There are, however, few studies of packaged water production. This study aims to assess the source water, treatment, and manufacturing characteristics of sachet water (vended in 500 mL plastic bags), together with point-of-manufacture risks to hygienic production. A sample of 90 sachets was collected of brands sold in four neighbourhoods in Accra, Ghana, their packaging and physical characteristics recorded, and a risk score calculated from these.

The influence of distance and quality on utilisation of birthing services at health facilities in Eastern Region, Ghana

Abstract Objectives: Skilled birth attendance is the single most important intervention to reduce maternal mortality. However, studies have not used routinely collected health service birth data at named health facilities to understand the influence of distance and quality of care on childbirth service utilisation. Thus, this paper aims to quantify the influence of distance and quality of healthcare on utilisation of birthing services using routine health data in Eastern Region, Ghana.

Sachet water quality and product registration: a cross-sectional study in Accra, Ghana

Abstract: The study’s objectives were to assess the extent to which packaged water producers follow product registration procedures and to assess the relationship between product registration and drinking water quality in Accra, Ghana. Following preliminary analysis of a national water quality survey, 118 packaged sachet water samples were collected by sampling all brands sold by 66 vendors. A sample of vendors was selected from two high-income and two low-income areas of Accra, Ghana.

A cross-sectional ecological analysis of international and sub-national health inequalities in commercial geospatial resource availability

Abstract Background: Commercial geospatial data resources are frequently used to understand healthcare utilisation. Although there is widespread evidence of a digital divide for other digital resources and infra-structure, it is unclear how commercial geospatial data resources are distributed relative to health need. Methods To examine the distribution of commercial geospatial data resources relative to health needs, we assembled coverage and quality metrics for commercial geocoding, neighbourhood characterisation, and travel time calculation resources for 183 countries.

Geographic Distribution of Registered Packaged Water Production in Ghana: Implications for Piped Supplies, Groundwater Management and Product Transportation

Abstract: Packaged water consumption has grown rapidly in urban areas of many low‐income and middle‐income countries, but particularly in Ghana. However, the sources of water used by this growing packaged water industry and the implications for water resource management and transport‐related environmental impacts have not been described. This study aimed to assess the spatial distribution of regulated packaged water production in Ghana, both in relation to demand for natural mineral water and hydrogeological characteristics.

Use of a spatial scan statistic to identify clusters of births occurring outside Ghanaian health facilities for targeted intervention

Objective: To identify and evaluate clusters of births that occurred outside health facilities in Ghana for targeted intervention. Methods: A retrospective study was conducted using a convenience sample of live births registered in Ghanaian health facilities from January 1 to December 31, 2014. Data were extracted from the district health information system. A spatial scan statistic was used to investigate clusters of home births through a discrete Poisson probability model. Scanning with a circular spatial window was conducted only for clusters with high rates of such deliveries.

Spatial distribution of emergency obstetric and newborn care services in Ghana: Using the evidence to plan interventions

Objective: To provide clear policy directions for gaps in the provision of signal function services and sub-regions requiring priority attention using data from the 2010 Ghana Emergency Obstetric and Newborn Care (EmONC) survey. Methods: Using 2010 survey data, the fraction of facilities with only one or two signal functions missing was calculated for each facility type and EmONC designation. Thematic maps were used to provide insight into inequities in service provision.