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Article ; Online: Inequalities in access to water and soap matter for the COVID-19 response in sub-Saharan Africa.

Jiwani, Safia S / Antiporta, Daniel A

International journal for equity in health

2020 Volume 19, Issue 1, Page(s) 82

Abstract: The COVID-19 pandemic has spread rapidly since the first case notification of the WHO in December 2019. Lacking an effective treatment, countries have implemented non-pharmaceutical interventions including social distancing measures and have encouraged ... ...

Abstract	The COVID-19 pandemic has spread rapidly since the first case notification of the WHO in December 2019. Lacking an effective treatment, countries have implemented non-pharmaceutical interventions including social distancing measures and have encouraged maintaining adequate and frequent hand hygiene to slow down the disease transmission. Although access to clean water and soap is universal in high-income settings, it remains a basic need many do not have in low- and middle-income settings.We analyzed data from Demographic and Health Surveys (DHS) of 16 countries in sub-Saharan Africa, using the most recent survey since 2015. Differences in the percentage of households with an observed handwashing place with water and soap were estimated by place of residence and wealth quintiles. Equiplots showed wide within-country disparities, disproportionately affecting the poorest households and rural residents, who represent the majority of the population in most of the countries.Social inequalities in access to water and soap matter for the COVID-19 response in sub-Saharan Africa. Interventions such as mass distribution of soap and ensuring access to clean water, along with other preventive strategies should be scaled up to reach the most vulnerable populations.
MeSH term(s)	Africa South of the Sahara/epidemiology ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Demography ; Humans ; Pandemics/prevention & control ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Soaps/supply & distribution ; Socioeconomic Factors ; Water Supply/statistics & numerical data
Chemical Substances	Soaps
Keywords	covid19
Language	English
Publishing date	2020-06-03
Publishing country	England
Document type	Journal Article
ISSN	1475-9276
ISSN (online)	1475-9276
DOI	10.1186/s12939-020-01199-z
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Implementing the Countrywide Mortality Surveillance in Action in Mozambique: How Much Did It Cost?

Jiwani, Safia S / Mavie, Victor Américo / Williams, Emma / Kante, Almamy Malick / Amouzou, Agbessi

The American journal of tropical medicine and hygiene

2023 Volume 108, Issue 5_Suppl, Page(s) 40–46

Abstract: Complete sample registration systems are almost inexistent in sub-Saharan Africa. The Countrywide Mortality Surveillance in Action (COMSA) project in Mozambique, a national mortality and cause of death surveillance system, was launched in January 2017, ... ...

Abstract	Complete sample registration systems are almost inexistent in sub-Saharan Africa. The Countrywide Mortality Surveillance in Action (COMSA) project in Mozambique, a national mortality and cause of death surveillance system, was launched in January 2017, began data collection in March 2018, and covers over 800,000 population. The objectives of this analysis are to quantify the costs of establishing and maintaining the project between 2017 and 2020 and to assess the cost per output of the surveillance system using data from financial reports produced by the National Institute of Health in Mozambique. The program cost analysis consists of start-up (fixed) costs and average annual operating costs covering the period of maximum implementation in 700 clusters. The cost per output analysis quantifies the annual operating cost of surveillance outputs during the same period. Approximately two million dollars were spent on setting up the system, with infrastructure, technological investments, and training making up over 80% of these start-up costs. The average annual operating costs of maintaining COMSA was $984,771 per year, of which 66% were spent on wages and data collection incentives. The cost per output analysis indicates costs of $37-$42 per vital event captured in the surveillance system (deaths, pregnancies, pregnancy outcomes), $303-$340 per verbal and social autopsy conducted on a reported death, and a per capita cost of $1-$1.3. In conclusion, establishing COMSA required large costs associated with infrastructure and technological investments. However, the system offers long-term benefits for real-time data generation and informing government decision-making for health.
MeSH term(s)	Pregnancy ; Female ; Humans ; Mozambique/epidemiology ; Costs and Cost Analysis ; Data Collection ; Rural Population
Language	English
Publishing date	2023-04-10
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.22-0438
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Article ; Online: Inequalities in access to water and soap matter for the COVID-19 response in sub-Saharan Africa

Jiwani, Safia S. / Antiporta, Daniel A.

International Journal for Equity in Health

2020 Volume 19, Issue 1

Keywords	Public Health, Environmental and Occupational Health ; Health Policy ; covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
ISSN	1475-9276
DOI	10.1186/s12939-020-01199-z
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Access to water, sanitation and hygiene services in health facilities in sub-Saharan Africa 2013-2018: Results of health facility surveys and implications for COVID-19 transmission.

Kanyangarara, Mufaro / Allen, Savannah / Jiwani, Safia S / Fuente, David

BMC health services research

2021 Volume 21, Issue 1, Page(s) 601

Abstract: Background: The COVID-19 pandemic has highlighted important needs in water, sanitation and hygiene (WASH) services and standard practices for infection prevention and control in sub-Saharan Africa. We assessed the availability of WASH and standard ... ...

Abstract	Background: The COVID-19 pandemic has highlighted important needs in water, sanitation and hygiene (WASH) services and standard practices for infection prevention and control in sub-Saharan Africa. We assessed the availability of WASH and standard precautions for infection prevention in health facilities across 18 countries in sub-Saharan Africa, as well as inequalities by location (rural/urban) and managing authority (public/private). Data from health facility surveys conducted between 2013 and 2018 in 18 sub-Saharan African countries were used to estimate the access to an improved water source within 500 m, an improved toilet, soap and running water or alcohol-based hand rub, and standard precautions for infection prevention at health facilities. Rural-urban differences and public-private differences in access to services were calculated. We also compared population level access to health facility access to services. Result: Overall, 16,456 health facilities from 18 countries were included. Across countries, an estimated 88 % had an improved water source, 94 % had an improved toilet, 74 % had soap and running water or alcohol-based hand rub, and 17 % had standard precautions for infection prevention available. There was wide variability in access to water, sanitation and hygiene services between rural and urban health facilities and between public and private facilities, with consistently lower access in both rural and public facilities. In both rural and urban areas, access to water, sanitation and hygiene services was ubiquitously better at health facilities than households. Conclusions: Availability of WASH services in health facilities in sub-Saharan Africa has improved but remains below the global target of 80 % in many countries. Ensuring adequate access to WASH services and enforcing adherence to safety and hygiene practices in health facilities will be essential to minimize the risk of COVID-19 transmission.
MeSH term(s)	Africa South of the Sahara ; COVID-19 ; Health Facilities ; Humans ; Hygiene ; Pandemics ; SARS-CoV-2 ; Sanitation ; Water ; Water Supply
Chemical Substances	Water (059QF0KO0R)
Language	English
Publishing date	2021-06-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-021-06515-z
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Article: Inequalities in access to water and soap matter for the COVID-19 response in sub-Saharan Africa

Jiwani, Safia S / Antiporta, Daniel A

Int J Equity Health

Abstract	The COVID-19 pandemic has spread rapidly since the first case notification of the WHO in December 2019. Lacking an effective treatment, countries have implemented non-pharmaceutical interventions including social distancing measures and have encouraged maintaining adequate and frequent hand hygiene to slow down the disease transmission. Although access to clean water and soap is universal in high-income settings, it remains a basic need many do not have in low- and middle-income settings.We analyzed data from Demographic and Health Surveys (DHS) of 16 countries in sub-Saharan Africa, using the most recent survey since 2015. Differences in the percentage of households with an observed handwashing place with water and soap were estimated by place of residence and wealth quintiles. Equiplots showed wide within-country disparities, disproportionately affecting the poorest households and rural residents, who represent the majority of the population in most of the countries.Social inequalities in access to water and soap matter for the COVID-19 response in sub-Saharan Africa. Interventions such as mass distribution of soap and ensuring access to clean water, along with other preventive strategies should be scaled up to reach the most vulnerable populations.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #505707
Database	COVID19

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Article ; Online: Inequalities in access to water and soap matter for the COVID-19 response in sub-Saharan Africa

Safia S. Jiwani / Daniel A. Antiporta

International Journal for Equity in Health, Vol 19, Iss 1, Pp 1-

2020 Volume 3

Abstract: Abstract The COVID-19 pandemic has spread rapidly since the first case notification of the WHO in December 2019. Lacking an effective treatment, countries have implemented non-pharmaceutical interventions including social distancing measures and have ... ...

Abstract	Abstract The COVID-19 pandemic has spread rapidly since the first case notification of the WHO in December 2019. Lacking an effective treatment, countries have implemented non-pharmaceutical interventions including social distancing measures and have encouraged maintaining adequate and frequent hand hygiene to slow down the disease transmission. Although access to clean water and soap is universal in high-income settings, it remains a basic need many do not have in low- and middle-income settings. We analyzed data from Demographic and Health Surveys (DHS) of 16 countries in sub-Saharan Africa, using the most recent survey since 2015. Differences in the percentage of households with an observed handwashing place with water and soap were estimated by place of residence and wealth quintiles. Equiplots showed wide within-country disparities, disproportionately affecting the poorest households and rural residents, who represent the majority of the population in most of the countries. Social inequalities in access to water and soap matter for the COVID-19 response in sub-Saharan Africa. Interventions such as mass distribution of soap and ensuring access to clean water, along with other preventive strategies should be scaled up to reach the most vulnerable populations.
Keywords	Inequalities ; Hand hygiene ; Water and soap ; COVID-19 ; Sub-Saharan Africa ; Public aspects of medicine ; RA1-1270 ; covid19
Subject code	306
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Access to water, sanitation and hygiene services in health facilities in sub-Saharan Africa 2013–2018

Mufaro Kanyangarara / Savannah Allen / Safia S Jiwani / David Fuente

BMC Health Services Research, Vol 21, Iss 1, Pp 1-

Results of health facility surveys and implications for COVID-19 transmission

2021 Volume 11

Abstract: Abstract Background The COVID-19 pandemic has highlighted important needs in water, sanitation and hygiene (WASH) services and standard practices for infection prevention and control in sub-Saharan Africa. We assessed the availability of WASH and ... ...

Abstract	Abstract Background The COVID-19 pandemic has highlighted important needs in water, sanitation and hygiene (WASH) services and standard practices for infection prevention and control in sub-Saharan Africa. We assessed the availability of WASH and standard precautions for infection prevention in health facilities across 18 countries in sub-Saharan Africa, as well as inequalities by location (rural/urban) and managing authority (public/private). Data from health facility surveys conducted between 2013 and 2018 in 18 sub-Saharan African countries were used to estimate the access to an improved water source within 500 m, an improved toilet, soap and running water or alcohol-based hand rub, and standard precautions for infection prevention at health facilities. Rural-urban differences and public-private differences in access to services were calculated. We also compared population level access to health facility access to services. Result Overall, 16,456 health facilities from 18 countries were included. Across countries, an estimated 88 % had an improved water source, 94 % had an improved toilet, 74 % had soap and running water or alcohol-based hand rub, and 17 % had standard precautions for infection prevention available. There was wide variability in access to water, sanitation and hygiene services between rural and urban health facilities and between public and private facilities, with consistently lower access in both rural and public facilities. In both rural and urban areas, access to water, sanitation and hygiene services was ubiquitously better at health facilities than households. Conclusions Availability of WASH services in health facilities in sub-Saharan Africa has improved but remains below the global target of 80 % in many countries. Ensuring adequate access to WASH services and enforcing adherence to safety and hygiene practices in health facilities will be essential to minimize the risk of COVID-19 transmission.
Keywords	Water ; Sanitation and hygiene ; Health care facilities ; Coronavirus disease (COVID-19) ; Inequalities ; Sub-Saharan Africa ; Public aspects of medicine ; RA1-1270
Subject code	360 ; 306
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Measuring coverage of maternal and child health services using routine health facility data: a Sierra Leone case study.

Maïga, Abdoulaye / Amouzou, Agbessi / Bagayoko, Moussa / Faye, Cheikh M / Jiwani, Safia S / Kamara, Dauda / Koroma, Ibrahim B / Sankoh, Osman

BMC health services research

2021 Volume 21, Issue Suppl 1, Page(s) 547

Abstract: Background: There are limited existing approaches to generate estimates from Routine Health Information Systems (RHIS) data, despite the growing interest to these data. We calculated and assessed the consistency of maternal and child health service ... ...

Abstract	Background: There are limited existing approaches to generate estimates from Routine Health Information Systems (RHIS) data, despite the growing interest to these data. We calculated and assessed the consistency of maternal and child health service coverage estimates from RHIS data, using census-based and health service-based denominators in Sierra Leone. Methods: We used Sierra Leone 2016 RHIS data to calculate coverage of first antenatal care contact (ANC1), institutional delivery and diphtheria-pertussis-tetanus 3 (DPT3) immunization service provision. For each indicator, national and district level coverages were calculated using denominators derived from two census-based and three health service-based methods. We compared the coverage estimates from RHIS data to estimates from MICS 2017. We considered the agreement adequate when estimates from RHIS fell within the 95% confidence interval of the survey estimate. Results: We found an overall poor consistency of the coverage estimates calculated from the census-based methods. ANC1 and institutional delivery coverage estimates from these methods were greater than 100% in about half of the fourteen districts, and only 3 of the 14 districts had estimates consistent with the survey data. Health service-based methods generated better estimates. For institutional delivery coverage, five districts met the agreement criteria using BCG service-based method. We found better agreement for DPT3 coverage estimates using DPT1 service-based method as national coverage was close to survey data, and estimates were consistent for 8 out of 14 districts. DPT3 estimates were consistent in almost half of the districts (6/14) using ANC1 service-based method. Conclusion: The study highlighted the challenge in determining an appropriate denominator for RHIS-based coverage estimates. Systematic and transparent data quality check and correction, as well as rigorous approaches to determining denominators are key considerations to generate accurate coverage statistics using RHIS data.
MeSH term(s)	Child ; Child Health Services ; Female ; Health Facilities ; Health Information Systems ; Humans ; Maternal Health Services ; Pregnancy ; Sierra Leone/epidemiology ; Surveys and Questionnaires
Language	English
Publishing date	2021-09-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-021-06529-7
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Article: Closing the inequality gaps in reproductive, maternal, newborn and child health coverage: slow and fast progressors.

Amouzou, Agbessi / Jiwani, Safia S / da Silva, Inácio Crochemore Mohnsam / Carvajal-Aguirre, Liliana / Maïga, Abdoulaye / Vaz, Lara M E

BMJ global health

2020 Volume 5, Issue 1, Page(s) e002230

Abstract: Introduction: Universal Health Coverage (UHC) is a critical goal under the Sustainable Development Goals (SDGs) for health. Achieving this goal for reproductive, maternal, newborn and child health (RMNCH) service coverage will require an understanding ... ...

Abstract	Introduction: Universal Health Coverage (UHC) is a critical goal under the Sustainable Development Goals (SDGs) for health. Achieving this goal for reproductive, maternal, newborn and child health (RMNCH) service coverage will require an understanding of national progress and how socioeconomic and demographic subgroups of women and children are being reached by health interventions. Methods: We accessed coverage databases produced by the International Centre for Equity in Health, which were based on reanalysis of Demographic and Health Surveys, Multiple Indicator Cluster Surveys and Reproductive and Health Surveys. We limited the data to 58 countries with at least two surveys since 2008. We fitted multilevel linear regressions of coverage of RMNCH, divided into four main components-reproductive health, maternal health, child immunisation and child illness treatment-to estimate the average annual percentage point change (AAPPC) in coverage for the period 2008-2017 across these countries and for subgroups defined by maternal age, education, place of residence and wealth quintiles. We also assessed change in the pace of coverage progress between the periods 2000-2008 and 2008-2017. Results: Progress in RMNCH coverage has been modest over the past decade, with statistically significant AAPPC observed only for maternal health (1.25, 95% CI 0.90 to 1.61) and reproductive health (0.83, 95% CI 0.47 to 1.19). AAPPC was not statistically significant for child immunisation and illness treatment. Progress, however, varied largely across countries, with fast or slow progressors spread throughout the low-income and middle-income groups. For reproductive and maternal health, low-income and lower middle-income countries appear to have progressed faster than upper middle-income countries. For these two components, faster progress was also observed in older women and in traditionally less well-off groups such as non-educated women, those living in rural areas or belonging to the poorest or middle wealth quintiles than among groups that are well off. The latter groups however continue to maintain substantially higher coverage levels over the former. No acceleration in RMNCH coverage was observed when the periods 2000-2008 and 2008-2017 were compared. Conclusion: At the dawn of the SDGs, progress in coverage in RMNCH remains insufficient at the national level and across equity dimensions to accelerate towards UHC by 2030. Greater attention must be paid to child immunisation to sustain the past gains and to child illness treatment to substantially raise its coverage across all groups.
MeSH term(s)	Child ; Developing Countries ; Female ; Health/statistics & numerical data ; Healthcare Disparities/statistics & numerical data ; Healthcare Disparities/trends ; Humans ; Infant, Newborn ; Poverty ; Surveys and Questionnaires
Language	English
Publishing date	2020-01-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2059-7908
ISSN	2059-7908
DOI	10.1136/bmjgh-2019-002230
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Article ; Online: Trends and inequalities in the nutritional status of adolescent girls and adult women in sub-Saharan Africa since 2000

Jiwani, Safia S. / Gatica-Domínguez, Giovanna / Crochemore-Silva, Inacio / Maïga, Abdoulaye / Walton, Shelley / Verstraeten, Roosmarijn

BMJ Global Health 5(10): 2948

A cross-sectional series study

2020

Abstract: Evidence on the rate at which the double burden of malnutrition unfolds is limited. We quantified trends and inequalities in the nutritional status of adolescent girls and adult women in sub-Saharan Africa. ... PR ... IFPRI3; CRP4; DCA; ISI; Alive and Thrive; ...

Abstract	Evidence on the rate at which the double burden of malnutrition unfolds is limited. We quantified trends and inequalities in the nutritional status of adolescent girls and adult women in sub-Saharan Africa. PR IFPRI3; CRP4; DCA; ISI; Alive and Thrive; 2 Promoting Healthy Diets and Nutrition for all; Transform Nutrition West Africa PHND; A4NH CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)
Keywords	AFRICA SOUTH OF SAHARA ; AFRICA ; adolescents ; nutrition ; women ; malnutrition ; thinness ; obesity ; overweight
Language	English
Publisher	BMJ
Publishing country	us
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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