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Kuria-Ndiritu S, Karanja S, Mubita B, Kapsandui T, Kutna J, Anyona D, Murerwa J, Ferguson L. Impact of the COVID-19 pandemic and policy response on access to and utilization of reproductive, maternal, child and adolescent health services in Kenya, Uganda and Zambia. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002740. [PMID: 38271454 PMCID: PMC10810520 DOI: 10.1371/journal.pgph.0002740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 11/29/2023] [Indexed: 01/27/2024]
Abstract
Global health crises can negatively impact access to and utilisation of essential health services. Access to and utilisation of reproductive health services were already challenged in Sub-Saharan Africa with the COVID-19 pandemic further complicating the critical situation. This cross-sectional qualitative study aimed to assess the impact of the COVID-19 pandemic and policy responses to it on the access to, and utilization of reproductive, maternal, child and adolescent health services in Kenya, Uganda, and Zambia. It sought to explore the perspectives of women of reproductive age (18-49), frontline health workers and government representatives, all from geographies that are under-researched in this context. Using purposive sampling, key informant and in-depth interviews were carried out with 63 participants across the three countries between November 2020 and February 2021. The study population included women of reproductive age (18-49 years), front-line health service providers, and government representatives We established that COVID-19 and the policy response to it affected access to and utilization of services in the three countries, the most affected being antenatal care, delivery, family planning, and immunization services. Women reported not accessing the health facilities for various reasons. Barriers to access and utilization of services cut across all the socioecological levels. Movement restrictions, particularly in Uganda where they were most severe, and fear of contracting COVID-19 at health facilities were the most reported barriers. Weak structures at community level and inadequate supply of commodities in health facilities exacerbated the situation. Mitigation factors were put in place at different levels. There is need to strengthen the health system, particularly the supply chain and to have services closer to the community to enhance access to and utilisation of services at all times and particularly during crises such as the Covid-19 pandemic.
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Affiliation(s)
| | | | | | | | - John Kutna
- Amref Health Africa in Kenya, Nairobi, Kenya
| | - Dona Anyona
- Amref Health Africa, Headquarters, Nairobi, Kenya
| | | | - Laura Ferguson
- Institute on Inequalities in Global Health, University of Southern California, Los Angeles, California, United States of America
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Musoke D, Deane K, Nalinya S, Lubega GB, Ekirapa-Kiracho E, McCoy D. The Unequal Economic and Livelihood Impacts of COVID-19 Lockdowns: Qualitative Evidence from Uganda. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241284281. [PMID: 39305024 PMCID: PMC11418437 DOI: 10.1177/00469580241284281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 07/29/2024] [Accepted: 08/13/2024] [Indexed: 09/25/2024]
Abstract
Lockdowns were a key policy response to the COVID-19 pandemic. While they were viewed as a necessary intervention, concerns were raised about their potential for harmful economic and livelihood impacts. However, few studies have addressed the unequal economic and livelihood impacts of lockdowns. Our article reports findings from a qualitative study conducted in Uganda on economic and livelihood impacts of COVID-19 lockdowns in urban and rural settings. This study used 14 focus group discussions, 40 household, and 31 key informant interviews in both urban (Kampala district) and rural (Wakiso district) areas in central Uganda. Data analysis was conducted thematically with NVivo 2020 (QSR International). The findings emphasize the unequal impacts of the COVID-19 lockdowns across a range of dimensions: informal sector activities, formal employment, fluctuating prices alongside scarcity and surpluses, food insecurity, and government interventions. Wealthier households in urban areas were least affected, with urban households reliant on informal sector activities experiencing the most significant impacts. Our findings also suggest that longer-term development strategies, such as increased food self-sufficiency and informal sector interventions can support future pandemic preparedness and response. To address these impacts, policymakers should provide targeted support, alongside protecting key productive sectors, and supply chains.
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Affiliation(s)
| | | | | | | | | | - David McCoy
- United Nations University, Kuala Lumpur, Malaysia
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Stanikzai MH, Wafa MH, Rahimi BA, Sayam H. Conducting Health Research in the Current Afghan Society: Challenges, Opportunities, and Recommendations. Risk Manag Healthc Policy 2023; 16:2479-2483. [PMID: 38024503 PMCID: PMC10662640 DOI: 10.2147/rmhp.s441105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023] Open
Abstract
Research makes a significant contribution to academic excellence and holds the potential to facilitate societal development. Despite the increasing importance of health research in developing new therapies and galvanizing notable progress in public health, the landscape of health research in Afghanistan remains profoundly deficient. This article reveals that health research in Afghanistan requires significant growth to meet the standards set on regional and global grounds.
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Affiliation(s)
| | - Mohammad Hashim Wafa
- Neuropsychiatric and Behavioral Sciences Department, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
| | - Bilal Ahmad Rahimi
- Department of Pediatrics, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
| | - Hadia Sayam
- Para-Clinic Departments, Faculty of Medicine, Malalay Institute of Higher Education, Kandahar, Afghanistan
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Konstantinus A, Konstantinus I. Choice preference and willingness to pay for COVID-19 vaccination in Namibia. Vaccine X 2023; 14:100324. [PMID: 37333055 PMCID: PMC10249368 DOI: 10.1016/j.jvacx.2023.100324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 03/12/2023] [Accepted: 05/30/2023] [Indexed: 06/20/2023] Open
Abstract
Background Namibia has not been spared from the coronavirus (COVID-19) pandemic, and as intervention the Namibian government has rolled out vaccination programmes. This study was conducted before the roll out of these vaccines to assess the preference for COVID-19 vaccinations. Stated preference studies provide information about social demand, access, willingness-to-pay and financing for future COVID-19 vaccination. Methods A stated choice experiment (SCE) survey was administered to a sample of 506 participants from Namibia's general population between October 2020 and December 2020. Participants were asked to make a series of hypothetical choices and estimate their preference for different attributes of a vaccine. A latent class model was used to analyse the SCE data. The study also assessed anti-vaccination behaviour, past vaccination behaviour, impacts of COVID-19 on mental and physical health and Willingness-To-Pay (WTP) measures. The WTP measures were captured as out-of-pocket and further calculated using the marginal rate of substitution method in SCE. Results Data from 269 participants was included in the analysis. Vaccine side effects (40.065), population coverage (4.688), payment fee to receive vaccine immediately (3.733) were the top three influential attributes for vaccine preferences. Accordingly, increases in mild and severe side effects of vaccine options had negative impacts on utility; with an average WTP of N$728.26 to reduce serious side effects. The average WTP to receive a high-quality vaccine with 90% efficient was found to be N$233.11 (US$15.14). Across classes, there was a strong preference for vaccines with high effectiveness over longer durations of time. Conclusions The results provide useful information for the Namibian government to improve the current strategies for vaccine rollout interventions.
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Affiliation(s)
| | - Iyaloo Konstantinus
- Ndatara Surveys, Swakopmund, Namibia
- Namibia Institute of Pathology, Windhoek, Namibia
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Gómez-Pérez GP, de Groot R, Abajobir AA, Wainaina CW, Rinke de Wit TF, Sidze E, Pradhan M, Janssens W. Reduced incidence of respiratory, gastrointestinal and malaria infections among children during the COVID-19 pandemic in Western Kenya: An analysis of facility-based and weekly diaries data. J Glob Health 2023; 13:06024. [PMID: 37448326 DOI: 10.7189/jogh.13.06024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
Background Epidemics can cause significant disruptions of essential health care services. This was evident in West-Africa during the 2014-2016 Ebola outbreak, raising concerns that COVID-19 would have similar devastating consequences for the continent. Indeed, official facility-based records show a reduction in health care visits after the onset of COVID-19 in Kenya. Our question is whether this observed reduction was caused by lower access to health care or by reduced incidence of communicable diseases resulting from reduced mobility and social contacts. Methods We analysed monthly facility-based data from 2018 to 2020, and weekly health diaries data digitally collected by trained fieldworkers between February and November 2020 from 342 households, including 1974 individuals, in Kisumu and Kakamega Counties, Kenya. Diaries data was collected as part of an ongoing longitudinal study of a digital health insurance scheme (Kakamega), and universal health coverage implementation (Kisumu). We assessed the weekly incidence of self-reported medical symptoms, formal and informal health-seeking behaviour, and foregone care in the diaries and compared it with facility-based records. Linear probability regressions with household fixed-effects were performed to compare the weekly incidence of health outcomes before and after COVID-19. Results Facility-based data showed a decrease in health care utilization for respiratory infections, enteric illnesses, and malaria, after start of COVID-19 measures in Kenya in March 2020. The weekly diaries confirmed this decrease in respiratory and enteric symptoms, and malaria / fever, mainly in the paediatric population. In terms of health care seeking behaviour, our diaries data find a temporary shift in consultations from health care centres to pharmacists / chemists / medicine vendors for a few weeks during the pandemic, but no increase in foregone care. According to the diaries, for adults the incidence of communicable diseases/symptoms rebounded after COVID-19 mobility restrictions were lifted, while for children the effects persisted. Conclusions COVID-19-related containment measures in Western Kenya were accompanied by a decline in respiratory infections, enteric illnesses, and malaria / fever mainly in children. Data from a population-based survey and facility-based records aligned regarding this finding despite the temporary shift to non-facility-based consultations and confirmed that the drop in utilization of health care services was not due to decreased accessibility, but rather to a lower incidence of these infections.
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Affiliation(s)
- Gloria P Gómez-Pérez
- Amsterdam Institute of Global Health and Development, Amsterdam, the Netherlands
- PharmAccess Foundation, Amsterdam, the Netherlands
| | - Richard de Groot
- Amsterdam Institute of Global Health and Development, Amsterdam, the Netherlands
| | | | - Caroline W Wainaina
- African Population and Health Research Centre, Nairobi, Kenya
- Universiteit Utrecht, Amsterdam, the Netherlands
| | - Tobias F Rinke de Wit
- Amsterdam Institute of Global Health and Development, Amsterdam, the Netherlands
- PharmAccess Foundation, Amsterdam, the Netherlands
| | - Estelle Sidze
- African Population and Health Research Centre, Nairobi, Kenya
| | - Menno Pradhan
- Amsterdam Institute of Global Health and Development, Amsterdam, the Netherlands
- Vrije Universiteit, Amsterdam, the Netherlands
- Universiteit van Amsterdam, the Netherlands
| | - Wendy Janssens
- Amsterdam Institute of Global Health and Development, Amsterdam, the Netherlands
- Vrije Universiteit, Amsterdam, the Netherlands
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Chippaux JP. COVID-19 impacts on healthcare access in sub-Saharan Africa: an overview. J Venom Anim Toxins Incl Trop Dis 2023; 29:e20230002. [PMID: 37405230 PMCID: PMC10317188 DOI: 10.1590/1678-9199-jvatitd-2023-0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023] Open
Abstract
This overview aimed to describe the situation of healthcare access in sub-Saharan Africa, excluding South Africa, during the COVID-19 pandemic. A PubMed® search from March 31, 2020, to August 15, 2022, selected 116 articles. Healthcare access and consequences of COVID-19 were assessed based on comparisons with months before its onset or an identical season in previous years. A general reduction of healthcare delivery, associated with the decline of care quality, and closure of many specialty services were reported. The impact was heterogeneous in space and time, with an increase in urban areas at the beginning of the pandemic (March-June 2020). The return to normalcy was gradual from the 3rd quarter of 2020 until the end of 2021. The impact of COVID-19 on the health system and its use was attributed to (a) conjunctural factors resulting from government actions to mitigate the spread of the epidemic (containment, transportation restrictions, closures of businesses, and places of entertainment or worship); (b) structural factors related to the disruption of public and private facilities and institutions, in particular, the health system; and (c) individual factors linked to the increase in costs, impoverishment of the population, and fear of contamination or stigmatization, which discouraged patients from going to health centers. They have caused considerable socio-economic damage. Several studies emphasized some adaptability of the healthcare offer and resilience of the healthcare system, despite its unpreparedness, which explained a return to normal activities as early as 2022 while the COVID-19 epidemic persisted. There appears to be a strong disproportion between the moderate incidence and severity of COVID-19 in sub-Saharan Africa, and the dramatic impact on healthcare access. Several articles make recommendations for lowering the socioeconomic consequences of future epidemics to ensure better management of health issues.
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Affiliation(s)
- Jean-Philippe Chippaux
- Paris Cité University, Research Institute for Development, Mother and child in tropical environment: pathogens, health system and epidemiological transition, Paris, France
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Chippaux JP. [Impact of COVID-19 on public health in sub-Saharan Africa]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 2023; 207:150-164. [PMID: 36628105 PMCID: PMC9816877 DOI: 10.1016/j.banm.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/27/2022] [Indexed: 01/09/2023]
Abstract
Objective This work aimed to assess the impact of COVID-19 on healthcare supply in sub-Saharan Africa except South Africa. Method A search through PubMed® between April 2020 and August 2022 selected 135 articles. The impact of COVID-19 was assessed on comparisons with the months prior to the onset of COVID-19 or an identical season in previous years. Results The decline of health services, associated with a reduction in their quality, and the closure of specialized health units have been reported. Many control programs and public health interventions have been interrupted, with the risk of an increase of the corresponding diseases. Social disorganization has generated mental health issues among the population, including health personnel. The impact was heterogeneous in space and time. The main causes were attributed to containment measures (transport restrictions, trade closures) and the lack of human and material resources. The increase in costs, in addition to the impoverishment of the population, and the fear of being contaminated or stigmatized have discouraged patients from going to health centres. The studies mention the gradual return to normal after the first epidemic wave and the resilience of the healthcare system. Conclusion Several articles make recommendations aimed at reducing the impact of future epidemics: support for community workers, training of health workers and reorganization of services to improve the reception and care of patients, technological innovations (use of telephones, drones, etc.) and better information monitoring.
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Ongoma V, Epule TE, Brouziyne Y, Tanarhte M, Chehbouni A. COVID-19 response in Africa: impacts and lessons for environmental management and climate change adaptation. ENVIRONMENT, DEVELOPMENT AND SUSTAINABILITY 2023; 26:1-23. [PMID: 36714211 PMCID: PMC9873540 DOI: 10.1007/s10668-023-02956-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic adds pressure on Africa; the most vulnerable continent to climate change impacts, threatening the realization of most Sustainable Development Goals (SDGs). The continent is witnessing an increase in intensity and frequency of extreme weather events, and environmental change. The COVID-19 was managed relatively well across in the continent, providing lessons and impetus for environmental management and addressing climate change. This work examines the possible impact of the COVID-19 pandemic on the environment and climate change, analyses its management and draws lessons from it for climate change response in Africa. The data, findings and lessons are drawn from peer reviewed articles and credible grey literature on COVID-19 in Africa. The COVID-19 pandemic spread quickly, causing loss of lives and stagnation of the global economy, overshadowing the current climate crisis. The pandemic was managed through swift response by the top political leadership, research and innovations across Africa providing possible solutions to COVID-19 challenges, and redirection of funds to manage the pandemic. The well-coordinated COVID-19 containment strategy under the African Centers for Disease Control and Prevention increased sharing of resources including data was a success in limiting the spread of the virus. These strategies, among others, proved effective in limiting the spread and impact of COVID-19. The findings provide lessons that stakeholders and policy-makers can leverage in the management of the environment and address climate change. These approaches require solid commitment and practical-oriented leadership. Supplementary Information The online version contains supplementary material available at 10.1007/s10668-023-02956-0.
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Affiliation(s)
- Victor Ongoma
- International Water Research Institute, Mohammed VI Polytechnic University, Lot 660, Hay Moulay Rachid, 43150 Ben Guerir, Morocco
| | - Terence Epule Epule
- International Water Research Institute, Mohammed VI Polytechnic University, Lot 660, Hay Moulay Rachid, 43150 Ben Guerir, Morocco
| | - Youssef Brouziyne
- International Water Management Institute, Level 3, 7 Abd El-Hady Saleh St., Off Nile Street, Giza, Egypt
| | - Meryem Tanarhte
- Faculty of Sciences and Techniques of Mohammedia, Laboratory of Process Engineering and Environment, Hassan II University of Casablanca, 20650 Mohammedia, Morocco
| | - Abdelghani Chehbouni
- International Water Research Institute, Mohammed VI Polytechnic University, Lot 660, Hay Moulay Rachid, 43150 Ben Guerir, Morocco
- Center for Remote Sensing and Applications, Mohammed VI Polytechnic University, Lot 660, Hay Moulay Rachid, 43150 Ben Guerir, Morocco
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Osuagwu UL, Mashige KP, Ovenseri-Ogbomo G, Envuladu EA, Abu EK, Miner CA, Timothy CG, Ekpenyong BN, Langsi R, Amiebenomo OM, Oloruntoba R, Goson PC, Charwe DD, Ishaya T, Agho KE. The impact of information sources on COVID-19 vaccine hesitancy and resistance in sub-Saharan Africa. BMC Public Health 2023; 23:38. [PMID: 36609264 PMCID: PMC9816548 DOI: 10.1186/s12889-022-14972-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 12/29/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Vaccination remains the most powerful weapon against the emergence of new variants of coronavirus (COVID-19). However, false information about COVID-19 vaccines through various platforms including social media remains a major threat to global public health. This study examined the impact of information sources on COVID-19 vaccine hesitancy and resistance in sub-Saharan Africa (SSA). METHODS A validated web-based cross-sectional study was conducted from 14 March to 16 May 2021, and was administered in both French and English to 2572 participants aged 18 years and over. Data on sociodemographic characteristics, medical and vaccination history, and the information sources (mainstream media and social media) used by the participants during the pandemic were obtained. There were three main outcomes: The vaccinated group were those who responded in the affirmation (Yes) to the question of whether they have been vaccinated against COVID-19. Those who responded 'not sure' or 'no' to the question were then asked if they were willing to be vaccinated when the vaccine became available in their home countries. The responses to this follow-up question were used to derive the second and third outcome variables of 'vaccine hesitancy' and 'vaccine resistance', respectively. A series of logistic regression analyses were used to examine the impact of information sources on the three main outcomes. RESULTS The prevalence of COVID-19 vaccine hesitancy among the participants was lowest among newspaper readers (42%) and highest among TV (72%) and social media users (73%). The prevalence of COVID-19 vaccine-resistance was also lowest among newspaper readers (37%) but highest among social media users (87%). Multivariate analyses revealed that compared to those who did not use these information sources, SSA participants who relied on the radio (aOR 0.83, 95%CI = 0.70, 0.99), TV (aOR 0.80, 95%CI = 0.65, 0.97) and social media (aOR 0.79, 95%CI = 0.65, 0.97) for information during the pandemic were less likely to be hesitant towards taking the vaccines. However, social media users (aOR 2.13, 95%CI = 1.62, 2.80), those who watched TV (aOR 1.40, 95%CI =1.08, 1.80), relied on healthcare workers (HCWs: aOR 1.32, 95%CI = 1.07, 1.63) and families/friends (aOR 1.31, 95%CI = 1.06, 1.61) for COVID-19 related information during the pandemic were more likely to resist taking the COVID vaccines in this study. Participants who relied on the newspaper for information during the pandemic were less likely to resist the vaccines (aOR 0.77, 95%CI = 0.62, 0.95) compared to non-readers of a newspaper. CONCLUSION We found that all six information sources except radio were strong predictors of the resistance towards COVID-19 vaccination. Further research on how these channels can be used to improve the availability of reliable healthcare information is needed. Investments in these resources will protect people and empower them to make appropriate choices about their health.
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Affiliation(s)
- Uchechukwu L. Osuagwu
- grid.1029.a0000 0000 9939 5719Bathurst Rural Clinical School (BRCS), School of Medicine, Western Sydney University Bathurst, Bathurst, NSW 2795 Australia ,grid.16463.360000 0001 0723 4123African Vision Research Institute, Discipline of Optometry, Westville Campus, University of KwaZulu-Natal, Durban, 3629 South Africa ,grid.1029.a0000 0000 9939 5719Translational Health Research Institute (THRI), Western Sydney University, Campbeltown, NSW 2560 Australia
| | - Khathutshelo P. Mashige
- grid.16463.360000 0001 0723 4123African Vision Research Institute, Discipline of Optometry, Westville Campus, University of KwaZulu-Natal, Durban, 3629 South Africa
| | - Godwin Ovenseri-Ogbomo
- grid.23378.3d0000 0001 2189 1357Department of Optometry, University of the Highlands and Islands, Inverness, IV2 3JH UK
| | - Esther Awazzi Envuladu
- grid.412989.f0000 0000 8510 4538Department of Community Medicine, College of Health Sciences, University of Jos, Jos, 930003 Nigeria
| | - Emmanuel Kwasi Abu
- grid.413081.f0000 0001 2322 8567Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, 00233 Ghana
| | - Chundung Asabe Miner
- grid.412989.f0000 0000 8510 4538Department of Community Medicine, College of Health Sciences, University of Jos, Jos, 930003 Nigeria
| | - Chikasirimobi G. Timothy
- grid.442592.c0000 0001 0746 093XDepartment of Optometry, Faculty of Health sciences, Mzuzu University, P. Bag 201 Luwinga 2,, Mzuzu, Malawi
| | - Bernadine N. Ekpenyong
- grid.16463.360000 0001 0723 4123African Vision Research Institute, Discipline of Optometry, Westville Campus, University of KwaZulu-Natal, Durban, 3629 South Africa ,grid.413097.80000 0001 0291 6387Department of Public Health, Faculty of Allied Medical Sciences, College of Medical Sciences, University of Calabar, Cross River State, Calabar, 540271 Nigeria
| | - Raymond Langsi
- grid.449799.e0000 0004 4684 0857Health Division, University of Bamenda, Bambili, P. O. Box 39, Cameroon
| | - Onyekachukwu M. Amiebenomo
- grid.413068.80000 0001 2218 219XDepartment of Optometry, Faculty of Life Sciences, University of Benin, Benin, Nigeria ,School of Optometry and Vision Sciences, College of Biomedical Sciences, Cardiff, CF24 4HQ UK
| | - Richard Oloruntoba
- grid.1032.00000 0004 0375 4078School of Management and Marketing, Curtin Business School, Curtin University, Bentley, WA 6151 Australia
| | - Piwuna Christopher Goson
- grid.412989.f0000 0000 8510 4538Department of Psychiatry, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Deborah Donald Charwe
- grid.419861.30000 0001 2217 1343Tanzania Food and Nutrition Center, P. O. Box 977, Dar es Salaam, Tanzania
| | - Tanko Ishaya
- grid.412989.f0000 0000 8510 4538Department of Computer Science, University of Jos, Jos, 930003 Nigeria
| | - Kingsley E. Agho
- grid.16463.360000 0001 0723 4123African Vision Research Institute, Discipline of Optometry, Westville Campus, University of KwaZulu-Natal, Durban, 3629 South Africa ,grid.1029.a0000 0000 9939 5719Translational Health Research Institute (THRI), Western Sydney University, Campbeltown, NSW 2560 Australia ,grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Campbelltown, NSW 2560 Australia
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