The burden of road traffic crashes, injuries and deaths in Africa: a systematic review and meta-analysis

Objective

To estimate the burden of road traffic injuries and deaths for all road users and among different road user groups in Africa.

Methods

We searched MEDLINE, EMBASE, Global Health, Google Scholar, websites of African road safety agencies and organizations for registry- and population-based studies and reports on road traffic injury and death estimates in Africa, published between 1980 and 2015. Available data for all road users and by road user group were extracted and analysed. We conducted a random-effects meta-analysis and estimated pooled rates of road traffic injuries and deaths.

Findings

We identified 39 studies from 15 African countries. The estimated pooled rate for road traffic injury was 65.2 per 100 000 population (95% confidence interval, CI: 60.8–69.5) and the death rate was 16.6 per 100 000 population (95% CI: 15.2–18.0). Road traffic injury rates increased from 40.7 per 100 000 population in the 1990s to 92.9 per 100 000 population between 2010 and 2015, while death rates decreased from 19.9 per 100 000 population in the 1990s to 9.3 per 100 000 population between 2010 and 2015. The highest road traffic death rate was among motorized four-wheeler occupants at 5.9 per 100 000 population (95% CI: 4.4–7.4), closely followed by pedestrians at 3.4 per 100 000 population (95% CI: 2.5–4.2).

Conclusion

The burden of road traffic injury and death is high in Africa. Since registry-based reports underestimate the burden, a systematic collation of road traffic injury and death data is needed to determine the true burden.

Factors influencing maternal mortality among rural communities in southwestern Nigeria

BACKGROUND

Maternal mortality and morbidity reflect the status of population health and quality of life across nations. Poor understanding of the interplay of many antecedent factors, including sociocultural, economic and logistic factors, combined with an overwhelming poor health services delivery, is a basic challenge in several countries, particularly in rural settings where functional health care services are relatively scarce. There are still uncertainties as to the extent of this burden, owing to current challenges with information and data collation. This study aimed at identifying nonmedical factors associated with maternal mortality in rural and semiurban communities of southwestern Nigeria.

METHODOLOGY

The study was carried out in Ado-Odo/Ota Local Government Area of Ogun State. A multistage sampling technique and an informant survey approach were used in the study. A total sample of 360 eligible respondents were selected randomly from 11 out of 16 political wards in the study area and interviewed through the administration of questionnaires. The data were processed using descriptive statistics and regression analyses.

RESULTS

Place of consultation (P=0.000), who pays the treatment costs (P=0.000), awareness of pregnancy complications (P=0.002) and knowledge of the place of antenatal care treatment (P=0.000) significantly influenced maternal mortality (proxy by place of delivery of last birth). The F-statistic (15.100) confirmed the hypothesis that nonmedical factors influence maternal mortality. The correlation of predictor variables was significant at both the 0.01 level and the 0.05 level (2-tailed).

CONCLUSION

Our findings suggest that in a rural community setting with a depleted health care system, health education tailored toward community culture, subsidized maternal health care services by the government and operators of private clinics, as well as empowering and improving the status of women may reduce maternal mortality and prompt better utilization and survival chances of women in the study area as well as in all of Nigeria.

Self-reported physical activity among health care professionals in South-West Nigeria

INTRODUCTION

Physical activity (PA) is a key requirement for maintaining good health. There is growing evidence of declining PA worldwide. Physical inactivity is linked with the global obesity pandemic and increasing burden of noncommunicable diseases (NCDs) in developing countries. A barrier to PA counseling by health care providers (HCPs) is personal PA habits. Information regarding PA among HCPs in Nigeria is limited. We aimed to determine the adequacy and predictors of PA among HCPs of a tertiary health care facility in Lagos, Nigeria.

METHODS

A cross-sectional study was carried out with the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Using the World Health Organization (WHO) guideline, PA was categorized as adequate or inadequate. Predictors of PA were explored with multivariate logistic regression.

RESULTS

A total of 300 HCPs were recruited, comprising 47.7% doctors and dentists, 43.3% nurses and 9.0% other HCPs. Mean age was 39.9 (9.0 years), 79.2%, 9.7% and 11.1% of the HCPs had low, moderate or high PA levels respectively. Thus, only 20.8% had adequate PA. 71.3% had body mass index (BMI) above the recommended value. BMI of ≥25 kg/m2 was associated with inadequate PA (Adjusted Odds Ratio-2.1,P=0.018).

CONCLUSION

Majority of the HCPs had inadequate PA levels according to WHO guidelines. BMI≥25 kg/m2 was associated with inadequate physical inactivity. The low level of PA implies that these HCPs are at risk for NCDs. This will have a negative impact on availability of human resource for health. There is an urgent need to establish programs to increase PA among HCPs.

Variations in preference for family care support among the elderly in Southwestern Nigeria

Preference for family care support among the elderly has become a prominent issue in Nigeria. Hence, the study explored variations in preference for family care support among the elderly in South-western Nigeria (Lagos and Oyo states). Data were extracted from a 2012 elderly survey dataset, and analyzed using quantitative techniques (univariate and bivariate). The results showed that study locations, marriage-type, educational attainment, employment status, religious affiliation, means of livelihood and usual place of residence have little and apparent variations in preferences for family care support in Southwestern Nigeria. We recommend that in order to keep on sustaining high-preferences for family care support, elderly people should be given all-round communal supports by family caregivers in the Nigerian extended family system.

Influence of socio-economic factors on prevalence of teenage pregnancy in Nigeria

The study utilized the theory of fertility as initiated by Davis and Blakes (1956) and developed by Bongaarts in 1978 to underscore why teenage fertility has remained high in Nigeria. This study investigates women socio-economic factors influencing pregnancy in Nigeria. A total sample of 8448 female teenagers with pregnancy experiences were extracted from the 2018 Nigeria Demographic and Health Survey (NDHS). The study revealed that 19% of young girls with 15-19 years have experienced teenage pregnancy in Nigeria. More importantly, the socio-economic factors with significant influence on teenage pregnancy are: respondents with age 18-19 years (33.2 percent), rural (27.2 percent), Islamic religion (25.2 percent), North-west (28.5 percent), poorest (32 percent), no educational (43.7 percent), married/living with partners (73.9 percent), employed (21.5 percent), visited any health facility in the last 12 months (42 percent) and those who were informed about family planning at a health facility (84.3 per cent) . There is need for sound education for females in Nigeria that will equip girls and women with adequate knowledge needed to make informed decisions on matters relating to sexual and reproductive health, hence resulting in the actualization of the SDG 5.