Browsing by Author "Assefa, Nega"

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    The Continued Impacts of the COVID-19 Pandemic on Education and Mental Health Among Sub-Saharan African Adolescents
    (Elsevier, 2022) Wang, Dongqing; Adedokun, Olufemi A; Millogo, Ourohiré; Madzorera, Isabel; Hemler, Elena C; Workneh, Firehiwot; Mapendo, Frank; Lankoandev, Bruno; Ismail, Abbas; Chukwu, Angela; Assefa, Nega; Watara, Sulemana; Lyatuu, Isaac; Okpara, Daniel; Abdullahi, Yasir Y; Zabre, Pascal; Vuai, Said; Soura, Abdramane Bassiahi
    This multicountry survey assessed the levels and the determinants of the impacts of the pandemic on education and mental health among adolescents in sub-Saharan Africa and the potential factors that may exacerbate these adverse impacts. A phone survey was conducted among adolescents in nine diverse areas in Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania between July and December 2021. Approximately 300 adolescents per area and 2,803 adolescents in total were included. The survey collected information on adolescents’ sociodemographic characteristics, current COVID-19 preventive measures, and the impacts of the pandemic on daily activities, education, and mental health. Log-binomial models were used to calculate the adjusted prevalence ratios (aPRs) for determinants of education and mental health outcomes. Overall, 17% of the adolescents were not receiving any education. Compared to boys, girls were 15% more likely than boys to lack fully in-person education (aPR: 1.15; 95% confidence interval [CI]: 1.02, 1.30). Rural residence was associated with 2.7 times the prevalence of not currently receiving any education (aPR: 2.68; 95% CI: 2.23, 3.22). Self-reported experience of the current impacts of the pandemic on daily activities was associated with a higher prevalence of possible psychological distress (aPR: 1.86; 95% CI: 1.55, 2.24), high anxiety level (aPR: 3.37; 95% CI: 2.25, 5.06), and high depression level (aPR: 3.01; 95% CI: 2.05, 4.41). The COVID-19 pandemic presents continued challenges to adolescents’ education and mental health. Multisectoral efforts are needed to ensure that adolescents in sub-Saharan Africa do not fall further behind due to the pandemic
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    Covid-19 preventive practices, psychological distress, and reported barriers to healthcare access during the pandemic among adult community members in sub-Saharan Africa: a phone survey
    (American Society of Tropical Medicine and Hygiene, 2022) Assefa, Nega; Abdullahi, Yasir Y.; Hemler, Elena C.; Lankoande, Bruno; Madzorera, Isabel; Wang, Dongqing; Ismail, Abbas; Chukwu, Angela; Workneh, Firehiwot; Mapendo, Frank; Millogo, Ourohire; Abubakari, Sulemana Watara; Febir, Lawrence Gyabaa; Lyatuu, Isaac; Dianou, Kassoum; Baernighausen, Till; Soura, Abdramane; Asante, Kwaku Poku; Smith, Emily; Vuai, Said; Worku, Alemayehu; Killewo, Japhet; Mwanyika-Sando, Mary; Berhane, Yemane; Sie, Ali; Tajudeen, Raji; Oduola, Ayo; Fawzi, Wafaie W.
    The COVID-19 pandemic has had serious negative health and economic impacts in sub-Saharan Africa. Continuous monitoring of these impacts is crucial to formulate interventions to minimize the consequences of COVID-19. This study surveyed 2,829 adults in urban and rural sites among five sub-Saharan African countries: Burkina Faso, Ethiopia, Nigeria, Tanzania, and Ghana. Participants completed a mobile phone survey that assessed self-reported sociodemographic, COVID-19 preventive practices, psychological distress, and barriers to healthcare access. A modified Poisson regression model was used to estimate adjusted prevalence ratios (aPRs) and 95% CIs to investigate potential factors related to psychological distress and barriers to reduced healthcare access. At least 15.6% of adults reported experiencing any psychological distress in the previous 2 weeks, and 10.5% reported that at least one essential healthcare service was difficult to access 2 years into the pandemic. The majority of participants reported using several COVID-19 preventive methods, with varying proportions across the sites. Participants in the urban site of Ouagadougou, Burkina Faso (aPR: 2.29; 95% CI: 1.74–3.03) and in the rural site of Kintampo, Ghana (aPR: 1.68; 95% CI: 1.21–2.34) had a higher likelihood of experiencing any psychological distress compared with those in the rural area of Nouna, Burkina Faso. Loss of employment due to COVID-19 (aPR: 1.77; 95% CI: 1.47–2.11) was also associated with an increased prevalence of psychological distress. The number of children under 5 years in the household (aPR: 1.23; 95% CI: 1.14–1.33) and participant self-reported psychological distress (aPR: 1.83; 95% CI: 1.48–2.27) were associated with an increased prevalence of reporting barriers to accessing health services, whereas wage employment (aPR: 0.67; 95% CI: 0.49–0.90) was associated with decreased prevalence of reporting barriers to accessing health services. Overall, we found a high prevalence of psychological distress and interruptions in access to healthcare services 2 years into the pandemic across five sub-Saharan African countries. Increased effort and attention should be given to addressing the negative impacts of COVID-19 on psychological distress. An equitable and collaborative approach to new and existing preventive measures for COVID-19 is crucial to limit the consequences of COVID-19 on the health of adults in sub-Saharan Africa.
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    Gender differences in nutritional status, diet and physical activity among adolescents in eight countries in sub-Saharan Africa
    (John Wiley & Sons Ltd, 2020) Darling, Anne Marie; Sunguya, Bruno; Ismail, Abbas; Manu, Abubakar; Canavan, Chelsey; Assefa, Nega; Sie, Ali; Fawzi, Wafaie; Sudfeld, Chris; Guwattude, David
    The objective of this study was to evaluate gender differences in nutritional status, dietary intake, physical activity and hand hygiene among adolescents from diverse geographical settings in sub‐Saharan Africa.This study utilised cross‐sectional data from six countries (Burkina Faso, Ethiopia, Ghana, Nigeria, Tanzania and Uganda) within the ARISE Adolescent Health Survey (n = 7625). Body mass index (BMI) was calculated using measured heights and weights, and z‐scores were calculated based on the 2007 WHO growth standards for age and sex. Information on demographics, diet and health behaviours was collected through face‐to‐face interviews using a standardised questionnaire. Site‐specific and pooled prevalence ratios were determined. The prevalence of underweight, overweight and stunting pooled across sites was 14.3%, 6.8% and 18.1%, respectively. Female sex was associated with a lower risk of being underweight (pooled prevalence ratio 0.66, 95% 0.57, 0.77) and stunted (pooled PR 0.63, 95% CI 0.55, 0.71), but a higher risk of being overweight (pooled PR 1.60, 95% CI 1.26, 2.06). Females were also less likely to exercise for 1 h or more per day (pooled PR 0.77, 95% CI 0.67, 0.88), and more likely to wash hands after using toilets or latrines and to wash hands with soap (pooled PRs 1.13, 95% CI 1.05, 1.21 and 1.35, 95% CI 1.23, 1.45, respectively).Our results emphasise that sex is a key predictor of nutritional status among sub‐Saharan African adolescents and suggest that gender‐specific interventions may be required to reduce the double burden of under‐ and overnutrition.
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    Impact of COVID-19 on nutrition, food security and dietary diversity and quality in Burkina Faso, Ethiopia and Nigeria
    (Oxford University Press, 2021) Madzorera, Isabel; Ismail, Abbas; Hemler, Elena; Korte, Michelle; Olufemi, Adedokun; Wang, Dongqing; Assefa, Nega; Workneh, Firehiwot; Lankoande, Bruno; Chukwu, Angela; Ourohire, Millogo; Mattei, Josiemer; Soura, Abdramane; Berhane, Yemane; Sie, Ali; Oduola, Ayoade; Fawzi, Wafaie
    COVID-19 has far-reaching consequences for developing countries through the combined effects of infection and mortality and unintended consequences from mitigation measures. COVID-19 can adversely impact food systems and dietary diversity for populations. This cross-sectional study evaluated, using a mobile platform, the effect of COVID-19 on food prices and dietary diversity and quality, among 1797 households in Nouna and Ouagadougou (Burkina Faso), Addis Ababa and Kersa (Ethiopia), and Lagos and Ibadan. Methods: Dietary intake was assessed as the frequency of consumption of 20 food groups over the previous 7 days. Dietary diversity scores (DDS; range: 0–10) and Prime Diet Quality Score (PDQS; range: 0–40) assessed dietary diversity and quality. Linear regression models were used to evaluate associations between changes in the prices of staples, pulses, vegetables, fruits, and animal source foods (ASF) with DDS and PDQS during COVID-19. Most households reported increases in prices of staples, pulses, fruits, vegetables and ASF, and ≥40% reported decreased consumption of staples, legumes, ASF, other vitamin A rich vegetables, other vegetables and other fruits, and lower DDS and PDQS compared to the period before the COVID-19 emergency. Increases in pulse prices were associated with lower DDS (estimate − 0.35, 95% CI: −0.61, −0.09). Lower crop production (estimate − 0.70, 95% CI: −1.02, −0.37), and skipping meals (estimate − 0.39, 95% CI: −0.56, −0.21) or not eating for a whole day (estimate − 0.23, 95% CI: −0.43, −0.03) were also associated with lower DDS. The price increases and worsening dietary diversity and quality call for social protection and other strategies to increase the availability and affordability of nutrient-rich foods during the COVID19 pandemic and other public health emergencies.
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    Impact of COVID-19 on nutrition, food security and dietary diversity and quality in Burkina Faso, Ethiopia and Nigeria
    (OXFORD ACADEMIC, 2021) Madzorera, Isabel; Ismail, Abbas; Hemler, Elena; Korte, Michelle; Olufemi, Adedokun; Wang, Dongqing; Assefa, Nega; Workneh, Firehiwot; Lankoande, Bruno; Chukwu, Angela; Ourohire, Millogo; Mattei, Josiemer; Soura, Abdramane; Berhane, Yemane; Sie, Ali; Oduola, Ayoade; Fawzi, Wafaie
    COVID-19 has far-reaching consequences for developing countries through the combined effects of infection and mortality and unintended consequences from mitigation measures. COVID-19 can adversely impact food systems and dietary diversity for populations. This cross-sectional study evaluated, using a mobile platform, the effect of COVID-19 on food prices and dietary diversity and quality, among 1797 households in Nouna and Ouagadougou (Burkina Faso), Addis Ababa and Kersa (Ethiopia), and Lagos and Ibadan (Nigeria). Dietary intake was assessed as the frequency of consumption of 20 food groups over the previous 7 days. Dietary diversity scores (DDS; range: 0–10) and Prime Diet Quality Score (PDQS; range: 0–40) assessed dietary diversity and quality. Linear regression models were used to evaluate associations between changes in the prices of staples, pulses, vegetables, fruits, and animal source foods (ASF) with DDS and PDQS during COVID-19. Most households reported increases in prices of staples, pulses, fruits, vegetables and ASF, and ≥40% reported decreased consumption of staples, legumes, ASF, other vitamin A rich vegetables, other vegetables and other fruits, and lower DDS and PDQS compared to the period before the COVID-19 emergency. Increases in pulse prices were associated with lower DDS (estimate − 0.35, 95% CI: −0.61, −0.09). Lower crop production (estimate − 0.70, 95% CI: −1.02, −0.37), and skipping meals (estimate − 0.39, 95% CI: −0.56, −0.21) or not eating for a whole day (estimate − 0.23, 95% CI: −0.43, −0.03) were also associated with lower DDS. The price increases and worsening dietary diversity and quality call for social protection and other strategies to increase the availability and affordability of nutrient-rich foods during the COVID-19 pandemic and other public health emergencies. The Bill and Melinda Gates Foundation Grant as well as institutional support from the Heidelberg Institute of Global Health, Germany and the Harvard T.H. Chan School of Public Health, USA, supported this work.
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    The COVID-19 pandemic and its impacts on diet quality and food prices in sub-Saharan Africa
    (Public Library of Science (PLOS), 2023) Ismail, Abbas; Madzorera, Isabel; Apraku, Edward A.; Tinkasimile, Amani; Dasmane, Dielbeogo; Zabre, Pascal; Ourohire, Millogo; Assefa, Nega; Chukwu,Angela; Workneh, Firehiwot; Mapendo, Frank; Lankoande, Bruno; Hemler, Elena; Wang, Dongqing; Abubakari, Sulemana W.; Asante, Kwaku P.; Baernighausen, Till; Killewo, Japhet; Oduola, Ayoade; Sie, Ali; Soura, Abdramane; Vua, Said; Smith, Emily; Berhane, Yemane; Fawz, Wafaie W.
    Background Sub-Saharan Africa faces prolonged COVID-19 related impacts on economic activity, livelihoods and nutrition, with recovery slowed down by lagging vaccination progress. Objective This study investigated the economic impacts of COVID-19 on food prices, consumption and dietary quality in Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania. Methods We conducted a repeated cross-sectional study using a mobile platform to collect data from July-December, 2021 (round 2). We assessed participants’ dietary intake of 20 food groups over the previous seven days and computed the primary outcome, the Prime Diet Quality Score (PDQS), and Dietary Diversity Score (DDS), with higher scores indicating better quality diets. We used generalized estimating equation (GEE) linear regression models to assess factors associated with diet quality during COVID-19. Results Most of the respondents were male and the mean age was 42.4 (±12.5) years. Mean PDQS (±SD) was low at 19.4(±3.8), out of a maximum score of 40 in this study. Respondents (80%) reported higher than expected prices for all food groups. Secondary education or higher (estimate: 0.73, 95% CI: 0.32, 1.15), medium wealth status (estimate: 0.48, 95% CI: 0.14, 0.81), and older age were associated with higher PDQS. Farmers and casual laborers (estimate: -0.60, 95% CI: -1.11, -0.09), lower crop production (estimate: -0.87, 95% CI: -1.28, -0.46) and not engaged in farming (estimate: -1.38, 95% CI: -1.74, -1.02) were associated with lower PDQS. Conclusion Higher food prices and lower diet quality persisted during the COVID-19 pandemic. Economic and social vulnerability and reliance on markets (and lower agriculture production) were negatively associated with diet quality. Although recovery was evident, consumption of healthy diets remained low. Systematic efforts to address the underlying causes of poor diet quality through transforming food system value chains, and mitigation measures, including social protection programs and national policies are critical.
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    The COVID-19 pandemic and its prolonged impacts on food prices, food consumption and diet quality in sub-Saharan Africa
    (Cold Spring Harbor Laboratory, 2022) Ismail, Abbas; Madzorera, Isabel; Apraku, Edward A.; Tinkasimile, Amani; Dasmane, Dielbeogo; Zabre, Pascal; Ourohire, Millogo; Assefa, Nega; Chukwu, Angela; Workneh, Firehiwot; Mapendo, Frank; Lankoande, Bruno; Hemler, Elena; Wang, Dongqing; Abubakari, Sulemana W.; Asante, Kwaku P.; Baernighausen, Till; Killewo, Japhet; Oduola, Ayoade; Sie, Ali; Soura, Abdramane; Vuai, Said; Smith, Emily; Berhane, Yemane; Fawzi, Wafaie W.
    Background Sub-Saharan Africa faces prolonged COVID-19 related impacts on economic activity, livelihoods, nutrition, and food security, with recovery slowed down by lagging vaccination progress. Objective This study investigated the economic impacts of COVID-19 on food prices, consumption and dietary quality in Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania. Methods We conducted a repeated cross-sectional study and used a mobile platform to collect data. Data collected from round 1 (July-November, 2020) and round 2 (July-December, 2021) were considered. We assessed participants’ dietary intake of 20 food groups over the previous seven days. The study’s primary outcome was the Prime Diet Quality Score (PDQS), with higher scores indicating better dietary quality. We used linear regression and generalized estimating equations to assess factors associated with diet quality during COVID-19. Results Most of the respondents were male and the mean age (±SD) was 42.4 (±12.5) years. Mean PDQS (±SD) was low at 19.1 (±3.8) before COVID-19, 18.6(±3.4) in Round 1, and 19.4(±3.8) in Round 2. A majority of respondents (80%) reported higher than expected prices for all food groups during the pandemic. Secondary education or higher (estimate: 0.73, 95% CI: 0.32, 1.15), older age (estimate: 30-39 years: 0.77, 95% CI: 0.35, 1.19, or 40 years or older: 0.72, 95% CI: 0.30, 1.13), and medium wealth status (estimate: 0.48, 95% CI: 0.14, 0.81) were associated with higher PDQS. Farmers and casual laborers (estimate: -0.60, 95% CI: -1.11, - 0.09), lower crop production (estimate: -0.87, 95% CI: -1.28, -0.46) and not engaged in farming (estimate: -1.38, 95% CI: -1.74, -1.02) associated with lower PDQS. Conclusion Diet quality which had declined early in the pandemic had started to improve. However, consumption of healthy diets remained low, and food prices remained high. Efforts should continue to improve diet quality for sustained nutrition recovery through mitigation measures, including social protection.