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Background: Medicinal plants (MPs) are widely accepted and used in most rural communities in sub-Saharan Africa and beyond to treat and control village chicken (VC) diseases and parasites. They are readily available, accessible and cheap. Moreover, they are nature friendly and have adapted to the local environment, making them easy to produce. Over and above, their use has health benefits for consumers. Little is known about the opportunities and challenges faced when commercialising these MPs. Aim: It imperative to unpack the opportunities and challenges that are encountered while commercialising MPs used for treating VC diseases and controlling parasites. Despite these multiple benefits, the commercialisation of these plants seems to be under researched. In South Africa, different rural communities use various MPs in their locality. For instance, most rural families in South Africa are using Aloe ferox, Helichrysum petiolare, Tagetes minuta, Lippia javanica, Agave sisalana, Gunnera perpensa and Millettia grandis. Conspicuously, not much is known about the efforts made to commercialise these products. Method: Through a systematic review of the literature, this paper unpacks the trends, opportunities and challenges faced in commercialising MPs used to treat VC disease and control parasites. Results: Results have revealed that globally MPs for VC management are not widely recognised, despite their wide usage by local communities. If properly harnessed, they have the potential to strengthen local economic development through income generation. However, currently, little is derived from the sale of these products because of the presence of middlemen. Their commercialisation efforts are hampered by the lack of organised support systems and networks, lack of regularisation strategies and clear criteria for supporting quality, protection and presumed efficiency. Conclusion: By commercialising MPs, local farmers can exploit MPs beyond the village chickens to broiler and layer chickens, thus offering alternative chicken health and affordable medicinal options for the farmers. Contribution: The study contributes to understanding the available opportunities and challenges in commercialising MPs used for village chicken health management. It further demonstrates that MPs for village health can be used to transform the livelihoods of the custodians of these plants. [ABSTRACT FROM AUTHOR]

Background: A major disparity exists in access to specialised healthcare between rural and urban areas. Specialist outreach programmes are one of the ways in which rural specialist healthcare inequality is being addressed. A number of rural district hospitals (RDH) employ local, private specialists (LPS) to supplement public specialist outreach. Limited research exists on private specialist outreach and support (PSOS) in sub-Saharan Africa or South Africa. Methods: This was a descriptive, exploratory, qualitative study using thematic analysis of semi-structured interviews. Non-probability, purposive sampling was used to obtain a sample size of 16 participants. The audio recordings were transcribed verbatim and analysed with the framework method and ATLAS.ti version 8© software. Results: Four major themes emerged, namely roles of LPS, effects, sustainability and feasibility of PSOS. Overall PSOS was considered sustainable, feasible and had positive effects in and beyond the sub-districts. The value of PSOS was supported by improved access and timeliness of services, improved competency of RDH medical practitioners, improved coordination, comprehensiveness and continuity of care. Private specialist outreach and support was, however, associated with increased burden on the RDH resources and required a basic level of RDH infrastructure to function effectively. Conclusion: The perceived contribution of private specialist outreach services was positive overall. Implementation in RDHs is feasible, but should involve consideration of factors in the hospital, town, sub-district and district prior to implementation. Contribution: This paper provides evidence that private specialist outreach and support services are feasible in the state health sector, provided that certain considerations are taken into account. [ABSTRACT FROM AUTHOR]

Background: Community health worker (CHW) programmes, when adequately integrated into mainstream health systems, can provide a viable, affordable and sustainable path to strengthened health systems that better meets demands for improved child health, especially in resource-constrained settings. However, studies that report on how CHW programmes are integrated into respective health systems in sub-Saharan Africa (SSA) are missing. Aim: This review presents evidence on CHW programmes' integration into National Health Systems for improved health outcomes in SSA. Setting: Sub-Saharan Africa. Method: Six CHW programmes representing three sub-Saharan regions (West, East, and Southern Africa) were purposively selected based on their deemed integration into respective National Health Systems. A database search of literature limited to the identified programmes was then conducted. Screening and literature selection was guided a scoping review framework. Abstracted data were synthesised and presented in a narrative form. Results: A total of 42 publications met the inclusion criteria. Reviewed papers had an even focus on all six CHW programmes integration components. Although some similarities were observed, evidence of integration on most CHW programme integration components varied across countries. The linkage of CHW programmes to respective health systems runs across all reviewed countries. Some CHW programme components such as CHW recruitment, education and certification, service delivery, supervision, information management, and equipment and supplies are integrated into the health systems differently across the region. Conclusion: Different approaches to the integration of all the components depict complexity in the field of CHW programme integration in the region. Contribution: The study presents synthesized evidence on CHW programmes integration into national health systems in SSA. [ABSTRACT FROM AUTHOR]

Background: After coronavirus disease 2019 (COVID-19) was declared a pandemic, movement restrictions were implemented across sub-Saharan Africa. There has been much speculation on what the long-term impacts on urban transport might be. Objectives: The aim of this paper is to identify the revealed and future travel impacts of the pandemic. Method: To pursue this aim, evidence was compiled from two sources: secondary big data; and a (n = 15) two-wave Delphi panel survey of experts in the region. Results: It is predicted that longer-term impacts will take the form of: reduced travel by, and accessibility for, low-income households residing in peripheral locations because of decreased welfare; reduced transport service availability; operator reduction (particularly amongst unsubsidised formal operators); increased remote activity participation for a minority of better resourced households with white-collar workers; and disrupted trip distributions as the mix of city-centre land use changes in response to business attrition in economic recession rather than to disrupted bid rents. Conclusion: The major impact of the pandemic is likely to be on welfare, rather than on trip substitution. There is a need, therefore, to focus policy on the mitigation of these impacts and, more particularly, on ways of measuring changes in transport disadvantage and exclusion so that reliable data are available to inform mitigation strategies. The mitigation strategies considered should include investment in affordable 'digital connectivity' as a means of complementing accessibility from physical proximity and mobility. The pandemic also highlights the need to develop more robust transport planning practices to deal with uncertainty. [ABSTRACT FROM AUTHOR]

Globally the health space is being revolutionised by rapid digital transformation to support care activities, promote healthier lifestyles and ensure informed decision making to improve service delivery. However, many health systems in sub-Saharan Africa are yet to realise the full potential of health information systems (HIS) as a digital transformation initiative. The objective of this article is to establish how the sociotechnical challenges in Africa's health systems can be addressed by recommending a fitting approach to implement HIS relevant to the context of the continent. The Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) technique was applied to search, identify and filter articles over a 10-year period by applying inclusion and exclusion criteria accordingly. Only 42 articles satisfied the objective of this article. The emergent themes include contextual factors, coordination and collaboration, data complexity, organisation structure, accountability and stakeholders' perspectives. The results indicated that less attention has been given to how the implementation approach could impact the output of health systems. In conclusion, the authors argue that a decentralised approach to the implementation of HIS is more appropriate for Africa's health systems. The premise of the authors' argument is informed by the tiered structure of health systems, varying levels of infrastructural development and use of large volumes of healthrelated data for resources allocation at the national level. Future studies should investigate the processes for formulation and evaluation of health policies to actively redress the administrative issues associated with the current functional HIS in each African country. Transdisciplinarity Contribution: The paper contributes to the practical implications of implementing HIS in sub-Saharan African health systems by highlighting the contextual realities and data governance complexities that support a decentralised approach towards ensuring resilience and health security. [ABSTRACT FROM AUTHOR]

Issues: The scarcity of pathologists in sub-Saharan Africa is a well established fact that is attributable to few training programmes in the region; this is further compounded by the lack of harmonised curricula, training and exams within and without member countries. Description of the intervention: Through the Association of Pathologists of East, Central and Southern Africa, the College of Pathologists of East, Central and Southern Africa (COPECSA) was formed with the clear-cut goal of establishing a regional and internationally recognised college to support and inform good quality medical and laboratory practice by promoting leadership, mentorship and excellence in the safe practice of pathology through training, exams, accreditation, advocacy and professional development for health. Lessons learnt: Since its inception in 2010, COPECSA has conferred fellowships to 120 practising pathologists in the East, Central and Southern Africa in partnership with international organisations; the college has been awarded five competitive grants and conducted several quality improvement workshops. Recommendations: This paper describes the journey that COPECSA has made towards standardising the practice and training of pathology in the East Central and Southern Africa region. [ABSTRACT FROM AUTHOR]

In the context of addressing the pressing health needs for the global population, the World Health Organization has repeatedly called for universal health coverage (UHC) to be prioritised by its member countries. This is to be achieved through a high-quality primary health care (PHC) approach that provides comprehensive and integrated generalist care as close to where people live as well as links the clinical care to health promotion and disease prevention. In this paper, we argue for the introduction of family medicines as a critical player in the healthcare system of Tanzania to strengthen the strategies towards UHC. The paper reviews how PHC is understood, the context of family medicine in sub-Saharan Africa and makes a case for how family medicine can assist in addressing the current burden of disease in Tanzania. [ABSTRACT FROM AUTHOR]

Background Workforce factors present a significant barrier to the development of rehabilitation services for people with communication disabilities in sub-Saharan Africa (SSA). Exploring how the work of speech and language therapists (SLTs) in the region is organised and delivered can provide insight into existing services, areas for future workforce development and improved rehabilitation access for people with communication disability. Objectives This paper describes the employment and service provision patterns and work roles of a sample of SLTs in SSA. Method A broad, purpose-designed, mixed-methods survey was designed to collect data from SLTs living in Anglophone countries of SSA. Descriptive statistics and qualitative content analysis were undertaken. This paper reports on a subset of data from the wider survey. Results A description of the employment and work roles of the 33 respondents to the survey and characteristics of their service users is presented. SLTs were commonly employed within private and not-for-profit sectors and frequently worked in temporary jobs. SLTs engaged in a range of work roles, including capacity building and training others. Services were provided by SLTs across age ranges, health conditions and settings, with paediatric, urban services commonly reported. Costs for service users and urban-centred services give indications of barriers to service access. Conclusion Knowledge of the way in which speech and language therapy services are organised and provided has the potential to shape the development of communication disability rehabilitation in SSA. This research has identified a range of issues requiring consideration as the profession develops and grows. [ABSTRACT FROM AUTHOR]