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BackgroundThis research prioritization aimed to identify major research gaps in maternal, newborn, child and adolescent health (MNCAH) to help mitigate the direct and indirect effects of the COVID-19 pandemic.MethodsWe adapted the Child Health and Nutrition Research Initiative methodology. We defined scope, domains, themes and scoring criteria. We approached diverse global experts via email to submit their research ideas in MNCAH and MNCAH-related cross-cutting/health systems area. We curated the research ideas as research questions (RQs) and sent them to the consenting experts for scoring via the online link. For each RQ, the research priority score (RPS) was calculated as an average of individual criterion scores and ranked based on RPS in each area.ResultsWe identified top-ranked 10 RQs in each maternal, newborn, and child and adolescent health and 5 in the cross-cutting/health systems area. In maternal health, indirect effects on care, measures to improve care, health risks and outcomes, and preventing and managing SARS-CoV-2 infection/COVID-19 disease were priority RQs. In newborn health, clinical characterization and managing SARS-CoV-2 infection/COVID-19 disease, mode of transmission and interventions to prevent transmission were the focus. For child and adolescent health, top-ranked RQs were indirect effects on care, clinical status and outcomes, interventions to protect against SARS-CoV-2 infection/COVID-19 disease, and educational institute-related RQs. The cross-cutting RQs were the effects of the pandemic on availability, access, care-seeking and utilization of MNCAH services and potential solutions.ConclusionsWe call on partners, including governments, non-governmental organizations, research institutes, and donors, to address this urgent research agenda.

PurposeThe development of valid measures of built environments relevant for physical activity is an important step toward controlling the global epidemic of physical inactivity-related noncommunicable diseases and deaths. This study assessed the construct validity of a self-report neighborhood environment walkability scale adapted for Africa (NEWS-Africa), by examining relationships with self-reported walking for transportation and recreation using pooled data from six sub-Saharan African countries.MethodsNEWS was systematically adapted to assess urban, periurban, and rural environments in sub-Saharan Africa. Adults (n = 469, 18-85 yr, 49.7% women) from Cameroon, Ghana, Mozambique, Nigeria, South Africa, and Uganda were purposively recruited from neighborhoods varying in walkability and socioeconomic status, with some from villages. Participants completed the 76-item (13 subscales) NEWS-Africa by structured interview and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire.ResultsThe overall "walkability" index had a positive relationship with both walking for transportation (η = 0.020, P = 0.005) and recreation (η = 0.013, P = 0.028) in the pooled analyses. The mixed-use access and stranger danger scales were positively related with transport walking (η = 0.020, P = 0.006 and η = 0.021, P = 0.040, respectively). Proximity of recreational facilities (η = 0.016, P = 0.015), road/path connectivity (η = 0.025, P = 0.002), path infrastructure (η = 0.021, P = 0.005), and overall places for walking and cycling (η = 0.012, P = 0.029) scales were positively related to recreational walking. Country-specific results were mostly nonsignificant except for South Africa and Uganda.ConclusionsOf 14 NEWS-Africa scales, 7 were significantly related to walking behavior in pooled analyses, providing partial support for the construct validity of NEWS-Africa. However, effect sizes appeared to be lower than those from other continents. Further study with larger and more diverse samples is needed to determine whether the instrument performs well in each country.

BackgroundBuilt environment and policy interventions are effective strategies for controlling the growing worldwide deaths from physical inactivity-related non-communicable diseases. To improve built environment research and develop African specific evidence, it is important to first tailor built environment measures to African contexts and assess their psychometric properties across African countries. This study reports on the adaptation and test-retest reliability of the Neighborhood Environment Walkability Scale in seven sub-Saharan African countries (NEWS-Africa).MethodsThe original NEWS comprising 8 subscales measuring reported physical and social attributes of neighborhood environments was systematically adapted for Africa through extensive input from physical activity and public health researchers, built environment professionals, and residents in seven African countries: Cameroon, Ghana, Kenya, Mozambique, Nigeria, South Africa and Uganda. Cognitive testing of NEWS-Africa was conducted among diverse residents (N = 109, 50 youth [12 - 17 years] and 59 adults [22 - 67 years], 69 % from low socioeconomic status [SES] neighborhoods). NEWS-Africa was translated into local languages and evaluated for 2-week test-retest reliability in adult participants (N = 301; female = 50.2 %; age = 32.3 ± 12.9 years) purposively recruited from neighborhoods varying in walkability (high and low walkable) and SES (high and low income) and from villages in six of seven participating countries.ResultsThe original 67 NEWS items was expanded to 89 scores (76 individual NEWS items and 13 computed scales). Several modifications were made to individual items, and some new items were added to capture important attributes in the African environment. A new scale on personal safety was created, and the aesthetics scale was enlarged to reflect African specific characteristics. Over 95 % of all NEWS-Africa scores (items plus computed scales) demonstrated evidence of "excellent" (ICCs > .75 %) or "good" (ICCs = 0.60 to 0.74) reliability. Seven (53.8 %) of the 13 computed NEWS scales demonstrated "excellent" agreement and the other six had "good" agreement. No items or scales demonstrated "poor" reliability (ICCs

Mental development refers to the cognitive, language, socio-emotional and fine motor maturity of children as they age. It is now acknowledged that 39% of children under 5 years of age [...], OBJECTIVES: Two studies aimed to assess the provision of nutrition and psychosocial stimulation in the home and to examine associations between mental development and nutrition and stimulation using a validated measure of development milestones. METHODS: The first study consisted of secondary analyses on health and nutrition data from 1081 mother-child pairs (the children aged 0-12 months) and their households in Ghana&apos;s Eastern Region. For the second study, the Ghana Milestones Measure, consisting of items assessing cognitive and language development, was used to assess child development in a subsample (N = 330) of Study 1 participants one year later (children 10-24 months of age). This measure was mother-reported and had been validated in a separate community in Ghana. Correlation and linear regression analyses were used to analyze the data. RESULTS: Family assets and maternal education were identified as key factors of the family context. Both variables were positively associated with preventive health practices (r = 0.08 to 0.13, p < 0.0001 to 0.01), and dietary diversity (r = 0.15, p = 0.0001 to 0.0006), and negatively associated with maternal depressive symptoms (r = -0.19 to -0.12, p < 0.0001). Taller children had higher receptive (standardized beta = 0.16; p = 0.04) and expressive (0.21; 0.003) language, but not cognitive (0.15; 0.07) milestone scores, and psychosocial stimulation was positively associated with all three milestones (receptive = 0.13, p = 0.01; expressive = 0.21, p < 0.0001; and cognitive = 0.24, p < 0.0001). CONCLUSION: Our study provides the first validated measure of children&apos;s language and cognitive development in Ghana, finding associations with nutrition and stimulation. The Ghana Milestones Measure can be used to assess and help promote children&apos;s mental development. KEY WORDS: Child development; cognitive/language milestones; home environment; Ghana OBJECTIFS : Deux etudes ont evalue la nutrition et la stimulation psychosociale en milieu familial et ont examine les associations entre le developpement mental d&apos;une part, et la nutrition et la stimulation d&apos;autre part, a l&apos;aide d&apos;un indicateur valide des etapes de developpement. METHODE : Pour la premiere etude, des analyses secondaires des donnees de sante et de nutrition de 1 081 couples mere-enfant (les enfants etant ages de 0 a 12 mois) et de leurs menages ont ete menees dans la Region orientale du Ghana. La seconde etude a fait appel au Ghana Milestones Measure, un indicateur d&apos;evaluation du developpement cognitif et de l&apos;acquisition du langage, pour evaluer le developpement des enfants dans un sous-echantillon (N = 330) des participants de l&apos;etude 1 un an plus tard (les enfants etant ages de 10 a 24 mois). Les elements de l&apos;indicateur ont ete declares par les meres et valides dans une autre communaute du Ghana. Les donnees ont ete analysees par correlation et par regression lineaire. RESULTATS : L&apos;actif familial et l&apos;instruction maternelle ont ete juges etre les facteurs cles du milieu familial. Ces deux variables etaient associees positivement aux pratiques sanitaires preventives (r = 0,08 a 0,13, p < 0,0001 a 0,01) et a la diversite alimentaire (r = 0,15, p = 0,0001 a 0,0006), et associees negativement aux symptomes depressifs maternels (r = -0,19 a -0,12, p < 0,0001). Le langage receptif (coefficient normalise [beta] = 0,16; p = 0,04) et expressif (0,21; 0,003) des enfants de plus grande taille etait plus developpe, mais non leurs indices de developpement cognitif (0,15; 0,07), et la stimulation psychosociale etait associee positivement aux trois etapes (langage receptif = 0,13, p = 0,01; langage expressif = 0,21, p < 0,0001; et developpement cognitif = 0,24, p < 0,0001). CONCLUSION : Notre etude, qui offre le premier indicateur valide du developpement linguistique et cognitif des enfants au Ghana, etablit des associations avec la nutrition et la stimulation. L&apos;outil Ghana Milestones Measure peut etre utilise pour evaluer et contribuer a favoriser le developpement mental des enfants. MOTS CLES : developpement de l&apos;enfant; etapes cognitives et d&apos;acquisition du langage; milieu familial; Ghana

Developing Ghana's first Food-based dietary guidelines: An evidence-informed process Globally, sub-optimal diets across the entire lifecycle have been identified as an important driver of malnutrition in all its forms (global [...]