Meeting the food needs of Africa's growing population will require innovative and appropriate technologies whose effectiveness needs to be assessed. To evaluate the impact of Solar Market Gardens (SMGs) on crops production diversity and dietary diversity in the Kalalé district of Northern Benin. In 2007, SMGs were installed in 2 villages for women's agricultural groups as a strategy for enhancing food and nutrition security. Data were collected through interviews at installation and 1 year later from all women's group households (30–35 women/group) and from a random representative sample of 30 households in each village, for both treatment and matched-pair comparison villages. Comparison of baseline and endline data indicated increases in the variety of fruits and vegetables produced and consumed by SMG women's groups compared to other groups. The proportion of SMG women’s group households engaged in vegetable and fruit production significantly increased by 26% and 55%, respectively (P < .05). After controlling for baseline values, SMG women's groups were 3 times more likely to increase their fruit and vegetable consumption compared with comparison non-women's groups (P < .05). In addition, the percentage change in corn, sorghum, beans, oil, rice and fish purchased was significantly greater in the SMG women’s groups compared to other groups. At endline, 57% of the women used their additional income on food, 54% on health care, and 25% on education. Solar Market Gardens have the potential to improve household nutritional status through direct consumption and increased income to make economic decisions.

Background: Public health literature is replete with evidence on individual and interpersonal indicators of modern contraceptive use. There is, however, limited knowledge regarding healthcare system indicators of modern contraceptive use. This study assessed how the healthcare system influences use of modern contraceptive among women in Ghana, Kenya, and two large population states in Nigeria. Methods: This study used data from Phase 1 of the Performance Monitoring and Accountability 2020. The analytical sample was limited to women with a need for contraception, defined as women of reproductive age (15 to 49 years) who wish to delay or limit childbirth. Therefore, this analysis consisted of 1066, 1285, and 1955 women from Nigeria, Ghana, and Kenya respectively. Indicators of healthcare assessed include user-fees, visit by health worker, type of health facility, multiple perinatal services, adolescent reproductive healthcare, density of healthcare workers, and regularity of contraceptive services. All analyses were conducted with SAS (9.4), with statistical significance set at p < 5%. Results: The prevalence of modern contraceptive was 22.7, 33.2, and 68.9% in Nigeria, Ghana, and Kenya respectively. The odds of modern contraceptive use were higher among Nigerian women who lived within areas that provide adolescent reproductive healthcare (OR = 2.05; 95% C.I. = 1.05—3.99) and Kenyan women residing in locales with polyclinic or hospitals (OR = 1.91; 1.27—2.88). Also, the odds of contraceptive use were higher among Kenyan women who lived in areas with user-fee for contraceptive services (OR = 1.40; 1.07–1.85), but lower among Ghanaian women residing in such areas (OR = 0.46; 0.23—0.92). Lastly, the odds of modern contraceptive use were higher among women visited by a health-worker visit among women in Ghana (OR = 1.63; 1.11—2.42) and Nigeria (OR = 2.97; 1.56—5.67) than those without a visit. Conclusion: This study found an association between country-specific indicators of healthcare and modern contraceptive use. Evidence from this study can inform policy makers, health workers, and healthcare organizations on specific healthcare factors to target in meeting the need for contraception in Ghana, Kenya, and Nigeria.

The prevalence and severity of natural hazards pose a serious risk to food systems, undermining their function to provide food security and improved nutrition. The impact of such events is extensive, and the level of damage and recovery significantly depend on ecosystem services, including their own resilience capacity. This paper provides evidence that the role, value, and utilization of local ecosystem services are essential for food system resilience and for food security in parts of the world where high vulnerability and lack of coping capacity exist to combat climate change. Patterns of ecosystem services-based strategies were revealed that can be introduced to cope and adapt to climate-related natural hazards at the smallholder food system level. The study suggests that food system diversification, technological innovations and nature-based practices, and traditional and indigenous knowledge operationalized across the food system components have a potential for sustaining smallholder resilience in the face of natural hazards.

Background: The clinical burden of Long COVID, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and other post-infectious fatiguing illnesses (PIFI) is increasing. There is a critical need to advance understanding of the effectiveness and sustainability of innovative approaches to clinical care of patients having these conditions. Methods: We aim to assess the effectiveness of a Long COVID and Fatiguing Illness Recovery Program (LC&FIRP) in a two-arm, single-blind, pragmatic, quality improvement, professional cluster, randomized controlled trial in which 20 consenting clinicians across primary care clinics in a Federally Qualified Health Center system in San Diego, CA, will be randomized at a ratio of 1:1 to either participate in (1) weekly multi-disciplinary team-based case consultation and peer-to-peer sharing of emerging best practices (i.e., teleECHO (Extension for Community Healthcare Outcomes)) with monthly interactive webinars and quarterly short courses or (2) monthly interactive webinars and quarterly short courses alone (a control group); 856 patients will be assigned to participating clinicians (42 patients per clinician). Patient outcomes will be evaluated according to the study arm of their respective clinicians. Quantitative and qualitative outcomes will be measured at 3- and 6-months post-baseline for clinicians and every 3-months post assignment to a participating clinician for patients. The primary patient outcome is change in physical function measured using the Patient-Reported Outcomes Measurement Information System (PROMIS)-29. Analyses of differences in outcomes at both the patient and clinician levels will include a linear mixed model to compare change in outcomes from baseline to each post-baseline assessment between the randomized study arms. A concurrent prospective cohort study will compare the LC&FIRP patient population to the population enrolled in a university health system. Longitudinal data analysis approaches will allow us to examine differences in outcomes between cohorts. Discussion: We hypothesize that weekly teleECHO sessions with monthly interactive webinars and quarterly short courses will significantly improve clinician- and patient-level outcomes compared to the control group. This study will provide much needed evidence on the effectiveness of a technology-enabled multi-disciplinary team-based care model for the management of Long COVID, ME/CFS, and other PIFI within a federally qualified health center. Trial registration: ClinicalTrials.gov, NCT05167227. Registered on December 22, 2021.