The available literature suggests that natural disasters, especially droughts and floods, were occurring in southern Africa in the early 1900s. However, their frequency and intensity increased during the 1980s. The aim of this systematic review was to assess the relationship between resilience to droughts and people’s well-being in southern Africa. A combination of keywords was used to search the following 13 electronic bibliographic databases: Africa Journal Online (AJOL), MEDLINE, Academic Search Complete, Environment Complete, Humanities International Complete, Psychology and Behavioral Sciences Collection, PsycINFO, Embase, Scopus, Web of Science, Applied Social Science Index and Abstracts, ProQuest Central, and CINAHL. Relevant websites were also searched and potential studies for inclusion were downloaded in an EndNote database and screened for eligibility using pre-determined criteria. Quality assessment of the studies was undertaken using the Joana Briggs Qualitative Assessment and Review Instrument, the National Institutes of Health (NIH) checklist, and the Authority, Accuracy, Coverage, Objectivity, Date, Significance (AACODS) checklist. Resilience and well-being scales used in the studies for inclusion were also assessed using pre-defined criteria. Nineteen studies met the inclusion criteria. Poverty alleviation policies were important in strengthening resilience and well-being outcomes. Resilience and well-being were connected by old age, gender, race, adaptive farming and livelihoods diversification, security, and knowledgeability. Resilience and well-being outcomes were advanced by the synergistic effect of household, community and governance level capacities encapsulated in knowledgeability. This systematic review is critical to improving southern Africa context-specific resilience, and well-being policies and interventions.

Undernutrition is an important public health indicator for monitoring nutritional status and survival. In spite of its importance, undernutrition is a significant problem health problem in many East African communities. The aim of this study was to identify factors associated with childhood undernutrition in three disadvantaged East African Districts. We examined data for 9270 children aged 0–59 months using cross-sectional survey from Gicumbi District in Rwanda, Kitgum District in Uganda and Kilindi District in Tanzania. We considered the level of undernutrition (stunting, wasting and underweight) as the outcome variables with four ordinal categories (severely undernourished, moderately undernourished, mildly undernourished, and nourished). Generalized linear latent and mixed models (GLLAMM) with the mlogit link and binomial family that adjusted for clustering and sampling weights were used to identify factors associated with undernutrition among children aged 0–59 months in three disadvantaged East African Districts. After adjusting for potential confounding factors, the odds of a child being stunted were higher in Gicumbi District in Rwanda while the odds of a child being wasted and underweight were higher in Kitgum District in Uganda. Having diarrhoea two weeks prior to the survey was significantly associated with severe undernutrition. Wealth index (least poor household), increasing child’s age, sex of the child (male) and unavailability of water all year were reported to be associated with moderate or severe stunting/wasting. Children of women who did not attend monthly child growth monitoring sessions and children who had Acute Respiratory Infection (ARI) symptoms were significantly associated with moderate or severe underweight. Findings from our study indicated that having diarrhoea, having ARI, not having water availability all year and not attending monthly child growth monitoring sessions were associated with undernutrition among children aged 0–59 months. Interventions aimed at improving undernutrition in these disadvantaged communities should target all children especially those children from households with poor sanitation practices.

Background: Despite the negative impact of chronic school absenteeism on the psychological and physical health of adolescents, data on the burden of adolescent chronic school absenteeism (ACSA) and interventions and programs to address it are lacking. We estimated the global, regional and national level prevalence of ACSA and its correlation with violence and unintentional injury, psychosocial, protective, lifestyle, and food security-related factors among in-school adolescents across low and middle-income, and high-income countries (LMICs–HICs). Objectives: This study aimed to estimate the prevalence of chronic school absenteeism (CSA) as well as to determine its associated factors among in-school adolescents across 71 low-middle and high-income countries. Methods: We used data from the most recent Global School-based Student Health Survey of 207,107 in-school adolescents aged 11–17 years in 71 LMICs-HICs countries across six WHO regions. We estimated the weighted prevalence of ACSA from national, regional and global perspectives. Multiple binary logistic regression analyses were used to estimate the adjusted effect of independent factors on ACSA. Results: The overall population-weighted prevalence of CSA was 11·43% (95% confidence interval, CI: 11·29–11·57). Higher likelihood of CSA was associated with severe food insecurity, peer victimisation, loneliness, high level of anxiety, physically attack, physical fighting, serious injury, poor peer support, not having close friends, lack of parental support, being obese, and high levels of sedentary behaviours. Lower likelihood of CSA was associated with being female (odds ratio, OR = 0·76, 95% CI: 0·74–0·78). Conclusion: Our findings indicate that a combination of different socio-economic factors, peer conflict and injury factors, factors exacerbate CSA among adolescents. Interventions should be designed to focus on these risk factors and should consider the diverse cultural and socioeconomic contexts.

Lesotho and Swaziland experience intense, recurring drought resulting in disaster situations. Despite the recurrence of drought, both its influence on rural subsistence communities’ support systems and the actions that enable structures of resilience remain poorly understood. Each incidence of drought stimulates a disaster resilience discussion that stalls without achievement of positive results until the next disaster. This study has examined the influence of recurring drought on communities’ inherent resilience and proposes an evidence-based framework to enhance community resilience. Data were collected from 16 focus group discussions (N = 197) in the Highveld, Midveld and Lowveld agro-ecological regions of Swaziland and Lesotho. Themes and subthemes have been identified, defined, categorised and narrated using structuration theory as a guide. Resilience activities were found to be characterised by knowledgeability and changes in behaviour in adapting and applying appropriate actions, all of which were enhanced by institutional support. The effectiveness of institutional support hinged on harnessing communities’ knowledge, social groups, value systems, connectedness, participation, decision-making and collectivism. Large-scale interventions to build and strengthen resilience are urgently needed in order to maintain cohesiveness and development gains, especially because rural subsistence farmers make up the majority of these two countries’ populations. Policies that integrate resilience with national development planning must be urgently developed and executed.

The southern African kingdoms of Eswatini and Lesotho experience recurrent drought-induced disasters. Policies have been enacted, but no attempt has been made to synthesise the effects on disaster resilience. This review analyses the characteristics, quality, and comprehensiveness of drought-resilience policies in Eswatini and Lesotho. We have systematically reviewed public policies that shape responses to disaster resilience published between 1 January 1980 and 30 June 2019. A combination of keywords was used to search electronic bibliographic databases, multidisciplinary databases, key organisational websites, and the first 20 pages of Google for policies that addressed disaster and/or drought resilience. Identified documents were downloaded into an EndNote database and screened for eligibility using predetermined criteria. The logic of events framework was used for quality assessment, and a metaethnographic approach was applied for data synthesis. Three broad categories of characteristics, thematic outcomes and quality, and comprehensiveness of policy documents emerged and are presented. Policy responses contributing to disaster resilience were found in n = 32 out of 13,700 documents. Three (n = 3/32) policies were statutory, and the rest were nonstatutory. Eleven (n = 11/32) were assessed to be of high quality. Policy responses relating to drought resilience focused on reducing vulnerability to recurrent disasters; promoting drought and climate change adaptation; improving agriculture and food security; safeguarding cultural heritage; and preventing gender inequality and gender-based violence as well as improving disaster governance. However, the construct of drought resilience was not strongly articulated as a major policy goal across policy documents. There is an urgent need to promote better understanding of drought resilience in order to motivate policymakers to steer away from reactive interventions and position resilience as a major national policy goal in both countries to expedite inclusive growth and safeguard development gains and the health and wellbeing of the majority of their populations who are rural-based populations.

Southern Africa has long been vulnerable to climate-induced disasters, especially droughts and floods. The severity and frequency of disasters increased in the early 1980s, continuously eroding livelihoods, which in turn invoked humanitarian intervention. A systematic review of the relationship between resilience to drought and well-being will be undertaken. Studies will be included if they were conducted between January 1980 and December 2017; used quantitative and/or qualitative methods; were peer reviewed or comprise grey literature; covered Southern Africa; and measured resilience and its relationship to well-being. Data extraction will be informed by the Cochrane Public Health Group and the Joanna Briggs Institute manuals. The quality of evidence of the studies included will be assessed for risk bias, psychometric properties of tools used, and their suitability. The findings will be summarised into themes and narrated. This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. The protocol gives insight of the scope and parameters for the systematic review to be carried out. The systematic review will establish how resilience to climate-induced disasters affects well-being. It will also provide recommendations to improve humanitarian coordination in Southern Africa. The protocol was registered by the PROSPERO international prospective register of systematic reviews, reference CRD42017064396 .