Diabetes is one of the leading non-communicable diseases in Africa, contributing to the increasing disease burden among the old adults. Thus, the aim of this study was to determine the prevalence and determinants of diabetes among adults aged 50 years and above in Ghana. A cross sectional study based on data collected from Study of Ageing and Adult Health (SAGE) Wave 1 from 2007 to 2008. Data was collected from 5565 respondents of whom 4135 were aged 50+ years identified using a multistage stratified clusters design. Bivariate and hierarchical multivariable logistic regression models were used to examine the association of the determinants and diabetes. The weighted prevalence of diabetes among the adults aged 50 years and above in Ghana was 3.95% (95% Confidence Interval: 3.35–4.55) with the prevalence being insignificantly higher in females than males (2.16%, 95% CI: 1.69–2.76 vs. 1.73%, 95% CI: 1.28–2.33). Low level of physical activity (Adjusted Odds Ratio [AOR] 2.11, 95% CI: 1.21–3.69) and obesity (AOR 4.81, 95% CI: 1.92–12.0) were associated with increased odds of diabetes among women while old age (AOR 2.58, 95% CI: 1.29–5.18) and university (AOR 12.8, 95% CI: 4.20–39.1), secondary (AOR 3.61, 95% CI: 1.38–9.47) and primary education (AOR 2.71, 95% CI: 1.02–7.19) were associated with increased the odds of diabetes among men. The prevalence of diabetes among old adults shows a similar trend with that of the general population. However, the prevalence may have been underestimated due to self-reporting and a high rate of undiagnosed diabetes. In addition, the determinants of diabetes among older adults are a clear indication of the need for diabetes prevention programme targeting the young people and that are gender specific to reduce the burden of diabetes at old age. Physical activity and nutrition should be emphasised in any prevention strategy.

Early initiation of breastfeeding (EIBF) lowers the risk for all-cause mortality in babies, including those with low birth weight. However, rates of neonatal mortality and delayed initiation of breastfeeding remain high in most low- and middle-income countries. This study aimed to assess the trends and factors associated with EIBF in Namibia from 2000 to 2013. An analysis of EIBF trends was conducted using data from three Namibia Demographic Health Surveys. The present sample included singleton children younger than 2-years from 2000 (n = 1655), 2006–2007 (n = 2152) and 2013 (n = 2062) surveys. Descriptive statistics were used to analyse respondents’ demographic, socioeconomic and obstetric characteristics. Factors associated with EIBF were assessed using univariate analysis and further evaluated using multivariable logistic regression analysis. EIBF significantly decreased from 82.5% (confidence interval [CI]: 79.5–85.0) in 2000 to 74.9% (72.5–77.2) in 2013. Factors associated with EIBF in 2000 were urban residence (adjusted odds ratio 0.58, 95% CI: 0.36–0.93), poorer household wealth index (1.82, 1.05–3.17), lack of antenatal care (0.14, 0.03–0.81), small birth size (0.38, 0.24–0.63) and large birth size (0.51, 0.37–0.79). In 2013, factors associated with EIBF were maternal age of 15–19 years (2.28, 1.22–4.24), vaginal delivery (2.74, 1.90–3.93), married mothers (1.57, 1.16–2.14), delivery assistance from health professionals (3.67, 1.23–10.9) and birth order of fourth or above (1.52, 1.03–2.26). Namibia has experienced a declining trend in EIBF rates from 2000 to 2013. Factors associated with EIBF differed between 2000 and 2013. The present findings highlight the importance of continued commitment to addressing neonatal health challenges and strengthening implementation of interventions to increase EIBF in Namibia.

Workplace violence (WPV) is a major occupational and health hazard for nurses. It affects nurses' physical and psychological well-being and impacts health service delivery. We aimed to assess the prevalence and describe the consequences of WPV experienced by nurses working in an emergency department in Kenya. We conducted a descriptive cross-sectional study among emergency nurses at one of the largest tertiary hospitals in Kenya. We collected data using a structured questionnaire adapted from the ‘WPV in the Health Sector, Country Case Studies Research Instruments’ questionnaire. We described the prevalence and effects of WPV using frequencies and percentages. Of the 82 participating nurses, 64.6% were female, 57.3% were married and 65.8% were college-educated (65.8%). Participants' mean age was 33.8 years (standard deviation: 6.8 years, range: 23–55). The overall lifetime prevalence of WPV was 81.7% (n = 67, 95% confidence interval [CI]: 71.6%–88.8%) and the 1-year prevalence was 73.2% (n = 63, 95% CI: 66.3–84.8%). The main WPV included verbal abuse, physical violence, and sexual harassment. Most incidents were perpetrated by patients and their relatives. No action was taken in 50% of the incidents, but 57.1% of physical violence incidents were reported to the hospital security and 28.6% to supervisors. Perpetrators of physical violence were verbally warned (42.9%) and reported to the hospital security (28.6%). Workplace violence is a significant problem affecting emergency nurses in Kenya. Hospitals should promote workplace safety with zero-tolerance to violence. Nurses should be sensitised on WPV to mitigate violence and supported when they experience WPV.

Background: Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania.Methods: We conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016–2017). A woman who mentioned at least three out of five BPCR components was considered well-prepared. Bivariate and multivariable proportional odds model were used to determine the factors associated with the BPCR. The STROBE guidelines for cross-sectional studies informed the design and reporting of this study.Results: Only 11.4% (59/519) and 7.6% (31/409) of women were well-prepared for birth and its complications in Kenya and Tanzania, respectively, while 39.7 and 30.6% were unprepared, respectively. Level of education (primary: adjusted odds ratio (aOR): 1.59, 95% CI: 1.14–2.20, secondary: aOR: 2.24, 95% CI: 1.39–3.59), delivery within health facility (aOR: 1.63, 95% CI: 1.15–2.29), good knowledge of danger signs during pregnancy (aOR: 1.28, 95% CI: 0.80–2.04), labour and childbirth (aOR: 1.57, 95% CI: 0.93–2.67), postpartum (aOR: 2.69, 95% CI: 1.24–5.79), and antenatal care were associated with BPCR (aOR: 1.42, 95% CI: 1.13–1.78).Conclusion: Overall, most pregnant women were not prepared for birth and its complications in Kilifi, Kisii and Mwanza region. Improving level of education, creating awareness on danger signs during preconception, pregnancy, childbirth, and postpartum period, and encouraging antenatal care and skilled birth care among women and their male partners/families are recommended strategies to promote BPCR practices and contribute to improved pregnancy outcomes in women and newborns.

Background: One in four Kenyans aged 18–69 years have raised blood pressure. Despite this high prevalence of hypertension and known association between socioeconomic status and hypertension, there is limited understanding of factors explaining inequalities in raised blood pressure in Kenya. Hence, we quantified the socioeconomic inequality in hypertension in Kenya and decomposed the determinants contributing to such inequality. Methods: We used data from the 2015 Kenya STEPwise survey for non-communicable diseases risk factors. We included 4422 respondents aged 18–69 years. We estimated the socioeconomic inequality using the concentration index (C) and decomposed the C using Wagstaff decomposition analysis. Results: The overall concentration index of hypertension in Kenya was − 0.08 (95% CI: − 0.14, − 0.02; p = 0.005), showing socioeconomic inequalities in hypertension disfavouring the poor population. About half (47.1%) of the pro-rich inequalities in hypertension was explained by body mass index while 26.7% by socioeconomic factors (wealth index (10.4%), education (9.3%) and paid employment (7.0%)) and 17.6% by sociodemographic factors (female gender (10.5%), age (4.3%) and marital status (0.6%)). Regional differences explained 7.1% of the estimated inequality with the Central region alone explaining 6.0% of the observed inequality. Our model explained 99.7% of the estimated socioeconomic inequality in hypertension in Kenya with a small non-explained part of the inequality (− 0.0002). Conclusion: The present study shows substantial socioeconomic inequalities in hypertension in Kenya, mainly explained by metabolic risk factors (body mass index), individual health behaviours, and socioeconomic factors. Kenya needs gender- and equity-focused interventions to curb the rising burden of hypertension and inequalities in hypertension.

Background: Caesarean section (CS) is an important medical intervention for reducing the risk of poor perinatal outcomes. However, CS trends in sub-Saharan Africa (SSA) continue to increase yet maternal and neonatal mortality and morbidity remain high. Rwanda, like many other countries in SSA, has shown an increasing trend in the use of CS. This study assessed the trends and factors associated with CS delivery in Rwanda over the past two decades. Methods: We used nationally representative child datasets from the Rwanda Demographic and Health Survey 2000 to 2019–20. All births in the preceding 3 years to the survey were assessed for the mode of delivery. The participants’ characteristics, trends and the prevalence of CS were analysed using frequencies and percentages. Unadjusted and adjusted logistic regression analyses were used to assess the factors associated with population and hospital-based CS in Rwanda for each of the surveys. Results: The population-based rate of CS in Rwanda significantly increased from 2.2% (95% CI 1.8–2.6) in 2000 to 15.6% (95% CI 13.9–16.5) in 2019–20. Despite increasing in all health facilities over time, the rate of CS was about four times higher in private (60.6%) compared to public health facilities (15.4%) in 2019–20. The rates and odds of CS were disproportionately high among women of high socioeconomic groups, those who resided in Kigali city, had multiple pregnancies, and attended at least four antenatal care visits while the odds of CS were significantly lower among multiparous women and those who had female babies. Conclusion: Over the past two decades, the rate of CS use in Rwanda increased significantly at health facility and population level with high regional and socio-economic disparities. There is a need to examine the disparities in CS trends and developing tailored policy guidelines to ensure proper use of CS in Rwanda.