Interventions for older adults with NCDs and depression should be relevant to the risk factors for NCDs in non-WEIRD populations. We conducted a single-group pilot study of the Ziba Ufa intervention, consisting of problem-solving therapy and health education over 6 weekly sessions delivered by lay counsellors; there was no control group. Participants were opportunistically sampled through outpatient NCD clinics in four sites in Kilimanjaro, Tanzania. We conducted exploratory analyses of the clinical relevance of the health education using self-report survey data, and perceived relevance using qualitative interviews. Thirty-two participants enrolled (88% with hypertension and 44% with type 2 diabetes). Of the 21 participants with height and weight data, 12 (57%) were obese. Advice on weight loss, a sleep routine, and increasing fruit and vegetable consumption may be clinically relevant, but alcohol and tobacco consumption, levels of physical activity and consumption of processed foods with added sugar or salt were self-reported as meeting recommendations; therefore, they may be less clinically relevant. Participants reported acting on the sleep advice more than on the dietary and physical activity advice. This may indicate that sleep advice was perceived as relevant, but dietary and physical activity advice was not.

Rheumatic heart disease remains a leading cause of preventable cardiovascular morbidity and premature mortality among children and young adults in Sub-Saharan Africa. Advances in portable echocardiography, standardised World Heart Federation diagnostic criteria, and task-sharing strategies have substantially expanded the detection of latent rheumatic heart disease. However, increased diagnostic capacity has not consistently translated into improved long-term clinical outcomes. This viewpoint argues that the principal challenge in rheumatic heart disease control has shifted from underdiagnosis to the inability of health systems to provide sustained longitudinal care after screening. Although the GOAL Trial demonstrated that secondary prophylaxis with benzathine penicillin reduces echocardiographic progression of latent disease, robust evidence that screening alone decreases heart failure, stroke, need for valve surgery, or mortality remains limited. Furthermore, recurrent shortages of benzathine penicillin, fragmented follow-up, weak referral pathways, and socioeconomic barriers continue to undermine the effectiveness of screening programmes across Sub-Saharan Africa. We propose a paradigm shift in the evaluation of rheumatic heart disease screening initiatives: programme success should no longer be measured primarily by the number of cases detected but by the proportion of patients retained in continuous care and protected from major cardiovascular outcomes. Future rheumatic heart disease programmes should integrate early diagnosis with reliable access to secondary prophylaxis, structured follow-up, timely referral for specialist and surgical care, and outcome-based evaluation. Redefining screening success around care retention rather than diagnostic yield may substantially improve the long-term impact of rheumatic heart disease control strategies in resource-limited settings.

The objective of this study was to develop a framework to support the identification of root causes of energy injustice in sub-Saharan Africa. Currently, existing literature identifies specific energy injustices on the continent; however, it fails to delve into root causes of these inequalities. Additionally, a paper that synthesises these injustices to understand prevailing challenges is absent. This study, therefore, filled this gap by conducting a systematised literature review to identify dominant themes of energy injustice in sub-Saharan Africa. The identified themes were found along the entire energy value chain, from mining of critical minerals used in technology manufacturing to the disposal of energy technologies. Injustices were also identified in cross-cutting issues, including community engagement, project financing and power dynamics between donors and countries on the continent. A framework titled “Energy Injustice in Stakeholder Interactions” was developed to encapsulate these injustices and support the identification of root causes of energy injustice. This framework demonstrated the flow of injustices across stakeholders and, in doing so, provided multiple perspectives of energy injustice. Further, it included the constraints these stakeholders faced in executing their mandates, thereby limiting energy justice. Lastly, it demonstrates trade-offs that must be considered in the quest for energy justice. Thus, framework, therefore, provides critical information on points of intervention for actors working towards restorative justice.

The prevalence of mental health problems (MHPs) among school-going adolescents in Sub-Saharan Africa (SSA) remains high. However, help-seeking behaviours are disproportionately low in this population. This qualitative evidence synthesis (QES) aimed to identify and integrate existing qualitative findings on the barriers and facilitators of formal and informal mental health (MH) help-seeking behaviours in this population. The objective was to generate insights from relevant studies and settings to inform the development of effective interventions for culturally grounded public mental health initiatives in schools in SSA. We conducted a systematic search across six databases (PubMed, CINAHL, Scopus, PsycINFO, ERIC and Google Scholar) for qualitative studies published until September 2025. Eligible studies were appraised using the Critical Appraisal Skills Programme (CASP) checklist. Thematic synthesis was employed to analyse and interpret the findings. Twelve studies met the inclusion criteria. Six key barriers were identified: (1) perceived stigma, (2) gender norms as a barrier to help-seeking, (3) poor mental health knowledge, misconceptions and awareness gaps, (4) privacy, trust and confidentiality concerns with MH professionals, (5) lack of accessibility and availability of MH services and (6) family and parental attitudes, peer influence and alternative support. Facilitators included (1) MH education and literacy enhancement, (2) supportive school environment or climate, (3) improved professional services, (4) family, community involvement and peer support and (5) improved service accessibility and affordability. This synthesis highlights the significant structural and sociocultural determinants of help-seeking behaviour in school-going adolescents in SSA. The scarcity of qualitative studies in this area underscores a critical gap in the existing literature. Further context-sensitive qualitative research is urgently needed to gain insights into adolescents’ lived experiences with MHPs and to guide responsive school-based MH interventions.

Malnutrition remains a major public health challenge in low- and middle-income countries and disproportionately affecting children under five. Eggs, given their high nutrient density and relative physical or economic accessibility, have been tested for their effect on improving nutritional outcomes in children under five. However, findings from scientific exercises to test the impact of egg-based trials on child growth have not been systhematically pooled and synthesised. Therefore, this meta-analysis aimed to synthesise evidence on the impact of egg-based interventions on the nutritional status of children underfive as determined by weight-for-height Z-score (WHZ), weight-for-age z-score (WAZ), and height-for-age z-score (HAZ). Research articles of randomised controlled trials published between 2013 and 2023 were identified through a comprehensive search of PubMed/MEDLINE, Web of Science, CINAHL, Embase, Science Direct, Google Scholar, and African Index Medicus data bases. Articles evaluated the effect of egg-based interventions against alternative diets, behaviour-change education, or no alternative intervention were included. Primary outcomes are WHZ, WAZ, and HAZ. Random-effects models were used to pool effect sizes (mean difference), and subgroup analyses and meta-regression explored sources of heterogeneity. Publication bias was assessed using funnel plots and Egger’s test. Seven studies involving 3673 children met the inclusion criteria. Egg-based intervention significantly improved WAZ (MD: 0.33; 95% CI: 0.11–0.55) and WHZ (MD: 0.30; 95% CI: 0.12–0.48). However, no significant effect was observed on HAZ (MD: 0.05; 95% CI: –0.05–0.14). It is figuredout that egg-based interventions can improve weight-related nutritional outcomes (WHZ and HAZ) among children underfive in sub-Saharan Africa, but not linear growth (HAZ).

In November 2025, Ethiopia confirmed its first outbreak of Marburg virus disease in South Omo Zone, marking a critical public health emergency in a previously unaffected country. The outbreak was detected following reports of suspected viral hemorrhagic fever in Jinka town, with laboratory confirmation achieved within days through national reference laboratory testing. By mid-December 2025, 14 laboratory-confirmed cases had been identified, including 9 deaths and 5 recoveries, following nearly 2 thousand investigations nationwide. This report describes the detection of the outbreak, early epidemiological characteristics, and key response actions implemented by national and regional authorities. It highlights operational challenges related to surveillance, diagnostic access, and response coordination in remote settings, as well as the importance of community engagement and multisectoral collaboration. Ethiopia’s first experience with Marburg virus disease provides timely lessons for strengthening preparedness, early detection, and response capacity for high-consequence pathogens in sub-Saharan Africa.

Mental health literacy (MHL) strategies are crucial for mental health promotion and prevention. This study aimed to determine the acceptability, feasibility, appropriateness and initial efficacy of an adapted MHL program in a community sample of adults in Kenya. This was a quasi-experimental pre-post study conducted from July 2023 through July 2024. The MHL program contained nine modules delivered over 3 days. Participants were assessed at baseline and immediately after the program. The primary outcomes were mental health knowledge and participants’ attitudes on mental health/illness. Secondary outcomes included depressive symptoms, anxiety symptoms, self-perceived social support, self-perceived wellbeing, MHL program acceptability, feasibility and appropriateness. Relative to baseline, we observed statistically significant improvement in mental health knowledge and attitude on mental health/illness postintervention. We also observed significant improvements in all secondary outcomes. The MHL program also emerged as contextually appropriate, acceptable and feasible. The adapted MHL program is acceptable and appropriate and can feasibly be delivered by trained non-specialist facilitators. Also, the MHL program has the potential to increase participants’ MHL and attitudes and reduce symptoms of common mental disorders and promote self-perceived wellbeing. Future research should explore how improvements can be sustained over the long term.

A chemical explosion and fire erupted in Conakry, Guinea, West Africa on December 18, 2023, destroying Guinea’s main fuel depot and resulting in 25 dead and 459 injured. Fifteen of the deaths occurred directly at the explosion site. Firefighters initiated efforts to control the blaze and transported injured, non-ambulatory victims to local hospitals with assistance from the military, Red Cross, and mining companies. Thirteen clinical facilities within an eight-mile radius of the explosion received burn and non-burn victims, with only one of these, Donka National Hospital, capable of handling burn victims. Many less seriously injured victims self-selected where they sought care, although anecdotal information indicates that an unknown number of injured did not seek care or chose to leave the city. The disaster marked the first time stakeholders from various sectors in the Guinean society (from first responders to mining companies) came together in a concerted response. Ranked 179th of 193 countries on the Human Development Index (HDI), the disaster rapidly outstripped Guinea’s response and health care capabilities, leaving behind economic shocks affecting livelihoods and the local economy. These experiences underscore the need for improved capabilities and coordination in disaster planning, warning and communication systems, and prehospital and hospital response in developing countries.

Malnutrition remains a major public health issue in Sub-Saharan Africa, with one-third of all malnourished children residing in the region. In Malawi, 37.1% of children under five are stunted, and 63% are anaemic. Poor diets and poverty contribute significantly. Legumes, being rich in protein, fibre, and micronutrients, offer a sustainable food-based approach to improve child nutrition and support local agriculture. This study aimed at assessing the association between legume consumption and nutritional status in children aged 6–59 months in rural Malawi. A community-based cross-sectional study was conducted in Mzimba, Mchinji, and Mangochi districts, involving 1275 children. Data were collected on dietary intake, socioeconomic status, and anthropometry using semi-structured questionnaires. Nutritional status was determined using WHO Anthro, and associations were analysed using logistic regression in Stata. Prevalence of stunting was 42.8%, underweight 17.4%, and wasting 8.4%. Over half of the children did not consume legumes. Pigeon pea consumption significantly reduced odds of wasting (AOR = 0.14), and common beans were associated with lower odds of both wasting and stunting. Conversely, groundnut consumption was linked to increased underweight (AOR = 1.68). Animal food consumption was associated with lower underweight but higher odds of wasting. Legume consumption showed both protective and adverse associations with child malnutrition. In conclusion, this study has shown that promoting dietary diversity and appropriate legume use could enhance nutrition outcomes. Findings highlight the potential of legumes in addressing undernutrition but also the need for targeted nutrition education and interventions in rural Malawi.

To what extent do sub-Saharan Africans actively participate in voluntary groups, and how does development aid influence this involvement? This paper presents a baseline assessment of membership predictors for secular and religious voluntary groups across 20 sub-Saharan African countries. Using Afrobarometer survey data, I adopt an asset-based resources approach in which development aid is seen to mobilize local resources and increase incentives to join voluntary groups. The theory is tested with multilevel, cross-national logistic regression models, including both individual-level and country-level variables to predict active membership. At the individual level, I find that membership in voluntary groups is most likely among those who are well educated, rural-dwelling, male, black, and middle aged—a reflection of social advantage. However, poorer Africans are also likely to join such groups, as are those with a strong religious affinity. At the national level, development aid is positively tied to voluntary group membership, but democratic and economic progresses have little to no consequence on this behavior.

Besides elections, the sub-Saharan wave of political reforms of the 1990s led several countries to introduce limits to the number of terms that a chief executive can serve, even though several leaders managed to bypass them. While Africa’s executive term limits (ETLs) politics has gained scholarly attention, the literature mostly consists of in-depth small-N analyses. Systematic comparative research is rare. To contribute filling this gap, this article presents a new Africa Executive Term Limits (AETL) dataset. Covering 49 sub-Saharan polities throughout the 1990–2019 period, AETL represents the most complete and updated collection of data on Africa’s ETLs politics, and a versatile research tool to address several questions on the present and future of this continent. A preliminary assessment of the new data finds ETLs to be increasingly respected, and to have positive returns for government alternation and development. These findings point to new research avenues that AETL may help travel.

Twin children are more likely to die than singletons. This is an additional burden in sub-Saharan African (SSA) countries, as child mortality levels are already higher than anywhere else. This article provides estimates of under-5 mortality rates (U5MRs) for twins and singletons in SSA from 1986 to 2016. It describes the geographical variations and changes over time. It also describes the variation of twins’ excess mortality according to age from 0 to 5 years. Additionally, it analyzes the factors associated with twins’ excess mortality. We used data from 156 national surveys from 42 countries. We estimated U5MRs for twins and single children and built a Cox model to analyze factors associated with excess mortality among twins. Although child mortality has declined on the continent, twins’ excess mortality remains very high. U5MRs are, on average, 3 times higher among twins than singletons. The Cox model shows that all other things being equal, the adjusted hazard ratio of under-5 mortality (U5M) is 3.2 (2.9−3.3; p < .001) times higher among twins than singletons. The main factors associated with excess mortality risks among twins are biomedical and nutritional features, such as low birth weight, non-use of cesarean section delivery, and lack of breastfeeding. Health policy makers in SSA should be aware of the vulnerability of twins, and interventions to prevent their early deaths should be considered.

We examine the distributional impact of domestic carbon pricing in three Sub-Saharan African countries. We combine household expenditure surveys and sectoral carbon intensity data derived from a multi-regional input-output model for Ghana, Nigeria and Uganda. Our findings indicate that domestic carbon pricing is progressive in all three countries. This primarily results from higher budget allocations for direct energy consumption in wealthier households, especially concerning motor vehicles and electrical appliances. Disparities in welfare losses within income groups are primarily due to varying energy consumption patterns. Importantly, we identify low-income households as being disproportionately affected by carbon taxes. Lump-sum transfers could fully compensate most households in the bottom two income quintiles, significantly reducing poverty. Our comparative analysis emphasizes the importance of country-specific differences in energy expenditures and carbon intensities in shaping the distributional outcomes of carbon taxes.

Spousal age differences are highest in Sub-Saharan Africa, where trends in age at first marriage indicate an increase for both men and women. However, the net outcome for spousal age difference is difficult to predict without explicit analysis of these distributions. This study examines differentials in spousal age for women in first union. Further, it examines differences within population sub-groups and across countries, focusing on the influence of age at marriage and educational attainment. The analysis pools 144 survey datasets from the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) conducted between 1980 and 2020 in 34 countries. OLS regression analysis was used to predict the spousal age difference at marriage with five-year cohorts used to study time trends. The analysis finds a decline of 1.7 years in the spousal age difference at first marriage between the earliest (1980–1984) and most recent (2014–2019), indicating that there has been minimal reduction in age at first marriage over four decades, despite rising ages at marriage for females. Increasing age at first marriage and educational attainment of women partly explain the decline observed over time.