Emmanuel Nene Odjidja

Climate change creates new humanitarian crises and worsens existing ones in vulnerable communities. It displaces people and disrupts their livelihoods, leaving loss of jobs, insecurity and distress...

Millions of orphaned or vulnerable children are separated from their parents globally because of poverty, conflict, epidemics, and abuse (Willi & Arisi, 2024). A growing number of these children ar...

Background Arterial hypertension is a major global public health concern. It coexists with other non-communicable and communicable diseases in Burundi, creating complex health challenges difficult to address. We aimed to assess the burden of newly diagnosed hypertension, identify associated risk factors, and assess 10-year cardiovascular risk among hypertensive and non-hypertensive patients. Knowing at-risk populations and level of risk could guide evidence-based interventions. Methods We conducted a modelling study on 714 patients admitted at Kamenge Teaching Hospital between January 2018 and December 2022. Retrospective data were obtained from medical records. Bayesian belief update methods, Bayesian logistic regression with bootstrapping, and Bayesian linear models were used to respectively estimate prevalence, risk factors, and associations between diastolic blood pressure (DBP) and cardiovascular risk. The 10-year cardiovascular risk was evaluated using the Canadian Framingham Risk Score. Findings: The prevalence of newly diagnosed hypertension was 16.9% (95% CrI: 14.2–19.7). Higher rates were observed among women (18%), patients aged 40–59 (21.3%) and ≥ 60 years (33.9%), those with higher education (up to 28.9%), and individuals with obesity, overweight, or family history of hypertension. Significant predictors included age ≥ 40, tobacco use, higher education, and excess weight. Moderate or severe 10-year cardiovascular risk was found in 24.9% of patients, with more than 60% of hypertensive patients classified as high risk. DBP showed a positive correlation with cardiovascular risk in both hypertensive and non-hypertensive groups. Interpretation: Newly detected hypertension and its strong association with elevated cardiovascular risk highlight missed opportunities for early diagnosis and prevention. Targeted screening and management of modifiable risk factors could reduce cardiovascular risk in this population and support national efforts to curb the growing burden of non-communicable diseases in Burundi. Conclusion The burden of newly diagnosed hypertension and its association with increased cardiovascular risk underscore the need for systematic screening, early diagnosis, and preventive strategies in Burundi. Interventions addressing modifiable risk factors could support national policies and resource allocation to reduce cardiovascular disease burden in line with the 2030 agenda.

Background. Depression among women survivors of armed extremist violence in the Sahel is widespread, largely untreated, and rarely the subject of structured evaluation. Mental-health and psychosocial support (MHPSS) in stabilisation programming is typically the first thing cut and the last thing measured. Methods. We evaluated KAOURAL, a community-based psychosocial programme implemented by Femmes et Développement (FEDE) and funded by GCERF, across five communes of Mali’s Mopti region between February 2025 and January 2026. At endline, 337 internally displaced women (225 intervention, 112 comparison) completed the PHQ-9 in Bambara, administered orally by independent psychologists. Commune-level violence exposure was built from ACLED events within 25 km of each commune centroid over the preceding 12 months. The intervention effect was estimated five ways: adjusted negative binomial regression, IPTW, TMLE for clinical depression at PHQ-9 ≥10, a Bayesian multilevel model with commune random intercepts, and a causal forest. e-values tested unmeasured confounding. Findings. All five estimators converged. Bayesian posterior median IRR 0·271 (95% CrI 0·188 to 0·383); posterior probability of ≥50% reduction 0·999. TMLE risk difference for clinical depression −0·27 (95% CI −0·35 to −0·20), or 27 fewer cases per 100 women. E-values were 6·6 against the point estimate and 4·1 against the upper CI bound. The causal forest predicted benefit for every individual; the largest predicted effects fell on younger women with fewer dependents and higher baseline depression. Interpretation. Community-based psychosocial care delivered by women from displaced communities themselves was associated with substantially lower depression among women survivors of violent extremism. Five different identifying assumptions returned the same answer; unmeasured confounding strong enough to overturn it would have to dwarf anything we measured. Treating MHPSS as a second-order concern in counter-extremism and stabilisation programming in the central Sahel is no longer a defensible policy default.

Undernutrition and micronutrient deficiencies such as anemia are considered significant public health challenges in Bangladesh, which enhancing fish consumption is a well-established food-based intervention to address these. This paper documents the establishment of community-based fish chutney production and reports the impact of its consumption on mid-upper arm circumference (MUAC) and hemoglobin (Hb) levels among targeted 150 pregnant and lactating women (PLW) in rural Bangladesh. A fish chutney was developed using locally available ingredients followed by a series of laboratory tests, including nutrient composition, shelf-life and food safety. A community-based fish chutney production process was designed to: (1) supply locally available ingredients for processing; (2) establish two fish drying sites; (3) initiate a community-based production site; and (4) distribute fish chutney to PLW for one year by six women nutrition field facilitators. Then a pre- and post-intervention study was designed for a selected 150 PLW to receive 30 g of fish chutney daily for 12 months. Differences in mean MUAC and Hb levels pre- and post-consumption were analyzed using one-way analysis of variance. Consumption of 30 g of fish-chutney resulted in significant increases of the mean values of Hb levels and MUAC among the targeted PLW.

Undernutrition and micronutrient deficiencies such as anemia are considered significant public health challenges in Bangladesh, which enhancing fish consumption is a well-established food-based intervention to address these. This paper documents the establishment of community-based fish chutney production and reports the impact of its consumption on mid-upper arm circumference (MUAC) and hemoglobin (Hb) levels among targeted 150 pregnant and lactating women (PLW) in rural Bangladesh. A fish chutney was developed using locally available ingredients followed by a series of laboratory tests, including nutrient composition, shelf-life and food safety. A community-based fish chutney production process was designed to: 1) supply locally available ingredients for processing; 2) establish two fish drying sites; 3) initiate a community-based production site, and 4) distribute fish chutney to PLW by six women nutrition field facilitators for one year. Then a pre- and post-intervention study was designed for a selected 150 PLW to receive 30g of fish chutney daily for 12 months. Differences in mean mid-upper arm circumference (MUAC) and hemoglobin (Hb) levels pre- and post-consumption were analyzed using one-way analysis of variance. Consumption of 30g of fish-chutney resulted in significant increases of the mean values of Hb levels and MUAC among the targeted PLW.

Introduction: In 2003, Ghana abolished direct out of pockets payments and implemented health financing reforms including the national health insurance scheme in 2004. Treatment of childhood infections is a key component of services covered under this scheme, yet, outcomes on incidence and treatment of these infections after introducing these reforms have not been covered in evaluation studies. This study fills this gap by assessing the impact on the reforms on the two most dominant childhood infections; fever (malaria) and diarrhoea. Methods: Nigeria was used as the control country with pre-intervention period of 1990 and 2003 and 1993 and 1998 in Ghana. Post-intervention period was 2008 and 2014 in Ghana and 2008 and 2018 in Nigeria. Data was acquired from demographic health surveys in both countries and propensity score matching was calculated based on background socioeconomic covariates. Following matching, difference in difference analysis was conducted to estimate average treatment on the treated effects. All analysis were conducted in STATA (psmatch2, psgraph and pstest) and statistical significance was considered when p-value ≤ 0.05. Results: After matching, it was determined that health reforms significantly increased general medical care for children with diarrhoea (25 percentage points) and fever (40 percentage points). Also for those receiving care specifically in government managed facilities for diarrhoea (14 percentage points) and fever (24 percentage points). Conclusions: Introduction of health financing reforms in Ghana had positive effects on childhood infections (malaria and diarrhoea).

In 2003, Ghana abolished direct out of pockets payments and implemented health financing reforms including the national health insurance scheme in 2004. Treatment of childhood infections is a key component of services covered under this scheme, yet, outcomes on incidence and treatment of these infections after introducing these reforms have not been covered in evaluation studies. This study fills this gap by assessing the impact on the reforms on the two most dominant childhood infections; fever (malaria) and diarrhoea. Nigeria was considered as a control country and using four data points (pre and post reforms periods) from the demographic health surveys, we calculate the probability of treatment based on background covariates. All analysis were conducted in STATA (psmatch2, psgraph and pstest) and statistical significance was considered when p-value ≤ 0.05. After matching, it was determined that health reforms significantly increased general medical care for children with diarrhoea (25 percentage points) and fever (40 percentage points). Also for those receiving care specifically in government managed facilities for diarrhoea (14 percentage points) and fever (24 percentage points).This denotes that introducing health financing reforms can have marginal impact on child health outcomes.