Rural­urban health disparities among older adults in South Africa

Background: There are limited studies assessing rural­urban disparities among older adults in Africa including South Africa. Aim: This study explores rural­urban health disparities among older adults in a population-based survey in South Africa. Setting: Data for this study emanated from the 2008 study on 'Global Ageing and Adult Health (SAGE) wave 1' (N= 3280) aged 50 years or older in South Africa. Methods: Associations between exposure variables and outcome variables (health status variables and chronic conditions) were examined through bivariate analyses and multivariable logistic regression. Results: Rural dwellers were more likely to be older, black African and had lower education and wealth than urban dwellers. Rural and urban dwellers reported a similar prevalence of self-rated health status, quality of life, severe functional disability, arthritis, asthma, lung disease, hypertension, obesity, underweight, stroke and/or angina, low vision, depression, anxiety and nocturnal sleep problems. Adjusting for socio-demographic and health risk behaviour variables, urban dwellers had a higher prevalence of diabetes (OR: 2.36, 95%CI:1.37, 4.04), edentulism (OR: 2.79, 95% CI: 1.27, 6.09) and cognitive functioning (OR: 1.91, 95% CI: 1.27, 2.85) than rural dwellers. Conclusion: There are some rural­urban health disparities in South Africa, that is, urban dwellers had a higher prevalence of diabetes, edentulism and cognitive functioning than rural ones. Understanding these rural­urban health variations may help in developing better strategies to improve health across geolocality in South Africa

The demographic transition in the Democratic Republic of Congo: facts and challenges to reach a demographic dividend

Background: The channels linking the demographic and economic situation of a population are numerous. We focus on the process of a demographic transition and the demographic dividend that Sub-Saharan Africa and, in particular, the Democratic Republic of Congo (DRC), are currently undergoing. Data source and methods: Secondary data are used to highlight the diverse paths of demographic transition in Sub-Saharan African countries. Additionally, the specific situation of the DRC is selected as a case study. Results: The potential of Sub-Saharan Africa to enjoy a demographic dividend is exceptional. Although the DRC is in the group of the least advanced countries, its increasing share of working age population is a key to reap the benefits of the potential economic growth. Conclusion: There are some recent economic and social advancements in the DRC, but the benefits of its demographic performance are dependent on whether government and institutions are capable of responding to current circumstances with targeted, effective and coordinated policies

Rural-urban differences in the prevalence and predictors of depression among adolescents in South Africa

Background. Mental health is part of overall health, but there is dearth of research on the rural­urban differences of depression among adolescents in South Africa (SA). Objectives. To present an analysis of rural­urban differences in the prevalence of depression and to assess the sociodemographic predictors of depression among adolescents in SA. Methods. Data were obtained from the National Income Dynamics Study (NIDS), wave 4 of 2014, which was conducted on a nationally representative sample of 3 751 respondents (15 - 19 years). Univariate analysis was used to describe the study population while bivariate analysis was used to test for significant differences in the depression status of the population. Finally, binary logistic regression was used to estimate the predictors of depression. Results. Urban adolescents (14.64%) were more depressed than their rural counterparts (9.40%). Gender, income levels and province of residence also showed significant differences in both rural and urban areas. The significant predictors of depression in both rural and urban areas were race, age, income and province of residence. Conclusion. Counselling and rehabilitation programmes should be targeted more at urban, more educated and higher-earning adolescents, especially in provinces with a relatively higher prevalence of depression

Determinants of Active Ageing in Zambia

"This study assesses the 2002 world health organisation Active Ageing Framework and how it applies to developing countries using data from Zambia. Up to date; there is little or no evidence of studies conducted to answer whether or not the 2002 world health organisation Active Ageing Framework is applicable to developing countries like Zambia. This study set out to (1) explore which of the determinants of the active ageing framework apply to Africa and Zambia in particular and; (2) the influence of HIV/AIDS on active ageing in general. A non-experimental exploratory research design was used to collect data for this paper. Snowball and purposive sampling was employed to select 690 respondents (284 males and 406 females) for the study. The study reveals that income accessibility (Economic Determinant); functional limitations (Health Determinants); low self-esteem and loneliness (Personal/Behavioural Determinants); low family and peer interactions (Social Determinants) and HIV/AIDS apply to Zambia in determining active ageing. The study suggests that focused research is needed to clarify and specify the role of each determinant; as well as the interactions between determinants in the active ageing process. In fact; the framework proposes that for such studies; a life course approach is required so as to take advantage of transitions and ""window of opportunity"" for enhancing health; participation and security at different stages. The study also recommends that policies on ageing should be structured to incorporate the applicability of the 2002 world health organisation active ageing framework's main determinants of active ageing to reflect the Zambian context."

Rapid Population Growth and its Implications in Malawi

This article looks at how current and prospective population growth is exerting intense pressures on Malawi's land; food security and nutrition; income and employment; health and education

Rapid Population Growth and its Implications in Malawi

This article looks at how current and prospective population growth is exerting intense pressures on Malawi's land; food security and nutrition; income and employment; health and education

The risk and dynamics of onchocerciasis recrudescence after cessation of vector control

Using a computer simulation study, we have investigated the risk and dynamics of onchocerciasis recrudescence after stopping vector control, in order to provide guidelines for operational decision-making in the Onchocerciasis Control Programme in West Africa (OCP). For this purpose, we used the microsimulation model ONCHOSIM to predict for periods of 9-15 years of vector control the ensuing risk and dynamics of recrudescence in an onchocerciasis focus. The model was quantified and validated using OCP evaluation and field research data. A range of plausible values was determined for important confounding parameters, i.e., vector biting rate, variation in exposure between individuals, parasite life span, and the relation between skin microfilarial load and vector infection. Different model quantifications were used in order to take account of the possible confounding effect of these parameters on the prediction of recrudescence. In the absence of immigration of infected humans or invasion by infected flies, the model predicts that 14 years of full-scale vector control are required to reduce the risk of recrudescence to less than 1%. The risk depends, in particular, on the vector biting rate, and this has implications for the planning of post-larviciding surveillance. Recrudescence will be a relatively slow process, and its rate will depend on the duration of vector control. Even if vector control were stopped too early, i.e., after 12-13 years in a highly endemic area, it would take more than 20 years before the intensity of infection in the community would reach levels of public health importance

National development plan Malawi: Future population growth

Has information on future population levels; characteristics; summary conclusions and implications for the preparation of the National Physical Development Plan