Edmonton's Race-based Data Table: A municipal approach to addressing systemic racism through the collection and use of disaggregated, race-based data.

Recent events, such as the COVID-19 pandemic, have drawn nationwide attention to systemic racism as a serious threat to public health in Canada. One promising approach to address such racism is through developing and implementing standardized procedures for collecting and using disaggregated, race-based data. In this commentary, we summarize why this approach is necessary to address systemic racism in Canada, and highlight municipal actions being taken in Edmonton, Alberta, to move this approach forward. In 2021, a Race-based Data Table, comprising 24 institutions and organizations affiliated with health, education, and policing systems, was formed in Edmonton. It aimed to engage practitioners, systems representatives, academics, and community members in collective advocacy around accessing race-based data to better understand and address disparate health outcomes associated with COVID-19 for racialized communities. Further, the Table intends to co-create a charter and toolkit outlining best practices for ethical, race-based data collection and use with local stakeholders and knowledge users. In documenting the beginning stages of the Table, and in evaluating its ongoing progress, we contribute to national conversations regarding the need for government institutions and other organizations to consistently collect and use race-based data as a means of increasing transparency and accountability in their actions.

RéSUMé: De récents événements, comme la pandémie de COVID-19, ont attiré l'attention du pays sur la grave menace que pose le racisme systémique pour la santé publique au Canada. Une approche prometteuse pour aborder ce racisme consiste à élaborer et à appliquer des méthodes standardisées pour la collecte et l'utilisation de données désagrégées fondées sur la race. Dans ce commentaire, nous résumons les raisons pour lesquelles cette approche est nécessaire pour aborder le racisme systémique au Canada et nous présentons des actions posées au palier municipal à Edmonton, en Alberta, pour faire avancer les choses. En 2021, une « table des données fondées sur la race ¼ composée de 24 établissements et organismes affiliés aux systèmes de santé, d'éducation et de maintien de l'ordre a été créée à Edmonton. Elle veut favoriser une action collective des praticiens, des représentants des systèmes, des universitaires et des résidents, articulée autour de l'accès aux données fondées sur la race, afin de mieux comprendre et de mieux aborder les résultats cliniques disparates associés à la COVID-19 dans les communautés racisées. Cette table veut aussi cocréer une charte et une trousse d'outils définissant des pratiques exemplaires de collecte et d'utilisation de données éthiques, fondées sur la race, avec les parties prenantes et les utilisateurs de connaissances locaux. En documentant les débuts de cette table et en évaluant ses progrès au fil du temps, nous contribuons aux conversations nationales sur la nécessité, pour les institutions gouvernementales et d'autres organismes, de collecter et d'utiliser systématiquement des données fondées sur la race pour accroître la transparence et la responsabilisation dans leurs actions.

School closures and well-being-related topic searches on Google during the COVID-19 pandemic in Sub-Saharan Africa.

BACKGROUND: Following the outbreak of the 2020 coronavirus, governments adopted non-pharmaceutical interventions (NPIs) to save lives. The NPIs have been deemed to have unintended consequences on mental health and well-being. This study aimed to estimate the impact of the COVID-19 pandemic-induced school closures on the relative search volumes (RSVs) of well-being-relevant topics in 30 low and lower- middle income countries in Sub-Saharan Africa. METHODS: Google Trends search data, difference-in-differences and event study methods were used to evaluate the impact on the related search volume (RSV) of well-being related topic queries in Sub-Saharan Africa. RESULTS: The results suggest positive and significant increases in the search intensity for anger, boredom, fear, sleep, exercise, and prayer. Contrary to other studies, we find no discernible effects on the relative search volumes (RSVs) on loneliness, sadness, and suicide. CONCLUSION: Our findings suggest that the pandemic and the associated restrictions had a mixed effect on well-being-related searches. We recommend increased vigilance and proactive communication from the government and policy makers with the general population in times of emergencies when social policies that restrict lives and liberties need to be adopted.

Multilevel analysis of individual- and community-level determinants of birth certification of children under-5 years in Nigeria: evidence from a household survey.

Promoting birth certification is central to achieving legal identity for all - target 16.9 of the 2030 Sustainable Development Goals. Nigeria is not on track to achieve this goal with its low coverage of birth certification (BC). This study is aimed at identifying patterns of BC and its associated individual- and community-level factors, using pooled cross-sectional data from three rounds (2008, 2013, and 2018) of the nationally representative Nigerian Demographic and Health Survey. A weighted sample of 66,630 children aged 0-4 years was included, and a two-level multilevel logistic model which accommodates the hierarchical nature of the data was employed. Of the total sample, 17.1% [95% CI: 16.3-17.9] were reported to be certified. Zamfara state (2.3, 95% CI: 0.93-3.73) and the Federal Capital Territory (36.24, 95% CI: 31.16-41.31) reported the lowest and the highest BC rates. Children with an SBA [AOR = 1.283, 95% CI: 1.164-1.413] and with at least one vaccination [AOR = 1.494, 95% CI: 1.328-1.681] had higher odds of BC. The AOR for mothers with at least one prenatal visit was 1.468 [95% CI: 1.271-1.695], and those aged 30-34 years at the time of birth [AOR = 1.479, 95% CI: 1.236-1.772] had the highest odds. Further, the odds of BC increased the most for mothers [AOR = 1.559, 95% CI: 1.329-1.829] and fathers [AOR = 1.394, 95% CI: 1.211-1.605] who were tertiary-educated. In addition, children in middle-income [AOR = 1.430, 95% CI: 1.197-1.707] or rich wealth HHs [AOR = 1.776, 95% CI: 1.455-2.169] or those whose families had bank accounts [AOR = 1.315, 95% CI: 1.187-1.456] had higher odds. Living in non-poor and within close proximity to a registration center (RC) act as protective factors for BC, while living in poor communities [AOR = 0.613, 95% CI: 0.486-0.774] and more than 10kms from an RC reduce the odds of BC [AOR = 0.466, 95% CI: 0.377-0.576]. The study identified several protective and risk factors which policymakers can adopt as strategic areas for universal birth certification. National and sub-national programs should integrate non-formal institutions as well as target child and maternal utilization of healthcare services to promote BC in Nigeria.

Effect of public health expenditure on health outcomes in Nigeria and Ghana.

Despite the prevailing literature examining the effect public health expenditure has on health outcomes in Africa, Malaria and HIV/AIDS mortality which are key indicators of the outcome variable were unconsidered when drawing inferences. In view of this oversight, we investigate the impact of public health expenditure on health outcomes in Nigeria and Ghana whilst reconceptualizing health outcome by capturing infant, maternal, Malaria and HIV/AIDS mortality. Using the health expenditure commitment at the 1999 United Nations General Assembly and the Abuja Declaration of 2000, we also assessed public policy's role in this relationship via linear regression analysis. With hindsight, our findings disclosed a low public health expenditure in both countries despite the Ghanaian case revealing a negative relationship, which was primarily insignificant whilst Nigeria indicated a positive one. These empirical evidences accentuate the need to augment public health expenditure in both countries to boost health outcomes whilst bringing to bear the significant influence of GDP, school enrolment and residing in urban areas on health outcomes.