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Review Article
Infant and Child Mortality and Its Risk Factors in
Sub-Saharan Africa: The Contribution of Healthcare Delivery
Issue:
Volume 14, Issue 4, August 2026
Pages:
153-164
Received:
7 May 2026
Accepted:
8 June 2026
Published:
8 July 2026
DOI:
10.11648/j.sjph.20261404.11
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Abstract: Background. Infant and child mortality remains a key indicator of population health in sub-Saharan Africa (SSA), where the risk of death before age five is more than six times higher than in Europe. Biological, maternal, socio-economic and environmental factors interact with the organisation of healthcare delivery, whose impact on under-five mortality has not yet been comprehensively synthesised. This scoping review aimed to map the risk factors for under-five mortality documented in SSA between 2003 and 2023, with particular attention to components of healthcare delivery. Methods. A scoping review was conducted following the Arksey & O’Malley framework as updated by Levac et al., and aligned with the PRISMA-ScR guidelines and the JBI manual. The research question followed the PCC format, targeting infants (0 -11 months) and children under five. Four sources were searched (PubMed/MEDLINE, Web of Science, African Index Medicus, Google Scholar), complemented by grey literature. Double-blind screening (Rayyan) and standardised extraction were conducted by two independent reviewers. A structured narrative synthesis was performed. Results. Twenty-nine documents were retained (19 original studies and 10 contextual documents) covering Western, Eastern, Southern and Central Africa. Four groups of determinants emerged: (i) biological and perinatal factors (malaria, acute respiratory infections, diarrhoea, prematurity, perinatal asphyxia, sickle-cell disease, breastfeeding); (ii) maternal and obstetric factors (maternal education, parity, antenatal care, three-delays model); (iii) socio-economic and environmental determinants (poverty, rural residence, WASH); (iv) healthcare delivery (geographical and financial access, quality of care, continuum of care). User-fee exemption policies and Universal Health Coverage have increased service use but may widen pro-rich inequalities in the absence of targeted measures and parallel quality improvements. Conclusion. Infant and child mortality in SSA is multifactorial and socially structured. In Senegal, the effectiveness of free-care policies depends on improving quality of care, addressing socio-environmental determinants, and pursuing an explicit territorial and social equity strategy. Rigorous impact evaluations are needed to inform future reforms.
Abstract: Background. Infant and child mortality remains a key indicator of population health in sub-Saharan Africa (SSA), where the risk of death before age five is more than six times higher than in Europe. Biological, maternal, socio-economic and environmental factors interact with the organisation of healthcare delivery, whose impact on under-five mortal...
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Research Article
On Some Curiosities of Tumor Immunotherapy
Moses Schorr-Tschudnowski*
Issue:
Volume 14, Issue 4, August 2026
Pages:
165-170
Received:
3 June 2026
Accepted:
17 June 2026
Published:
17 July 2026
DOI:
10.11648/j.sjph.20261404.12
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Abstract: This article discusses unresolved questions and contradictions in modern tumor immunotherapy, focusing specifically on the state of the immune system, checkpoint inhibitors (CPIs), chemo-immunotherapy, and the significance of systemic immune system activation. The discussion begins with the observation that, despite significant progress, the clinical success of CPI therapies remains severely limited, and the individual baseline status of the immune system is rarely taken into account in oncological immunotherapy. Drawing on the authors' own clinical experience, it is argued that robust immune system activation via PAMP-based therapy—combined with low-dose chemotherapy and reduced CPI dosages—can lead to improved tumor control while simultaneously reducing toxicity. Particular attention is paid to the role of natural killer (NK) cells, which, in the authors' view, is underestimated in current immuno-oncology. Furthermore, the article explores the interrelationships between immune status, body temperature, the tumor microenvironment, tumor mutation rates, and therapeutic efficacy. The article advocates for an individualized immuno-oncological treatment approach that systematically evaluates and specifically modulates the functional state of the immune system, thereby enhancing the effectiveness of existing immunotherapies. Such a post-treatment strategy has the potential to improve relapse prevention, long-term survival, and cure rates in cancer patients.
Abstract: This article discusses unresolved questions and contradictions in modern tumor immunotherapy, focusing specifically on the state of the immune system, checkpoint inhibitors (CPIs), chemo-immunotherapy, and the significance of systemic immune system activation. The discussion begins with the observation that, despite significant progress, the clinic...
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Research Article
Orange Fleshed Sweet Potato Potential in Combating VAD Among Under Five Children in Mbeya, Tanzania: Community’s Knowledge, Attitude and Practice
Diana Nicodemas*,
Stewart Venance Mlwilo,
Diana Deogratias Komba
Issue:
Volume 14, Issue 4, August 2026
Pages:
171-177
Received:
5 November 2025
Accepted:
21 November 2025
Published:
27 July 2026
DOI:
10.11648/j.sjph.20261404.13
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Abstract: Vitamin A deficiency (VAD) among children under five years of age remains a significant public health concern in Tanzania. Orange-fleshed sweet potatoes (OFSP), rich in provitamin A, offer a sustainable dietary solution to address this challenge. This study aimed to assess the community’s knowledge, attitudes, and practices (KAP) regarding OFSP in Mbeya Municipality—an area identified with notable cases of VAD despite the availability of diverse nutrient-rich foods. A descriptive cross-sectional study design was employed, involving 90 caregivers from three wards and 15 healthcare workers from the corresponding health facilities. Data were collected through structured questionnaires and interviews, and analyzed using descriptive statistics for quantitative data and thematic analysis for qualitative insights. Results revealed that although general awareness of OFSP was relatively high across the municipality (80% and above), specific knowledge about its vitamin A content and associated health benefits was considerably low, averaging only 8.9%. Positive attitudes toward OFSP were also limited, particularly in Iyunga Ward (56.7%). Only 14.4% of caregivers reported regularly feeding OFSP to their children. Among healthcare workers, moderate levels of knowledge (53.3%), attitude (86.7%), and practice (73.3%) were observed in promoting the consumption of OFSP, despite the presence of OFSP programs at the health centers. This may be attributed to insufficient training materials, limited professional capacity, and minimal policy support to reinforce positive attitudes and practices. These findings highlight the importance of reinforcing and motivating nutrition education for both caregivers and healthcare workers. Strengthening such initiatives is vital for improving child nutrition, which continues to demand considerable attention. The study concludes that enhancing knowledge to close the gap between awareness and practice, promoting positive attitudes, and building workforce capacity at the ward level are essential strategies for increasing OFSP utilization and reducing the prevalence of vitamin A deficiency.
Abstract: Vitamin A deficiency (VAD) among children under five years of age remains a significant public health concern in Tanzania. Orange-fleshed sweet potatoes (OFSP), rich in provitamin A, offer a sustainable dietary solution to address this challenge. This study aimed to assess the community’s knowledge, attitudes, and practices (KAP) regarding OFSP in ...
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Research Article
Prevalence and Pattern of Sexual Abuse Among Adolescents in Senior Secondary Schools in Gwagwalada Federal Capital Territory, Nigeria
Raymond Chukwuma Onovo*,
Rabi Susan Adelaiye
Issue:
Volume 14, Issue 4, August 2026
Pages:
178-192
Received:
25 May 2026
Accepted:
2 June 2026
Published:
27 July 2026
DOI:
10.11648/j.sjph.20261404.14
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Abstract: Background: Child sexual abuse (CSA) is a major public health concern with serious physical, emotional, and social consequences. This study assessed the prevalence and pattern of CSA among senior secondary school students in Gwagwalada, Abuja. Methods: A mixed-method descriptive cross-sectional study was conducted from January to March 2025 among 270 adolescents selected through multistage sampling. Data were collected using structured questionnaires and in-depth interviews. Quantitative data were analyzed at a significance level of p ≤ 0.05, and thematic analysis was applied to qualitative responses. Results: The prevalence of CSA was 38.9% (105 students). The most commonly reported abusive act was being forced to expose their naked body. Perpetrators were mainly known to victims, including family members and neighbors, with most incidents occurring between ages 2–14, either at home or in public spaces. Significant associations were observed between CSA and age group, class level, living arrangement, parental education, parental occupation, and stigma. Key determinants identified were living arrangement, father’s occupation, and perceived stigma. Qualitative findings highlighted abuse occurring in trusted environments, involving coercion and threats, with non-disclosure driven by fear, shame, and blame. Conclusion: CSA is highly prevalent in Gwagwalada and linked to family and social vulnerabilities, requiring strengthened preventive and supportive interventions.
Abstract: Background: Child sexual abuse (CSA) is a major public health concern with serious physical, emotional, and social consequences. This study assessed the prevalence and pattern of CSA among senior secondary school students in Gwagwalada, Abuja. Methods: A mixed-method descriptive cross-sectional study was conducted from January to March 2025 among 2...
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