Frederick Wekesah

African Population and Health Research Center | APHRC · Health Challenges and Systems Program

Background and Objective: Medical students experience poorer psychological well-being than age-matched individuals. Social determinants and cultural factors influence an individuals health. The association between social determinants and the mental health of medical students is poorly understood. This study aims to compare the association of stress...

Objective: To determine the patterns of cardiometabolic multimorbidity and associated risk factors in sub-Saharan Africa (SSA). Design: We used data from the WHO STEPwise approach to non-communicable disease risk factor surveillance cross-sectional surveys conducted between 2014 and 2017. Participants: The participants comprised 39, 658 respon...

Objectives The aim of this paper is to share the results of a systematic review on the state of inequalities in access to and utilization of maternal, newborn and child health (MNCH) services in the sub-Saharan African region. The focus of the review was on urban settings where growing needs and challenges have been registered over the past few yea...

In the early 2000s, massive economic and technical resources accompanied the framing of HIV as a humanitarian and global health crisis in much of the Global South. These resources and framing combined to produce and enhance a wide range of HIV-related structures, skills, and knowledge with afterlives that have exceeded the crisis period in Kenya an...

Purpose In low- and middle-income countries, there are limited data on mental disorders among adolescents. To address this gap, the National Adolescent Mental Health Surveys (NAMHS) will provide nationally representative prevalence data of mental disorders among adolescents in Kenya, Indonesia, and Vietnam. This paper details the NAMHS study protoc...

Background Although recent policies have sought to increase the rates of exclusive breastfeeding (EBF) and continued breastfeeding for HIV exposed infants, few programs have considered the multiple social and cultural barriers to the practice. Therefore, to generate evidence for exclusive and continued breastfeeding policies in Kenya, we examined c...

Motivation The Sustainable Development Goals (SDGs) are globally touted as an opportunity for more strategic policy and programmatic focus on marginalized groups, including sexual minorities. Purpose To explore Togolese, Nigerian, and Ugandan policymakers’ views and experiences of harnessing SDGs‐era national policies and programmes to address the...

The baby-friendly hospital initiative (BFHI) promotes exclusive breastfeeding (EBF) in hospitals, but this is not accessible in rural settings where mothers give birth at home, hence the need for a community intervention. We tested the effectiveness of the baby-friendly community initiative (BFCI) on EBF in rural Kenya. This cluster randomized stud...

Introduction Tracking progress in reaching global targets for reducing premature mortality from non-communicable diseases (NCDs) requires accurately collected population based longitudinal data. However, most African countries lack such data because of weak or non-existent civil registration systems. We used data from the Nairobi Urban Health and D...

At STIAS, the ‘Health in Transition’ theme includes a programme to address the epidemic rise in the incidence of non-communicable diseases (NCDs) such as Type 2 diabetes, hypertension, obesity, coronary heart disease and stroke in Africa. The aim is to advance awareness, research capacity and knowledge translation of science related to the Developm...

The vulnerability of lesbian, gay, bisexual and transgender (LGBT) persons in Africa to public health and other risks is heightened by their exclusion from socio-economic opportunities and services. We analysed existing regional-level legal and policy instruments and treaties for the opportunities they offer to tackle the exclusion of LGBT persons...

Background: Maternal nutrition depletion during pregnancy compromises fetal programming, and is a cause of adverse birth outcomes. Maternal body composition measurement using direct body composition assessment methods such as the deuterium dilution technique provides better prediction of birth outcomes as compared with commonly used techniques like...

Background: Although the baby-friendly community initiative (BFCI) has been proposed as a community-level approach to improve infant feeding practices, there is little data on its variation in effectiveness by HIV status. We conducted a study to determine the effectiveness of BFCI in changing knowledge and attitudes towards exclusive breastfeeding...

Background Cardiovascular diseases (CVD) cause 18 million deaths annually. Low- and middle-income countries (LMICs) account for 80% of the CVD burden, and the burden is expected to grow in the region in the coming years. Screening for and identification of individuals at high risk for CVD in primary care settings can be accomplished using available...

Background: Cardiovascular diseases (CVD) comprise eighty percent of non-communicable disease (NCD) burden in low- and middle-income countries and are increasingly impacting the poor inequitably. Traditional and socioeconomic factors were analyzed for their association with CVD mortality over 10 years of baseline assessment in an urban slum of Nai...

At the 1994 ICPD, sub-Saharan African (SSA) states pledged, inter alia, to guarantee quality post-abortion care (PAC) services. We synthesized existing research on PAC services provision , utilization and access in SSA since the 1994 ICPD. Generally, evidence on PAC is only available in a few countries in the sub-region. The available evidence howe...

This chapter summarizes existing research on mental health among young people in West and Central Africa (WCA). Although data in this area are limited, small scale, nonrepresentative studies suggest that mental disorders are prevalent in WCA due to civil conflicts and political instability, sexual violence, poverty, underemployment and unemployment...

Objectives Although cardiovascular disease (CVD) is of growing importance in low- and middle-income countries (LMICs), there are conflicting views regarding CVD as a major public health problem for the urban poor, including those living in slums. We examine multivariable risk prediction in a slum population and assess the number of cardiovascular r...

Background Although cardiovascular disease (CVD) is of growing importance in low- and middle-income countries (LMICs), there are conflicting views regarding CVD as a major public health problem for the urban poor, including those living in slums. We examined multivariable risk prediction in a slum population and assessed the number of cardiovascula...

Objectives The study explored the understanding of and perception towards cardiovascular disease (CVD) and risk factors, and how they influence prevention and development of the conditions, care-seeking and adhering to treatment. Setting Informal settlements of Nairobi. Participants Nine focus group discussions consisting of between six and eight...

Conservation agriculture (CA) involves the practice of concurrent minimum tillage, permanent soil cover using crop residue, and crop rotation. Evidence indicates that CA increases agricultural productivity, reduces farming labour requirements, and improves soil quality. While CA is practised in several African contexts, little is known about its in...

Malnutrition remains a universal problem, with at least one in three people experiencing it. It is linked, either directly or indirectly, to the major causes of death and disability. Although the amounts of certain nutrients required by the body vary somewhat depending on the stage of life, human beings generally require the same nutrients througho...

Background Non-communicable diseases and unintentional injuries are emerging public health problems in sub-Saharan Africa. These threats have multiple risk factors with complex interactions. Though some studies have explored the magnitude and distribution of those risk factors in many populations in Kenya, an exploration of segmentation of populati...

Background Non-communicable diseases (NCDs), are increasing globally, causing about 60% of disability-adjusted life years and 39.8 million deaths in 2015. Risk factors often cluster and interact multiplicatively in an individual and this is strongly associated with the development and severity of NCDs. We assessed the sociodemographic factors assoc...

Abstract Background Hypertension is the most important risk factor for cardiovascular diseases and the leading cause of death worldwide. Despite growing evidence that the prevalence of hypertension is rising in sub-Saharan Africa, national data on hypertension that can guide programming are missing for many countries. In this study, we estimated th...

Background: In Kenya, poor maternal nutrition, suboptimal infant and young child feeding practices and high levels of malnutrition have been shown among the urban poor. An intervention aimed at promoting optimal maternal infant and young child nutrition (MIYCN) practices in urban poor settings in Nairobi, Kenya was implemented. The intervention in...

Objectives To establish exclusive breastfeeding (EBF) practice, women are encouraged to initiate breastfeeding of their newborns within one hour of delivery and breastfeed exclusively for the first 6 months of the infant’s life. Research in Kenya has shown evidence of a reduced rate of EBF with an increase in socio-economic class (SES). This study...

East Africa, and sub-Saharan Africa (SSA) as a whole, are on the verge of a demographic transition, with a consequent window of opportunity to achieve a demographic dividend. Family planning (FP) is key to facilitating and sustaining the emerging fertility transition in the sub-region; supporting individuals and couples to take charge of their fert...

Background Exclusive breastfeeding (EBF) improves infant health and survival. We tested the effectiveness of a home-based intervention using Community Health Workers (CHWs) on EBF for six months in urban poor settings in Kenya. Methods We conducted a cluster-randomized controlled trial in Korogocho and Viwandani slums in Nairobi. We recruited pregn...

Introduction Cardiovascular diseases (CVDs) are the most common cause of non-communicable disease mortality in sub-Saharan African (SSA) countries. Gaps in knowledge of CVD conditions and their risk factors are important barriers in effective prevention and treatment. Yet, evidence on the awareness and knowledge level of CVD and associated risk fac...

Search strategy for PubMed. (DOCX)

Results of quality assessment of the quantitative and qualitative studies. (XLSX)

PRISMA 2009 checklist. (DOC)

This report synthesizes essential evidence consolidated from Demographic and Health Surveys (DHS) and other data sources on key socioeconomic, educational, health, and demographic situations of young people in the WCA sub-region as part of the current drive towards the sub-region’s first demographic dividend (DD). It also identifies critical eviden...

User priorities regarding quality care in contexts of medical pluralism are poorly documented. Drawing on group and individual interviews with women, we interrogate ideas of quality maternity care in the context of Nigeria's medical pluralism. We found complex utilization patterns for conventional , complementary and alternative maternity care serv...

Background Despite numerous interventions promoting optimal breastfeeding practices in Kenya, pockets of suboptimal breastfeeding practices are documented in Kenya’s urban slums. This paper describes cultural and social beliefs and practices that influence breastfeeding in two urban slums in Nairobi, Kenya. Methods Qualitative data were collected...

Non-communicable diseases (NCDs) are emerging as a public health issue in sub-Saharan Africa. This paper examines the relationship between the risk of NCDs and perceptions about such risk among urban slum population in Nairobi, Kenya. The analysis is based on data collected between 2008 and 2009 as part of a cross-sectional survey that was designed...

Non-communicable diseases (NCDs) are emerging as a public health issue in sub-Saharan Africa. This paper examines the relationship between the risk of NCDs and perceptions about such risk among urban slum population in Nairobi, Kenya. The analysis is based on data collected between 2008 and 2009 as part of a cross-sectional survey that was designed...

Despite increased recognition that urban slum dwellers are both extremely vulnerable and highly underserved, the national and international commitment to address urban food crises is constrained by a dearth of information. In Nairobi, Kenya, an estimated 60 % of the population live in slums or slum-like conditions. On average, the Nairobi poor spen...

Objective Children in slums are at high risk of undernutrition, which has long-term negative consequences on their physical growth and cognitive development. Severe undernutrition can lead to the child’s death. The present paper aimed to understand the causes of undernutrition in children as perceived by various groups of community members in Nairo...

Background Many interventions have been implemented to improve maternal health outcomes in sub-Saharan Africa (SSA). Currently, however, systematic information on the effectiveness of these interventions remains scarce. We conducted a systematic review of published evidence on non-drug interventions that reported effectiveness in improving outcomes...

Early nutrition is critical for later health and sustainable development. We determined potential effectiveness of the Kenyan Community Health Strategy in promoting exclusive breastfeeding (EBF) in urban poor settings in Nairobi, Kenya. We used a quasi-experimental study design, based on three studies [Pre-intervention (2007-2011; n=5824), Interven...

Background: To assess the availability, price and market share of quality-assured artemisinin-based combination therapy (QAACT) in remote areas (RAs) compared with non-remote areas (nRAs) in Kenya and Ghana at end-line of the Affordable Medicines Facility-malaria (AMFm) intervention. Methods: Areas were classified by remoteness using a composite...

Background Interventions promoting optimal infant and young child nutrition could prevent a fifth of under-5 deaths in countries with high mortality. Poor infant and young child feeding practices are widely documented in Kenya, with potential detrimental effects on child growth, health and survival. Effective strategies to improve these practices a...

Poor breastfeeding practices are widely documented in Kenya, where only a third of children are exclusively breastfed for 6 months and only 2% in urban poor settings. This study aimed to better understand the factors that contribute to poor breastfeeding practices in two urban slums in Nairobi, Kenya. In-depth interviews (IDIs), focus group discuss...

Food and nutrition security is critical for economic development due to the role of nutrition in healthy growth and human capital development. Slum residents, already grossly affected by chronic poverty, are highly vulnerable to different forms of shocks, including those arising from political instability. This study describes the food security sit...

Nutrition in the first 1,000 days of life (during pregnancy and the first two years) is critical for child growth and survival. Poor maternal, infant and young child nutrition (MIYCN) practices are widely documented in Kenya, with potential detrimental effects on child growth and survival. This is particularly a problem in slums, where most urban r...

The prevalence of HIV in the adult population in slum areas in Nairobi, Kenya, is higher than for residents in the city as a whole. This disparity suggests that the characteristics of slum areas may adversely influence the HIV-prevention strategies directed at reducing the national prevalence of HIV. The objective of the study was to identify some...

BACKGROUND: Food insecurity has consistently remained a major challenge in the horn of Africa in recent years. While focus has been on rural areas; many urban areas are now facing increasing challenges. This study aims to describe whether the sources of livelihood can predict household food security among people residing in two urban slums in Nairo...