This mixed-methods study examined menstrual poverty among 447 female learners in Zambian urban and rural schools. Urban students showed better understanding of menstruation than rural peers, though both groups reported similar emotional responses including fear and discomfort. Support-seeking behaviors and cultural practices varied by location, with rural learners often using herbal remedies. Over 50% of all students reported inadequate sanitary facilities, citing problems with cleanliness, privacy, and handwashing. The authoprs indicate that the significant urban-rural disparities in menstrual knowledge and practices highlight the need for comprehensive menstrual health education in public schools and collaboration with the Ministry of Health to ensure access to essential resources and gender-sensitive facilities.
Poverty and health
This paper investigates demographic, maternal, and child-related factors associated with the coexistence of stunting, wasting, and underweight. Secondary data from 2,158 children aged 0–23 months in the 2022 Tanzania Demographic and Health Survey were analyzed. Risk factors assessed included child age, birth weight, size at birth, birth order, and maternal education. Multinomial regression analysis was conducted to determine associations. The risk of coexisting undernutrition was significantly higher among children aged 12–17 months and 18–23 months. Protective factors included birth weight < 2,501 g, average size at birth, and higher birth order. The authors propose that interventions target the 12–23-month age group and address maternal education to address child malnutrition in Tanzania.
This paper examined socio-economic and demographic determinants of undernutrition among children aged 6–59 months, offering insights to guide interventions in these areas. This cross-sectional study of 1,275 caregiver-child pairs from Mzimba, Mchinji, and Mangochi Malawi used multi-stage sampling. Wasting was linked to occupation, marital status, household size, religious affiliation, and vaccination, with protective factors including farming, business, being single, and full vaccination. Underweight was associated with occupation and household type, with higher risks in business and single-parent households, and protection in smaller households. Stunting was related to unemployment and full vaccination. Education and income showed no significant association with stunting.
While recent evidence established a positive causal relationship between some social protection programmes and food security there is little evidence on the extent to which these initiatives are associated with better educational and sexual and reproductive health outcomes among vulnerable adolescents in Lesotho. This study used cross-sectional, nationally representative data from the 2018 Lesotho Violence Against Children and Youth Survey to examine the association between social protection receipt and educational and sexual and reproductive health outcomes among adolescents and young people living in poverty. Social protection receipt was defined as household receipt of financial support from a governmental, non-governmental, or community-based program that provides income. Among the 3 506 adolescent females and males living in the two lowest poverty quintiles, receipt of social protection was associated with improvements in multiple adolescent outcomes: higher odds of consistent condom use, educational attainment, and school enrolment. Stratified analyses by sex showed that social protection receipt was also associated with reduced likelihood of child marriage among females and higher odds of educational attainment and school enrolment among males. The study provides evidence that social protection programs are associated with improved educational, sexual and reproductive health and child marriage prevention outcomes among adolescents living in poverty. The author recommends implementing and expanding such social protection initiatives to improve the well-being of vulnerable adolescents.
This paper documented the contexts in which women selling sex in Kampala Uganda meet and provide services to their clients, using qualitative data from semi-structured interviews with 20 women 18 years or older, who were self-identified as sex workers. Women met clients in physical and virtual spaces. Physical spaces included venues and outdoor locations, and virtual spaces were online platforms like social media applications and websites. Of the 20 women included, 12 used online platforms to meet clients. Generally, women from a clinic sample were less educated and predominantly unmarried, while those from a snowball sample had more education, had professional jobs, or were university students. Women from both samples reported experiences of stigma, violence from clients and authorities, and challenges accessing health care services due to the illegality of sex work. Even though all participants worked in settings where sex work was illegal and consequently endured harsh treatment, those from the snowball sample faced additional threats of cybersecurity attacks, extortion and high levels of violence from clients. To reduce risk of HIV acquisition among women who sell sex, the authors suggest that researchers and implementers consider these differences in contexts, challenges, and risks to design innovative interventions and programs that reach and include all women.
This study explored how food insecurity influences child marriage practices in Chiredzi, Zimbabwe. It used mixed methods, including participant-led storytelling and key informant interviews. A total of 1,668 community members participated in the story-telling, while 22 staff participated in interviews. The authors found that food insecurity was a primary concern among community members and was among the contextual factors of deprivation that influenced parents’ and adolescent girls’ decisions around child marriage. Parents often forced their daughters into marriage to relieve the household economic burden. At the same time, adolescents were found to be initiating their own marriages due to limited alternative survival opportunities and within the restraints imposed by food insecurity, poverty, abuse in the home, and parental migration. COVID-19 and climate hazards exacerbated food insecurity and child marriage, while education was assessed to be a modifier that reduces girls’ risk of marriage. The authors suggest that child marriage programming in humanitarian settings should be community-led and address the gender inequality that underpins child marriage. They argues that programming must be responsive to the diverse risks and realities that adolescents face to address intersecting levels of deprivation.
This study explored barriers to access health and nutrition services in drought and food insecurity emergency affected districts in north-east Uganda. The authors interviewed 30 patients and 20 Village Health Teams from 15 districts and used thematic data analysis on the findings. The majority of respondents reported that difficulties in access to health and nutrition services, with various sociocultural, economic, environmental, health system, and individual barriers. The study identified several modifiable barriers that are addressed in proposals for comprehensive interventions in the paper.
This paper explores the impacts of COVID-19 and past pandemics on food security and key strategies that could be put in place to manage these impacts on security. The coronavirus pandemic deepened disruptions in the flow of farm workers and farm operations leading to post-harvest food losses, and diets were affected. The authors recommend future responses to prevent and mitigate the effects of pandemics on food security consider inter-connected pro-active policy, program, and institutional actions.
A broken sewerage system in Bophelong near the Vaal River in Gauteng, forces people to live “like pigs”, says environmental activist Lawrence Majoro. The department of water and sanitation acknowledges the Vaal is “one of the worst polluted rivers in South Africa”, leaving residents exposed to diseases like cholera. In this episode of Bhekisisa’s monthly television show, Health Beat, viewers are taken to see the Emfuleni municipality in Vanderbijlpark’s rundown sewers, with input from an infectious diseases expert and a water scientist on the implications if water treatment services don’t improve.
This study investigated how water and food insecurity were associated in nationally representative samples of individuals from 25 low- and middle-income countries, using data from the Individual Water Insecurity Experiences Scale and the Food Insecurity Experience Scale administered to 31 755 respondents, measuring insecurity in the previous 12 months. The likelihood of experiencing moderate-to-severe food insecurity was higher among respondents also experiencing water insecurity, including in sub-Saharan Africa. The results suggest that water insecurity should be considered when developing food and nutrition policies and interventions and the authors propose research to understand the paths between these insecurities.