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Ghana Systematic Map to guide decision-making on the current landscape of research on World Health Assembly indicators in West Africa

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A new study by Transform Nutrition West Africa identifies the trends and gaps in research that cover the World Health Assembly indicators across West Africa. These are potentially valuable insights for nutrition decision makers in the region. This presentation is to be used as a freely accessible resource for decision-makers at all levels.

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Ghana Systematic Map to guide decision-making on the current landscape of research on World Health Assembly indicators in West Africa

  1. 1. Ghana International Food Policy Research Institute The Current Landscape of Research on World Health Assembly Indicators in West Africa: A Systematic Map to Guide Decision-Making
  2. 2. 2 The West Africa (WA) Region has been one of the slowest in reducing its many burdens of malnutrition. The World Health Assembly’s (WHA) 2025 nutrition targets were developed to track countries’ nutritional situations, and measure progress in reducing malnutrition. These indicators are therefore essential to guide decision making. Understanding the regional and in-country dynamics are an essential first step to highlight gaps and trends in evidence in the region. Introduction This study aimed to identify and catalogue peer-reviewed research on the WHA indicators in West Africa, and create a map of recent research evidence to inform decision-making for nutrition policies and programs in the region. Objective
  3. 3. Data were extracted at abstract level. No quality appraisal of publications was undertaken. A systematic approach was applied to literature searches, developing inclusion criteria, screening, coding, taxonomy, data extraction, and study synthesis The MEDLINE database was searched for research published on World Health Assembly (WHA) indicators from 2010 to April 2018 Search terms were developed to capture evidence on the prevalence, drivers, programs (Randomized Controlled Trials), and policies relating to the WHA indicators. These include stunting, wasting and overweight in children under 5, low birth weight (LBW), exclusive breastfeeding (EBF) up to 6 months, and anemia in women of reproductive age (WRA) Methods
  4. 4. References identified through systematic search (n=6,630) References excluded (n=2,581) - Not WA region (n=130) - Not target population (n=172) - Disease specific/not nutrition related (n=1729) - Nutrition related but not WHA specific (n=337) - Additional program studies (n=75) - RCT Protocol (n=9) - Other (n=129) Duplicates removed (n=3,669) References retrieved after title and abstract screening (n=380) - Primary studies (n=359) - Reviews (n=21) References retrieved for title and abstract screening (n=2,961) References included in mapping (n=363) Primary Studies (n=340) Reviews (n=23) Excluded at extraction level (n=17) Flow chart of search approach
  5. 5. Results – Ghana
  6. 6. Analysis General characteristics Characteristics of WHA indicators Characteristics of focus of research Results
  7. 7. 21 39 4 12 10 86 5 5 5 15 18 147 14 8 2 1 Benin Burkina Faso Cape Verde Cote d'Ivoire Gambia Ghana Guinea Guinea- Bassau Liberia Mali Niger Nigeria Senegal Sierre Leone Togo WA region Number of publications per country A quarter of publications report on Ghana 78 publications focus only on Ghana and 8 publications are on multi- country studies that include Ghana
  8. 8. Publications per year in four focal countries 0 2 4 6 8 10 12 14 16 18 20 22 24 26 2010 2011 2012 2013 2014 2015 2016 2017 Nrofpublications Nigeria Ghana Burkina Faso Senegal
  9. 9. Publications reporting on Ghana by study setting 28 8 9 3 27 11 0 5 10 15 20 25 30 Not specified National District Community Hospital Health facility Nr of publications
  10. 10. Publications reporting on Ghana by study design 1% 21% 2% 54% 12% 9% 1% Percent of publications per study design (n=86) Other Not specified Case-control Case series Cross-sectional Cohort RCT Review 67% 9% Hierarchy of evidence
  11. 11. Analysis General characteristics Characteristics of WHA indicators Characteristics of focus of research Results
  12. 12. Publications per indicator category grouping in focal countries 16 24 23 5 21 18 20 5 7 33 61 2 1 4 7 2 8 20 50 3 9 13 20 4 0 20 40 60 80 100 120 140 160 180 200 Burkina Faso Ghana Nigeria Senegal U5 Stunting U5 Wasting LBW U5 Overweight Anaemia WRA EBF
  13. 13. Publications reporting on Ghana per indicator category 45% 13% 18% 24% Percent of publications per indicator category (n=86) U5NS EBF Anaemia WRA More than 1 WHA indicator 20% 8% 67% 5% Breakdown of publications within U5NS (n=137) U5 Stunting U5 Wasting LBW U5 Overweight
  14. 14. Analysis General characteristics Characteristics of WHA indicators Characteristics of focus of research Results
  15. 15. Publications reporting on Ghana per indicator category and research focus 22 17 29 4 12 16 2 4 1 4 1 2 3 3 1 0 5 10 15 20 25 30 35 40 U5 Stunting U5 Wasting LBW U5 Overweight EBF Anaemia WRA Problem Program Policy
  16. 16. Program studies by intervention type and outcome 18 8 4 1 0 5 10 15 20 Burkina Faso Ghana Nigeria Senegal Nrofprogramstudies Ghana’s programs Intervention description U5NS (n=5) EBF (n=1) Anaemia (n=4) Supplementation 2 0 2 Counseling/ Health promotion 1 1 0 Screening/Treatment Malaria 2 0 2
  17. 17. Key Messages Most publications were conducted within health facilities The majority of publications reported on the prevalence and drivers of indicator categories, and very few report on policy and programs The majority of research studies report on under 5 nutritional status. Within this, the majority of studies report on low birth weight and very few report on under 5 overweight 25% of the publications were conducted in Ghana

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