Keyword: Sub-Saharan Africa

ABSTRACT: Background: Generative AI and large language models are changing how people seek health information, but their effect on maternal health in sub-Saharan Africa is unclear. This narrative review synthesizes evidence on generative AI and maternal health misinformation, examines community health workers (CHWs) as information intermediaries, and proposes a conceptual framework for safe AI implementation.
Methods: We ran a purposive search of PubMed/MEDLINE, Web of Science, Scopus, ACM Digital Library, and Google Scholar for publications from January 2014 to August 2026. We synthesized findings narratively and used the Consolidated Framework for Implementation Research (CFIR) to organize implementation determinants.
Results: We found no study of generative AI maternal health misinformation in sub-Saharan Africa. Evidence from high-income settings and non-maternal topics shows AI answers on reproductive health can be inaccurate or inconsistent, and fluent AI text can seem more compelling than human writing. Multi-specialty African benchmarks and a global benchmark review point to a gap between benchmark performance and clinical safety, but maternal-specific performance is unreported. CHWs have a well-documented record of improving maternal and child health, but their ability to identify AI errors is untested. African digital health implementations highlight user-centered design, interoperability, and sustained investment.
Conclusions: We propose, as hypotheses for evaluation, localized benchmarking, retrieval-augmented generation restricted to national guidelines with added safeguards, CHW curricula that include AI literacy, and decentralized research hubs. Unvalidated AI could bypass CHW authority and affect trust, though this is unstudied. Priorities include measuring AI use among pregnant women and prospectively evaluating CHW-facing tools.

ABSTRACT: The relationship between official development assistance to the health sector, health outcome improvements, State legitimacy building, conflict prevention in sub-Saharan Africa's fragile and conflict-affected States, is one of the most policy-relevant but analytically under-explored questions which face the developing countries globally. Does health Official Development Assistance (ODA) to fragile States, build the State legitimacy which reduces armed group recruitment vulnerability, or does it substitute for domestic health investment in ways that undermine, rather than strengthen institutional capacity and State-citizen trust? This paper examines the aid effectiveness, health investment, conflict prevention nexus across six sub-Saharan African country cases, and it draws on the Organisation for Economic Cooperation and Development's Development Assistance Committee (OECD-DAC) Creditor Reporting System data, on health ODA (2018 to 2022), World Bank World Development Indicators government health expenditure data (2022), the World Health Organisation's Universal Health Coverage (WHO-UHC) Service Coverage Index (2021), the Mo Ibrahim Foundation's Ibrahim Index of African Governance (IIAG) Overall Governance scores (2023 data year), and the Armed Conflict Location and Event Data Project's (ACLED) Conflict Severity Index (2022). Rwanda provides the most compelling positive case as the study finds a pattern that is consistent with health ODA supporting State legitimacy and favourable governance outcomes, when it is channelled through government systems which are aligned with a country's health priorities, and are designed to build domestic institutional capacity, rather than to substitute it. It further finds that Somalia and Northeast Nigeria illustrate the cautionary cases, in which large volumes of health ODA which are channelled through parallel systems of non-governmental organizations, are associated with weaker domestic health governance capacity in this comparative sample, and may be associated with reduced State legitimacy by linking health services with international actors rather than government. The paper argues for a fundamental reorientation of health ODA in fragile States toward government-aligned, conflict-sensitive, capacity-building approaches, that explicitly measure and pursue security dividends alongside health outcomes.

ABSTRACT: Background: The health outcomes of women living with the Human Immunodeficiency Virus (HIV) in sub-Saharan Africa remain poor, despite global efforts to improve access to antiretroviral therapy. Social determinants have been identified as key factors contributing to these disparities, however, evidence remains limited. This systematic review aims to synthesize evidence on the association between social factors and health outcomes among women living with HIV in sub-Saharan Africa.
Methods: A systematic review was conducted following the PRISMA 2020 guidelines. Peer-reviewed articles published between January 2015 and November 2025 were identified through an extensive literature search in PubMed/Medline, Web of Science, and Google Scholar. The search yielded 1,589 studies, of which 23 were included in the final analysis. A thematic approach was used to synthesize eligible studies that examined one or more social factors and reported health outcomes.
Results: Twenty-three studies were included in the review, comprising 13 quantitative (11 cross-sectional and 2 cohort) and 10 qualitative studies across sub-Saharan Africa. After quality appraisal, 20 studies were rated as high quality, while 3 were moderate. None was classified as low quality. The main social factors influencing treatment outcomes included HIV-related stigma, socioeconomic status, gender norms, intimate partner violence, healthcare access, cultural and religious beliefs, and social support. These factors were consistently linked to late testing, poor antiretroviral therapy adherence, low retention in care, low viral suppression, and adverse mental health outcomes. Conversely, social support networks, peer-based interventions, and community- and faith-based care were associated with improved ART adherence, empowerment, and quality of life.
Discussion: These findings emphasize that social determinants do not function in isolation but through interconnected structural, community, and interpersonal pathways, creating both risks and protections for health outcomes.
Conclusion: Intersecting social and structural determinants of health impact outcomes among women living with HIV in sub-Saharan Africa. Addressing these factors requires integrated, gender-responsive, and community-empowering strategies beyond biomedical treatment alone.

ABSTRACT: Background: Gender-based violence (GBV) and Human Immunodeficiency Virus (HIV) are critical public health issues in Sub-Saharan Africa, disproportionately affecting women. Gender-based violence (GBV)—including intimate partner violence and sexual assault—fuels HIV transmission via trauma, coercion, and healthcare barriers. This syndemic demands urgent, evidence-based solutions to break the cycle of risk.
Objectives: This study aims to explore the prevalence, types, and socio-cultural, economic, and power-related factors linking GBV to HIV risk among women in Sub-Saharan Africa, and to assess the effectiveness of integrated interventions addressing both issues.
Methodology: In carrying out this review, a scoping review design was employed. PubMed, African Journals Online (AJOL), and Google Scholar were searched for peer-reviewed studies conducted across Sub-Saharan Africa focusing on association of GBV and HIV risks. Data was extracted on the prevalence of HIV cases linked to GBV, and interventions addressing such prevalence. A thematic synthesis was used to identify common trends and gaps in the literature.
Findings: This study found GBV prevalence rates ranging from 3.4–89.3% across included studies, with significant geographic and population-based variations. GBV was identified as a major risk factor for HIV, particularly in settings with high economic dependence and gender inequality. Integrated interventions combining HIV care and GBV services were found to improve health outcomes, though access remains limited in rural areas.
Conclusion: This study underscores the urgent need for integrated, multi-sectoral approaches to address both GBV and HIV. Future research should focus on longitudinal studies and the scalability of successful interventions in diverse settings. Policymakers must prioritize these intersections to reduce the burden on women’s health in Sub-Saharan Africa.

ABSTRACT: Antimicrobial resistance (AMR) is a growing global threat, and sub-Saharan Africa (SSA) bears a disproportionate share of this burden. This narrative review examines how deficiencies in water, sanitation, and hygiene (WASH) contribute to AMR in SSA. It draws on peer-reviewed literature, institutional reports, and regional policy documents published between 2015 and 2025. Sources were identified through databases such as PubMed, Google Scholar, and WHO/UN databases using combinations of keywords including ‘AMR’, ‘WASH’, ‘Sub-Saharan Africa’, and ‘One Health’. We survey recent literature on the regional AMR problem, the role of inadequate WASH in propagating resistant infections among humans, animals, and the environment, and the relevance of a One Health approach. Key themes include the high AMR mortality in Africa, the persistence of antibiotic residues and pathogens in poorly managed water and sanitation systems, and how poverty-related WASH gaps drive frequent infections that require antibiotics. Evidence suggests that unsafe water and sanitation facilitate the environmental circulation of resistant bacteria and genes. The One Health framework is highlighted as essential for addressing these links, since AMR crosses human, animal, and ecological domains. We conclude that improving WASH infrastructure and practices, alongside integrated AMR strategies, is critical to curb resistance in the region. Focusing on WASH under a One Health perspective can reveal overlooked pathways of AMR spread and inform targeted interventions in SSA.

ABSTRACT: One of the major public health emergencies that has affected lives globally is infectious disease outbreaks. These issues are of great concern due to their potential to transcend borders. The control and management of such outbreaks even with the attention channelled towards it globally has been a difficult task in many developing and underdeveloped countries of the world of which the majority of sub-saharan african countries fall under. However, with this review, we aim to contribute to the body of knowledge dedicated towards control of infectious diseases by analyzing the preparedness of Sub-Saharan African (SSA) countries in managing infectious disease outbreaks based on lessons from recent outbreaks (with focus on COVID-19, Lassa fever and Ebola outbreaks). In carrying out this narrative review, we make use of PubMed and African Journals Online (AJOL) as the primary literature sources. To ensure we capture publications from reputable organizations that are solely involved in control of infectious diseases in the region, we carried out a grey literature search.
However in this review, we synthesized challenges such as weak healthcare systems, inadequate healthcare infrastructure, inefficient surveillance systems, poor data management and reporting practices, limited laboratory capacity and reliance on external donors for supplies during emergencies.
The review proposes potential interventional measures aimed at addressing these challenges aimed at enhancing the preparedness
The findings from this review provide critical insights into the preparedness gaps and potential interventions, informing policy and practice to enhance the region's resilience future outbreaks.