Europeans target better health services for sub-Saharan Africa

EU website. People living in sub-Saharan Africa continue to feel the pressure of increasing poverty and morbidity (incidence of specific diseases). Teenagers in particular are at risk of reproductive health problems, and now a new EU-funded project is set to address this problem by investigating the effectiveness of existing programmes and identifying the structural drivers that restrict access to adolescent reproductive health (ARH) services in Niger and Tanzania.

The INTHEC (‘Health, education and community integration: evidence based strategies to increase equity, integration and effectiveness of reproductive health services for poor communities in sub-Saharan Africa’) project has received EUR 2.75 million in funding under the EU’s Seventh Framework Programme (FP7).

The project, launched in March 2010 and scheduled to end in February 2014, will be instrumental in addressing the cultural barriers that currently limit access to or curb the effectiveness of ARH services found in the partner countries today.

Led by the Liverpool School of Tropical Medicine (LSTM) in the UK, the INTHEC consortium comprises experts from the fields of reproductive health research and interventional implementation, as well as leaders in governance and policymaking in Belgium, Niger and Tanzania.

The INTHEC partners will develop and assess interventions for use in communities, schools and workshops. They will, for example, forge stronger ties between the communities and health units, and work to make local ARH services more effective.

According to the team, the interventions will be developed gradually, and a series of process evaluation studies will be used to test their effectiveness. The information obtained will result in a population-based cluster randomised trial.

‘This research will tackle some of the key structural drivers which limit access to effective reproductive health services by assessing the weakness of current programmes and directly developing specific actions to tackle them,’ explained Dr Angela Obasi of the LSTM and INTHEC’s project leader.

‘The government ministries responsible for ARH in Tanzania and Niger are partners in the programme, meaning that the outcome of the research will be genuinely owned by the key policymakers, so ensuring the impact of this research beyond the life of the project.’

The INTHEC team will hold a ‘Project Launch Workshop’ at the LSTM from 10 to 14 May.

According to Advocates for Youth, a US-based non-profit organisation that is not involved in the project, early sexual activity is linked to adolescent morbidity and mortality. The adolescent fertility rate in sub-Saharan Africa is generally higher than for other regions worldwide.

When teens give birth to babies, the health risks for both mother and child increase. Myriad problems could arise including toxaemia, anaemia, malnutrition and vesico- or recto-vaginal fistula (an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect).
Adolescent females aged between 15 and 19 represent 80% of all fistula cases in Niger, for example.

Research has also shown that sexually transmitted diseases (STDs) also have a vital impact on young women, as they are more easily infected than their older peers. These women are more frequently asymptomatic. Failure to correctly diagnose the problem can trigger more serious and long-term complications for these patients.

Bearing in mind that improved access to prevention, treatment, care and support services, notably sexual and reproductive health is one of the main expected outcome of the third priority action of the Africa-EU MDGs Partnership, to accelerate the achievement of the health targets of the MDGs.

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