Effect of nutrition-related infodemics and social media on maternal experience: A nationwide survey in a low/middle income country

BACKGROUND Undernutrition is a crucial cause of morbidity and mortality among children in low-or middle-income countries(LMICs).A better understanding of maternal general healthy nutrition knowledge,as well as misbeliefs,is highly essential,especially in such settings.In the current era of infodemics,it is very strenuous for mothers to select not only the right source for maternal nutrition information but the correct information as well.AIM To assess maternal healthy nutritional knowledge and nutrition-related misbeliefs and misinformation in an LMIC,and to determine the sources of such information and their assessment methods.METHODS This cross-sectional analytical observational study enrolled 5148 randomly selected Egyptian mothers who had one or more children less than 15 years old.The data were collected through online questionnaire forms:One was for the general nutrition knowledge assessment,and the other was for the nutritional myth score.Sources of information and ways of evaluating internet sources using the Currency,Relevance,Authority,Accuracy,and Purpose test were additionally analyzed.RESULTS The mean general nutrition knowledge score was 29±9,with a percent score of 70.8%±12.1%(total score:41).The median myth score was 9(interquartile range:6,12;total score:18).The primary sources of nutrition knowledge for the enrolled mothers were social media platforms(55%).Half of the mothers managed information for currency and authority,except for considering the author's contact information.More than 60%regularly checked information for accuracy and purpose.The mothers with significant nutrition knowledge checked periodically for the author's contact information(P=0.012).The nutrition myth score was significantly lower among mothers who periodically checked the evidence of the information(P=0.016).Mothers dependent on their healthcare providers as the primary source of their general nutritional knowledge were less likely to hold myths by 13%(P=0.044).However,using social media increased the likelihood of having myths among mothers by approximately 1.2(P=0.001).CONCLUSION Social media platforms were found to be the primary source of maternal nutrition information in the current era of infodemics.However,healthcare providers were the only source for decreasing the incidence of maternal myths among the surveyed mothers.

Hospital Acquired Infections in Low and Middle Income Countries: Root Cause Analysis and the Development of Infection Control Practices in Bangladesh

Nosocomial or hospital acquired infections are a major challenge for low and middle income countries (LMICs) which have limited healthcare resources. Risk factors include the lack of appropriate hospital facilities such as isolation units, bed space, and sinks;inadequate waste management, contaminated equipment, inappropriate use of antibiotics and transmission of infection from the hands of healthcare workers and family caretakers due to inadequate hand washing. Nosocomial infections increase the costs of healthcare due to added antimicrobial treatment and prolonged hospitalization. Since the prevalence of nosocomial infections is generally higher in developing countries with limited resources, the socio-economic burden is even more severe in these countries. This review summarizes the current knowledge on the risks of hospital acquired infections and summarizes current recommendations for the development of hospital infrastructure and the institution of protocols to reduce these infections in LMICs such as Bangladesh.

Petrogenesis and Tectonic Implications of Middle Ordovician Ocean Island Basalts from the Chagantaolegai Ophiolitic Mélange in Junggar,NW China

Seamount accretion is one of the most significant accretionary orogenic processes in the Central Asian Orogenic Belt,but there are few paleo-seamounts reported from and debate on the tectonic evolution of the Junggar Ocean still exists.In this study,we present geochronological,mineralogical,geochemical and isotopic data for basalts from the Chagantaolegai ophiolitic mélanges in Junggar.Zircon U-Pb dating on one basalt yielded a weighted mean^(206)Pb/^(238)U age of 469±7 Ma,which suggests that it formed in the Middle Ordovician.All rock samples belong to alkaline basalt and show similar geochemical characteristics,displaying high TiO_(2)(~3 wt%),(La/Yb)N(17.6–19.0),ΣREE(232–289 ppm)and enrichment in Nb and Ta,which implies an ocean island basalt(OIB)affinity.Based upon positiveεN d(t)(+4.16 to+4.23),ΔNb(0.20–0.22)and low initial^(87)Sr/^(86)Sr(0.70425 to 0.70452)and Zr/Nb(3.35–3.57),we suggest that the Chagantaolegai OIB samples were likely derived from a fertile mantle source related to plume.The OIB rock assemblage,chert and marble in the southern part of the Chagantaolegai ophiolitic mélange indicates that a Middle Ordovician seamount was accreted to the Boshchekul-Chingiz arc due to the northward subduction of the Junggar-Balkhash Ocean.

The New Shift in the Cooperation of the European Union With Middle and Upper-Middle-Income Countries

The objective of this article is to analyze the new cooperation of the European Union,in particular with middle and upper-middle-income countries,in order to understand the development policy of the Union in view of the new global scenario,taking into account the new status that these countries have acquired and the implications of this entails in international cooperation processes.This leads us to delve into how the EU cooperates with the middle-income countries and more advanced developing countries.The contribution of this work addresses some of the challenges and perspectives that are currently being planned about the EU’s development policy,providing different elements of analysis and reflection on its future evolution.

The Prospects of Blue Economy to Promote Bangladesh into a Middle-Income Country

This paper draws attention to the prospects of sea-based economy to promote Bangladesh in a middle-income country through the sustainable use of marine resources. About three-fourths of the earth is covered by the seas. It plays the vital role in two important functions from ancient time known as the means of communication and the source of huge living and non-living natural resources. At present, the countries are becoming very much concerned about their marine resources to resolve many of the present and future challenges of their economies. Generally for Bangladesh, ocean is contributing a significant role to its overall socio-economic progress through rising up the economic activities across the country and especially to the coastal zone at southern part. This paper investigates how much Bangladesh is capable to take of or handle the challenges to become a middle income country through the Sustainable Development Goals (SDGs). In addition, it has attempted with a closer-look to find out the barriers or limitations of these activities from different angles if exist.

The Economics of Reorganizing Otolaryngology Out-Patient Services for COVID-19 Pandemic in Low- and Middle-Income Countries

The Coronavirus 2019 (COVID-19) pandemic has widespread implications for clinical practice of otolaryngologists in clinics and hospitals. With various reports of otolaryngology practitioners catching infection, a profound structural reorganization of ENT services in the clinic is mandatory for protecting both patients and healthcare workers. The present study focused on quantifying the cost involved in reorganizing the otolaryngology out-patient services in a third world country during the ongoing Covid-19 pandemic. Though the pandemic has increased the cost of running of an otolaryngology practice world over, the impact is huge in India as penetration of health insurance/social security is minimal. As out of pocket expenditure forms a significant proportion of healthcare spending by majority in India, any transfer of additional cost incurred because of Covid-19 pandemic to the patient will burn a bigger hole in their pocket.

First experience in laparoscopic surgery in low and middle income countries: A systematic review

BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources.However,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and trainers.AIM To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources.METHODS MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC.Included studies were published between 1996 and 2022 with full text available in English.Exclusion criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric surgery.RESULTS Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 patients.Most reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical kits.Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff.The benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/mortality.The introduction of laparoscopic surgery also provided training opportunities for junior doctors.CONCLUSION Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients.While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critically required,in particular regarding training.

Strengthening Weak Healthcare Systems for Maternal and Neonatal Care in Low and Middle Income Countries: The Missing Link

Introduction: Preventable maternal and newborn mortalities still occur in local communities in Kenya since access to maternal and newborn healthcare services remains a big challenge. Barriers to access in resource-constrained settings have not been examined adequately in literature. The World Health Organization (WHO) has 6 building blocks for strengthening healthcare systems that informed this study. This paper examines how user-side and institutional factors influence access and use of Maternal and Newborn Healthcare (MNH) Services in Matayos sub-County-Busia County. Methods: A mixed method approach, with an ethnographic inquiry and a descriptive cross-sectional design, was adopted to assess access to MNH services in Matayos-Busia County, Western Kenya. Postpartum women who had delivered within the previous 12 months and health care providers in the study area were recruited as respondents. A total of 348 postpartum women were selected through stratified systematic random sampling for the survey. Purposive sampling was used to select postpartum women, conventional and traditional health care providers for 16 in-depth interviews and 7 focus group discussions. Data were analyzed using descriptive and inferential statistics. Qualitative data analysis was done thematically. Results: Institutional delivery was low at 68% and family planning at 75% although demand for services was high at 99%. User-side barriers to access included shared beliefs and practices in the community;high direct transport costs from home;and high costs for missing drugs and other supplies in hospitals. Middle (5th-7th) order deliveries occurred at home with traditional birth attendants. The choice of place of delivery in households was influenced by spouses to respondents and communities of residence where respondents lived or were married. All 6 WHO health system building blocks were weak in Matayos sub-County and needed system-wide strengthening involving all pillars. The user-community voice alone was insufficient and the 7th pillar for user-community engagement was absent. The underlying factors were weak governance and underfunding for healthcare. Conclusion: The six WHO building blocks were inadequate due to weak governance and inadequate funding. User-community engagement, the 7th Pillar, was absent in these resource-limited settings. We recommend user-community empowerment, engagement and participation, adoption of a system thinking approach and adequate funding.

It’s for the Greater Good: Perspectives on Maltreatment during Labor and Delivery in Rural Ghana

Aim: Encouraging women to deliver in facility settings is one strategy to improve maternal and neonatal outcomes in the developing world. However, in much of sub-Saharan Africa, fewer than half of pregnant women deliver in health facilities. Fear of maltreatment during labor and delivery has been shown to be one barrier to facility delivery, yet previous studies have focused solely on reports from women, rarely seeking insights from practicing midwives. Method: All seven practicing midwives from a rural hospital in Ghana and ten pregnant women seeking antenatal care from the same hospital were recruited to participate in in-depth interviews regarding their perceptions of care during labor and delivery. A semi-structured interview tool and qualitative field interviewing approach were utilized. All interviews were audio taped, transcribed, and analyzed using NVivo 9.0. Results: Respondents described situations that precipitate abuse during facility deliveries, yet not all abuse was seen as acceptable. Two overarching themes emerged: 1) The interaction between midwives and their patients is analogous to a mother/daughter relationship, including both a knowledge imbalance and the need for disciplinary action when necessary;and 2) Midwives feel a strong sense of responsibility for the delivery outcomes and as a result, they will do whatever it takes to deliver a live baby to a healthy mother. Hitting, yelling, and neglecting women were reported as common occurrences in the labor and delivery ward. However, each was undertaken to encourage women to do what was needed to deliver safely. Conclusion: These findings suggest that the issue of patient maltreatment in low-resource labor and delivery settings is complex and may be undertaken in what is perceived to be the laboring woman’s best interest. The exploration of alternative strategies to facilitate labor and delivery is warranted, as well as the provision of adequate support and resources for practicing midwives in rural settings.

Evidence based review of type 2 diabetes prevention and management in low and middle income countries

AIM:To identify the newest approaches to type 2diabetes(T2DM)prevention and control in the developingworld context.METHODS:We conducted a systematic review of published studies of diabetes prevention and control programs in low and middle-income countries,as defined by the World Bank.We searched Pub Med using Medical Subject Headings terms.Studies needed to satisfy four criteria:(1)Must be experimental;(2)Must include patients with T2DM or focusing on prevention of T2DM;(3)Must have a lifestyle intervention component;(4)Must be written in English;and(5)Must have measurable outcomes related to diabetes.RESULTS:A total of 66 studies from 20 developing countries were gathered with publication dates through September 2014.India contributed the largest number of trials(11/66).Of the total 66 studies reviewed,all but 3 studies reported evidence of favorable outcomes in the prevention and control of type 2 diabetes.The overwhelming majority of studies reported on diabetes management(56/66),and among these more than half were structured lifestyle education programs.The evidence suggests that lifestyle education led by allied health professionals(nurses,pharmacists)were as effective as those led by physicians or a team of clinicians.The remaining diabetes management interventions focused on diet or exercise,but the evidence to recommend one approach over another was weak.CONCLUSION:Large experimental diabetes prevention/control studies of dietary and exercise interventions are lacking particularly those that consider quality rather than quantity of carbohydrates and alternative exercise.

Preventing breast cancer in LMICs via screening and/or early detection: The real and the surreal

To review the present status of breast cancer(BC) screening/early detection in low- and middle-income countries(LMICs) and identify the way forward, an open focused search for articles was undertaken in Pub Med, Google Scholar and Google, and using a snowball technique, further articles were obtained from the reference list of initial search results. In addition, a query was put up on Research Gate to obtain more references and find out the general opinion of experts on the topic. Experts were also personally contacted for their opinion. Breast cancer(BC) is the most common cancer in women in the world. The rise in incidence is highest in LMICs where the incidence has often been much lower than high-income countries. In spite of more women dying of cancer than pregnancy or childbirth related causes in LMICs, most of the focus and resources are devoted to maternal health. Also, the majority of women in LMICs present at late stages to a hospital to initiate treatment. A number of trials have been conducted in various LMICs regarding the use of clinical breast examination and mammography in various combinations to understand the best ways of implementing a population level screening/early detection of BC; nevertheless, more research in this area is badly needed for different LMIC specific contexts. No-tably, very few LMICs have national level programs for BC prevention via screening/early detection and even stage reduction is not on the public health agenda. This is in addition to other barriers such as lack of awareness among women regarding BC and the presence of stigma, inappropriate attitudes and lack of following proper screening behavior, such as conducting breast self-examinations. The above is mixed with the apathy and lack of awareness of policy makers regarding the fact that BC prevention is much more cost-effective and humane than BC treatment. Implementation of population level programs for screening/early detection of BC, along with use of ways to improve awareness of women regarding BC, can prove critical in stemming the increasing burden of BC in LMICs. Use of newer modalities such as ultrasonography which is more suited to LMIC populations and use of m Health for awareness creation and increasing screening compliance are much needed extra additions to the overall agenda of LMICs in preventing BC.

Enablers and Barriers to Respectful Maternity Care in Low and Middle-Income Countries: A Literature Review of Qualitative Research

Background: Low and Middle-Income Countries (LMIC) account for 94% of maternal deaths annually. Interventions to reduce these deaths include;access to Emergency Obstetric Care (EmOC) and Skilled Birth Attendant (SBA) at childbirth. However, evidence indicates increasing access to EmOC, and SBA only does not translate into positive maternal and newborn outcome due to disrespectful care faced by women during labour. World Health Organization (WHO) guidelines emphasize on positive birth experience through Respectful Maternity Care (RMC). Therefore, this review aims to explore enablers and barriers to respectful maternity care in low and middle-income countries. Methods: We conducted an exhaustive literature search for studies that reported on enablers and barriers to respectful maternity care. Qualitative studies done in low and middle-income countries, published in English Language from the year 2000 to June 2020 were included in this study. Articles were screened by two researchers for eligibility and critical appraisal skills programme checklist was used to appraise the quality. The themes and quotes from the studies were extracted and synthesized using thematic synthesis. Results: The search strategy generated 14,190 articles and 54 studies met the inclusion criteria. Two main themes: interpersonal relationship and support, and privacy and confidential care were reported as both enablers and barriers to respectful maternity care. Strategies to promote RMC were: health education to pregnant women on care expected during labour, good communication between maternity staff and women, capacity building of staff on RMC and staff motivation. Conclusion: Respectful maternity care plays a big role in promoting health-seeking behaviours among pregnant women. However, women experience barriers ranging from provider behaviour, work environment and health system challenges. Ensuring a dignified and respectful working environment could contribute to an increase in health seeking-behaviours and consequently reduction of maternal mortality.

A Study of English Classroom Feedback in Intra-country Junior Middle School

Feedback refers to comments or other information that leaders receive concerning their success on learning tasks or tests, either from teachers or other persons according to Longman Dictionary of Language Teaching and Applied Linguistics. According to the subjects who give feedback, the English classroom feedback can be divided into teacher feedback, peer feedback and self feedback. Through the analysis of teaching cases based on classroom observation and interview, the study discusses the application and effectiveness of feedback given by different subjects on different teaching phases.

Establishment of trauma registry at Queen Elizabeth Central Hospital(QECH), Blantyre, Malawi and mapping of high risk geographic areas for trauma

BACKGROUND: Less attention is directed toward gaining a better understanding of the burden and prevention of injuries, in low and middle income countries(LMICs). We report the establishment of a trauma registry at the Adult Emergency and Trauma Centre(AETC) at Queen Elizabeth Central Hospital(QECH) in Blantyre, Malawi and identify high risk geographic areas. METHODS: We devised a paper based two-page trauma registry form. Ten data clerks and all AETC clinicians were trained to complete demographic and clinical details respectively. Descriptive data, regression and hotspot analyses were done using STATA 15 statistical package and ArcGIS(16) software respectively.RESULTS: There were 3,747 patients from May 2013 to May 2015. The most common mechanisms of injury were assault(38.2%), and road traffi c injuries(31.6%). The majority had soft tissue injury(53.1%), while 23.8% had no diagnosis indicated. Fractures(OR 19.94 [15.34–25.93]), head injury and internal organ injury(OR 29.5 [16.29–53.4]), and use of ambulance(OR 1.57 [1.06–2.33]) were found to be predictive of increased odds of being admitted to hospital while assault(OR 0.69 [0.52–0.91]) was found to be associated with less odds of being admitted to hospital. Hot spot analysis showed that at 99% confidence interval, Ndirande, Mbayani and Limbe were the top hot spots for injury occurrence. CONCLUSION: We have described the process of establishing an integrated and potentially sustainable trauma registry. Signifi cant data were captured to provide details on the epidemiology of trauma and insight on how care could be improved at AETC and surrounding health facilities. This approach may be relevant in similar poor resource settings.

Modeling CO_(2) Emission of Middle Eastern Countries Using Intelligent Methods

CO_(2) emission is considerably dependent on energy consumption and on share of energy sources as well as on the extent of economic activities.Consequently,these factors must be considered for CO_(2) emission prediction for seven middle eastern countries including Iran,Kuwait,United Arab Emirates,Turkey,Saudi Arabia,Iraq and Qatar.In order to propose a predictive model,a Multilayer Perceptron Artificial Neural Network(MLP ANN)is applied.Three transfer functions including logsig,tansig and radial basis functions are utilized in the hidden layer of the network.Moreover,various numbers of neurons are applied in the structure of the models.It is revealed that using MLP ANN makes it possible to accurately predict CO_(2) emission of these countries.In addition,it is concluded that using logsig transfer function leads to the highest accuracy with minimum value of mean squared error(MSE)which is followed by the networks with radial basis and tansig transfer functions.The R-squared of the networks with logsig,radial basis and tansig transfer functions are 0.9998,0.9997 and 0.9996,respectively.Finally,comparison of the proposed model with a similar study,considered five countries in the same region,reveals higher accuracy in term of MSE.

Adapting chronic care models for diabetes care delivery in low-and-middle-income countries:A review

A contextual review of models for chronic care was done to develop a context-adapted chronic care model-based service delivery model for chronic conditions including diabetes.The Philippines was used as the setting of a low-to-middle-income country.A context-based narrative review of existing models for chronic care was conducted.A situational analysis was done at thegrassroots level,involving the leaders and members of the community,the patients,the local health system and the healthcare providers.A second analysis making use of certain organizational theories was done to explore on improving feasibility and acceptability of organizing care for chronic conditions.The analyses indicated that care for chronic conditions may be introduced,considering the needs of people with diabetes in particular and the community in general as recipients of care,and the issues and factors that may affect the healthcare workers and the health system as providers of this care.The context-adapted chronic care model-based service delivery model was constructed accordingly.Key features are:incorporation of chronic care in the health system's services; assimilation of chronic care delivery with the other responsibilities of the healthcare workers but with redistribution of certain tasks; and ensuring that the recipients of care experience the whole spectrum of basic chronic care that includes education and promotion in the general population,risk identification,screening,counseling including self-care development,and clinical management of the chronic condition and any co-morbidities,regardless of level of control of the condition.This way,low-to-middle income countries can introduce and improve care for chronic conditions without entailing much additional demand on their limited resources.

Continuing Professional Development: Perspectives of Kenyan Nurses and Midwives

Background: The purpose of this paper is to report the perceptions of continuous professional development by the nurses and midwives in a low resource country. These findings are part of a larger study on the experiences of nurses and midwives providing postpartum care in rural areas of Kenya. Besides being the main healthcare providers in rural areas, nurses in low resource countries have limited access to continuous professional development. Research design: This is a qualitative research guided by critical theory and Foucault’s concepts of power and knowledge. Focused ethnography provided the framework of data collection and analysis. 23 in-depth interviews were contacted, and thematic analysis was used for data analysis. Reflexive memos kept throughout the research process helped to ensure the trustworthiness of data. Findings: This paper will focus on the theme of continuing professional development (CPD) as a resource for a healthy work environment. While the knowledge of the nurses and midwives allowed them to provide care to the mothers and their infants adequately, personal and structural barriers prevented them from participating in continuing professional development. Discussion and Conclusion: A well-prepared nursing and midwifery workforce could have the capacity to transform the health outcomes of their clients through the application of evidence-based practices. Therefore, courses that are context-appropriate and meet the needs of different learners should be available to support the nurses’ and midwives’ professional growth. There is a need for more research on the nurses’ and midwives’ participation in CPD in Kenya, and the effect of CPD on specific health outcomes.

Single-Use Bag Valve Masks: Evaluation of Device Design and Residual Bioburden Analytical Methods

Background: A recent survey of in-hospital reprocessing in Tanzanian hospitals identified bag-valve masks (BVM) as a commonly reused single-use device. In low- and middle-income countries (LMIC), in-hospital reprocessing supports neonatal resuscitation strategies by helping to maintain adequate supplies of BVM. However, there is a need for device-specific protocols defining reprocessing procedures and inspection criteria to overcome variations in reprocessing practices between hospitals. The purposes of this study were: 1) to complete a comprehensive design review and identify challenges to reprocessing BVMs;and 2) to investigate three different residual bioburden analysis methods for assessing the efficacy of decontaminating a disposable BVM. Methods: New, unused bag-valve-masks were contaminated with Staphylococcus epidermidis and Artificial Mucus Soil to simulate the worst case soiling conditions. Devices underwent one of five disinfection protocols, including one currently used in a LMIC hospital. Three analytical (two quantitative and one qualitative) methods were selected to evaluate residual bioburden on the device following decontamination. Results: Of all protocols tested, only the positive control and the Soap and Bleach protocols met disinfection targets. Most cleaning outcomes were consistent from trial to trial for each protocol. However, cleaning outcomes varied greatly for the Alcohol Wipe protocol. For the residual bioburden analyses, the two quantitative methods produced similar results, but the qualitative measurement exhibited increased variability. Conclusion: While this study revealed positive disinfection outcomes for the Tanzanian hospital decontamination protocol, more studies are required to support these findings. Design features of the BVM mask presented challenges to cleaning and drying during different decontamination protocols, as seen in the variability in the Alcohol Wipe protocol performance. These findings support the case for a device-specific protocol for the BVM. Given proper hospital personnel training and available resources, in-hospital reprocessing could support neonatal resuscitation strategies and other demands for manual resuscitation by helping to maintain adequate supplies of BVM.

西非国家2009年与2019年居民健康预期寿命及死亡状况比较及对中非卫生合作的启示

目的:比较西非国家2009年和2019年各国居民健康预期寿命及死亡状况,为后续规划与布局新时期的中非健康卫生合作,开展精准的援助项目提供数据支持。方法:基于2019年全球疾病负担研究(GBD 2019),收集和比较西非15个国家2009年和2019年健康预期寿命,传染病、母婴疾病和营养缺乏性疾病,慢性病及伤害的死亡变化情况。结果:与2009年相比,2019年西非15个国家的居民健康预期寿命有所增加,其中佛得角的居民健康预期寿命最高(64.6岁),几内亚比绍最低(53.6岁);2019年西非15个国家传染病、母婴疾病和营养缺乏性疾病的标化死亡率较2009年均显著下降;佛得角、布基纳法索和冈比亚的慢性病标化死亡率有所增加;布基纳法索和马里的伤害标化死亡率有所增加,尼日尔保持不变;其他国家的慢性病和伤害标化死亡率有所下降。与2009年相比,西非国家2019年传染病、母婴和营养缺乏性疾病死因占比均有所下降,但在多数国家的死因占比依然超过50%;其中,佛得角是唯一慢性病死因占比多于传染病、母婴和营养缺乏性疾病(72.2%vs.17.9%)的国家;2019年孕产妇疾病、麻疹和艾滋病等传染病死因顺位较2009年下降明显,而多种慢性病(如糖尿病、慢性肾脏疾病)的死因顺位有所上升。结论:在过去10年间,西非国家在国民健康状况方面取得了一些进步,但健康预期寿命仍相对偏低,面临着传染病和慢性非传染病双重威胁,而伤害死亡率也依然较高;中非健康卫生合作的援助内容和方式应根据受援国情况,因地制宜、精准施策。