English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Sub-Saharan Africa (SSA) region is a home for over one billion population distributed in 46 different countries. Over the decades, this region has confronted with high disease burden accounting around 24% of the global disease burden [1]. Traditionally, communicable diseases such as HIV, TB, and Malaria have long been the most prominent contributors to the disease burden. However, in the last two decades, the region has witnessed an epidemiological transition to non-communicable diseases (NCDs) [2]. Around 80% of all NCDs deaths occur in low and middle-income countries. It is projected that by 2020, NCDs will account for 27% of mortality in SSA [3]. Majority of NCDs related deaths can be prevented by addressing the common modifiable risk factors for NCDs include tobacco use, physical inactivity, the harmful use of alcohol, and unhealthy diet [4]. The NCDs and reproductive health morbidity and mortality, has become a significant part of the disease burden in the region requiring a rethink on policy prioritisation and implementation to minimise the burden. The WHO defines reproductive health as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and its functions and processes.” This implies that people are able to have a satisfying and safe sex life and that they can reproduce and the freedom to decide if, when, and how often to do so [5]. However, reproductive health among women was often constrained by socio-cultural and economic factors across the societies, particularly in SSA. The access to abortion and contraception are severely restricted, contributing to high maternal mortalities and poor sexual and reproductive health outcomes [6–9]. Reproductive and maternal morbidities increase the risk of maternal mortality, stillbirth, neonatal death. Women facing pregnancy related complications are predisposed to immediate and long-term disabilities and infertility as well as adverse psychological and socio-economic consequences. SSA region faces high burden of maternal mortality, stillbirth and neonatal mortality rates [10]. In 2015, twothirds of all maternal deaths worldwide occurred in SSA (546 maternal deaths per 100,000 live births [11]. SSA women in reproductive age (15–49 years) have low contraceptive prevalence rate (28%), and about half of them do not receive four or more antenatal check-ups (54%), and do not give birth in health facilities (52%). Further, adolescent girls and young women in the region face high risk of unintended pregnancies, sexually transmitted infections, HIV, and exposure to violence [12]. Further, 244,000 infants in the region annually become infected with HIV during pregnancy and delivery (115, 000) or breast-feeding (129,000) [13]. The unmet needs of sexual and reproductive health services among SSA women are coupled with the rising burden of non-communicable diseases. NCDs account for almost 65% of women’s deaths globally, and the majority of these deaths occur in LMICs and are premature. In recent years, NCDs among women of reproductive age has doubled in many African countries [14]. Also, there are established linkages between NCDs and reproductive health. Several NCDs risk factors adversely affect the reproductive health of women. For example, obesity, CVDs, hypertension, hyperglycemia, and gestational diabetes predispose pregnant women at higher risk of menstrual problems, hypertension in pregnancy, caesarean sections, post-natal complications and maternal mortality [10]. Obesity also increases the odds of developing CVDs and cancers in women [15, 16]. In a recent study, the prevalence of obesity across 32 Sub-Saharan African countries ranged from 1.1% in Madagascar to 23.0% in Swaziland [17]. A study shows that that women at the beginning of pregnancy 73.7% and 60.2% women in

Non-communicable diseases and reproductive health in sub-Saharan Africa: bridging the policy-implementation gaps