Optimal nutrition in children is the cornerstone of good health (1) . About a third of the world's population lives in informal settlements, and the population is rapidly growing every year (2,3) . Poor livelihoods in informal settlements have been linked with poor nutrition and ill-health in children (3,4) . Childhood malnutrition is an underlying cause of the increased risk of infections, reduced quality of life, impaired physical, and cognitive development (4) . Even though poor nutrition affects the general population, children living in informal settlements have been reported to be more vulnerable to undernutrition, attributed to lack of basic needs and limited social infrastructure (5) . This study aimed to assess the determinants of nutritional status of children aged 6-59 months in Kiandutu informal settlement; Thika, Kenya.A community-based cross-sectional design was used in this study. Multi staged stratified sampling followed by systematic random sampling was used to recruit 170 caregivers with children aged 6-59 months from different households living in Kiandutu Informal Settlement, Thika, Kiambu County, Kenya. A structured questionnaire was used to collect data. Anthropometric measurements were performed using standardized tools and methods. Data were analyzed using WHO-Anthro Analyzer and IBM SPSS version 26.0.The results of this study revealed that 18.8% and 34.7%children were underweight and stunted. The prevalence of wasting using WHZ was 15.3% and 9% using MUAC. Children who were exclusively breastfed for less than 6 months were statistically associated with being underweight and stunted. Stunting and wasting was significantly associated with the house household decision-maker (p < 0.05), with children living in households whose decision-maker was the father, had a higher likelihood to develop wasting and stunting than those living in households whose decision-makers was the mother, both parents, and other family members. The type of food feed first to the child when complementary feeding was initiated was correlated with stunting (p < 0.05). Weight-for-height and height-for-age Z-scores were significantly associated with child wellness clinic visits for monthly check-ups (p <0.05). and child well clinic visits (p < 0.05. Wasting (MUAC) was significantly associated with child age group (p < 0.001), child breast feeding (p < 0.05), reports of diarrhea during the last two weeks' prior the survey (p < 0.01) and child wellness clinic visit (p = 0.05).It is evident that childhood malnutrition remains an important public health nutrition concern in informal settlements. There is a need to address access to sustainable diets, nutrition education, and improving livelihoods of populations in informal settlements.

This study assesses the fruit and vegetable consumption patterns and risk factors for chronic diseases of lifestyle (CDL) among young adults attending Kenyatta University, Kenya. Four hundred and twenty-three young adults aged 19–30 years participated in the cross-sectional study. Males were 75.0% less likely to be overweight than females (OR = 0.25; 0.13–0.47). The mean overall consumption of fruit and/or vegetables amounted to 3.6 servings in a typical day. Eight in ten participants consumed lower amounts of fruits and vegetables than recommended by the WHO. At least one combined risk factor of CDL was observed among 91.3% of the young adults. About 8.7% of the participants were classified as low risk for CDL (having none of the five risk factors), 48.9% had one risk factor, 32.9% had two risk factors, 8.5% had three risk factors, while 0.9% had four risk factors. A significant relationship between daily fruit consumption and waist circumference was observed. These findings show the dire need to develop public health nutrition activities aimed at increasing the intake of fruit and vegetables and sensitizing young adults, and the general population, to the risk factors of CDL.

The nutrition transition in developing countries has contributed to the significant early onset of Chronic Diseases of Lifestyle (CDLs) in the adult population at a younger age (1) . CDLs including type 2 diabetes, accounts for 27% of deaths suffered by Kenyans, and the likelihood of dying too young from a CDL in Kenya is 18% (2,3) .The aim of this study was to assess the fruit and vegetable consumption patterns and risk of CDLs among university students aged 19-30 years.A cross-sectional analytical design was used to randomly recruit 423 self-catering subjects (168 males; 255 females) aged 19-30 years attending Kenyatta University in Kenya. The sample was representative of all faculties in the University, and all regions in Kenya. Fruit and vegetable consumption patterns were measured using a fruit and vegetable intake questionnaire and a food frequency questionnaire. Physical and biochemical measures were used to assess the risk factors of chronic diseases of lifestyle among the participants. Data were analysed by IBM SPSS Version 26.0.The proportion (95% CI) of respondents who met the WHO recommendation of 5 or more servings of fruits and/or vegetables per day in a typical week was 21.5%. The mean intake of fruits was1.7 servings per day and for vegetables, 1.9 servings per day. The prevalence of risk factors of CDLs: 28.1% of the respondents are current consumers of alcohol; 4.0% current tobacco users; 18.2% were overweight (BMI); 16.5% had abdominal obesity (WC); 9.5% had high WHR; 8.3% had raised blood pressure, and 39.5% had raised cholesterol. A significant association between meeting the WHO recommendation of 5 or more servings of fruits and/or vegetables in a day and combined risk factors of CDLs (p = 0.0001).Over 78% of the study population consumed lower amounts of fruits and vegetables than recommended by the WHO. Eighty-five percent had at least one combined risk factors of CDLs. There is a need to develop and strengthen nutrition campaigns aimed at increasing fruit and vegetable intake levels among young adults, and the prevention of chronic diseases of lifestyle.

Background: Access to medicines and technologies is a key building block of the WHO health systems framework. In 2018, the World Health Organization (WHO) published the first Essential Diagnostics List (EDL) to address the need for countries to make essential diagnostics more accessible and affordable to patients in low-and-middle-income countries and to complement the more established Essential Medicines List (EML). The effective implementation of the WHO EDL is vital to ensure its impact on improving health outcomes. This scoping review aims to map literature on the implementation, uptake and evaluation of the WHO essential lists in African nations in order to guide the effective implementation and evaluation of the WHO EDL. Methods: This review will map literature on the implementation and evaluation of the WHO’s essential diagnostic list (EDL) and essential medical list (EML), using the Joanna Briggs Institute guidelines for scoping review. The implementation considerations we will review include, study designs used in the evaluation of the WHO essential lists, and the outcome measures, findings, gaps and limitations highlighted in the included articles. We will review both primary and secondary quantitative and qualitative literature evaluating the WHO essential lists. A comprehensive search strategy, developed with an information scientist, will be used to identify relevant sources. The database to be searched include: MEDLINE (Pubmed), CINAHL, the Cochrane Library, the Health Technology Assessment database, EMBASE, Health systems evidence, African Index Medicus, Web of Science, Science Direct, Scopus and WHO library databases. Grey Literature will be accessed by searching for policy documents, diagnostic guidelines, and reports of ministry of health, health agencies through their websites and links published in the last three years from selected African countries. Searches, study selection and data extraction will be conducted using the covidence platform by two independent reviewers. The Mixed Method Appraisal Tool (MMAT) version 2018 will be used to assess the quality of included studies. The findings will be analysed using the thematic content analysis approach and the results presented narratively and graphically.Discussion: We anticipate finding relevant literature on the implementation considerations for WHO’s essential diagnostic and medicines list in Africa. This review is likely to reveal implementation considerations, challenges, gaps, which could guide future evaluation, implementation, policy development, and development of practice tools to support the wider adoption of the WHO essential diagnostic list in Africa. Dissemination: We plan to publish our findings in a peer-reviewed journal and develop useful and accessible summary of the results.

Background The World Health Organization (WHO) model list of Essential In vitro Diagnostic (EDL) introduced in 2018 complements the established Essential Medicines List (EML) and improves its impact on advancing universal health coverage and better health outcomes. We conducted a scoping review of the literature on the implementation of the WHO essential lists in Africa to inform the implementation of the recently introduced EDL. Methods We searched eight electronic databases for studies reporting on the implementation of the WHO EDL and EML in Africa. Two authors independently conducted study selection and data extraction, with disagreements resolved through discussion. We used the Supporting the Use of Research Evidence (SURE) framework to extract themes and synthesized findings using thematic content analysis. We used the Mixed Method Appraisal Tool (MMAT) version 2018 to assess the quality of included studies where applicable. Results We included 172 studies reporting on EDL and EML after screening 3,813 articles titles and abstracts and 1,545 full-text papers. Most (75%, n=129) included studies were purely quantitative in design comprising descriptive cross-sectional designs (60%, n=104), 15% (n=26) were purely qualitative, and 10% (n=17) had mixed-methods approaches. There were no qualitative or randomised experimental studies about the EDL. The main barrier facing the EML and EDL was poorly equipped health facilities - including unavailability or stock-outs of essential in vitro diagnostics and medicines and inadequate infrastructure to enable health service delivery. Financial and non-financial incentives to health facilities and workers were a key enabler to the implementation of the EML however, their impact differed from one context to another. Fifty-six (33%) of the included studies were of high quality. Conclusions The EDL implementation at the national level can learn from health system interventions to improve the availability and supply of essential medicines such as financial and non-financial incentives in different contexts.

The World Health Organization (WHO) model list of Essential In vitro Diagnostic (EDL) introduced in 2018 complements the established Essential Medicines List (EML) and improves its impact on advancing universal health coverage and better health outcomes. We conducted a scoping review of the literature on implementing the WHO essential lists in Africa to inform the implementation of the recently introduced EDL. We searched eight electronic databases for studies reporting on implementing the WHO EDL and EML in Africa. Two authors independently conducted study selection and data extraction, with disagreements resolved through discussion. We used the Supporting the Use of Research Evidence (SURE) framework to extract themes and synthesised findings using thematic content analysis. We used the Mixed Method Appraisal Tool (MMAT) version 2018 to assess the quality of included studies. We included 172 studies reporting on EDL and EML after screening 3,813 articles titles and abstracts and 1,545 full-text papers. Most (75%, n = 129) studies were purely quantitative in design, comprising descriptive cross-sectional designs (60%, n = 104), 15% (n = 26) were purely qualitative, and 10% (n = 17) had mixed-methods approaches. There were no qualitative or randomised experimental studies about EDL. The main barrier facing the EML and EDL was poorly equipped health facilities—including unavailability or stock-outs of essential in vitro diagnostics and medicines. Financial and non-financial incentives to health facilities and workers were key enablers in implementing the EML; however, their impact differed from one context to another. Only fifty-six (33%) of the included studies were of high quality. Poorly equipped and stocked health facilities remain an implementation barrier to essential diagnostics and medicines. Health system interventions such as financial and non-financial incentives to improve their availability can be applied in different contexts. More implementation study designs, such as experimental and qualitative studies, are required to evaluate the effectiveness of essential lists.