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Opinion Piece
Strengthening health systems in communities: the experiences of Amref Health Africa
Amref Health Africa focuses on the generation of the research outcomes that are based on the organization’s community and or institution based projects that are implemented by the Country Offices across Africa. Such research products are used for advocacy and influence of policy and practice aimed at strengthening health systems especially for communities in Africa. The papers presented in this supplement have been contributed by staff from AMREF Health Africa based across respective country offices. They demonstrate the key findings of the research carried out in the countries and are usefu
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Research Papers
Implementing a regional integrated laboratory proficiency testing scheme for peripheral health facilities in East Africa
The East African Regional External Quality Assessment Scheme (EA-REQAS), launched in 2004, provides proficiency testing (PT) to support laboratory quality in resource-limited settings. Between 2008 and 2015, 16 surveys were conducted, with facility enrollment rising from 195 to 560. Although average response rates remained steady, performance scores improved from 51% to 68%, and the number of facilities scoring 80% or higher increased from none to 25. Facilities with more frequent participation performed better, highlighting PT’s value in identifying gaps, supporting post-market surveillance
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Research Papers
Macpherson Cystic Echinococcosis in Turkana, Kenya: The Role of Cross-Sectional Screening Surveys in Assessing the Prevalence of Human Infection
Cystic echinococcosis (CE), a neglected zoonotic disease caused by Echinococcus granulosus, was once highly prevalent in northwest Turkana, Kenya. Following the launch of a control program by AMREF and KEMRI in 1983, CE prevalence dropped from 5.6% in 1985 to between 1.9% and 3.8% by 2010–2012. Over time, cases shifted from younger to older age groups, and infection rates among females declined, indicating the program’s long-term impact in reducing CE burden in the region. Read More >>>
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Opinion Piece
Response to an African-driven health agenda
Africa faces unique health challenges, with nearly 80% of mortality from preventable conditions, rising non-communicable diseases, low health insurance coverage, and a growing dependent population. While these issues are significant, African-led solutions are emerging—such as community health workers, mobile health innovations, cross-sector partnerships, and youth-driven approaches. The Africa Health Agenda International Conference, co-hosted with WHO Africa, showcases these efforts and emphasizes the importance of African leadership in shaping the continent’s health future
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Research Papers
The impact and cost-effectiveness of the Amref Health Africa-Smile Train Cleft Lip and Palate Surgical Repair Programme in Eastern and Central Africa
Cleft lip and palate (CLP) cause significant disability in low- and middle-income countries, prompting Amref Health Africa and Smile Train to provide corrective surgeries in eastern and central Africa since 2006. An analysis of 37,274 patients operated on between 2006 and 2014 revealed a median surgery age of 5.4 years, with 207,879 Disability-Adjusted Life Years (DALYs) averted at a cost of $13 million—averaging $62.8 per DALY. Despite a delayed burden of 36,352 DALYs due to late surgeries, the intervention yielded substantial economic benefits: $292 million using the human capital approach
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Research Papers
The impact of community led alternative rite of passage on eradication of female genital mutilation/cutting in Kajiado County, Kenya:A quasi-experimental study.
This study evaluated the impact of Amref Health Africa’s community-led alternative rite of passage (CLARP) model in reducing harmful practices among the Maasai in Kajiado County, Kenya. Using mixed methods and comparative analysis with control counties, CLARP was found to significantly reduce FGM/C by 24.2%, child marriages by 4.9%, and teenage pregnancies by 6.3%, while increasing girls’ schooling by 2.5 years. Community stakeholders reported positive perceptions of CLARP, citing improved education and reduced early marriages. The model is now being replicated in Tanzania, with recommenda
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Research Papers
Institutionalizing Leadership Management and Governance for Health System Strengthening in Emerging Economies: Evidence from the Partnership for Health System Strengthening in Africa (PHSSA)Programme
Health systems in Sub-Saharan Africa face challenges in achieving Universal Health Coverage (UHC), largely due to weak governance and leadership. This study, using evidence from the PHSSA programme, finds that effective health governance is context-specific and recommends strengthening leadership through competency-based recruitment, supportive structures, ethical development, financial investment, and institutionalized training to enhance participatory and sustainable health system governance. Read More >>>
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Research Papers
Interventions to improve early retention of patients in antiretroviral therapy programmes in sub-Saharan Africa: A systematic review
This study systematically reviewed evidence on interventions aimed at improving early retention (within six months) in antiretroviral therapy (ART) programs across 11 Sub-Saharan African countries. Out of 2,241 articles screened, 19 met the inclusion criteria, with most being randomized controlled trials or cohort studies. Interventions were grouped into health system strategies (e.g., Universal Test-and-Treat, service integration, cost reduction), patient-centered approaches (e.g., fast-track ART initiation, Differentiated Drug Delivery models), and behavioral support (e.g., mentor mothers, l
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