No description available.

Despite decades of the implementation of the directly observed therapy short-course (DOTS), Sierra Leone is ranked among the 30 highest TB-burdened countries. Several factors account for unfavorable treatment outcomes, among which are patient characteristics. Previous studies have only focused on treatment compliance without any consideration for the factors that lead to noncompliance to treatment. The purpose of this study was to investigate patient characteristics that are associated with treatment noncompliance (treatment not completed) among TB patients undergoing the DOTS program in Sierra Leone. A retrospective longitudinal quantitative design was used to analyze secondary data from the completed records of 1,633 TB patients, using the Andersen's behavioral model of health services utilization as a theoretical framework work. Descriptive statistics and bivariate and multivariate logistic regressions were used to analyze the data. The results show that there was no significant association between treatment completion and age, gender, and TB-case category. On the other hand, being HIV-positive decreases the odds of treatment completion. Also, the educational level, geographic location, and year of treatment were significantly associated with treatment completion. Overall, program performance improved as the number of dropouts decreased significantly between 2013 and 2015. The social change implication of this study was that it identified HIV-positive patients and rural communities as areas needing specific attention such as the assignment of case managers to ensure compliance thereby improve DOTS program performance, thereby reducing the incidence and transmission of TB

Th. doct.--Hist.--Paris 7, 1996. / En appendice, choix de documents en français et en anglais. Bibliogr. vol. 2, p. 478-506. Index à la fin de chaque vol.

Introduction Anemia prevalence in pregnancy ranges from 51%-60% globally. Genetic disorders, infectious diseases, reproductive factors, nutritional deficiencies, and poverty can affect anemia status. Anemia can negatively impact economic progress, social and intellectual development, and maternal health. Estimates indicate that anemia is the direct cause of 3-7% of maternal deaths and an indirect cause of 20-40% of maternal deaths. Although several initiatives by the international community address the anemia problem, prevalence remains unacceptably high in Sierra Leone at 2,000 per 100,000 live births. This study explored ecological determinants of anemia status of pregnant women living in Freetown, Sierra Leone. Method This was a mixed-method, retrospective, unmatched case-control research study based on the Modified Ecological Model for Health Behavior and Health Promotion. One hundred and seventy one pregnant women, who visited one of five health facilities were interviewed for the study. Anemic participants' (Hgb<11.0g/dL) responses were compared to responses of non-anemic participants and the differences were assessed. Content analysis and descriptive statistics were used to assess qualitative knowledge items, whereas t-tests were conducted to determine if mean knowledge differences existed between those with anemia and those without. Chi-square was used to analyze forced choice attitude items: perceived threat to anemia and perceived benefits of anemia prevention and treatment. Chi-square was also used to analyze selected behaviors and perceived barriers to anemia prevention and treatment. Odds ratio determined the strength of the relationship between the dependent variable (anemia status) and selected exposure variables (modifying factors). Results Seventy-seven percent of participants were anemic (M: Hgb=9.63g/dL). Those with anemia were more likely to first see a health care provider after 12 weeks of pregnancy (p<.05). Participants who earned income in the top two quintiles were less likely to have anemia than those in the lower three quintiles (p=.007). Participants who had anemia were more likely to cite lack of finances as a barrier to seeking prenatal services (p=.007). Although differences existed between participants who had anemia and those who did not have anemia, they were generally not statistically significant for knowledge, behavior or modifying factors. Participants who had pica, however, were more likely to have anemia than those who did not (p=.005). There was misinformation among participants about the use of palm oil, Vimto and "blood tonic" as treatment options. In addition, participants cited family and friends as sources of this same information as well as correct suggestions and information about anemia prevention and treatment. Discussion Health providers need to be clearer about messages that they deliver to service users to reduce misinformation about anemia prevention and treatment. Community awareness about anemia, anemia causes, anemia prevention and anemia treatment needs to be raised. Information, particularly about anemia causes, need to be disseminated and programs to address those causes need to be developed and implemented. Program development and implementation should be a comprehensive effort that includes training traditional birth attendants and lay health workers. Efforts should incorporate health efforts from government agencies, the non-governmental sector, donor groups, and community and civil society groups to deliver culturally and regionally appropriate interventions.

This study is the product, chiefly, of fieldwork, undertaken in Sierra Leone, which sought to interview and experience contemporary Limba religio-cultural practices. Using a systematic approach, the goal was to provide a broader understanding of Limba religion, as well as to discover the effect of Limba religiosity, and the tenacity with which the Limba hold to their culture and religion, on the National Pentecostal Limba Church (NPLC) over the past three decades. The study begins with an introduction, which outlines its objectives and structure, the research methods, and its general outline. This is followed by a basic introduction to the socio-history of the Limba people, their origin, environment, language, politics, economy and other socio-cultural characteristics, in order to provide an understanding of the background on which their religion is formed. The heart of the study is a detailed examination of Limba religious beliefs and their intersection with Christianity. It includes a definition of Limba religion and its components. This seeks to identify the current state of Limba religion amidst the changes it has experienced and continues to experience as a result of internal and external influences, and to provide a template for this study, an analysis of the Limba belief in a supreme creator God whom they call Kanu Masala, his epithets, attributes and activities, Limba worship and worship methods, the Limba understanding of the spirit world, humankind, sin and salvation, and the roles of sacred specialists. The study concludes with an examination of the causes of the tenacious loyalty with which some Limba Christians hold to their traditional religious beliefs and practices, their reluctance to part with them, and the effects of their dual religiosity on the NPLC, as well as the church's response, and the resulting reciprocal effects over the past three decades in Sierra Leone. This study fills a gap in the extant literature about the ethno-theological landscape of Sierra Leone, and provides a detailed study on the intersection of African Traditional Religion and Christianity. / Systematic Theology & Theological Ethics / D.Th. (Systematic Theology)

This study is the product, chiefly, of fieldwork, undertaken in Sierra Leone, which sought to interview and experience contemporary Limba religio-cultural practices. Using a systematic approach, the goal was to provide a broader understanding of Limba religion, as well as to discover the effect of Limba religiosity, and the tenacity with which the Limba hold to their culture and religion, on the National Pentecostal Limba Church (NPLC) over the past three decades. The study begins with an introduction, which outlines its objectives and structure, the research methods, and its general outline. This is followed by a basic introduction to the socio-history of the Limba people, their origin, environment, language, politics, economy and other socio-cultural characteristics, in order to provide an understanding of the background on which their religion is formed. The heart of the study is a detailed examination of Limba religious beliefs and their intersection with Christianity. It includes a definition of Limba religion and its components. This seeks to identify the current state of Limba religion amidst the changes it has experienced and continues to experience as a result of internal and external influences, and to provide a template for this study, an analysis of the Limba belief in a supreme creator God whom they call Kanu Masala, his epithets, attributes and activities, Limba worship and worship methods, the Limba understanding of the spirit world, humankind, sin and salvation, and the roles of sacred specialists. The study concludes with an examination of the causes of the tenacious loyalty with which some Limba Christians hold to their traditional religious beliefs and practices, their reluctance to part with them, and the effects of their dual religiosity on the NPLC, as well as the church's response, and the resulting reciprocal effects over the past three decades in Sierra Leone. This study fills a gap in the extant literature about the ethno-theological landscape of Sierra Leone, and provides a detailed study on the intersection of African Traditional Religion and Christianity. / Philosophy, Practical and Systematic Theology / D.Th. (Systematic Theology)

This study which is the product of library research and fieldwork seeks, on account of the persistent marginalisation of African Traditional Religion (ATR) in Sierra Leone by Islam and Christianity, to investigate the place of ATR in inter-religious encounters in the country since the advent of Islam and Christianity. As in most of sub-Saharan Africa, ATR is the indigenous religion of Sierra Leone. When the early forebears and later progenitors of Islam and Christianity arrived, they met Sierra Leone indigenes with a remarkable knowledge of God and a structured religious system. Successive Muslim clerics, traders, and missionaries were respectful of and sensitive to the culture and religion of the indigenes who accommodated them and offered them hospitality. This approach resulted in a syncretistic brand of Islam. In contrast, most Christian missionaries adopted an exclusive and insensitive approach to African culture and religiosity. Christianity, especially Protestantism, demanded a complete abandonment of African culture and religion, and a total dedication to Christianity. This attitude has continued by some indigenous clerics and religious leaders to the extent that Sierra Leone Indigenous Religion (SLIR) and it practitioners continue to be marginalised in Sierra Leone's inter-religious dialogue and cooperation. Although the indigenes of Sierra Leone were and continue to be hospitable to Islam and Christianity, and in spite of the fact that SLIR shares affinity with Islam and Christianity in many theological and practical issues, and even though there are many Muslims and Christians who still hold on to traditional spirituality and culture, Muslim and Christian leaders of these immigrant religions are reluctant to include Traditionalists in interfaith issues in the country. The formation and constitution of the Inter-Religious Council of Sierra Leone (IRCSL) which has local and international recognition did not include ATR. These considerations, then beg the questions: * Why have Muslim and Christian leaders long marginalised ATR, its practices and practitioners from interfaith dialogue and cooperation in Sierra Leone? * What is lacking in ATR that continues to prevent practitioners of Christianity and Islam from officially involving Traditionalists in the socio-religious development of the country? Muslim and Christians have given several factors that are responsible for this exclusion: * The prejudices that they inherited from their forebears * ATR lacks the hallmarks of a true religion * ATR is primitive and economically weak * The fear that the accommodation of ATR will result in syncretism and nominalism * Muslims see no need to dialogue with ATR practitioners, most of whom they considered to be already Muslims Considering the commonalities ATR shares with Islam and Christianity, and the number of Muslims and Christians who still hold on to traditional spirituality, these factors are not justifiable. Although Islam and Christianity are finding it hard to recognise and include ATR in interfaith dialogue and cooperation in Sierra Leone, ATR continues to play a vital role in Sierra Leone's national politics, in the search and maintenance of employment, and in the judicial sector. ATR played a crucial part during and after the civil war. The national government in its Truth and Reconciliation Commission (TRC) report acknowledged the importance and contribution of traditional culture and spirituality during and after the war. Outside of Sierra Leone, the progress in the place and level of the recognition of ATR continues. At varying degrees, the Sociétié Africaine de Culture (SAC) in France, the All Africa Conference of Churches (AACC), the Vatican, and the World Council of Churches, have taken positive steps to recognise and find a place for ATR in their structures. Much about the necessity for dialogue and cooperation with ATR can be learnt in the works and efforts of these secular and religious bodies. If nothing else, there are two main reasons why Islam and Christianity in Sierra Leone must be in dialogue with ATR: * Dialogue of life or in community. People living side-by-side meet and interact personally and communally on a regular basis. They share common resources and communal benefits. These factors compel people to be in dialogue * Dual religiosity. As many Muslims and Christians in Sierra Leone are still holding on to ATR practices, it is crucial for Muslims and Christians to dialogue with ATR practitioners. If Muslims and Christians are serious about meeting and starting a process of dialogue with Traditionalists, certain practical issues have to be considered: * Islam and Christianity have to validate and accept ATR as a true religion and a viable partner in the socio-religious landscape of Sierra Leone * Muslims and Christians must educate themselves about ATR, and the scriptures and teachings of their respective religious traditions in order to relate well with Traditionalists These are starting points that can produce successful results. Although at present Muslims and Christians in Sierra Leone are finding it difficult to initiate dialogue and cooperation with Traditionalists, all hope is not lost. It is now the task of the established IRCSL to ensure the inclusion of ATR. Islam and Christianity must remember that when they came as strangers, ATR, played host to them and has played and continues to play a vital role in providing hospitality, and allowing them to blossom on African soil. / Religious Studies and Arabic / D.Litt. et Phil. (Religious Studies)

This study which is the product of library research and fieldwork seeks, on account of the persistent marginalisation of African Traditional Religion (ATR) in Sierra Leone by Islam and Christianity, to investigate the place of ATR in inter-religious encounters in the country since the advent of Islam and Christianity. As in most of sub-Saharan Africa, ATR is the indigenous religion of Sierra Leone. When the early forebears and later progenitors of Islam and Christianity arrived, they met Sierra Leone indigenes with a remarkable knowledge of God and a structured religious system. Successive Muslim clerics, traders, and missionaries were respectful of and sensitive to the culture and religion of the indigenes who accommodated them and offered them hospitality. This approach resulted in a syncretistic brand of Islam. In contrast, most Christian missionaries adopted an exclusive and insensitive approach to African culture and religiosity. Christianity, especially Protestantism, demanded a complete abandonment of African culture and religion, and a total dedication to Christianity. This attitude has continued by some indigenous clerics and religious leaders to the extent that Sierra Leone Indigenous Religion (SLIR) and it practitioners continue to be marginalised in Sierra Leone's inter-religious dialogue and cooperation. Although the indigenes of Sierra Leone were and continue to be hospitable to Islam and Christianity, and in spite of the fact that SLIR shares affinity with Islam and Christianity in many theological and practical issues, and even though there are many Muslims and Christians who still hold on to traditional spirituality and culture, Muslim and Christian leaders of these immigrant religions are reluctant to include Traditionalists in interfaith issues in the country. The formation and constitution of the Inter-Religious Council of Sierra Leone (IRCSL) which has local and international recognition did not include ATR. These considerations, then beg the questions: * Why have Muslim and Christian leaders long marginalised ATR, its practices and practitioners from interfaith dialogue and cooperation in Sierra Leone? * What is lacking in ATR that continues to prevent practitioners of Christianity and Islam from officially involving Traditionalists in the socio-religious development of the country? Muslim and Christians have given several factors that are responsible for this exclusion: * The prejudices that they inherited from their forebears * ATR lacks the hallmarks of a true religion * ATR is primitive and economically weak * The fear that the accommodation of ATR will result in syncretism and nominalism * Muslims see no need to dialogue with ATR practitioners, most of whom they considered to be already Muslims Considering the commonalities ATR shares with Islam and Christianity, and the number of Muslims and Christians who still hold on to traditional spirituality, these factors are not justifiable. Although Islam and Christianity are finding it hard to recognise and include ATR in interfaith dialogue and cooperation in Sierra Leone, ATR continues to play a vital role in Sierra Leone's national politics, in the search and maintenance of employment, and in the judicial sector. ATR played a crucial part during and after the civil war. The national government in its Truth and Reconciliation Commission (TRC) report acknowledged the importance and contribution of traditional culture and spirituality during and after the war. Outside of Sierra Leone, the progress in the place and level of the recognition of ATR continues. At varying degrees, the Sociétié Africaine de Culture (SAC) in France, the All Africa Conference of Churches (AACC), the Vatican, and the World Council of Churches, have taken positive steps to recognise and find a place for ATR in their structures. Much about the necessity for dialogue and cooperation with ATR can be learnt in the works and efforts of these secular and religious bodies. If nothing else, there are two main reasons why Islam and Christianity in Sierra Leone must be in dialogue with ATR: * Dialogue of life or in community. People living side-by-side meet and interact personally and communally on a regular basis. They share common resources and communal benefits. These factors compel people to be in dialogue * Dual religiosity. As many Muslims and Christians in Sierra Leone are still holding on to ATR practices, it is crucial for Muslims and Christians to dialogue with ATR practitioners. If Muslims and Christians are serious about meeting and starting a process of dialogue with Traditionalists, certain practical issues have to be considered: * Islam and Christianity have to validate and accept ATR as a true religion and a viable partner in the socio-religious landscape of Sierra Leone * Muslims and Christians must educate themselves about ATR, and the scriptures and teachings of their respective religious traditions in order to relate well with Traditionalists These are starting points that can produce successful results. Although at present Muslims and Christians in Sierra Leone are finding it difficult to initiate dialogue and cooperation with Traditionalists, all hope is not lost. It is now the task of the established IRCSL to ensure the inclusion of ATR. Islam and Christianity must remember that when they came as strangers, ATR, played host to them and has played and continues to play a vital role in providing hospitality, and allowing them to blossom on African soil. / Religious Studies and Arabic / D.Litt. et Phil. (Religious Studies)