Across sub-Saharan Africa, women and children play major roles as pedestrian load-transporters, in the widespread absence of basic sanitation services, electricity and affordable/reliable motorised transport. The majority of loads, including water and firewood for domestic purposes, are carried on the head. Load-carrying has implications not only for school attendance and performance, women's time budgets and gender relations, but arguably also for health and well-being. We report findings from a comprehensive review of relevant literature, undertaken June–September 2012, focussing particularly on biomechanics, maternal health, and the psycho-social impacts of load-carrying; we also draw from our own research. Key knowledge gaps and areas for future research are highlighted.
Porter, G., Hampshire, K., Dunn, C., Hall, R., Levesley, M., Burton, K., ... Panther, J. (2013). Health impacts of pedestrian head-loading: A review of the evidence with particular reference to women and children in sub-Saharan Africa. Social Science and Medicine, 88, 90-97. https://doi.org/10.1016/j.socscimed.2013.04.010