Mônica W.P., Carvalho; Ana P.M., Leboute; Silviene F., Oliveira; Sandra M.B., Sousa; Maria de Nazaré, Klautau-Guimarães; Aguinaldo L., Simões.
Full Text Available This study reports the frequencies of the CCR5D32 mutation of the beta-chemokine 5 gene and discusses the possible effects of past and recent gene flow in three quilombo remnants (Brazilians communities with anthropological African ancestry whose ancestors were escaped slaves): Rio das Rãs, Mocambo, [...] and São Gonçalo in the northeastern region of Brazil. The CCR5D32 allele frequency of the Mocambo population was significantly higher (5.6%) than that found in the Rio das Rãs (1%) and São Gonçalo (0.9%) populations. These differences may reflect different proportions of parental populations in the founders individuals, a founder-effect and/or different histories of inter-ethnic contact. The frequency of the CCR5D32 allele in the Mocambo sample is similar to that found in those urban Brazilian populations which have a large amount of European genetic input, indicating a European contribution to the gene pool of this population and suggesting that, perhaps since its foundation, Mocambo has had a high level of admixture or experienced a founder-effect.
Weaver, J.N.; Brownfield, M.E.; Bergin, M.J.
Coal has been reported in 11 of the 16 sub-Saharan countries discussed in this appraisal: Mauritania, Senegal, Mali, Niger, Benin, Nigeria, Cameroon, Central African Republic, Sudan, Ethiopia, and Somalia. No coal occurrences have been reported in Gambia, Togo, Burkina, Chad, and Djibouti but coal may be present within these countries because neighboring countries do contain coal-bearing rocks. Most of these countries are undergoing desertification or will in the near future. Wood, directly or in the form of charcoal, constitutes two-thirds of the fuel used in Africa. Destruction of forest and shrub lands for fuel is occurring at an increasing rate because of desertification and increasing energy demands. The decline in biological productivity, coupled with concentration of population in areas where water is available and crops may be grown, leads to increasing shortages of wood for fuel. Part of the present and future energy needs of the sub-Saharan region could be met by use of indigenous coal and peat. Nine sedimentary basins, completely or partially within the sub-Saharan region, have the potential of either coal and/or peat deposits of economic value: 1- Senegal Basin, 2- Taoudeni Basin and Gao Trough, 3- Niger Basin, 4- Chad Basin, 5- Chari Basin, 6- Benue Trough (Depression), 7- Sudan Trough, 8- Plateau and Rift Belt, and 9- Somali Basin. Niger and Nigeria are the only countries in sub-Saharan Africa in which coal is presently being mined as a fuel source for powerplants and domestic use. Peat occurs in the deltas, lower river, and interdunal basin areas of Senegal, Mauritania, and Sudan. Peat can be used as an alternate fuel source and is currently being tested as a soil amendment in the agricultural sector. Coal and peat exploration and development studies are urgently required and should be initiated so the coal and peat utilization potential of each country can be determined. The overall objective of these studies is to establish, within the sub-Saharan region, energy independent countries using indigenous coal and peat resources. These resources have the potential to replace wood and wood charcoal as domestic fueld in the urban centers, as well as producing electrical and industrial energy, thus reducing expensive oil imports and decreasing the rate of deforestation. ?? 1991.
Starchy roots, tubers, and plantain (RTP) are the staple food in sub-Saharan Africa, and also important energy sources in Asia, Europe, and America. In this work, inorganic arsenic (iAs) in these crops was quantified by hydride generation-atomic fluorescence spectrometry (HG-AFS) after solid phase e...
de Graft Aikins Ama
Full Text Available Abstract Background Most European countries are ethnically and culturally diverse. Globally, cardiovascular disease (CVD is the leading cause of death. The major risk factors for CVD have been well established. This picture holds true for all regions of the world and in different ethnic groups. However, the prevalence of CVD and related risk factors vary among ethnic groups. Methods This article provides a review of current understanding of the epidemiology of vascular disease, principally coronary heart disease (CHD, stroke and related risk factors among populations of Sub-Sahara African descent (henceforth, African descent in comparison with the European populations in Europe. Results Compared with European populations, populations of African descent have an increased risk of stroke, whereas CHD is less common. They also have higher rates of hypertension and diabetes than European populations. Obesity is highly prevalent, but smoking rate is lower among African descent women. Older people of African descent have more favourable lipid profile and dietary habits than their European counterparts. Alcohol consumption is less common among populations of African descent. The rate of physical activity differs between European countries. Dutch African-Suriname men and women are less physically active than the White-Dutch whereas British African women are more physically active than women in the general population. Literature on psychosocial stress shows inconsistent results. Conclusion Hypertension and diabetes are highly prevalent among African populations, which may explain their high rate of stroke in Europe. The relatively low rate of CHD may be explained by the low rates of other risk factors including a more favourable lipid profile and the low prevalence of smoking. The risk factors are changing, and on the whole, getting worse especially among African women. Cohort studies and clinical trials are therefore needed among these groups to determine the relative contribution of vascular risk factors, and to help guide the prevention efforts. There is a clear need for intervention studies among these populations in Europe.
Agyemang, Charles; Addo, Juliet; Bhopal, Raj; de Graft Aikins, Ama; Stronks, Karien
Background Most European countries are ethnically and culturally diverse. Globally, cardiovascular disease (CVD) is the leading cause of death. The major risk factors for CVD have been well established. This picture holds true for all regions of the world and in different ethnic groups. However, the prevalence of CVD and related risk factors vary among ethnic groups. Methods This article provides a review of current understanding of the epidemiology of vascular disease, principally coronary heart disease (CHD), stroke and related risk factors among populations of Sub-Sahara African descent (henceforth, African descent) in comparison with the European populations in Europe. Results Compared with European populations, populations of African descent have an increased risk of stroke, whereas CHD is less common. They also have higher rates of hypertension and diabetes than European populations. Obesity is highly prevalent, but smoking rate is lower among African descent women. Older people of African descent have more favourable lipid profile and dietary habits than their European counterparts. Alcohol consumption is less common among populations of African descent. The rate of physical activity differs between European countries. Dutch African-Suriname men and women are less physically active than the White-Dutch whereas British African women are more physically active than women in the general population. Literature on psychosocial stress shows inconsistent results. Conclusion Hypertension and diabetes are highly prevalent among African populations, which may explain their high rate of stroke in Europe. The relatively low rate of CHD may be explained by the low rates of other risk factors including a more favourable lipid profile and the low prevalence of smoking. The risk factors are changing, and on the whole, getting worse especially among African women. Cohort studies and clinical trials are therefore needed among these groups to determine the relative contribution of vascular risk factors, and to help guide the prevention efforts. There is a clear need for intervention studies among these populations in Europe. PMID:19671137
Full Text Available Abstract Background The ability of the Y chromosome to retain a record of its evolution has seen it become an essential tool of molecular anthropology. In the last few years, however, it has also found use in forensic genetics, providing information on the geographic origin of individuals. This has been aided by the development of efficient screening methods and an increased knowledge of geographic distribution. In this study, we describe the development of single base extension assays used to resolve 61 Y chromosome haplogroups, mainly within haplogroups A, B and E, found in Africa. Results Seven multiplex assays, which incorporated 60 Y chromosome markers, were developed. These resolved Y chromosomes to 61 terminal branches of the major African haplogroups A, B and E, while also including a few Eurasian haplogroups found occasionally in African males. Following its validation, the assays were used to screen 683 individuals from Southern Africa, including south eastern Bantu speakers (BAN, Khoe-San (KS and South African Whites (SAW. Of the 61 haplogroups that the assays collectively resolved, 26 were found in the 683 samples. While haplogroup sharing was common between the BAN and KS, the frequencies of these haplogroups varied appreciably. Both groups showed low levels of assimilation of Eurasian haplogroups and only two individuals in the SAW clearly had Y chromosomes of African ancestry. Conclusions The use of these single base extension assays in screening increased haplogroup resolution and sampling throughput, while saving time and DNA. Their use, together with the screening of short tandem repeat markers would considerably improve resolution, thus refining the geographic ancestry of individuals.
Coffe, Hilde; Bolzendahl, Catherine
A substantial literature has studied gender differences in political participation in Western industrialized democracies, but little is known about such gaps in sub-Saharan African nations. Using 2005 Afrobarometer data, this paper presents a systematic investigation of the gender gap in political participation across 18 sub-Saharan African
Munisi, S E
Food problems faced by sub-Saharan African nations center around the widening gap between food needs and availablity. Food shortages are suggested to originate from poor distribution and as a result of natural disasters; not as a consequence of population growth. Imperialism, colonialism, and neocolonial exploitation has encouraged African economic and cultural backwardness; a situation in which high population growth can have grave consequences. Fertility control is promoted by industrialized governments as a means of solving socioeconomic problems. However, fertility control may not be justified in many African nations which experience high infant mortality and labor intensive agriculture. Although the number of people who can be fed in any circumstance is ultimately finite, Africa's situation could be improved. If presently uninhabitable land was made suitable for settlement, land shortage from overpopulation would not be problematic for a long time. Modernization of agricultural practices could have a substantial impact of food production. At present, innovations are largely associated with the production of export crops which has often necessitated food imports. Food aid for relief in emergencies or for support of regions with chronic shortages is appropriate and beneficial, however, in some cases food aid can be detrimental, e.g., by lowering food prices thus burdening small farmers. Food aid tends to create dependency, not self-sufficiency. Malnutrition and hunger are symptoms of underdevelopment. At the policy level, a food and nutrition strategy should include rural development designed to improve income redistribution, agricultural modernization, and measures to influence the production of various foods to ensure a balanced diet, and nutrition and health intervention programs for vulnerable groups. In addition to overall agricultural development, 2 general recommendations are offered: increased production of staple food stuffs and a concentrated effort to improve small farms. PMID:12264793
This article reviews what is known about the incidence, aetiology, presentation, bacteriology and management of septic arthritis in children. It compares where possible the different presentations and characteristics of this condition in the Western and sub-Saharan African regions.
Blanckenberg, Janine; Bardien, Soraya; Glanzmann, Brigitte; Okubadejo, Njideka U; Carr, Jonathan A
Parkinson's disease (PD) is under-studied in Black Sub-Saharan African (SSA) populations. To date, there have been only six prevalence and no incidence studies. The crude prevalence of PD in SSA varies from 7 to 20 per 100,000, which is appreciably lower than in Caucasian populations. There are a limited number of published studies (nine) on the genetic factors associated with PD in SSA populations. Mutations have been reported in the parkin gene, and are restricted to only three patients (two Black South Africans and one Zambian). No mutations have been identified in the LRRK2, SNCA, PINK, or DJ-1 genes. Given the unique ancestry of SSA populations, their inclusion in genetic studies may provide a substantial contribution to the identification of novel genetic factors and genetic-environmental interactions underlying this disorder. More initiatives are needed to drive further research on PD in these populations and to facilitate collaborative projects across Africa. PMID:24079843
Quansah, Emmanuel; Karikari, Thomas K.
Motor neuron diseases (MNDs) are devastating neurological diseases that are characterised by gradual degeneration and death of motor neurons. Major types of MNDs include amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA). These diseases are incurable, with limited disease-modifying treatment options. In order to improve MND-based biomedical research, drug development, and clinical care, population-based studies will be important. These studies, especially among less-studied populations, might identify novel factors controlling disease susceptibility and resistance. To evaluate progress in MND research in Africa, we examined the published literature on MNDs in Sub-Saharan Africa to identify disease prevalence, genetic factors, and other risk factors. Our findings indicate that the amount of research evidence on MNDs in Sub-Saharan Africa is scanty; molecular and genetics-based studies are particularly lacking. While only a few genetic studies were identified, these studies strongly suggest that there appear to be population-specific causes of MNDs among Africans. MND genetic underpinnings vary among different African populations and also between African and non-African populations. Further studies, especially molecular, genetic and genomic studies, will be required to advance our understanding of MND biology among African populations. Insights from these studies would help to improve the timeliness and accuracy of clinical diagnosis and treatment.
Munisi, Gibson; Randøy, Trond
This paper examines the extent to which publicly listed companies across Sub-Saharan African countries have adopted good corporate governance practices. We investigate the association of these practices with companies accounting performance and market valuation. The findings indicate that companies across Sub-Saharan Africa have only partly implemented good corporate governance practices. We find a positive association between our constructed index of good corporate governance practices an...
Anthony Enisan Akinlo; Tajudeen Egbetunde
The paper examines the long run and causal relationship between financial developmentand economic growth for ten countries in sub-Saharan Africa. Using the vectorerror correction model (VECM), the study finds that financial development is cointegratedwith economic growth in the selected ten countries in sub-Saharan Africa. That is there isa long run relationship between financial development and economic growth in the selectedsub-Saharan African countries. The results show that financial deve...
Some scholars argue that the principle of voluntary informed consent is rooted in the Western ethos of liberal individualism; that it would be difficult to implement this requirement in societies where the norms of decision-making emphasize collective rather than individual decision-making (for example, Sub-Saharan Africa); that it would amount to cultural imperialism to seek to implement the principle of voluntary informed consent in non-Western societies. This thesis rejects this skeptici...
Lozano, F; Suárez, B
The lectin pathway of the complement system is activated when mannan-binding lectin (MBL) in complex with MBL-associated serine protease 2 (MASP-2) binds to carbohydrate structures on microorganisms. Structural gene mutations and promoter polymorphisms in the MBL2 gene responsible for low-MBL serum levels are present in all human populations and associate with increased risk of infection. Recently, investigations on Danes revealed the existence of a mutation on the MASP2 gene, which introduces an amino acid substitution in the CUB1 domain (Asp105Gly; numbering refers to the mature protein), and is associated with reduction in the level of MASP-2 in serum. Here, we present the results of a sequence-based typing analysis of the MBL2 and MASP2 gene polymorphisms in a group of 65 Africans (50 North Africans and 15 Sub-Saharan) and of 104 Spaniards. The analysis identified three novel exon 3 MASP2 variants introducing amino acid substitutions at positions 84 (Arg-->Gln), 103 (Arg-->Cys) and 111 (Pro-->Leu) in the CUB1 domain. None of these variants were identified in Spaniards. The Arg84Gln was detected in four of the 15 Sub-Saharans. The Arg103Cys and Pro111Leu variants were detected only among North Africans (two and four individuals, respectively). The Asp105Gly variant was similarly represented among Spaniards and North Africans (three and two individuals, respectively), which appears to be a lower frequency than that reported for Danes (5.5%). As reported for MBL2, the marked geographic distribution of the new MASP2 variants may represent an evolutionary adaptation to different environments.
...sub-Saharan African country for purposes of that...sub-Saharan African country and meets the requirements...1995, as the GSP was in effect on that date; (5...is claimed; (d) Origin and related rules...beneficiary developing country, wherever it...
Co, Catherine Y.
In the last decade, a large portion of capital goods imports of Sub-Saharan African countries is telecommunications equipment, and China is now the main source of equipment for 30 Sub-Saharan African countries. A connection between specific types of equipment imports and subsequent exports is found with elasticity estimates ranging from 0.2 to 1.2 per cent. Estimates show that controlling for price, the estimated quality of Sub-Saharan African countries' exports is lower than that of their pe...
Anthony Enisan Akinlo
Full Text Available The paper examines the long run and causal relationship between financial developmentand economic growth for ten countries in sub-Saharan Africa. Using the vectorerror correction model (VECM, the study finds that financial development is cointegratedwith economic growth in the selected ten countries in sub-Saharan Africa. That is there isa long run relationship between financial development and economic growth in the selectedsub-Saharan African countries. The results show that financial development Granger causeseconomic growth in Central African Republic, Congo Republic, Gabon, and Nigeria whileeconomic growth Granger causes financial development in Zambia. However, bidirectionalrelationship between financial development and economic growth was found in Kenya, Chad,South Africa, Sierra Leone and Swaziland. The results show the need to develop the financialsector through appropriate regulatory and macroeconomic policies. However, in Zambiaemphasis needs to be placed on economic growth to propel financial development.
Songul Kakilli, Acaravci; Ilhan, Ozturk; Ali, Acaravci.
Full Text Available In this paper we review the literature on the finance-growth nexus and investigate the causality between financial development and economic growth in sub-Saharan Africa for the period 1975-2005. Using panel co-integration and panel GMM estimation for causality, the results of the panel co-integratio [...] n analysis provide evidence of no long-run relationship between financial development and economic growth. The empirical findings in the paper show a bi-directional causal relationship between the growth of real GDP per capita and the domestic credit provided by the banking sector for the panels of 24 sub-Saharan African countries. The findings imply that African countries can accelerate their economic growth by improving their financial systems and vice versa.
Fiodendji, Daniel Komlan
One of the problems which sub-Saharan African (SSA) countries are confronted with is the low level of investment. Yet, the theory of capital tells us that it is impossible to envisage development without a considerable accumulation of capital. An important channel through which those countries can solve this capital issue is to resort to foreign direct investment (FDI), especially knowing the considerable role such investment played in the development of the economy of several Asian countries...
Munisi, Gibson Hosea; Mersland, Roy
In countries with weak institutions board governance becomes more important. This study uses a unique dataset from listed Sub-Saharan African companies to examine the relationship between ownership composition and board compensation. It further analyses the association between board compensation and company performance. The findings indicate that board ownership and CEO ownership are positively associated while state ownership and concentrated ownership are negatively associated with board co...
In this paper we have two complementary objectives: the first consists in proposing a description of the magnitude of social disparities that exist in the systems of education of Sub-Saharan African countries; we focus on recent data but we put also these data in a time perspective. The second objective aims at identifying some of the factors that may explain these disparities or the impact of the actions targeted to their reduction.
Muhammad Yusuf; Chinnasamy Agamudai Nambhi Malarvizhi; Sreenivasan Jayashree
This paper examines the linkage among financial liberalization, economic growth and poverty reduction inSub-Saharan African countries (SSA). The study applys the recent panel Co-integration and vector errorcorrection mechanism to address the heterogeneity and cross-border interdependence over the period of 1980 to2010. The results reveal that economic growth is positively associated with poverty reduction and financialliberalization coefficients are positively related to economic growth. It i...
This dissertation presents the transit experiences of migrants from Sub-Saharan African countries in the Turkish metropolis of Istanbul. Although the narratives of the individuals met in the course of fieldwork in Istanbul are the primary focus, the thesis also outlines the larger macro-structural conditions faced. The overarching goal of this thesis is thus, through the experiences of the migrants themselves, to critically approach and discuss the concept of transit with the aid of the theor...
Johnson Karin E
Full Text Available Abstract Background The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa. Methods We used the American Medical Association 2002 Masterfile to identify and describe physicians who received their medical training in sub-Saharan Africa and are currently practicing in the USA. Results More than 23% of America's 771 491 physicians received their medical training outside the USA, the majority (64% in low-income or lower middle-income countries. A total of 5334 physicians from sub-Saharan Africa are in that group, a number that represents more than 6% of the physicians practicing in sub-Saharan Africa now. Nearly 86% of these Africans practicing in the USA originate from only three countries: Nigeria, South Africa and Ghana. Furthermore, 79% were trained at only 10 medical schools. Conclusions Physician migration from poor countries to rich ones contributes to worldwide health workforce imbalances that may be detrimental to the health systems of source countries. The migration of over 5000 doctors from sub-Saharan Africa to the USA has had a significantly negative effect on the doctor-to-population ratio of Africa. The finding that the bulk of migration occurs from only a few countries and medical schools suggests policy interventions in only a few locations could be effective in stemming the brain drain.
Briggs, J.; Yeboah, I.E.A.
Although it has been suggested that structural adjustment policies have slowed Third World urban growth and have stimulated a spatial deconcentration of economic activity, this paper argues that African cities continue to grow and mainly through peri-urban development. This investment comes mainly from domestic sources and migrants' remittances, and tends to he in consumption rather than production. Reasons include cultural factors lack of confidence in the national economy and in the state's...
Shibata, Miyuki; Morrissey, Oliver
The 1990s have witnessed an increase in private capital inflows to sub-Saharan African (SSA) countries. Such capital flows are viewed as volatile and hence a threat to macroeconomic stability. A sudden reversal of capital inflows was one factor underlying the East Asian crisis of 1997. This paper begins with a brief review of theories of currency crises in the light of the East Asian financial crisis. From this, a number of 'crisis indicators', such as the rate of domestic credit expansion an...
Monge-Maillo, Begoña; López-Vélez, Rogelio; Norman, Francesca F; Ferrere-González, Federico; Martínez-Pérez, Ángela; Pérez-Molina, José Antonio
Migrants from developing countries are usually young and healthy but several studies report they may harbor asymptomatic infections for prolonged periods. Prevalence of infections were determined for asymptomatic immigrants from Latin America and sub-Saharan Africa who ettended to a European Tropical Medicine Referral Center from 2000 to 2009. A systematic screening protocol for selected infections was used. Data from 317 sub-Saharan Africans and 383 Latin Americans were analyzed. Patients were mostly young (mean age 29 years); there were significantly more males among sub-Saharan Africans (83% versus 31.6%) and pre-consultation period was longer for Latin Americans (5 versus 42 months). Diagnoses of human immunodeficiency virus (HIV), chronic hepatitis B and C virus infection, and latent tuberculosis were significantly more frequent in sub-Saharan Africans (2.3% versus 0.3%; 14% versus 1.6%; 1.3 versus 0%; 71% versus 32.1%). There were no significant differences in prevalence for syphilis and intestinal parasites. Malaria and schistosomiasis prevalence in sub-Saharan Africans was 4.6% and 5.9%, respectively, and prevalence of Chagas disease in Latin Americans was 48.5%. Identifying and treating asymptomatic imported infectious diseases may have an impact both for the individual concerned and for public health. Based on these results, a systematic screening protocol for asymptomatic immigrants is proposed. PMID:25646257
Simaga, Bamodi; Vicenzi, Marco; Faoro, Vitalie; Caravita, Sergio; Di Marco, Giovanni; Forton, Kevin; Deboeck, Gael; Lalande, Sophie; Naeije, Robert
Sex and age affect the pulmonary circulation. Whether there may be racial differences in pulmonary vascular function is unknown. Thirty white European Caucasian subjects (15 women) and age and body-size matched 30 black sub-Saharan African subjects (15 women) underwent a cardiopulmonary exercise test and exercise stress echocardiography with measurements of pulmonary artery pressure (PAP) and cardiac output (CO). A pulmonary vascular distensibility coefficient ? was mathematically determined from the natural curvilinearity of multipoint mean PAP (mPAP)-CO plots. Maximum oxygen uptake (V?o2max) and workload were higher in the whites, while maximum respiratory exchange ratio and ventilatory equivalents for CO2 were the same. Pulmonary hemodynamics were not different at rest. Exercise was associated with a higher maximum total pulmonary vascular resistance, steeper mPAP-CO relationships, and lower ?-coefficients in the blacks. These differences were entirely driven by higher slopes of mPAP-CO relationships (2.5 ± 0.7 vs. 1.4 ± 0.7 mmHg·l(-1)·min; P circulation is intrinsically less distensible in black sub-Saharan African men compared with white Caucasian Europeans men, and this is associated with a lower exercise capacity. This study did not identify racial differences in pulmonary vascular function in women. PMID:26205542
This paper focuses on how Sub-Saharan Africans present themselves as musicians in Chemnitz, an Eastern German town of around 200,000 citizens that is situated on the periphery of existing immigrant musicians' networks in Europe. Generally, immigration to Chemnitz has been rather limited; the quota of foreign nationals is 2.9 % for the whole city. I will explore what purposes Sub-Saharan African music and dance performances serve in this context both for the majority society as well as for the...
Hindin, Michelle J
Preventing unwanted adolescent pregnancy is key for keeping girls in school, leading to a more productive and healthier workforce in sub-Saharan Africa. Gender norms are an important indicator of the status of women and more conservative gender norms are associated with experiencing domestic violence, and poorer maternal and reproductive health care. This paper examines the association between adolescent childbearing and norms towards wife beating in sub-Saharan Africa, and the role of education in moderating this association. Data come from the most recent Demographic and Health Surveys-nationally representative cross-sectional surveys conducted every 5 years. Country-by-country multivariable logistic regressions were conducted in 25 countries, and country and regional estimates were obtained using meta-analytical techniques. More than half of sub-Saharan African adolescents have a child, with levels ranging from 23% in Rwanda to 69% in Niger. Between 12 and 87% of women believed wife beating is acceptable. In 20 of the 25 countries, women with a birth during adolescence were significantly more likely to believe wife beating is justified [OR = 1.39; 95% confidence interval (CI) 130-1.39]. After multivariate adjustment, the overall finding remains statistically significant [AOR = 1.09; 95% CI 105-1:13]. Education attenuates the observed association. Overall, the effects are strongest and most consistent in West Africa. Results suggest that women who have an adolescent birth more likely to hold more conservative attitudes. Working with adolescents to improve their attitudes on relationship expectations and the importance of furthering their education even after a pregnancy could be integrated into life skills and sexual education curricula. PMID:24158508
Page, Randy M.; Hall, Cougar P.
Background: This study examines the relationship between sexual behavior, alcohol use, and indicators of psychosocial distress (mental health) of adolescents in 6 sub-Saharan African countries using the Global School-based Student Health Survey (GSHS). Methods: The sample consisted of 22,949 adolescents from Botswana, Kenya, Namibia, Uganda,
Destro-Bisol, G; Donati, F; Coia, V; Boschi, I; Verginelli, F; Caglià, A; Tofanelli, S; Spedini, G; Capelli, C
In this paper, we present a study of genetic variation in sub-Saharan Africa, which is based on published and unpublished data on fast-evolving (hypervariable region 1 of mitochondrial DNA and six microsatellites of Y chromosome) and slow-evolving (haplogroup frequencies) polymorphisms of mtDNA and Y chromosome. Our study reveals a striking difference in the genetic structure of food-producer (Bantu and Sudanic speakers) and hunter-gatherer populations (Pygmies, Kung, and Hadza). In fact, the...
Taiwo Akinlo; Olumuyiwa Tolulope Apanisile
This study examined the relationship between insurance and economic growth in sub-Saharan Africa over the period 1986-2011. Pooled OLS, Fixed Effect Model and Generalized Method of Moment Panel Model were employed in the estimation. The estimations of the dynamic panel-data results show that insurance has positive and significance impact on economic growth in sub-Saharan Africa. This shows that premium contributes to economic growth in sub-Saharan Africa which means tha...
Leo J. de Haan
In this farewell lecture on the occasion of his departure as Professor of Development in sub-Saharan Africa at Leiden University and Director of the African Studies Centre (ASC), Leiden, the author starts with the vuvuzela issue as an illustration of the lack of confidence the world has in South Africa organizing and running the World Cup smoothly. He takes that as a sign that there still exists a stereotype of African incompetence, despite the social and economic progress Africa has witnesse...
Sindzingre, Alice N.
After the lost decades Sub-Saharan African economies have exhibited positive growth rates due to emerging countries. The paper shows the complexity of causalities, which depend on: i) channels (trade, investment); ii) the emerging country (especially China); and iii) African countries market structures. On the one hand, this growth relies on structural asymmetries and is generated by distorted export structures that are based on commodities. It falls if prices decline and in...
Objective To systematically review current smoking prevalence among adults in sub-Saharan Africa from 2007 to May 2014 and to describe the context of tobacco control strategies in these countries. Data Sources Five databases, Medline, Embase, Africa-wide Information, Cinahl Plus, and Global Health were searched using a systematic search strategy. There were no language restrictions. Study Selection 26 included studies measured current smoking prevalence in nationally representative adult populations in sub-Saharan African countries. Data Extraction Study details were independently extracted using a standard datasheet. Data on tobacco control policies, taxation and trends in prices were obtained from the Implementation Database of the WHO FCTC website. Results Studies represented 13 countries. Current smoking prevalence varied widely ranging from 1.8% in Zambia to 25.8% in Sierra Leone. The prevalence of smoking was consistently lower in women compared to men with the widest gender difference observed in Malawi (men 25.9%, women 2.9%). Rwanda had the highest prevalence of women smokers (12.6%) and Ghana had the lowest (0.2%). Rural, urban patterns were inconsistent. Most countries have implemented demand-reduction measures including bans on advertising, and taxation rates but to different extents. Conclusion Smoking prevalence varied widely across sub-Saharan Africa, even between similar country regions, but was always higher in men. High smoking rates were observed among countries in the eastern and southern regions of Africa, mainly among men in Ethiopia, Malawi, Rwanda, and Zambia and women in Rwanda and rural Zambia. Effective action to reduce smoking across sub-Saharan Africa, particularly targeting population groups at increased risk remains a pressing public health priority. PMID:26162085
Reinhart Kößler; Arnold-Bergstraesser-Institut
Review of the monograph:Joseph Patrick Ganahl, Corruption, Good Governance, and the African State: A Critical Analysis of the Political-Economic Foundations of Corruption in Sub-Saharan Africa, Potsdam: Potsdam University Press, 2013, ISBN 9783869562483, 300 pp.
Daniel J. Corsi
Full Text Available Background: Infant and child mortality rates are among the most important indicators of child health, nutrition, implementation of key survival interventions, and the overall social and economic development of a population. In this paper, we investigate the role of coverage of maternal and child health (MNCH interventions in contributing to declines in child mortality in sub-Saharan Africa. Design: Data are from 81 Demographic and Health Surveys from 35 sub-Saharan African countries. Using ecological time-series and child-level regression models, we estimated the effect of MNCH interventions (summarized by the percent composite coverage index, or CCI on child mortality with in the first 5 years of life net of temporal trends and covariates at the household, maternal, and child levels. Results: At the ecologic level, a unit increase in standardized CCI was associated with a reduction in under-5 child mortality rate (U5MR of 29.0 per 1,000 (95% CI: ?43.2, ?14.7 after adjustment for survey period effects and country-level per capita gross domestic product (pcGDP. At the child level, a unit increase in standardized CCI was associated with an odds ratio of 0.86 for child mortality (95% CI: 0.820.90 after adjustment for survey period effect, country-level pcGDP, and a set of household-, maternal-, and child-level covariates. Conclusions: MNCH interventions are important in reducing U5MR, while the effects of economic growth in sub-Saharan Africa remain weak and inconsistent. Improved coverage of proven life-saving interventions will likely contribute to further reductions in U5MR in sub-Saharan Africa.
This study carries out an empirical examination of the finance-led, export-led and import-led growth hypothesis for four of the largest Sub-Saharan African economies namely South Africa, Nigeria, Ghana and Kenya. Within a multivariate Vector-Auto Regressive (VAR) framework, the concept of Granger causality is employed to determine the direction of causation between exports and output, duly taking into account the stationarity properties of the time series data. With further substantiation fro...
Capucine de Fouchier
Full Text Available Background: To date no validated instrument in the French language exists to screen for posttraumatic stress disorder (PTSD in survivors of torture and organized violence. Objective: The aim of this study is to adapt and validate the Harvard Trauma Questionnaire (HTQ to this population. Method: The adapted version was administered to 52 French-speaking torture survivors, originally from sub-Saharan African countries, receiving psychological treatment in specialized treatment centers. A structured clinical interview for DSM was also conducted in order to assess if they met criteria for PTSD. Results: Cronbach's alpha coefficient for the HTQ Part 4 was adequate (0.95. Criterion validity was evaluated using receiver operating characteristic curve analysis that generated good classification accuracy for PTSD (0.83. At the original cut-off score of 2.5, the HTQ demonstrated high sensitivity and specificity (0.87 and 0.73, respectively. Conclusion: Results support the reliability and validity of the French version of the HTQ.
Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg
The present study provides evidence to support enhanced attention to reproductive health and comprehensive measures to increase access to quality reproductive health services. We compare and contrast the financing and utilization of reproductive health services in six sub-Saharan African countries using data from National Health Accounts and Demographic and Health Surveys. Spending on reproductive health in 2006 ranged from US$4 per woman of reproductive age in Ethiopia to US$17 in Uganda. These are below the necessary level for assuring adequate services given that an internationally recommended spending level for family planning alone was US$16 for 2006. Moreover, reproductive health spending shows signs of decline in tandem with insufficient improvement in service utilization. Public providers played a predominant role in antenatal and delivery care for institutional births, but home deliveries with unqualified attendants dominated. The private sector was a major supplier of condoms, oral pills and IUDs. Private clinics, pharmacies and drug vendors were important sources of STI treatment. The findings highlight the need to commit greatly increased funding for reproductive health services as well as more policy attention to the contribution of public, private and informal providers and the role of collaboration among them to expand access to services for under-served populations. PMID:21555087
Ichoku, Charles; Ellison, Luke
The northern sub-Saharan African (NSSA) region, bounded by the Sahara, Equator, and the West and East African coastlines, is subjected to intense biomass burning every year during the dry season. This is believed to be one of the drivers of the regional carbon and energy cycles, with serious implications for the water cycle anomalies that probably contribute to drought and desertification. In this presentation, we will discuss a new multi-disciplinary research in the NSSA region, review progress, evaluate preliminary results, and interact with the research and user communities to examine how best to coordinate with other research activities in order to address related environmental issues most effectively.
Freeman, E. E.; Orroth, K. K.; White, R.G.; Glynn, J.R.; Bakker, R.; Boily, M. C.; Habbema, D.; Buvé, A.; Hayes, R. J.
OBJECTIVE: To understand the changing impact of herpes simplex 2 (HSV-2) and other sexually transmitted infections (STIs) on HIV incidence over time in four sub-Saharan African cities, using simulation models. METHODS: An individual-based stochastic model was fitted to demographic, behavioural and epidemiological data from cross-sectional population-based surveys in four African cities (Kisumu, Kenya; Ndola, Zambia; Yaoundé, Cameroon; and Cotonou, Benin) in 1997. To estimate the proportion of...
Many help-seeking torture survivors in sub-Saharan Africa report sudden or violent bereavements, as well as risk factors associated with complicated grief. This mixed-methods article reviews 85 therapeutic client files from torture treatment centers in 3 countries in sub-Saharan Africa. Thirty-nine clients had lost loved ones and were at greater risk for depression (effect size 0.65) and thoughts of suicide (OR = 4.99). Qualitative analysis of case histories and interviews with clients elaborate the links between torture and complicated grief. Recommendations are offered for the treatment of complicated grief in sub-Saharan torture survivors, and implications for assessment, timing, and treatment duration are discussed. PMID:25089758
Ashford C. Chea
Full Text Available The paper begins with a brief review of the nature and historical perspective of strategy. This is followed by discussion of industry analysis as in important step in the strategy development process. The paper continues with an analysis of the strategy development process and the role of strategic leadership to sustain strategy. Also presented in the paper is the analysis of how the appropriate management system can be leveraged to support a successful strategy execution and evaluation. The paper ends with an outline of strategic implications and recommendations for sub-Saharan African business leaders and managers.
Full Text Available This paper investigates the causal relationship between energy consumption and real GDP in 14 Sub-Saharan African countries over the period 1971-2004. The results of panel co-integration tests showed that energy consumption and real GDP do not have a stable long-run equilibrium relationship. We find [...] that for all members of the panel, there is homogenous causality from energy consumption to real GDP and vice versa. This bi-directional causality supports the feedback hypothesis.
Fabian, D K; Lack, J B; Mathur, V; Schlötterer, C; Schmidt, P S; Pool, J E; Flatt, T
Clines in life history traits, presumably driven by spatially varying selection, are widespread. Major latitudinal clines have been observed, for example, in Drosophila melanogaster, an ancestrally tropical insect from Africa that has colonized temperate habitats on multiple continents. Yet, how geographic factors other than latitude, such as altitude or longitude, affect life history in this species remains poorly understood. Moreover, most previous work has been performed on derived European, American and Australian populations, but whether life history also varies predictably with geography in the ancestral Afro-tropical range has not been investigated systematically. Here, we have examined life history variation among populations of D. melanogaster from sub-Saharan Africa. Viability and reproductive diapause did not vary with geography, but body size increased with altitude, latitude and longitude. Early fecundity covaried positively with altitude and latitude, whereas lifespan showed the opposite trend. Examination of genetic variance-covariance matrices revealed geographic differentiation also in trade-off structure, and QST -FST analysis showed that life history differentiation among populations is likely shaped by selection. Together, our results suggest that geographic and/or climatic factors drive adaptive phenotypic differentiation among ancestral African populations and confirm the widely held notion that latitude and altitude represent parallel gradients. PMID:25704153
Full Text Available Abstract Background There exists no consistent explanation for why some countries are successful in combating HIV/AIDS and others are not, and we need such an explanation in order to design effective policies and programmes. Research evaluating HIV interventions from a biomedical or public health perspective does not always take full account of the historical and organizational characteristics of countries likely to influence HIV outcomes. The analysis in this paper addresses this shortcoming by testing the impact of organizational and structural factors, particularly those resulting from population interventions, on HIV outcomes at the country level in sub-Saharan Africa. Methods The primary independent variables are factors that originated from efforts to slow population growth: whether a country has a long-time affiliate of the International Planned Parenthood Federation and whether a country has a population policy. Additional structural factors likely to impact HIV outcomes include the level of wealth, the level of cultural fractionalization, and the former colonial power. The present study uses multivariate regression techniques with countries in sub-Saharan Africa as the unit of analysis, and four measures of success in addressing HIV: the change in prevalence between 2001 and 2009; the change in incidence between 2001 and 2009; the level of overall antiretroviral coverage in 2009; and the level of antiretroviral coverage for prevention of vertical transmission in 2009. Results Countries with the greatest declines in HIV prevalence and incidence had older International Planned Parenthood Federation affiliates and had adopted population policies, even after controlling for age of epidemic, level of antiretroviral coverage, and funding for HIV. Population policies are also important predictors of levels of overall antiretroviral coverage and of coverage of HIV-positive pregnant women to prevent vertical transmission. Structural factors with significant impacts include wealth, cultural fractionalization and former colonial power. Conclusions The organizational and structural context of African countries is strongly predictive of HIV outcomes. This finding implies that policy and programmatic efforts should be put towards strengthening existing organizations and perhaps even creating new ones. The fact that cultural fractionalization also influences HIV outcomes suggests that efforts must be put towards identifying ways to reach political consensus in diverse societies.
Akinboboye, O; Idris, O; Akinboboye, O; Akinkugbe, O
It has been suggested that the prevalence of coronary artery disease (CAD) is steadily increasing in sub-Saharan Africa. To address this issue, we conducted a Medline search of English language articles on cardiovascular diseases-and specifically CAD in Africa- from 1966 to 1997. The prevalence of CAD and related complications is relatively low in most regions in Africa compared to that obtained in the economically developed countries, although the situation is rapidly changing due to trends in urbanization, changes in lifestyle, acquisition of technology and the increasing numbers of tertiary care institutions. There are variations in reported prevalence rates within the different regions, but there is an upward trend in all the regions of the sub-Saharan Africa. This trend is believed to be related to the increasing frequencies of CAD risk factors in the subcontinent. PMID:12764400
Full Text Available This paper focuses on how Sub-Saharan Africans present themselves as musicians in Chemnitz, an Eastern German town of around 200,000 citizens that is situated on the periphery of existing immigrant musicians' networks in Europe. Generally, immigration to Chemnitz has been rather limited; the quota of foreign nationals is 2.9 % for the whole city. I will explore what purposes Sub-Saharan African music and dance performances serve in this context both for the majority society as well as for the immigrants, individually and as a community. In so doing, I use a case study on the yearly local "intercultural festival" and analyze what kind of local power structures, institutional and informal, economic and political, influence the Nigerian cultural association's festival performance. This analysis shows how immigrant networks or associations relate to expectations and ascriptions of "authenticity" in a small-scale city. With its focus on the local situation and its effects on the representation of immigrant groups, this paper builds on the work that Nina Glick Schiller and Ayse Caglar (2006, 2009 have done on the importance of locality for research on migration and immigrant incorporation.
Periasamy, Malini; Schafleitner, Roland; Muthukalingan, Krishnan; Ramasamy, Srinivasan
This study was undertaken to assess the genetic diversity and host plant races of M. vitrata population in South and Southeast Asia and sub-Saharan Africa. The cytochrome c oxidase subunit 1 (cox1) gene was used to understand the phylogenetic relationship of geographically different M. vitrata population, but previous studies did not include population from Southeast Asia, the probable center of origin for Maruca, and from east Africa. Extensive sampling was done from different host plant spe...
Spatio-temporal analysis was applied on data representing urbanisation, slumisation, poverty, safe water/ sanitation in urban sub-Saharan Africa (SSA). The findings include: rapid rates of national population growth and urbanisation throughout SSA from 1980 to 2005, averaging 93.8% (range: 90.5% points), lowest and highest rates being 40% (Lesotho) and 130.5% (Niger), respectively; high national poverty rates, widespread in SSA: (>50% in about seven countries; it might have been similar in mo...
Full Text Available Review of the monograph:Joseph Patrick Ganahl, Corruption, Good Governance, and the African State: A Critical Analysis of the Political-Economic Foundations of Corruption in Sub-Saharan Africa, Potsdam: Potsdam University Press, 2013, ISBN 9783869562483, 300 pp.
Manirankunda, Lazare; Loos, Jasna; Alou, Therese Assebide; Colebunders, Robert; Nostlinger, Christiana
This study explored perceptions, needs, and barriers of sub-Saharan African migrants in relation to HIV voluntary counseling and testing (VCT). Using an inductive qualitative methodological approach, data were obtained from focus group discussions. Results showed that participants were in principle in favor of VCT. However, they indicated that
Guiella, Georges; Bignami, Simona; LeGrand, Thomas K
Whether well founded or not, perceptions of one's own HIV risk have been shown by health behavior models to be an important factor in determining individuals' sexual behavior. Although empirical studies on the determinants of HIV risk perception exist, only a few have focused on adolescents who are not yet sexually active. Using data from nationally-representative surveys of adolescents, we assess the factors associated with HIV risk perception among sexually inactive adolescents in four sub-Saharan African countries at different stages of the HIV/AIDS epidemic (Burkina Faso, Ghana, Malawi and Uganda). The results show that there is no single influence on adolescents' HIV risk perception, but rather a range of individual, environmental and community factors such as schooling, knowledge about HIV, regional HIV prevalence and adolescents' social networks. These results can help better calibrate programs and policies addressing sexual and reproductive health issues among adolescents, a group that is disproportionately affected by new HIV infections. PMID:24689315
Gaita, S. M.; Boman, J.; Gatari, M. J.; Pettersson, J. B. C.; Janhäll, S.
Sources of airborne particulate matter and their seasonal variation in urban areas in Sub-Saharan Africa are poorly understood due to lack of long-term measurement data. In view of this, filter samples of airborne particulate matter (particle diameter ?2.5 ?m, PM2.5) were collected between May 2008 and April 2010 at two sites (urban background site and suburban site) within the Nairobi metropolitan area. A total of 780 samples were collected and analyzed for particulate mass, black carbon (BC) and 13 trace elements. The average PM2.5 concentration at the urban background site was 21±9.5 ?g m-3, whereas the concentration at the suburban site was 13±7.3 ?g m-3. The daily PM2.5 concentrations exceeded 25 ?g m-3 (the World Health Organization 24 h guideline value) on 29% of the days at the urban background site and 7% of the days at the suburban site. At both sites, BC, Fe, S and Cl accounted for approximately 80% of all detected elements. Positive matrix factorization analysis identified five source factors that contribute to PM2.5 in Nairobi, namely traffic, mineral dust, industry, combustion and a mixed factor (composed of biomass burning, secondary aerosol and aged sea salt). Mineral dust and traffic factors were related to approximately 74% of PM2.5. The identified source factors exhibited seasonal variation, apart from the traffic factor, which was prominently consistent throughout the sampling period. Weekly variations were observed in all factors, with weekdays having higher concentrations than weekends. The results provide information that can be exploited for policy formulation and mitigation strategies to control air pollution in Sub-Saharan African cities.
Background The burden of fevers remains enormous in sub-Saharan Africa. While several efforts at reducing the burden of fevers have been made at the macro level, the relationship between socioeconomic status and fever prevalence has been inconclusive at the household and individual levels. The purpose of this study was to examine how individual and household socioeconomic status influences the prevalence of fever among children under age five in four sub-Saharan African countries. Methods The study used data from the 2008 Demographic and Health Survey (DHS) from Ghana, Nigeria, Kenya and Sierra Leone with a total of 38,990 children below age five. A multi-level random effects logistic model was fitted to examine the socioeconomic factors that influence the prevalence of fever in the two weeks preceding the survey. Data from the four countries were also combined to estimate this relationship, after country-specific analysis. Results The results show that children from wealthier households reported lower prevalence of fever in Ghana, Nigeria and Kenya. Result from the combined dataset shows that children from wealthier households were less likely to report fever. In general, vaccination against fever-related diseases and the use of improved toilet facility reduces fever prevalence. The use of bed nets by children and mothers did not show consistent relationship across the countries. Conclusion Poverty does not only influence prevalence of fever at the macro level as shown in other studies but also the individual and household levels. Policies directed towards preventing childhood fevers should take a close account of issues of poverty alleviation. There is also the need to ensure that prevention and treatment mechanisms directed towards fever related diseases (such as malaria, pneumonia, measles, diarrhoea, polio, tuberculosis etc.) are accessible and effectively used. PMID:22840190
Full Text Available Abstract Background The burden of fevers remains enormous in sub-Saharan Africa. While several efforts at reducing the burden of fevers have been made at the macro level, the relationship between socioeconomic status and fever prevalence has been inconclusive at the household and individual levels. The purpose of this study was to examine how individual and household socioeconomic status influences the prevalence of fever among children under age five in four sub-Saharan African countries. Methods The study used data from the 2008 Demographic and Health Survey (DHS from Ghana, Nigeria, Kenya and Sierra Leone with a total of 38,990 children below age five. A multi-level random effects logistic model was fitted to examine the socioeconomic factors that influence the prevalence of fever in the two weeks preceding the survey. Data from the four countries were also combined to estimate this relationship, after country-specific analysis. Results The results show that children from wealthier households reported lower prevalence of fever in Ghana, Nigeria and Kenya. Result from the combined dataset shows that children from wealthier households were less likely to report fever. In general, vaccination against fever-related diseases and the use of improved toilet facility reduces fever prevalence. The use of bed nets by children and mothers did not show consistent relationship across the countries. Conclusion Poverty does not only influence prevalence of fever at the macro level as shown in other studies but also the individual and household levels. Policies directed towards preventing childhood fevers should take a close account of issues of poverty alleviation. There is also the need to ensure that prevention and treatment mechanisms directed towards fever related diseases (such as malaria, pneumonia, measles, diarrhoea, polio, tuberculosis etc. are accessible and effectively used.
Full Text Available Mercy Mvundura, Neeti Nundy, Maggie Kilbourne-Brook, Patricia S Coffey Technology Solutions Global Program, PATH, Seattle, WA, USA Background: Female condoms are the only currently available woman-initiated option that offers dual protection from pregnancy and sexually transmitted infections, including HIV. The Womans Condom is a new female condom designed to provide dual protection and to be highly pleasurable and acceptable. Objective: We sought to estimate the potential dual health impact and cost-effectiveness of a Womans Condom distribution program in 13 sub-Saharan African countries with HIV prevalence rates >4% among adults aged 1549 years. We used two separate, publicly available models for this analysis, the Impact 2 model developed by Marie Stopes International and the Population Services International disability-adjusted life years (DALY calculator program. We estimated the potential numbers of pregnancies and DALYs averted when the Womans Condom is used as a family planning method and the HIV infections and DALYs averted when it is used as an HIV prevention method. Results: Programming 100,000 Womans Condoms in each of 13 countries in sub-Saharan Africa during a 1-year period could potentially prevent 194 pregnancies and an average of 21 HIV infections in each country. When using the World Health Organization CHOosing Interventions that are Cost-Effective (WHO-CHOICE criteria as a threshold to infer the potential cost-effectiveness of the Womans Condom, we found that the Womans Condom would be considered cost-effective. Conclusion: This was a first and successful attempt to estimate the impact of dual protection of female condoms. The health impact is greater for the use of the Womans Condom as an HIV prevention method than for contraception. Dual use of the Womans Condom increases the overall health impact. The Womans Condom was found to be very cost-effective in all 13 countries in our sample. Keywords: female condoms, unintended pregnancy, HIV prevention, contraception, sub-Saharan Africa, cost-effectiveness
La construcción del proyecto migratorio y las razones para emigrar en la población de África subsahariana francófona. Un estudio intercontinental Europa - África / Construction of migration project and reasons for emigrating in sub-Saharan African francophone population. An intercontinental study Europe-Africa
Carlos Roberto, Velandia Torres; Marie-Françoise, Lacassagne.
Full Text Available Este estudio da cuenta de las razones de los ciudadanos de África subsahariana francófona para establecerse en Europa, y particularmente en Francia, mediante la creación de un marco comprensivo innovador que vincula tres ejes temáticos: la motivación, las migraciones, y África y sus relaciones con E [...] uropa. 155 participantes en ambos continentes respondieron a un cuestionario sobre su proyecto migratorio real o posible. Los resultados plantean un plano general de acercamiento a los imaginarios y la realidad de los migrantes en el contexto francés, marcado por la reflexión sobre la identidad nacional, los controles migratorios, un clima político reticente a la migración y un tejido social caracterizado por un creciente multiculturalismo. Abstract in english This study describes the motivations of citizens of sub-Saharan Africa francophone to establish in France thanks to the creation of an innovative framework for understanding with three key themes: motivation, migration and Africa and their relations with Europe. 155 participants from both continents [...] responded to a questionnaire about their actual or potential migration project. The results presented raise a general plan of approach to reality and imaginary of sub-Saharan African migrants in the French current context, marked by reflection on national identity, immigration and customs controls, a political climate reticent to migration and a social network characterized by a growing multiculturalism.
Biddlecom, Ann; Gregory, Richard; Lloyd, Cynthia B; Mensch, Barbara S
With the spread of formal schooling in sub-Saharan Africa and delays in the age at marriage, a growing proportion of adolescents remain enrolled in school when they "come of age." As a consequence, more and more adolescents have to negotiate sexual maturation and sexual initiation in a vastly different context from that of prior generations. Using data from the 2004 National Survey of Adolescents conducted in Burkina Faso, Ghana, Malawi, and Uganda, we investigate the empirical association between premarital sex and leaving school among those who were enrolled in school at the outset of adolescence (age 12). Discrete-time logistic regression models show that, in general, girls are more likely than boys to leave school before completing secondary school, before completing primary school, and, among those completing primary school, before progressing to secondary school. Girls who complete primary school, however, do so at the same age as or a younger age than their male peers. Girls appear more vulnerable to leaving school once they engage in premarital sex. These findings can assist researchers, policymakers, program managers, and educators in understanding and addressing the challenges to educational attainment posed by the increasing proportion of school-aged adolescents engaging in premarital sex. PMID:19248719
Full Text Available Basic provisions for design ground motions in seismic design codes of sub-Saharan African countries are critically reviewed. The seismic codes of Ethiopia, Kenya and Uganda are selected to represent the eastern region, Ghana to represent the west and South Africa to represent the south. The specific [...] provisions considered are those pertaining to site effect and the recurrence period of the design earthquake. The codes are also compared with one another and with selected current international codes from the US and Europe, with respect to selected provisions. The provisions are further viewed from the perspective of the state of the art and the state of the practice. It has been concluded that these basic provisions in most of the sub-Saharan African codes considered are inadequate in guaranteeing safety of human life and limiting damage to property, suggesting a need for immediate updating, an exception being the South African code.
Degboe Arnold N
Full Text Available Abstract Background Sub-Saharan African (SSA countries are currently experiencing one of the most rapid epidemiological transitions characterized by increasing urbanization and changing lifestyle factors. This has resulted in an increase in the incidence of non-communicable diseases, especially cardiovascular disease (CVD. This double burden of communicable and chronic non-communicable diseases has long-term public health impact as it undermines healthcare systems. Purpose The purpose of this paper is to explore the socio-cultural context of CVD risk prevention and treatment in sub-Saharan Africa. We discuss risk factors specific to the SSA context, including poverty, urbanization, developing healthcare systems, traditional healing, lifestyle and socio-cultural factors. Methodology We conducted a search on African Journals On-Line, Medline, PubMed, and PsycINFO databases using combinations of the key country/geographic terms, disease and risk factor specific terms such as "diabetes and Congo" and "hypertension and Nigeria". Research articles on clinical trials were excluded from this overview. Contrarily, articles that reported prevalence and incidence data on CVD risk and/or articles that report on CVD risk-related beliefs and behaviors were included. Both qualitative and quantitative articles were included. Results The epidemic of CVD in SSA is driven by multiple factors working collectively. Lifestyle factors such as diet, exercise and smoking contribute to the increasing rates of CVD in SSA. Some lifestyle factors are considered gendered in that some are salient for women and others for men. For instance, obesity is a predominant risk factor for women compared to men, but smoking still remains mostly a risk factor for men. Additionally, structural and system level issues such as lack of infrastructure for healthcare, urbanization, poverty and lack of government programs also drive this epidemic and hampers proper prevention, surveillance and treatment efforts. Conclusion Using an African-centered cultural framework, the PEN3 model, we explore future directions and efforts to address the epidemic of CVD risk in SSA.
Gurney, Karen A.; Mgone, Charles S.
Background The European & Developing Countries Clinical Trials Partnership (EDCTP) is a partnership of European and sub-Saharan African countries that aims to accelerate the development of medical interventions against poverty-related diseases (PRDs). A bibliometric analysis was conducted to 1) measure research output from European and African researchers on PRDs, 2) describe collaboration patterns, and 3) assess the citation impact of clinical research funded by EDCTP. Methodology/Principal Findings Disease-specific research publications were identified in Thomson Reuters Web of Science using search terms in titles, abstracts and keywords. Publication data, including citation counts, were extracted for 20032011. Analyses including output, share of global papers, normalised citation impact (NCI), and geographical distribution are presented. Data are presented as five-year moving averages. European EDCTP member countries accounted for ~33% of global research output in PRDs and sub-Saharan African countries for ~10% (20072011). Both regions contributed more to the global research output in malaria (43.4% and 22.2%, respectively). The overall number of PRD papers from sub-Saharan Africa increased markedly (>47%) since 2003, particularly for HIV/AIDS (102%) and tuberculosis (TB) (81%), and principally involving Southern and East Africa. For 20072011, European and sub-Saharan African research collaboration on PRDs was highly cited compared with the world average (NCI in brackets): HIV/AIDS 1.62 (NCI: 1.16), TB 2.11 (NCI: 1.06), malaria 1.81 (NCI: 1.22), and neglected infectious diseases 1.34 (NCI: 0.97). The NCI of EDCTP-funded papers for 20032011 was exceptionally high for HIV/AIDS (3.24), TB (4.08) and HIV/TB co-infection (5.10) compared with global research benchmarks (1.14, 1.05 and 1.35, respectively). Conclusions The volume and citation impact of papers from sub-Saharan Africa has increased since 2003, as has collaborative research between Europe and sub-Saharan Africa. >90% of publications from EDCTP-funded research were published in high-impact journals and are highly cited. These findings corroborate the benefit of collaborative research on PRDs. PMID:26262756
Manirankunda, L.; J. Loos; Alou, T. A.; Colebunders, R; Nöstlinger, C.
This study explored perceptions, needs, and barriers of sub-Saharan African migrants in relation to HIV voluntary counseling and testing (VCT). Using an inductive qualitative methodological approach, data were obtained from focus group discussions. Results showed that participants were in principle in favor of VCT. However, they indicated that barriers outweighed advantages. Such barriers included fear of positive test results and its related personal and social consequences, lack of informat...
Following a field survey in neighbourhoods and schools in the poor area of Brussels among adolescents from an African migrant background (Morocco and sub-Saharan Africa), this article examines young peoples attempts to rationalise the discrimination and injustice they experience. As well as their direct effects in terms of social success in particular, institutional discrimination and violence have repercussions on representations of oneself and of the world. The accumulation of experiences ...
Dandume, Muhammad Yusuf; A.C., Dr.Malarvizhi
This paper examines the linkage among financial liberalization, economic growth and poverty reduction in Sub-Saharan African countries (SSA). The study applies the recent panel Co-integration and vector error correction mechanism to address the heterogeneity and cross-border interdependence over the period of 1980 to 2010. The results reveal that economic growth is positively associated with poverty reduction and financial liberalization coefficients are positively related to economic growth....
Yue, Y.; Wang, J.; Ichoku, C. M.; Zhang, F.
This study aims to investigate the radiative effects of smoke and dust aerosols and of the underlying surface in the Northern Sub-Saharan African (NSSA) region using the Weather Research and Forecasting model coupled with Chemistry (WRF-Chem). We performed a yearlong (from September 2009 to September 2010) WRF-Chem simulation using hourly emissions from the Fire Energetics and Emissions Research (FEER) emission dataset derived by multiplying emission coefficients based on aerosol and fire observations from the Moderate Resolution Imaging Spectroradiometer (MODIS) instruments aboard Terra and Aqua with fire radiative energy (FRE) measurements from the geostationary Meteosat Spinning Enhanced Visible and Infrared Imager (SEVIRI). The geographic distribution and vertical profiles of simulated dust and smoke aerosols were evaluated with MODIS true color images and Cloud-Aerosol Lidar data with Orthogonal Polarization (CALIPSO) total attenuated backscatter, aerosol extinction coefficient and depolarization data. We found that simulated aerosol vertical concentration profiles are consistent with the above CALIPSO data. Surface albedo and columnar aerosol optical depth (AOD) sensitivity to smoke and dust simulations are performed with WRF-Chem. The simulated surface albedo and AOD were compared with MODIS albedo product (MODIS43) and AOD measurements from the Aerosol Robotic Network (AERONET). The modeled smoke/dust clear-sky and all-sky radiative impacts were analyzed in this study and reveal interesting results that will be discussed.
Osungbade, Kayode O.; Oladunjoye, Olubunmi O.
Objectives. Review of burden of congenital transmission of malaria, challenges of preventive measures, and implications for health system strengthening in sub-Saharan Africa. Methods. Literature from Pubmed (MEDLINE), Biomed central, Google Scholar, and Cochrane Database were reviewed. Results. The prevalence of congenital malaria in sub-Saharan Africa ranges from 0 to 23%. Diagnosis and existing preventive measures are constantly hindered by weak health systems and sociocultural issues. WHO ...
Leo J. de Haan
Full Text Available In this farewell lecture on the occasion of his departure as Professor of Development in sub-Saharan Africa at Leiden University and Director of the African Studies Centre (ASC, Leiden, the author starts with the vuvuzela issue as an illustration of the lack of confidence the world has in South Africa organizing and running the World Cup smoothly. He takes that as a sign that there still exists a stereotype of African incompetence, despite the social and economic progress Africa has witnessed in the last decade. He does not want to argue that African Studies have not been able to offset such a stereotype. What he tries to show is that it is not clear from the wealth of actor-oriented research in African Studies what the main social, political and economic trends in Africa are. He argues that actor-oriented research in African Studies should try to increase its relevance by contributing through meta-analyses and comparative research to the discussion on social, political and economic trends in Africa. Special attention should be paid to the possible rise of the developmental state in Africa. In doing so, African Studies may also substantiate its claim that it is able to challenge the universal pretensions of mainstream social science. In seiner Abschiedsvorlesung als Professor für Entwicklung im subsaharischen Afrika an der Universität Leiden und als Direktor des African Studies Centre (ASC, Leiden illustriert der Autor unter Hinweis auf die Diskussionen um die Vuvuzelas, wie gering das Vertrauen weltweit ist, dass der World Cup in Südafrika reibungslos organisiert und durchgeführt werden kann. Er sieht dies als Beispiel dafür, dass das Stereotyp der Inkompetenz in Afrika trotz der sozialen und wirtschaftlichen Fortschritte auf dem Kontinent in der letzten Dekade immer noch weit verbreitet ist. Er möchte nicht darüber klagen, dass die Afrikaforschung bislang nicht in der Lage war, ein solches Stereotyp zu beseitigen; vielmehr möchte er aufzeigen, dass die große Zahl handlungsorientierter Studien in der Afrikaforschung die wesentlichen sozialen, politischen und ökonomischen Trends in Afrika nicht klar herausgestellt hat. Er plädiert für eine Erhöhung der Relevanz handlungsorientierter Forschungsansätze, indem sie durch Metaanalysen und vergleichende Forschung zur Diskussion der sozialen, politischen und wirtschaftlichen Trends in Afrika beitragen. Besondere Aufmerksamkeit solle dem möglichen Wiederaufstieg des Entwicklungsstaates in Afrika gewidmet werden. Damit könne die Afrikaforschung auch ihren Anspruch untermauern, den Universalanspruch des Mainstreams der Sozialwissenschaften infrage zu stellen.
Olawoye, Olusola O; Pasquale, Louis R; Ritch, Robert
The goal of this review is to estimate the burden of exfoliation syndrome (XFS) and exfoliation glaucoma (XFG) in sub-Saharan Africa and to identify the gaps in knowledge of disease prevalence in this region. PubMed, Medline, African Journals Online and Google engine search were carried out using the following terms "pseudoexfoliation" or "exfoliation syndrome Africa", "pseudoexfoliation" or "exfoliation syndrome" + "glaucoma Africa," "glaucoma prevalence Africa," "pattern of glaucoma presentation Africa," "pseudoexfoliation" or "exfoliation syndrome" + "cataract Africa," "ophthalmic conditions Africa." Studies were included if they described the proportion or prevalence/incidence of XFG and XFS in sub-Saharan Africa or if they investigated lysyl oxidase-like 1 (LOXL1) variants in XFS among Africans. 22 papers were identified and classified as clinic-based studies (n = 16) and population-based (n = 4) studies. Two other studies were considered important, and therefore, included in the review. Clinic-based studies demonstrate that XFS is a common cause of glaucoma, as is true in many other parts of the world. Furthermore, XFS often co-exists with cataract and climatic droplet keratopathy. Its prevalence ranged from 5.1 to 7.7 % in patients >40 years in population-based studies, a value that is considerably higher than that reported in African Americans. XFS was strongly associated with increasing age in the prevalence studies. The burden of XFS in sub-Saharan Africa is high. More investigation is needed to determine why clinic-based studies report virtually no XFS in some countries (Ghana and Tanzania), while nearby countries report greater proportions (Nigeria and Ethiopia). PMID:24844849
Eskemose Andersen, JØrgen
Current definitions of urbanity lead to claims that a large proportion (75% according to UN Habitat) of Sub-Saharan Africas (SSA) urban population is housed in informal settlements with almost all new housing stock provided informally in contradiction to the formal that is defined as planned and regulated by the state. In most cases in SSA cities urban development has no professional assistance in the form of architects or engineers, and what is characterised as disorder, as is the case with informal urbanisation, is considered as undesirable, inappropriate, dangerous, unhealthy and un-modern (Folkers 2009, Hardoy 1990, Jenkins 2011, Nielsen 2008, Nguluma 2003, Mitlin, D. 2004, Koolhaas 2006). In 2003 the UN adopted a new terminology for what over decades used to be labelled as informal-, squatter-, illegal-, unplanned-, spontaneous settlements, shanty towns with the term slum (UN habitat 2003). However, defining what slum implies is complex and this author consider the term as prejudiced and not covering the diversity most informal settlements represents Further the term stigmatises a remarkable share of any city population in SSA (Huchzermeyer 2011, Davis 2007, Harber 2011, Garau 2005).
Full Text Available The status of older adults in Africa occupies a small but rapidly expanding share of the global literature on ageing. The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) pandemic has generated a new focus on the changing role of the elderly in communities that have [...] been affected. In sub-Saharan Africa, where millions are projected to be infected with HIV and about two million deaths are recorded annually amongst the traditionally productive adults, such loss of parents and breadwinners means children and the elderly have had to take up unusual responsibilities. A literature review on the elderly and HIV and AIDS provided the data analysed for this article. Access to databases was mainly via EBSCO (http://www.ebsco.co), which allowed searches in major databases and search engines useful in an academic setting for finding and accessing articles in health and health-related academic journals, repositories and archived reports. Results showed that the AIDS pandemic has direct and indirect effects which have manifested in a set of interrelated social, economic and psychological dimensions that could ultimately impact on the health and well-being of the elderly. It is concluded that more needs to be done to articulate the knowledge base of the impact of HIV and AIDS in order to inform social, economic and political policies for the purpose of alleviating the problems that the pandemic is wreaking on the elderly African population.
Haan, L.J., de
In seiner Abschiedsvorlesung als Professor für Entwicklung im subsaharischen Afrika an der Universität Leiden und als Direktor des African Studies Centre (ASC), Leiden illustriert der Autor unter Hinweis auf die Diskussionen um die Vuvuzelas, wie gering das Vertrauen weltweit ist, dass der World Cup in Südafrika reibungslos organisiert und durchgeführt werden kann. Er sieht dies als Beispiel dafür, dass das Stereotyp der Inkompetenz in Afrika trotz der sozialen und wirtschaftlichen Fortschr...
Barry, Boubakar; /Assoc. Afr. Univ.; Chukwuma, Victor; /Olabisi Onabanjo U.; Petitdidier, Monique; /CEPT, Velizy; Cottrell, Les; /SLAC; Bartons, Charles; /Australian Natl. U., RSES
The Digital Divide prevents Africa from taking advantages of new information technologies. One of the most urgent priorities is to bring the Internet in African Universities, Research, and Learning Centers to the level of other regions of the world. eGY-Africa, and the Sharing Knowledge Foundation are two bottom-up initiatives by scientists to secure better cyber-infrastructure and Internet facilities in Africa. Recommendations by the present scientific communities are being formulated at national, regional and international levels. The Internet capabilities are well documented at country level overall, but this is not the case at the University level. The snapshot of the Internet status in universities in 17 African countries, obtained by a questionnaire survey, is consistent with measures of Internet penetration in the corresponding country. The monitoring of Internet performance has been proposed to those African universities to provide an information base for arguing the need to improve the coverage for Africa. A pilot program is recommended that will start scientific collaboration with Europe in western Africa using ICT. The program will lay the foundations for the arrival of new technologies like Grids.
Wagner, Zachary; Barofsky, Jeremy; Sood, Neeraj
The President's Emergency Plan for AIDS Relief (PEPFAR) has provided billions of US tax dollars to expand HIV treatment, care, and prevention programs in sub-Saharan Africa. This investment has generated significant health gains, but much less is known about PEPFAR's population-level economic effects. We used a difference-in-differences approach to compare employment trends between ten countries that received a large amount of PEPFAR funding (focus countries) and eleven countries that received little or no funding (control countries). We found that PEPFAR was associated with a 13 percent differential increase in employment among males in focus countries, compared to control countries. However, we observed no change in employment among females. In addition, we found that increasing PEPFAR per capita funding by $100 was associated with a 9.1-percentage-point increase in employment among males. This rise in employment generates economic benefits equal to half of PEPFAR's cost. These findings suggest that PEPFAR's economic impact should be taken into account when making aid allocation decisions. PMID:26056199
Roger J. Chin, MA, MPA
Full Text Available Background: HIV and AIDS continue to have a calamitous effect on individuals living on the continent of Africa. U.S. President George W. Bush implemented the Presidents Emergency Plan for AIDS Relief (PEPFAR with the objective of committing approximately $15 billion from 2004 through 2008 to assist with the reduction of the HIV pandemic worldwide. The majority of the PEPFAR policy and funding focused on 12 countries in sub-Saharan Africa: Botswana, Cote dIvoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia. The policy question this research paper seeks to analyze is whether the PEPFAR funding (as a % of Gross Domestic Product (GDP allocated to the 12 countries in Africa had any effect on the decrease of HIV infection rates of males and females between the ages of 15 and 49. Methods: A fixed-effects panel regression analysis was conducted to determine if this association exists. This study examined the 12 African countries that received PEPFAR funding over the years 2002 to 2010; even though PEPFAR was only active from 2004 through 2008, this research included two years prior and two years after this timeframe in order to better estimate the effect of PEPFAR funding on HIV reduction. Results: The results illustrate that on average, ceteris paribus, for every 1 percentage point increase in PEPFAR funding per GDP a country received, the countrys HIV infection rate decreased by 0.355 percentage points. Conclusions and Global Health Implications: While the empirical findings in this study suggested that the correlation between PEPFAR funding and HIV reduction is statistically significant, the practical significance is perhaps less obvious. Arguably, the reduction rate should be higher given the extent of funding targeted to this project. The conclusion of this research provides suggestions on future research and the policy implications of PEPFAR.
Osungbade, Kayode O; Oladunjoye, Olubunmi O
Objectives. Review of burden of congenital transmission of malaria, challenges of preventive measures, and implications for health system strengthening in sub-Saharan Africa. Methods. Literature from Pubmed (MEDLINE), Biomed central, Google Scholar, and Cochrane Database were reviewed. Results. The prevalence of congenital malaria in sub-Saharan Africa ranges from 0 to 23%. Diagnosis and existing preventive measures are constantly hindered by weak health systems and sociocultural issues. WHO strategic framework for prevention: intermittent preventive therapy (IPT), insecticide-treated nets (ITNs), and case management of malaria illness and anaemia remain highly promising; though, specific interventions are required to strengthen the health systems in order to improve the effectiveness of these measures. Conclusion. Congenital malaria remains a public health burden in sub-Saharan Africa. Overcoming the challenges of the preventive measures hinges on the ability of national governments and development partners in responding to the weak health systems. PMID:21961019
Mullan, Fitzhugh; Frehywot, Seble; Omaswa, Francis; Buch, Eric; Chen, Candice; Greysen, S.R.; Wassermann, Travis; Abu Bakr, Diaa Eldin El Gali; Awases, Magda; Boelen, Charles; Diomande, Mohenou Jean-Marie Isidore; Dovlo, Delanyo; Ferro, Josefo; Haileamlak, Abraham; Iputo, Jehu
Small numbers of graduates from few medical schools, and emigration of graduates to other countries, contribute to low physician presence in sub-Saharan Africa. The Sub-Saharan African Medical School Study examined the challenges, innovations, and emerging trends in medical education in the region. We identified 168 medical schools; of the 146 surveyed, 105 (72%) responded. Findings from the study showed that countries are prioritising medical education scale-up as part of health-system...
This work comprises three parts. The first part aims at presenting the energy situation of sub-Saharan African (SSA) countries grouped in five regions. Because of the demographic pressure and of the petroleum shocks, the commercial energy consumption is growing up rapidly and the energy prices are high for the end-users (because the energy is imported and paid in dollars, and the fiscality share is increased by governments in the case of prices drop in the international market). The important problem of wood fuel is considered, together with the energy-economic growth relations and the determining factors of the energy demand in SSA. Some econometric relations are tested. The second part analyzes the mechanisms generated by petroleum shocks and counter-shocks, and stresses first on the transfers induced by these fluctuations. Then, it presents some macro-economical models which try to integrate the effects of a petroleum shock and makes some calculations based on a decomposition of imports and exports global and partial coefficients. Some important conclusions are inferred from this study: 1 - the second petroleum shock strikes more seriously the oil importing SSA countries because they do not benefit from a favorable international context, like during the first shock (also because the second shock is accompanied by a dollar shock); 2 - the absence of symmetry in oil shocks-counter-shocks; 3 - the crisis of SSA countries is not only of petroleum origin but is also linked with the drop of the export incomes (which itself is partially explained by the impact of petroleum shocks on the industrialized economies), with their bad insertion in the world economy, and with unsuitable domestic economies. The third part proposes some solutions to attenuate the energy and economical difficulties of these countries. It is necessary to implement an energy planning mainly based on the mastery of the demand and on a better management of local resources. The policies of stabilization and of structural adjustment are also presented with their effects on the different sectors. (J.S.)
Kabiru Caroline W; Izugbara Chimaraoke O; Beguy Donatien
Abstract A third of sub-Saharan Africas (SSA) population comprises persons aged 1024 years. These youth are growing up in a context marked by pervasive poverty, limited educational opportunities, high HIV/AIDS prevalence, widespread conflict, and weak social controls. Published research on the broad issues that affect youth health and wellbeing in SSA is limited and centers heavily on sexual and reproductive health. In this commentary, we provide a broad overview of sub-Saharan African yout...
Samba Michel Cyrille
Full Text Available This paper analyses the Feldstein-Horioka puzzle in 15 sub-Saharan African countries accounting for the correlation between inward and outward capital flows. Applying cross section, panel data, and even time series analyses, we show that our results are consistent with previous studies related to developing countries. More interesting, we confirm, for sub-Saharan African countries, the recent hypothesis of Georgepoulos and Hejazi (2009 that the Feldstein-Horioka home bias is unrelated to the correlation between inward and outward capital flows for developing countries. Although the saving-investment coefficient weakens in the correlation adjusted regression, we show that the coefficient on Flows, the variable which accounts for the correlation between inward and outward capital flows is always positive and insignificant. We argue that the downward movement in the saving-investment coefficient is due the omission of some factors (foreign aid and trade openness which are relevant for developing countries in the framework of the Feldstein-Horioka analysis. We also state that our results are more likely to reflect the poor financial structure of the countries in our sample. Therefore, we suggest that policymakers in Sub-Sahara Africa should put more emphasis in creating and developing efficient financial market which could favor portfolio diversification.
Eucebious Lekalakala- Mokgele
Full Text Available The status of older adults in Africa occupies a small but rapidly expanding share of the global literature on ageing. The human immunodeficiency virus (HIV and acquired immune deficiency syndrome (AIDS pandemic has generated a new focus on the changing role of the elderly in communities that have been affected. In sub-Saharan Africa, where millions are projected to be infected with HIV and about two million deaths are recorded annually amongst the traditionally productive adults, such loss of parents and breadwinners means children and the elderly have had to take up unusual responsibilities. A literature review on the elderly and HIV and AIDS provided the data analysed for this article. Access to databases was mainly via EBSCO (www.ebsco.co, which allowed searches in major databases and search engines useful in an academic setting for finding and accessing articles in health and health-related academic journals, repositories and archived reports. Results showed that the AIDS pandemic has direct and indirect effects which have manifested in a set of interrelated social, economic and psychological dimensions that could ultimately impact on the health and well-being of the elderly. It is concluded that more needs to be done to articulate the knowledge base of the impact of HIV and AIDS in order to inform social, economic and political policies for the purpose of alleviating the problems that the pandemic is wreaking on the elderly African population.
Die status van ouer volwassenes in Afrika bekleen klein, maar vinnig groeiende deel van die globale verouderings literatuur. Die menslike immuniteitsgebreksvirus (MIV en verworwe immuniteitsgebreksindroom (VIGS pandemie het n nuwe fokus op die veranderende rol van bejaardes in die gemeenskap wat deur VIGS beïnvloed word, gegenereer. In sub-Sahara Afrika waar na beraming miljoene geïnfekteer word met MIV, met sowat twee miljoen sterftes jaarliks gerekordeer onder die tradisoneel produktiewe volwassenes, word daar van die kinders en bejaardes verwag om ongewone verantwoordelikhede op hulle te neem as gevolg van die verlies aan ouers of broodwinners. n Literatuuroorsig wat handel oor bejaardes en MIV en VIGS het die geanaliseerde data voorsien vir hierdie artikel. Toegang tot die databasis was meestal deur EBSCO (www.ebsco.co wat soektog toegelaat het tot groot databasisse en soekenjins wat bruikbaar in die akademiese opset is en die vind van artikels aangaande gesondheid, gesondheidverwante akademiese joernale en argief verslae. Bevindings toon dat die VIGS pandemie direkte en indirekte effekte het. Hierdie effekte manifisteer in n stel sosiaal verwante, ekonomiese en psigologiese dimensies wat ten einde n impak op die gesondheid en welstand van bejaardes het. Daar is tot die gevolgtrekking gekom dat meer gedoen moet word om die kennis basis van MIV en VIGS te artikuleer om die sosiale, ekonomiese en politiese beleid in kennis te stel, om sodoende die resulterende probleme van MIV en VIGS op die bejaarde Afrika populasie te verlig.
How to cite this article: Lekalakala-Mokgele,E., 2011, A literature review of the impact of HIV and AIDS on the role of the elderly in the sub-Saharan African Community, Health SA Gesondheid 16(1, Art. #564, 6 pages. http://dx.doi.org/10:4102/hsag.v16i1.564
The characteristics of places where people live and work play an important role in explaining complex social, political, economic and demographic processes. In sub-Saharan Africa rapid urban growth combined with rising poverty is creating diverse urban environments inhabited by people with a wide variety of lifestyles. This research examines how spatial patterns of land cover in a southern portion of the West African country of Ghana are associated with particular characteristics of family organization and reproduction decisions. Satellite imagery and landscape metrics are used to create an urban context definition based on landscape patterns using a gradient approach. Census data are used to estimate fertility levels and household structure, and the association between urban context, household composition and fertility levels is modeled through OLS regression, spatial autoregressive models and geographically weighted regression. Results indicate that there are significant differences in fertility levels between different urban contexts, with below average fertility levels found in the most urbanized end of the urban context definition and above average fertility levels found on the opposite end. The spatial patterns identified in the association between urban context and fertility levels indicate that, within the city areas with lower fertility have significant impacts on the reproductive levels of adjacent neighborhoods. Findings also indicate that there are clear patterns that link urban context to living arrangements and fertility levels. Female- and single-headed households are associated with below average fertility levels, a result that connects dropping fertility levels with the spread of smaller nuclear households in developing countries. At the same time, larger extended family households are linked to below average fertility levels for highly clustered areas, a finding that points to the prevalence of extended family housing in the West African city.
Lindsay, K L
Pregnant women in countries of Sub-Saharan Africa (SSA) are at risk of poor nutritional status and adverse outcomes as a result of poverty, food insecurity, sub-optimal healthcare facilities, frequent infections and frequent pregnancies. Studies from Nigeria, for example, have revealed a high prevalence of both under- and over-nutrition, as well as nutrient deficiencies, including iron, folate, vitamin D and vitamin A. Subsequently, obstetric complications, including hypertension, anaemia, neural tube defects, night-blindness, low birth weight and maternal and perinatal mortality, are common. Migration patterns from SSA to the Western world are on the rise in recent years, with Nigerians now representing the most prevalent immigrant African population in many developed countries. However, the effect of immigration, if any, on the nutritional status and pregnancy outcomes of these women in their host countries has not yet been studied. Consequently, it is unknown to what extent the nutritional deficiencies and pregnancy complications occurring in Nigeria, and other countries of SSA, present in these women post-emigration. This may result in missed opportunities for appropriate antenatal care of a potential high-risk group in pregnancy. The present review discusses the literature regarding nutrition in pregnancy among SSA women, using Nigeria as an example, the common nutrition-related complications that arise and the subsequent obstetric outcomes. The concept of dietary acculturation among immigrant groups is also discussed and deficiencies in the literature regarding studies on the diets of pregnant immigrant women are highlighted.
Full Text Available Spatio-temporal analysis was applied on data representing urbanisation, slumisation, poverty, safe water/ sanitation in urban sub-Saharan Africa (SSA. The findings include: rapid rates of national population growth and urbanisation throughout SSA from 1980 to 2005, averaging 93.8% (range: 90.5% points, lowest and highest rates being 40% (Lesotho and 130.5% (Niger, respectively; high national poverty rates, widespread in SSA: (>50% in about seven countries; it might have been similar in more countries if a large number of SSA countries had reported their 1993 poverty rates; high urban/rural poverty ratios (1.05-1.79 points range between Nigeria and Benin Republics. High average rate (73% of slumisation in SSA in 2001 (range: 96%, lowest and highest rates being in Zimbabwe (3% and Chad/Ethiopia (99%, respectively. SSAs 2000 health adjusted life expectancy was generally low: 38.8 years (<40 years in 24 countries. Use of safe/improved water/sanitation services were poor almost throughout SSA: declined rapidly and ubiquitously from 72% (2000 to 55% (2002, minus 17% points decrease in three years within individual countries with alarming declines up to minus 69% points in Guinea. The policy implications of the findings include the urgent and imperative need to massively implement urban improvement programmes designed to provide health-inducing services/facilities across SSA.
Alam, Nazmul; Hajizadeh, Mohammad; Dumont, Alexandre; Fournier, Pierre
To assess social inequalities in the use of antenatal care (ANC), facility based delivery (FBD), and modern contraception (MC) in two contrasting groups of countries in sub-Saharan Africa divided based on their progress towards maternal mortality reduction. Six countries were included in this study. Three countries (Ethiopia, Madagascar, and Uganda) had 4.5% average annual reduction rate while another three (Cameroon, Zambia, and Zimbabwe) had >550 MMR in 2010 with only concur with a steady decline in maternal mortality. Relative inequality declined overtime in countries which made progress towards reducing maternal mortality. PMID:25853423
Meyrowitsch, Dan Wolf; Pedersen, Erling MØller
ABSTRACT: BACKGROUND: In sub-Saharan Africa (SSA), malaria caused by Plasmodium falciparum has historically been a major contributor to morbidity and mortality. Recent reports indicate a pronounced decline in infection and disease rates which are commonly ascribed to large-scale bed net programmes and improved case management. However, the decline has also occurred in areas with limited or no intervention. The present study assessed temporal changes in Anopheline populations in two highly malaria-endemic communities of NE Tanzania during the period 1998-2009. METHODS: Between 1998 and 2001 (1st period) and between 2003 and 2009 (2nd period), mosquitoes were collected weekly in 50 households using CDC light traps. Data on rainfall were obtained from the nearby climate station and was used to analyze the association between monthly rainfall and malaria mosquito populations. RESULTS: The average number of Anopheles gambiae and Anopheles funestus per trap decreased by 76.8% and 55.3%, respectively over the 1st period, and by 99.7% and 99.8% over the 2nd period. During the last year of sampling (2009), the use of 2368 traps produced a total of only 14 Anopheline mosquitoes. With the exception of the decline in An. gambiae during the 1st period, the results did not reveal any statistical association between mean trend in monthly rainfall and declining malaria vector populations. CONCLUSION: A longitudinal decline in the density of malaria mosquito vectors was seen during both study periods despite the absence of organized vector control. Part of the decline could be associated with changes in the pattern of monthly rainfall, but other factors may also contribute to the dramatic downward trend. A similar decline in malaria vector densities could contribute to the decrease in levels of malaria infection reported from many parts of SSA.
Chantal J, Badul; Ann, Strode.
Full Text Available It has been argued that three factors characterise the HIV epidemic in sub-Saharan Africa - its female face; the implications it poses for sexual and reproductive health services (particularly those provided to women); and the pervasive discrimination following those who are infected. These factors [...] also form the context within which there have been an increasing number of reports of HIV-positive women being coerced or forced into being permanently sterilised in order to prevent future pregnancies. The recent decision in LM and Others v Government of the Republic of Namibia deals with the alleged discriminatory and coerced sterilisation of three women living with HIV. This article describes and critiques the LM judgment. It concludes with brief comments on the way forward for similar litigation in other Southern African countries.
Materu, Peter; Righetti, Petra
This article assesses the status and practice of higher education quality assurance in sub-Saharan Africa, focusing on degree-granting tertiary institutions. A main finding is that structured national-level quality assurance processes in African higher education are a very recent phenomenon and that most countries face major capacity constraints.
Domatob, J K
Given the heavy Western metropolitan bias of the media in sub-Saharan Africa, the ideology of neocolonialism continues to exert a dominant influence on economic, social, political, and cultural life. This neocolonial influence is further reinforced by advertising that champions a consumerist culture centered around Western goods. The capital of multinational firms plays a crucial role in the strategy of media imperialism. The dramatic growth of monopolies and the creation of military-industrial-information conglomerates in the 1970s and 1980s have been reflected in the international exchange of information and the interlinkage of mass communication systems in sub-Saharan Africa. Another media strategy that reinforces neocolonialism is the use of satellite communication. If cultural autonomy is defined as sub-Saharan Africa's capacity to decide on the allocation of its environmental resources, then cultural synchronization is a massive threat to that autonomy. Few African nations have the resources or expertise necessary to design, establish, or maintain communication systems that could accurately reflect their own culture. Nonetheless, there are some policy options. Personnel can be trained to respect African values and to recognize the dangers of neocolonial domination. The production of indigenous programs could reduce the media's foreign content. The incorporation of traditional drama and dance in the media could enhance this process. Above all, a high degree of planning is necessary if sub-Saharan African states intend to tackle the media and its domination by neocolonialist ideology. PMID:12281808
Wicherts, Dolan, Carlson & van der Maas (WDCM) (2010) contend that the average IQ in sub-Saharan Africa is about 76 in relation to a British mean of 100 and sd of 15. This result is achieved by including many studies of unrepresentative elite samples. Studies of acceptably representative samples indicate a sub-Saharan Africa IQ of approximately
As universal service in terms of ICTs provision cannot be achieved in the times agreed for several international bilateral and multilateral aid organizations. It is important to create mechanisms to reduce the lack of use of ICTs in sub-Saharan African countries. This paper specifically analyses the different ICT underdeveloped areas in the sub-Saharan African countries and the factors explain such status. At the same time, the paper proposes a set of policy guidelines that might help improvi...
Karen H Keddy
Full Text Available OBJECTIVE: To evaluate three commercial typhoid rapid antibody tests for Salmonella Typhi antibodies in patients suspected of having typhoid fever in Mpumalanga, South Africa, and Moshi, United Republic of Tanzania. METHODS: The diagnostic accuracy of Cromotest® (semiquantitative slide agglutination and single tube Widal test,TUBEX®and Typhidot® was assessed against that of blood culture. Performance was modelled for scenarios with pretest probabilities of 5% and 50%. FINDINGS: In total 92 patients enrolled: 53 (57.6% from South Africa and 39 (42.4% from the United Republic of Tanzania. Salmonella Typhi was isolated from the blood of 28 (30.4% patients. The semiquantitative slide agglutination and single-tube Widal tests had positive predictive values (PPVs of 25.0% (95% confidence interval, CI: 0.6-80.6 and 20.0% (95% CI: 2.5-55.6, respectively. The newer typhoid rapid antibody tests had comparable PPVs: TUBEX®, 54.1% (95% CI: 36.9-70.5; Typhidot® IgM, 56.7% (95% CI: 37.4-74.5; and Typhidot® IgG, 54.3% (95% CI: 36.6-71.2. For a pretest probability of 5%, PPVs were: TUBEX®, 11.0% (95% CI: 6.6-17.9; Typhidot® IgM, 9.1% (95% CI: 5.8-14.0; and Typhidot® IgG, 11.0% (6.3-18.4. For a pretest probability of 50%, PPVs were: TUBEX®, 70.2% (95% CI: 57.3-80.5; Typhidot® IgM, 65.6% (95% CI: 54.0-75.6; and Typhidot® IgG, 70.0% (95% CI: 56.0-81.1. CONCLUSION: Semiquantitative slide agglutination and single-tube Widal tests performed poorly. TUBEX® and Typhidot® may be suitable when pretest probability is high and blood cultures are unavailable, but their performance does not justify deployment in routine care settings in sub-Saharan Africa.
The need to decompose CO2 emission intensity is predicated upon the need for effective climate change mitigation and adaptation policies. Such analysis enables key variables that instigate CO2 emission intensity to be identified while at the same time providing opportunities to verify the mitigation and adaptation capacities of countries. However, most CO2 decomposition analysis has been conducted for the developed economies and little attention has been paid to sub-Saharan Africa. The need for such an analysis for SSA is overwhelming for several reasons. Firstly, the region is amongst the most vulnerable to climate change. Secondly, there are disparities in the amount and composition of energy consumption and the levels of economic growth and development in the region. Thus, a decomposition analysis of CO2 emission intensity for SSA affords the opportunity to identify key influencing variables and to see how they compare among countries in the region. Also, attempts have been made to distinguish between oil and non-oil-producing SSA countries. To this effect a comparative static analysis of CO2 emission intensity for oil-producing and non oil-producing SSA countries for the periods 1971-1998 has been undertaken, using the refined Laspeyres decomposition model. Our analysis confirms the findings for other regions that CO2 emission intensity is attributable to energy consumption intensity, CO2 emission coefficient of energy types and economic structure. Particularly, CO2 emission coefficient of energy use was found to exercise the most influence on CO2 emission intensity for both oil and non-oil-producing sub-Saharan African countries in the first sub-interval period of our investigation from 1971-1981. In the second subinterval of 1981-1991, energy intensity and structural effect were the two major influencing factors on emission intensity for the two groups of countries. However, energy intensity effect had the most pronounced impact on CO2 emission intensity in non-oil-producing sub-Saharan African countries, while the structural effect explained most of the increase in CO2 emission intensity among the oil-producing countries. Finally, for the period 1991-1998, structural effect accounted for much of the decrease in intensity among non-oil-producers, while CO2 emission coefficient of energy use was the major force driving the decrease among oil-producing countries. The dynamic changes in the CO2 emission intensity and energy intensity effects for the two groups of countries suggest that fuel switching had been predominantly towards more carbon-intensive production in oil-producing countries and less carbon-intensive production in non-oil-producing SSA countries. In addition to the decomposition analysis, the article discusses policy implications of the results. We hope that the information and analyses provided here would help inform national energy and climate policy makers in SSA of the relative weaknesses and possible areas of strategic emphasis in their planning processes for mitigating the effects of climate change
Tully, K. L.; Russo, T.; Hickman, J. E.; Palm, C.
Nearly 80% of countries in sub-Saharan Africa (SSA) face problems of nitrogen (N) scarcity, which together with poverty causes food insecurity and malnutrition. The Alliance for a Green Revolution in Africa has set a goal of increasing fertilizer use in the region six-fold by 2015. While there is substantial evidence that greater N fertilizer use will improve crop yields, it could lead to increased N leaching and elevated nitrate (NO3-) concentrations in surface water and groundwater reservoirs. However, it is unclear what the magnitude of impacts will be in SSA given historically low nutrient additions (of less than 5 kg N/ha/yr), highly degraded soils (due to years of nutrient and soil organic matter depletion), and a wide range of soil types on which increased fertilizer use is occurring. Current estimates of N dynamics and balances in SSA agriculture now rely on data from other regions with different soil types, soil fertility, and land management practices. To understand the influence of increased fertilizer use on water quality requires data from representative areas in SSA. Experimental maize plots were established in a randomized complete block design in both western Kenya (clayey soil) and mid-western Tanzania (sandy soil). Plots were amended with 0, 50, 75, and 200 kg N/ha/yr as mineral fertilizer. Tension lysimeters were installed at three depths in each treatment, and water was collected throughout the maize growing season. Soil water solutions were analyzed for NO3--N. Flow through the soil column at each soil depth, was modeled using VS2DT, a variably saturated flow and solute transport model, and water flux values were multiplied by measured NO3--N concentrations to estimate seasonal N leaching flux. Soil texture was a major driver of N losses, altering both the pathways and magnitude of losses. Clayey soils in western Kenya show an enormous potential for loss of NO3--N immediately following the onset of rains as they trigger high rates of N mineralization and nitrification in the topsoil (known as the 'birch effect'). We did not observe this pulse in the sandy soils of central Tanzania. However, NO3- N concentrations in leachate were three times lower at 200 cm in clayey soils compared to sandy soils as a result of higher anion exchange capacity in clays. We show that while clayey soils lose NO3--N in a large pulse at the onset of rains, sandy soils lose large quantities of NO3--N over the course of the maize growing season. Results from this study can help inform recommended N application rates in similar soils (tropical Ultisols and Oxisols), to optimize yields while minimizing N leaching losses.
Naomi M., Seboni; Mabel K.M., Magowe; Leana R., Uys; Mary B, Suh; Komba N., Djeko; Haouaou, Moumouni.
Full Text Available To explore the role expectations of different stakeholders in the health care system on the roles and tasks that nurses and midwives perform, in order to clarify and strengthen these roles and shape the future of nursing education and practice in sub-Saharan Africa. Qualitative focus group discussio [...] ns were held with different stakeholders (nurses, health service managers, patients and their caregivers, community members and leaders and other health professionals) in eight African countries in order to establish their role expectations of nurses and midwives. Three questions about their role expectations and the interviews were taped, transcribed, and translated into English and analysed. There was consensus amongst the stakeholders regarding eight role functions: taking care of patients; giving health information; managing the care environment; advocating for patients; services and policies; providing emergency care; collaborating with other stakeholders; and providing midwifery care to women, infants and their families. There was disagreement amongst the stakeholders about the role of diagnosis and prescribing treatment. Nursing derives its mandate from communities it serves, and the roles expected must therefore form part of nursing regulation, education and practice standards. Health planners must use these as a basis for job descriptions and rewards. Once these are accepted in the training and regulation of nursing, they must be marketed so that recipients are aware thereof.
This study investigated the impact of energy consumption and CO2 emission on GDP (gross domestic product) growth and the financial development in thirty Sub Saharan African Countries. The panel model was used in this study from the period 1980 to 2008. The results showed that energy consumption had played an important role to increase both economic growth and the financial development in the investigated economies but with the consequence of high po llution. This study recommended that these countries should increase energy productivity by increasing energy efficiency, implementation of energy savings projects, energy conservation, and energy infrastructure outsourcing to achieve its financial development and GDP growth and to increase their investment on energy projects to achieve the full energy potential. -- Highlights: ? The impact of energy consumption, CO2 emission on GDP and the financial development in the SSA countries was investigated. ? The panel model was implied in this study from the period 1980 to 2008. ? The results show energy consumption increased economic growth and the financial development but with higher pollution.
Johnson Karin E; Fordyce Meredith; Thompson Matthew J; Hagopian Amy; Hart L Gary
Abstract Background The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa. Methods We used the American Medical Association 2002 Masterfile to identify and describe physicians who received their medical training in sub-Saharan Africa and are currently practicing in the USA. Results More than 23% of America's 771 491 physicians received their medical training outside the USA, the maj...
Kabiru, Caroline W; Izugbara, Chimaraoke O; Beguy, Donatien
A third of sub-Saharan Africa's (SSA) population comprises persons aged 10-24 years. These youth are growing up in a context marked by pervasive poverty, limited educational opportunities, high HIV/AIDS prevalence, widespread conflict, and weak social controls. Published research on the broad issues that affect youth health and wellbeing in SSA is limited and centers heavily on sexual and reproductive health. In this commentary, we provide a broad overview of sub-Saharan African youth, highlight research gaps with respect to youth health and wellbeing, and describe potential avenues to develop the region's research capacity on youth health and wellbeing. PMID:23406522
Full Text Available Published by Palgrave MacmillanOver the last decade the topic of energy security has reappeared on global policy agendas. Most analyses of international energy geopolitics examine the interests and behaviour of powerful energy-importing countries like the US and China. This chapter begins by examining foreign powers expanded exploitation of oil and uranium resources in Sub-Saharan Africa. It goes on to examine how energy importers efforts to enhance their energy security through Africa are impacting energy security within Africa. It assesses Sub-Saharan states attempts to increase consumption of local oil and uranium reserves. Observing the constraints on these efforts, it then outlines some alternative strategies that have been employed to enhance African energy security. It concludes that, while local community-based development projects have improved the well-being of many households, they are not a sufficient guarantor of energy security. Inadequate petroleum access, in particular, remains a development challenge. Foreign powers efforts to increase their oil security are undermining the energy security of Sub-Saharan African citizens.
Gnonlonfin, Gbemenou Joselin Benoit; Hell, K.
Mycotoxins contamination in some agricultural food commodities seriously impact human and animal health and reduce the commercial value of crops. Mycotoxins are toxic secondary metabolites produced by fungi that contaminate agricultural commodities pre- or postharvest. Africa is one of the continents where environmental, agricultural and storage conditions of food commodities are conducive of Aspergillus fungi infection and aflatoxin biosynthesis. This paper reviews the commodity-wise aetiology and contamination process of aflatoxins and evaluates the potential risk of exposure from common African foods. Possible ways of reducing risk for fungal infection and aflatoxin development that are relevant to the African context. The presented database would be useful as benchmark information for development and prioritization of future research. There is need for more investigations on food quality and safety by making available advanced advanced equipments and analytical methods as well as surveillance and awareness creation in the region.
Brown, Nicholas I.
Antivenom is the only specific treatment for systemic envenoming from snakebite, but remains unavailable to thousands of snakebite victims around the world. A cycle of inconsistent and low market demand, sub-optimal utilisation, rising costs and reduced output of antivenoms have resulted from long term under-investment in procurement and quality regulatory programs. This study provides a contemporary overview of the African antivenom market within the context of the global market. Globally, 3...
Katja Vintar Mally
Full Text Available Sub-Saharan Africa is a very diverse region with extensive natural wealth, great human potential, and a rich history. However, the majority of its countries are among the poorest in the world and about half of its 800 million inhabitants live in extreme poverty. Sub-Saharan Africa produces only 1.5% of the worlds GDP and its share in world trade has fallen from 6% in 1980 to 2% today. The regions exports remain dominated by primary goods (fuels, ores, and agricultural products. The roots of the regions economic weakness lie variously in the past colonial relationships with European countries and in unjust global trade patterns as well as in misuse of power by ruling political elites in the post-independence era. Numerous civil wars and other conflicts have fragmented the sub-Saharan countries into many factions and parties fighting for domination. The region is lagging behind developed countries because of corruption, lack of infrastructure, weakness of its institutions, heavy indebtedness, lack of education and health services, and unfavorable natural conditions, among other factors. Subsistence agriculture is the source of livelihood for most Africans. Nevertheless, average yields per hectare are low and heavily dependent on climatic conditions. Compared to urban areas (except for slums, people living in rural areas have worse infrastructure and are further from achieving the UNs Millennium Development Goals. The recent increase in food prices is threatening the limited progress in reducing hunger and malnutrition (28% of children under age five are underweight and particularly vulnerable to infectious diseases. Little progress has been made in reducing child and maternal mortality; mortality rates remain the highest in the world. In the previous decade, life expectancy in sub-Saharan countries has fallen due to the spread of HIV/AIDS and it still remains below fifty. In addition, many negative socioeconomic effects are the result of malaria, which kills approximately one million people every year, 91% of whom live in sub-Saharan Africa. In order to promote gender equality and empower women, education is of vital importance. Compared to other (especially developed regions, school enrollment rates are considerably lower and dropout rates considerably higher, particularly for girls. The majority of countries in subSaharan Africa will not be able to achieve their educational goals by 2015. Despite the fact that the region is not exceeding the carrying capacities of its environment (as measured by its ecological footprint, environmental problems in some areas are severe. Deforestation, desertification, coral bleaching, negative effects of climate changes (sea level rise, reduced freshwater availability, extreme weather events, etc., loss of biodiversity, and soil degradation are the most worrying. Population growth is exacerbating these environmental problems and is making it more difficult to achieve a higher standard of living for all. Owing to the complexity of developmental problems, sub-Saharan Africa will have to use its own resources very wisely and make the most of development aid from developed countries.
Zhang, Feng; Wang, Jun; Ichoku, Charles; Hyer, Edward J.; Yang, Zhifeng; Ge, Cui; Su, Shenjian; Zhang, Xiaoyang; Kondragunta, Shobha; Kaiser, Johannes W.; Wiedinmyer, Christine; da Silva, Arlindo
An ensemble approach is used to examine the sensitivity of smoke loading and smoke direct radiative effect in the atmosphere to uncertainties in smoke emission estimates. Seven different fire emission inventories are applied independently to WRF-Chem model (v3.5) with the same model configuration (excluding dust and other emission sources) over the northern sub-Saharan African (NSSA) biomass-burning region. Results for November and February 2010 are analyzed, respectively representing the start and end of the biomass burning season in the study region. For February 2010, estimates of total smoke emission vary by a factor of 12, but only differences by factors of 7 or less are found in the simulated regional (15degW-42degE, 13degS-17degN) and monthly averages of column PM(sub 2.5) loading, surface PM(sub 2.5) concentration, aerosol optical depth (AOD), smoke radiative forcing at the top-of-atmosphere and at the surface, and air temperature at 2 m and at 700 hPa. The smaller differences in these simulated variables may reflect the atmospheric diffusion and deposition effects to dampen the large difference in smoke emissions that are highly concentrated in areas much smaller than the regional domain of the study. Indeed, at the local scale, large differences (up to a factor of 33) persist in simulated smoke-related variables and radiative effects including semi-direct effect. Similar results are also found for November 2010, despite differences in meteorology and fire activity. Hence, biomass burning emission uncertainties have a large influence on the reliability of model simulations of atmospheric aerosol loading, transport, and radiative impacts, and this influence is largest at local and hourly-to-daily scales. Accurate quantification of smoke effects on regional climate and air quality requires further reduction of emission uncertainties, particularly for regions of high fire concentrations such as NSSA.
Kyongo, Jordan K; Crucitti, Tania; Menten, Joris; Hardy, Liselotte; Cools, Piet; Michiels, Johan; Delany-Moretlwe, Sinead; Mwaura, Mary; Ndayisaba, Gilles; Joseph, Sarah; Fichorova, Raina; van de Wijgert, Janneke; Vanham, Guido; Ariën, Kevin K; Jespers, Vicky
Data on immune mediators in the genital tract and the factors that modulate them in sub-Saharan women are limited. Cervicovaginal lavage (CVL) samples from 430 sexually active women from Kenya, South Africa, and Rwanda were analyzed for 12 soluble immune mediators using Bio-Plex and Meso Scale Discovery multiplex platforms, as well as single enzyme-linked immunosorbent assays. Ten bacterial species were quantified in vaginal swab samples. Bacterial vaginosis (BV) was defined by Nugent scoring. CVL samples from HIV-infected women showed a clear-cut proinflammatory profile. Pregnant women, adolescents, and women engaging in traditional vaginal practices differed in specific soluble markers compared to reference groups of adult HIV-negative women. Cervical mucus, cervical ectopy, abnormal vaginal discharge, and having multiple sex partners were each associated with an increase in inflammatory mediators. The levels of interleukin-1? (IL-1?), IL-1?, IL-6, IL-12(p70), and IL-8 were elevated, whereas the IL-1RA/IL-1(?+?) ratio decreased in women with BV. The level of gamma interferon-induced protein 10 was lower in BV-positive than in BV-negative women, suggesting its suppression as a potential immune evasion mechanism by BV-associated bacteria. Lactobacillus crispatus and Lactobacillus vaginalis were associated with decreased proinflammatory cytokines and each BV-associated species with increased proinflammatory cytokines. Remarkably, the in vitro anti-HIV activity of CVL samples from BV-positive women was stronger than that of BV-negative women. In conclusion, we found significant associations of factors, including vaginal microbiota, which can influence immune mediators in the vaginal environment in sexually active women. These factors need to be considered when establishing normative levels or pathogenic cutoffs of biomarkers of inflammation and associated risks in African women. PMID:25761460
Tankwanchi, Akhenaten Benjamin Siankam; Vermund, Sten H.; Perkins, Douglas D.
Data monitoring is a key recommendation of the WHO Global Code of Practice on the International Recruitment of Health Personnel, a global framework adopted in May 2010 to address health workforce retention in resource-limited countries and the ethics of international migration. Using data on African-born and African-educated physicians in the 2013 American Medical Association Physician Masterfile (AMA Masterfile), we monitored Sub-Saharan African (SSA) physician recruitment into the physician workforce of the United States (US) post-adoption of the WHO Code of Practice. From the observed data, we projected to 2015 with linear regression, and we mapped migrant physicians locations using GPS Visualizer and ArcGIS. The 2013 AMA Masterfile identified 11,787 active SSA-origin physicians, representing barely 1.3% (11,787/940,456) of the 2013 US physician workforce, but exceeding the total number of physicians reported by WHO in 34 SSA countries (N = 11,519). We estimated that 15.7% (1,849/11,787) entered the US physician workforce after the Code of Practice was adopted. Compared to pre-Code estimates from 2002 (N = 7,830) and 2010 (N = 9,938), the annual admission rate of SSA émigrés into the US physician workforce is increasing. This increase is due in large part to the growing number of SSA-born physicians attending medical schools outside SSA, representing a trend towards younger migrants. Projection estimates suggest that there will be 12,846 SSA migrant physicians in the US physician workforce in 2015, and over 2,900 of them will be post-Code recruits. Most SSA migrant physicians are locating to large urban US areas where physician densities are already the highest. The Code of Practice has not slowed the SSA-to-US physician migration. To stem the physician brain drain, it is essential to incentivize professional practice in SSA and diminish the appeal of US migration with bolder interventions targeting primarily early-career (age ? 35) SSA physicians. PMID:25875010
Access to safe water is currently a privilege for the citizens of many developing countries in Asia and Africa. In the last few decades changes in climate have increased concentrations of greenhouse gasses. The results of global warming have had a significant impact upon the hydrological cycle from freshwater resources to rising sea levels, flooding and precipitation changes. Population concentration and growth have also placed additional pressures on water resources resulting in changes to e...
Khan, Zeyaur R; Midega, Charles A. O.; Pittchar, Jimmy O.; Murage, Alice W.; Birkett, Michael A.; Bruce, Toby J. A.; Pickett, John A.
Food insecurity is a chronic problem in Africa and is likely to worsen with climate change and population growth. It is largely due to poor yields of the cereal crops caused by factors including stemborer pests, striga weeds and degraded soils. A platform technology, pushpull, based on locally available companion plants, effectively addresses these constraints resulting in substantial grain yield increases. It involves intercropping cereal crops with a forage legume, desmodium, and plantin...
Muideen O. Bakare
Full Text Available Sub-Saharan African (SSA population consists of about 45% children, while in Europe and North America children population is 10- 15%. Lately, attention has been directed at mitigating childhood infectious and communicable diseases to reduce under-five mortality. As the under-five mortality index in Sub-Saharan Africa has relatively improved over the last two decades, more Sub-Saharan African children are surviving beyond the age of five and, apparently, a sizeable percentage of this population would be living with one or more childhood neurodevelopmental disorders (NDD. The distribution of child mental health service resources across the world is unequal. This manifests in the treatment gap of major childhood onset mental health problems in SSA, with the gap being more pronounced for childhood NDD. It is important to balance the public health focus and research funding priorities in Sub-Saharan Africa. We urgently need to define the burden of childhood NDD in the region for healthcare planning and policy formulation.
Khan, Zeyaur R; Midega, Charles A O; Pittchar, Jimmy O; Murage, Alice W; Birkett, Michael A; Bruce, Toby J A; Pickett, John A
Food insecurity is a chronic problem in Africa and is likely to worsen with climate change and population growth. It is largely due to poor yields of the cereal crops caused by factors including stemborer pests, striga weeds and degraded soils. A platform technology, 'push-pull', based on locally available companion plants, effectively addresses these constraints resulting in substantial grain yield increases. It involves intercropping cereal crops with a forage legume, desmodium, and planting Napier grass as a border crop. Desmodium repels stemborer moths (push), and attracts their natural enemies, while Napier grass attracts them (pull). Desmodium is very effective in suppressing striga weed while improving soil fertility through nitrogen fixation and improved organic matter content. Both companion plants provide high-value animal fodder, facilitating milk production and diversifying farmers' income sources. To extend these benefits to drier areas and ensure long-term sustainability of the technology in view of climate change, drought-tolerant trap and intercrop plants are being identified. Studies show that the locally commercial brachiaria cv mulato (trap crop) and greenleaf desmodium (intercrop) can tolerate long droughts. New on-farm field trials show that using these two companion crops in adapted push-pull technology provides effective control of stemborers and striga weeds, resulting in significant grain yield increases. Effective multi-level partnerships have been established with national agricultural research and extension systems, non-governmental organizations and other stakeholders to enhance dissemination of the technology with a goal of reaching one million farm households in the region by 2020. These will be supported by an efficient desmodium seed production and distribution system in eastern Africa, relevant policies and stakeholder training and capacity development. PMID:24535391
Khan, Zeyaur R.; Midega, Charles A. O.; Pittchar, Jimmy O.; Murage, Alice W.; Birkett, Michael A.; Bruce, Toby J. A.; Pickett, John A.
Food insecurity is a chronic problem in Africa and is likely to worsen with climate change and population growth. It is largely due to poor yields of the cereal crops caused by factors including stemborer pests, striga weeds and degraded soils. A platform technology, pushpull, based on locally available companion plants, effectively addresses these constraints resulting in substantial grain yield increases. It involves intercropping cereal crops with a forage legume, desmodium, and planting Napier grass as a border crop. Desmodium repels stemborer moths (push), and attracts their natural enemies, while Napier grass attracts them (pull). Desmodium is very effective in suppressing striga weed while improving soil fertility through nitrogen fixation and improved organic matter content. Both companion plants provide high-value animal fodder, facilitating milk production and diversifying farmers income sources. To extend these benefits to drier areas and ensure long-term sustainability of the technology in view of climate change, drought-tolerant trap and intercrop plants are being identified. Studies show that the locally commercial brachiaria cv mulato (trap crop) and greenleaf desmodium (intercrop) can tolerate long droughts. New on-farm field trials show that using these two companion crops in adapted pushpull technology provides effective control of stemborers and striga weeds, resulting in significant grain yield increases. Effective multi-level partnerships have been established with national agricultural research and extension systems, non-governmental organizations and other stakeholders to enhance dissemination of the technology with a goal of reaching one million farm households in the region by 2020. These will be supported by an efficient desmodium seed production and distribution system in eastern Africa, relevant policies and stakeholder training and capacity development. PMID:24535391
Full Text Available PROBLEM: Little is known about the burden of influenza in sub-Saharan Africa. Routine influenza surveillance is key to getting a better understanding of the impact of acute respiratory infections on sub-Saharan African populations. APPROACH: A project known as Strengthening Influenza Sentinel Surveillance in Africa (SISA was launched in Angola, Cameroon, Ghana, Nigeria, Rwanda, Senegal, Sierra Leone and Zambia to help improve influenza sentinel surveillance, including both epidemiological and virological data collection, and to develop routine national, regional and international reporting mechanisms. These countries received technical support through remote supervision and onsite visits. Consultants worked closely with health ministries, the World Health Organization, national influenza laboratories and other stakeholders involved in influenza surveillance LOCAL SETTING: Influenza surveillance systems in the target countries were in different stages of development when SISA was launched. Senegal, for instance, had conducted virological surveillance for years, whereas Sierra Leone had no surveillance activity at all. RELEVANT CHANGES: Working documents such as national surveillance protocols and procedures were developed or updated and training for sentinel site staff and data managers was organized. LESSONS LEARNT: Targeted support to countries can help them strengthen national influenza surveillance, but long-term sustainability can only be achieved with external funding and strong national government leadership.
Gilioli, Gianni; Caroli, Anna Maria; Tikubet, Getachew; Herren, Hans R; Baumgärtner, Johann
This paper presents a framework for the development of socio-ecological systems towards enhanced sustainability. Emphasis is given to the dynamic properties of complex, adaptive social-ecological systems, their structure and to the fundamental role of agriculture. The tangible components that meet the needs of specific projects executed in Kenya and Ethiopia encompass project objectives, innovation, facilitation, continuous recording and analyses of monitoring data, that allow adaptive management and system navigation. Two case studies deal with system navigation through the mitigation of key constraints; they aim to improve human health thanks to anopheline malaria vectors control in Nyabondo (Kenya), and to improve cattle health through tsetse control and antitrypanosomal drug administration to cattle in Luke (Ethiopia). The second case deals with a socio-ecological navigation system to enhance sustainability, establishing a periurban diversified enterprise in Addis Ababa (Ethiopia) and developing a rural sustainable social-ecological system in Luke (Ethiopia). The project procedures are briefly described here and their outcomes are analysed in relation to the stated objectives. The methodology for human and cattle disease vector control were easier to implement than the navigation of social-ecological systems towards sustainability enhancement. The achievements considerably differed between key constraints removal and sustainability enhancement projects. Some recommendations are made to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability: i) technology system implementation should be carried out through an innovation system; ii) transparent monitoring information should be continuously acquired and evaluated for assessing the state of the system in relation to stated objectives for (a) improving the insight into the systems behaviour and (b) rationalizing decision support; iii) the different views of all stakeholders should be reconciled in a pragmatic approach to social-ecological system management. Significance for public healthRecently, there is a growing interest in studying the link between human, animal and environmental health. The connection between these different dimensions is particularly important for developing countries in which people face the challenge of escaping vicious cycle of high diseases prevalence, food insecurity driven by absolute poverty and population growth, and natural capital as a poverty trap. The design and implementation of such efforts, aiming at human health improvement and poverty alleviation, should be framed into adaptive social-ecological system management perspectives. In this paper, we present few case studies dealing with human health improvement through anopheline malaria vectors control in Kenya, cattle health improvement through tsetse vectored nagana control, antitrypanosomal drug administration to cattle in Ethiopia and with the development of rural sustainable communities in Ethiopia. Some recommendations are given to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability. PMID:25170511
Sánchez-Quinto, Federico; Botigué, Laura R
One of the main findings derived from the analysis of the Neandertal genome was the evidence for admixture between Neandertals and non-African modern humans. An alternative scenario is that the ancestral population of non-Africans was closer to Neandertals than to Africans because of ancient population substructure. Thus, the study of North African populations is crucial for testing both hypotheses. We analyzed a total of 780,000 SNPs in 125 individuals representing seven different North African locations and searched for their ancestral/derived state in comparison to different human populations and Neandertals. We found that North African populations have a significant excess of derived alleles shared with Neandertals, when compared to sub-Saharan Africans. This excess is similar to that found in non-African humans, a fact that can be interpreted as a sign of Neandertal admixture. Furthermore, the Neandertal's genetic signal is higher in populations with a local, pre-Neolithic North African ancestry. Therefore, the detected ancient admixture is not due to recent Near Eastern or European migrations. Sub-Saharan populations are the only ones not affected by the admixture event with Neandertals.
Thakrar, Jayshree; Zinn, Denise; Wolfenden, Freda
The challenges to teacher educators in sub-Saharan Africa are acute. This paper describes how the Teacher Education in Sub-Saharan Africa (TESSA) consortium is working within institutional and national policy systems to support school-based teacher professional development. The TESSA consortium (13 African institutions and 5 international
Pauly, M.; Hoppe, E.; Mugisha, L.; Petrelková, Klára Judita; Akoua-Koffi, C.; Couacy-Hymann, E.; Anoh, A. E.; Mossoun, A.; Schubert, G.; Wiersma, L.; Pascale, S.; Muyembe, J.-J.; Karhemere, S.; Weiss, S.; Leendertz, S. A.; Calvignac-Spencer, S.; Leendertz, F. H.; Ehlers, B.
Ro?. 11, ?. 25 (2014), s. 25. ISSN 1743-422X R&D Projects: GA ?R GA206/09/0927 Institutional support: RVO:68081766 Keywords : Adenoviridae * Human adenovirus D * Genotype * Sub-Saharan Africa * PCR Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 2.181, year: 2014
Selected French Speaking Sub-Saharan African Countries: Burundi, Cameroon (Eastern), Chad, Congo (Brazzaville), Dahomey, Gabon, Ivory Coast, Mali, Mauritania, Niger, Rwanda, Senegal, Togo, Upper Volta, Zaire. A Guide to the Academic Placement of Students from These Countries in Academic Institutions of the United States.
Trudeau, Edouard J. C.
The educational systems of 15 Sub-Saharan African countries are described, and guidelines concerning the academic placement of students who wish to study in U.S. institutions are provided. Tables indicate the grades covered by primary education and secondary education (academic and technical). Burundi, Rwanda, and Zaire have followed the Belgian
Adenowo, Abiola Fatimah; Oyinloye, Babatunji Emmanuel; Ogunyinka, Bolajoko Idiat; Kappo, Abidemi Paul
Schistosomiasis, a neglected tropical disease of poverty ranks second among the most widespread parasitic disease in various nations in sub-Saharan Africa. Neglected tropical diseases are causes of about 534,000 deaths annually in sub-Saharan Africa and an estimated 57 million disability-adjusted life-years are lost annually due to the neglected tropical diseases. The neglected tropical diseases exert great health, social and financial burden on economies of households and governments. Schistosomiasis has profound negative effects on child development, outcome of pregnancy, and agricultural productivity, thus a key reason why the "bottom 500 million" inhabitants of sub-Saharan Africa continue to live in poverty. In 2008, 17.5 million people were treated globally for schistosomiasis, 11.7 million of those treated were from sub-Saharan Africa. This enervating disease has been successfully eradicated in Japan, as well as in Tunisia. Morocco and some Caribbean Island countries have made significant progress on control and management of this disease. Brazil, China and Egypt are taking steps towards elimination of the disease, while most sub-Saharan countries are still groaning under the burden of the disease. Various factors are responsible for the continuous and persistent transmission of schistosomiasis in sub-Saharan Africa. These include climatic changes and global warming, proximity to water bodies, irrigation and dam construction as well as socio-economic factors such as occupational activities and poverty. The morbidity and mortality caused by this disease cannot be overemphasized. This review is an exposition of human schistosomiasis as it affects the inhabitants of various communities in sub-Sahara African countries. It is hoped this will bring a re-awakening towards efforts to combat this impoverishing disease in terms of vaccines development, alternative drug design, as well as new point-of-care diagnostics. PMID:25636189
Abiola Fatimah, Adenowo; Babatunji Emmanuel, Oyinloye; Bolajoko Idiat, Ogunyinka; Abidemi Paul, Kappo.
Full Text Available Schistosomiasis, a neglected tropical disease of poverty ranks second among the most widespread parasitic disease in various nations in sub-Saharan Africa. Neglected tropical diseases are causes of about 534,000 deaths annually in sub-Saharan Africa and an estimated 57 million disability-adjusted li [...] fe-years are lost annually due to the neglected tropical diseases. The neglected tropical diseases exert great health, social and ?nancial burden on economies of households and governments. Schistosomiasis has profound negative effects on child development, outcome of pregnancy, and agricultural productivity, thus a key reason why the "bottom 500 million" inhabitants of sub-Saharan Africa continue to live in poverty. In 2008, 17.5 million people were treated globally for schistosomiasis, 11.7 million of those treated were from sub-Saharan Africa. This enervating disease has been successfully eradicated in Japan, as well as in Tunisia. Morocco and some Caribbean Island countries have made signi?cant progress on control and management of this disease. Brazil, China and Egypt are taking steps towards elimination of the disease, while most sub-Saharan countries are still groaning under the burden of the disease. Various factors are responsible for the continuous and persistent transmission of schistosomiasis in sub-Saharan Africa. These include climatic changes and global warming, proximity to water bodies, irrigation and dam construction as well as socio-economic factors such as occupational activities and poverty. The morbidity and mortality caused by this disease cannot be overemphasized. This review is an exposition of human schistosomiasis as it affects the inhabitants of various communities in sub-Sahara African countries. It is hoped this will bring a re-awakening towards efforts to combat this impoverishing disease in terms of vaccines development, alternative drug design, as well as new point-of-care diagnostics.
Pitman, John P; Wilkinson, Robert; Liu, Yang; von Finckenstein, Bjorn; Smit Sibinga, Cees Th; Lowrance, David W; Marfin, Anthony A; Postma, Maarten J; Mataranyika, Mary; Basavaraju, Sridhar V
National blood use patterns in sub-Saharan Africa are poorly described. Although malaria and maternal hemorrhage remain important drivers of blood demand across Africa, economic growth and changes in malaria, HIV/AIDS, and noncommunicable disease epidemiology may contribute to changes in blood demand. We evaluated indications for blood use in Namibia, a country in southern Africa, using a nationally representative sample and discuss implications for the region. Clinical and demographic data related to the issuance of blood component units in Namibia were reviewed for a 4-year period (August 1, 2007-July 31, 2011). Variables included blood component type, recipient age and sex, and diagnosis. Diagnoses reported by clinicians were reclassified into International Statistical Classification of Diseases, 10th Revision categories. Multiple imputation methods were used to complete a data set missing age, sex or diagnosis data. Descriptive analyses were conducted to describe indications for transfusions and use of red blood cells (RBCs), platelets, and plasma. A total of 39,313 records accounting for 91,207 blood component units were analyzed. The median age of Namibian transfusion recipients was 45 years (SD, ±19). A total of 78,660 RBC units were issued in Namibia during the study period. Red blood cells transfused for "unspecified anemia" accounted for the single largest category of blood issued (24,798 units). Of the overall total, 38.9% were for diseases of the blood and blood-forming organs (D50-D89). Infectious disease (A00-B99), pregnancy (O00-O99), and gastrointestinal (K20-K93) accounted for 14.8%, 11.1%, and 6.1% of RBC units issued, respectively. Although a specific diagnosis of malaria accounted for only 2.7% of pediatric transfusions, an unknown number of additional transfusions for malaria may have been categorized by requesting physicians as unspecified anemia and counted under diseases of blood forming organs. During the study period, 9751 units of fresh-frozen plasma were issued. Nearly one-quarter of these units (23.1%) were issued for gastrointestinal (K20-K93) diagnoses. Malignant neoplasms (C00-C97) accounted for 38.1% of 2978 platelet units issued. Blood use in Namibia reflects changes in the health care system due to economic development, improvement in HIV/AIDS and malaria epidemiology, high rates of health care facility-based childbirth, and access to noncommunicable disease treatment. However, better documentation of the indications for transfusion is needed to confirm these observations. Changing patterns of health care will result in changing demands for blood components. Improved methods to evaluate blood use patterns in sub-Saharan Africa may help set realistic national blood collection goals. PMID:25573416
West Boma A
Full Text Available Abstract Background Sepsis is one of the most common causes of morbidity and mortality in the newborn. Early diagnosis and treatment is vital to improve outcome. The present study was therefore carried out to determine the usefulness of C-reactive protein (CRP for evaluation of neonatal sepsis in Port Harcourt, Nigeria in Sub-Saharan Africa. Method Four hundred and twenty neonates with clinical suspicion of sepsis were prospectively studied over a 6?month period. Blood was obtained from each subject recruited for the qualitative estimation of CRP. Blood culture was used as gold standard for diagnosis of NNS. Results Of 420 neonates studied, 196 (46.7% had positive CRP while 181 (43.1% had positive blood culture. The sensitivity, specificity, positive and negative predictive values of CRP were 74.0%, 74.1%, 68.4% and 79.0% respectively. Conclusion The qualitative method of estimating CRP which is cheap and rapid has moderate sensitivity, specificity and negative predictive value.
Rudel, Thomas K.
For decades, the dynamics of tropical deforestation in sub-Saharan Africa (SSA) have defied easy explanation. The rates of deforestation have been lower than elsewhere in the tropics, and the driving forces evident in other places, government new land settlement schemes and industrialized agriculture, have largely been absent in SSA. The context and causes for African deforestation become clearer through an analysis of new, national-level data on forest cover change for SSA countries for the ...
The international community is devoting increasing attention to social security issues in developing countries as part of its preoccupation with poverty reduction. This paper discusses social security arrangements in place in sub-Saharan African countries to mitigate the contingencies of their citizens, with emphasis on the masses of poor people, including the ways in which the poor themselves try to tackle unexpected adversity. The basic argument is that for a social security system to be fe...
Oyedokun Agbeja; R.O. Salawu
In an increasingly digitalized world economy, there exists a digital gap between Sub-Saharan Africa and the rest of the world that translates into economic marginalization of the African region. Consequently, the following phases of development are crucial for the region: (1) the phase of massive digitalization during which the digital divide is bridged and (2) the phase of information and knowledge management in which information is systematically converted into knowledge and the latter into...
Gabbert, T.; Ichoku, C. M.; Matsui, T.; Capehart, W. J.
The northern Sub-Saharan African region (NSSA) is an area of intense study due to the recent severe droughts that have dire consequences on the population, which relies mostly on rainfed agriculture for its food supply. This region's weather and hydrologic cycle are very complex and are dependent on the West African Monsoon. Different regional processes affect the West African Monsoon cycle and variability. One of the areas of current investigation is the water cycle response to the variability of land surface characteristics. Land surface characteristics are often altered in NSSA due to agricultural practices, grazing, and the fires that occur during the dry season. To better understand the effects of biomass burning on the hydrologic cycle of the sub-Saharan environment, an interdisciplinary team sponsored by NASA is analyzing potential feedback mechanisms due to the fires. As part of this research, this study focuses on the effects of land surface changes, particularly albedo and skin temperature, that are influenced by biomass burning. Surface temperature anomalies can influence the initiation of convective rainfall and surface albedo is linked to the absorption of solar radiation. To capture the effects of fire perturbations on the land surface, NASA's Unified Weather and Research Forecasting (NU-WRF) model coupled with NASA's Land Information System (LIS) is being used to simulate some of the fire-induced surface temperature anomalies and other environmental processes. In this presentation, we will report the strategy for these simulations, and show some preliminary results.
Laleman, G.; Kegels, G.; Marchal, B.; Van Roost, D; Bogaert, I.; Van Damme, W
ABSTRACT: BACKGROUND: In this paper, we aim to quantify the contribution of international health volunteers to the health workforce in sub-Saharan Africa and to explore the perceptions of health service managers regarding these volunteers. METHODS: Rapid survey among organizations sending international health volunteers and group discussions with experienced medical officers from sub-Saharan African countries. RESULTS: We contacted 13 volunteer organizations having more than 10 full-time equi...
Bogaert Isa; Van der Roost Dirk; Marchal Bruno; Kegels Guy; Laleman Geert; van Damme Wim
Abstract Background In this paper, we aim to quantify the contribution of international health volunteers to the health workforce in sub-Saharan Africa and to explore the perceptions of health service managers regarding these volunteers. Methods Rapid survey among organizations sending international health volunteers and group discussions with experienced medical officers from sub-Saharan African countries. Results We contacted 13 volunteer organizations having more than 10 full-time equivale...
Masinda, M. T.
There is a widespread recognition that the circulation of resources between knowledge providers and user agents is very important in the process of innovation. In this article we theoretically explore the policy implications of the concept of national systems of innovation on science and technology in Sub-Saharan Africa. After identifying the systemic weaknesses of Sub-Saharan African national systems of innovation we conclude by formulating some propositions for a new agenda science and tech...
Spearman, C Wendy; Sonderup, Mark W
Disparities in health reflect the differences in the incidence, prevalence, burden of disease and access to care determined by socio-economic and environmental factors. With liver disease, these disparities are exacerbated by a combination of limited awareness and preventable causes of morbidity and mortality in addition to the diagnostic and management costs. Sub-Saharan Africa, comprising 11% of the world's population, disproportionately has 24% of the global disease burden, yet allocates healthcare workforce with a mean of 0.8 healthcare workers per 1000 population. Barriers to healthcare access are many and compounded by limited civil registration data, socio-economic inequalities, discrepancies in private and public healthcare services and geopolitical strife. The UN 2014 report on the Millennium Development Goals suggest that sub-Saharan Africa will probably not meet several goals, however with HIV/AIDS and Malaria (goal 6), many successes have been achieved. A 2010 Global Burden of Disease study demonstrated that cirrhosis mortality in sub-Saharan Africa doubled between 1980 and 2010. Aetiologies included hepatitis B (34%), hepatitis C (17%), alcohol (18%) and unknown in 31%. Hepatitis B, C and alcohol accounted for 47, 23 and 20% of hepatocellular carcinoma respectively. In 10%, the underlying aetiology was not known. Liver disease reflects the broader disparities in healthcare in sub-Saharan Africa. However, many of these challenges are not insurmountable as vaccines and new therapies could comprehensively deal with the burden of viral hepatitis. Access to and affordability of therapeutics remains the major barrier. PMID:26053588
Sia, Drissa; Onadja, Yentéma; Nandi, Arijit; Foro, Anne; Brewer, Timothy
Within sub-Saharan Africa, women are disproportionately at risk for acquiring and having human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). It is important to clarify whether gender inequalities in HIV prevalence in this region are explained by differences in the distributions of HIV risk factors, differences in the effects of these risk factors or some combination of both. We used an extension of the Blinder-Oaxaca decomposition approach to explain gender inequalities in HIV/AIDS in Kenya, Lesotho and Tanzania using data from the demographic and health and AIDS indicator surveys. After adjusting for covariates using Poisson regression models, female gender was associated with a higher prevalence of HIV/AIDS in Kenya [prevalence ratio (PR) = 1.73, 95% confidence interval (CI) = 1.33, 2.23 in 2003] and Lesotho (PR = 1.39, 95% CI = 1.20, 1.62 in 2004/05), but not in Tanzania. Decomposition analyses demonstrated two distinct patterns over time. In Tanzania, the gender inequality in HIV/AIDS was explained by differences in the distributions of HIV risk factors between men and women. In contrast, in Kenya and Lesotho, this inequality was partly explained by differences in the effects across men and women of measured HIV/AIDS risk factors, including socio-demographic characteristics (age and marital status) and sexual behaviours (age at first sex); these results imply that gender inequalities in HIV/AIDS would persist in Kenya and Lesotho even if men and women had similar distributions of HIV risk factors. The production of gender inequalities may vary across countries, with inequalities attributable to the unequal distribution of risk factors among men and women in some countries and the differential effect of these factors between groups in others. These different patterns have important implications for policies to reduce gender inequalities in HIV/AIDS. PMID:24345343
Christopher R. Frei
Full Text Available The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS pandemic has caused far-reaching effects in sub-Saharan Africa. The pandemic has effectively diminished the workforce, increased poverty rates, reduced agricultural productivity, and transformed the structure of many rural households. HIV/AIDS further strains the already fragile relationship between livelihood and the natural and social environments of these regions. Therefore, the objective of this review is to characterize the impact of HIV/AIDS on the environment and the social infrastructure of rural sub-Saharan Africa. There are many aspects of rural life that contribute to disease transmission of HIV/AIDS and that pose unique challenges to the population dynamics in sub-Saharan Africa. Widespread AIDS-related mortality has caused a decrease in population growth for many African countries. In turn, these alterations in population dynamics have resulted in a decrease in the percentage of prime-age working adults, as well as a gender disparity, whereby, females carry a growing burden of household responsibilities. There is a rising proportion of older adults, often females, who assume the role of provider and caretaker for other dependent family members. These changing dynamics have caused many to exploit their natural surroundings, adopting less sustainable land use practices and utilizing protected resources as a primary means of generating revenue.
Luis Távora-Tavira, Rosa Teodósio, Jorge Seixas, Emília Prieto, Rita Castro, Filomena Exposto, Jorge Atouguia
Background: For geographical and recent historic reasons, Portugal is a gateway and home for immigration from sub-Saharan countries. Misconceptions related to these populations often lead to consider them as high-frequency clusters for dissemination of sexually transmitted infections (STIs). Epidemiological evidence-based data is needed to elucidate these issues and baseline prevalence studies are the starting point for this.Methodology: A prospective study was conducted in 220 African migran...
Matsobane J, Manala.
Full Text Available The aim of this article is to describe the impact of Christianity on sub-Saharan Africa. I shall start by first examining the key words in the title of this article, and by briefly discussing the phenomenal growth of Christianity in sub-Saharan Africa. The article further describes the impact of Chr [...] istianity on sub-Saharan Africa in terms of education, socio-politics, and health; here I shall base my remarks on the history of Christian missions in the region since the late nineteen century. As far as education is concerned, this article recognises that education that focuses on holistic human development is a positive force, and a force that was introduced by Christianity. I shall also point out that Christianity initiated medical advances that improved the health of those who live in the region. Regeneration as espoused by Christianity constitutes something of great value. On the downside, Christianity led to the demise of the African customs, which it viewed as pagan and evil; the religion also led to the implementation of apartheid (to which it gave its theological support), and undermined the leadership role of women. Finally, Christianity has bedevilled race relations in Africa generally.
Ashford C. Chea
The author began the paper with a brief historical perspective of the global financial crisis. This was followed by the review of the literature. Next, the researcher outlined his findings preceded by some policy analyses and implications of the crisis for sub-Saharan African economies. The writer ended the paper with recommendations for both sub-Saharan African policymakers and the international finance and development community.
Mónica, Carvalho; Pedro, Brito; Virgínia, Lopes; Lisa, Andrade; Mª João, Anjos; Francisco Corte, Real; Leonor, Gusmão.
Full Text Available The present-day Brazilian population is a consequence of the admixture of various peoples of very different origins, namely, Amerindians, Europeans and Africans. The proportion of each genetic contribution is known to be very heterogeneous throughout the country. The aim of the present study was to [...] compare the male lineages present in two distinct Brazilian populations, as well as to evaluate the African contribution to their male genetic substrate. Thus, two Brazilian population samples from Manaus (State of Amazon) and Ribeirão Preto (State of São Paulo) and three African samples from Guinea Bissau, Angola and Mozambique were typed for a set of nine Y chromosome specific STRs. The data were compared with those from African, Amerindian and European populations. By using Y-STR haplotype information, low genetic distances were found between the Manaus and Ribeirão Preto populations, as well as between these and others from Iberia. Likewise, no significant distances were observed between any of the African samples from Angola, Mozambique and Guinea Bissau. Highly significant Rst values were found between both Brazilian samples and all the African and Amerindian populations. The absence of a significant Sub-Saharan African male component resulting from the slave trade, and the low frequency in Amerindian ancestry Y-lineages in the Manaus and Ribeirão Preto population samples are in accordance with the accentuated gender asymmetry in admixture processes that has been systematically reported in colonial South American populations.
Gruca, Marta; van Andel, Tinde R.; Balslev, Henrik
Palms (Arecaceae) are prominent elements in African traditional medicines. It is, however, a challenge to find detailed information on the ritual use of palms, which are an inextricable part of African medicinal and spiritual systems. This work reviews ritual uses of palms within African ethnomedicine. We studied over 200 publications on uses of African palms and found information about ritual uses in 26 of them. At least 12 palm species in sub-Saharan Africa are involved in various ritual pr...
Full Text Available Objective To perform a systematic review of the literature on the prevalence of cognitive impairment and dementia in sub-Saharan Africa. Methods Five electronic databases were searched for relevant abstracts and to identify papers eligible for full-text review. A study was included if two authors agreed that it had a cohort, casecontrol or cross-sectional design and reported population-level data; was limited to black African adults older than 50 years or described as elderly or old; reported data for individuals residing in sub-Saharan Africa; and reported at least one measure of cognitive impairment or clinical outcomes relevant to cognitive decline. References of papers included in our study were searched to identify additional candidate publications. Disagreements about inclusion were adjudicated during discussions involving all authors. Data were extracted independently by two authors, using a form developed by the authors and tested on a sample of papers. Findings A total of 2320 unique papers was found; the full text of 87 was reviewed. Nineteen papers featuring 11 cross-sectional studies were included; all were published during 19952011. Studies occurred in Benin, Botswana, the Central African Republic, the Congo and Nigeria and enrolled approximately 10?500 participants. The prevalence of dementia ranged from 0%, in Nigeria, to 10.1% (95% confidence interval, CI: 8.611.8, also in Nigeria. The prevalence of cognitive impairment ranged from 6.3%, in Nigeria, to 25% (95% CI: 21.229.0, in the Central African Republic. Conclusion Prevalences of dementia and cognitive impairment in sub-Saharan Africa varied widely, with few published studies revealed by the literature search.
Adejumo, Olurotimi A; Malee, Kathleen M; Ryscavage, Patrick; Hunter, Scott J; Taiwo, Babafemi O
Introduction Adolescents are a unique and sometimes neglected group in the planning of healthcare services. This is the case in many parts of sub-Saharan Africa, where more than eight out of ten of the world's HIV-infected adolescents live. Although the last decade has seen a reduction in AIDS-related mortality worldwide, largely due to improved access to effective antiretroviral therapy (ART), AIDS remains a significant contributor to adolescent mortality in sub-Saharan Africa. Although inadequate access to ART in parts of the subcontinent may be implicated, research among youth with HIV elsewhere in the world suggests that suboptimal adherence to ART may play a significant role. In this article, we summarize the epidemiology of HIV among sub-Saharan African adolescents and review their adherence to ART, emphasizing the unique challenges and factors associated with adherence behaviour. Methods We conducted a comprehensive search of online databases for articles, relevant abstracts, and conference reports from meetings held between 2010 and 2014. Our search terms included adherence, compliance, antiretroviral use and antiretroviral adherence, in combination with adolescents, youth, HIV, Africa, interventions and the MeSH term Africa South of the Sahara. Of 19,537 articles and abstracts identified, 215 met inclusion criteria, and 148 were reviewed. Discussion Adolescents comprise a substantial portion of the population in many sub-Saharan African countries. They are at particular risk of HIV and may experience worse outcomes. Although demonstrated to have unique challenges, there is a dearth of comprehensive health services for adolescents, especially for those with HIV in sub-Saharan Africa. ART adherence is poorer among older adolescents than other age groups, and psychosocial, socio-economic, individual, and treatment-related factors influence adherence behaviour among adolescents in this region. With the exception of a few examples based on affective, cognitive, and behavioural strategies, most adherence interventions have been targeted at adults with HIV. Conclusions Although higher levels of ART adherence have been reported in sub-Saharan Africa than in other well-resourced settings, adolescents in the region may have poorer adherence patterns. There is substantial need for interventions to improve adherence in this unique population. PMID:26385853
Berman, Nicolas; Martin, Philippe
In the early stage of the 2008-2009 financial crisis, the conventional wisdom was that financial underdevelopment of sub Saharan African economies may have been a bless-ing in disguise because it insulated them from the direct effects of the crisis. This paper argues that this may also make African exporters, dangerously more dependent on the health of financial institutions in countries where they export. In the 2008-2009 financial crisis, we find that African exports to the US h...
Batana, Yele Maweki
Since the seminal work of Sen, poverty has been recognized as a multidimensional phenomenon. The recent availability of relevant databases renewed the interest in this approach. This paper estimates multidimensional poverty among women in fourteen Sub-Saharan African countries using the Alkire and Foster multidimensional poverty measures, whose
Abstract Background Sub-Saharan Africa faces a human resources crisis in the health sector. Over the past two decades its population has increased substantially, with a significant rise in the disease burden due to HIV/AIDS and recurrent communicable diseases and an increased incidence of noncommunicable diseases. This increased demand for health services is met with a rather low supply of health workers, but this notwithstanding, sub-Saharan African countries also experience significant wast...
Dillon, David G; Gurdasani, Deepti
Sub-Saharan Africa (SSA) has the highest burden of HIV in the world and a rising prevalence of cardiometabolic disease; however, the interrelationship between HIV, antiretroviral therapy (ART) and cardiometabolic traits is not well described in SSA populations.
Kim, Jane J; Campos, Nicole G; O'Shea, Meredith; Diaz, Mireia; Mutyaba, Innocent
Using population and epidemiologic data for 48 countries in sub-Saharan Africa, we used a model-based approach to estimate cervical cancer cases and deaths averted, disability-adjusted life years (DALYs) averted and incremental cost-effectiveness ratios (I$ (international dollar) per DALY averted) for human papillomavirus (HPV) vaccination of pre-adolescent girls. Additional epidemiologic data from Uganda and South Africa informed estimates of cancer risk reduction and cost-effectiveness ratios associated with pre-adolescent female vaccination followed by screening of women over age 30. Assuming 70% vaccination coverage, over 670,000 cervical cancer cases would be prevented among women in five consecutive birth cohorts vaccinated as young adolescents; over 90% of cases averted were projected to occur in countries eligible for GAVI Alliance support. There were large variations in health benefits across countries attributable to differential cancer rates, population size, and population age structure. More than half of DALYs averted in sub-Saharan Africa were in Nigeria, Tanzania, Uganda, the Democratic Republic of the Congo, Ethiopia, and Mozambique. When the cost per vaccinated girl was I$5 ($0.55 per dose), HPV vaccination was cost-saving in 38 sub-Saharan African countries, and cost I$300 per DALY averted or less in the remaining countries. At this vaccine price, pre-adolescent HPV vaccination followed by screening three times per lifetime in adulthood cost I$300 per year of life saved (YLS) in Uganda (per capita GDP I$1,140) and I$1,000 per YLS in South Africa (per capita GDP I$9,480). In nearly all countries assessed, HPV vaccination of pre-adolescent girls could be very cost-effective if the cost per vaccinated girl is less than I$25-I$50, reflecting a vaccine price being offered to the GAVI Alliance. In-country decision makers will need to consider many other factors, such as affordability, acceptability, feasibility, and competing health priorities, when making decisions about cervical cancer prevention. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in the Sub-Saharan Africa Region" Vaccine Volume 31, Supplement 5, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012. PMID:24331749
Konstantin A. Pantserev
Full Text Available The paper devotes to the problem of overcoming of the digital divide in the Sub Saharan African States. On the example of Kenya the author speaks about the comparative success of the development of the information technologies in Africa and in turn underlines the most significant obstacles on the way of African states to the global information society and suggests the means how to overcome them.
Betlloch-Mas, I; Albares-Tendero, M P; Soro-Martínez, M P; Pérez-Crespo, M
Scalp hyperkeratosis of childhood is most often associated with atopic or seborrheic dermatitis. However, in black children can be associated with tinea capitis. We undertook a retrospective study in all Sub-Saharan children presenting with chronic scalp scaling between June 2010 and June 2013, to determine whether chronic desquamation of the scalp is a clinical manifestation of tinea capitis. The criterion used to diagnose tinea capitis was a positive mycolological culture. Of the 23 Sub-Saharan African children attended, 12 (43.4 %) presented with chronic scalp flaking. Mycological culture was performed in 9 of the 12 cases. The culture was positive in 6 out of 9, so 26 % of the Sub-Saharan African children attended were diagnosed with tinea capitis. In 52.1 % of the cases with persistent scalp scaling the culture was positive. In conclusion, chronic scaling of the scalp may well be the sole form of presentation of tinea capitis in Sub-Saharan children. PMID:24917241
Full Text Available Abstract Our knowledge of pharmacogenetic variability in diverse populations is scarce, especially in sub-Saharan Africa. To bridge this gap in knowledge, we characterised population frequencies of clinically relevant pharmacogenetic traits in two distinct South African population groups. We genotyped 211 tagging single nucleotide polymorphisms (tagSNPs in 12 genes that influence antiretroviral drug disposition, in 176 South African individuals belonging to two distinct population groups residing in the Western Cape: the Xhosa (n = 109 and Cape Mixed Ancestry (CMA (n = 67 groups. The minor allele frequencies (MAFs of eight tagSNPs in six genes (those encoding the ATP binding cassette sub-family B, member 1 [ABCB1], four members of the cytochrome P450 family [CYP2A7P1, CYP2C18, CYP3A4, CYP3A5] and UDP-glucuronosyltransferase 1 [UGT1A1] were significantly different between the Xhosa and CMA populations (Bonferroni p CYP2C18, CYP3A4, the gene encoding solute carrier family 22 member 6 [SLC22A6] and UGT1A1 between the two South African populations. Characterising the Xhosa and CMA population frequencies of variant alleles important for drug transport and metabolism can help to establish the clinical relevance of pharmacogenetic testing in these populations.
Full Text Available Health systems played a key role in the dramatic rise in global life expectancy that occurred during the 20th century, and have continued to contribute enormously to the improvement of the health of most of the worldÃ¢ÂÂs population. The health workforce is the backbone of each health system, the lubricant that facilitates the smooth implementation of health action for sustainable socio-economic development. It has been proved beyond reasonable doubt that the density of the health workforce is directly correlated with positive health outcomes. In other words, health workers save lives and improve health. About 59 million people make up the health workforce of paid full-time health workers world-wide. However, enormous gaps remain between the potential of health systems and their actual performance, and there are far too many inequities in the distribution of health workers between countries and within countries. The Americas (mainly USA and Canada are home to 14% of the worldÃ¢ÂÂs population, bear only 10% of the worldÃ¢ÂÂs disease burden, have 37% of the global health workforce and spend about 50% of the worldÃ¢ÂÂs financial resources for health. Conversely, sub-Saharan Africa, with about 11% of the worldÃ¢ÂÂs population bears over 24% of the global disease burden, is home to only 3% of the global health workforce, and spends less than 1% of the worldÃ¢ÂÂs financial resources on health. In most developing countries, the health workforce is concentrated in the major towns and cities, while rural areas can only boast of about 23% and 38% of the countryÃ¢ÂÂs doctors and nurses respectively. The imbalances exist not only in the total numbers and geographical distribution of health workers, but also in the skills mix of available health workers. WHO estimates that 57 countries world wide have a critical shortage of health workers, equivalent to a global deficit of about 2.4 million doctors, nurses and midwives. Thirty six of these countries are in sub-Saharan Africa. They would need to increase their health workforce by about 140% to achieve enough coverage for essential health interventions to make a positive difference in the health and life expectancy of their populations. The extent causes and consequences of the health workforce crisis in Sub-Saharan Africa, and the various factors that influence and are related to it are well known and described. Although there is no Ã¢ÂÂmagic bulletÃ¢ÂÂ solution to the problem, there are several documented, tested and tried best practices from various countries. The global health workforce crisis can be tackled if there is global responsibility, political will, financial commitment and public-private partnership for country-led and country-specific interventions that seek solutions beyond the health sector. Only when enough health workers can be trained, sustained and retained in sub-Saharan African countries will there be meaningful socio-economic development and the faintest hope of attaining the Millennium Development Goals in the sub-continent.
Anyangwe, Stella C E; Mtonga, Chipayeni
Health systems played a key role in the dramatic rise in global life expectancy that occurred during the 20th century, and have continued to contribute enormously to the improvement of the health of most of the world's population. The health workforce is the backbone of each health system, the lubricant that facilitates the smooth implementation of health action for sustainable socio-economic development. It has been proved beyond reasonable doubt that the density of the health workforce is directly correlated with positive health outcomes. In other words, health workers save lives and improve health. About 59 million people make up the health workforce of paid full-time health workers world-wide. However, enormous gaps remain between the potential of health systems and their actual performance, and there are far too many inequities in the distribution of health workers between countries and within countries. The Americas (mainly USA and Canada) are home to 14% of the world's population, bear only 10% of the world's disease burden, have 37% of the global health workforce and spend about 50% of the world's financial resources for health. Conversely, sub-Saharan Africa, with about 11% of the world's population bears over 24% of the global disease burden, is home to only 3% of the global health workforce, and spends less than 1% of the world's financial resources on health. In most developing countries, the health workforce is concentrated in the major towns and cities, while rural areas can only boast of about 23% and 38% of the country's doctors and nurses respectively. The imbalances exist not only in the total numbers and geographical distribution of health workers, but also in the skills mix of available health workers. WHO estimates that 57 countries world wide have a critical shortage of health workers, equivalent to a global deficit of about 2.4 million doctors, nurses and midwives. Thirty six of these countries are in sub- Saharan Africa. They would need to increase their health workforce by about 140% to achieve enough coverage for essential health interventions to make a positive difference in the health and life expectancy of their populations. The extent causes and consequences of the health workforce crisis in Sub-Saharan Africa, and the various factors that influence and are related to it are well known and described. Although there is no "magic bullet" solution to the problem, there are several documented, tested and tried best practices from various countries. The global health workforce crisis can be tackled if there is global responsibility, political will, financial commitment and public-private partnership for country-led and country-specific interventions that seek solutions beyond the health sector. Only when enough health workers can be trained, sustained and retained in sub-Saharan African countries will there be meaningful socio-economic development and the faintest hope of attaining the Millennium Development Goals in the sub-continent. PMID:17617671
Abstract Problem The positive relationship between HIV-prevalence and education in sub-Saharan Africa has been verified by several studies. However, this hypothesis has been challenged recently, and it is in this context that I place my thesis. The HIV-epidemic in sub-Saharan Africa is the only major epidemic that has rooted itself in the main population. The other large epidemics spread mainly in marginalized groups like injecting drug users, men who have sex with men and people involved in...
Sidibé, El Hassane
Thyroid gland diseases vary according to the environment. In sub-Saharan Africa, they are also influenced by population isolation and the absence of food self-sufficiency, both factors affecting the onset and persistence of iodine-deficiency goiters. More cosmopolitan diseases are now added to these thyroid disorders. Women are mainly affected (94.2%), most often with euthyroid goiters (54.7%), followed by Graves disease (13.1%), hypothyroidism (8.8%), thyroiditis (6.6%), toxic multinodular goiters (6.6 %) and unclassified goiters (10%) [Gabon]. The paucity of laboratories specializing in endocrinology and of nuclear medicine facilities, the delay in diagnosis that results in compressive or recurrent goiters, and endemic goiters are all typical in Africa. In children and adolescents, death rates increase with congenital or acquired thyroiditis as with delayed physical or mental development. In this environment, thyroiditis can also be pregnancy-related. Very recent surveys show a prevalence of endemic goiters of 28.6% in the community of Sekota, Ethiopia, 64-70% in Sahel-Sudan (population aged 10-20 years), 20-29% in KwaZulu-Natal (school children), 14.3-30.2% in Namibia (school children), 0.21% (congenital hypothyroidism or cretinism) in Plateau State, Nigeria, 55.2% at Zitenga, Burkina Faso (210 persons 0-45 years), and 10% in Hararé and Wedza, Zimbabwe (newborn TSH >10.1 microIU/mL). The prevalence of goiters is 43.6% in children emigrating from Ethiopia to Israel. Millet from semi-arid zones contains apigenin at a concentration of 150 mg/kg and luteolin at 350 mg/kg, both of which can interfere with thyroid function. The harmful effects of cassava (also known as manioc) are better known: milling cassava reduces its goitrogenic potential. In addition to iodine deficiency, selenium deficiency, and the effect of the thiocyanates in cassava, ion concentrations in soil and drinking water appear to play a role. The proportion of thyroid surgery indicated for hyperthyroidism has tripled, now accounting for 18.5% of all such operations. This disorder is found today in subjects older than 50 years, mainly from rural areas, and caused most often by Graves disease (25 of 51 cases). Graves disease in young women can cause serious problems during pregnancy; in such cases assessment of the minimal effective dose of antithyroid agents is essential. Carbimazole leads to remission in 61% of cases of Graves disease. Hypothyroidism can be auto-immune and often in patent forms because of insufficient screening in Africa: 24 cases in Dakar (1984) and 37 others noticed by us (1998). Single-nodule tumors were assessed in 89 patients in Khartoum: they were found to be simple goiters in 72% of cases, follicular adenoma in 13.5%, cancer in 13.5% (with 6 of the 12 cases follicular, 5 papillary, and 1 anaplastic). The sex ratio for thyroid cancer in Ouagadougou is 0.22, thus mainly women. It affects mainly women in their 30s. Thyroid cancer at Ibadan was found to be papillary carcinoma in 45.3% of cases; follicular forms were seen in 44.5% and this series includes 5% of medullary cancers (7 cases), with a mean age of 34 years. Already 4 other cases from Francophone sub-Saharan Africa have been noticed. Iodine deficiency is suggested to play a role because follicular cancer in southern Africa accounts for up to 55% of thyroid cancers. Thyroid cancers in Algeria are associated with low socioeconomic status and characterized by a high prevalence of cancers discovered at an advanced stage and of anaplastic carcinomas. Oral potassium iodate is recommended: 30 mg of iodate a month or 8 mg every two weeks. Iodized oil has been recommended by some authors, as well as a combination of iodine and sugar, and the iodation of drinking water; these are in addition to the proposed methods of opening up areas by new infrastructure). In conclusion, thyroid disease is due predominantly to iodine deficiency and goitrogenic products, but we also note the increasing emergence of hyperthyroidism, especially Graves disease, atrophic auto-immune hypothyroidism, an
Monekosso, G L
Developments in medical education in Sub-Saharan Africa over the past 100 years have been characterized by the continent's unique history. During the first half of the 20th century, the Europeans effectively installed medical education in their African colonies. The years 1950 to 1960 were distinguished by successful movements for independence, with new governments giving priority to medical education. By 1980, there were 51 medical schools in Sub-Saharan Africa. The period from 1975 to 1990 was problematic both politically and economically for Sub-Saharan Africa, and medical schools did not escape the general difficulties. War, corruption, mounting national debts, and political instability were characteristics of this period. In many countries, maintaining medical school assets--faculty members, buildings, laboratories, libraries--became difficult, and emigration became the goal of many health professionals. In contrast, the past 20 years have seen rapid growth in the number of medical schools in Sub-Saharan Africa. Economic growth and political stability in most Sub-Saharan African countries augur well for investment in health systems strengthening and in medical education. There are, nonetheless, major problem areas, including inadequate funding, challenges of sustainability, and the continuing brain drain. The 20th century was a time of colonialism and the struggle for independence during which medical education did not advance as quickly or broadly as it did in other regions of the world. The 21st century promises a different history, one of rapid growth in medical education, leading to better care and better health for the people of Africa. PMID:25072563
Petroleum products are the lifeblood of the economies of all Sub-Saharan African countries. They are key fuels used in road transport and power generation. Households use kerosene and liquefied petroleum gas (LPG) for lighting and cooking. In this era of high oil prices, if the product is state-subsidized, the government budget bears the brunt of price increases. If the price changes are passed through to consumers, the household budgets are impacted directly. The countries most vulnerable to oil price shocks are the low-income oil importers which are disproportionately concentrated in Sub-Saharan Africa. End user prices are affected by several factors: market size and economies of scale, mode of product transport, controlled pricing, protection of inefficient domestic suppliers, degree of competition, clear and stable legal framework, effective monitoring and disclosure of industry statistics. This paper is based on two recent studies of the oil sectors of several countries in Sub-Saharan Africa which posed the following questions: Is each stage in the supply chain, from import of crude oil or refined products to retail, efficiently run and are the efficiency gains passed on to end-users? If not, what are the potential causes and possible means of remedying the problems? - Highlights: Examines comparative efficiencies of oil product supply chains in twelve sub-Saharan countries. Identifies areas for improvement towards best practice. Objective is to reduce differential between international reference prices and consumer prices
Sharp, Colin P.; Vermeulen, Marion; Nébié, Yacouba; Djoko, Cyrille F.; LeBreton, Matthew; Tamoufe, Ubald; Rimoin, Anne W.; Kayembe, Patrick K.; Carr, Jean K.; Servant-Delmas, Annabelle; Laperche, Syria; Harrison, G.L. Abby; Pybus, Oliver G.; Delwart, Eric; Wolfe, Nathan D.; Saville, Andrew; Lefrère, Jean-Jacques
Human parvovirus 4 infections are primarily associated with parenteral exposure in western countries. By ELISA, we demonstrate frequent seropositivity for antibody to parvovirus 4 viral protein 2 among adult populations throughout sub-Saharan Africa (Burkina Faso, 37%; Cameroon, 25%; Democratic Republic of the Congo, 35%; South Africa, 20%), which implies existence of alternative transmission routes. PMID:20875290
Sharp, Colin P.; Vermeulen, Marion; Nébié, Yacouba; Djoko, Cyrille F.; LeBreton, Matthew; Tamoufe, Ubald; Rimoin, Anne W.; Kayembe, Patrick K.; Carr, Jean K; Servant-Delmas, Annabelle; Laperche, Syria; Harrison, G. L. Abby; Pybus, Oliver G.; Delwart, Eric; Nathan D. Wolfe
Human parvovirus 4 infections are primarily associated with parenteral exposure in western countries. By ELISA, we demonstrate frequent seropositivity for antibody to parvovirus 4 viral protein 2 among adult populations throughout sub-Saharan Africa (Burkina Faso, 37%; Cameroon, 25%; Democratic Republic of the Congo, 35%; South Africa, 20%), which implies existence of alternative transmission routes.
Fredriksen, Birger; Fossberg, Camilla Helgø
Over the next two decades, sub-Saharan Africa will face substantial pressure to expand its secondary education system. This is driven by the current low development of secondary education compared to other world regions, continued rapid population growth, the increase in the enrollment and completion rates at the primary education level, and the
Ousman Mahmud; Centdrika Dates; Ahmad, Hafiz A.; Luma Akil
Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) are two catastrophic diseases affecting millions of people worldwide every year; and are considered to be pandemic by the World Health Organization. This study aims to compare the recent trends in TB and HIV in the United States and Sub-Saharan African Countries. Data (incidence, prevalence and death rates of HIV and TB) for the United States, Cameroon, Nigeria, and South Africa were collected from The Joint United Nations Programme for...
Goldblatt, Peter; MANNING, JOHN C.
Background Seventeen distinct pollination systems are known for genera of sub-Saharan African Iridaceae and recurrent shifts in pollination system have evolved in those with ten or more species. Pollination by long-tongued anthophorine bees foraging for nectar and coincidentally acquiring pollen on some part of their bodies is the inferred ancestral pollination strategy for most genera of the large subfamilies Iridoideae and Crocoideae and may be ancestral for the latter. Derived strategies...
Amavilah, Voxi Heinrich
I estimate and compare the effects of globalization, governance, and conventional factors and forces on the economic performance of Sub-Saharan African countries. The analysis finds that both physical and human capita as well as unexplained technical residuals affect economic performance, although human capital and technical change do not always have statistically significant impacts. The policy implication of these results calls for improvement of all three variables. Economic ...
The paper investigates the effect of financial development on economic growth conditional on the level of institutional quality for a panel of 21 Sub-Saharan African countries for the period 1986-2010. A standard growth regression is estimated with linear interaction between financial development and institutional quality. Our findings indicate that financial development has not significantly contributed to SSA economic growth, contrary to the significant positive effect of institutional qual...
Docquier, Frédéric; Vasilakis, Chrysovalantis; Tamfutu Munsi, Dieudonné
In this paper, we identify and quantify the role of international migration in the propagation of HIV across sub-Saharan African countries. We use a panel database on bilateral migration flows and HIV prevalence rates covering 44 countries over the nineties. Controlling for unobserved heterogeneity, spatial autocorrelation, reverse causality and reflection issues, and incorrect treatment of country fixed effects, we regress the log-change of HIV prevalence rates on the average levels of preva...
Ebeke, Christian; Ehrhart, Hélène
This paper focuses on the sources and consequences of the instability of tax revenue in Sub-Saharan African countries. We take advantage of a unique and extraordinarily rich dataset on the composition of tax revenues for a large number of countries. Using panel data for 39 countries observed over the period 1980-2005, our results are threefold. Firstly, the instability of government tax revenue leads to an instability of both the public investment and government consumption, and finally, redu...
This paper addresses the debate in the literature on how developing countries are affected by foreign monetary policy shocks. I analyze how contractionary monetary policy shocks originating in different regions, specifically the Euro Area (EU) and United States (US), affect a set of rarely investigated sub-Saharan African (SSA) countries. Foreign monetary policy shocks are identified using changes in central bank futures rates, and are inserted into a domestic structural vector autoregr...
Djurfeldt, Göran; Larsson, Rolf
This paper discusses food security and the African food crisis. By means of data from a survey of over 3000 farm households in eight sub-Saharan countries, the authors conclude that food security requires a broad integration of smallholders in the market. Subsistence orientation does not promote food security, while seed fertilizer technology does. Market integration of maize producers seems to be driven by the State, not by the market on its own. The diffusion of technology is stimulated by ...
d'Agostino, Giorgio; Pieroni, Luca; Scarlato, Margherita
This paper evaluates the effects of cash transfer (CT) programmes introduced during the 1990s and 2000s on food security in a sample of sub-Saharan African countries. We apply the synthetic control method to compare changes in the post-intervention food insecurity trajectories of economies affected by CT programmes relative to their unaffected counterparts. The results suggest that CT programmes exert differential effects on the prevalence of undernourishment. Although the estimates in the up...
Smith-Greenaway, Emily; Trinitapoli, Jenny
Contextual characteristics influence infant mortality above and beyond family-level factors. The widespread practice of polygyny is one feature of many sub-Saharan African contexts that may be relevant to understanding patterns of infant mortality. Building on evidence that the prevalence of polygyny reflects broader economic, social, and cultural features, and has implications for how families engage in the practice, we investigate whether and how the prevalence of polygyny (1) spills over t...
The focus of this report is to identify and portray current barriers to the scaling up of private investment and finance for electricity generation from renewable energy sources in the sub-Saharan region. Best practice in tackling these barriers is identified, partly from a literature review but especially from the results of a survey conducted among 36 financial institutions that are UNEP Finance Initiative members and two non-member banks (all survey respondents have experience in the field of energy infrastructure finance). Promising avenues in the areas of local policy reform, incentive mechanisms and international de-risking instruments are highlighted. In particular, this report addresses the following questions: (a) Why are sub-Saharan Africa and developing countries elsewhere failing to expand electricity generation from renewable sources? What are the barriers to such expansion? What is keeping the risk-return profile of renewable energy investments in sub-Saharan Africa unattractive and projects commercially unviable?; (b) What have been the experiences of private sector lenders and investors in the area of renewable energy projects in developing countries? What barriers and drivers have they encountered, and how can these experiences be of use in sub-Saharan Africa?; (c) What can be learned from the modest but encouraging successes of a few sub-Saharan African countries? Can these results be replicated? What was done in these countries to improve the risk-return profile of renewable energy and unlock private finance?.
Buchholz, Kathleen B.
Sub-Saharan Africa has the lowest rates of electrification and some of the worst education statistics worldwide. In the absence of strong infrastructure for a reliable grid system and quality universal primary schooling, the poor suffer significantly. Though substantial research has been done on both issues separately, the relationship between the two has yet to be explored. This thesis uses social justice theories to introduce the connections between energy poverty and an individual's education capabilities through a case study in Zambia. Case study research was carried out in the urban low-resource settlements of Lusaka, Zambia over a period of two months with Lifeline Energy, using methods of participant observation. Drawing on trends discovered in survey responses, interviews and feedback from a distribution of renewable technologies, this study demonstrates that a lack of modern forms of energy detracts from education. By synthesizing the data with Martha Nussbaum's capabilities approach and Sendhil Mullainathan and Eldar Shafir's scarcity theory, the research reveals that energy poverty hinders an individual's ability to study and gain a quality education and diminishes their available cognitive capacity to learn by tunneling attention to the resource deficit. Furthermore, it supports the claim that energy poverty is not gender neutral. The research concludes that the scarcity caused by energy poverty can be lessened by the investment in and use of small-scale renewable technologies which alleviates some of the daily stress and grind of poverty. This thesis lays the groundwork to recognize energy poverty as an injustice. Keywords: Energy Poverty, Education, Gender, Sub-Saharan Africa, Scarcity, Capabilities Approach..
Dzik, Walter Sunny; Kyeyune, Dorothy; Otekat, Grace; Natukunda, Bernard; Hume, Heather; Kasirye, Phillip G; Ddungu, Henry; Kajja, Isaac; Dhabangi, Aggrey; Mugyenyi, Godfrey R; Seguin, Claire; Barnes, Linda; Delaney, Meghan
In November 2014, a 3-day conference devoted to transfusion medicine in sub-Saharan Africa was held in Kampala, Uganda. Faculty from academic institutions in Uganda provided a broad overview of issues pertinent to transfusion medicine in Africa. The conference consisted of lectures, demonstrations, and discussions followed by 5 small group workshops held at the Uganda Blood Transfusion Service Laboratories, the Ugandan Cancer Institute, and the Mulago National Referral Hospital. Highlighted topics included the challenges posed by increasing clinical demands for blood, the need for better patient identification at the time of transfusion, inadequate application of the antiglobulin reagent during pretransfusion testing, concern regarding proper recognition and evaluation of transfusion reactions, the expanded role for nurse leadership as a means to improve patient outcomes, and the need for an epidemiologic map of blood usage in Africa. Specialty areas of focus included the potential for broader application of transcranial Doppler and hydroxyurea therapy in sickle cell disease, African-specific guidelines for transfusion support of cancer patients, the challenges of transfusion support in trauma, and the importance of African-centered clinical research in pediatric and obstetric transfusion medicine. The course concluded by summarizing the benefits derived from an organized quality program that extended from the donor to the recipient. As an educational tool, the slide-audio presentation of the lectures will be made freely available at the International Society of Blood Transfusion Academy Web site: http://www.isbtweb.org/academy/. PMID:25752939
Emily Smith Greenaway
Full Text Available BACKGROUND Despite considerable concern regarding the social consequences of sub-Saharan Africa's high orphan prevalence, there has been no research investigating how living in a community densely populated with orphans is more broadly associated with children's - including nonorphans' - acquisition of human capital. OBJECTIVE We provide a new look at the implications of widespread orphanhood in sub-Saharan Africa by examining whether living in an area with a high concentration of orphans is associated with children's likelihood of school enrollment. METHODS We use data from the Demographic and Health Survey (DHS and the Multiple Indicators Cluster Survey (MICS among 383,010 children in 336 provinces in 34 sub-Saharan African countries to estimate multilevel logistic regression models to assess whether living in a setting with a higher concentration of orphans is associated with school enrollment. RESULTS Orphan concentration has a curvilinear association with children's school enrollment in western and eastern Africa: The initially positive association becomes negative at higher levels. In central and southern Africa, orphan concentration has a positive linear association with children's school enrollment. CONCLUSIONS In western and eastern Africa, the negative association between living in a setting more densely populated with orphans and children's school enrollment provides suggestive evidence that the orphan disadvantage "spills over" in those communities most heavily affected. Conversely, in central and southern Africa, the positive association between living in a setting more densely populated with orphans and children's school enrollment highlights the resiliency of these relatively wealthier communities with high levels of orphans. Although longitudinal research is needed to confirm these findings and clarify the underlying mechanisms, this study lays the groundwork for a new body of research aimed at understanding the broader social implications of widespread orphanhood in sub-Saharan Africa.
Full Text Available OBJECTIVE: To provide internationally comparable data on the frequencies of different causes of death. METHODS: We analysed verbal autopsies obtained during 1999 -2002 from 12 demographic surveillance sites in sub-Saharan Africa and Bangladesh to find cause-specific and age-specific mortality rates. The cause-of-death codes used by the sites were harmonized to conform to the ICD-10 system, and summarized with the classification system of the Global Burden of Disease 2000 (Version 2. FINDINGS: Causes of death in the African sites differ strongly from those in Bangladesh, where there is some evidence of a health transition from communicable to noncommunicable diseases, and little malaria. HIV dominates in causes of mortality in the South African sites, which contrast with those in highly malaria endemic sites elsewhere in sub-Saharan Africa (even in neighbouring Mozambique. The contributions of measles and diarrhoeal diseases to mortality in sub-Saharan Africa are lower than has been previously suggested, while malaria is of relatively greater importance. CONCLUSION: The different patterns of mortality we identified may be a result of recent changes in the availability and effectiveness of health interventions against childhood cluster diseases.
Kluth, Michael Friederich
This article argues that aspirations of maintaining a dominant influence over sub-Saharan security issues has spurred the French and British leadership of European Union (EU) foreign and security policy integration, just as it has informed military capability expansions by the armed forces of the main EU powers. While Europe's initial African focus was on stabilising a continent marred by state failure, civil wars and genocides, changes in the global security context, especially the shift towards multipolarity manifest in China's growing engagement, has prompted a complementary focus on deterring other powers from making military inroads into the subcontinent. Hence Europe's sub-Saharan security focus is shifting from stabilisation towards deterrence. This helps explain recent military procurements which, in spite of the extremely challenging fiscal position of most EU member states, feature large-scale investments in long-range deterrence capabilities.
Dobdinga Cletus Fonchamnyo
Full Text Available Remittances have become an important source of foreign exchange earnings in many countries as migrants continue to send income to relatives at home. However, the main motives for sending remittances remain controversial. This paper examines the relative importance of the socio-political and economic determinants of remittance inflow using an unbalance panel data of 36 economies in the Sub Saharan African Region in an attempt to assess the altruistic motive of remittance inflow. The results using a random effect estimation technique show that altruism is important for remitting, as the per capita income differential between host and home country and the age dependency ratio are positive and statistically significant. The level of per capita income of the home country is also found to be negative and statistically significant which also supports the altruistic motive of remittances. The results further suggest that the development of the financial sector and the proportion of Catholics in the population will encourage remittance inflow. These results are robust to the different specifications and estimation methodology.
Steyn, N P; Walker, A R
The subject of the future regarding nutritional status and food security, and of their ramifications in terms of nutrition-related disorders/diseases in Sub-Saharan African (SSA) populations, is a complex one. As well as social unrest, a country's socioeconomic situation may affect food availability and, crucially, influence the generally low proportions of the Gross National Product devoted to health services. Additional determinants include changes in the roles of non-dietary adverse factors (i.e. smoking practice, alcohol consumption, physical inactivity) and of infections (i.e. gastroenteritis, malaria, tuberculosis and, particularly, HIV). As to future health in 2020, major increases in socioeconomic status are very unlikely; in fact, there has been a deterioration in some countries with food shortages affecting nutrition status and food security. However, with some measures of prosperity there are likely to be decreases in family size and falls in the proportions of children born with low birthweights or with protein-energy-malnutrition (PEM), and of children lying under the 5th percentile of growth reference standards. Simultaneously, though. there will be variable rises, especially in urban dwellers, in the occurrence of hypertension, diabetes, cardiovascular disease and certain cancers. Improvements in the health status of both children and adults are likely to be strongly affected by whether HIV infection can be controlled or whether it becomes rampant. PMID:24394308
Full Text Available In an increasingly digitalized world economy, there exists a digital gap between Sub-Saharan Africa and the rest of the world that translates into economic marginalization of the African region. Consequently, the following phases of development are crucial for the region: (1 the phase of massive digitalization during which the digital divide is bridged and (2 the phase of information and knowledge management in which information is systematically converted into knowledge and the latter into innovative-sustainable development. Information for conversion into knowledge is supplied by the first phase. The second phase is therefore existence dependent on the first. Therefore, the attainment of digitalized state is primary-sine qua non. The envisaged digitalized state can be actualized and consolidated with a combination of: (a curriculum in computer education consisting of computer taxonomy, networking and ICTS in general for secondary and tertiary institutions but also aptly adoptable for informal groups and (b establishment of multipurpose telecentres in rural areas and a diffusion of networks in urban centres. Once a steady digitalized state evidenced by uninterrupted connectivity to the internet is attained, the second phase can be realized. Without steady supply of electricity, however, sustainable development and competitive edge may be hard to come by in a world of fierce competition.
Makulilo, Alex B.
Africa is by far the least developed continent in terms of protection of personal data. At present there are 11 countries out of 54 which have implemented comprehensive data privacy legislation. Nine of them namely, Angola, Benin, Burkina Faso, Cape Verde, Gabon, Ghana, Mauritius, Senegal and Seychelles belong to sub-Saharan Africa. The other two countries, Morocco and Tunisia, belong to North Africa. Yet, there are seven countries in sub-Saharan Africa with either Bills or drafts on data pri...
Danert, K.; Carter, R. C.; Adekile, D.; MacDonald, A.
A common assertion is that the cost of water well drilling in sub?Saharan Africa is too high and that construction quality is regularly compromised. Over the last 20 years, several studies regarding this have been undertaken, covering more than ten countries in the region. Although drilling costs in sub?Saharan Africa are generally higher than in India, there are valid reasons for this. However, changes to borehole designs, procurement and contract management practices, well clust...
Zimkus, Breda M; Rödel, Mark-Oliver; Hillers, Annika
Puddle frogs (Anura: Phrynobatrachidae) are one of the most species-rich sub-Saharan amphibian groups, occupying an extraordinarily diverse range of habitats. We construct the first phylogeny of puddle frogs, utilizing mitochondrial (12S rRNA, valine-tRNA, and 16S rRNA) and nuclear (RAG-1) DNA. Phylogenetic analyses are conducted using separate and combined partitions under maximum parsimony, maximum likelihood, and Bayesian criterion. Monophyly of the Phrynobatrachidae is well supported, and three major clades of Phrynobatrachus are identified. We reconstructed a biogeographic history using habitat preference, elevation, and geographic distribution. Habitat niches appear to be conserved between sister species, with the majority of species favoring forest over savanna habitats and the most recent common ancestor of the Phrynobatrachidae reconstructed as a forest species. Analyses of elevational data identify three independent colonizations of highland regions, one in each of the three major clades. Ancestral reconstructions support an East African origination of puddle frogs. Most species are restricted to one of five sub-Saharan regions and are distributed within the Eastern, Central, and Western zones with far fewer species in Southern Africa. These results elucidate the complex patterns of spatial niche partitioning that have contributed to the diversification of this widely distributed, sub-Saharan genus. PMID:20034584
Ekenze, Sebastian O; Onumaegbu, Okechukwu O; Nwankwo, Okechukwu E
Disparity still exists in the surgical care between sub-Saharan Africa and developed countries. Several international initiatives have been undertaken in the past decades to address the disparity. This study looks at the impact of these programs in child surgery in Sub-Saharan Africa. Review of electronic databases Medline and African Index Medicus on international partnerships for child surgery in Sub-Saharan Africa was undertaken. Four types of international initiatives were identified and consist of periodic medical missions; partnerships between foreign medical institutions or charities and local institutions; international health electives by surgical residents; and training of individual surgeons from developing countries in foreign institutions. The results of these efforts were variable, but sustainability and self-reliance of host nations were limited. Sociocultural factors, dearth of facilities, and lack of local governments' commitment were main impediments to effective local development or transfer of modern protocols of surgical management and improvement of pediatric surgical care at the host community level. Current initiatives may need improvements with better understanding of the sociocultural dynamics and local politics of the host nation, and improved host nation involvement and commitment. This may engender development of locally controlled viable services and sustainable high level of care. PMID:25216431
This study investigates the causality relationship between crude oil consumption and economic growth in twenty three Sub-Saharan African countries. We applied a multivariate panel Granger causality framework during 19852011 and we included crude oil price as the control variable of the model. The results indicate that in the short-run, there is a bi-directional causality relationship between crude oil consumption and economic growth in oil importing region and there is a uni-directional causality relationship from crude oil consumption to GDP in oil exporting region. However, in the long-run there is a bi-directional causality relationship between them in both regions. Therefore, reducing crude oil consumption without employing appropriate policies adversely impacts on economic growth of Sub-Saharan Africa. Hence, in order to reduce crude oil dependency of the region policymakers should pay more attention to the issue of energy efficiency programs. - Highlights: ? We examined Granger causality among oil consumption and GDP in Sub-Saharan Africa. ? Crude oil price is the control variable of the model. ? There is short run bi-directional causality among oil and GDP (oil importing). ? There is short run uni-directional causality from oil to GDP (oil exporting). ? There is a long run bi-directional causality among oil and GDP in both regions
Stefanos, Xenarios; Paul, Pavelic.
Full Text Available Greater use of groundwater in Sub-Saharan Africa is a pre-requisite for improved human welfare; however, the costs associated with groundwater development are prohibitively high and poorly defined. This study identifies and disaggregates the costs of groundwater development in 11 Sub-Saharan African [...] countries, while the cost factors that most strongly affect drilling expenditures are traced. Further, the institutional and technical constraints impeding groundwater development are also explored while a time-series analysis forecasts future drilling expenditures. The results indicate that mobilisation and demobilisation costs, together with well development costs, factors that are difficult to change, are most significantly affecting the total costs of drilling. Further, the nature of the hydrogeological formation (which is largely a site characteristic), along with the often-aged machinery (which can be controlled), are also major impediments to lowering the cost of drilling. All countries are forecasted to have a slight to considerable drilling cost decrease for the next decade which offers encouragement for future groundwater development. Greater attention to the individual cost factors and to forecasting analysis could help to design more coherent and consistent groundwater development policies in Sub-Saharan Africa.
Deaton, Angus S; Tortora, Robert
The health of people in sub-Saharan Africa is a major global concern. However, data are weak, and little is known about how people in the region perceive their health or their health care. We used data from the Gallup World Poll in 2012 to document sub-Saharan Africans' perceived health status, their satisfaction with health care, their contact with medical professionals, and the priority they attach to health care. In comparison to other regions of the world, sub-Saharan Africa has the lowest ratings for well-being and the lowest satisfaction with health care. It also has the second-lowest perception of personal health, after only the former Soviet Union and its Eastern European satellites. HIV prevalence is positively correlated with perceived improvements in health care in countries with high prevalence. This is consistent with an improvement in at least some health care services as a result of the largely aid-funded rollout of antiretroviral treatment. Even so, sub-Saharan Africans do not prioritize health care as a matter of policy, although donors are increasingly shifting their aid efforts in the region toward health. PMID:25715657
Luis Távora-Tavira, Rosa Teodósio, Jorge Seixas, Emília Prieto, Rita Castro, Filomena Exposto, Jorge Atouguia
Full Text Available Background: For geographical and recent historic reasons, Portugal is a gateway and home for immigration from sub-Saharan countries. Misconceptions related to these populations often lead to consider them as high-frequency clusters for dissemination of sexually transmitted infections (STIs. Epidemiological evidence-based data is needed to elucidate these issues and baseline prevalence studies are the starting point for this.Methodology: A prospective study was conducted in 220 African migrants (171 men and 49 women, recently arrived in Portugal, at the time of their first consultation. The presence of STIs was evaluated using a clinical syndromic approach and biological confirmation for gonorrhoea, Chlamydia trachomatis genital infection, syphilis, Hepatitis B and Human Immunodeficiency Virus (HIV infection.Results: Global prevalence of the targeted infections were 1.8% for gonorrhoea, 0 % for Chlamydia infection, 4.1% for Syphilis, 5.9% for HBsAg presence and 7.3% for HIV infection. Globally, 16.4% of the studied persons had at least one sexually transmitted infection.Conclusions: We concluded that prevalence rates encountered in this population is similar to that of non-migrant Portuguese populations with a high risk for sexually transmitted diseases. Therefore migration from sub-Saharan Africa doesnt seem to constitute a particularly critical isolated factor for public health risk of STIs in the community.
Full Text Available There is no doubt that communicable diseases will remain the predominant health problem for the populations in sub-Saharan Africa, including adults, for the next 10--20 years. Concern has been expressed that the available resources to deal with this problem would be reduced by increasing the emphasis on noncommunicable diseases. The latter, however, already present a substantial burden because their overall age-specific rates are currently higher in adults in sub-Saharan Africa than in populations in Established Market Economies. There is also evidence that the prevalence of certain noncommunicable diseases, such as diabetes and hypertension, is increasing rapidly, particularly in the urban areas, and that significant demands are being made on the health services by patients with these diseases. To ignore the noncommunicable diseases would inevitably lead to an increase in their burden; the provision of health services for them would be largely undirected by issues of clinical and cost effectiveness, and their treatment and prevention would be left to the mercy of local and global commercial interests. Improved surveillance of all diseases within sub-Saharan Africa is needed in order to place noncommunicable diseases properly within the context of the overall burden of disease. Research is needed to guide improvements in the clinical and cost effectiveness of resources currently committed to the care of patients with noncommunicable diseases, and to direct and evaluate preventive measures.
Full Text Available Tuberculosis (TB and Human Immunodeficiency Virus (HIV are two catastrophic diseases affecting millions of people worldwide every year; and are considered to be pandemic by the World Health Organization. This study aims to compare the recent trends in TB and HIV in the United States and Sub-Saharan African Countries. Data (incidence, prevalence and death rates of HIV and TB for the United States, Cameroon, Nigeria, and South Africa were collected from The Joint United Nations Programme for HIV/AIDS (UNAIDS, US Census Bureau and World Health Organization (WHO databases and analyzed using Statistical Analysis Software (SAS v 9.1. Analysis of Variance (ANOVA was performed to compare the variables of interest between the countries and across time. Results showed that percent rates of TB cases, TB deaths, HIV cases and HIV deaths were significantly different (P < 0.001 among these countries from 1993 to 2006. South Africa had the highest rates of HIV and TB; while US had the lowest rates of both diseases. Tuberculosis and HIV rates for Cameroon and Nigeria were significantly higher when compared to the United States, but were significantly lower when compared to South Africa (P < 0.001. There were significant differences (P < 0.001 in the prevalence of TB and HIV between the United States and the Sub-Saharan African countries, as well as differences within the Sub-Saharan African countries from 1993 to 2006. More analysis needs to be carried out in order to determine the prevalence and incidence of HIV and TB among multiple variables like gender, race, sexual orientation and age to get a comprehensive picture of the trends of HIV and TB.
Wang, Shuoguo; Lachance, Joseph; Tishkoff, Sarah A; Hey, Jody; Xing, Jinchuan
Recent studies have found evidence of introgression from Neanderthals into modern humans outside of sub-Saharan Africa. Given the geographic range of Neanderthals, the findings have been interpreted as evidence of gene exchange between Neanderthals and modern humans descended from the Out-of-Africa (OOA) migration. Here, we examine an alternative interpretation in which the introgression occurred earlier within Africa, between ancestors or relatives of Neanderthals and a subset of African mod...
Smith, AD; Tapsoba, P; Peshu, N.; Sanders, EJ; Jaffe, HW
Globally, men who have sex with men (MSM) continue to bear a high burden of HIV infection. In sub-Saharan Africa, same-sex behaviours have been largely neglected by HIV research up to now. The results from recent studies, however, indicate the widespread existence of MSM groups across Africa, and high rates of HIV infection, HIV risk behaviour, and evidence of behavioural links between MSM and heterosexual networks have been reported. Yet most African MSM have no safe access to relevant HIV/A...
Hansen, Henrik; Rand, John
Based on firm level data from 16 Sub-Saharan African countries we show how three different measures of credit constraints lead to three different estimates of gender differences in manufacturing firms credit situation. Using a perception based credit constraint measure female owned firms appear relatively more constrained than male owned firms. Using formal financial access data we find no gender effect. Finally, using direct information on credit constraints, male owned small firms appear disadvantaged. Furthermore we show a strong size gradient in the gender gap for the two measures for which we find significant gender differences.
Diallo Ibrahima; Coton Thierry
AIM: Celiac disease is rarely described in sub-Saharan Africa.METHODS: From a series of 17 cases diagnosed between 2005and 2007 in Djibouti, we describe our diagnosis an managementdifficulties.RESULTS: African ethnics represented 64.7%. Sex ratio (F/M) is1.4, mean age 82 months, associated diseases in 47%. Anti-gliadine,anti-endomysium and anti-transglutaminase antibodies were positivein 100%, 66.6% and 100%. Upper digestive tract endoscopy wasrealized 4 times. Eleven patients (64.7%) began g...
Full Text Available Abstract Background In this paper, we aim to quantify the contribution of international health volunteers to the health workforce in sub-Saharan Africa and to explore the perceptions of health service managers regarding these volunteers. Methods Rapid survey among organizations sending international health volunteers and group discussions with experienced medical officers from sub-Saharan African countries. Results We contacted 13 volunteer organizations having more than 10 full-time equivalent international health volunteers in sub-Saharan Africa and estimated that they employed together 2072 full-time equivalent international health volunteers in 2005. The numbers sent by secular non-governmental organizations (NGOs is growing, while the number sent by development NGOs, including faith-based organizations, is mostly decreasing. The cost is estimated at between US$36 000 and US$50 000 per expatriate volunteer per year. There are trends towards more employment of international health volunteers from low-income countries and of national medical staff. Country experts express more negative views about international health volunteers than positive ones. They see them as increasingly paradoxical in view of the existence of urban unemployed doctors and nurses in most countries. Creating conditions for employment and training of national staff is strongly favoured as an alternative. Only in exceptional circumstances is sending international health volunteers viewed as a defendable temporary measure. Conclusion We estimate that not more than 5000 full-time equivalent international health volunteers were working in sub-Saharan Africa in 2005, of which not more than 1500 were doctors. A distinction should be made between (1 secular medical humanitarian NGOs, (2development NGOs, and (3 volunteer organizations, as Voluntary Service Overseas (VSO and United Nations volunteers (UNV. They have different views, undergo different trends and are differently appreciated by government officials. International health volunteers contribute relatively small numbers to the health workforce in sub-Saharan Africa, and it seems unlikely that they will do more in the future. In areas where they play a role, their contribution to service delivery is sometimes very significant.
E. Jane Morris
Full Text Available Modern biotechnology, including the application of transgenic techniques to produce Genetically Modified Organisms (GMOs, can play a significant role in increasing agricultural production in a sustainable way, but its products need to be tailored for the developing world. In sub-Saharan Africa, the capacity to develop GMOs and ensure they meet stringent regulatory requirements is somewhat limited. Most African governments contribute little to science and technology either financially or through strong policies. This leaves the determination of research and development priorities in the hands of international funding agencies. Whereas funding from the United States is generally supportive of GM technology, the opposite is true of funding from European sources. African countries are thus pulled in two different directions. One alternative to this dilemma might be for countries in the sub-Saharan Africa region to develop stronger South-South collaborations, but these need to be supported with adequate funding. African governments as well as external funding agencies are urged to consider the important role that biotechnology, including GM technology, can play in contributing to sustainable development in Africa, and to provide adequate support to the development of capacity to research, develop and commercialize GMOs in the region.
Full Text Available There has been lingering contention on what development means in the African context. The meaning of development in the African context is crucial in order to know whether Africa is developing or not, particularly since 1970. This debate becomes critical when it is appreciated that Africa appears as the least developed continent in the world. This paper conceptualises development; in doing this, the paper considers both economic and political development, and looks into the complex question: Must economic development precede political development in Africa or vice-versa? In an attempt to address these issues, the paper considers and examines the views of many scholars and studies on these subject matters. While the paper recognises the rise and importance of recent global development paradigms, such as feminism, and green-environmentalism, it however, applies the long traditional approaches modernisation, liberalism, dependency and Marxism in analysing the meaning of development in Sub-Saharan African context. This is because this paper is concerned with the real development stage of this Sub continent of Africa, and not merely an intellectual exercise. The paper finally proffers a definition of development, which it believes to be germane in the context of real developmental stage of Sub-Saharan Africa.
Full Text Available Abstract Background Because of previously reported ethnic differences in determinants and markers of obesity and related metabolic disorders, we sought to investigate circulating levels of adiponectin and their correlates in a sub-Saharan African (sSA population. Subjects and Methods We studied 70 non-diabetic volunteers (33M/37F living in Yaoundé, Cameroon, aged 2469 yr, with BMI 2042 kg/m2. In all participants we measured waist circumference and total body fat by bioimpedance, and obtained a fasting venous blood sample for measurement of plasma glucose, serum insulin and adiponectin concentrations. We performed a euglycaemic hyperinsulinaemic clamp in 1/4 subjects, and HOMAIR was used as surrogate of fasting insulin sensitivity index since it best correlates to clamp measurements. Results Males had lower adiponectin levels than females (8.8 ± 4.3 vs. 11.8 ± 5.5 ?g/L. There was no significant correlation between adiponectin and total body fat (rs = -0.03; NS, whereas adiponectin was inversely correlated with waist circumference (rs = -0.39; p = 0.001. Adiponectin correlated negatively with insulin resistance (rs = -0.35; p = 0.01. In a regression analysis using fasting adiponectin concentration as the dependent variable, and age, HOMAIR, waist circumference, and fat mass as predictors, waist circumference (? = -3.30; p = 0.002, fat mass (? = -2.68; p = 0.01, and insulin resistance (? = -2.38; p = 0.02 but not age (? = 1.11; p = 0.27 were independent predictors of adiponectin. When considering gender, these relations persisted with the exception of waist circumference in females. Conclusion Adiponectin correlates in this study population are comparable to those observed in Caucasians with the exception of waist circumference in women. The metabolic significance of waist circumference is therefore questioned in sSA women.
Utilizing the stochastic frontier approach, this study conducts a comparative analysis of profit efficiency and cost inefficiency of commercial banks operating in 29 sub-Saharan African (SSA) countries by bank ownership (domestic bank, SSA foreign bank or non-SSA foreign bank), as well as by the bank size during 2000-07. Tobit regressions are employed to assess the impact of environmental factors on the efficiency of commercial banks. The key findings of this empirical analysis suggest that f...
This paper draws on rich ethnographic data and complementary survey research from a three-country study (Ghana, Malawi, South Africa) of young peoples mobility to explore the gendered nature of childrens journeys to school in sub-Saharan Africa. In most African countries, girls participation in formal education is substantially lower than boys, especially at secondary school level. Transport and mobility issues often form an important component of this story, though the precise patterning...
Financing of agriculture by commercial and non-commercial institutions in rural Sub-Saharan African in recent years has being relatively constant despite remarkable increase in the number of institutions operating within this area. This development may be attributed to how these institutions rate the business of agriculture and the risks involved. However the slow pace of financing sustainable agriculture such as bio-based economy in the presence of internationaliza...
Ndikumana, Léonce; Verick, Sher
While the recent increase in foreign direct investment (FDI) to African countries is a welcome development, the question remains as to the impact of these resource inflows on economic development. This study posits that a key channel of the impact of FDI on development is through its effects on domestic factor markets, especially domestic investment and employment. In this context, this study analyses the two-way linkages between FDI and domestic investment in Sub-Saharan Africa. The results ...
Perlman, Stacey; Wamai, Richard G; Bain, Paul A.; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon
Objectives: We assessed the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate in sub-Saharan African (SSA) countries. We further identified countries that fulfill the two GAVI Alliance eligibility criteria to support nationwide HPV vaccination. Methods: We conducted a systematic review of peer-reviewed studies on the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate. Tre...
Gyimah, Nana Afua Boamah; Tita, Bertrand Asongwe
One of the major reasons for political instability in Sub-Saharan Africa originates from the way elections are conducted. Most African countries have quite a handful of electoral malpractices which lead to political instability, civil wars and low economic growth. Electronic voting might be a solution to the election problems and thus bring in a stable political atmosphere which attracts investors. This thesis looks at the prospects and challenges of implementing e-voting in Ghana and Sub-Sa...
Chersich, Matthew F.; Stanley Luchters; Innocent Ntaganira; Antonio Gerbase; Ying-Ru Lo; Fiona Scorgie; Richard Steen
Introduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods: We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes...
Renzaho, Andre M. N.
Background Diabetes is one of the non-communicable diseases (NCDs) which is rising significantly across sub-Saharan African (SSA) countries and posing a threat to the social, economic, and cultural fabric of the SSA population. The inclusion of NCDs into the post-2015 development agenda along with the global monitoring framework provides an opportunity to monitor progress of development programmes in developing countries. This paper examines challenges associated with dealing with diabetes within the development agenda in SSA and explores some policy options. Design This conceptual review draws from a range of works published in Medline and the grey literature to advance the understanding of the post-2015 development agenda and how it relates to NCDs. The paper begins with the burden of diabetes in sub-Sahara Africa and then moves on to examine challenges associated with diabetes prevention, treatment, and management in Africa. It finishes by exploring policy implications. Results With regards to development programmes on NCDs in the SSA sub-continent, several challenges exist: 1) poor documentation of risk factors, 2) demographic transitions (rapid urbanisation and ageing), 3) the complementary role of traditional healers, 4) tuberculosis and the treatment of the acquired immunodeficiency syndrome as risk factors for diabetes, 5) diabetes in complex emergencies, 6) diabetes as an international development priority and not a policy agenda for many SSA countries, and 7) poorly regulated food and beverage industry. Conclusion For the post-2015 development agenda for NCDs to have an impact, sufficient investments will be needed to address legislative, technical, human, and fiscal resource constraints through advocacy, accountability, political leadership, and effective publicprivate partnership. Striking the right balance between competing demands and priorities, policies, and implementation strategies hold the key to an effective response to diabetes in SSA countries. PMID:25994288
Andre M. N. Renzaho
Full Text Available Background: Diabetes is one of the non-communicable diseases (NCDs which is rising significantly across sub-Saharan African (SSA countries and posing a threat to the social, economic, and cultural fabric of the SSA population. The inclusion of NCDs into the post-2015 development agenda along with the global monitoring framework provides an opportunity to monitor progress of development programmes in developing countries. This paper examines challenges associated with dealing with diabetes within the development agenda in SSA and explores some policy options. Design: This conceptual review draws from a range of works published in Medline and the grey literature to advance the understanding of the post-2015 development agenda and how it relates to NCDs. The paper begins with the burden of diabetes in sub-Sahara Africa and then moves on to examine challenges associated with diabetes prevention, treatment, and management in Africa. It finishes by exploring policy implications. Results: With regards to development programmes on NCDs in the SSA sub-continent, several challenges exist: 1 poor documentation of risk factors, 2 demographic transitions (rapid urbanisation and ageing, 3 the complementary role of traditional healers, 4 tuberculosis and the treatment of the acquired immunodeficiency syndrome as risk factors for diabetes, 5 diabetes in complex emergencies, 6 diabetes as an international development priority and not a policy agenda for many SSA countries, and 7 poorly regulated food and beverage industry. Conclusion: For the post-2015 development agenda for NCDs to have an impact, sufficient investments will be needed to address legislative, technical, human, and fiscal resource constraints through advocacy, accountability, political leadership, and effective publicprivate partnership. Striking the right balance between competing demands and priorities, policies, and implementation strategies hold the key to an effective response to diabetes in SSA countries.
Bram De Jonge
Full Text Available Sub-Saharan African countries, through their regional organizations, have embarked on the harmonisation of plant variety protection (PVP systems. These initiatives are largely modelled on the UPOV 1991 act, which claims to incentivize plant breeding and facilitate agricultural development. Civil Society Organisations (CSO, however, strongly criticise this process for being out of step with Sub-Saharan African agricultural realities, undermining smallholder farmers agricultural practices and, ultimately, threatening food security. Among their main concerns are the fear that the proposed regimes facilitate biopiracy and lack recognition of farmers rights. This article discussed three of the main CSO concerns in tandem with examples of alternative provisions from PVP systems from around the world. While it will be shown that the CSO concerns are not likely to be acted upon, this article aims to answer the pressing question whether a UPOV 91 based PVP system hampers farming practices in developing countries, and explores several legal avenues to accommodate the needs and traditions of smallholder farmers.
Full Text Available A growing body of scholarly literature suggests confluence or even convergence of organized crime and terrorism in various parts of the world. However, links remain somewhat nebulous at this stage and vary considerably, based on region and context. Africa has come under the spotlight due to perceived weaknesses in the criminal justice sector, limited law enforcement capacity, political and systemic corruption, poor border patrol and weak anti-terror and organized crime laws which are believed to provide an ideal environment for the terror-crime nexus to flourish. This article provides an African perspective on the links between organized crime and terror networks in Sub-Saharan Africa, with a particular focus on Southern Africa. The discussion begins with an overview of the theoretical discourse on the subject relying on African definitions of the contested concepts of terrorism and organized crime and will then narrow the analysis on the sub-Saharan case. It relies on an extensive literature review and concludes with empirical findings of a research project on organized crime in Southern Africa, which found no strong empirical links between criminal and terrorist organizations.
Full Text Available Community-acquired pneumonia causes substantial morbidity and mortality in sub-Saharan Africa with an estimated 131 million new cases each year. Viruses such as influenza virus, respiratory syncytial virus and parainfluenza virus are now recognised as important causes of respiratory disease in older children and adults in the developed world following the emergence of sensitive molecular diagnostic tests, recent severe viral epidemics, and the discovery of novel viruses. Few studies have comprehensively evaluated the viral aetiology of adult pneumonia in Africa, but it is likely to differ from Western settings due to varying seasonality and the high proportion of patients with immunosuppression and co-morbidities. Emerging data suggest a high prevalence of viral pathogens, as well as multiple viral and viral/bacterial infections in African adults with pneumonia. However, the interpretation of positive results from highly sensitive polymerase chain reaction tests can be challenging. Therapeutic and preventative options against viral respiratory infections are currently limited in the African setting. This review summarises the current state of the epidemiology, aetiology, diagnosis and management of viral pneumonia in sub-Saharan Africa.
Hall, Victoria; Thomsen, Reimar W
ABSTRACT: BACKGROUND: Diabetes prevalence is increasing globally, and Sub-Saharan Africa is no exception. With diverse health challenges, health authorities in Sub-Saharan Africa and international donors need robust data on the epidemiology and impact of diabetes in order to plan and prioritise their health programmes. This paper aims to provide a comprehensive and up-to-date review of the epidemiological trends and public health implications of diabetes in Sub-Saharan Africa. METHODS: We conducted a systematic literature review of papers published on diabetes in Sub-Saharan Africa 1999-March 2011, providing data on diabetes prevalence, outcomes (chronic complications, infections, and mortality), access to diagnosis and care and economic impact. RESULTS: Type 2 diabetes accounts for well over 90% of diabetes in Sub-Saharan Africa, and population prevalence proportions ranged from 1% in rural Uganda to 12% in urban Kenya. Reported type 1 diabetes prevalence was low and ranged from 4 per 100,000 in Mozambique to 12 per 100,000 in Zambia. Gestational diabetes prevalence varied from 0% in Tanzania to 9% in Ethiopia. Proportions of patients with diabetic complications ranged from 7-63% for retinopathy, 27-66% for neuropathy, and 10-83% for microalbuminuria. Diabetes is likely to increase the risk of several important infections in the region, including tuberculosis, pneumonia and sepsis. Meanwhile, antiviral treatment for HIV increases the risk of obesity and insulin resistance. Five-year mortality proportions of patients with diabetes varied from 4-57%. Screening studies identified high proportions (>40%) with previously undiagnosed diabetes, and low levels of adequate glucose control among previously diagnosed diabetics. Barriers to accessing diagnosis and treatment included a lack of diagnostic tools and glucose monitoring equipment and high cost of diabetes treatment. The total annual cost of diabetes in the region was estimated at US$67.03 billion, or US$8836 per diabetic patient. CONCLUSION: Diabetes exerts a significant burden in the region, and this is expected to increase. Many diabetic patients face significant challenges accessing diagnosis and treatment, which contributes to the high mortality and prevalence of complications observed. The significant interactions between diabetes and important infectious diseases highlight the need and opportunity for health planners to develop integrated responses to communicable and non-communicable diseases.
Full Text Available Abstract Background Diabetes prevalence is increasing globally, and Sub-Saharan Africa is no exception. With diverse health challenges, health authorities in Sub-Saharan Africa and international donors need robust data on the epidemiology and impact of diabetes in order to plan and prioritise their health programmes. This paper aims to provide a comprehensive and up-to-date review of the epidemiological trends and public health implications of diabetes in Sub-Saharan Africa. Methods We conducted a systematic literature review of papers published on diabetes in Sub-Saharan Africa 1999-March 2011, providing data on diabetes prevalence, outcomes (chronic complications, infections, and mortality, access to diagnosis and care and economic impact. Results Type 2 diabetes accounts for well over 90% of diabetes in Sub-Saharan Africa, and population prevalence proportions ranged from 1% in rural Uganda to 12% in urban Kenya. Reported type 1 diabetes prevalence was low and ranged from 4 per 100,000 in Mozambique to 12 per 100,000 in Zambia. Gestational diabetes prevalence varied from 0% in Tanzania to 9% in Ethiopia. Proportions of patients with diabetic complications ranged from 7-63% for retinopathy, 27-66% for neuropathy, and 10-83% for microalbuminuria. Diabetes is likely to increase the risk of several important infections in the region, including tuberculosis, pneumonia and sepsis. Meanwhile, antiviral treatment for HIV increases the risk of obesity and insulin resistance. Five-year mortality proportions of patients with diabetes varied from 4-57%. Screening studies identified high proportions (> 40% with previously undiagnosed diabetes, and low levels of adequate glucose control among previously diagnosed diabetics. Barriers to accessing diagnosis and treatment included a lack of diagnostic tools and glucose monitoring equipment and high cost of diabetes treatment. The total annual cost of diabetes in the region was estimated at US$67.03 billion, or US$8836 per diabetic patient. Conclusion Diabetes exerts a significant burden in the region, and this is expected to increase. Many diabetic patients face significant challenges accessing diagnosis and treatment, which contributes to the high mortality and prevalence of complications observed. The significant interactions between diabetes and important infectious diseases highlight the need and opportunity for health planners to develop integrated responses to communicable and non-communicable diseases.
Full Text Available Half of the 10 million children who die annually in the world are from Sub-Saharan Africa (SSA. The reasons are known, but lack of will and resources avoid the development of sustainable policies. Associated factors to the high infant mortality rate (IMR in SSA have been investigated in this research. An ecological multi-group study was designed comparing rates within SSA. The dependent variable is the IMR and health services, economic and development indicators are the independent variables. Information and data sources were WHO, World Bank, UNICEF and UNDP (1997-2007. IMR mean value is 92.2 (per 1000 live births and a relationship with several of the factors could be observed. In the bi-variate analysis direct relationship was observed with maternal mortality rate and an inverse relationship was observed with prenatal care coverage, births assisted by skilled health personnel, gross national income per capita, per capita government expenditure on health, social security expenditure, adult literacy rate, net primary school enrolment rate, population with access to safe drinking water (in urban and rural areas and with population with access to basic sanitation in rural areas. In the multi-variate analysis IMR had an inverse relationship with children under 5 years with diarrhoea who receive oral re-hydration, with social security expenditure as percentage of general government expenditure on health and with per capita government expenditure on health. The situation in SSA would change if their inhabitants received education and information to demand more equitable polices and better investments from their governments.
Lewin, Keith M.
This paper makes the case for managed expansion of secondary schooling in Sub-Saharan Africa. The great majority of secondary age African children remain excluded from access to good quality secondary schooling. Increasing numbers are graduating from primary schools where enrolments are rapidly growing as a result of successful Education for All
Baker, David P.; Collins, John M.; Leon, Juan
Numerous epidemiological studies from the early years of the tragic HIV and AIDS pandemic in sub-Saharan Africa identified formal education as a risk factor increasing the chance of infection. Instead of playing its usual role as a preventative factor, as has been noted in many other public health cases, until the mid-1990s educated African men
This bibliography concerns the existing scientific literature on different aspects of rural employment. It contains 301 references, listed in alphabetical order by author. The references are either of a general nature or concern the situation in the countries of sub-Saharan Africa. Also included are subject and country indexes. The introduction provides some background information on employment generation in rural areas.
Mutula, Stephen M.
Purpose: Seeks to argue that the peculiarities of sub-Saharan Africa, in terms of its socio-cultural diversity, low economic development, linguistic factors, HIV/AIDS pandemic, gender discrimination, low ICT awareness and so on, demand a new model of addressing the digital divide. Design/methodology/approach: Paper largely based on literature
Chukwuemeka Afigbo; Steven Muegge
SW Global is an African-based application service provider of information technology infrastructure and software. This article describes how SW Global, a for-profit private sector company, creates high-impact value at universities and governments in developing countries through an innovative business model anchored around service subscriptions, open source software, and open content.
Gurdasani, Deepti; Carstensen, Tommy; Tekola-Ayele, Fasil; Pagani, Luca; Tachmazidou, Ioanna; Hatzikotoulas, Konstantinos; Karthikeyan, Savita; Iles, Louise; Pollard, Martin O.; Choudhury, Ananyo; Ritchie, Graham R. S.; Xue, Yali; Asimit, Jennifer; Nsubuga, Rebecca N.; Young, Elizabeth H.; Pomilla, Cristina; Kivinen, Katja; Rockett, Kirk; Kamali, Anatoli; Doumatey, Ayo P.; Asiki, Gershim; Seeley, Janet; Sisay-Joof, Fatoumatta; Jallow, Muminatou; Tollman, Stephen; Mekonnen, Ephrem; Ekong, Rosemary; Oljira, Tamiru; Bradman, Neil; Bojang, Kalifa; Ramsay, Michele; Adeyemo, Adebowale; Bekele, Endashaw; Motala, Ayesha; Norris, Shane A.; Pirie, Fraser; Kaleebu, Pontiano; Kwiatkowski, Dominic; Tyler-Smith, Chris; Rotimi, Charles; Zeggini, Eleftheria; Sandhu, Manjinder S.
Given the importance of Africa to studies of human origins and disease susceptibility, detailed characterization of African genetic diversity is needed. The African Genome Variation Project provides a resource with which to design, implement and interpret genomic studies in sub-Saharan Africa and worldwide. The African Genome Variation Project represents dense genotypes from 1,481 individuals and whole-genome sequences from 320 individuals across sub-Saharan Africa. Using this resource, we find novel evidence of complex, regionally distinct hunter-gatherer and Eurasian admixture across sub-Saharan Africa. We identify new loci under selection, including loci related to malaria susceptibility and hypertension. We show that modern imputation panels (sets of reference genotypes from which unobserved or missing genotypes in study sets can be inferred) can identify association signals at highly differentiated loci across populations in sub-Saharan Africa. Using whole-genome sequencing, we demonstrate further improvements in imputation accuracy, strengthening the case for large-scale sequencing efforts of diverse African haplotypes. Finally, we present an efficient genotype array design capturing common genetic variation in Africa.
Full Text Available Abstract Background The rapid urban malaria appraisal (RUMA methodology aims to provide a cost-effective tool to conduct rapid assessments of the malaria situation in urban sub-Saharan Africa and to improve the understanding of urban malaria epidemiology. Methods This work was done in Yopougon municipality (Abidjan, Cotonou, Dar es Salaam and Ouagadougou. The study design consists of six components: 1 a literature review, 2 the collection of available health statistics, 3 a risk mapping, 4 school parasitaemia surveys, 5 health facility-based surveys and 6 a brief description of the health care system. These formed the basis of a multi-country evaluation of RUMA's feasibility, consistency and usefulness. Results A substantial amount of literature (including unpublished theses and statistics was found at each site, providing a good overview of the malaria situation. School and health facility-based surveys provided an overview of local endemicity and the overall malaria burden in different city areas. This helped to identify important problems for in-depth assessment, especially the extent to which malaria is over-diagnosed in health facilities. Mapping health facilities and breeding sites allowed the visualization of the complex interplay between population characteristics, health services and malaria risk. However, the latter task was very time-consuming and required special expertise. RUMA is inexpensive, costing around 8,50013,000 USD for a six to ten-week period. Conclusion RUMA was successfully implemented in four urban areas with different endemicity and proved to be a cost-effective first approach to study the features of urban malaria and provide an evidence basis for planning control measures.
Full Text Available Although schools are generally regarded as a 'safe haven' for children, the reality for many girls is that schools can be a place of sexual discrimination, harassment and violence, perpetrated by fellow male students and teachers alike. The widespread problem of sexual and gender-based violence, par [...] ticularly sexual violence, in schools has been well-documented in a range of studies and reports in sub-Saharan Africa. Sexual and gender-based violence in schools not only violates girls' fundamental rights to dignity and equality, and their rights to be free from violence, but it also undermines their rights to education, particularly when, as is often the case, states fail to take measures to protect girls. Although there is a growing body of empirical research documenting the nature and extent of this problem, particularly in various sub-Saharan African countries, how regional and international human rights law applies to protect girls in this situation appears to have received limited consideration. This article attempts to fill this gap in the literature, by providing an analysis of the problem of sexual and gender-based violence in schools within the framework of regional and international human rights law. The article's objective is to identify and discuss rights-based legal strategies to combat this pervasive human rights violation, specifically within the sub-Saharan African context, with an emphasis on regional developments and regional responses.
Dray, James Daniel; Tilley, James; Wiliams, Gavin
This thesis addresses the question of who votes in Africa and why. It uses three sets of quantitative data at three different levels to test its claims: an original compilation of national level institutional and socioeconomic indicators for over 700 elections from independence until 2006 compiled by the author; the Afrobarometer survey of almost 50 000 voters in 17 multiparty African regimes; and the first ever purpose-built survey aimed at testing rational choice turnout models in an Africa...
Full Text Available As Chinas footprint in African trade grows larger by the day, the need to contextualize this rise through comparative analysis becomes ever more necessary. This paper contrasts the sub-Saharan trade relations of both China and Europe with their respective designated stereotypes: those of a dragon and a dove. The article compares the trade dynamics on four levels: the policies and institutional mechanisms that shape the relationship; the composition of the trade flows; the geographic distribution of trade dominance; and the influence of norms and values on the trade pattern. It concludes that although there are empirical grounds behind these stereotypes, Chinese and European trade relations with sub-Saharan Africa are becoming more similar, partly due to a more hawkish European stance.
Sheppard Walter S.; Rinderer Thomas E.; Garnery Lionel; Shimanuki Hachiro
Within the past 40 years, Africanized honey bees spread from Brazil and now occupy most areas habitable by the species Apis mellifera, from Argentina to the southwestern United States. The primary genetic source for Africanized honey bees is believed to be the sub-Saharan honey bee subspecies A. m. scutellata. Mitochondrial markers common in A. m. scutellata have been used to classify Africanized honey bees in population genetic and physiological studies. Assessment of composite mitochondrial...
Full Text Available Abstract Background End of life (EoL care in sub-Saharan Africa still lacks the sound evidence-base needed for the development of effective, appropriate service provision. It is essential to make evidence from all types of research available alongside clinical and health service data, to ensure that EoL care is ethical and culturally appropriate. This article aims to synthesize qualitative research on EoL care in sub-Saharan Africa to inform policy, practice and further research. It seeks to identify areas of existing research; describe findings specifically relevant to the African context; and, identify areas lacking evidence. Methods Relevant literature was identified through eight electronic databases: AMED, British Nursing Index & Archive, CINAHL, EMBASE, IBSS, MEDLINE, PsycINFO, and the Social Sciences Citation Index; and hand searches. Inclusion criteria were: published qualitative or mixed-method studies in sub-Saharan Africa, about EoL care. Study quality was assessed using a standard grading scale. Relevant data including findings and practice recommendations were extracted and compared in tabular format. Results Of the 407 articles initially identified, 51 were included in the qualitative synthesis. Nineteen came from South Africa and the majority (38 focused on HIV/AIDS. Nine dealt with multiple or unspecified conditions and four were about cancer. Study respondents included health professionals, informal carers, patients, community members and bereaved relatives. Informal carers were typically women, the elderly and children, providing total care in the home, and lacking support from professionals or the extended family. Twenty studies focused on home-based care, describing how programmes function in practice and what is needed to make them effective. Patients and carers were reported to prefer institutional care but this needs to be understood in context. Studies focusing on culture discussed good and bad death, culture-specific approaches to symptoms and illness, and the bereavement process. Conclusions The data support or complement the findings from quantitative research. The review prompts a reconsideration of the assumption that in Africa the extended family care for the sick, and that people prefer home-based care. The review identifies areas relevant for a research agenda on socio-cultural issues at the EoL in sub-Saharan Africa.
Full Text Available Abstract Background Leadership is widely regarded as central to effective health-care systems, and resources are increasingly devoted to the cultivation of strong health-care leadership. Nevertheless, the literature regarding leadership capacity building has been developed primarily in the context of high-income settings. Less research has been done on leadership in low-income settings, including sub-Saharan Africa, particularly in health care, with attention to historical, political and sociocultural context. We sought to characterize the experiences of individuals in key health-care leadership roles in sub-Saharan Africa. Methods We conducted a qualitative study using in-person interviews with individuals (n?=?17 in health-care leadership roles in four countries in sub-Saharan Africa: the Federal Democratic Republic of Ethiopia, the Republic of Ghana, the Republic of Liberia and the Republic of Rwanda. Individuals were identified by their countrys minister of health as key leaders in the health sector and were nominated to serve as delegates to a global health leadership conference in June 2010, at Yale University in the United States. Interviews were audio recorded and professionally transcribed. Data analysis was performed by a five-person multidisciplinary team using the constant comparative method, facilitated by ATLAS.ti 5.0 software. Results Five key themes emerged as important to participants in their leadership roles: having an aspirational, value-based vision for improving the future health of the country, being self-aware and having the ability to identify and use complementary skills of others, tending to relationships, using data in decision making, and sustaining a commitment to learning. Conclusions Current models of leadership capacity building address the need for core technical and management competencies. While these competencies are important, skills relevant to managing relationships are also critical in the sub-Saharan African context. Developing such skills may require more time and a deeper level of engagement and collaboration than is typically invested in efforts to strengthen health systems.
Koelling, Fritz [Sustainable Energy and Environment, Karlsruhe (Germany); Gaul, Mirco; Schroeder, Miriam [SiNERGi Consultancy for Renewable Energies, Berlin (Germany)
The vast potential of mini and micro hydro power (MHP) in Sub-Saharan African countries is one promising option to cover increasing energy demand and to enable electricity access for remote rural communities. Based on the analysis of 6 African countries (Ethiopia, Kenya, Mozambique, Nigeria, Rwanda, South Africa), this study sheds light on some of the main barriers on the level of political and regulatory framework conditions which include gap between the national-level policies and regulations and local MHP project implementation, lack of financing and limited capacities for project planning, building and operation. The paper also identifies some promising practices employed in several SSA countries of how to overcome these barriers and concludes with recommendations of how to create positive feed-backs between ambitious policies and regulations and MHP financing and capacity development needs in order to scale up MHP deployment and MHP sector development. (orig.)
Full Text Available This study presents a summary overview of the carbon balance of Sub-Saharan Africa (SSA by synthesizing the available data from national communications to UNFCCC and first results from the project CarboAfrica (net ecosystem productivity and emissions from fires, deforestation and forest degradation, by field and model estimates. According to these preliminary estimates the overall carbon balance of SSA varies from 0.43 Pg C y?1 (using in situ measurements for savanna NEP to a much higher sink of 2.53 Pg C y?1 (using model estimates for savanna NEP. UNFCCC estimates lead to a moderate carbon sink of 0.58 Pg C y?1. Excluding anthropogenic disturbance and intrinsic episodic events, the carbon uptake by forests (0.98 Pg C y?1 and savannas (from 1.38 to 3.48 Pg C y?1, depending on the used methodology are the main components of the SSA sink effect. Fires (0.72 Pg C y?1, deforestation (0.25 Pg C y?1 and forest degradation (0.77 Pg C y?1 are the main contributors to the SSA carbon emissions, while the agricultural sector contributes only with 0.12 Pg C y?1. Notably, the impact of forest degradation is higher than that caused by deforestation, and the SSA forest net carbon balance is close to equilibrium. Savannas play a major role in shaping the SSA carbon balance, due to their large areal extent, their fire regime, and their strong interannual NEP variability, but they are also a major uncertainty in the overall budget. This paper shows that Africa plays a key role in the global carbon cycle system and probably could have a potential for carbon sequestration higher than expected, even if still highly uncertain. Further investigations are needed, particularly to better address the role of savannas and tropical forests. The current CarboAfrica network of carbon measurements could provide future unique data sets for better estimating the African carbon balance.
Scheibe, Andrew; Kanyemba, Brian; Syvertsen, Jennifer; Adebajo, Sylvia; Baral, Stefan
Despite consistent evidence, effective interventions and political declarations to reduce HIV infections among men who have sex with men (MSM), coverage of MSM programmes in sub-Saharan Africa (SSA) remains low. Punitive legal frameworks and hostile social circumstances and inadequate health systems further contribute to the high HIV burden among MSM in SSA. The authors use the Modified Social Ecological Model to discuss economic influences in relation to HIV and MSM in SSA. Nigerian, South African and Ugandan case studies are used to highlight economic factors and considerations related to HIV among MSM. The authors argue that criminalisation of consensual sexual practices among adults increases the frequency of human rights violations contributing to the incidence of HIV infections. Furthermore, marginalisation and disempowerment of MSM limits their livelihood opportunities, increases the prevalence of sex work and drug use and limits financial access to HIV services. Sexual and social networks are complex and ignoring the needs of MSM results in increased risks for HIV acquisition and transmission to all sexual partners with cumulative economic and health implications. The authors recommend a public health and human rights approach that employs effective interventions at multiple levels to reduce the HIV burden among MSM and the general population in SSA. PMID:26050380
Full Text Available The signatory countries of the Convention on Biological Diversity set the objective of halting the decline of biodiversity by 2010, but as the target date arrived and passed, the status of biodiversity on the planet remained dismal. With the dawn of the UN Decade for Biodiversity at the Rio+20 Earth Summit in June 2012 and as the UN Biodiversity Strategic Plan moves forward, this article contextualizes biodiversity prospects in sub-Saharan Africa by examining the history of interactions between African communities and the environment, from the pre-colonial period to today. It provides a critical analysis of the current biodiversity conservation planning methodologies and pinpoints several inherent obstacles, including the neo-Malthusianism that dominates the thinking of certain wildlife experts. Setting out an argument with far-reaching implications for the success of future conservation efforts all over the world, the author examines the basis of emerging conservation approaches in sub-Saharan Africa, focusing on the need to forge a more inclusive conservation practice and open up to the perceptions, representations and cultural universe of the Other.
Kofi B. Afful
Full Text Available This study examines the effectiveness of the state in stimulating stock market activity in sub-Saharan Africa (SSA using fiscal policy, governance quality and stock market as the main determinant variables. Using annual data from six selected sub-Saharan African economies and employing a dynamic panel data estimating technique, we find that government effectiveness stimulates capitalization while business regulations decrease it in SSA. In addition, we find that final consumption expenditure, interest rate spread and credit to the state increase capitalization whereas credit to the private sector and inflation had adverse effects. With respect to business regulations, our study reveals that starting a business, closing it and enforcing contracts engender stock market activity in SSA. Among the several variables that stimulate stock market activity; only foreign direct investment (FDI did increase capitalization. Thus, the study concludes that since not all government institutions and business regulations are critical to stock market development, various governments should be careful and selective in their economic stimulants if they want to develop their stock markets.
Full Text Available Background: This study described the current conditions of work of paediatric surgeons in Francophone sub-Saharan Africa (FSSA and set the debate at the level of the humanist thinking in medicine. Patients and Methods: This was a multicentre study from 1 st May to 30 th October 2008. The African Society of paediatric surgeons? directory was used to identify paediatric surgeons in the Francophone?s countries in Sub Saharan Africa. The parameters studied were number of surgeons per country, means of training, working conditions, remunerations, needs for continuous training and the research. Results: A total of 41 paediatric surgeons (68.33% responded. The average number of paediatric surgeons per country was 5. The means of training included government scholarships among 7 paediatric surgeons (17.07%, scholarship from a non-governmental organisations in 14 (34.15% and self-sponsorships in 20 (48.78%. The average salary was 450 Euros ( (range: 120-1 400 Euros. Most of the paediatric surgeons (68.29% had internet services for continuous update courses and research. Thirty six paediatric surgeons (87.80% had no subscription to specialised scientific journals. Conclusion: The paediatric surgeon in FSSA faces many problems related to his working and living conditions that may have a negative impact on their competences.
Muuka, Geoffrey; Songolo, Nadi; Kabilika, Swithine; Hang'ombe, Bernard M; Nalubamba, King S; Muma, John B
Contagious bovine pleuropneumonia (CBPP) is a disease of economic importance that is widely distributed in sub-Saharan African and contributes significantly to cattle morbidity and mortality. Control of CBPP offers a number of challenges as a result many developing countries in Africa are still struggling with this disease. In this study, we look at the challenges encountered in CBPP control in sub-Saharan Africa from the Zambian perspective. In conducting this study, we reviewed scientific literature and reports from the Ministry of Agriculture and Livestock and related animal institutions, and also made interviews with experts and key government officials involved in CBPP control in Zambia. Among the challenges identified for the successful control of CBPP were as follows: failure in the delivery of veterinary services, lack of a cattle identification system, natural phenomenon, livestock husbandry systems in the traditional sector, human movements, traditional practices among cattle farmers and cattle marketing systems. It was seen that the epidemiology of CBPP in Zambia is influenced by both ecological and anthological factors. Therefore, design and implementation of any control or eradication programme should be area/regional-dependent taking into account the different factors influencing disease transmission and maintenance. PMID:22843213
Georgios K. Bountagkidis
Full Text Available The EU and most aid donors invoke a strong normative power face by explicitly connecting foreign aid with human and social development. However, how well the EUs rhetoric is consistent with its practices as a multilateral development actor has not been explored extensively. In this study, we challenge the normative dimension of the EUs development policy and explore whether the EUs Official Development Assistance to Sub-Saharan Africa is based on objective deprivation on the part of recipient countries or whether it is interest driven. We use a least squares dummy variable model regression to examine aid flows from the EU to all 48 Sub-Saharan African states for the period 2000 to 2010. The evidence found indicates that in certain instances, aid allocation contradicts the normative rhetoric that the EU uses to describe its development policy, as the donors own interests in the region seem to supersede priority given to the needs of the aid recipient states. A limitation to the findings is the fact that normative values and strategic interests are not mutually exclusive. Nevertheless, the present study suggests that the EUs portrayal as a force for good in international relations requires cautious critique.
Debats, S. R.; Luo, D.; Estes, L. D.; Fuchs, T.; Caylor, K. K.
Sub-Saharan Africa is an important focus for food security research, because it is experiencing unprecedented population growth, agricultural activities are largely dominated by smallholder production, and the region is already home to 25% of the world's undernourished. One of the greatest challenges to monitoring and improving food security in this region is obtaining an accurate accounting of the spatial distribution of agriculture. Households are the primary units of agricultural production in smallholder communities and typically rely on small fields of less than 2 hectares. Field sizes are directly related to household crop productivity, management choices, and adoption of new technologies. As population and agriculture expand, it becomes increasingly important to understand both the distribution of field sizes as well as how agricultural communities are spatially embedded in the landscape. In addition, household surveys, a common tool for tracking agricultural productivity in Sub-Saharan Africa, would greatly benefit from spatially explicit accounting of fields. Current gridded land cover data sets do not provide information on individual agricultural fields or the distribution of field sizes. Therefore, we employ cutting edge approaches from the field of computer vision to map fields across Sub-Saharan Africa, including semantic segmentation, discriminative classifiers, and automatic feature selection. Our approach aims to not only improve the binary classification accuracy of cropland, but also to isolate distinct fields, thereby capturing crucial information on size and geometry. Our research focuses on the development of descriptive features across scales to increase the accuracy and geographic range of our computer vision algorithm. Relevant data sets include high-resolution remote sensing imagery and Landsat (30-m) multi-spectral imagery. Training data for field boundaries is derived from hand-digitized data sets as well as crowdsourcing.
Mereu, V.; Spano, D.; Gallo, A.; Carboni, G.
Agriculture in Sub-Saharan Africa (SSA) drives the economy of many African countries and it is mainly rain-fed agriculture used for subsistence. Increasing temperatures, changed precipitation patterns and more frequent droughts may lead to a substantial decrease of crop yields. The projected impacts of future climate change on agriculture are expected to be significant and extensive in the SSA due to the shortening of the growing seasons and the increasing of water-stress risk. Differences in Agro-Ecological Zones and geographical characteristics of SSA influence the diverse impacts of climate change, which can greatly differ across the continent and within countries. The vulnerability of African Countries to climate change is aggravated by the low adaptive capacity of the continent, due to the increasing of its population, the widespread poverty, and other social factors. In this contest, the assessment of climate change impact on agricultural sector has a particular interest to stakeholder and policy makers, in order to identify specific agricultural sectors and Agro-Ecological Zones that could be more vulnerable to changes in climatic conditions and to develop the most appropriate policies to cope with these threats. For these reasons, the evaluation of climate change impacts for key crops in SSA was made exploring climate uncertainty and focusing on short period monitoring, which is particularly useful for food security and risk management analysis. The DSSAT-CSM (Decision Support System for Agrotechnology Transfer - Cropping System Model) software, version 4.5 was used for the analysis. Crop simulation models included in DSSAT-CSM are tools that allow to simulate physiological process of crop growth, development and production, by combining genetic crop characteristics and environmental (soil and weather) conditions. For each selected crop, the models were used, after a parameterization phase, to evaluate climate change impacts on crop phenology and production. Multiple combinations of soils and climate conditions, crop management and varieties were considered for the different Agro-Ecological Zones. The climate impact was assessed using future climate prediction, statistically and/or dynamically downscaled, for specific areas. Direct and indirect effects of different CO2 concentrations projected for the future periods were separately explored to estimate their effects on crops. Several adaptation strategies (e.g., introduction of full irrigation, shift of the ordinary sowing/planting date, changes in the ordinary fertilization management) were also evaluated with the aim to reduce the negative impact of climate change on crop production. The results of the study, analyzed at local, AEZ and country level, will be discussed.
This study analyses the outcomes of independent power projects (IPPs) across Sub-Saharan Africa. Approximately 20 such projects have taken root to date, concentrated mainly in 8 countries. A suite of country level and project level factors play a critical role in determining project success, chief among them: the manner in which planning, procurement and contracting are coherently linked, the role of development finance institutions along with the development origins of firms and credit enhancements. - Highlights: ? We analyse the outcomes of independent power projects (IPPs) across Sub-Saharan Africa. ? Approximately 20 IPPs have taken root to date, concentrated mainly in 8 countries. ? A suite of country level and project level factors play a critical role in determining project success. ? Key success factors are the coherence of planning, procurement and contracting. ? Also important is the role of DFIs, the development origins of firms, and credit enhancements.
Kaul, Rupert; Prodger, Jessica; Joag, Vineet; Shannon, Brett; Yegorov, Sergey; Galiwango, Ronald; McKinnon, Lyle
While the per-contact risk of sexual HIV transmission is relatively low, it is fourfold higher in sub-Saharan Africa, and this may partly explain the major global disparities that exist in HIV prevalence. Genital immune parameters are key determinants of HIV transmission risk, including epithelial integrity and the presence of highly HIV-susceptible intraepithelial or submucosal CD4+ T cell target cells. Biological parameters that may enhance mucosal HIV susceptibility in highly HIV-affected regions of sub-Saharan Africa include increased levels of mucosal inflammation, which can affect both epithelial integrity and target cell availability, as well as the increased mucosal surface area that is afforded by an intact foreskin, contraceptive choices, and intravaginal practices. There are multifactorial causes for increased mucosal inflammation, with the prevalence and nature of common co-infections being particularly relevant. PMID:25877253
Ana Paula F., Mendes; Mário A., Bertella; Rudolph F. A. P., Teixeira.
Full Text Available This article aims to contribute to the understanding of the process of import substitution in Sub-Saharan Africa. The process of industrialization in Sub-Saharan Africa occurred in two phases: a first step, even very early during the colonial regime began around the 1920s and ended in the late forti [...] es; a second phase of industrialization began in the late fifties and gained momentum in the sixties, when import substitution was implemented more widely. Although these countries were the last to embark on the strategy of import substitution, they followed the same steps of Latin American countries, and as the structural domestic and external constraints were too strong, the failure of the policy of import substitution arrived early and the negative impact on these economies had a greater magnitude.
Recent years have seen a considerable shift in economic conditions in sub-Saharan Africa. Economic growth has been robust, international reserves are on the rise and levels of external debt are falling. Combined with the global boom in commodity prices, as well as expansion of Chinese interests in the region, international investors are increasingly viewing Africa as a serious investment option. As a result of these trends, the landscape in which foreign donors have operated is changing rapid...
Slayton, Rachel B.; Date, Kashmira A.; Mintz, Eric D
New data on the epidemiologic, clinical and microbiologic aspects of typhoid fever in sub-Saharan Africa call for new strategies and new resources to bring the regional epidemic under control. Areas with endemic disease at rates approaching those in south Asia have been identified; large, prolonged and severe outbreaks are occurring more frequently; and resistance to antimicrobial agents, including fluoroquinolones is increasing. Surveillance for typhoid fever is hampered by the lack of labor...
Graham, R.L.; Perlack, R.D.; Prasad, A.M.G.; Ranney, J.W.; Waddle, D.B.
Current and future carbon emissions from land-use change and energy consumption were analyzed for Sub-Saharan Africa. The energy sector analysis was based on UN energy data tapes while the land-use analysis was based on a spatially-explicit land-use model developed specifically for this project. The impacts of different energy and land-use strategies on future carbon emissions were considered. (A review of anthropogenic emissions of methane, nitrous oxides, and chlorofluorocarbons in Sub-Saharan Africa indicated that they were probably minor in both a global and a regional context. The study therefore was focused on emissions of carbon dioxide.) The land-use model predicts carbon emissions from land use change and the amount of carbon stored in vegetation (carbon inventory) on a yearly basis between 1985 and 2001. Emissions and inventory are modeled at 9000 regularly-spaced point locations in Sub-Saharan Africa using location-specific information on vegetation type, soils, climate and deforestation. Vegetation, soils, and climate information were derived from continental-scale maps while relative deforestation rates(% of forest land lost each year) were developed from country-specific forest and deforestation statistics (FAO Tropical Forest Resources Assessment for Africa, 1980). The carbon emissions under different land use strategies in Sub-Saharan Africa were analyzed by modifying deforestation rates and altering the amount of carbon stored under different land uses. The considered strategies were: preservation of existing forests, implementation of agroforestry, and establishment of industrial tree plantations. 82 refs., 16 figs., 25 tabs.
Ogundipe, Adeyemi; Ogundipe, Oluwatomisin
This study examined the relationship between foreign aid and economic development in Sub Saharan Africa. The study seeks to examine the role of institutions in aid effectiveness in SSA countries by adopting a theoretical framework similar to the Endogenous/New Growth model and the System Generalized Method of Moments (GMM) technique of estimation in order to overcome the challenge of endogeneity perceived in the institution variables and Aid-Growth argument. It was observed that foreign aid d...
Ángel Gil; José M. Freire; Valentín Hernández; Pablo Viguera Ester; Alberto Torres
Half of the 10 million children who die annually in the world are from Sub-Saharan Africa (SSA). The reasons are known, but lack of will and resources avoid the development of sustainable policies. Associated factors to the high infant mortality rate (IMR) in SSA have been investigated in this research. An ecological multi-group study was designed comparing rates within SSA. The dependent variable is the IMR and health services, economic and development indicators are the independent variable...
Gouvras, Anouk N
Schistosomiasis is a chronic infection by a digean trematode of the genus Schistosoma. More than 207 million people are infected with this parasite, of which 120 million are symptomatic. There are two main species infecting humans in sub-Saharan Africa: Schistosoma haematobium and S. mansoni, both occur in areas with similar socio-economic and environmental conditions and often have matching distribution patterns. The principle aims of the research presented in this thesis were ...
Bhorat, Haroon; Kanbur, Ravi; Stanwix, Benjamin
Although the sectors and fraction of workers covered are small given the low rates of formality and urbanization in Sub-Saharan Africa (SSA), as the number of covered workers grows wage regulation will become increasingly significant. We find that higher minimum wage values are associated with higher GDP per capita. Importantly, however, we find that the minimum wage relative to the mean wage is higher in low income countries than in lower- and upper-middle income countries. Indeed, SSA as a ...
The focus of this chapter is on the economics of sub-Saharan African media. Using the history of sub-Saharan African newspapers as well as historical evidence from Europe and the United States, I study the emergence of market-oriented journalism and of an independent and informative press in sub-Saharan Africa. I document the extent to which sub-Saharan African newspapers have followed the same development steps than newspapers in other countries, moving from living off patronage and governme...
Stewart Sarah L
Full Text Available Abstract Background The cause of the high HIV prevalence in sub-Saharan Africa is incompletely understood, with heterosexual penile-vaginal transmission proposed as the main mechanism. Heterosexual HIV transmission has been estimated to have a very low probability; but effects of cofactors that vary in space and time may substantially alter this pattern. Methods To test the effect of individual variation in the HIV infectiousness generated by co-infection, we developed and analyzed a mathematical sexual network model that simulates the behavioral components of a population from Malawi, as well as the dynamics of HIV and the co-infection effect caused by other infectious diseases, including herpes simplex virus type-2, gonorrhea, syphilis and malaria. Results The analysis shows that without the amplification effect caused by co-infection, no epidemic is generated, and HIV prevalence decreases to extinction. But the model indicates that an epidemic can be generated by the amplification effect on HIV transmission caused by co-infection. Conclusion The simulated sexual network demonstrated that a single value for HIV infectivity fails to describe the dynamics of the epidemic. Regardless of the low probability of heterosexual transmission per sexual contact, the inclusion of individual variation generated by transient but repeated increases in HIV viral load associated with co-infections may provide a biological basis for the accelerated spread of HIV in sub-Saharan Africa. Moreover, our work raises the possibility that the natural history of HIV in sub-Saharan Africa cannot be fully understood if individual variation in infectiousness is neglected.
Flinkenflögel, Maaike; Essuman, Akye; Chege, Patrick; Ayankogbe, Olayinka; De Maeseneer, Jan
Background. Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. Objective. To explore the extent to which the Primafamed SouthSouth cooperative project contributed to the development of family medicine in sub-Saharan Africa. Methods. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. Results. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. Conclusions. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The SouthSouth cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels. PMID:24857843
Full Text Available Abstract Background HIV-related immune-suppression increases the risk of malaria (infection, disease and treatment failure and probably the circulating parasite biomass, favoring the emergence of drug resistance parasites. Methods The additional malaria parasite biomass related to HIV-1 co-infection in sub-Saharan Africa was estimated by a mathematical model. Parasite biomass was computed as the incidence rate of clinical malaria episodes multiplied by the number of parasites circulating in the peripheral blood of patients at the time symptoms appear. A mathematical model estimated the influence of HIV-1 infection on parasite density in clinical malaria by country and by age group, malaria transmission intensity and urban/rural area. In a multivariate sensitivity analysis, 95% confidence intervals (CIs were calculated using the Monte Carlo simulation. Results The model shows that in 2005 HIV-1 increased the overall malaria parasite biomass by 18.0% (95%CI: 11.626.9. The largest relative increase (134.9243.9% was found in southern Africa where HIV-1 prevalence is the highest and malaria transmission unstable. The largest absolute increase was found in Zambia, Malawi, the Central African Republic and Mozambique, where both malaria and HIV are highly endemic. A univariate sensitivity analysis shows that estimates are sensitive to the magnitude of the impact of HIV-1 infection on the malaria incidence rates and associated parasite densities. Conclusion The HIV-1 epidemic by increasing the malaria parasite biomass in sub-Saharan Africa may also increase the emergence of antimalarial drug resistance, potentially affecting the health of the whole population in countries endemic for both HIV-1 and malaria.
Hogan, Daniel R.; Joshua A. Salomon; CANNING, David; Hammitt, James K.; Zaslavsky, Alan M; Bärnighausen, Till
Objectives: Population-based HIV testing surveys have become central to deriving estimates of national HIV prevalence in sub-Saharan Africa. However, limited participation in these surveys can lead to selection bias. We control for selection bias in national HIV prevalence estimates using a novel approach, which unlike conventional imputation can account for selection on unobserved factors. Methods: For 12 Demographic and Health Surveys conducted from 2001 to 2009 (N=138 300), we predict HIV ...
Full Text Available AIM: Celiac disease is rarely described in sub-Saharan Africa.METHODS: From a series of 17 cases diagnosed between 2005and 2007 in Djibouti, we describe our diagnosis an managementdifficulties.RESULTS: African ethnics represented 64.7%. Sex ratio (F/M is1.4, mean age 82 months, associated diseases in 47%. Anti-gliadine,anti-endomysium and anti-transglutaminase antibodies were positivein 100%, 66.6% and 100%. Upper digestive tract endoscopy wasrealized 4 times. Eleven patients (64.7% began gluten free diet, 7recovered. Two patients died (11.7%.CONCLUSION: CD is difficult to diagnose for technical reasons.GFD is successful thanks to parental continuous medical education.
Delpeuch, Claire; Leblois, Antoine
La libéralisation des secteurs agricoles de nombreuses économies africaines du sud du Sahara a été encouragée par les institutions internationales, à l'instar d'autres régions dépendantes de l'aide internationale, ces dernières appelant à une modernisation et à une amélioration des performances par le biais des mécanismes concurrentiels. Les travaux analysant l'impact de ces réformes ont cependant souvent des difficultés à en identifier un impact clair. Dans ce papier, nous construisons une s...
Full Text Available The present international approach to management of transboundary animal diseases (TADs is based on the assumption that most can be eradicated ; consequently, that is the usual objective adopted by international organizations concerned with animal health. However, for sub-Saharan Africa and southern Africa more particularly, eradication of most TADs is impossible for the foreseeable future for a variety of technical, financial and logistical reasons. Compounding this, the present basis for access to international markets for products derived from animals requires that the area of origin (country or zone is free from trade-influencing TADs. The ongoing development of transfrontier conservation areas (TFCAs, extending across huge areas of southern Africa, therefore presents a development conundrum because it makes creation of geographic areas free from TADs more difficult and brings development based on wildlife conservation on the one hand and that based on livestock production on the other into sharp conflict. Sub-Saharan Africa is consequently confronted by a complex problem that contributes significantly to retarded rural development which, in turn, impedes poverty alleviation. In southern Africa specifically, foot-and-mouth disease (FMD presents the greatest problem in relation to access to international markets for animal products. However, it is argued that this problem could be overcome by a combination between (1 implementation of a commodity-based approach to trade in products derived from animals and (2 amendment of the international standards for FMD specifically (i.e. the FMD chapter in the Terrestrial Animal Health Code of the World Organisation for Animal Health [OIE] so that occurrence of SAT serotype viruses in free-living African buffalo need not necessarily mean exclusion of areas where buffalo occur from international markets for animal products. This would overcome a presently intractable constraint to market access for southern African countries and enable conservation and livestock production to be more effectively integrated, to the benefit of both.
Manirakiza, Alexandre; Megne-Boudjeka, Prisca; Bobossi-Serengbe, Gustave; Bercion, Raymond; le Faou, Alain
INTRODUCTION: Shigellosis is still a major public health problem in sub-Saharan countries, especially among children. METHODOLOGY: The prevalence of shigellosis in children presenting with diarrhoea in the Complexe Pédiatrique de Bangui, Central African Republic, was determined. Stools were analyzed in the bacteriology laboratory of the Institut Pasteur de Bangui, Central African Republic, where identification of Shigella species and analysis of antibiotics susceptibility were performed. RESU...
This paper addresses current and emerging HIV prevention strategies for women in Sub-Saharan Africa, in light of recent trial results and ongoing research. What are the major opportunities and challenges for widespread implementation of new and emerging HIV prevention strategies? The paper discusses the major individual, social and structural factors that underpin women's disproportionate risk for HIV infection, with attention to gender, adolescents as a vulnerable population, and the need to engage men. Also, the influence of these factors on the ultimate success of both behavioral and biomedical HIV prevention technologies for women in sub-Saharan Africa is discussed. Finally, the paper examined how the new and emerging biobehavioral prevention strategies served as tools to empower women to adopt healthy HIV preventive and reproductive health behaviors. PMID:26050373
Seims, Sara; Khadduri, Rolla
Recent studies on development aid from European donors revealed that their funding of the health sector in sub-Saharan Africa rarely includes performance measures suitable for tracking operational progress in improving sexual and reproductive health and rights. Analysis of health sector agreements verifies this. Particularly lacking are metrics related to four critically important areas: (1) reducing mortality and morbidity from unsafe abortion, (2) preventing and treating gender-based violence, (3) reducing unwanted pregnancies among the poorest women, and (4) reducing unwanted pregnancies among adolescents. During 2011 and the first half of 2012, the authors interviewed 85 experts in health service delivery, ministries of health, human rights, development economics and social science from sub-Saharan Africa, Europe and the United States. We asked them to identify measures to assess progress in these areas, and built on their responses to propose up to four practical performance measures for each of the areas, for inclusion in health sector support agreements. These measures are meant to supplement, not replace, current population-based measures such as changes in maternal mortality ratios. The feasibility of using these performance measures requires political commitment from donors and governments, investment in baseline data, and expanding the role of sexual and reproductive health and rights civil society in determining priorities. PMID:23245424
Although considerable achievements in the global reduction of hunger and poverty have been made, progress in Africa so far has been very limited. At present, a third of the African population faces widespread hunger and chronic malnutrition and is exposed to a constant threat of acute food crisis and famine. The most affected are rural households whose livelihood is heavily dependent on traditional rainfed agriculture. Rainfall plays a major role in determining agricultural production and hence the economic and social well being of rural communities. The rainfall pattern in sub-Saharan Africa is influenced by large-scale intra-seasonal and inter-annual climate variability including occasional El Niño events in the tropical Pacific resulting in frequent extreme weather event such as droughts and floods that reduce agricultural outputs resulting in severe food shortages. Households and communities facing acute food shortages are forced to adopt coping strategies to meet the immediate food requirements of their families. These extreme responses may have adverse long-term, impacts on households' ability to have sustainable access to food as well as the environment. The HIV/AIDS crisis has also had adverse impacts on food production activities on the continent. In the absence of safety nets and appropriate financial support mechanisms, humanitarian aid is required to enable households effectively cope with emergencies and manage their limited resources more efficiently. Timely and appropriate humanitarian aid will provide households with opportunities to engage in productive and sustainable livelihood strategies. Investments in poverty reduction efforts would have better impact if complemented with timely and predictable response mechanisms that would ensure the protection of livelihoods during crisis periods whether weather or conflict-related. With an improved understanding of climate variability including El Niño, the implications of weather patterns for the food security and vulnerability of rural communities have become more predictable and can be monitored effectively. The purpose of this paper is to investigate how current advances in the understanding of climate variability, weather patterns and food security could contribute to improved humanitarian decision-making. The paper will propose new approaches for triggering humanitarian responses to weather-induced food crises. PMID:16433102
Full Text Available Sub-Saharan African countries report high levels of growth and GDP per capita and yet they are unable to achieve the Millennium Development Goals (MDGs such as quality education and health. The paper argued that GDP might not be sufficient for measuring development because the funds obtained may not necessarily be used to improve the quality of life of worse off communities. Even with a constituent level of GDP, the problem of poverty and underdevelopment is becoming more intractable in Sub-Saharan Africa. This paper focused on the Challenges facing Sub-Saharan African countries in achieving the Millennium Development Goals (MDGs. This was discussed after revealing growth in GDP and inequality trends in Sub-Saharan Africa. Using examples from countries like Nigeria, it is evident that many countries in Sub-Saharan Africa are unlikely to achieve their MDG targets due to persistence of poverty and other challenges such as corruption and mal-administration of funds. Moreover, the required growth to substantially reduce poverty is too high by international standards. The paper concluded by concurring with the view that redistribution of the growth increment of income is more likely to be effective in reducing poverty than growth in GDP alone. Therefore while growth in GDP may be prone to poverty reduction, it should be complemented with policies to ensure investment and broad participation, reduce violence, root out corruption and increase investment in infrastructure. The paper recommends that countries development strategies must take into consideration national realities in each country rather than adopting targets and policies from the western world.
Full Text Available Here, we present 12 loci paternal haplotypes (Y-STR profiles against the backdrop of the Y-SNP marker system of Bantu males from the Maputo Province of Southeast Africa, a region believed to represent the southeastern fringe of the Bantu expansion. Our Maputo Bantu group was analyzed within the context of 27 geographically relevant reference populations in order to ascertain its genetic relationship to other Bantu and non Bantu (Pygmy, Khoisan and Nilotic sub-equatorial tribes from West and East Africa. This study entails statistical pair wise comparisons and multidimensional scaling based on YSTR Rst distances, network analyses of Bantu (B2a-M150 and Pygmy (B2b-M112 lineages as well as an assessment of Y-SNP distribution patterns. Several notable findings include the following: 1 the Maputo Province Bantu exhibits a relatively close paternal affinity with both east and west Bantu tribes due to high proportion of Bantu Y chromosomal markers, 2 only traces of Khoisan (1.3% and Pygmy (1.3% markers persist in the Maputo Province Bantu gene pool, 3 the occurrence of R1a1a-M17/M198, a member of the Eurasian R1a-M420 branch in the population of the Maputo Province, may represent back migration events and/or recent admixture events, 4 the shared presence of E1b1b1-M35 in all Tanzanian tribes examined, including Bantu and non-Bantu groups, in conjunction with its nearly complete absence in the West African populations indicate that, in addition to a shared linguistic, cultural and genetic heritage, geography (e.g., east vs. west may have impacted the paternal landscape of sub-Saharan Africa, 5 the admixture and assimilation processes of Bantu elements were both highly complex and region-specific.
Rowold, Diane; Garcia-Bertrand, Ralph; Calderon, Silvia; Rivera, Luis; Benedico, David Perez; Alfonso Sanchez, Miguel A.; Chennakrishnaiah, Shilpa; Varela, Mangela; Herrera, Rene J.
Here, we present 12 loci paternal haplotypes (Y-STR profiles) against the backdrop of the Y-SNP marker system of Bantu males from the Maputo Province of Southeast Africa, a region believed to represent the southeastern fringe of the Bantu expansion. Our Maputo Bantu group was analyzed within the context of 27 geographically relevant reference populations in order to ascertain its genetic relationship to other Bantu and non Bantu (Pygmy, Khoisan and Nilotic) sub-equatorial tribes from West and East Africa. This study entails statistical pair wise comparisons and multidimensional scaling based on YSTR Rst distances, network analyses of Bantu (B2a-M150) and Pygmy (B2b-M112) lineages as well as an assessment of Y-SNP distribution patterns. Several notable findings include the following: 1) the Maputo Province Bantu exhibits a relatively close paternal affinity with both east and west Bantu tribes due to high proportion of Bantu Y chromosomal markers, 2) only traces of Khoisan (1.3%) and Pygmy (1.3%) markers persist in the Maputo Province Bantu gene pool, 3) the occurrence of R1a1a-M17/M198, a member of the Eurasian R1a-M420 branch in the population of the Maputo Province, may represent back migration events and/or recent admixture events, 4) the shared presence of E1b1b1-M35 in all Tanzanian tribes examined, including Bantu and non-Bantu groups, in conjunction with its nearly complete absence in the West African populations indicate that, in addition to a shared linguistic, cultural and genetic heritage, geography (e.g., east vs. west) may have impacted the paternal landscape of sub-Saharan Africa, 5) the admixture and assimilation processes of Bantu elements were both highly complex and region-specific. PMID:25606451
Gruca, Marta; van Andel, Tinde
Palms (Arecaceae) are prominent elements in African traditional medicines. It is, however, a challenge to find detailed information on the ritual use of palms, which are an inextricable part of African medicinal and spiritual systems. This work reviews ritual uses of palms within African ethnomedicine. We studied over 200 publications on uses of African palms and found information about ritual uses in 26 of them. At least 12 palm species in sub-Saharan Africa are involved in various ritual practices: Borassus aethiopum, Cocos nucifera, Dypsis canaliculata, D. fibrosa, D. pinnatifrons, Elaeis guineensis, Hyphaene coriacea, H. petersiana, Phoenix reclinata, Raphia farinifera, R. hookeri, and R. vinifera. In some rituals, palms play a central role as sacred objects, for example the seeds accompany oracles and palm leaves are used in offerings. In other cases, palms are added as a support to other powerful ingredients, for example palm oil used as a medium to blend and make coherent the healing mixture. A better understanding of the cultural context of medicinal use of palms is needed in order to obtain a more accurate and complete insight into palm-based traditional medicines.
Gruca, Marta; van Andel, Tinde R; Balslev, Henrik
Palms (Arecaceae) are prominent elements in African traditional medicines. It is, however, a challenge to find detailed information on the ritual use of palms, which are an inextricable part of African medicinal and spiritual systems. This work reviews ritual uses of palms within African ethnomedicine. We studied over 200 publications on uses of African palms and found information about ritual uses in 26 of them. At least 12 palm species in sub-Saharan Africa are involved in various ritual practices: Borassus aethiopum, Cocos nucifera, Dypsis canaliculata, D. fibrosa, D. pinnatifrons, Elaeis guineensis, Hyphaene coriacea, H. petersiana, Phoenix reclinata, Raphia farinifera, R. hookeri, and R. vinifera. In some rituals, palms play a central role as sacred objects, for example the seeds accompany oracles and palm leaves are used in offerings. In other cases, palms are added as a support to other powerful ingredients, for example palm oil used as a medium to blend and make coherent the healing mixture. A better understanding of the cultural context of medicinal use of palms is needed in order to obtain a more accurate and complete insight into palm-based traditional medicines. PMID:25056559
Isabel, Gentil García.
Full Text Available Justificación: La población inmigrante subsahariana es la más desconocida para los profesionales de la salud. Objetivo: Conocer, a través de sus voces, su cosmovisión que enmarca valores, creencias y prácticas sobre salud y enfermedad, centrándonos en el ser humano con enfoque holístico. Metodología [...] : Cualitativa, fenomenología. Resultados: Su concepción de la vida y del universo está impregnada de la religión más antigua del mundo: el animismo. Los antepasados que murieron siguen estando para protegerles. Aprecian la atención sanitaria española pero hay padecimientos que resuelve mejor la medicina tradicional africana. Aunque la atención es correcta puede despertarse susceptibilidad al no conocer los códigos culturales de la nueva sociedad. La solidaridad familiar es el valor fundamental. Conclusión: La solidaridad, valor ancestral en los humanos, debe seguir guiando a los profesionales de la salud comprometidos con la salud de la población, defendiendo el Estado de Bienestar frente a las voces que pretenden desmantelarlo. Abstract in english The population of sub-Saharan immigrants is unknown by health care professionals. Objective: know, across his voices, his cosmovision that frames values, beliefs and practices on health and disease, centring on the human being with holistic approach. Methodology qualitative, phenomenology. Results: [...] His conception of the life and of the universe is impregnated with the most ancient religion of the world: the animism. The forbears who died continue being to protect them. They estimate the sanitary Spanish attention though there are sufferings that there solves better the traditional African medicine. Though the attention is correct one can wake susceptibility up on not having known all the cultural codes of the new company. The familiar solidarity is a fundamental value. Conclusions: the ancient solidarity in the human beings must continue guiding the professionals of the health compromised with the health of the population, defending the Welfare state opposite to the voices they it tries to dismantle.
Stambler, Bruce Sheldon; Ngunga, Leonard M
Health care in Sub-Saharan Africa is being challenged by a double burden of disease as lifestyle diseases common in the developed world, such as stroke and atrial fibrillation (AF), increase, while, simultaneously, health issues of the developing world in terms of communicable disease persist. The prevalence of AF is lower in Africa than in the developed world but is expected to increase significantly over the next few decades. Patients with AF in Africa tend to be younger and have a higher prevalence of rheumatic valvular heart disease than patients with AF in other regions. Permanent AF is the most prevalent type of AF in Africa, possibly due to the lower use of rhythm control strategies than in the developed world. Mortality rates of patients with AF in Africa are high, due largely to poor health care access and suboptimal therapy. The risk of stroke in AF, which is moderate to high in Africans as in the developed world, contributes to the high mortality rate. Patients with AF in Africa are often undertreated with antithrombotics, as cost and access to monitoring are major barriers. Vitamin K antagonists, including warfarin, are the most commonly available oral anticoagulants, but regular monitoring can be challenging, especially for patients in remote areas. Several non-vitamin K antagonist oral anticoagulants (NOACs) have been approved for use in countries across Sub-Saharan Africa and have the potential to reduce stroke burden. The higher cost of newer agents may be offset by the reduced need for regular monitoring, fixed dosing, and lower risk of intracranial bleeding; NOACs could provide a treatment option for patients in remote areas with limited access to regular monitoring. However, NOACs are not indicated in valvular AF. More work is needed to increase understanding of the epidemiology of AF and stroke, as well as to improve management strategies to reduce the burden of cardiovascular disease predicted for Africa. PMID:26261423
Thomas Zschocke; Jan Beniest; Dramé Yayé Aissétou; Sebastian Chakeredza
E-learning is likely to be an increasingly important element in teaching agriculture and related subjects at universities in Sub-Saharan Africa. The purpose of this study was to explore the factors involved in determining the readiness and intention to adopt e-learning by faculty members at member institutions of the African Network for Agriculture, Agroforestry and Natural Resources Education (ANAFE). The study was based on the decomposed theory of planned behavior (DTPB) to predict intentio...
Müller, B; Hilty, M; Berg, S.; Garcia-Pelayo, M. C.; Dale, J.; Boschiroli, M. L.; Cadmus, S.; Ngandolo, B. N. R.; Godreuil, S.; Diguimbaye-Djaibé, C.; Kazwala, R.; Bonfoh, B; Njanpop-Lafourcade, B. M.; Sahraoui, N; Guetarni, D
We have identified a clonal complex of Mycobacterium bovis present at high frequency in cattle in population samples from several sub-Saharan west-central African countries. This closely related group of bacteria is defined by a specific chromosomal deletion (RDAf1) and can be identified by the absence of spacer 30 in the standard spoligotype typing scheme. We have named this group of strains the African 1 (Af1) clonal complex and have defined the spoligotype signature of this clonal complex ...
...United States (Export-Import Bank). SUMMARY: The Sub-Saharan...support the expansion of the Bank's financial commitments in Sub- Saharan Africa under the loan, guarantee, and insurance programs of the Bank. Further, the committee...
...the United States (Ex-Im Bank) SUMMARY: The Sub-Saharan...support the expansion of the Bank's financial commitments in Sub- Saharan Africa under the loan, guarantee, and insurance programs of the Bank. Further, the Committee...
Müller, Christoph; Waha, Katharina; Bondeau, Alberte; Heinke, Jens
Development efforts for poverty reduction and food security in sub-Saharan Africa will have to consider future climate change impacts. Large uncertainties in climate change impact assessments do not necessarily complicate, but can inform development strategies. The design of development strategies will need to consider the likelihood, strength, and interaction of climate change impacts across biosphere properties. We here explore the spread of climate change impact projections and develop a composite impact measure to identify hotspots of climate change impacts, addressing likelihood and strength of impacts. Overlapping impacts in different biosphere properties (e.g. flooding, yields) will not only claim additional capacity to respond, but will also narrow the options to respond and develop. Regions with severest projected climate change impacts often coincide with regions of high population density and poverty rates. Science and policy need to propose ways of preparing these areas for development under climate change impacts. PMID:24796720
Mveyange, Anthony Francis; Skovsgaard, Christian
Estimating the impact of HIV/AIDS epidemic on economic growth is challenging because of endogeneity concerns. In this paper, we use novel data on male circumcision and distance from the first HIV outbreak as instrumental variables for the HIV/AIDS epidemic in 241 regions across 25 countries in sub-Saharan Africa during 200312. Our main finding shows that the impact of HIV/AIDS epidemic on economic growth is negative but statistically insignificant. Further investigation on the main channels through which HIV/AIDS may affect economic growthnamely human capital, population growth, and productivityfinds no impacts of the HIV/AIDS epidemic on these channels.
Shanaube, Kwame; Bock, Peter
For the last three decades, sub-Saharan Africa has been the epicentre of the HIV epidemic. Some key drivers of the epidemic are specific to this region and there is an urgent need to develop context-specific strategies to reduce HIV-related burden. Implementation frameworks should endeavour to combine structural, behavioural and biomedical interventions and the future of the HIV response involves embracing different approaches for different populations; it is not 'one-size fits all approach'. Expanded use of community-based interventions will be key in expanding the role of antiretroviral treatment as prevention (TasP) in the region. For TasP to be effective, high antiretroviral therapy (ART) coverage rates need to be attained. Data from programmatic trials currently underway will provide crucial data to guide the future implementation of TasP. PMID:25929960
Lema, Valentino M
Unconsummated marriage is a condition where newly married couples are unable to achieve penile-vaginal intercourse for variable periods despite desire and several attempts to do so. Its exact cause(s) is/are unknown, but performance anxiety resulting from or leading to other conditions is reportedly the major etiological factor. It is thought to be more prevalent in traditional and conservative religious communities where premarital sexual exposure is strictly prohibited. Most publications on unconsummated marriage have originated from North America, European and Middle Eastern countries. There have not been any such reports from sub-Saharan Africa, which is home to diverse cultures and traditions regarding premarital sex and marriage. This paper presents a sample of four cases with unconsummated marriage managed by the author in his private clinic based in the city of Nairobi Kenya, over the past five years. Possible etiological factors and management approaches are discussed, with a review of relevant literature. PMID:25508052
...commitments in Sub- Saharan Africa under the loan, guarantee...for trade with Sub-Saharan Africa. Time and Place: April 21...developments in Sub-Saharan Africa markets by Export-Import Bank...any person wishes auxiliary aids (such as a sign language...
...commitments in Sub- Saharan Africa under the loan, guarantee...for trade with Sub-Saharan Africa. Time and Place: July 13...developments in Sub-Saharan Africa markets by Export-Import Bank...any person wishes auxiliary aids (such as a sign language...
...commitments in Sub-Saharan Africa under the loan, guarantee...for trade with Sub-Saharan Africa. Time and Place: December...developments in Sub-Saharan Africa markets by Export Import Bank...any person wishes auxiliary aids (such as a sign language...
Ichoku, C. M.; Gatebe, C. K.; Lee, J.; Wang, J.; Bolten, J. D.; Wilcox, E. M.; Policelli, F.; Habib, S.; Adegoke, J. O.
The northern sub-Saharan African (NSSA) region, bounded on the north and south by the Sahara and the Equator, respectively, and stretching from the West to the East African coastlines, has one of the highest biomass-burning rates per unit land area among all regions of the world. Because of the high concentration and frequency of fires in this region, with the associated abundance of heat release and gaseous and particulate smoke emissions, biomass-burning activity is believed to be one of the drivers of the regional carbon and energy cycles, with serious implications for the water cycle. A new interdisciplinary research effort sponsored by NASA is presently being focused on the NSSA region, to better understand the possible connection between the intense biomass burning observed from satellite year after year across the region and the rapid depletion of the regional water resources, as exemplified by the dramatic drying of Lake Chad. A combination of remote sensing and modeling approaches is being utilized in investigating multiple regional surface, atmospheric, and water-cycle processes, and inferring possible links between them. In this presentation, we will discuss preliminary results as well as the path toward improved understanding of the interrelationships and feedbacks between the biomass burning and the environmental change dynamics in the NSSA region.
José Luiz, Telles; Ana Paula Abreu, Borges.
Full Text Available A região Subsaariana do continente africano é onde se concentra a maior carga de doença do mundo e é a única região do planeta onde se espera que o número de pessoas pobres irá aumentar nas próximas décadas. Os países desta região, em diferentes graus, experimentam processo lento de envelhecimento p [...] opulacional, mas, ao mesmo tempo, é onde a população idosa mais cresce em números absolutos. A partir de revisão da bibliografia, buscou-se destacar a situação demográfica e social em que vivem as pessoas idosas na região subsaariana e os principais desafios que se impõem aos governos locais para a superação dos complexos problemas postos a toda a sociedade. Constatou-se que as políticas públicas voltadas para este segmento populacional na região não representam prioridade e, por conseguinte, dificilmente entram na agenda atual da cooperação internacional. Abstract in english The Sub-Saharan part of the African continent is the area that has the highest disease burden in the world and is the only region of the planet where it is expected that the number of poor people will increase in the coming decades. The countries of this region, to different degrees, experience slow [...] process of population aging but at the same time, it is the are where the elderly population grows fastest in absolute numbers. Based on a review of the literature, an attempt was made to highlight the social and demographic situation in which the elderly live in the Sub-Saharan region and the main challenges faced by local governments to overcome the complex problems affecting society as a whole. It was found that public policies geared to this segment of the population in the region do not represent a priority and, consequently, are unlikely to be included in the current agenda of international cooperation.
Beaudoin, Christopher E
In light of the great threat that HIV/AIDS poses in sub-Saharan Africa, the current study assesses HIV/AIDS posters from this region with specific reference to health message frames, including HIV sources, consequences, self-efficacy, preventive means, and barriers and benefits to employing such means of prevention. There is a two-step methodology. First, the content of HIV/AIDS posters from 15 sub-Saharan African countries was coded for the six health message frames. Second, relationships between the health message frames and four social determinants (HIV rate, HIV awareness, condom use and uncertainty avoidance (UAI)) were assessed with hierarchical linear modeling (HLM). Analysis indicates that self-efficacy is the most common frame, but that almost one-quarter of the posters has none of the six health message frames. HLM indicates some favorable findings, including that health message frames are used most often in countries with the most troubling levels of HIV awareness and condom use. Less favorably, health message frames are used least common in countries that have high levels of UAI and high HIV rates. Improvements for related media practices and policy are articulated. PMID:17596544
Full Text Available OBJECTIVE: To determine participation in polio supplementary immunization activities (SIAs in sub-Saharan Africa among users and non-users of routine immunization services and among users who were compliant or non-compliant with the routine oral poliovirus vaccine (OPV immunization schedule. METHODS: Data were obtained from household-based surveys in non-polio-endemic sub-Saharan African countries. Routine immunization service users were children (aged 85% in 12 SIAs but non-user participation was > 85% in only 5 SIAs. In 18 SIAs, participation was greater among users (P < 0.01 in 16, 0.05 in 1 and < 0.10 in 1 than non-users. In 14 SIAs, adjusted analyses revealed lower participation among non-compliant users than among compliant users (P < 0.01 in 10, < 0.05 in 2 and < 0.10 in 2. CONCLUSION: Large percentages of children participated in SIAs. Prior use of routine immunization services and compliance with the routine OPV schedule showed a strong positive association with SIA participation.
Ala, F; Allain, J-P; Bates, I.; Boukef, K; Boulton, F; Brandful, J; Dax, EM; El Ekiaby, M; Farrugia, A.; Gorlin, J; Hassall, O.; Lee, H; Loua, A; Maitland, K; Mbanya, D
Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking.
Herslund, Lise Byskov; Jalyer, Fatameh
In this paper, we develop and apply a multi-dimensional vulnerability assessment framework for understanding the impacts of climate change-induced hazards in Sub- Saharan African cities. The research was carried out within the European/African FP7 project CLimate change and Urban Vulnerability in Africa, which investigated climate change-induced risks, assessed vulnerability and proposed policy initiatives in five African cities. Dar es Salaam (Tanzania) was used as a main case with a particular focus on urban flooding. The multi-dimensional assessment covered the physical, institutional, attitudinal and asset factors influencing urban vulnerability. Multiple methods were applied to cover the full range of vulnerabilities and to identify potential response strategies, including: model-based forecasts, spatial analyses, document studies, interviews and stakeholder workshops. We demonstrate the potential of the approach to assessing several dimensions of vulnerability and illustrate the complexity of urban vulnerability at different scales: households (e.g., lacking assets); communities (e.g., situated in low-lying areas, lacking urban services and green areas); and entire cities (e.g., facing encroachment on green and flood-prone land). Scenario modeling suggests that vulnerability will continue to increase strongly due to the expected loss of agricultural land at the urban fringes and loss of green space within the city. However, weak institutional commitment and capacity limit the potential for strategic coordination and action. To better adapt to urban flooding andthereby reduce vulnerability and build resilience, we suggest working across dimensions and scales, integrating climate change issues in city-level plans and strategies and enabling local actions to initiate a learning-by-doing process of adaptation.
Downing Raymond V
Full Text Available Abstract Background The principles and practice of Family Medicine that arose in developed Western countries have been imported and adopted in African countries without adequate consideration of their relevance and appropriateness to the African context. In this study we attempted to elicit a priori principles of generalist medical practice from the experience of long-serving medical officers in a variety of African counties, through which we explored emergent principles of Family Medicine in our own context. Methods A descriptive study design was utilized, using qualitative methods. 16 respondents who were clinically active medical practitioners, working as generalists in the public services or non-profit sector for at least 5 years, and who had had no previous formal training or involvement in academic Family Medicine, were purposively selected in 8 different countries in southern, western and east Africa, and interviewed. Results The respondents highlighted a number of key issues with respect to the external environment within which they work, their collective roles, activities and behaviours, as well as the personal values and beliefs that motivate their behaviour. The context is characterized by resource constraints, high workload, traditional health beliefs, and the difficulty of referring patients to the next level of care. Generalist clinicians in sub-Saharan Africa need to be competent across a wide range of clinical disciplines and procedural skills at the level of the district hospital and clinic, in both chronic and emergency care. They need to understand the patient's perspective and context, empowering the patient and building an effective doctor-patient relationship. They are also managers, focused on coordinating and improving the quality of clinical care through teamwork, training and mentoring other health workers in the generalist setting, while being life-long learners themselves. However, their role in the community, was found to be more aspirational than real. Conclusions The study derived a set of principles for the practice of generalist doctors in sub-Saharan Africa based on the reported activities and approaches of the respondents. Patient-centred care using a biopsychosocial approach remains as a common core principle despite wide variations in context. Procedural and hospital care demands a higher level of skills particularly in rural areas, and a community orientation is desirable, but not widely practiced. The results have implications for the postgraduate training of family physicians in sub-Saharan Africa, and highlight questions regarding the realization of community-orientated primary care.
Sub-Saharan African (SSA) countries rely heavily on donor assistance and international borrowing. The Official Development Assistance (ODA)/GNP ratio in SSA is expected to rise well into the next century. Increases or decreases of ODA, which is known to be the main source of SSA's investment, may depend on the type of global settlement expected to emerge in the post-cold war world. SSA has therefore a stake on the type of globalisation which may frame world economic policy and financial aid to it. Neo-liberal globalisation has no enthusiasm for massive financial transfers. The incipient globalising ideas which emerged from the Rio Summit in 1992 have suggested to increase ODAs in real terms and debt relief to control crushing debt service payments. Agenda 21 has created new and additional facilities formally for increasing donor assistance in the form of financial and investment transfers. The question is whether this new mechanism will make any difference to stem the SSA decline and can "incentivise" the region's renewal or renaissance. This article will focus on how globalisation may be related to increase or decrease of financial transfer to SSA. (C) 2000 Elsevier Science Ltd. All rights reserved.
Full Text Available There is a critical need for governments in the region to realize the magnitude of the challenge in order to proactively respond to it. This means that for the region to meet its sanitation goals, these governments must prioritize sanitation in their national budgets. While the scale of sanitation challenges differs from one country to another, common bottlenecks arise from the pace of demographic growth, rapid urbanization and growth of informal settlements. All these factors are further aggravated by poverty, a critical developmental challenge that has continued to undermine the efforts of most governments. The irony however, is the fact that sanitation can considerably alleviate poverty, but due to other competing priorities such as education, health, environment, gender equality and economic growth, sanitation is least prioritized at all levels of governance. This phenomenon explains why majority of African people cannot access basic sanitation. This paper examines the challenges of financing sanitation in sub-Saharan countries, focusing on (i what is to be financed (ii how much will it cost (iii policy shifts to remedy the situation. The paper concludes by suggesting pertinent recommendations.
Full Text Available This report presents the proceedings of the field research conducted in the framework of a doctoralresearch on the European Union (EU as an emerging coordinator in development cooperation.This research aims to seek in-depth and interpreted understanding of the paradox betweenthe EUs ambitions on the one hand and practice on the ground on the other by investigating theEUs role in four sub-Saharan African countries (Tanzania, Zambia, Burkina Faso and Senegal.As such, it aims to add empirical evidence to the debate on the role of the EU as a developmentactor. More specifically, it investigates how the ambitions of the EU are translated at country leveland in which situations the EU is more/less likely to act as a coordinator, making use of a pragmatistresearch approach. This approach is especially suited to problem-driven research that aims tounderstand a complex phenomenon. The article introduces the research question and the rationale,gives an overview of the research approach and the methodological considerations and endswith a summary of the research process and the preliminary findings of the field research.
Bove, Riley; Valeggia, Claudia
In this paper we review the literature on the association between polygyny and women's health in sub-Saharan Africa. We argue that polygyny is an example of "co-operative conflict" within households, with likely implications for the vulnerability of polygynous women to illness, and for their access to treatment. We begin with a review of polygyny and then examine vulnerability to sexually transmitted infections (STIs, including HIV) and differential reproductive outcomes. Polygyny is associated with an accelerated transmission of STIs, both because it permits a multiplication of sexual partners and because it correlates with low rates of condom use, poor communication between spouses, and age and power imbalances among other factors. Female fertility is affected by the interplay between marital rank, household status, and cultural norms in polygynous marriages. Finally, we present areas which have received only cursory attention: mental health and a premature, "social" menopause. Although data are scarce, polygyny seems to be associated with higher levels of anxiety and depression, particularly around stressful life events. It is our hope that the examples reviewed here will help build a framework for mixed method quality research, which in turn can inform decision makers on more appropriate, context-dependent health policies. PMID:18952335
Kuepfer, Irene; Burri, Christian
The urgent need for new, safe and sustainable interventions against diseases that disproportionally affect the poor is finally receiving global attention and the funding landscape for development projects has significantly improved during the past decade. For the development of new drug and vaccine candidates, clinical trials have become the most important tool to assess their safety and efficacy. Recently, there has been a seismic shift in the number of clinical trials conducted in resource-limited settings. We discuss the current framework of clinical research in sub-Saharan Africa, from building product pipelines to the capacities needed for the conduct of trials according the harmonised Good Clinical Practice (GCP) ICH E6 guideline. We place emphasis on clinical research in neglected tropical diseases which still frequently has to be conducted with limited financial, logistical and human resources. Given those short-comings we recommend minimum standards needed at the local, national and sponsor levels to provide GCP-compliant clinical research. PMID:19324048
Kuzvinetsa Peter, Dzvimbo; Kholeka Constance, Moloi.
Full Text Available In a shrinking world, in which a neo-liberal discourse has permeated sub-Saharan African higher education, critical reflection is required to assess the merits and demerits of globalisation. Research, intensive discussion and hearings conducted over a two-year period by the Task Force on Higher Educ [...] ation and Society, convened by the World Bank and United Nations Educational, Scientific, and Cultural Organization (UNESCO) for the purpose of exploring the future of higher education in the developing world, led to the conclusion that without more and better higher education, developing countries would find it increasingly difficult to benefit from the global knowledge economy. A decade later, we argue for a radical change in the traditional discourse on globalisation because of the emergence of countries such as China, South Africa, India, and Brazil as global players in the world economy. These emerging global powers, reframe the political and imperial philosophy at the epicentre of globalisation discourse - an economic creed, through their mutual consultation and coordination on significant political issues. Their economic and military capabilities enable them to influence the trade regime and thereby strengthen the voice of the developing world as a whole. In relation to this paper's inquiry, the cooperation of these emerging powers gives the free enfranchised people of the world an opportunity to choose a different path of international relations (internationalisation) formed on more liberal lines, as opposed to the neo-liberal economic rationality of globalisation. This paper therefore examines globalisation and internationalisation of higher education in sub-Saharan Africa, a field in which increased knowledge production and distribution open up opportunities for users, institutions and societies. Against a background of chronic economic uncertainty we examine the influence of major international institutions on the direction of higher education, in particular teacher education. Drawing on relevant literature and our own experience, reflexively, we argue that the tendency, towards free market regulation ideologies, privileges neo-liberal global knowledge discourses, such that they impose on higher education a need to respond across a range of fields.
Louise Leroux; Audrey Jolivot; Agnès Bégué; Danny Lo Seen; Bernardin Zoungrana
Accurate cropland maps at the global and local scales are crucial for scientists, government and nongovernment agencies, farmers and other stakeholders, particularly in food-insecure regions, such as Sub-Saharan Africa. In this study, we aim to qualify the crop classes of the MODIS Land Cover Product (LCP) in Sub-Saharan Africa using FAO (Food and Agricultural Organisation) and AGRHYMET (AGRiculture, Hydrology and METeorology) statistical data of agriculture and a sample of 55 very-high-resol...
Bryceson, D. F.
Sub-Saharan Africa is steadily becoming less rural in character. For decades development thinking has prescribed industrialization as the virtuous path leading away from economic dependence on agriculture. The present paper rejects the view that rural or even national industrialization has taken place or is likely to take place in sub-Saharan Africa in the immediate future. The author argues that the preconditions for this happening are largely absent. She proposes an alternative perspective ...
INOUE, TAKESHI; Hamori, Shigeyuki
This article empirically analyzes the role of finance in economic growth in Sub-Saharan Africa from the perspective of what is termed herein financial permeation. By estimating panel data on 37 countries in Sub-Saharan Africa between 2004 and 2010, we examine whether financial permeation through improved convenience and access to financial services has contributed to economic growth in this region. Empirical results clearly indicate that financial permeation has a statistically significant ...
Alagidede, Paul; Adu, George; Frimpong, Prince Boakye
This paper is a contribution to the empirics of climate change and its effect on sustainable economic growth in Sub-Saharan Africa. Using data on two climate variables, temperature and precipitation, and employing panel cointegration techniques, we estimate the short- and long-run effects of climate change on growth. We establish that an increase in temperature significantly reduces economic performance in Sub-Saharan Africa. Furthermore, we show that the relationship between real gross domes...
This article provides a comparative summary of the findings of the survey of Business Ethics as field of Teaching, Training and Reserach across the four sub-regions in Sub-Saharan Africa ( Western Africa, Southern Africa, Eastern Africa and Francophone Africa). The article commences with a discussion on the terminology that is used to refer to Business and Economic Ethics in Sub-Saharan Africa. It Then provides an overview of the prevalence and distribution of Business Ethics as field of Teac...
Hofwegen, G., van; Becx, G.A.; Broek, J.A., van den; Koning, N.B.J.
Sub-Saharan Africa is trapped in a complex unsustainability spiral with demographic, biophysical, technical and socio-political dimensions. Unravelling the spiral is vital to perceive which policy actions are needed to reverse it and initiate sustainable pro-poor growth. The article presents an evolutionary, multi-agent modelling framework that marries a socio-ecological approach to a world system perspective and takes agriculture as the engine for sustainable development in Sub-Saharan Afric...
Joep A. van den Broek; Gertjan A. Becx; Guido van Hofwegen; Niek B.J. Koning
Sub-Saharan Africa is trapped in a complex unsustainability spiral with demographic, biophysical, technical and socio-political dimensions. Unravelling the spiral is vital to perceive which policy actions are needed to reverse it and initiate sustainable pro-poor growth. The article presents an evolutionary, multi-agent modelling framework that marries a socio-ecological approach to a world system perspective and takes agriculture as the engine for sustainable development in sub-Saharan Afric...
... Highlights: African Americans Smoking Fast Stats Overweight and Obesity Adult Obesity Facts Overweight & Obesity Fast Stats High Cholesterol ... lower than among white adults. The prevalence of obesity among adults from 2007-2010 was largest among African American ...
Chivenge, Pauline; Mabhaudhi, Tafadzwanashe; Modi, Albert T.; Mafongoya, Paramu
Modern agricultural systems that promote cultivation of a very limited number of crop species have relegated indigenous crops to the status of neglected and underutilised crop species (NUCS). The complex interactions of water scarcity associated with climate change and variability in sub-Saharan Africa (SSA), and population pressure require innovative strategies to address food insecurity and undernourishment. Current research efforts have identified NUCS as having potential to reduce food an...
Novignon, Jacob; Olakojo, Solomon A.; Nonvignon, Justice
Background: Health care expenditure has been low over the years in developing regions of the world. A majority of countries in these regions, especially sub-Saharan Africa (SSA), rely on donor grants and loans to finance health care. Such expenditures are not only unsustainable but also inadequate considering the enormous health care burden in the region. The objectives of this study are to determine the effect of health care expenditure on population health status and to examine the effect b...
Ngugi, AK; Bottomley, C; Kleinschmidt, I.; Wagner, RG; Kakooza-Mwesige, A; Ae-Ngibise, K; Owusu-Agyei, S; Masanja, H; Kamuyu, G; Odhiambo, R.; Chengo, E; Sander, JW; Newton, CR
Background: The prevalence of epilepsy in sub-Saharan Africa seems to be higher than in other parts of the world, but estimates vary substantially for unknown reasons. We assessed the prevalence and risk factors of active convulsive epilepsy across five centres in this region. Methods: We did large population-based cross-sectional and case-control studies in five Health and Demographic Surveillance System centres: Kilifi, Kenya (Dec 3, 2007-July 31, 2008); Agincourt, South Africa (Aug 4, 2008...
Lapworth, D. J.; Macdonald, A. M.; H. C. Bonsor; Tijani, M.N.; Calow, R.C.
In stark contrast to food scarcity, very little systematic data collection has been done to investigate the role water scarcity has on livelihoods within rural communities in sub-Saharan Africa, particularly during droughts or periods of water stress (Calow et al. 2009). The sustainable development and management of water resources in Africa, particularly perennial groundwater resources, remains a major priority, especially within the context of climate variability, population growth and pres...
Hauffe, T.; Schultheiß, R.; Van Bocxlaer, B.; Prömmel, K.; Albrecht, C.
Species diversity and how it is structured on a continental scale is influenced by stochastic, ecological, and evolutionary driving forces, but hypotheses on determining factors have been mainly examined for terrestrial and marine organisms. The extant diversity of African freshwater mollusks is in general well assessed to facilitate conservation strategies and because of the medical importance of several taxa as intermediate hosts for tropical parasites. This historical accumulation of knowledge has, however, not resulted in substantial macroecological studies on the spatial distribution of freshwater mollusks. Here, we use continental distribution data and a recently developed method of random and cohesive allocation of species distribution ranges to test the relative importance of various factors in shaping species richness of Bivalvia and Gastropoda. We show that the mid-domain effect, that is, a hump-shaped richness gradient in a geographically bounded system despite the absence of environmental gradients, plays a minor role in determining species richness of freshwater mollusks in sub-Saharan Africa. The western branch of the East African Rift System was included as dispersal barrier in richness models, but these simulation results did not fit observed diversity patterns significantly better than models where this effect was not included, which suggests that the rift has played a more complex role in generating diversity patterns. Present-day precipitation and temperature explain richness patterns better than Eemian climatic condition. Therefore, the availability of water and energy for primary productivity during the past does not influence current species richness patterns much, and observed diversity patterns appear to be in equilibrium with contemporary climate. The availability of surface waters was the best predictor of bivalve and gastropod richness. Our data indicate that habitat diversity causes the observed species-area relationship, and hence, that environmental heterogeneity is a principal driver of freshwater mollusk richness on a continental scale.
Leon, Natalie; Sanders, David; Van Damme, Wim; Besada, Donela; Daviaud, Emmanuelle; Oliphant, Nicholas P; Berzal, Rocio; Mason, John; Doherty, Tanya
Community-based research on child survival in sub-Saharan Africa has focussed on the increased provision of curative health services by a formalised cadre of lay community health workers (CHWs), but we have identified a particular configuration, that deserves closer scrutiny. We identified a two-tiered CHW system, with the first tier being the lessor known or 'hidden' community/village level volunteers and the second tier being formal, paid CHWs, in Ethiopia, Mali, and Niger. Whilst the disease-focussed tasks of the formal CHW tier may be more amenable to classic epidemiological surveillance, we postulate that understanding the relationship between formalised CHWs and volunteer cadres, in terms of scope, location of practice and ratio to population, would be important for a comprehensive evaluation of child survival in these countries. We report on the findings from our joint qualitative and quantitative investigations, highlighting the need to recognise the 'hidden' contribution of volunteers. We need to better characterize the volunteers' interaction with community-based and primary care services and to better understand ways to improve the volunteer systems with the right type of investments. This is particularly important for considering the models for scale-up of CHWs in sub-Saharan Africa. PMID:25770090
Full Text Available Community-based research on child survival in sub-Saharan Africa has focussed on the increased provision of curative health services by a formalised cadre of lay community health workers (CHWs, but we have identified a particular configuration, that deserves closer scrutiny. We identified a two-tiered CHW system, with the first tier being the lessor known or hidden community/village level volunteers and the second tier being formal, paid CHWs, in Ethiopia, Mali, and Niger. Whilst the disease-focussed tasks of the formal CHW tier may be more amenable to classic epidemiological surveillance, we postulate that understanding the relationship between formalised CHWs and volunteer cadres, in terms of scope, location of practice and ratio to population, would be important for a comprehensive evaluation of child survival in these countries. We report on the findings from our joint qualitative and quantitative investigations, highlighting the need to recognise the hidden contribution of volunteers. We need to better characterize the volunteers interaction with community-based and primary care services and to better understand ways to improve the volunteer systems with the right type of investments. This is particularly important for considering the models for scale-up of CHWs in sub-Saharan Africa.
Matthew F Chersich
Full Text Available Introduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods: We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed and non-indexed journals were searched for studies with quantitative study outcomes. Results: We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers access to care and antiretroviral treatment (ART, but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. Conclusions: There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services including peer interventions, condom promotion and STI screening would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers. Initiatives are required to enhance access to HIV testing and ART for sex workers, using current CD4 thresholds, or possibly earlier for prevention. Services implemented at sufficient scale and intensity also serve as a platform for subsequent community mobilization and sex worker empowerment, and alleviate a major source of incident infection sustaining even generalized HIV epidemics. Ultimately, structural and legal changes that align public health and human rights are needed to ensure that sex workers on the continent are adequately protected from HIV.
Donald P., King; Miki, Madi; Valerie, Mioulet; Jemma, Wadsworth; Caroline F., Wright; Bego& #241; a, Valdazo-González; Nigel P., Ferris; Nick J., Knowles; Jef, Hammond.
Full Text Available Using foot-and-mouth disease (FMD) as an example, this review describes new tools that can be used to detect and characterise livestock diseases. In recent years, molecular tests that can detect and characterise pathogens in a diverse range of sample types have revolutionised laboratory diagnostics. [...] In addition to use in centralised laboratories, there are opportunities to locate diagnostic technologies close to the animals with suspected clinical signs. Work in this area has developed simple-to-use lateral-flow devices for the detection of FMD virus (FMDV), as well as new hardware platforms to allow molecular testing to be deployed into the field for use by non-specialists. Once FMDV has been detected, nucleotide sequencing is used to compare field strains with reference viruses. Transboundary movements of FMDV are routinely monitored using VP1 sequence data, while higher resolution transmission trees (at the farm-to-farm level) can be reconstructed using full-genome sequencing approaches. New technologies such as next-generation sequencing technologies are now being applied to dissect the viral sequence populations that exist within single samples. The driving force for the use of these technologies has largely been influenced by the priorities of developed countries with FMD-free (without vaccination) status. However, it is important to recognise that these approaches also show considerable promise for use in countries where FMD is endemic, although further modifications (such as sample archiving and strain and serotype characterisation) may be required to tailor these tests for use in these regions. Access to these new diagnostic and sequencing technologies in sub-Saharan Africa have the potential to provide novel insights into FMD epidemiology and will impact upon improved strategies for disease control. Effective control of infectious diseases is reliant upon accurate diagnosis of clinical cases using laboratory tests, together with an understanding of factors that impact upon the epidemiology of the infectious agent. A wide range of new diagnostic tools and nucleotide sequencing methods are used by international reference laboratories to detect and characterise the agents causing outbreaks of infectious diseases. In the past, high costs (initial capital expenses, as well as day-to-day maintenance and running costs) and complexity of the protocols used to perform some of these tests have limited the use of these methods in smaller laboratories. However, simpler and more cost-effective formats are now being developed that offer the prospect that these technologies will be even more widely deployed into laboratories particularly those in developing regions of the world such as sub-Saharan Africa.
Neerinckx, Simon B; Peterson, Andrew T
Background Plague is a rapidly progressing, serious illness in humans that is likely to be fatal if not treated. It remains a public health threat, especially in sub-Saharan Africa. In spite of plague's highly focal nature, a thorough ecological understanding of the general distribution pattern of plague across sub-Saharan Africa has not been established to date. In this study, we used human plague data from sub-Saharan Africa for 1970-2007 in an ecological niche modeling framework to explore the potential geographic distribution of plague and its ecological requirements across Africa. Results We predict a broad potential distributional area of plague occurrences across sub-Saharan Africa. General tests of model's transferability suggest that our model can anticipate the potential distribution of plague occurrences in Madagascar and northern Africa. However, generality and predictive ability tests using regional subsets of occurrence points demonstrate the models to be unable to predict independent occurrence points outside the training region accurately. Visualizations show plague to occur in diverse landscapes under wide ranges of environmental conditions. Conclusion We conclude that the typical focality of plague, observed in sub-Saharan Africa, is not related to fragmented and insular environmental conditions manifested at a coarse continental scale. However, our approach provides a foundation for testing hypotheses concerning focal distribution areas of plague and their links with historical and environmental factors.
Full Text Available Abstract Background The continued poor sexual and reproductive health (SRH outcomes in sub-Saharan Africa highlight the difficulties in reforming policies and laws, and implementing effective programmes. This paper uses one international and two national case studies to reflect on the challenges, dilemmas and strategies used in operationalising sexual and reproductive health and rights (SRHR in different African contexts. Methods The international case study focuses on the progress made by African countries in implementing the African Unions Maputo Plan of Action (for the Operationalisation of the Continental Policy Framework for Sexual and Reproductive Health and Rights and the experiences of state and non-state stakeholders in this process. The case was developed from an evaluation report of the progress made by nine African countries in implementing the Plan of Action, qualitative interviews exploring stakeholders experiences and perceptions of the operationalisation of the plan (carried out as part of the evaluation in Botswana and Nigeria, and authors reflections. The first national case study explores the processes involved in influencing Ghanas Domestic Violence Act passed in 2007; developed from a review of scientific papers and organisational publications on the processes involved in influencing the Act, qualitative interview data and authors reflections. The second national case study examines the experiences with introducing the 2006 Sexual Offences Act in Kenya, and it is developed from organisational publications on the processes of enacting the Act and a review of media reports on the debates and passing of the Act. Results Based on the three cases, we argue that prohibitive laws and governments reluctance to institute and implement comprehensive rights approaches to SRH, lack of political leadership and commitment to funding SRHR policies and programmes, and dominant negative cultural framing of womens issues present the major obstacles to operationalising SRH rights. Analysis of successes points to the strategies for tackling these challenges, which include forming and working through strategic coalitions, employing strategic framing of SRHR issues to counter opposition and gain support, collaborating with government, and employing strategic opportunism. Conclusion The strategies identified show future pathways through which challenges to the realisation of SRHR in Africa can be tackled.
Bock, John; Johnson, Sara E
The human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) pandemic has left large numbers of orphans in sub-Saharan Africa. Botswana has an HIV prevalence rate of approximately 40% in adults. Morbidity and mortality are high, and in a population of a 1.3 million there are nearly 50,000 children who have lost one or both parents to HIV/AIDS. The extended family, particularly grandparents, absorbs much of the childrearing responsibilities. This creates large amounts of additional work for grandmothers especially. The embodied capital model and the grandmother hypothesis are both derived from life history theory within evolutionary ecology, and both predict that one important factor in the evolution of the human extended family structure is that postreproductive individuals such as grandmothers provide substantial support to their grandchildren's survival. Data collected in the pre-pandemic context in a traditional multi-ethnic community in the Okavango Delta of Botswana are analyzed to calculate the amount of work effort provided to a household by women of different ages. Results show that the contributions of older and younger women to the household in term of both productivity and childrearing are qualitatively and quantitatively different. These results indicate that it is unrealistic to expect older women to be able to compensate for the loss of younger women's contributions to the household, and that interventions be specifically designed to support older women based on the type of activities in which they engage that affect child survival, growth, and development. PMID:18193346
Full Text Available The declining efficacy of acaricide treatment as a means of reducing the prevalence of Theileria parva infections in sub-Saharan Africa has intensified efforts to achieve control through immunization of susceptible cattle. The infection and treatment method of immunization has enjoyed a resurgence with the availability of more effective cold chain facilities, although concerns remain regarding the possibility of vaccine strains spreading in local tick populations. In addition, an in-depth understanding of protective mechanisms deployed by immune cattle and the antigens targeted by them has led to substantial progress in the development of candidate subunit vaccines against both sporozoite and schizont stages of the parasite. The likely success of these vaccines, as well as infection and treatment immunization, will ultimately depend on the extent to which they disturb the endemic status of the parasite. These issues are discussed in the light of recent information on the genotypic diversity of T. parva in the field and the extent to which this is compromised by the immune response.
Full Text Available The primary cause of soil degradation in sub-Saharan Africa (SSA is expansion and intensification of agriculture in efforts to feed its growing population. Effective solutions will support resilient systems, and must cut across agricultural, environmental, and socioeconomic objectives. While many studies compare and contrast the effects of different management practices on soil properties, soil degradation can only be evaluated within a specific temporal and spatial context using multiple indicators. The extent and rate of soil degradation in SSA is still under debate as there are no reliable data, just gross estimates. Nevertheless, certain soils are losing their ability to provide food and essential ecosystem services, and we know that soil fertility depletion is the primary cause. We synthesize data from studies that examined degradation in SSA at broad spatial and temporal scales and quantified multiple soil degradation indicators, and we found clear indications of degradation across multiple indicators. However, different indicators have different trajectoriespH and cation exchange capacity tend to decline linearly, and soil organic carbon and yields non-linearly. Future research should focus on how soil degradation in SSA leads to changes in ecosystem services, and how to manage these soils now and in the future.
The bulk of rural populations in sub-Saharan Africa have no access to electricity and are under-served by any other form of modern infrastructure. The cost of infrastructure to mainly scattered communities has been perennially cited as largely to blame. This is an undeniable truth, but only part of it. There are in addition, myriads of social, economic and political obstacles that play an unquantified and frequently unrecognized negative role. At the route of the problem lies a subdued role of the would-be recipients who in fact, unlike anybody else, are conversant with their problems. Consequently, a number of products may come as impositions or misplaced priorities. Consumer participation for sustainable development has been articulated at international forums and in publications as being advantageous. In practice however, the concept appears to be generally shunned and even when, occasionally, tried the needs of the consumers are presumed and their roles prescribed. This paper discusses a range of social, economic and political issues that constitute major obstacles to the realisation of sustainable rural development
Full Text Available In recent times, disasters and risk management have gained significant attention, especially with increasing awareness of the risks and increasing impact of natural and other hazards especially in the developing world. Vulnerability, the potential for loss of life or property from disaster, has biophysical or social dimensions. Social vulnerability relates to societal attributes which has negative impacts on disaster outcomes. This study sought to develop a spatially explicit index of social vulnerability, thus addressing the dearth of research in this area in sub-Saharan Africa. Nineteen variables were identified covering various aspects. Descriptive analysis of these variables revealed high heterogeneity across the South West region of Nigeria for both the state and the local government areas (LGAs. Feature identification using correlation analysis identified six important variables. Factor analysis identified two dimensions, namely accessibility and socioeconomic conditions, from this subset. A social vulnerability index (SoVI showed that Ondo and Ekiti have more vulnerable LGAs than other states in the region. About 50% of the LGAs in Osun and Ogun have a relatively low social vulnerability. Distribution of the SoVI shows that there are great differences within states as well as across regions. Scores of population density, disability and poverty have a high margin of error in relation to mean state scores. The study showed that with a geographical information system there are opportunities to model social vulnerability and monitor its evolution and dynamics across the continent.
Full Text Available The declining efficacy of acaricide treatment as a means of reducing the prevalence of Theileria parva infections in sub-Saharan Africa has intensified efforts to achieve control through immunization of susceptible cattle. The infection and treatment method of immunization has enjoyed a resurgence with the availability of more effective cold chain facilities, although concerns remain regarding the possibility of vaccine strains spreading in local tick populations. In addition, an in-depth understanding of protective mechanisms deployed by immune cattle and the antigens targeted by them has led to substantial progress in the development of candidate subunit vaccines against both sporozoite and schizont stages of the parasite. The likely success of these vaccines, as well as infection and treatment immunization, will ultimately depend on the extent to which they disturb the endemic status of the parasite. These issues are discussed in the light of recent information on the genotypic diversity of T. parva in the field and the extent to which this is compromised by the immune response.
Canossi, A; Piancatelli, D; Aureli, A; Oumhani, K; Ozzella, G; Del Beato, T; Liberatore, G; El Aouad, R; Adorno, D
The aim of this study was to provide genetic and anthropological information on the Chaouya (CH), an Arabic-speaking population living in West Morocco, Atlantic coast (Settat). In 98 unrelated healthy CH volunteers, we first investigated the human leukocyte antigen (HLA) class I and II allele polymorphisms using a sequence-based typing method and examined haplotypes and relatedness of this group to other African and Mediterranean populations. The study showed the close relatedness with Tunisian population and other North Africans, together with a strong influence of various immigrations, mainly Spaniards, French, and Portuguese, as expected. Nevertheless, analysis of class II allele frequencies (afs) showed that Oromo and Amhara Ethiopian groups cluster together with the Berbers and other North Africans, confirming the relationship between these populations (Afro-Asiatic linguistic group, Hamites). South and sub-Saharan Africans cluster separately at a great distance from CH, except the sub-Saharan Bantu population from Congo Kinshasa, which shows a relatively close genetic relationship ascribable to the effect of a diversifying selection. On the other hand, considering HLA class I afs analyses, it was noteworthy that CH grouped together with sub-Saharans, showing a close genetic distance mainly with Ugandas and Kenians Luo. PMID:20492599
The highest damages from climate change are predicted to be in the agricultural sector in sub-Saharan Africa. Agriculture is predicted to be especially vulnerable in this region because of its current state of high temperature and low precipitation and because it is usually rain-fed or relies on relatively basic technologies which therefore limit its ability to sustain in increased poor climatic conditions . The goal of this research is to quantify the vulnerability of this ecosystem by projecting future changes in agriculture due to IPCC predicted climate change impacts on precipitation and temperature. This research will provide a better understanding of the relationship between precipitation and rain-fed agriculture in savannas. In order to quantify the effects of climate change on agriculture, the impacts of climate change are modeled through the use of a land surface vegetation dynamics model previously developed combined with a crop model [2,4]. In this project, it will be used to model yield for point cropland locations within sub-Saharan Africa between Kenya and Botswana with a range of annual rainfall. With this model, future projections are developed for what can be anticipated for the crop yield based on two precipitation climate change scenarios; (1) decreased depth and (2) decreased frequency as well as temperature change scenarios; (3) only temperature increased, (4) temperature increase dand decreased precipitation depth, and (5) temperature increased and decreased precipitation frequency. Therefore, this will allow conclusions to be drawn about how mean precipitation and a changing climate effect food security in sub-Saharan Africa. As an additional analysis, irrigation is added to the model as it is thought to be the solution to protect food security by maximizing on the potential of food production. In water-limited areas such as Sub-Saharan Africa, it is important to consider water efficient irrigation techniques such as demand-based micro-irrigation where less water is lost to evaporative demand. Demand-based irrigation is based on two main parameters; a trigger level, to initiate the irrigation, and a target level to calculate the amount of irrigation . In order to understand the impact of these two parameters on amount of irrigated water and yield, irrigation is added to the model with variations of these two parameters considered. This analysis will provide the information needed to understand whether irrigation is a feasible and sustainable solution to the loss of food production due to climate change. Resources: Kurukulasuriya, P., and Mendelsohn, Robert (2008). "A Ricardian analysis of the impact of climate change on African cropland." African Journal Agriculture and Resource Economics 02(1). Raes, D., Steduto, P., Hsiao, T., and Fereres, E. (2011). Chapter 3: Calculation Procedure. . AquaCrop Reference Manual Version 3.1 Plus. Vico, G. and A. Porporato (2011). "From rainfed agriculture to stress-avoidance irrigation: I. A generalized irrigation scheme with stochastic soil moisture." Advances in Water Resources 34(2): 263-271. Williams, C., and Albertson, J. (2005). "Contrasting Short- and Long-Timescale Effects of Vegetation Dynamics on Water and Carbon Fluxes in Water-Limited Ecosystems." Water Resources Research. 41: 1-13
Ichoku, C. M.; Ellison, L.; Willmot, K. E.; Gatebe, C. K.; Matsui, T.; Wang, J.; Okonkwo, C.; Damoah, R.; Lee, J.; Adegoke, J. O.; Bolten, J. D.; Policelli, F. S.; Wilcox, E. M.; Habib, S.
The northern sub-Saharan African (NSSA) region, bounded on the north and south by the Sahara and the Equator, respectively, and stretching East-West across Africa, is very vulnerable because of the highly active environmental and meteorological processes associated with its unique location and human activities. Over the years, this region has suffered frequent severe droughts that have caused tremendous hardship and loss of life to millions of its inhabitants due to the rapid depletion of the regional water resources. On the other hand, the NSSA region shows one of the highest biomass-burning rates per unit land area among all regions of the world. Because of the high concentration and frequency of fires in this region, with the associated abundance of heat release and gaseous and particulate smoke emissions, biomass-burning activity is believed to be one of the drivers of the regional carbon and energy cycles, with serious implications for the water cycle and climate. An interdisciplinary research effort sponsored by NASA is presently being focused on the NSSA region, to better understand possible connections between the intense biomass burning observed from satellite year after year across the region and the water cycle, through associated changes in certain essential climate variables (ECVs) including land-cover, albedo, soil moisture, evapotranspiration, and atmospheric composition, which can drive changes in additional ECVs such as atmospheric water vapor and wind patterns, precipitation, surface runoff, and groundwater recharge. A combination of remote sensing and modeling approaches is being utilized to investigate these multiple processes to clarify possible links between them. We are finding significant relationships between biomass burning and many of the above-listed ECVs. In this presentation, we will discuss interesting results as well as the path toward improved understanding of the interrelationships and feedbacks between the water cycle components and the environmental change dynamics due to biomass burning and related processes in the NSSA region.
Brodish, Paul Henry
This paper investigates whether community-level wealth inequality predicts HIV serostatus using DHS household survey and HIV biomarker data for men and women ages 15-59 pooled from six sub-Saharan African countries with HIV prevalence rates exceeding 5%. The analysis relates the binary dependent variable HIV-positive serostatus and two weighted aggregate predictors generated from the DHS Wealth Index: the Gini coefficient, and the ratio of the wealth of households in the top 20% wealth quintile to that of those in the bottom 20%. In separate multilevel logistic regression models, wealth inequality is used to predict HIV prevalence within each statistical enumeration area, controlling for known individual-level demographic predictors of HIV serostatus. Potential individual-level sexual behaviour mediating variables are added to assess attenuation, and ordered logit models investigate whether the effect is mediated through extramarital sexual partnerships. Both the cluster-level wealth Gini coefficient and wealth ratio significantly predict positive HIV serostatus: a 1 point increase in the cluster-level Gini coefficient and in the cluster-level wealth ratio is associated with a 2.35 and 1.3 times increased likelihood of being HIV positive, respectively, controlling for individual-level demographic predictors, and associations are stronger in models including only males. Adding sexual behaviour variables attenuates the effects of both inequality measures. Reporting eleven plus lifetime sexual partners increases the odds of being HIV positive over five-fold. The likelihood of having more extramarital partners is significantly higher in clusters with greater wealth inequality measured by the wealth ratio. Disaggregating logit models by sex indicates important risk behaviour differences. Household wealth inequality within DHS clusters predicts HIV serostatus, and the relationship is partially mediated by more extramarital partners. These results emphasize the importance of incorporating higher-level contextual factors, investigating behavioural mediators, and disaggregating by sex in assessing HIV risk in order to uncover potential mechanisms of action and points of preventive intervention. PMID:24406021
BREGUET, Georges; Bütler, R; Bütler-Brunner, E; Sanchez-Mazas, Alicia
The aim of this investigation is to examine the distribution of the Ag immunological polymorphism in human populations on a worldwide scale and to look for possible explanations of this distribution in the field of modern human peopling history and Ag-system evolution. Extensive Ag-antigene typings were carried out on 13 human population samples, including sub-Saharan African, European, west and east Asiatic, Melanesian, Australian aborigine, and Amerindian groups. Complete Ag-haplotype frequ...
Full Text Available Abstract Background Violence against women, especially by intimate partners, is a serious public health problem that is associated with physical, reproductive and mental health consequences. Even though most societies proscribe violence against women, the reality is that violations against women's rights are often sanctioned under the garb of cultural practices and norms, or through misinterpretation of religious tenets. Methods We utilised data from 17 Demographic and Health Surveys (DHS conducted between 2003 and 2007 in sub-Saharan Africa to assess the net effects of socio-demographic factors on men's and women's attitudes toward intimate partner violence against women (IPVAW using multiple logistic regression models estimated by likelihood ratio test. Results IPVAW was widely accepted under certain circumstances by men and women in all the countries studied. Women were more likely to justify IPVAW than men. "Neglecting the children" was the most common reason agreed to by both women and men for justifying IPVAW followed by "going out without informing husband" and "arguing back with the husband". Increasing wealth status, education attainment, urbanization, access to media, and joint decision making were associated with decreased odds of justifying IPVAW in most countries. Conclusion In most Sub-Saharan African countries studied where IPVAW is widely accepted as a response to women's transgressing gender norms, men find less justification for the practice than do women. The present study suggests that proactive efforts are needed to change these norms, such as promotion of higher education and socio-demographic development. The magnitude and direction of factors associated with attitudes towards IPVAW varies widely across the countries, thus suggesting the significance of capitalizing on need-adapted interventions tailored to fit conditions in each country.
Full Text Available Abstract Background Despite growing HIV and cancer prevalence in Sub-Saharan Africa, and WHO advocacy for a public health approach to palliative care provision, opioid availability is severely limited. Uganda has achieved a morphine roll-out programme in partnership with the Ministry of Health. This study aimed to evaluate that programme by identifying challenges to implementation that may inform replication. Methods A multi-methods protocol appraised morphine regulation, storage, prescribing, and consumption in three phases: key informant interviews throughout the opioid supply chain, and direct observation and audit of clinical practice. Results Regulation had achieved its goal of preventing misuse and leakage from the supply chain. However, the Government felt that relaxation of regulation was now appropriate. Confusion and complexity in storage and authorisation rules led to discontinuation of opioid pain management at the patient level and also wasted service time in trying to obtain supplies to which they were entitled. Continued neglect to prescribe among clinicians and public fear of opioids led to under prescribing, and clinical skills showed some evidence of need for improvement with respect to physical assessment and follow-up. Conclusion The Ugandan programme offers a successful model for both advocacy and Governmental support in achieving opioid roll-out across health districts. Despite initial concerns, abuse of opioids has not been evident. Further work is required to ensure that available supplies of opioids are prescribed to those in need, and that clinical standards are met. However, the programme for roll-out has proved a useful model to expand opioid availability as the first step in improving patient care, and may prove a useful template for other Sub-Saharan African countries.
Pool Robert; Straus Lianne; Pell Christopher; Gysels Marjolein
Abstract Background End of life (EoL) care in sub-Saharan Africa still lacks the sound evidence-base needed for the development of effective, appropriate service provision. It is essential to make evidence from all types of research available alongside clinical and health service data, to ensure that EoL care is ethical and culturally appropriate. This article aims to synthesize qualitative research on EoL care in sub-Saharan Africa to inform policy, practice and further research. It seeks to...
Riddell, P. J.; Westlake, Michael; Burke, Jacob J.
If irrigated production is to make a significant contribution to food security and economic growth in Sub Saharan Africa, it will have to be re-structured across the region as a whole. This is the main conclusion of a study undertaken by FAO to analyse the drivers of demand for irrigated production in Sub-Saharan Africa (SSA). Steeply rising commercial food import bills for staple crops across SSA are indicative of the level demand that is not being met from domestic production. The increase ...
Coburn, Carolyn; Restivo, Michael; Shandra, John M
We conduct a cross-national analysis to test the hypothesis that African Development Bank (AfDB) structural adjustment lending adversely impacts maternal mortality in Sub-Saharan Africa. We analyze data for thirty-five Sub-Saharan African nations with up to four time points (1990, 1995, 2000, and 2005) with generalized least squares random effects regression models and modified two-step Heckman models that correct for potential endogeneity regarding whether or not a Sub-Saharan African nations receives an AfDB structural adjustment loan. We find support for our hypothesis that indicates that Sub-Saharan African nations that receive an AfDB structural adjustment loan tend to have higher levels of maternal mortality than Sub-Saharan African nations that do not receive such a loan. This finding remains stable even when controlling for endogeneity. We conclude by talking about the theoretical and methodological implications along with possible directions for future research. PMID:25769869
John G Cleland
Full Text Available OBJECTIVE: To review progress towards adoption of contraception among married or cohabiting women in western and eastern Africa between 1991 and 2004 by examining subjective need, approval, access and use. METHODS: Indicators of attitudes towards and use of contraception were derived from Demographic and Health Surveys, which are nationally representative and yield internationally comparable data. Trends were examined for 24 countries that had conducted at least two surveys between 1986 and 2007. FINDINGS: In western Africa, the subjective need for contraception remained unchanged; about 46% of married or cohabiting women reported a desire to stop and/or postpone childbearing for at least two years. The percentage of women who approved of contraception rose from 32 to 39 and the percentage with access to contraceptive methods rose from 8 to 29. The proportion of women who were using a modern method when interviewed increased from 7 to 15% (equivalent to an average annual increase of 0.6 percentage points. In eastern African countries, trends were much more favourable, with contraceptive use showing an average annual increase of 1.4 percentage points (from 16% in 1986 to 33% in 2007. CONCLUSION: In western Africa, progress towards adoption of contraception has been dismally slow. Attitudinal resistance remains a barrier and access to contraceptives, though improving, is still shockingly limited. If this situation does not change radically in the short run, the United Nations population projections for this subregion are likely to be exceeded. In eastern Africa, the prospects for a future decline in fertility are much more positive.
Naylor, R.; Burney, J. A.; Postel, S.
The poorest populations in sub-Saharan Africa live in rural areas and depend on smallholder agricultural production for their livelihoods. Over 90% of all farmed area in Sub-Saharan Africa is rainfed, with crop production centering on 3-5 months of rainfall. Rapid population growth is reducing land per capita ratios, and low yields for staple crops make food security an increasingly challenging goal. Malnutrition, most noticeable among children, peaks during the dry season. Recent data on aggregate economic growth and investment in Africa hide these patterns of seasonal hunger and income disparity. Perhaps most perversely, smallholder farmers in the dry tropical regions of sub-Saharan Africa are (and will continue to be) some of the earliest and hardest hit by climate change. Our research focuses on the role distributed, small-scale irrigation can play in food security and climate change adaptation in sub-Saharan Africa. As Asia's agricultural success has demonstrated, irrigation, when combined with the availability of inputs (fertilizer) and improved crop varieties, can enable year-round production, growth in rural incomes, and a dramatic reduction in hunger. The situation in Africa is markedly different: agroecological conditions are far more heterogeneous than in Asia and evaporation rates are relatively high; most smallholders lack access to fertilizers; and market integration is constrained by infrastructure, information, and private sector incentives. Yet from a resource perspective, national- and regional-level estimates suggest that Internal Renewable Water Resources (IRWR) are nowhere near fully exploited in Sub-Saharan Africa -- even in the Sudano-Sahel, which is considered to be one of the driest regions of the continent. Irrigation can thus be implemented on a much larger scale sustainably. We will present (a) results from controlled, experimental field studies of solar-powered drip irrigation systems in the rural Sudano-Sahel region of West Africa. We have shown that such systems can be implemented in a cost-competitive and environmentally responsible manner, with significant and sustained impact on livelihoods. These findings will be coupled with (b) case studies of successful and failed irrigation projects across the continent that reveal technical and institutional requirements for success; and (c) regional and continental data that quantify the larger-scale food security, development, adaptation, and mitigation potentials of these types of smallholder systems.
Injuries are common and on increase in most developing countries, including sub-Saharan Africa. A large proportion of the injuries are caused by road traffic accidents, falls, burns, assaults, bites, stings and other animal-related injuries, poisonings, drownings/near-drownings and suicide. Globally, injuries are responsible for about five per cent of the total mortality, and the overall global annual costs were estimated in the late 1980s at around 500 billion US dollars. The burden and pattern of injuries in Africa and other developing areas are poorly known and not well studied. The incidence is on the increase, partly due to rapid growth of motorised transport and to expansion of industrial production without adequate safety precautions. This is a review of data on various kinds of injuries in developing countries with a focus on sub-Saharan Africa. A computerised search of the relevant literature published between 1985 and 1998 was conducted and a manual search of journals publishing texts on health in low-income countries and in tropical environments was also done. A few studies on injury prevention policy and on research related to injury epidemiology and prevention have also been identified and included. It is concluded that in a relatively typical East African area with a total mortality rate of 1,300/100,000/year, injuries are likely to cause around 100 of these deaths. The corresponding total rate of significant injuries is estimated at 40,000/100,000/year with a breakdown as tabulated below. [table: see text] Although a few surveys and other investigations of injuries have been conducted over the years, injury epidemiology and control remain under-researched and relatively neglected subject areas. Much needs to be done. Collection and analysis of injury data need to be standardised, for example regarding age groups, gender disaggregation and severity. Injuries and accidents should be subdivided in at least road traffic injury, fall, burn, assault, poisoning, drowning, suicide, homicide and others, and details regarding time and place, victim and main cause should be noted. Morbidity survey field staff should be informed that injuries are part of the illness concept and that questions should be asked accordingly. Details regarding the circumstances surrounding different injuries must be known to those who develop preventive programmes. Injury is a public health problem affecting some people more than others. Our ordinary environment--the home, the work-site, the street or road--represents various kinds of risk, and some of these are difficult to eliminate. Not only do we have to accept much of our environment with its existing houses, equipment, vehicles, transport systems, energy supply, toxic substances etcetera, many also suffer from various inherited or acquired conditions that increase the risk. We therefore need to develop safer and more "forgiving" living environments where ordinary people can live and move around safely. Injury control activities may focus on different categories of injury. Road safety measures often include information and education campaigns, improved driver training, road design and maintenance, regular vehicle safety checks, separation of pedestrians from vehicle traffic, speed limits, safety belt, air-bag and helmet use, special training and control of public service vehicle drivers, bicycle lane separation, road lighting, reflectorised materials on clothing, review of the road traffic related legislation and law enforcement, and emergency medical services improvement. Domestic injuries can be prevented for example with window guards, child barriers at stairs, smoke detectors, clothes and furniture in less flammable materials, replacement of open stoves, stabilising of open lamps, fire-fighting equipment and practice, child-proof poison packaging and storage, safe disposal of toxic waste, home safety education of parents, and strict building code enforcement. Occupational injuries can largely be prevented if well adapted to the work environment. Research is required in s
J, Edge; I, Buccimazza; H, Cubasch; E, Panieri.
Full Text Available Communicable diseases are the major cause of mortality in lower-income countries. Consequently, local and international resources are channelled mainly into addressing the impact of these conditions. HIV, however, is being successfully treated, people are living longer, and disease patterns are chan [...] ging. As populations age, the incidence of cancer inevitably increases. The World Health Organization has predicted a dramatic increase in global cancer cases during the next 15 years, the majority of which will occur in low- and middle-income countries. Cancer treatment is expensive and complex and in the developing world 5% of global cancer funds are spent on 70% of cancer cases. This paper reviews the challenges of managing breast cancer in the developing world, using sub-Saharan Africa as a model.
Nygaard, Ivan; Bindner, Henrik W.
Solar PV is one among other low carbon technologies for rural electrification in Sub Saharan Africa (SSA). Solar PV systems have for almost 30 years been disseminated in SSA, resulting in more than half a million installations concentrated in a few countries. While PV systems have technically matured and markets have gradually developed, PV for rural electrification has often been perceived with scepticism from potential users, donors, government officials and researchers, and solar PV has in many camps been labelled as donor driven, expensive and fragile technology mainly serving the richest parts of the populations and with little or no value for productive uses. However, feasibility for solar PV has improved in the last few years. Retail prices for solar photovoltaic modules are reduced by 20-30% since 2001, and although far from the peak in 2008, oil prices in the next two years to come are expected to settle at a level, which is about three times the world market average in the years from 1985-2003. Therefore, rather than being limited to a niche for populations living in dispersed settlements outside the reach of grid electrification, solar PV is expected to play an important role in mini grid rural electrification schemes based on hybrid solar PVdiesel generators. This may bring PV systems in line with fossil fuel based systems in terms of consumer cost and options for productive use and it changes the market for PV from mainly donor supported schemes into mainstream rural electrification schemes governed and financed by electric utilities and rural electrification agencies. Based on a literature review and the experience with a full scale hybrid wind/PV diesel system at RISØ DTU, this paper provides cost estimates for hybrid PV-diesel systems and policy recommendations to change the application of PV technologies for development in SSA.
The morphology of the Dryopteris species occurring in sub-Saharan Africa is discussed. This is followed by a revision of the genus in this region, and the Cape Verde Islands in the Gulf of Guinea. Twenty-six species are recognised for the region.
Cross-sectional and repeated surveys from household components of Demographic and Health Surveys in sub-Saharan Africa were examined to determine whether household composition indicators for older adults (N = 52,573), involving offspring and grandchildren, correlated with national levels of AIDS mortality. One in 4 was living with a grandchild
Morell, Jonathan A., Ed.
Describes 14 evaluations of HIV and AIDS programs undertaken in sub-Saharan Africa over the last decade. These programs demonstrate the importance of enhancing program quality and providing national coverage, rooting programs in community, empowering young people, and developing partnerships to combat HIV and AIDS. (SLD)
Mortlock, Marinda; Kuzmin, Ivan V.; Weyer, Jacqueline; Gilbert, Amy T.; Agwanda, Bernard; Rupprecht, Charles E.; Nel, Louis H.; Kearney, Teresa; Malekani, Jean M.
As part of a larger survey for detection of pathogens among wildlife in sub-Saharan Africa conducted during 20072012, multiple diverse paramyxovirus sequences were detected in renal tissues of bats. Phylogenetic analysis supports the presence of at least 2 major viral lineages and suggests that paramyxoviruses are strongly associated with several bat genera. PMID:26402433
Koosimile, Anthony T.; Suping, Shanah M.
This paper takes the view that the emergence of some trends and practices in science education mirrors the influence of the process of globalisation in Anglophone Sub-Saharan Africa. Through a literature review, an attempt is made to link science education and globalisation by answering the question: "What influence does globalisation have on
Ngwana, Terfot Augustine
This paper argues that a framework for strategic planning in universities in Sub-Saharan Africa can be developed with the background of global, regional, and institutional realities. Using the specific case of the University of Buea in Cameroon, the paper attempts to expose the global trends of polarization in knowledge production capacity as an
Caradee Y., Wright; Mary, Norval; Beverley, Summers; Lester, Davids; Gerrie, Coetzee; Matthew O., Oriowo.
Full Text Available Photoprotection messages and 'SunSmart' programmes exist mainly to prevent skin cancers and, more recently, to encourage adequate personal sun exposure to elicit a vitamin D response for healthy bone and immune systems. Several developed countries maintain intensive research networks and monitor sol [...] ar UV radiation to support awareness campaigns and intervention development. The situation is different in sub-Saharan Africa. Adequate empirical evidence of the impact of solar UV radiation on human health, even for melanomas and cataracts, is lacking, and is overshadowed by other factors such as communicable diseases, especially HIV, AIDS and tuberculosis. In addition, the established photoprotection messages used in developed countries have been adopted and implemented in a limited number of sub-Saharan countries but with minimal understanding of local conditions and behaviours. In this review, we consider the current evidence for sun-related effects on human health in sub-Saharan Africa, summarise published research and identify key issues. Data on the prevalence of human diseases affected by solar UV radiation in all subpopulations are not generally available, financial support is insufficient and the infrastructure to address these and other related topics is inadequate. Despite these limitations, considerable progress may be made regarding the management of solar UV radiation related health outcomes in sub-Saharan Africa, provided researchers collaborate and resources are allocated appropriately.
...commitments in Sub- Saharan Africa under the loan, guarantee...for trade with Sub-Saharan Africa. Time and Place: Wednesday...developments in Sub-Saharan Africa markets by Ex-Im Bank staff...any person wishes auxiliary aids (such as a sign language...
...commitments in Sub- Saharan Africa under the loan, guarantee...for trade with Sub-Saharan Africa. Time and Place: Tuesday...developments in Sub-Saharan Africa markets by Ex-Im Bank staff...any person wishes auxiliary aids (such as a sign language...
...commitments in Sub- Saharan Africa under its loan, guarantee...for trade with Sub- Saharan Africa. Time and Place: Monday...developments in Sub-Saharan Africa markets by Ex-Im Bank staff...any person wishes auxiliary aids (e.g., a sign...
Esayas Haregot Hilawe
Full Text Available Objective To assess differences between men and women in the prevalence of diabetes mellitus, impaired fasting glycaemia and impaired glucose tolerance in sub-Saharan Africa. Methods In September 2011, the PubMed and Web of Science databases were searched for community-based, cross-sectional studies providing sex-specific prevalences of any of the three study conditions among adults living in parts of sub-Saharan Africa (i.e. in Eastern, Middle and Southern Africa according to the United Nations subregional classification for African countries. A random-effects model was then used to calculate and compare the odds of men and women having each condition. Findings In a meta-analysis of the 36 relevant, cross-sectional data sets that were identified, impaired fasting glycaemia was found to be more common in men than in women (OR: 1.56; 95% confidence interval, CI: 1.202.03, whereas impaired glucose tolerance was found to be less common in men than in women (OR: 0.84; 95% CI: 0.720.98. The prevalence of diabetes mellitus which was generally similar in both sexes (OR: 1.01; 95% CI: 0.911.11 was higher among the women in Southern Africa than among the men from the same subregion and lower among the women from Eastern and Middle Africa and from low-income countries of sub-Saharan Africa than among the corresponding men. Conclusion Compared with women in the same subregions, men in Eastern, Middle and Southern Africa were found to have a similar overall prevalence of diabetes mellitus but were more likely to have impaired fasting glycaemia and less likely to have impaired glucose tolerance.
Daar Abdallah S
Full Text Available Abstract In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation. This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive on-the-ground research in the form of four country case studies of health and biotechnology innovation, six studies of institutions within Africa involved in health product development, and one study of health venture funds in Africa. To the best of our knowledge it is the first extensive collection of empirical work on African science-based health innovation. The four country cases are Ghana, Rwanda, Tanzania and Uganda. The six case studies of institutions are A to Z Textiles (Tanzania, Acorn Technologies (South Africa, Bioventures venture capital fund (South Africa, the Malagasy Institute of Applied Research (IMRA; Madagascar, the Kenyan Medical Research Institute (KEMRI; Kenya, and Niprisans development by Nigerias National Institute for Pharmaceutical Research and Development and Xechem (Nigeria. All of the examples highlight pioneering attempts to build technological capacity, create economic opportunities, and retain talent on a continent significantly affected by brain drain. They point to the practical challenges for innovators on the ground, and suggest potentially helpful policies, funding streams, and other support systems. For African nations, health innovation represents an opportunity to increase domestic capacity to solve health challenges; for international funders, it is an opportunity to move beyond foreign aid and dependency. The shared goal is creating self-sustaining innovation that has both health and development impacts. While this is a long-term strategy, this series shows the potential of African-led innovation, and indicates how it might balance realism against opportunity. There is ample scope to learn lessons more systematically from cases like those we discuss; to link entrepreneurs, scientists, funders, and policy-makers into a network to share opportunities and challenges; and ultimately to better support and stimulate African-led health innovation.
This website created by the Philadelphia Museum of Art complements an exhibition that "surveys the artistic achievements of just a few of the many cultures of sub-Saharan Africa" organized by the Seattle Art Museum, using artifacts from its African collections. The largest section of the Web site, African Voices, features interviews with African artists, art historians and others, focusing on particular aspects of African cultures. For example, Hannah Kema Foday, a Mende woman from Segbwema, southwestern Sierra Leone, now living in New York city, speaks about Sowei masks and initiation for girls into womanhood. The other two sections - African Art in Motion and Contemporary African Art, show the expressive use of figures in African sculpture and the work of modern African artists, living in Africa and all over the world, respectively.
Lund, C; Alem, A; Schneider, M; Hanlon, C; Ahrens, J; Bandawe, C; Bass, J; Bhana, A; Burns, J; Chibanda, D; Cowan, F; Davies, T; Dewey, M; Fekadu, A; Freeman, M; Honikman, S; Joska, J; Kagee, A; Mayston, R; Medhin, G; Musisi, S; Myer, L; Ntulo, T; Nyatsanza, M; Ofori-Atta, A; Petersen, I; Phakathi, S; Prince, M; Shibre, T; Stein, D J; Swartz, L; Thornicroft, G; Tomlinson, M; Wissow, L; Susser, E
There is limited evidence on the acceptability, feasibility and cost-effectiveness of task-sharing interventions to narrow the treatment gap for mental disorders in sub-Saharan Africa. The purpose of this article is to describe the rationale, aims and methods of the Africa Focus on Intervention Research for Mental health (AFFIRM) collaborative research hub. AFFIRM is investigating strategies for narrowing the treatment gap for mental disorders in sub-Saharan Africa in four areas. First, it is assessing the feasibility, acceptability and cost-effectiveness of task-sharing interventions by conducting randomised controlled trials in Ethiopia and South Africa. The AFFIRM Task-sharing for the Care of Severe mental disorders (TaSCS) trial in Ethiopia aims to determine the acceptability, affordability, effectiveness and sustainability of mental health care for people with severe mental disorder delivered by trained and supervised non-specialist, primary health care workers compared with an existing psychiatric nurse-led service. The AFFIRM trial in South Africa aims to determine the cost-effectiveness of a task-sharing counselling intervention for maternal depression, delivered by non-specialist community health workers, and to examine factors influencing the implementation of the intervention and future scale up. Second, AFFIRM is building individual and institutional capacity for intervention research in sub-Saharan Africa by providing fellowship and mentorship programmes for candidates in Ethiopia, Ghana, Malawi, Uganda and Zimbabwe. Each year five Fellowships are awarded (one to each country) to attend the MPhil in Public Mental Health, a joint postgraduate programme at the University of Cape Town and Stellenbosch University. AFFIRM also offers short courses in intervention research, and supports PhD students attached to the trials in Ethiopia and South Africa. Third, AFFIRM is collaborating with other regional National Institute of Mental Health funded hubs in Latin America, sub-Saharan Africa and south Asia, by designing and executing shared research projects related to task-sharing and narrowing the treatment gap. Finally, it is establishing a network of collaboration between researchers, non-governmental organisations and government agencies that facilitates the translation of research knowledge into policy and practice. This article describes the developmental process of this multi-site approach, and provides a narrative of challenges and opportunities that have arisen during the early phases. Crucial to the long-term sustainability of this work is the nurturing and sustaining of partnerships between African mental health researchers, policy makers, practitioners and international collaborators. PMID:25833714
Full Text Available Abstract Background The identification of safe and effective alternatives to blood transfusion is a public health priority. In sub-Saharan Africa, blood shortage is a cause of mortality and morbidity. Blood transfusion can also transmit viral infections. Giving tranexamic acid (TXA to bleeding surgical patients has been shown to reduce both the number of blood transfusions and the volume of blood transfused. The objective of this study is to investigate whether routinely administering TXA to bleeding elective surgical patients is cost effective by both averting deaths occurring from the shortage of blood, and by preventing infections from blood transfusions. Methods A decision tree was constructed to evaluate the cost-effectiveness of providing TXA compared with no TXA in patients with surgical bleeding in four African countries with different human immunodeficiency virus (HIV prevalence and blood donation rates (Kenya, South Africa, Tanzania and Botswana. The principal outcome measures were cost per life saved and cost per infection averted (HIV, Hepatitis B, Hepatitis C averted in 2007 International dollars ($. The probability of receiving a blood transfusion with and without TXA and the risk of blood borne viral infection were estimated. The impact of uncertainty in model parameters was explored using one-way deterministic sensitivity analyses. Probabilistic sensitivity analysis was performed using Monte Carlo simulation. Results The incremental cost per life saved is $87 for Kenya and $93 for Tanzania. In Botswana and South Africa, TXA administration is not life saving but is highly cost saving since fewer units of blood are transfused. Further, in Botswana the administration of TXA averts one case of HIV and four cases of Hepatitis B (HBV per 1,000 surgical patients. In South Africa, one case of HBV is averted per 1,000 surgical patients. Probabilistic sensitivity analyses confirmed the robustness of the model. Conclusion An economic argument can be made for giving TXA to bleeding elective surgical patients. In countries where there is a blood shortage, TXA would be a cost effective way to reduce mortality. In countries where there is no blood shortage, TXA would reduce healthcare costs and avert blood borne infections.
Ben Chirwa; Chipayeni Mtonga; Anyangwe, Stella C. E.
The United Nations Millennium Development Goals (MDGs) are a series of 8 goals and 18 targets aimed at ending extreme poverty by 2015, and there are 48 quantifiable indicators for monitoring the process. Most of the MDGs are health or health-related goals. Though the MDGs might sound ambitious, it is imperative that the world, and sub-Saharan Africa in particular, wake up to the persistent and unacceptably high rates of extreme poverty that populations live in, and find lasting solutions to a...
Full Text Available Abstract Background Although sub-Saharan Africa (SSA is rapidly urbanizing, the terms used to classify urban ecotypes are poorly defined in the context of malaria epidemiology. Lack of clear definitions may cause misclassification error, which likely decreases the accuracy of continent-wide estimates of malaria burden, limits the generalizability of urban malaria studies, and makes identification of high-risk areas for targeted interventions within cities more difficult. Accordingly, clustering techniques were applied to a set of urbanization- and malaria-related variables in Kisumu, Kenya, to produce a quantitative classification of the urban environment for malaria research. Methods Seven variables with a known or expected relationship with malaria in the context of urbanization were identified and measured at the census enumeration area (EA level, using three sources: a the results of a citywide knowledge, attitudes and practices (KAP survey; b a high-resolution multispectral satellite image; and c national census data. Principal components analysis (PCA was used to identify three factors explaining higher proportions of the combined variance than the original variables. A k-means clustering algorithm was applied to the EA-level factor scores to assign EAs to one of three categories: "urban," "peri-urban," or "semi-rural." The results were compared with classifications derived from two other approaches: a administrative designation of urban/rural by the census or b population density thresholds. Results Urban zones resulting from the clustering algorithm were more geographically coherent than those delineated by population density. Clustering distributed population more evenly among zones than either of the other methods and more accurately predicted variation in other variables related to urbanization, but not used for classification. Conclusion Effective urban malaria epidemiology and control would benefit from quantitative methods to identify and characterize urban areas. Cluster analysis techniques were used to classify Kisumu, Kenya, into levels of urbanization in a repeatable and unbiased manner, an approach that should permit more relevant comparisons among and within urban areas. To the extent that these divisions predict meaningful intra-urban differences in malaria epidemiology, they should inform targeted urban malaria interventions in cities across SSA.
Stulac, Sara; Binagwaho, Agnes; Tapela, Neo M; Wagner, Claire M; Muhimpundu, Marie Aimee; Ngabo, Fidele; Nsanzimana, Sabin; Kayonde, Leonard; Bigirimana, Jean Bosco; Lessard, Adam J; Lehmann, Leslie; Shulman, Lawrence N; Nutt, Cameron T; Drobac, Peter; Mpunga, Tharcisse; Farmer, Paul E
Despite an estimated 456?000 deaths caused by cancer in sub-Saharan Africa in 2012 and a cancer burden that is predicted to double by 2030, the region accounts for only 0·3% of worldwide medical expenditure for cancer. Challenges to cancer care in sub-Saharan Africa include a shortage of clinicians and training programmes, weak healthcare infrastructure, and inadequate supplies. Since 2011, Rwanda has developed a national cancer programme by designing comprehensive, integrated frameworks of care, building local human resource capacity through partnerships, and delivering equitable, rights-based care. In the 2 years since the inauguration of Rwanda's first cancer centre, more than 2500 patients have been enrolled, including patients from every district in Rwanda. Based on Rwanda's national cancer programme development, we suggest principles that could guide other nations in the development of similar cancer programmes. PMID:26248848
Adisa, Femi; Isabalija, Stephen R.
This paper discusses the need for IS research with a focus on SME adoption of enterprise systems in the context of Sub-Saharan Africa. Previous IS research into general adoption in several developing countries have shown that local context play a significant role in the successful implementation of any information system. SMEs constitute a majority of all organizations in most Sub Saharan economies, thus their importance to the socioeconomic development and empowerment of the region cannot be overemphasized. However, the absence of literature and focused research into factors that influence enterprise systems adoption and use that are particular to this region represents a huge gap for both researchers and practitioners. This call to action paper will attempt to present the implications of this deficiency and outline areas where future research can be most beneficial to stakeholders.
Kamau, Edwin; Campino, Susana; Amenga-Etego, Lucas; Drury, Eleanor; Ishengoma, Deus; Johnson, Kimberly; Mumba, Dieudonne; Kekre, Mihir; Yavo, William; Mead, Daniel; Bouyou-Akotet, Marielle; Apinjoh, Tobias; Golassa, Lemu; Randrianarivelojosia, Milijaona; Andagalu, Ben; Maiga-Ascofare, Oumou; Amambua-Ngwa, Alfred; Tindana, Paulina; Ghansah, Anita; MacInnis, Bronwyn; Kwiatkowski, Dominic; Djimde, Abdoulaye A
Mutations in the Plasmodium falciparum K13-propeller domain have recently been shown to be important determinants of artemisinin resistance in Southeast Asia. This study investigated the prevalence of K13-propeller polymorphisms across sub-Saharan Africa. A total of 1212 P. falciparum samples collected from 12 countries were sequenced. None of the K13-propeller mutations previously reported in Southeast Asia were found, but 22 unique mutations were detected, of which 7 were nonsynonymous. Allele frequencies ranged between 1% and 3%. Three mutations were observed in >1 country, and the A578S was present in parasites from 5 countries. This study provides the baseline prevalence of K13-propeller mutations in sub-Saharan Africa. PMID:25367300
Lund, Henrik Hautop
This concept paper explores a technological building block approach to the development of a flexible rehabilitation tool that may address some of the needs in sub-Saharan Africa. We briefly outline some of the health challenges that lead us to suggest a concept for physical rehabilitation solutions to address many diverse patient groups (e.g. disabled children, cardiac, and stroke patients), to be used in both urban and rural areas, to be easily used in community based rehabilitation (e.g. by community rehabilitation workers), to motivate the users, and to be robust to failure (e.g. power failure) in remote areas. The concept leads to the implementation of modular interactive tiles for rehabilitation, and suggestions for future use in sub-Saharan Africa.
Agreement between clinicians' and care givers' assessment of intelligence in Nigerian children with intellectual disability: 'ratio IQ' as a viable option in the absence of standardized 'deviance IQ' tests in sub-Saharan Africa
Aguocha Chinyere M
Full Text Available Abstract Background There may be need to assess intelligent quotient (IQ scores in sub-Saharan African children with intellectual disability, either for the purpose of educational needs assessment or research. However, modern intelligence scales developed in the western parts of the world suffer limitation of widespread use because of the influence of socio-cultural variations across the world. This study examined the agreement between IQ scores estimation among Nigerian children with intellectual disability using clinicians' judgment based on International Classification of Diseases, tenth Edition (ICD - 10 criteria for mental retardation and caregivers judgment based on 'ratio IQ' scores calculated from estimated mental age in the context of socio-cultural milieu of the children. It proposed a viable option of IQ score assessment among sub-Saharan African children with intellectual disability, using a ratio of culture-specific estimated mental age and chronological age of the child in the absence of standardized alternatives, borne out of great diversity in socio-cultural context of sub-Saharan Africa. Methods Clinicians and care-givers independently assessed the children in relation to their socio-cultural background. Clinicians assessed the IQ scores of the children based on the ICD - 10 diagnostic criteria for mental retardation. 'Ratio IQ' scores were calculated from the ratio of estimated mental age and chronological age of each child. The IQ scores as assessed by the clinicians were then compared with the 'ratio IQ' scores using correlation statistics. Results A total of forty-four (44 children with intellectual disability were assessed. There was a significant correlation between clinicians' assessed IQ scores and the 'ratio IQ' scores employing zero order correlation without controlling for the chronological age of the children (r = 0.47, df = 42, p = 0.001. First order correlation controlling for the chronological age of the children showed higher correlation score between clinicians' assessed IQ scores and 'ratio IQ' scores (r = 0.75, df = 41, p = 0.000. Conclusion Agreement between clinicians' assessed IQ scores and 'ratio IQ' scores was good. 'Ratio IQ' test would provide a viable option of assessing IQ scores in sub-Saharan African children with intellectual disability in the absence of culture-appropriate standardized intelligence scales, which is often the case because of great diversity in socio-cultural structures of sub-Saharan Africa.
KOETHE, John R.; Heimburger, Douglas C.
The twin global epidemics of HIV infection and food scarcity disproportionately affect sub-Saharan Africa, and a significant proportion of patients who require antiretroviral therapy (ART) are malnourished because of a combination of HIV-associated wasting and inadequate nutrient intake. Protein-calorie malnutrition, the most common form of adult malnutrition in the region, is associated with significant morbidity and compounds the immunosuppressive effects of HIV. A low body mass index (BMI)...
Bärnighausen, Till; Chaiyachati, Krisda; Chimbindi, Natsayi; Peoples, Ashleigh; Haberer, Jessica; Newell, Marie-Louise
The success of potent antiretroviral treatment (ART) for HIV infection is primarily determined by the level of medication adherence. We systematically review the evidence on effectiveness of interventions to enhance ART adherence in sub-Saharan Africa (SSA), where four fifths of the more than five million people receiving ART live. We identified 26 relevant publications reporting on 25 studies, conducted between 2003 and 2010, of behavioural, cognitive, biological, structural, and combination...
This paper discusses the abundance of freshwater availability in Nigeria which is approximately 0.51% of world freshwater resources. It further highlights the projected freshwater crises in Nigeria and Africa as a whole. Based on analyzed country data retrieved from International Organizations, Nigeria and in fact many developing countries in Sub Saharan Africa is presently termed water secure based on total Actual Renewable Water Resources, but projections into the nearest future (2025) clas...
Craig, MH; Snow, RW; le Sueur, D
Malaria remains the single largest threat to child survival in sub-Saharan Africa and warrants long-term investment for control. Previous malaria distribution maps have been vague and arbitrary. Marlies Craig, Bob Snow and David le Sueur here describe a simple numerical approach to defining distribution of malaria transmission, based upon biological constraints of climate on parasite and vector development. The model compared well with contemporary field data and historical 'expert opinion' m...
The study uses power relations theory to investigate existence of perceived retaliation against internal whistleblowers in Sub-Saharan Africa using evidence from employees in public institutions of Kenya. Focus was on the way perceived retaliation is related to seriousness of wrongdoing, whistleblower psychological power and management support to whistleblowers. The research design was quantitative, exploratory and analytical using cross-sectional data. Respondents were selected using simple ...
De Garine-Wichatitsky, Michel; Caron, Alexandre; Kock, Richard A.; Tschopp, R.; Munyeme, M.; Hofmeyr, Markus; Michel, Anita Luise
Infection of wild animals by bovine tuberculosis (bTB) is raising concern worldwide. This article reviews the current epidemiological situation, risk of emergence and control options at the wildlife-livestock-human interface in sub-Saharan Africa. In livestock, bTB has been confirmed in the majority of countries from all parts of the continent. Wildlife infection is confirmed in 7 countries from southern and eastern Africa, apparently spreading in the southern Africa region. My...
Vastveit, Lene Kristin
This thesis examines two cases of Export Processing Zone (EPZ) programmes in sub-Saharan Africa (SSA), specifically in Kenya and Lesotho. Using data from the respective countries' EPZ programme authorities, central banks, relevant studies, and country reports, I show that although the programmes have facilitated employment generation and foreign exchange earnings from textile and apparel exports, such exports rely highly on preferential trade agreements such as the Africa...
Little investigation has been made to explain why women are less likely than are men to support democracy in sub-Saharan Africa. This gender difference in politics has been found in numerous studies and may hinder the much needed legitimation of democracy in this region. This paper addresses the question of whether this observed gender gap is due to the omission of social institutions related to gender inequality, something that affects women's daily life and deprives them of autonomy at home...
The principal objectives of this research were: · to develop a conceptual framework on sustainability and sustainable development and · to propose a strategy framework for sustainable industrial development in Sub-Saharan Africa (SSA). The research was done based on systems evolutionary approach having the following methodological principles as a guide. · The dynamic complexity of environmental and developmental issues can be better understood by utilizing transdisciplinary theories such as ...
Curry Leslie; Taylor Lauren; Chen Peggy; Bradley Elizabeth
Abstract Background Leadership is widely regarded as central to effective health-care systems, and resources are increasingly devoted to the cultivation of strong health-care leadership. Nevertheless, the literature regarding leadership capacity building has been developed primarily in the context of high-income settings. Less research has been done on leadership in low-income settings, including sub-Saharan Africa, particularly in health care, with attention to historical, political and soci...
In the past decades, most of the countries in Sub-Saharan Africa have been affected by armed conflicts. By means of a time-series cross-sectional (TSCS) database, we attempt to measure the impact of war on a sample of 43 countries in Africa from 1950 to 2010. These conflicts, and especially civil wars, are shown to have a strong negative effect on
Soil fertility management in sub-Saharan Africa is complex, diverse and dynamic. Farmers' investments are determined by a wide variety of factors, including bio-physical characteristics of the environment, access to resources and the institutional, and socio-economic context of farming and livelihood making. Within this context, defining soil fertility problems in general terms is not meaningful and proposing a limited number of standard interventions, aimed at the 'average' farmer is of limi...
Aphane, Bonolo Manai
The objective of this dissertation is the designing of a performance measurement and continuous improvement framework for electoral logistics in Sub-Saharan Africa. A reference model, named ECOR (Electoral Chain Operations Reference) model has been developed in order to achieve this objective. Extensive research on existing process modelling and other Industrial Engineering techniques that could be used to develop this model was undertaken. The IEC was the main source of the information colle...
Orosz, Matthew; Quoilin, Sylvain; Hemond, Harold
This paper examines technical and economic choices for rural electrification in Africa and presents the rationale for trigeneration (capability for electricity, heating, and cooling) in health and education applications. An archetypal load profile for a rural health clinic (25 kWhe/day and 118139 kWht) is described, and a regional analysis is performed for sub-Saharan Africa by aggregating NASA meteorological data (insolation, temperature, and heating and cooling degree-days) using correlate...
Eugene Sobngwi; Andre Pascal Kengne; Leopold Fezeu; Paschal Awah; Alain Lekoubou
Chronic diseases are becoming increasingly important in sub-Saharan Africa (SSA). The current density and distribution of health workforce suggest that SSA cannot respond to the growing demand for chronic disease care, together with the frequent infectious diseases. Innovative approaches are therefore needed to rapidly expand the health workforce. In this article, we discuss the evidences in support of nurse-led strategies for chronic disease management in SSA, with a focus on hypertension an...
Full Text Available Chronic diseases are becoming increasingly important in sub-Saharan Africa (SSA. The current density and distribution of health workforce suggest that SSA cannot respond to the growing demand for chronic disease care, together with the frequent infectious diseases. Innovative approaches are therefore needed to rapidly expand the health workforce. In this article, we discuss the evidences in support of nurse-led strategies for chronic disease management in SSA, with a focus on hypertension and diabetes mellitus.
OShea, Brian J.
Based on a recent moss checklist of sub-Saharan Africa, an analysis is made of moss diversity and endemism in the area. There are over 3000 taxa, 77% of which are endemic. Figures for diversity and endemism for each country are listed, mapped and graphed, and endemism is also considered at the genus level. As the bryophyte flora of Africa is comparatively poorly known, it is important to be prudent when drawing conclusions about biodiversity and endemism.
Full Text Available Abstract Background Maternal health is one of the major worldwide health challenges. Currently, the unacceptably high levels of maternal mortality are a common subject in global health and development discussions. Although some countries have made remarkable progress, half of the maternal deaths in the world still take place in Sub-Saharan Africa where little or no progress has been made. There is no single simple, straightforward intervention that will significantly decrease maternal mortality alone; however, there is a consensus on the importance of a strong health system, skilled delivery attendants, and women's rights for maternal health. Our objective was to describe and determine different factors associated with the maternal mortality ratio in Sub-Saharan countries. Methods An ecological multi-group study compared variables between many countries in Sub-Saharan Africa using data collected between 1997 and 2006. The dependent variable was the maternal mortality ratio, and Health care system-related, educational and economic indicators were the independent variables. Information sources included the WHO, World Bank, UNICEF and UNDP. Results Maternal mortality ratio values in Sub-Saharan Africa were demonstrated to be high and vary enormously among countries. A relationship between the maternal mortality ratio and some educational, sanitary and economic factors was observed. There was an inverse and significant correlation of the maternal mortality ratio with prenatal care coverage, births assisted by skilled health personnel, access to an improved water source, adult literacy rate, primary female enrolment rate, education index, the Gross National Income per capita and the per-capita government expenditure on health. Conclusions Education and an effective and efficient health system, especially during pregnancy and delivery, are strongly related to maternal death. Also, macro-economic factors are related and could be influencing the others.
Awel, Ahmed Mohammed
This paper investigated the effect of terms of trade growth and its volatility on economic growth in Sub-Saharan Africa. I employed dynamic panel data models of difference and system GMM that could account biases associated with endogeneity of explanatory variables and problems induced by unobserved country specific characteristics. I used both net barter terms of trade and income terms of trade as a measure of terms of trade for the entire analysis of this paper. Using data from 1985 to 2010...
Draper, Peter; Freytag, Andreas; Al Doyaili, Sarah
In recent years sub-Saharan Africa, notwithstanding the global financial crisis, has increased its share in global trade and investment flows. This has led to an appreciable improvement in development levels, albeit off a small base. However, these patterns are still dominated by commodity flows and investment, and remain marginal on the global stage. Increased trade and investment flows, particularly related to network services, would be of great benefit to the sub-continent. Yet many domest...
Sevcsik Ann-Marie; Boakye Isaac; Amuasi John; Diap Graciela; Pecoul Bernard
Abstract At a recent meeting (Sept 18, 2009) in which reasons for the limited access to artemisinin-based combination therapy (ACT) in sub-Saharan Africa were discussed, policy and market surveys on anti-malarial drug availability and accessibility in Burundi and Sierra Leone were presented in a highly interactive brainstorming session among key stakeholders across private, public, and not-for-profit sectors. The surveys, the conduct of which directly involved the national malaria control pro...
Technical, vocational education, and training has remained an explosive topic because it can create a divided society in terms of education and the benefits associated with it. Internationally, it has always been a complex and controversial topic compared to the general education strand. It has presented inconsistent arguments over the years, particularly in Sub-Saharan Africa were policies have too often prescribed it as the panacea to addressing youth unemployment. On the one hand, it seems...
Toonen, J.; CANAVAN, A; Vergeer, P; Elovainio, R.
This synthesis report explores the lessons learned on design, implementation and effects of financial incentives in the form of performance based financing in the health sector, as supported in SubSaharan Africa by the two Dutch NGOs Cordaid and HealthNet TPO. Towards this aim a multi-country study was undertaken led by the Royal Tropical Institute of the Netherlands (KIT) in collaboration with World Health Organization (WHO) Geneva and the implementing agencies in DRC, Burundi, Tanzania and...
Voluntary counselling and testing (VCT) for HIV is promoted as a primary prevention strategy to reduce the heterosexual transmission of HIV in sub-Saharan Africa. A theoretical framework for the determinants of uptake of VCT and behavioural outcomes following VCT was developed. Demographic and Health Survey (DHS) data collected from 2003 to 2005 from ten countries were analysed to test the framework by comparing nationally representative trends in uptake of testing. Data from a...
Kodila-Tedika, Oasis; Agbor, Julius
This paper investigates the effects of religion on a broad set of development outcomes in sub-Saharan Africa. We regroup these outcomes into three broad categories, namely, development process outcomes (growth, investment, conflict, and government quality), institutional outcomes (property rights and the rule of law) and social development outcomes (social and gender protection). Using two new measures of religion religious fractionalization (RELFRAC) and religious polarization (RELPOL), al...
Ndugwa, Robert P; Kabiru, Caroline W; Cleland, John; Beguy, Donatien; Egondi, Thaddeus; Zulu, Eliya M; Jessor, Richard
Adolescent involvement in problem behaviors can compromise health, development, and successful transition to adulthood. The present study explores the appropriateness of a particular theoretical framework, Problem Behavior Theory, to account for variation in problem behavior among adolescents in informal settlements around a large, rapidly urbanizing city in sub-Saharan Africa. Data were collected from samples of never married adolescents of both sexes, aged 1219, living in two Nairobi slum ...
Milagrosa, A.; Frickenstein, J.
Despite acknowledgment of the significant role of women in economic growth, gender-biased development policies still persist worldwide. In this context, the paper reviews recent policy reforms in Sub-Saharan Africa that perpetuate gender inequality and female poverty for the already impoverished continent. Citing two reforms from the World Bank's Doing Business Reports, the paper analyses their possible negative effect on women entrepreneurs within the private sector. The paper argues that du...
Recently there has been increasing public concern regarding escalating child sexual abuse (CSA) in the sub-Saharan Africa. Medical consequences of child sexual abuse (CSA) include sexually transmitted infection (STI) and human immune virus (HIV) infection. The purpose of the study was to review literature on CSA and associated STI/HIV in the sub-Saharan Africa. The study covered the 23-year period from 1980 to 2003. The mean age of the child victims was 8 years. The incidence of penetrative sex in the studies ranged from 70 to 97%. Physical signs of CSA included genital or anal injuries, perineal trauma, and vesico-vaginal or recto-vaginal fistula. The incidence of STD varied according to whether the study was retrospective or prospective. Ten percent to 67% of children with STD had been sexually abused while 15 to 30% of sexual abuse incidents were associated with STD. The prevalence of HIV ranged from 3% in Togo to 37.5% in Cameroon. Most alleged child abusers were adult males known by the child, i.e., family members (30-60%), instructors or teachers, household personnel or neighbours. Some acts were motivated by traditional practices such as early, forced marriage and beliefs such as presumed benefits of sex with virgin children (cure for STI/HIV/STD, magic powers or wealth). This study shows that CSA is widespread throughout sub-Saharan Africa. Most problem involving CSA in sub-Saharan Afica have not been documented. Knowledge about the extent and special aspects of CSA in Africa can be useful for implementation of suitable management measures. PMID:16555518
Gayi, Samuel K.
The paper examines the state of food security in Sub-Saharan Africa (SSA), based on an analysis of a selection of indicators of food security and nutritional wellbeing during the period 1990-2002 within the context of the WTO Agreement on Agriculture. It argues that it may be advisable for those SSA countries with both static and dynamic comparative advantage in agriculture to pursue policies towards food self-sufficiency as a means to attaining food security, considering their large rural ...
Kifle Gelan, Mengistu
The Sub-Saharan Africa (SSA) region is faced with limited medical personnel and healthcare services to address the many healthcare problems of the region. Poor health indicators reflect the overall decline in socio-economic development. Shortages of access to health services in the region is further complicated by the concentration of health services in urban areas, the regions multiple medical problems (over 70% of HIV/AIDS cases in the world); and the brain drain phenomenon it is estimat...
Blackden, Mark; Canagarajah, Sudharshan; Klasen, Stephan; Lawson, David
The study suggests that gender inequality acts as a significant constraint to growth in sub-Saharan Africa, and that removing gender-based barriers to growth will make a substantial contribution to realizing Africas economic potential. In particular we highlight gender gaps in education, related high fertility levels, gender gaps in formal sector employment, and gender gaps in access to assets and inputs in agricultural production as particular barriers reducing the ability of women to contr...
Frank Chirowa; Stephen Atwood; Marc Van der Putten
Background: This article provided an analysis of gender inequality, health expenditure and itsrelationship to maternal mortality. Objective: The objective of this article was to explore gender inequality and its relationship with health expenditure and maternal mortality in sub-Saharan Africa (SSA). A unique analysis was used to correlate the Gender Inequality Index (GII), Health Expenditure and Maternal Mortality Ratio (MMR). The GII captured inequalities across three dimensions Reproducti...
Sulstarova, Brikela; Poglia Mileti, Francesca; Mellini, Laura; Villani, Michela; Singy, Pascal
No study to date has focused specifically on the reasons for and against disclosure of HIV-positive status among sub-Saharan migrant women. Thirty HIV-positive women from 11 sub-Saharan countries living in French-speaking Switzerland participated in semi-structured individual interviews. The reasons women reported for disclosure or nondisclosure of their HIV serostatus were classified into three categories: social, medical, and ethical. The women identified the stigma associated with HIV as a major social reason for nondisclosure. However, this study identifies new trends related to disclosure for medical and ethical reasons. Being undetectable played an important role in the life of sub-Saharan migrant women, and analysis revealed their medical reasons for both disclosure and nondisclosure. Disclosure to new sexual partners occurred when women had a more positive perception about HIV and when they believed themselves to be in a long-term relationship. Women reported nondisclosure to family members when they did not need help outside the support provided by the medical and social fields. The results on ethical reasons suggested that challenging stigma was a reason for disclosure. Since the women' perceptions on HIV changed when they came to see it as a chronic disease, disclosure occurred in an attempt to normalize life with HIV in their communities in migration and to challenge racism and discrimination. Our findings can help health providers better understand the communication needs of sub-Saharan migrant women with respect to HIV/AIDS and sexuality and offer them adequate disclosure advice that takes into account migration and gender issues. PMID:25297928
Full Text Available Epilepsy is a leading serious neurological condition worldwide and has particularly significant physical, economic and social consequences in SubSaharan Africa. This paper aims to contribute to the understanding of epilepsy prevalence in this region and how this varies by age and sex so as to inform understanding of the disease characteristics as well as the development of infrastructure, services and policies.
Full Text Available Abstract Background As a result of widespread chloroquine and sulphadoxine-pyrimethamine (SP resistance, 90% of sub-Saharan African countries had adopted policies of artemisinin-based combination therapy (ACT for treatment of uncomplicated malaria by 2007. In Malawi, cessation of chloroquine use was followed by the re-emergence of chloroquine-susceptible malaria. It was expected that introduction of ACT would lead to a return in chloroquine susceptibility throughout Africa, but this has not yet widely occurred. This observation suggests that there is continuing use of ineffective anti-malarials in Africa and that persistent chloroquine-resistant malaria is due to ongoing drug pressure despite national policy changes. Methods To estimate drug use on a national level, 2006-2007 Demographic Health Survey and Multiple Indicator Cluster Survey data from 21 African countries were analysed. Resistance data were compiled by systematic review of the published literature on the prevalence of the Plasmodium falciparum chloroquine resistance transporter polymorphism at codon 76, which causes chloroquine resistance. Results Chloroquine was the most common anti-malarial used according to surveys from 14 of 21 countries analysed, predominantly in West Africa. SP was most commonly reported in two of 21 countries. Among eight countries with longitudinal molecular resistance data, the four countries where the highest proportion of children treated for fever received chloroquine (Uganda, Burkina Faso, Guinea Bissau, and Mali also showed no significant declines in the prevalence of chloroquine-resistant infections. The three countries with low or decreasing chloroquine use among children who reported fever treatment (Malawi, Kenya, and Tanzania had statistically significant declines in the prevalence of chloroquine resistance. Conclusions This study demonstrates that in 2006-2007, chloroquine and SP continued to be used at high rates in many African countries. In countries reporting sustained chloroquine use, chloroquine-resistant malaria persists. In contrast, a low level of estimated chloroquine use is associated with a declining prevalence of chloroquine resistance.
Full Text Available There is a growing interest in using Information and Communication Technologies (ICTs to support poverty reduction efforts and strategies in the framework of the Millennium Development Goals (MDGs. These interest ended up revealing how much the Poverty Reduction Strategy Papers (PRSPs of many african nations have underestimated the importance of ICTs as a development tool. The fact that so little was mentionned about the use of ICTs for poverty alleviation and creation of employment highlighted the confusion, and uncertainty of decision makers. At the country level, ICT is still to be effectively integrated into national poverty alleviation and development strategies. The question then is how ICTs can help achieve those objectives. How can ICTs be used as tools to fight against poverty? Poverty is widely recognized as multidimensional, encompassing food security, health, education, rights, security and dignity, amongst others as stressed by Bachelor and al in a model showing the intricate linkages between ICTs and most PRSP goals. The link between ICTs and poverty reduction strategy is therefore not that obvious. Although, researchers and development partners involved in poverty alleviation recognize more easily the linkage between ICT and poverty reduction strategies. In any case, it is a prerequisite to have a conducive environment and country readiness for ICTs implementation. Unfortunately, in many Sub-Saharan Africa countries, there is not yet a clear and effective policy and strategy for the use of ICT.
T. P., Masere; K. J., Duffy.
Full Text Available Achieving food security is a challenge for the developed and developing world. These challenges are greater for developing nations such as in Africa because of the severity of the problems. An important aspect of this is poor agricultural productivity. Worldwide, technology is being developed to inc [...] rease agricultural production. One aspect of this is the development of predictive computer models that enable farmers to optimise crops using management decision based on simulation scenarios. Most African farmers do not have the computer resources or expertise to implement these types of technology. Even extension offices in Africa, who provide much needed advice, can be under resourced in this way. We suggest here that simpler computer models that are cheaper and easier to use need to be developed. As a first step in this process we investigate here which factors are most cost effectively managed using computer simulations in semi-arid conditions pertinent to much of sub-Saharan Africa. Factors known to be important in crop farming are planting date, sowing density, variety, weeding, soils and fertiliser. We use qualitative arguments with simulations and conclude that interactions between rainfall, soil condition and fertiliser can benefitfrom simulations and thus should help in their management.
Rispel, Laetitia C; de Sousa, César A D Palha; Molomo, Boitumelo G
The global resurgence of interest in the social determinants of health provides an opportunity for determined action on unacceptable and unjust health inequalities that exist within and between countries. This paper reviews three categories of social inclusion policies: cash-transfers; free social services; and specific institutional arrangements for programme integration in six selected countries--Botswana, Mozambique, South Africa, Ethiopia, Nigeria, and Zimbabwe. The policies were appraised as part of the Social Exclusion Knowledge Network (SEKN) set up under the auspices of the World Health Organization's Commission on Social Determinants of Health. The paper highlights the development landscape in sub-Saharan Africa and presents available indicators of the scale of inequity in the six countries. A summary of the policies appraised is presented, including whether or what the impact of these policies has been on health inequalities. Cross-cutting benefits include poverty alleviation, notably among vulnerable children and youths, improved economic opportunities for disadvantaged households, reduction in access barriers to social services, and improved nutrition intake. The impact of these benefits, and hence the policies, on health status can only be inferred. Among the policies reviewed, weaknesses or constraints were in design and implementation. The policy design weaknesses include targeting criteria, their enforcement and latent costs, inadequate participation of the community and failure to take the cultural context into account. A major weakness of most policies was the lack of a monitoring and evaluation system, with clear indicators that incorporate system responsiveness. The policy implementation weaknesses include uneven regional implementation with rural areas worst affected; inadequate or poor administrative and implementation capacity; insufficient resources; problems of fraud and corruption; and lack of involvement of civil servants, exacerbating implementation capacity problems. The key messages to sub-Saharan African governments include: health inequalities must be measured; social policies must be carefully designed and effectively implemented addressing the constraints identified; monitoring and evaluation systems need improvement; and participation of the community needs to be encouraged through conducive and enabling environments. There is a need for a strong movement by civil society to address health inequalities and to hold governments accountable for improved health and reduced health inequalities. PMID:19761083
The years since 9/11 have been characterised by the increasing threat of terrorist action in the Middle East and South Asia. Yet Sub-Saharan Africa was has also become a region of concern. In 1998, it had been the scene of two Al-Qaeda attacks against US embassies; besides Africa is home to large Muslim populations. Since 9/11 African violent non-state groups unrelated to Al- Qaeda or to the wider Islamist movement have been recast as terrorist organisations. These groups primarily oper...
Steyn Nelia P
Full Text Available Abstract Background During the last century we have seen wide-reaching changes in diet, nutritional status and life expectancy. The change in diet and physical activity patterns has become known as the nutrition transition. At any given time, a country or region within a country may be at different stages within this transition. This paper examines a range of nutrition-related indicators for countries in Sub-Saharan Africa (SSA and attempts to develop a typical model of a country in transition. Methods Based on the availability of data, 40 countries in SSA were selected for analysis. Data were obtained from the World Health Organisation, Demographic and Health Surveys and the Food and Agriculture Organisation of the United Nations. Multiple linear regression analysis (MLRA was used to explore the determinants of infant mortality. A six point score was developed to identify each country's stage in the nutrition transition. Results MLRA showed that underweight-for-age, protein and the percentage of exclusively breastfed infants were associated with the infant mortality rate (IMR. The majority of countries (n = 26 used in the analysis had nutrition transition scores of zero and one. Most of them had a high prevalence of infant mortality, children that were stunted or underweight-for-age, small percentages of women that were overweight and obese, and low intakes of energy, protein, and fat. Countries with the highest scores include South Africa, Ghana, Gabon, Cape Verde and Senegal which had relatively low IMRs, high levels of obesity/overweight, and low levels of underweight in women, as well as high intakes of energy and fat. These countries display classic signs of a population well established in the nutrition-related non-communicable disease phase of the nutrition transition. Conclusions Countries in SSA are clearly undergoing a nutrition transition. More than half of them are still in the early stage, while a few have reached a point where changes in dietary patterns are affecting health outcomes in a large portion of the population. Those in the early stage of the transition are especially important, since primordial prevention can still be introduced.
Clark, Shelley; Hamplová, Dana
Single motherhood in sub-Saharan Africa has received surprisingly little attention, although it is widespread and has critical implications for children's well-being. Using survival analysis techniques, we estimate the probability of becoming a single mother over women's life course and investigate the relationship between single motherhood and child mortality in 11 countries in sub-Saharan Africa. Although a mere 5 % of women in Ethiopia have a premarital birth, one in three women in Liberia will become mothers before first marriage. Compared with children whose parents were married, children born to never-married single mothers were significantly more likely to die before age 5 in six countries (odds ratios range from 1.36 in Nigeria to 2.61 in Zimbabwe). In addition, up to 50 % of women will become single mothers as a consequence of divorce or widowhood. In nine countries, having a formerly married mother was associated with a significantly higher risk of dying (odds ratios range from 1.29 in Zambia to 1.75 in Kenya) relative to having married parents. Children of divorced women typically had the poorest outcomes. These results highlight the vulnerability of children with single mothers and suggest that policies aimed at supporting single mothers could help to further reduce child mortality in sub-Saharan Africa. PMID:23839100
Langevang, Thilde; Gough, Katherine
Shrinking public sectors and limited opportunities for gaining formal wage employment in the private sector have resulted in entrepreneurship being promoted as a means of generating youth employment. This discourse is being widely promoted within sub-Saharan Africa despite little being known about how best to support youth employment and entrepreneurship. This paper focuses on two of the main trades which young women in sub-Saharan Africa have typically entered: hairdressing and dressmaking. Through drawing on a qualitative case study of hairdressers and seamstresses in Ghana, it is shown how the two professions have fared quite differently in recent years: whereas hairdressing has boomed, dressmaking has been stagnating. The paper shows how these diverging trajectories can be attributed to three related factors. First, globalisation has affected the two trades differently; second, their respective trade associations have reacted differently to the new constraints and opportunities generated by globalisation and their training systems have undergone different degrees of professionalisation; and third, the prestige associated with the two professions has changed affecting the aspirations of young women to enter the professions and the experiences of those that do. As the paper shows, geographers potentially have much to contribute to employment and entrepreneurship debates by providing more contextualised studies which recognise the complex interplay between globalisation, institutions and individuals in particular places and acknowledge the ensuing diverse employment experiences. Such studies are highly relevant for policymakers who are facing the difficult challenge of how to create employment and stimulate entrepreneurship in sub-Saharan Africa.
Full Text Available Abstract Background The HIV/AIDS pandemic in sub-Saharan Africa is widely recognised as a development disaster threatening poverty reduction, economic growth and not merely a health issue. Its mitigation includes the societal-wide adoption and implementation of specific health technologies, many of which depend on functional institutions and State. Discussion Donor and International Institutions' strategies to mitigate HIV/AIDS in sub-Saharan Africa are premised on a single optimal model of the State, one which focuses on the decentralised delivery of public goods alone (such as healthcare the service delivery state. The empirical evidence, though sparse, of "successful" and "unsuccessful" sub-Saharan Africa states' performance in mitigating HIV/AIDS does not support this model. Rather, the evidence suggests an alternative model that takes a country context specific approach encompassing political power, institutional structures and the level of health technology needed. This model draws on the historical experience of East Asian countries' rapid development. Summary For international public health policies to be effective, they must consider a country tailored approach, one that advocates a coordinated strategy designed and led by the State with involvement of wider society specific to each country's particular history, culture, and level of development.
Vouking, Marius Zambou; Tamo, Violette Claire; Mbuagbaw, Lawrence
Buruli ulcer (BU) is a cutaneous neglected tropical disease caused by Mycobacterium ulcerans. Participation of Community Health Workers (CHWs) is an integral part of the management of BU, yet their impact has not been systematically evaluated in sub-Saharan Africa. METHODS: Our objectives were to summarize the evidence on the impact of CHWs on the control of BU in sub-Saharan Africa by looking at their recruitment, training, non-governmental support and performance. We searched the following ...
Bruno, Lars C.
This thesis looks at the differences in economic growth between Sub-Saharan Africa and East Asia in the time period from 1960 until today. Three major causes are assessed which all are attempted linked to the governments role; i) Structural causes; ii) Economic policy; and iii) Institutional causes. The main results indicate that Sub-Saharan Africa suffered from worse structural effects than East Asia; and that East Asia had a more favourable institutional environment. The role of economic p...
Yawson, Robert M.; Yawson, Ivy
This paper reviews the status of Agricultural Biotechnology in Sub-Saharan Africa. It addresses the potential economic benefits to Sub-Saharan Africa and the effect biotechnology policies may have on growth, production and poverty reduction. The extent to which agricultural biotechnology will compound or mitigate the constraints faced by smallholders/subsistence farmers is also discussed. The status of crop biotechnology research worldwide is reviewed and the influence of intellectual propert...
OLoughlin, John; Linke, Andrew M; Witmer, Frank D. W.
A robust debate about the effects of climate change on conflict occurrences has attained wide public and policy attention, with sub-Saharan Africa generally viewed as most susceptible to increased conflict risk. Using a new disaggregated dataset of violence and climate anomaly measures (temperature and precipitation variations from normal) for sub-Saharan Africa 19802012, we consider political, economic, and geographic factors, not only climate metrics, in assessing the chances of increased ...
Ossa, Gonzalo; Kramer-Schadt, Stephanie; Peel, Alison J; Scharf, Anne K; Voigt, Christian C
Flying foxes (Pteropodidae) are key seed dispersers on the African continent, yet their migratory behavior is largely unknown. Here, we studied the movement ecology of the straw-colored fruit bat, Eidolon helvum, and other fruit bats by analyzing stable isotope ratios in fur collected from museum specimens. In a triple-isotope approach based on samples of two ecologically similar non-migratory pteropodids, we first confirmed that a stable isotope approach is capable of delineating between geographically distinct locations in Sub-Saharan Africa. A discriminant function analysis assigned 84% of individuals correctly to their capture site. Further, we assessed how well hydrogen stable isotope ratios (?(2)H) of fur keratin collected from non-migratory species (n = 191 individuals) records variation in ?(2)H of precipitation water in sub-Saharan Africa. Overall, we found positive, negative and no correlations within the six studied species. We then developed a reduced major axis regression equation based on individual data of non-migratory species to predict where potentially migratory E. helvum (n = 88) would come from based on their keratin ?(2)H. Across non-migratory species, ?(2)H of keratin and local water correlated positively. Based on the isoscape origin model, 22% of E. helvum were migratory, i.e. individuals had migrated over at least 250 km prior to their capture. Migratory individuals came from locations at a median distance of about 860 km from the collection site, four even from distances of at least 2,000 km. Ground-truthing of our isoscape origin model based on keratin ?(2)H of extant E. helvum (n = 76) supported a high predictive power of assigning the provenance of African flying foxes. Our study highlights that stable isotope ratios can be used to explain the migratory behavior of flying foxes, even on the isotopically relatively homogenous African continent, and with material collected by museums many decades or more than a century ago. PMID:23029206
Agyemang, C.; Bhopal, R.; Bruijnzeels, M.
Broad terms such as Black, African, or Black African are entrenched in scientific writings although there is considerable diversity within African descent populations and such terms may be both offensive and inaccurate. This paper outlines the heterogeneity within African populations, and discusses the strengths and limitations of the term Black and related labels from epidemiological and public health perspectives in Europe and the USA. This paper calls for debate on appropriate terminologies for African descent populations and concludes with the proposals that (1) describing the population under consideration is of paramount importance (2) the word African origin or simply African is an appropriate and necessary prefix for an ethnic label, for example, African Caribbean or African Kenyan or African Surinamese (3) documents should define the ethnic labels (4) the label Black should be phased out except when used in political contexts. PMID:16286485
We provide evidence on the distribution of school attendance and educational attainment across African countries, focusing on the correlation with literacy rates in the population, level of resources and country institutional features. We also estimate sample correlations between enrolment and macro-aggregates, related to resources (GDP per capita, student/teacher ratio), computing some counterfactuals. We then move to micro-data, selecting three African countries as representative e...
Kelly-Hope Louise A
Full Text Available Abstract Plasmodium falciparum malaria is a serious tropical disease that causes more than one million deaths each year, most of them in Africa. It is transmitted by a range of Anopheles mosquitoes and the risk of disease varies greatly across the continent. The "entomological inoculation rate" is the commonly-used measure of the intensity of malaria transmission, yet the methods used are currently not standardized, nor do they take the ecological, demographic, and socioeconomic differences across populations into account. To better understand the multiplicity of malaria transmission, this study examines the distribution of transmission intensity across sub-Saharan Africa, reviews the range of methods used, and explores ecological parameters in selected locations. It builds on an extensive geo-referenced database and uses geographical information systems to highlight transmission patterns, knowledge gaps, trends and changes in methodologies over time, and key differences between land use, population density, climate, and the main mosquito species. The aim is to improve the methods of measuring malaria transmission, to help develop the way forward so that we can better assess the impact of the large-scale intervention programmes, and rapid demographic and environmental change taking place across Africa.
It is broadly accepted that agricultural growth is essential for Sub-Saharan Africas development, in support of economic growth and a structural transformation of the economy towards industrialization, food security and poverty reduction. Many believe that genetically modified crops have the potential to produce higher yields in many of Sub-Saharan Africas unfavourable climatic conditions and can therefore help in providing food security to the region. While some countries in Sub-Saharan Af...
Full Text Available Abstract Background The efficacy of anti-malarial drugs is assessed over a period of 28-63 days (depending on the drugs' residence time following initiation of treatment in order to capture late failures. However, prolonged follow-up increases the likelihood of new infections depending on transmission intensity. Therefore, molecular genotyping of highly polymorphic regions of Plasmodium falciparum msp1, msp2 and glurp loci is usually carried out to distinguish recrudescence (true failures from new infections. This tool has now been adopted as an integral part of anti-malarial efficacy studies and clinical trials. However, there are concerns over its utility and reliability because conclusions drawn from molecular typing depend on the genetic profile of the respective parasite populations, but this profile is not systematically documented in most endemic areas. This study presents the genetic diversity of P. falciparum msp1, msp2 and glurp markers in selected sub-Saharan Africa countries with varying levels of endemicity namely Malawi, Tanzania, Uganda, Burkina Faso and São Tomé. Methods A total 780 baseline (Day 0 blood samples from children less than seven years, recruited in a randomized controlled clinical trials done between 1996 and 2000 were genotyped. DNA was extracted; allelic frequency and diversity were investigated by PCR followed by capillary electrophoresis for msp2 and fragment sizing by a digitalized gel imager for msp1 and glurp. Results and Conclusion Plasmodium falciparum msp1, msp2 and glurp markers were highly polymorphic with low allele frequencies. A total of 17 msp1 genotypes [eight MAD20-, one RO33- and eight K1-types]; 116 msp2 genotypes [83 3D7 and 33 FC27- types] and 14 glurp genotypes were recorded. All five sites recorded very high expected heterozygosity (HE values (0.68 - 0.99. HE was highest in msp2 locus (HE = 0.99, and lowest for msp1 (HE = 0.68 (P msp1, msp2 and glurp in malaria clinical trials in sub-Saharan Africa to discriminate new from recrudescent infections.
Paz-Zulueta, María; Llorca, Javier; Santibáñez, Miguel
This retrospective cohort study compares the utilization of prenatal care between African immigrant and native Spanish women. For 2007-2010, we identified 231 pregnant African immigrant women. The native-born population sample was obtained by simple random sampling in a 1:3 ratio. The Kessner Index (KI) and our Own Index (OI) were applied to rate prenatal care adequacy in three categories (adequate, intermediate, and inadequate). Odds ratios (ORs) were estimated using non-conditional logistic regression. Prenatal care was adequate according to the indexes (KI or OI) in 21.3 and 25.8 % of North Africans and in 22.5 and 30.4 % of sub-Saharan Africans. The ORs of inadequacy when adjusted for maternal age, social risk factors, and previous reproductive outcomes were 30.32 and 35.47 (KI or OI) in North and 64.43 and 67.93 in sub- Saharan Africans. These results suggest significant differences in obtaining adequate prenatal care between immigrant and native Spanish women. PMID:25138137
Full Text Available Accurate cropland maps at the global and local scales are crucial for scientists, government and nongovernment agencies, farmers and other stakeholders, particularly in food-insecure regions, such as Sub-Saharan Africa. In this study, we aim to qualify the crop classes of the MODIS Land Cover Product (LCP in Sub-Saharan Africa using FAO (Food and Agricultural Organisation and AGRHYMET (AGRiculture, Hydrology and METeorology statistical data of agriculture and a sample of 55 very-high-resolution images. In terms of cropland acreage and dynamics, we found that the correlation between the statistical data and MODIS LCP decreases when we localize the spatial scale (from R2 = 0.86 *** at the national scale to R2 = 0.26 *** at two levels below the national scale. In terms of the cropland spatial distribution, our findings indicate a strong relationship between the user accuracy and the fragmentation of the agricultural landscape, as measured by the MODIS LCP; the accuracy decreases as the crop fraction increases. In addition, thanks to the Pareto boundary method, we were able to isolate and quantify the part of the MODIS classification error that could be directly linked to the performance of the adopted classification algorithm. Finally, based on these results, (i a regional map of the MODIS LCP user accuracy estimates for cropland classes was produced for the entire Sub-Saharan region; this map presents a better accuracy in the western part of the region (43%70% compared to the eastern part (17%43%; (ii Theoretical user and producer accuracies for a given set of spatial resolutions were provided; the simulated future Sentinel-2 system would provide theoretical 99% user and producer accuracies given the landscape pattern of the region.
Ricardo J Soares Magalhães
Full Text Available OBJECTIVE: To determine whether blood haemoglobin concentration in preschool-age children (< 5 years of age is geographically heterogeneous in sub-Saharan Africa and describe its association with environmental variables that drive anaemia of different etiologies. METHODS: Data were obtained on 24 277 preschool-age children in western Africa (2862 cluster sites and 25 343 in eastern Africa (2999 cluster sites from the 2001-2007 Demographic and Health Surveys (DHS for sub-Saharan Africa. Cluster sites were linked to environmental information on distance to perennial water body, elevation, land surface temperature and normalized difference vegetation index (NDVI; a proxy for rainfall in a geographical information system. Statistical associations with environmental variables were determined using multivariate regression models, and the spatial dependence of haemoglobin concentration unexplained by these factors was quantified using semivariograms. FINDINGS: In eastern Africa, the lowest haemoglobin concentrations (< 70 g/l occurred in small clusters throughout the region; in western Africa, they occurred in a large cluster straddling the border between Burkina Faso and Mali. Our results show significant continent-wide associations between haemoglobin concentration and environmental variables, particularly in western Africa for land surface temperature and NDVI, and in eastern Africa for elevation. Residual spatial dependence was significant, and the magnitude was greater in western than in eastern Africa. CONCLUSION: The distribution of anaemia is driven by large-scale environmental factors, and the epidemiological drivers differ in western and eastern Africa. Strategies for anaemia control in preschool-age children in sub-Saharan Africa should be tailored to local conditions, taking into account the specific etiology and prevalence of anaemia.
Chen Guanjie; Adeyemo Adebowale A; Chen Yuanxiu; Rotimi Charles
Abstract Background Africa contains the most genetically divergent group of continental populations and several studies have reported that African populations show a high degree of population stratification. In this regard, it is important to investigate the potential for population genetic structure or stratification in genetic epidemiology studies involving multiple African populations. The presences of genetic sub-structure, if not properly accounted for, have been reported to lead to spur...
In the past decades, most of the countries in sub-Saharan Africa have been affected by armed conflicts. By means of a time-series cross-sectional (TSCS) database, we attempt to measure the impact of war on a sample of 43 countries in Africa from 1950 to 2010. These conflicts, and especially civil wars, are shown to have a strong negative effect on the educational performances of the countries studied. The rate of children not attending school, as well as secondary school enrollment rates, see...
Slim Slama; Louis Loutan; Nicolas Perone; Tetanye Ekoe; Alexander Bischoff
Public health specialists and clinicians alike agree that Humanity faces a global pandemic of chronic diseases in the 21st century. In this article we discuss the implications of this pandemic on another global issue, the health workforce. Because both issues are particularly acute in Sub-Saharan Africa (SSA), we will focus on this region and use Cameroon as a case in point. We first gauge the epidemic of chronic conditions in SSA. We then discuss the implications of chronic conditions for th...
Meaningful investment in the water sector can easily increase food production and productivity of human resources and thus stimulate economic growth, human and environmental health. The author indicates that, the Mar del Plata Action Plan (1977), the New Delhi Statement (1990), Dublin Statement (1991)and the Agenda 21 Chapter 18 of UNCED (1992) emphasise the urgent need for integrated, sustainable water resources management. The publication looks at the policy development in the water sector, the disparities in the allocation of water supplies in the urban and the rural areas, the importance of water in the development of the industrial sector and how to manage the demand for water in sub-Saharan Africa
This paper examines the effect of aid on domestic savings in Sub-Saharan Africa. It departs from the previous literature on aid and savings in developing countries by abandoning the pervasive, but untenable, assumption that all aid is used to expand the trade deficit and thus applied wholly to consumption or investment. In fact, for the period 1965-2006, the evidence suggests that 35% of any increase in aid relative to output was used to finance reverse flows (some combination of interest pay...
Addison, Tony; Ghoshray, Atanu
Commodity price shocks are an important type of external shock and are often cited as a problem for economic growth in sub-Saharan Africa. This paper quantifies the impact of agricultural commodity price shocks using a near vector autoregressive model. The novel aspect of this model is that we define an auxiliary variable that can potentially capture the definition of a price shock that allows us to determine whether the response of per capita Gross domestic product (GDP) growth in sub-Sahara...
Weaver, J.N.; Landis, E.R.
Coal and peat are essentially unused and in some cases unknown in sub-Saharan Africa. However, they might comprise valuable alternative energy sources in some or all of the developing nations of the region. The 11 countries considered in this appraisal reportedly contain coal and peat. On the basis of regional geology, another five countries might also contain coal-bearing rocks. If the resource potential is adequate, coal and peat might be utilized in a variety of ways including substituting for fuelwood, generating electricity, supplying process heat for local industry and increasing agricultural productivity. -from Author
Corker, Jamaica; Coast, Ernestina
1. Significance/background Polygyny is rarely, if ever, included in family planning (FP) messaging in Sub-Saharan Africa, even though the region has the worlds highest rates of polygyny. In West Africa a majority of women will spend some portion of their married life in a polygynous union as a co-wife. Research on polygyny has tended to focus on the influence of polygyny on outcomes such as fertility preferences and rates and contraceptive use, and there is little consensus as to the...
Full Text Available Food security can be defined as stable access to food of good nutritional quality. In Sub Saharan Africa access to food is strongly linked to local food production and the capacity to generate enough calories to sustain the local population. Therefore it is important in these regions to generate not only sufficiently high yields but also to reduce interannual variability in food production. Traditionally, climate impact simulation studies have focused on factors that underlie maximum productivity ignoring the variability in yield. By using Modern Portfolio Theory, a method stemming from economics, we here calculate optimum current and future crop selection that maintain current yield while minimizing variance, vs. maintaining variance while maximizing yield. Based on simulated yield using the LPJ-GUESS dynamic vegetation model, the results show that current cropland distribution for many crops is close to these optimum distributions. Even so, the optimizations displayed substantial potential to either increase food production and/or to decrease its variance regionally. Our approach can also be seen as a method to create future scenarios for the sown areas of crops in regions where local food production is important for food security.
Pérez García-Pando, C.; Thomson, M. C.; Stanton, M. C.; Diggle, P. J.; Miller, R. L.; Perlwitz, J. P.; Ceccato, P.
Epidemics of meningococcal meningitis occur in sub-Saharan Africa during the dry season, a period when the region is affected by the Harmattan, a dry and dusty northeasterly trade wind blowing from the Sahara into the Gulf of Guinea. Although the mechanisms remain unclear, the location and seasonality of meningitis epidemics suggest that environmental factors, such as low absolute or relative humidity, high temperatures, and dusty atmospheric conditions play an important role. Using a 20-year time series of meningitis incidence in Niger we examined the potential of statistical models to predict seasonal incidence based on data that would be operationally available, such as climate and dust, population and previous incidence. We used surface dust concentration estimates from a model given the paucity of direct in situ measurements especially at district level. The soil dust aerosol component of the model was thoroughly evaluated with existing satellite and in situ data over the region of interest showing daily aerosol optical depth correlations around 0.6 (p vaccination.
Kasper, Jennifer; Bajunirwe, Francis
A double jeopardy exists in resource-limited settings (RLS) in sub-Saharan Africa (SSA): there are a disproportionately greater number of acutely ill patients, but a paucity of healthcare workers (HCW) to care for them. SSA has 25% of the global disease burden but only 3% of the world's HCW. Thirty-two SSA countries do not meet the WHO minimum of 23 HCW per 10000 population. Contributing factors include insufficient supply, inadequate distribution and migration. Potential remedies include international workforce policies, non-governmental organisations, national and international medical organisations' codes of conduct, inter-country collaborations, donor-directed policies and funding to train more people in-country, and health system strengthening and task-shifting. Collaborations among academic institutions from resource-rich and poor countries can help address HCW supply, distribution and migration. It is now opportune to harness bright, committed people from academic centres in resource-rich and poor settings to create long-term, collaborative relationships focused on training, clinical skills and locally relevant research endeavours, who mutually strive for HCW retention, less migration, and ultimately sufficient HCW to provide optimal care in all RLS. PMID:22962319
Bodin, P.; Olin, S.; Pugh, T. A. M.; Arneth, A.
Food security can be defined as stable access to food of good nutritional quality. In Sub Saharan Africa access to food is strongly linked to local food production and the capacity to generate enough calories to sustain the local population. Therefore it is important in these regions to generate not only sufficiently high yields but also to reduce interannual variability in food production. Traditionally, climate impact simulation studies have focused on factors that underlie maximum productivity ignoring the variability in yield. By using Modern Portfolio Theory, a method stemming from economics, we here calculate optimum current and future crop selection that maintain current yield while minimizing variance, vs. maintaining variance while maximizing yield. Based on simulated yield using the LPJ-GUESS dynamic vegetation model, the results show that current cropland distribution for many crops is close to these optimum distributions. Even so, the optimizations displayed substantial potential to either increase food production and/or to decrease its variance regionally. Our approach can also be seen as a method to create future scenarios for the sown areas of crops in regions where local food production is important for food security.
Ngo, Nicole S.; Gatari, Michael; Yan, Beizhan; Chillrud, Steven N.; Bouhamam, Kheira; Kinney, Patrick L.
Few studies examine urban air pollution in sub-Saharan Africa (SSA), yet urbanization rates there are among the highest in the world. In this study, we measured 8-hr average occupational exposure levels of fine particulate matter (PM2.5), black carbon (BC), ultra violet active-particulate matter (UV-PM), and trace elements for individuals who worked along roadways in Nairobi, specifically bus drivers, garage workers, street vendors, and women who worked inside informal settlements. We found BC and re-suspended dust were important contributors to PM2.5 levels for all study populations, particularly among bus drivers, while PM2.5 exposure levels for garage workers, street vendors, and informal settlement residents were not statistically different from each other. We also found a strong signal for biomass emissions and trash burning, which is common in Nairobi's low-income areas and open-air garages. These results suggest that the large portion of urban residents in SSA who walk along roadways would benefit from air quality regulations targeting roadway emissions from diesel vehicles, dust, and trash burning. This is the first study to measure occupational exposure to urban air pollution in SSA and results imply that roadway emissions are a serious public health concern.
Agyemang, C; Bhopal, R; Bruijnzeels, M
Broad terms such as Black, African, or Black African are entrenched in scientific writings although there is considerable diversity within African descent populations and such terms may be both offensive and inaccurate. This paper outlines the heterogeneity within African populations, and discusses the strengths and limitations of the term Black and related labels from epidemiological and public health perspectives in Europe and the USA. This paper calls for debate on appropriate terminologie...
Mukanga, David; Tshimanga, Mufuta; Wurapa, Frederick; Binka, Fred; Serwada, David; Bazeyo, William; Pariyo, George; Wabwire-Mangen, Fred; Gitta, Sheba; Chungong, Stella; Trostle, Murray; Nsubuga, Peter
In an effort to contain the frequently devastating epidemics in sub-Saharan Africa, the World Health Organization (WHO) Regional Office for Africa launched the Integrated Disease Surveillance and Response (IDSR) strategy in an effort to strengthen surveillance and response. However, 36 sub-Saharan African countries have been described as experiencing a human resource crisis by the WHO. Given this human resource situation, the challenge ...
Kenfack, Joseph; Bignom, Blaise
Sub-Saharan Africa owns important renewable energy potential and is still heavily using carbon energy. This is having a negative impact on the climate and on the environment. Given the local cost of carbon energy, the purchase power of people, the availability and the reserve of carbon energy in the area, this resource is being heavily used. This practice is harmful to the climate and is also resulting on poor effort to promote renewable energy in remote areas. The important renewable energy potential is still suffering from poor development. The purpose of this paper is among other things aiming at showing the rate of carbon energy use and its potential impact on climate and environment. We will also ensure that the renewable energy resources of Central Sub-Saharan Africa are known and are subject to be used optimally to help mitigate climate change. After showing some negative impacts of carbon energy used in the area, the work also suggests actions to promote and sustain the development of renewable energy. Based on the knowledge of the Central African energy sector, this paper will identify actions for reduce access to carbon energy and improved access to sustainable, friendly, affordable energy services to users as well as a significant improvement of energy infrastructure and the promotion of energy efficiency. We will show all type of carbon energy used, the potential for solar, biomass and hydro while showing where available the level of development. After a swot analysis of the situation, identified obstacles for the promotion of clean energy will be targeted. Finally, suggestions will be made to help the region develop a vision aiming at developing good clean energy policy to increase the status of renewable energy and better contribute to fight against climate change. Cameroon case study will be examined as illustration. Analysis will be made from data collected in the field. |End Text|
Full Text Available Owing to its nutritional value, especially proteins, carbohydrates, vitamins and micronutrients, common bean (Phaseolus Vulgaris L. has been recognised as a crop that could ensure food security mostly, in Sub-Saharan Africa, where its productivity is low. Its low productivity is attributed to a milliard of constraints, of which low plant-available phosphorus (P and limited moisture in soil are among the major limiting factors. Synergistic effects of the two factors are accentuated in Sub-Saharan African region. This paper discloses the importance of the synergistic effects of plant-available P and moisture in soils on common bean production. It has been observed that studies investigating impacts of interactions of low P levels and moisture deficit conditions in soils are yet to be conducted. Identification of traits that contribute to high performance under low P availability and moisture deficit in the same genotypes remains a major research and development challenge. However, engineering new genotypes alone may not alleviate the problem of ensuring improvement of high bean yields. Root architecture and root exploration of the soil that enable the plant to access the two soil resources, traditional methods that preserve good status of organic matter in soils and moisture and soil preparation techniques are equally important. This, calls for holistic investigations that include soil plant-available P and moisture, common bean genotypes and their root systems, and agronomic measures to facilitate a comprehensive evaluation of impacts of deficiencies in soils on common bean yields. This paper explores and synthesizes existing research and development of common bean grown in soils deficient in plant-available P and moisture, aiming at designing future research to enhance common bean productivity.
Deenanath, Evanie Devi; Iyuke, Sunny; Rumbold, Karl
Recently, interest in using bioethanol as an alternative to petroleum fuel has been escalating due to decrease in the availability of crude oil. The application of bioethanol in the motor-fuel industry can contribute to reduction in the use of fossil fuels and in turn to decreased carbon emissions and stress of the rapid decline in crude oil availability. Bioethanol production methods are numerous and vary with the types of feedstock used. Feedstocks can be cereal grains (first generation feedstock), lignocellulose (second generation feedstock), or algae (third generation feedstock) feedstocks. To date, USA and Brazil are the leading contributors to global bioethanol production. In sub-Saharan Africa, bioethanol production is stagnant. During the 1980s, bioethanol production has been successful in several countries including Zimbabwe, Malawi, and Kenya. However, because of numerous challenges such as food security, land availability, and government policies, achieving sustainability was a major hurdle. This paper examines the history and challenges of bioethanol production in sub-Saharan Africa (SSA) and demonstrates the bioethanol production potential in SSA with a focus on using bitter sorghum and cashew apple juice as unconventional feedstocks for bioethanol production. PMID:22536020
Rees Helen V
Full Text Available Abstract Sub-Saharan Africa carries a massive dual burden of HIV and alcohol disease, and these pandemics are inextricably linked. Physiological and behavioural research indicates that alcohol independently affects decision-making concerning sex, and skills for negotiating condoms and their correct use. More than 20 studies in Africa have reported higher occurrence of HIV among people with problem drinking; a finding strongly consistent across studies and similar among women and men. Conflation of HIV and alcohol disease in these setting is not surprising given patterns of heavy-episodic drinking and that drinking contexts are often coterminous with opportunities for sexual encounters. HIV and alcohol also share common ground with sexual violence. Both perpetrators and victims of sexual violence have a high likelihood of having drunk alcohol prior to the incident, as with most forms of violence and injury in sub-Saharan Africa. Reducing alcohol harms necessitates multi-level interventions and should be considered a key component of structural interventions to alleviate the burden of HIV and sexual violence. Brief interventions for people with problem drinking (an important component of primary health care, must incorporate specific discussion of links between alcohol and unsafe sex, and consequences thereof. Interventions to reduce alcohol harm among HIV-infected persons are also an important element in positive-prevention initiatives. Most importantly, implementation of known effective interventions could alleviate a large portion of the alcohol-attributable burden of disease, including its effects on unsafe sex, unintended pregnancy and HIV transmission.
Accelerating development in Sub-Saharan Africa will require massive expansion of access to electricity-currently reaching only about one third of households. This paper explores how essential economic development might be reconciled with the need to keep carbon emissions in check. We develop a geographically explicit framework and use spatial modeling and cost estimates from recent engineering studies to determine where stand-alone renewable energy generation is a cost effective alternative to centralized grid supply. Our results suggest that decentralized renewable energy will likely play an important role in expanding rural energy access. However, it will be the lowest cost option for a minority of households in Africa, even when likely cost reductions over the next 20 years are considered. Decentralized renewables are competitive mostly in remote and rural areas, while grid connected supply dominates denser areas where the majority of households reside. These findings underscore the need to decarbonize the fuel mix for centralized power generation as it expands in Africa. - Research highlights: ? Expansion of electricity access in Sub-Saharan Africa remains a development priority. ? Low carbon options are important to reduce GHG emissions growth and avoid lock-ins. ? Spatially explicit cost modeling guides choice of supply options. ? Decentralized renewables are lowest cost for a significant minority of households. ? Grid supply remains attractive, suggesting focus on decarbonizing centralized supply.
This paper analyses national, regional and international biofuels policies and strategies to assess whether these policies promote or undermine the development of biofuels sector in Africa. Despite having a huge comparative advantage in land, labour and good climatic conditions favourable for the growing of energy crops, few countries in Sub-Saharan Africa have included biofuels strategies in their energy or national development policies. Further results show that while developed countries commit huge financial resources for research, technology development and the provision of tax-incentives to both producers and consumers, there is little government support for promoting biofuels in Africa. Although the consequences of biofuels on food supply remain uncertain, the mandatory blending of biofuels with fossil fuels by industrialized countries will create demand for land in Africa for the growing of energy crops for biofuels. This paper urgently calls upon national governments in Sub-Saharan Africa to develop appropriate strategies and regulatory frameworks to harness the potential economic opportunities from biofuels sector development, while protecting the environment and rural communities from the adverse effects of land alienation from the mainstream agriculture towards the growing of energy crops for biofuels at the expense of traditional food crops.
Pamela Y. Collins
Full Text Available The 2010 Global Burden of Disease Study points to a changing landscape in which non-communicable diseases, such as mental, neurological, and substance use (MNS disorders, account for an increasing proportion of premature mortality and disability globally. Despite evidence of the need for care, a remarkable deficit of providers for MNS disorder service delivery persists in sub-Saharan Africa. This critical workforce can be developed from a range of non-specialist and specialist health workers who have access to evidence-based interventions, whose roles, and the associated tasks, are articulated and clearly delineated, and who are equipped to master and maintain the competencies associated with providing MNS disorder care. In 2012, the Neuroscience Forum of the Institute of Medicine convened a meeting of key stakeholders in Kampala, Uganda, to discuss a set of candidate core competencies for the delivery of mental health and neurological care, focusing specifically on depression, psychosis, epilepsy, and alcohol use disorders. This article discusses the candidate core competencies for non-specialist health workers and the complexities of implementing core competencies in low- and middle-income country settings. Sub-Saharan Africa, however, has the potential to implement novel training initiatives through university networks and through structured processes that engage ministries of health. Finally, we outline challenges associated with implementing competencies in order to sustain a workforce capable of delivering quality services for people with MNS disorders.
Environmental change and sustainable development present a challenge for all nations. Developed countries have to dismantle and change historic practice before progressing, whereas developing countries can move directly to new technology and new institutional frameworks. This chapter seeks to identify trends in energy supply and use that both improve sustainability and provide opportunities for commerce and industry. Worldwide experience is studied for application in sub-Saharan Africa (abbreviated as 'Africa' henceforward). Such application is central to UNIDO's programmes in energy and environment. These programmes consider both the supply and the demand sides, by the provision of energy for industry, use of renewable energy resources and improved industrial energy end-use efficiency. Key factors are de-linking intensity of energy use from economic growth and reducing environmental damage from energy supply and use The background for this chapter is 'Sustainable Energy Regulation and Policy-making for Africa', a set of 20 training-modules produced for UNIDO and REEEP (the Renewable Energy and Energy Efficiency Partnership). The modules will be used by governments, regulatory offices and industry in Africa for stimulating policy and commercial development in renewable energy and energy efficiency. Of particular relevance is the general trend to more liberalized electricity supplies, as regulated within new legislation. Within each country, institutional frameworks can be changed and improved for the benefit of both citizens and commerce alike. There is a common trend worldwide to include institutional mechanisms for the increase of renewable energy generation and the efficient use of energy within regulatory legislation, e.g. (Harrington et al., 2007). Government involvement and ministerial regulation is most common for electricity. In all countries, the introductory stages of electricity supply have been strongly influenced by national and local government action and ownership. However, once initiated, an established market economy, involving many competitive private companies, should produce electricity at less cost to the consumer and the nation, than if wholly owned and operated by government. Such improvement requires a carefully constructed legal framework, especially because there are many monopoly aspects of electricity supply. The administration and control of the legal objectives requires jurisdiction, usually by the appointment of a Regulator with a specialist and independent staff. Thus, hand-in-hand with the liberalization of energy supplies is the requirement for regulation. Since 1990, liberalization of energy supply, especially of electricity, has been introduced throughout Europe. The main actions have been at national level; consequently, individual national policies and methods dominate. Nevertheless, having an integrated European electricity grid encourages commonality throughout Europe. Associated with liberalization is the growth of private company participation and hence the need for legally enforceable regulation by a Regulator. The pattern of development in Europe is similar to many other world regions including North America. However, European electricity supply is older and the population more concentrated than in most other regions, therefore the opportunity for structured liberalization came first in Europe. Consequently, the European experience is important for formulating policy elsewhere, including Africa. However, without competition from several private companies for each contract, liberalization may well fail to deliver the improved services and reduced energy tariffs expected; chapter three considers such experience. Coincidentally with the trend to energy supply liberalization, has come the need for renewable energy supplies and increased energy efficiency. This change is promoted by several factors, including: sustainable development, new technology, reduced emissions and climate change. New technology enables improvements in the efficient generation and use of energy, thus bri ngin
Mally, Richard; Korycinska, Anastasia; Agassiz, David J L; Hall, Jayne; Hodgetts, Jennifer; Nuss, Matthias
The larvae of the Old World genera Leucinodes Guenée, 1854 and Sceliodes Guenée, 1854 are internal feeders in the fruits of Solanaceae, causing economic damage to cultivated plants like Solanummelongena and Solanumaethiopicum. In sub-Saharan Africa five nominal species of Leucinodes and one of Sceliodes occur. One of these species, the eggplant fruit and shoot borer Leucinodesorbonalis Guenée, 1854, is regarded as regularly intercepted from Africa and Asia in Europe, North and South America and is therefore a quarantine pest on these continents. We investigate the taxonomy of African Leucinodes and Sceliodes based on morphological characters in wing pattern, genitalia and larvae, as well as mitochondrial DNA, providing these data for identification of all life stages. The results suggest that both genera are congeneric, with Sceliodes syn. n. established as junior subjective synonym of Leucinodes. Leucinodesorbonalis is described from Asia and none of the samples investigated from Africa belong to this species. Instead, sub-Saharan Africa harbours a complex of eight endemic Leucinodes species. Among the former nominal species of Leucinodes (and Sceliodes) from Africa, only Leucinodeslaisalis (Walker, 1859), comb. n. (Sceliodes) is confirmed, with Leucinodestranslucidalis Gaede, 1917, syn. n. as a junior subjective synonym. The other African Leucinodes species were unknown to science and are described as new: Leucinodesafricensis sp. n., Leucinodesethiopica sp. n., Leucinodeskenyensis sp. n., Leucinodesmalawiensis sp. n., Leucinodespseudorbonalis sp. n., Leucinodesrimavallis sp. n. and Leucinodesugandensis sp. n. An identification key based on male genitalia is provided for the African Leucinodes species. Most imports of Leucinodes specimens from Africa into Europe refer to Leucinodesafricensis, which has been frequently imported with fruits during the last 50 years. In contrast, Leucinodeslaisalis has been much less frequently recorded, and Leucinodespseudorbonalis as well as Leucinodesrimavallis only very recently in fruit imports from Uganda. Accordingly, interceptions of Leucinodes from Africa into other continents will need to be re-investigated for their species identity and will likely require, at least in parts, revisions of the quarantine regulations. The following African taxa are excluded from Leucinodes: Hyperanalyta Strand, 1918, syn. rev. as revised synonym of Analyta Lederer, 1863; Analytaapicalis (Hampson, 1896), comb. n. (Leucinodes); Lygropiaaureomarginalis (Gaede, 1916), comb. n. (Leucinodes); Sylleptehemichionalis Mabille, 1900, comb. rev., Sylleptehemichionalisidalis Viette, 1958, comb. rev. and Sylleptevagans (Tutt, 1890), comb. n. (Aphytoceros). Deanolisiriocapna (Meyrick, 1938), comb. n. from Indonesia is originally described and misplaced in Sceliodes, and Leucinodescordalis (Doubleday, 1843), comb. n. (Margaritia) from New Zealand, Leucinodesraondry (Viette, 1981), comb. n. (Daraba) from Madagascar as well as Leucinodesgrisealis (Kenrick, 1912), comb. n. (Sceliodes) from New Guinea are transferred from Sceliodes to Leucinodes. While Leucinodes is now revised from Africa, it still needs further revision in Asia. PMID:25632252
Smith, D G; Pearson, R A
The large fluctuations seen in cattle populations during periods of drought in sub-Saharan Africa are not evident in the donkey population. Donkeys appear to have a survival advantage over cattle that is increasingly recognized by smallholder farmers in their selection of working animals. The donkey's survival advantages arise from both socioeconomic and biological factors. Socioeconomic factors include the maintenance of a low sustainable population of donkeys owing to their single-purpose role and their low social status. Also, because donkeys are not usually used as a meat animal and can provide a regular income as a working animal, they are not slaughtered in response to drought, as are cattle. Donkeys have a range of physiological and behavioural adaptations that individually provide small survival advantages over cattle but collectively may make a large difference to whether or not they survive drought. Donkeys have lower maintenance costs as a result of their size and spend less energy while foraging for food; lower energy costs result in a lower dry matter intake (DMI) requirement. In donkeys, low-quality diets are digested almost as efficiently as in ruminants and, because of a highly selective feeding strategy, the quality of diet obtained by donkeys in a given pasture is higher than that obtained by cattle. Lower energy costs of walking, longer foraging times per day and ability to tolerate thirst may allow donkeys to access more remote, under-utilized sources of forage that are inaccessible to cattle on rangeland. As donkeys become a more popular choice of working animal for farmers, specific management practices need to be devised that allow donkeys to fully maximize their natural survival advantages. PMID:16335068
Plambeck, Hauke Heinrich Friedrich
Africa: A continent is waking up. Not through aid or wealth from the exploitation of natural resources, but through a technological revolution. The access to affordable mobile telecommunication. Inspired by deregulation and pioneered by local champions who have taken a lead in what is today's fastest growing mobile market in the world. There is money to be made in these markets, attracting more and more operators from the northern hemisphere. However positive the short term impact of this ...
Claudia L. McCalman
Full Text Available Understanding patients? cultural expectations could contribute to better health outcomes and decrease cultural health disparities. This qualitative pilot study objective was to explore experiences, perceptions, and expectations of males and females Angolan students as patients in America. Eighteen face-to-face interviews were conducted at a Midwestern university. Burgoon?s expectancy violation theory (1991 was the theoretical background. Results revealed as positive expectation violations an advanced technology, quality of services, medicine availability, and emphasis on preventive care. Negative expectation violations included high service costs, complicated insurance system, short medical encounters, and difficulty in building relational history with providers. The study also revealed that culturally related communication barriers as well as negative violations of expectations hinder the quality of intercultural clinical encounters and can affect health outcomes. Participants emphasized the importance of these interpersonal relations and their connection with perceptions of caregivers? professional competence. International patients/students revealed that they believe friendliness on the part of the caregiver is a signal that they are dealing with a good doctor or nurse. Intercultural competence is an important asset of caregivers who work in multicultural clinics and in college health. Practical implications emerged in international advising and clinician?s education.
Raji Abdulghafar Bello
Full Text Available Human immunodeficiency syndrome (HIV whose full-blown period is called acquired immunity deficiency syndrome (AIDS is today a terminal disease. While one weakens the body hormones, the other comes to claim the life with its accompanying opportunistic diseases. Several factors have been reviewed to be causing the infection and its prevalence as well as its socio-economic, scientific and cultural dimensions. The cost implication of this ailment is enormous when considered from individual, national or global perspective, especially when the cost of treatment and the cost of the disability adjusted life years (DALYs lost to incapacitation from HIV/AIDS is considered. This study has investigated the financial implications of treatment and the DALYs lost to HIV/AIDS from the perspective of sub-Saharan Africa covering thirty-five countries. Infected population of age 15-49 years were considered, being the active life year age group. Applying Morrows DALYs measurement, and Ainsworths per capita general rule method of costing HIV/AIDS, it was found that the cost of treatment of HIV/AIDS in any country depends on her economic strength on the one hand and the size of the infected population on the other, to the extent that no country spends or loses less than 3 percent of her national income on treatment and to DALYs. To any country, the financial cost of the DALYs lost to HIV/AIDS is much more than the cost of treatment per episode, mostly huge enough to develop a sector of the countrys economy. However, a single recommendation could be difficult as individual countries experience different effect, but different countries must pursue long-run anti-prevalence policies individually and as economic region or bloc.
Full Text Available The United Nations Millennium Development Goals (MDGs are a series of 8 goals and 18 targets aimed at ending extreme poverty by 2015, and there are 48 quantifiable indicators for monitoring the process. Most of the MDGs are health or health-related goals. Though the MDGs might sound ambitious, it is imperative that the world, and sub-Saharan Africa in particular, wake up to the persistent and unacceptably high rates of extreme poverty that populations live in, and find lasting solutions to age-old problems. Extreme poverty is a cause and consequence of low income, food insecurity and hunger, education and gender inequities, high disease burden, environmental degradation, insecure shelter, and lack of access to safe drinking water and basic sanitation. It is also directly linked to unsound governance and inequitable distribution of public wealth. While many regions in the world will strive to attain the MDGs by 2015, most of the countries in sub-Saharan Africa, with major human development challenges associated with socio-economic disparities, will not. ZambiaÃ¢ÂÂs MDG progress reports of 2003 and 2005 show that despite laudable political commitment and some advances made towards achieving universal primary education, gender equality, improvement of child health and management of the HIV/AIDS epidemic, it is not likely that Zambia will achieve even half of the goals. ZambiaÃ¢ÂÂs systems have been weakened by high disease burden and excess mortality, natural and man-made environmental threats and some negative effects of globalization such as huge external debt, low world prices for commodities and the human resource Ã¢ÂÂbrain drainÃ¢ÂÂ, among others. Urgent action must follow political will, and some tried and tested strategies or Ã¢ÂÂquick winsÃ¢ÂÂ that have been proven to produce high positive impact in the short term, need to be rapidly embarked upon by Zambia and other countries in sub-Saharan Africa if they are to achieve the Millennium Development Goals.
Prevalences of dementia and cognitive impairment among older people in sub-Saharan Africa: a systematic review / : / Prevalence de la demence et des troubles cognitifs chez les personnes agees en Afrique sub-saharienne : une etude systematique / : / : / La prevalencia de la demencia y el deterioro cognitivo en las personas mayores en el Africa subsahariana: una revision sistematica
Angelique, Mavrodaris; John, Powell; Margaret, Thorogood.
Full Text Available Resumen Objetivo Realizar una revisión sistemática de la literatura sobre la prevalencia del deterioro cognitivo y la demencia en el África subsahariana. Métodos Se hicieron búsquedas en cinco bases de datos electrónicas a fin de hallar resúmenes pertinentes e identificar los documentos que cumpl [...] ieran con los requisitos para una revisión del texto completo. Los estudios se incluyeron cuando dos autores coincidían en que el diseño era de cohorte, de casos y controles o transversal y si presentaban los datos a nivel de población, si se limitaban a los adultos africanos negros mayores de 50 años o descritos como "personas mayores" o "ancianas", si incluían datos correspondientes a las personas que residen en el África subsahariana y si presentaban, al menos, un grado de deterioro cognitivo o resultados clínicos relevantes sobre el deterioro cognitivo. Se realizaron búsquedas de las referencias de los artículos incluidos en nuestro estudio a fin de identificar más publicaciones que cumplieran los requisitos, se arbitraron los desacuerdos sobre la inclusión en las discusiones que involucraban a todos los autores y se recogieron los datos de forma independiente por dos autores mediante un formulario desarrollado por los autores y probado en una muestra de trabajos. Resultados Se halló un total de 2320 documentos únicos y se revisó el texto completo de 87 de ellos. Se seleccionaron diecinueve documentos que incluían 11 estudios transversales, todos ellos publicados entre 1995 y 2011. Los estudios tuvieron lugar en Benin, Botswana, la República Centroafricana, el Congo y Nigeria, en los que se registraron aproximadamente 10 500 participantes. La prevalencia de la demencia varió del 0 % en Nigeria, al 10,1 % (intervalo de confianza del 95 %, IC: 8,06-11,08), también en Nigeria. La prevalencia del deterioro cognitivo varió del 6,3 % en Nigeria, al 25 % (IC del 95 %: 21,2 a 29,0) en la República Centroafricana. Conclusión La prevalencia de la demencia y el deterioro cognitivo en el África subsahariana variaron mucho, y fueron pocos los estudios publicados que se revelaron mediante la búsqueda bibliográfica. Abstract in english Objective To perform a systematic review of the literature on the prevalence of cognitive impairment and dementia in sub-Saharan Africa. Methods Five electronic databases were searched for relevant abstracts and to identify papers eligible for full-text review. A study was included if two authors [...] agreed that it had a cohort, casecontrol or cross-sectional design and reported population-level data; was limited to black African adults older than 50 years or described as elderly or old; reported data for individuals residing in sub-Saharan Africa; and reported at least one measure of cognitive impairment or clinical outcomes relevant to cognitive decline. References of papers included in our study were searched to identify additional candidate publications. Disagreements about inclusion were adjudicated during discussions involving all authors. Data were extracted independently by two authors, using a form developed by the authors and tested on a sample of papers. Findings A total of 2320 unique papers was found; the full text of 87 was reviewed. Nineteen papers featuring 11 cross-sectional studies were included; all were published during 19952011. Studies occurred in Benin, Botswana, the Central African Republic, the Congo and Nigeria and enrolled approximately 10?500 participants. The prevalence of dementia ranged from 0%, in Nigeria, to 10.1% (95% confidence interval, CI: 8.611.8), also in Nigeria. The prevalence of cognitive impairment ranged from 6.3%, in Nigeria, to 25% (95% CI: 21.229.0), in the Central African Republic. Conclusion Prevalences of dementia and cognitive impairment in sub-Saharan Africa varied widely, with few published studies revealed by the literature search.
Tadesse, T.; Haile, M.; Senay, G.; Wardlow, B.D.; Knutson, C.L.
Reducing the impact of drought and famine remains a challenge in sub-Saharan Africa despite ongoing drought relief assistance in recent decades. This is because drought and famine are primarily addressed through a crisis management approach when a disaster occurs, rather than stressing preparedness and risk management. Moreover, drought planning and food security efforts have been hampered by a lack of integrated drought monitoring tools, inadequate early warning systems (EWS), and insufficient information flow within and between levels of government in many sub-Saharan countries. The integration of existing drought monitoring tools for sub-Saharan Africa is essential for improving food security systems to reduce the impacts of drought and famine on society in this region. A proactive approach emphasizing integration requires the collective use of multiple tools, which can be used to detect trends in food availability and provide early indicators at local, national, and regional scales on the likely occurrence of food crises. In addition, improving the ability to monitor and disseminate critical drought-related information using available modern technologies (e.g., satellites, computers, and modern communication techniques) may help trigger timely and appropriate preventive responses and, ultimately, contribute to food security and sustainable development in sub-Saharan Africa. ?? 2008 United Nations.
Muller, Bernadette; Haller, Max
It is widely recognised that higher education is crucial for socio-economic growth in developing countries. Sub-Saharan Africa (SSA) is lagging behind in this regard in spite of a strong expansion of universities in the last decades. However, this growth may have led to a deterioration of the quality of higher education. There is no dearth of
Duvall, Susan; Thurston, Sarah; Weinberger, Michelle; Nuccio, Olivia; Fuchs-Montgomery, Nomi
Between 2008 and 2012, Marie Stopes International (MSI) provided 1.7 million contraceptive implants in sub-Saharan Africa as part of a comprehensive method mix, primarily through mobile outreach using dedicated MSI providers and also through social franchising and MSI-run clinics. Large-scale access, quality, and informed choice were key elements of MSI's strategy.
Akintayo, Akinola Ebunolu
The purpose of this research is to describe the role of human rights lawyers in a rights based approach to poverty reduction in Sub-Saharan Africa. The objective is to inform these role players of their proper functions and powers in using human rights regime to fight poverty in the region.
Johnson, Ane Turner
The purpose of this phenomenological study was to explore the life and career paths of women higher education administrators in sub-Saharan Africa. Specifically, the study sought to interpret the women's experiences and identities, through the framework of intersectionality and gender performance, as ones that contributed to advancement
Nchise, Abinwi C.
The exponential growth of the Internet and mobile phone usage in sub-Saharan Africa (SSA) within the last decade has created many different platforms for citizens' political participation. This appears to be changing the political landscape of most countries within the region as governments are increasingly held responsible for their actions.
Kluth, Michael Friederich; Pilegaard, Jess
Sub-Saharan Africa constitutes a distinct security region and hosts a high proportion of fragile and failed states presiding over territories with abundant resources but no indigenous great powers! Following offensive neorealist logic, the absence of local great powers explains the continued benign neglect of the US. External influence from European powers is nonetheless significant, albeit several BRIC countries are challenging the position of the former colonial masters. In response France and the United Kingdom (UK) have turned to European foreign and security policy integration to pool resources and promote burden sharing with other EU partners, in order to maintain power in the region. This European mobilization has kept rivals at bay but has also instigated balancing behaviour as revisionist suitors boost their conventional power projection capabilities.
Full Text Available Public health specialists and clinicians alike agree that Humanity faces a global pandemic of chronic diseases in the 21st century. In this article we discuss the implications of this pandemic on another global issue, the health workforce. Because both issues are particularly acute in Sub-Saharan Africa (SSA, we will focus on this region and use Cameroon as a case in point. We first gauge the epidemic of chronic conditions in SSA. We then discuss the implications of chronic conditions for the reshaping of health systems and the health workforce. We conclude by making a strong case for the building up and strengthening the health workforce, insisting on the crucial role of nurses, their training, and involvement in chronic disease management.
This paper provides a test of the generalizability of the barriers approach (Rahat and Hazan, 2011) to the study of electoral system reform attempts. It does so by examining a set of recent attempts of electoral system change in four Sub-Saharan countries (South Africa, Lesotho, Kenya, and Zimbabwe), some of which were successful, while other were abortive. The conclusion reached is that the barriers approach is useful as a helpful framework for evaluating such reform attempts, even though it is also less convincing in some cases. Two of the barriers (actors vested interest and the superiority of the institutional status quo) appear to be more important than the other five barriers, i.e., what one would also expect from the outset.
Jasper M. Teboh
Full Text Available Remote sensors have a growing legacy for improving crop N use efficiency (NUE in several parts of the world. The technology employs crop spectral properties to determine fertilizer rates by matching crop N requirement based on midseason yield potential. Conclusions that the technology is inappropriate for Sub Saharan Africa (SSA because the farmers use little or no fertilizer, or cannot afford it, are reviewed. Opportunities and applicability using a model concept from the GreenSeeker® sensor ($4000 are presented. Because farmers in SSA inefficiently apply fertilizer through blanket recommendations, they must improve crop NUE to minimize cost. Application of this technology would enable refinement or development of N recommendation protocols for target groups of farmers based on site and delineated management field zones. With new developments of a prototype GreenSeeker®, the Optical Pocket Sensor (<$250, this technology will definitely be affordable and applicable, at least for institutional research purposes in SSA.
Götz, Annette E.
Palynological data of Permian-Triassic formations of the Sub-Saharan Karoo basins play a crucial role in the study and for the understanding of Gondwana's climate history and biodiversity in this time of major global changes in terrestrial and marine ecosystems. The palynological record reflects changes in land plant communities and vegetational patterns related to climate change and thus provides significant data for high-resolution palaeoclimate reconstructions in deep time. Recent palynological investigations of Triassic successions of South Africa, Mozambique and Tanzania document major changes in palaeoclimate. The spore/pollen ratios are used as a proxy for humidity changes. Stratal variations in the composition of the pollen group indicate warming and cooling phases. Variations in the amount and in the type, size and shape of phytoclasts reflect short-term changes in transport and weathering. The detected palaeoclimate signals are used for high-resolution correlation on basin-wide, intercontinental and intra-Gondwanic scales.
English, Mike; English, Rex; English, Atti
Sub-Saharan Africa is a highly diverse geo-political region. Any brief discussion of the progress made over the last 15 years towards the Millennium Development Goals (MDGs) will therefore not do justice to the true complexity of context and events. Our focus will be MDG4-to reduce child mortality by 66% from 1990 levels. We will touch briefly on MDG1, to eradicate extreme poverty and hunger, MDG2, to achieve universal primary education, and MDG5, to improve maternal health, which are inextricably linked with child well-being. We will also draw on an eclectic mix of additional global indicators. Acknowledging the limitations of this approach, we first offer a summary of expected progress and then point to debates on future goals. PMID:25613971
Although considerable achievements in the global reduction of hunger and poverty have been made, progress in Africa so far has been very limited. At present, a third of the African population faces widespread hunger and chronic malnutrition and is exposed to a constant threat of acute food crisis and famine. The most affected are rural households whose livelihood is heavily dependent on traditional rainfed agriculture. Rainfall plays a major role in determining agricultural production and hen...
Himmelgreen, David A; Romero-Daza, Nancy; Turkon, David; Watson, Sharon; Okello-Uma, Ipolto; Sellen, Daniel
Recently a few vocal health experts have suggested that some of the billions of dollars currently used to prevent and treat HIV and AIDS be reallocated to address more basic problems such as malnutrition, tuberculosis, malaria, and enteric and diarrheal disease caused by lack of access to clean water. While not universally agreed upon, this reassessment of policy priorities acknowledges that there are multiple other health problems that deserve renewed attention from the international community. It also highlights the fact that the impacts of the HIV pandemic are exacerbated by widespread poverty, food insecurity and malnutrition, and gender inequality. Nowhere is this more evident than in sub-Saharan Africa, where multiple epidemics conflate and seriously compromise the survival of individuals and communities. Given the widespread occurrence of famine in sub-Saharan Africa, issues of food and economic security become of paramount importance in efforts to address the region's HIV epidemics. This paper examines the historical, political-economic, and cultural dimensions of the HIV epidemic in the context of the growing problem of food and economic insecurity. Furthermore, using theoretical frameworks that emphasize the dynamic interrelation between HIV/AIDS and food insecurity, we present suggestions for combining traditional HIV-prevention strategies with food production and nutritioneducation programming. In light of the complex interactions between HIV/AIDS and food insecurity and the lack of accessible treatment modalities, such programming could potentially reduce the risk for transmission of HIV through behavioural changes and improved nutritional and immune status, and increase the life expectancy of people living with HIV or AIDS. PMID:25875704
Alberta L Wang
Full Text Available OBJECTIVE: To review the types, content and accuracy of print media reports on male circumcision for preventing HIV infection among men in sub-Saharan Africa. METHODS: We conducted a trilingual search (English, French, Portuguese of LexisNexis® with the phrase "male circumcision" for the period from 28 March 2007 to 30 June 2008. The articles identified were screened for the central theme of male circumcision for preventing HIV infection in men in sub-Saharan Africa and for publication types targeting lay audiences - newspapers, magazines, newswires or newsletters. We judged the accuracy of the reports and determined the context, public perceptions, misconceptions and areas of missing information in the print media. We also explored whether the media could be better used to maximize the impact of male circumcision. FINDINGS: We identified 412 articles, of which 219 were unique and 193 were repeats. "Peaks and valleys" occurred in the volume of articles over time. Most articles (56.0% presented male circumcision for the prevention of HIV infection in a positive light. Those that portrayed it negatively had an overall repeat rate 2.9 times higher than positive articles. Public health messages formulated by international health agencies were few but generally accurate. CONCLUSION: The accuracy of the reports was good, although the articles were few and frequently omitted important messages. This suggests that public health authorities must help the media understand important issues. A communication strategy to sequence important themes as male circumcision programmes are scaled up would allow strategic coverage of accurate messages over time.
Schlag, Nicolai; Zuzarte, Fiona
In the developing nations of sub-Saharan Africa, providing households with modern energy services is a critical step towards development. A large majority of households in the region rely on traditional biomass fuels for cooking, which represent a significant proportion of energy used in the domestic setting. The disadvantages of these fuels are many: they are inefficient energy carriers and their heat is difficult to control; they produce dangerous emissions; and their current rate of extraction is not sustainable for forests. Transition to clean cooking fuels such as liquefied petroleum gas (LPG) or ethanol would resolve many of these issues as they do not produce dangerous particulate emissions, and are commercially viable, offering a number of socio-economic advantages over traditional options. Despite the benefits of fuel switching, clean cooking fuels are rarely used in households in sub-Saharan Africa. Their failure to attain widespread use can be attributed to a number of market barriers. One of the major issues is cost: clean cooking fuels are prohibitively expensive for many households, and the high price of compatible stoves further discourages their use. Besides the expense, many consumers are hesitant to adopt the new technology, reflecting the lack of public awareness of the relevant issues. At the same time, Africa's underdeveloped infrastructure prevents these fuels from being made available in many local marketplaces. To date, this combination of factors has largely stifled the transition to clean cooking fuels. National governments can adopt a number of strategies to address these issues. The creation of clean cooking-fuel initiatives at the national level would be an important first step, after which governments can begin to address the issues more effectively. The introduction of relevant financial instruments would help to tackle the economic barriers to clean cooking fuels, and public outreach and education could overcome socio-cultural obstacles. Through such a policy framework, national governments can play a significant role in encouraging the transition to clean cooking fuels
Full Text Available Background: This article provided an analysis of gender inequality, health expenditure and itsrelationship to maternal mortality. Objective: The objective of this article was to explore gender inequality and its relationship with health expenditure and maternal mortality in sub-Saharan Africa (SSA. A unique analysis was used to correlate the Gender Inequality Index (GII, Health Expenditure and Maternal Mortality Ratio (MMR. The GII captured inequalities across three dimensions Reproductive health, Women empowerment and Labour force participation between men and women. The GII is a composite index introduced by the UNDP in 2010 and corrects for the disadavanatges of the other gender indices. Although the GII incorporates MMR in its calculation, it should not be taken as a substitute for, but rather as complementary to, the MMR.Method: An exploratory and descriptive design to a secondary documentary review using quantitative data and qualitative information was used. The article referred to sub-Saharan Africa, but seven countries were purposively selected for an in-depth analysis based on the availability of data. The countries selected were Angola, Botswana, Malawi, Mozambique,South Africa, Zambia and Zimbabwe.Results: Countries with high gender inequality captured by the gender inequality index were associated with high maternal mortality ratios as compared with countries with lower gender inequality, whilst countries that spend less on health were associated with higher maternal deaths than countries that spend more.Conclusion: A potential relationship exists between gender inequality, health expenditure, and maternal mortality. Gender inequalities are systematic and occur at the macro, societal and household levels.
The purpose of this paper is to identify and develop potential solutions on how to facilitate the financing of bioenergy projects in Sub-Saharan Africa. We focus on four main areas that have been identified from empirical research in achieving this objective; these are: (i) financing, (ii) markets; (iii) trade and (iv) policy. The sources utilised consist of primary and secondary data compilation and analysis. Of particular relevance are the results of a market survey undertaken on funding opportunities, where the perspectives of both, project developers as well as project financiers are taken into account. Results indicate that the four areas cannot be treated autonomously, as they not only overlap but impact each other. There are a number of difficulties for biofuel ventures, not least the nature of the projects themselves, but also around the financing and political landscape of these enterprises. Common solutions which cross cut the four areas are the need to raise awareness and the skillsets, in areas including, financing opportunities, markets, policy, technical aspects among a range of stakeholders involved in biofuel ventures. There is also a necessity to create a supporting framework for the emerging carbon trading-related activities in Africa. - Highlights: ? We identify and develop potential solutions towards facilitating the financing of bioenergy projects in sub-Saharan Africa. ? We focus on four areas to achieve this objective; these are: (i) financing, (ii) markets; (iii) trade and (iv) policy. ? Common solutions which cross cut the four areas are the need to raise awareness and develop skillsets of stakeholders involved.
Kefi, Rym; Hsouna, Sana; Ben Halim, Nizar; Lasram, Khaled; Romdhane, Lilia; Messai, Habib; Abdelhak, Sonia
Tunisia is located at the crossroads of Europe, the Middle East and Sub-Saharan Africa. This position might lead to numerous waves of migrations, contributing to the current genetic landscape of Tunisians. In this study, we analyzed 815 mitochondrial DNA (mtDNA) sequences from Tunisia in order to characterize the mitochondrial DNA genetic structure of this region, to construct the processes for its composition and to compare it to other Mediterranean populations. To that end, additional 4206 mtDNA sequences were compiled from previous studies performed in African (1237), Near Eastern (231) and European (2738) populations. Both phylogenetic and statistical analyses were performed. This study confirmed the mosaic genetic structure of the Tunisian population with the predominance of the Eurasian lineages, followed by the Sub-Saharan and North African lineages. Among Tunisians, the highest haplogroup and haplotype diversity were observed in particular in the Capital Tunis. No significant differentiation was observed between both geographical (Northern versus Southern Tunisia) and different ethnic groups in Tunisia. Our results highlight the presence of outliers and most frequent unique sequences in Tunisia (10.2%) compared to 45 Mediterranean populations. Phylogenetic analysis showed that the majority of Tunisian localities were closer to North Africans and Near Eastern populations than to Europeans. The exception was found for Berbers from Jerba which are clustered with Sardinians and Valencians. PMID:24491098
Deployment of community health workers across rural sub-Saharan Africa: financial considerations and operational assumptions / Déploiement des agents de santé communautaires en Afrique rurale subsaharienne: considérations financières et hypothèses opérationnelles / Despliegue de trabajadores comunitarios de la salud en zonas rurales del África subsahariana: consideraciones financieras y supuestos operativos
Gordon C, McCord; Anne, Liu; Prabhjot, Singh.
Full Text Available OBJETIVO: Facilitar asesoramiento sobre los costes necesarios para desarrollar un sistema de trabajadores comunitarios de la salud (TCS) con capacidad para adaptarse a ámbitos locales y con flexibilidad a nivel nacional, en el marco de los sistemas sanitarios de atención primaria en el África subsah [...] ariana. MÉTODOS: Se estimaron los gastos anuales para la capacitación, el equipamiento y el despliegue de los trabajadores comunitarios de la salud en las zonas rurales del África subsahariana mediante el análisis de datos procedentes de la literatura, así como del Proyecto Aldeas del Milenio. Los supuestos del modelo son adecuados para permitir a los gobiernos nacionales adaptar el subsistema de los trabajadores comunitarios de la salud a las necesidades nacionales, así como para realizar un despliegue medio de un trabajador comunitario de la salud por cada 650 habitantes en las zonas rurales antes de 2015. El subsistema de trabajadores comunitarios de la salud descrito se calculó mediante el análisis de datos del sistema de información geográfica (GIS, por sus siglas en inglés) sobre la población, los territorios urbanos, la incidencia de enfermedades a nivel nacional y subnacional, así como los costes unitarios (en el campo de salarios y necesidades básicas). El modelo puede configurarse y reproducirse con facilidad. Los países pueden adaptarlo a los precios, los salarios, la densidad demográfica, así como a la carga de enfermedades locales en distintas áreas geográficas. RESULTADOS: Se estima que el coste medio anual por el despliegue de trabajadores comunitarios de la salud para prestar atención a toda la población de las zonas rurales del África subsahariana antes de 2015 sería de unos 2,6 billones (es decir, 2 600 millones) de dólares estadounidenses (US$). Dicha suma, que será cubierta tanto por los gobiernos nacionales como por los socios donantes, se traduce en US$ 6,86 anuales por habitante, cubierta por el subsistema de trabajadores comunitarios de la salud, y en US$ 2,72 anuales por habitante. Asimismo, la capacitación, el equipamiento y el apoyo a cada TCS supondría una media anual de US$ 3750. CONCLUSIÓN: Se pueden desplegar subsistemas integrales de trabajadores comunitarios de la salud en todo el África subsahariana por un coste modesto, si se compara con los costes previstos para un sistema de atención sanitaria primaria. A juzgar por los éxitos documentados, estos ofrecen un sólido complemento para la atención en servicios sanitarios en entornos rurales de África. Abstract in english OBJECTIVE: To provide cost guidance for developing a locally adaptable and nationally scalable community health worker (CHW) system within primary-health-care systems in sub-Saharan Africa. METHODS: The yearly costs of training, equipping and deploying CHWs throughout rural sub-Saharan Africa were c [...] alculated using data from the literature and from the Millennium Villages Project. Model assumptions were such as to allow national governments to adapt the CHW subsystem to national needs and to deploy an average of 1 CHW per 650 rural inhabitants by 2015. The CHW subsystem described was costed by employing geographic information system (GIS) data on population, urban extents, national and subnational disease prevalence, and unit costs (from the field for wages and commodities). The model is easily replicable and configurable. Countries can adapt it to local prices, wages, population density and disease burdens in different geographic areas. FINDINGS: The average annual cost of deploying CHWs to service the entire sub-Saharan African rural population by 2015 would be approximately 2.6 billion (i.e. 2600 million) United States dollars (US$). This sum, to be covered both by national governments and by donor partners, translates into US$ 6.86 per year per inhabitant covered by the CHW subsystem and into US$ 2.72 per year per inhabitant. Alternatively, it would take an annual average of US$ 3750 to train, equip and support each CHW. CONCLUSION: Comprehensive CHW subsy
C, Steffen; F, Debellut; BD, Gessner; FC, Kasolo; AA, Yahaya; N, Ayebazibwe; O, Bassong; Y, Cardoso; S, Kebede; S, Manoncourt; KA, Vandemaele; AW, Mounts.
Full Text Available SITUACIÓN: Existe poca información sobre la carga de morbilidad de la gripe en el África subsahariana. La vigilancia rutinaria de la gripe es clave para poder entender mejor el impacto de las infecciones respiratorias agudas en las poblaciones del África subsahariana. ENFOQUE: Se inició un proyecto [...] conocido como SISA, Strengtheninginfluenza sentinel surveillance in Africa, (Refuerzo de la vigilancia centinela de la gripe en África) en Angola, Camerún, Ghana, Nigeria, Ruanda, Senegal, Sierra Leona y Zambia para ayudar a mejorar la vigilancia centinela de la gripe, incluida la recopilación de datos epidemiológicos y virológicos, y para desarrollar mecanismos de información rutinarios a nivel nacional, regional e internacional. Estos países recibieron asistencia técnica por medio de supervisión remota y visitas directas. Los consultores trabajaron estrechamente con los ministerios de sanidad, la Organización Mundial de la Salud, los laboratorios nacionales de gripe y otros interesados relacionados con la vigilancia de la gripe. MARCO REGIONAL: Los sistemas de vigilancia de la gripe en los países objetivo se encontraban en diferentes fases de desarrollo cuando se implementó el proyecto SISA. Por ejemplo, en Senegal se había llevado a cabo la vigilancia virológica durante años, mientras que en Sierra Leona no se había realizado ninguna actividad de vigilancia. CAMBIOS IMPORTANTES: Se desarrollaron o actualizaron los documentos de trabajo, como protocolos y procedimientos de vigilancia nacional, y se organizaron cursos para el personal centinela in situ y para los administradores de datos. LECCIONES APRENDIDAS: La asistencia específica para los países puede ayudar a los mismos a reforzar la vigilancia de la gripe a nivel nacional, pero solo se puede conseguir una sostenibilidad a largo plazo con financiación externa y con un fuerte liderazgo gubernamental nacional. Abstract in english PROBLEM: Little is known about the burden of influenza in sub-Saharan Africa. Routine influenza surveillance is key to getting a better understanding of the impact of acute respiratory infections on sub-Saharan African populations. APPROACH: A project known as Strengthening Influenza Sentinel Survei [...] llance in Africa (SISA) was launched in Angola, Cameroon, Ghana, Nigeria, Rwanda, Senegal, Sierra Leone and Zambia to help improve influenza sentinel surveillance, including both epidemiological and virological data collection, and to develop routine national, regional and international reporting mechanisms. These countries received technical support through remote supervision and onsite visits. Consultants worked closely with health ministries, the World Health Organization, national influenza laboratories and other stakeholders involved in influenza surveillance LOCAL SETTING: Influenza surveillance systems in the target countries were in different stages of development when SISA was launched. Senegal, for instance, had conducted virological surveillance for years, whereas Sierra Leone had no surveillance activity at all. RELEVANT CHANGES: Working documents such as national surveillance protocols and procedures were developed or updated and training for sentinel site staff and data managers was organized. LESSONS LEARNT: Targeted support to countries can help them strengthen national influenza surveillance, but long-term sustainability can only be achieved with external funding and strong national government leadership.
Gwenzi, Willis; Chaukura, Nhamo; Mukome, Fungai N D; Machado, Stephen; Nyamasoka, Blessing
Sub-Saharan Africa (SSA) experiences soil degradation, food and livelihood insecurity, environmental pollution and lack of access to energy. Biochar has gained international research attention, but few studies have investigated the potential of biochar to address the challenges in SSA. This paper seeks to identify and evaluate generic potential opportunities and constraints associated with biochar application in sub-Saharan Africa using Zimbabwe as case study. Specific objectives were to; (1) identify and quantify feedstocks for biochar production; (2) review literature on the biochar properties, and evaluate its potential applications in agriculture, environmental remediation and energy provision, and (3) identify research gaps, risks and constraints associated with biochar technology. Biochar feedstocks in Zimbabwe were estimated to be 9.9 Mton yr(-1), predominantly derived from manure (88%) and firewood (10%). This will yield 3.5, 1.7 and 3.1 Mton yr(-1) of biochar, bio-oil and synthetic gas, respectively. Land application of the 3.5 Mton yr(-1) of biochar (?63% C) would sequester approximately 2.2 Mton yr(-1) of soil carbon in Zimbabwe alone, while simultaneously minimizing the environmental and public health risks, and greenhouse gas emissions associated with solid organic wastes. Biochar potentially enhances soil and crop productivity through enhanced nutrient and soil moisture availability, amelioration of acidic soils and stimulation of microbial diversity and activity. Due to its excellent adsorption properties, biochar has potential applications in industrial and environmental applications including water and wastewater treatment, remediation and revegetation of contaminated soils and water. Biochar products have energy values comparable or higher than those of traditional biomass fuels; thereby making them ideal alternative sources of energy especially for poor households without access to electricity. Before the benefits of biochar can be realized in SSA, there is need to overcome multiple risks and constraints such as lack of finance, socio-economic constraints including negative perceptions and attitudes among both researchers and consumers, and environmental and public health risks. Therefore, there is need to conduct fundamental research to demonstrate the benefits of biochar applications, and develop policy framework and criteria for its production and subsequent adoption. PMID:25521347
Full Text Available Abstract At a recent meeting (Sept 18, 2009 in which reasons for the limited access to artemisinin-based combination therapy (ACT in sub-Saharan Africa were discussed, policy and market surveys on anti-malarial drug availability and accessibility in Burundi and Sierra Leone were presented in a highly interactive brainstorming session among key stakeholders across private, public, and not-for-profit sectors. The surveys, the conduct of which directly involved the national malaria control programme managers of the two countries, provides the groundwork for evidence-based policy implementation. The results of the surveys could be extrapolated to other countries with similar socio-demographic and malaria profiles. The meeting resulted in recommendations on key actions to be taken at the global, national, and community level for better ACT accessibility. At the global level, both public and private sectors have actions to take to strengthen policies that lead to the replacement of loose blister packs with fixed-dose ACT products, develop strategies to ban inappropriate anti-malarials and regulate those bans, and facilitate technology and knowledge transfer to scale up production of fixed-dose ACT products, which should be readily available and affordable to those patients who are in the greatest need of these medicines. At the national level, policies that regulate the anti-malarial medicines market should be enacted and enforced. The public sector, including funding donors, should participate in ensuring that the private sector is engaged in the ACT implementation process. Research similar to the surveys discussed is important for other countries to develop and evaluate the right incentives at a local level. At the community level, community outreach and education about appropriate preventive and treatment measures must continue and be strengthened, with service delivery systems developed within both public and private sectors, among other measures, to decrease access to ineffective and inappropriate anti-malarial medicines. What was clear during the meeting is that continuing commitment, strengthened interaction and transparency among various stakeholders, with focus on communities, national governments, and evidence-based policy and action are the only way to sustainably address the control of malaria, a disease which continues to have a significant health and socio-economic impact worldwide, particularly in sub-Saharan Africa. Details on the methodology employed in carrying out the studies discussed at this meeting, as well as more detailed results, data analysis and discussion of the studies are soon to be published.
Geoff, Harris; Claire, Vermaak.
Full Text Available This article examines whether the close association of income inequality and violence identified for high income countries applies also to sub-Saharan Africa and, in particular, to South Africa. Cross sectional analysis across sub-Saharan countries provided no evidence of such an association. Howeve [...] r, using homicide rates and several measures of inequality across South Africa's 52 districts does provide evidence of a significant positive relationship between homicide rates and expenditure inequality. A one per cent increase in inequality is associated with an increase in the homicide rate of 2.3 to 2.5 per cent. This relationship remains significant after controlling for other characteristics of the district.
Villholth, Karen G.; Ganeshamoorthy, Jegan
A simple but comprehensive framework for analysing the potential for and constraints to groundwater development for irrigated agriculture in sub-Saharan Africa is proposed. The framework, based on food value chain principles, is applied to the sub-Saharan context and a specific catchment in Tanzania, the Usangu plains, where groundwater has been proposed as a strategic resource for augmenting food production and smallholder livelihoods and to alleviate seasonal water scarcity. The novel contribution of the work is the presentation of a tool that can be applied to support an interdisciplinary approach to systematically identify most significant barriers and most critical water management and development interventions for sustainable development of groundwater irrigation. The result of the case study shows that farmer economics, capacity, and pump and well drilling market constraints limit groundwater irrigation in the Usangu plains rather than hydrogeological conditions.
Harding Richard; Logie Dorothy E
Abstract Background Despite growing HIV and cancer prevalence in Sub-Saharan Africa, and WHO advocacy for a public health approach to palliative care provision, opioid availability is severely limited. Uganda has achieved a morphine roll-out programme in partnership with the Ministry of Health. This study aimed to evaluate that programme by identifying challenges to implementation that may inform replication. Methods A multi-methods protocol appraised morphine regulation, storage, prescribing...
Nsubuga, Peter; Johnson, Kenneth; Tetteh, Christopher; Oundo, Joseph; Weathers, Andrew; Vaughan, James; Elbon, Suzanne; Tshimanga, Mufuta; Ndugulile, Faustine; Ohuabunwo, Chima; Evering-Watley, Michele; Mosha, Fausta; Oleribe, Obinna; Nguku, Patrick; Davis, Lora
As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these ...
This paper analyses a selection of the literature that has been published on the relationship between the development of food trade and urbanization in sub-Saharan Africa. The evolution of food marketing systems and the urbanization process are described in three phases: the precolonial period, the colonial period, and the postindependence period. The paper concludes that the evolution of food trade and urbanization have been closely interlinked from the beginning. Sometimes urbanization was ...
The delivery of HIV counseling and testing programs throughout Sub-Saharan Africa relies on the work performed by trained HIV counselors. These individuals occupy a critical position: they are intermediaries between the rule-making of international and national policymakers, and the norms of the communities in which they live and work. This paper explains when, how and why HIV counselors adapt Western testing guidelines (the 3Cs- consent, confidentiality and counseling) to local concerns, a...
Robbins John B.; Schneerson Rachel; Gotschlich Emil C.; Mohammed Idris; Nasidi Abdulsalami; Chippaux Jean-Philippe; Bernardino Luis; Maiga Moussa A.
Endemic and epidemic group A meningococcal meningitis remains a major cause of morbidity and mortality in sub-Saharan Africa, despite the availability of the safe and inexpensive group A meningococcal polysaccharide vaccine, which is protective at all ages when administered as directed. Despite optimal therapy, meningococcal meningitis has a 10% fatality rate and at least 15% central nervous system damage. WHO's policy of epidemic containment prevents, at best, about 50% of cases and ignores ...
Economists have a long argue that institutions and implementation of good governance are important for economic growth. The main objective of this research is to demonstrate that one of positive institutions effects is its ability to mitigate the negative effect of economic vulnerability linked to terms of trade fluctuations on economic growth. The impact of the economic vulnerability and implementation of good governance are estimated for a panel of 15 Sub-Saharan-Africa countries over the p...
Olesen, Tina Bech; Munk, Christian
BACKGROUND: We performed a systematic review and meta-analysis to summarise the available data on the prevalence of human papillomavirus (HPV) among men in sub-Saharan Africa. METHODS: PubMed and Embase were searched up to 10 March 2014. Random effects meta-analyses were used to calculate a pooled prevalence of any HPV and high-risk (HR) HPV. RESULTS: A total of 11 studies comprising 9342 men were identified. We found that HPV is very common among men in sub-Saharan Africa, the prevalence of any HPV ranging between 19.1% and 100%. Using random effects meta-analysis, the pooled prevalence of any HPV was 78.2% (95% CI 54.2 to 91.6) among HIV-positive and 49.4% (95% CI 30.4 to 68.6) among HIV-negative men (p=0.0632). When restricting the analyses to PCR-based studies, the pooled prevalence of any HPV was 84.5% (95% CI 74.2 to 91.2) among HIV-positive and 56.4% (95% CI 49.7 to 62.9) among HIV-negative men (p<0.0001). Of the HPV types included in the nine-valent HPV vaccine, the most common HR HPV types were HPV16 and HPV52, and HPV6 was the most common low-risk HPV type. When examining the prevalence of HPV in relation to age no clear trend was observed. CONCLUSIONS: The prevalence of HPV is high among men in sub-Saharan Africa, which could contribute to the high rates of penile and cervical cancer in this part of the world. Implementation of the prophylactic HPV vaccines could potentially help prevent this large burden of HPV and HPV-associated disease in sub-Saharan Africa. CLINICALTRIALS.GOV IDENTIFIER: NCT00932009.
Agricultural research management in the public sector in Sub Saharan Africa suffers from a lack of relevant, timely and accurate information on which to base decision-making. Developments in Management information systems over the past several years have been dramatic and can offer research managers in developing countries a great deal of help in the orderly capture, processing and presentation of information for decision-making. This thesis describes case study research on institutionalizati...
This dissertation aims at contributing to the comparative analysis of trade and agricultural policies in Sub-Saharan Africa from a policy coherence for development point of view. The framework is established by reviewing the policies historically implemented in the region, linking them to the history of economic thought. The debates on the role of agriculture for development and on the use of public intervention and trade policies to promote development strategies are explored justifying the ...
Frey, Leo; Volz, Ulrich
This paper examines the effects of political agreements on regional financial integration (RFI) on financial market development and access to and cost of finance in Sub-Saharan Africa. Our results suggest that RFI positively affects financial development - measured very broadly as the size of the financial sector, including the liabilities of the central banks - when combined with a sufficient level of institutional quality. If institutional quality is below a threshold level, RFI apparently ...
This bulletin presents a number of new insights concerning suitable instruments for the promotion of sustainable land use in sub-Saharan Africa. The careful balancing of macroeconomic policy with regional investments is absolutely necessary to provide incentives for land use intensification. Targeting public investments to unlock marginal areas might generate unexpectedly high returns. In addition, increasing investments in rural education is important to reinforcing the position of migrants ...
Ngo, Nicole S.; Gatari, Michael; Yan, Beizhan; CHILLRUD, STEVEN N.; Bouhamam, Kheira; Kinneym, Patrick L.
Few studies examine urban air pollution in sub-Saharan Africa (SSA), yet urbanization rates there are among the highest in the world. In this study, we measured 8-hr average occupational exposure levels of fine particulate matter (PM2.5), black carbon (BC), ultra violet active-particulate matter (UV-PM), and trace elements for individuals who worked along roadways in Nairobi, specifically bus drivers, garage workers, street vendors, and women who worked inside informal settlements. We found B...
Okonta, Kelechi E.
Heart failure (HF) is an important cause of morbidity and mortality in sub-Saharan Africa and indeed worldwide. The management of this condition has largely been thought to be within the domain of the Physician with the Surgeon having little or no role to play. The commonest cause of HF that may require surgical intervention is rheumatic valvular heart disease especially in the young age group while ischaemic heart disease still remains at the low rung of the ladder and interestingly, hy...
Akpan, E E; C. E Ekpenyong
The growing trend of obesity worldwide and in sub-Saharan Africa can be linked to theurbanization drift experienced in recent years both in developed and developing countrieslike Nigeria, at four pivotal points namely: physical activity level, socio-economic status(SES), nutritional and psychosocial factors. Literature search was done usingMedline/PubMed and Google Scholar for published studies on the urbanization rate, andthe prevalence of overweight and obesity in Nigeria. The socio-demogra...
Ndebele, Paul; Wassenaar, Douglas; Benatar, Solomon; Fleischer, Theodore; Kruger, Mariana; Adebamowo, Clement; Kass, Nancy; Adnan A. Hyder; Meslin, Eric M
The last fifteen years have witnessed a significant increase in investment in research ethics capacity development throughout the world. We examine nine research ethics training programs that are focused on Sub-Saharan Africa and supported by the US National Institutes of Health. We collected data from grants awards documents and annual reports supplemented by questionnaires completed by the training program directors. Together, these programs provided long-term training in research ethics t...
Elst, H J
Despite isolated progress there seems to be no clear-cut guideline or solution to the collective eradication of extreme poverty in sub-Saharan Africa. In an attempt to overcome the above reality, the objective of the Millennium Development Goals (MDGs) is short term poverty relief to the poorest of the poor by 2015. This is to be achieved through the realisation of eight pro-poor objectives. Since 2000 there has been notable progress. Developmental organisations such as the Wor...
Xie, H.; Longuevergne, L.; Ringler, C.; Scanlon, B.
Irrigation development is rapidly expanding in mostly rainfed Sub-Saharan Africa. This expansion underscores the need for a more comprehensive understanding of water resources beyond surface water. Gravity Recovery and Climate Experiment (GRACE) satellites provide valuable information on spatio-temporal variability of water storage. The objective of this study was to calibrate and evaluate a semi-distributed regional-scale hydrological model, or a large-scale application of the Soil and Water...
Today is World Toilet Day, which aims to draw attention to the 2.5 billion people who live without adequate toilet facilities. Andrew Cotton looks at the effectiveness of the EUs Official Development Assistance to sub-Saharan Africa where around 200 million people live without access to a toilet of any sort finding that EU aid has made a significant contribution to improving sanitation.
Seale, AC; Mwaniki, M; Newton, CR; Berkley, JA
Maternal and child health are high priorities for international development. Through a Review of published work, we show substantial gaps in current knowledge on incidence (cases per live births), aetiology, and risk factors for both maternal and early onset neonatal bacterial sepsis in sub-Saharan Africa. Although existing published data suggest that sepsis causes about 10% of all maternal deaths and 26% of neonatal deaths, these are likely to be considerable underestimates because of method...
Schouten Erik; Pariyo George W; van Damme Wim; Hermann Katharina; Assefa Yibeltal; Cirera Anna; Massavon William
Abstract Low-income countries with high HIV/AIDS burdens in sub-Saharan Africa must deal with severe shortages of qualified human resources for health. This situation has triggered the renewed interest in community health workers, as they may play an important role in scaling-up antiretroviral treatment for HIV/AIDS by taking over a number of tasks from the professional health workers. Currently, a wide variety of community health workers are active in many antiretroviral treatment delivery s...
Benczes, István; Szent-Iványi, Balázs
According to the textbook approach, the developmental states of the Far East have been considered as strong and autonomous entities. Although their bureaucratic elites have remained isolated from direct pressures stemming from society, the state capacity has also been utilised in order to allocate resources in the interest of the whole society. Yet, society by and large has remained weak and subordinated to the state elite. On the other hand, the general perception of Sub-Saharan Africa (S...
Full Text Available E-learning is likely to be an increasingly important element in teaching agriculture and related subjects at universities in Sub-Saharan Africa. The purpose of this study was to explore the factors involved in determining the readiness and intention to adopt e-learning by faculty members at member institutions of the African Network for Agriculture, Agroforestry and Natural Resources Education (ANAFE. The study was based on the decomposed theory of planned behavior (DTPB to predict intentions on the use of e-learning. DTPB draws on constructs influencing the attitude to use technology from two frequently investigated models in this area, that is, the theory of planned behavior (TPB and the technology acceptance model (TAM. Valid responses were collected from 70 faculty members with a survey questionnaire. Validated scales from previous research were used to measure the variables of interest. The results revealed that the majority of the respondents have only limited access to ICT infrastructure and support services. However, they perceived e-learning to be very useful in general and to have the potential to enhance their teaching-related activities.
Baskind, Roy; Birbeck, Gretchen L
Many studies in developed regions of the world have confirmed that stigma contributes substantially to the psychological and social burden of epilepsy. Relatively few studies of epilepsy-associated stigma have been conducted in Africa, where much of the world's burden of epilepsy exists. In sub-Saharan Africa (SSA), particularly in rural regions, close family ties, communal living situations, and traditional belief systems undoubtedly influence the expression of stigmatization. A review of the epidemiologic, anthropologic, and sociologic studies of epilepsy in SSA provides significant insights into how people with epilepsy (PWE) are perceived by their communities and families and how these perceptions translate into limited social and economic opportunities and possibly worsen the physical vulnerability of PWE in this region. The medical community is not exempt from the social process of stigmatization, and poor public health infrastructure and medical services undoubtedly contribute to the cycle of epilepsy-associated stigma through wide treatment gaps, poor seizure control, and high rates of seizure-related injury. In this review, we extrapolate data from existing studies of epilepsy in SSA coupled with our own experience providing epilepsy care in the region to give an overview of the social landscape of this common, devastating condition. PMID:15978874
Kamali, Bahareh; Yang, Hong; abbaspour, karim
Sub-Saharan Africa (SSA) has been faced with frequent drought events in the past. Future climate change scenarios have suggested increasing drought frequency and severity. The devastating impacts of drought on rainfed farming and food production pose many challenges in SSA countries both today and in the future. Therefore, a comprehensive investigation of droughts and assessment of their impacts on crop yield and production are critically important to support SSA to formulate effective adaptive measures to improve food security. The current study assesses the historical meteorological and agricultural droughts and quantifies their impacts on two major crop yields namely maize and cassava in SSA. The GIS-based crop model (GEPIC) is used for the simulation of the historical yields. Drought severities are categorized into levels of mild, moderate and severe. The impacts of each category on maize and cassava yields are examined and drought hotspots are highlighted. The knowledge learnt from the historical data helps enhance the projection of the impacts of future weather conditions on crop yield in the region and facilitate the societal preparedness to drought impact.
This paper outlines policies to secure and reduce the cost of oil supplies in Sub-Saharan Africa (SSA), taking into account the existing forces at play: limited foreign exchange, competition for increasingly scarce funds, and the likely emergence of Africa as the fastest growing centre of energy demand over the coming decade. It identifies major inefficiencies in petroleum procurement, refining and distribution, and analyses the specific bottlenecks at each stage of the supply chain. Many of the diseconomies, estimated to yield savings of US$ 1.4 per year, are traced to an inefficient regulatory set-up in SSA countries, as well as unnecessary government interference in the downstream petroleum sector. In particular, price controls, small topping refineries, monopolistic agencies, government subsidies and opaque management structures prevent the working of efficient market mechanisms. The paper discusses the importance of policy reform, outlining what changes need to be implemented on the levels of institutional arrangements, closing of inefficient units, petroleum pricing and encouraging foreign investment in the sector. (author). 1 ref., 7 figs
Full Text Available This article is about the theory of social motivation as a tool to increase social performance in Sub Saharan countries. So in the first part we will retell the theoretical understanding of motivation and its limits and then the explanation of the concept of social motivation as an alternative to complete the existing and old form of motivation. The second part of the article will talk about social performance and how to measure it. Several techniques are available for measuring performance of an employee. But the difference is in the sources of traits or qualities to be appraised. Jobs are different and have different requirements and different opinion of the management too. The practice is difficult sometime because of different kinds of workers (factory workers, executives or salespeople, which cannot be measured with the same indicators all the time. In this article we will see some theoretical and practical models of performance appraisal based on effectiveness and efficiency at work with concrete indicators. Also the readers will understand how social motivation, when well used in a company can increase the performance and transform the work place into a livelihood place for all stakeholders. And the article will end with the conclusion in which we have a piece of advice and literature references
This paper explores an alternative approach to future climate policies in developing countries. Although climate change seems marginal compared to the pressing issues of poverty alleviation and economic development, it is becoming clear that the realisation of development goals may be hampered by climate change. However, development can be shaped in such a way as to achieve its goals and at the same time reduce vulnerability to climate change, thereby facilitating sustainable development that realises economic, social, local and global environmental goals. This approach has been coined the 'development first approach', in which a future climate regime should focus on development strategies with ancillary climate benefits and increase the capability of developing countries to implement these. This is anticipated to offer a possible positive way out of the current deadlock between North and South in the climate negotiations. First, elements are presented for an integrated approach to development and climate; second, the approach is elaborated for food and energy security in sub-Saharan Africa; and third, possibilities are outlined for international mechanisms to support such integrated development and climate strategies
Davidson, O.; Halsnæs, K.
This paper explores an alternative approach to future climate policies in developing countries. Although climate change seems marginal compared to the pressing issues of poverty alleviation and economic development, it is becoming clear that the realisation of development goals may be hampered by climate change. However, development can be shaped in such a way as to achieve its goals and at the same time reduce vulnerability to climate change, thereby facilitating sustainable development that realises economic, social, local and global environmental goals. This approach has been coined the 'development first approach', in which a future climate regime should focus on development strategies with ancillary climate benefits and increase the capability of developing countries to implement these. This is anticipated to offer a possible positive way out of the current deadlock between North and South in the climate negotiations. First, elements are presented for an integrated approach to development and climate; second, the approach is elaborated for food and energy security in sub-Saharan Africa; and third, possibilities are outlined for international mechanisms to support such integrated development and climate strategies. (C) 2003 Elsevier Ltd. All rights reserved.
Full Text Available A panel dataset of 30 countries in Sub-Saharan Africa (SSA is used to analyze the total factor productivity (TFP growth pedigree over the period 1999-2011. We initially compute the output-oriented Malmquist productivity indexes and their decomposition using data envelopment analysis approach. The curiosity is to ascertain whether Malmquist indexes are catching-up or lagging behind. The results indicate that the marginal source of TFP growth is technical progress and that the regional disparities in TFP growth deteriorated over time. Fourteen countries representing 46.7% of the number under study have positive trend in both pure technical efficiency and scale efficiency each (53.3% lagging behind negatively. Also the efficiency change component (catch-up effect result shown that only six countries representing 20% of the number under study have positive trend with 80% lagging behind negatively in the sub-region. The second-stage regression results using tobit model show that the eleven (11 identified GCI pillars globally advocated by the World Economic Forum Report 2011/2012 be the policy priorities for improving efficiency in particular and TFP in general for the SSA to optimally harvest the opportunities of the 21st century. Key words: Total factor productivity; SSA; Malmquist productivity indexes and Tobit Model
Coker-Bolt, Patty; DeLuca, Stephanie C; Ramey, Sharon L
Hospitals and therapists in developing countries often seek to learn how to deliver new forms of evidenced-based practice (EBP), including paediatric constraint-induced movement therapy (CIMT). This study examines a partnership implemented in Ethiopia, which trained therapists in CIMT and proposes a framework for sustainable EBP training. The aim of this study is to apply a translational and implementation framework to build capacity for CIMT in Addis Ababa, Ethiopia, that included intensive in-country training and hands-on delivery with patients, followed by clinical implementation and feedback. A goal was to develop a locally feasible, culturally relevant form of CIMT. We framed our partnership model in terms of an implementation science model for therapists from multiple hospitals in Addis Ababa. Measures included workshop attendance, delivery of the curriculum and assessment of therapist's knowledge, skills and feedback postworkshop. We established a successful partnership with a lead hospital and completed training for 12 therapists from five hospitals who demonstrated increases in knowledge and skills following training. We developed a new, practically useful, culturally appropriate form of CIMT for later implementation. This partnership was limited to training of paediatric therapists in sub-Saharan Africa. Future studies will report on therapists' ability to integrate this EBP training into clinical practice as well as future training. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26010006
Skeen, Sarah; Lund, Crick; Kleintjes, Sharon; Flisher, Alan
Mental health is a crucial public health and development issue in sub-Saharan Africa (SSA), a region where little progress has been made towards achieving the Millennium Development Goals (MDGs). In this paper we argue that not only will limited progress in achieving these targets have a significant impact on mental health, but it will be impossible to achieve some of these aspirations in the absence of addressing mental health concerns. We consider the strong relationship of mental health with dimensions of human development represented in the MDGs, including reducing poverty, achieving universal primary education, decreasing child mortality rates, improving maternal health, HIV, environmental factors and improving the lives of those living in informal settlements. With these links in mind, we examine the mental health context in SSA settings and provide some specific examples of best practice for addressing mental health and the MDGs. It is recommended that the role of mental health interventions in accelerating the realization of the MDGs is investigated; further efforts are dedicated to probing the impact of different development projects upon mental health outcomes, and that mental health is declared a global development priority for the remainder of the MDG period and beyond. PMID:21226650
Rudi, Lisa-Marie; Azadi, Hossein; Witlox, Frank
Are the achievements of sustainable development and the improvement of environmental standards mutually exclusive in the 21st century? Is there a possibility to combine the two? This study is an effort to investigate the mutual exclusiveness of the two policy areas and asks for the necessity and possibility to combine the two with a reference to Sub-Saharan Africa (SSA). After describing the historical, geographical, and climatic backgrounds of SSA, negative effects of global warming and local environmentally harmful practices are discussed. Subsequently, the appropriate development measures for the region are elaborated in order to understand their compatibility with regards to improving the environment. It is concluded that to change the dependency on agriculture, the economy needs to be restructured towards technologies. Furthermore, it is found that there is a direct link between global warming and economic efficiency. Theories, which imply that some regions are simply 'too poor to be green', are investigated and rebutted by another theory, which states that it is indeed possible to industrialize in an environmentally friendly way. It follows that environmental and development measures are interconnected, equally important and can be reconciled. The paper finally concludes that the threat posed by global warming and the previously practised environmentally-harmful local measures might be so pressing that it may be too tragic to go for 'develop first and clean up later' approach.
Randy Trinity Nijkamp
Full Text Available This study was conducted to evaluate root exudates from sub-Saharan indigenous weed species to induce germination of Striga hermonthica (Del. Beth., a root parasitic weed. Significant variation in Striga seed germination was observed, ranging from an absence to the induction of 74.1% Striga seeds. Direct compa-rison of Striga germination was obscured by differences in weed root biomass as within most of the species, a direct proportional relation between Striga seed germination and weed root dry weight was observed. Expression of Striga seed germination in % g-1 root dry weight (GIC was found a suitable solution as stable values for GIC were obtained despite considerable variation in root dry weight. GIC was significant for 25 species and highest with Commelina forskalaei and Sesamum alatum (9.91; 9.78 % g-1 dry root, respectively. Striga seeds did not germinate following application of exudates from Mitracarpus scaber and Phyllanthus pentrandus. These results show that a substantial number of indigenous weed species may serve as alternative trap crops to control the parasites seed bank. Furthermore, the timing of weeds in the cropping system may provide a (partial explanation for the erratic infestation levels found across fields and years that have dazed researchers for many years.
Bazuin, Sjoerd; Azadi, Hossein; Witlox, Frank
While the Green Revolution has been successful in some regions like South and East Asia, it could hardly address any achievement in Sub-Saharan Africa (SSA). This paper tries to draw a picture on lessons learned from the failures of this revolution that should be taken into account before implementing the so-called Gene Revolution in the SSA region. After scrutinizing the failures and the pros and cons of GM crops in the region, the paper introduces some potentials for improving the malnutrition situation in SSA through launching a successful GM technology. However, it remains doubtful whether this technology can improve the situation of small-scale farmers as long as they receive no financial support from their national governments. Therefore, before any intervention, the socio-economic and environmental impacts of GM technology need to be carefully addressed in the framework of a series of risk assessment studies. Besides, some sort of multi-stakeholder dialog (from small-scale farmers to consumers) involving public-private sector and non-governmental organizations should be heated up at both national and regional levels with regard to the myths and truths of this technology. PMID:21813087
Decroo, Tom; Van Damme, Wim; Kegels, Guy; Remartinez, Daniel; Rasschaert, Freya
Since the introduction of antiretroviral treatment, HIV/AIDS can be framed as a chronic lifelong condition, requiring lifelong adherence to medication. Reinforcement of self-management through information, acquisition of problem solving skills, motivation, and peer support is expected to allow PLWHA to become involved as expert patients in the care management and to decrease the dependency on scarce skilled medical staff. We developed a conceptual framework to analyse how PLWHA can become expert patients and performed a literature review on involvement of PLWHA as expert patients in ART provision in Sub-Saharan Africa. This paper revealed two published examples: one on trained PLWHA in Kenya and another on self-formed peer groups in Mozambique. Both programs fit the concept of the expert patient and describe how community-embedded ART programs can be effective and improve the accessibility and affordability of ART. Using their day-to-day experience of living with HIV, expert patients are able to provide better fitting solutions to practical and psychosocial barriers to adherence. There is a need for careful design of models in which expert patients are involved in essential care functions, capacitated, and empowered to manage their condition and support fellow peers, as an untapped resource to control HIV/AIDS. PMID:22577527
Richard A. Wilson
Full Text Available Abstract: The view advanced in this article is that over the past few decades, the efforts of Sub-Saharan Africa elites to promote human rights discourse and establish liberal institutions of the nation-state have constrained the space for justifiable law-breaking and enlarged the category of criminality. Taken together, national and international security are now pursued more through the idiom of crime and rule of law than through the political process. As a result, there is more crime than there used to be in sub-Saharan Africa. It means that law-breaking and collective political opposition is more often construed as criminal behavior. Not only have the classifications changed, but so have the ways of knowing about violence in Africa, and all the while, a legal prism for apprehending transgressions has gained greater prominence. This paper illustrates this general argument by reference to South Africa during its transition from apartheid in the 1990s and to the international criminal tribunals presently prosecuting violations in the Democratic Republic of the Congo and Sierra Leone. The argument works best for those post-conflict countries affected by liberal political and legal reforms and the interventions of international criminal law, and that now includes many sub-Saharan countries, but not all. It does not apply to relatively peaceful and prosperous countries such as Tanzania or Botswana. It does not work for Zimbabwe, but may once a post-Mugabe transition is underway. Keywords: Human rights. Crime. Rule of law
Financial Sector and Economic Development: How Institutions, Financial Markets, and Prudential Oversight can be Enhanced to Accelerate Economic Growth and Sustainable Development in Sub-Saharan Africa
Ashford C. Chea
The author began the paper with a brief historical perspective of financial development and economic growth in general and in Sub-Saharan Africa in particular. He then presented the methodology employed during the research. This was followed by the review of the literature. Next the researcher outlined his findings preceded by analysis and policy implications for decision-makers in Sub-Saharan Africa. The writer ended the paper with some policy recommendations to accelerate the development of...
Sargent, Carolyn; Larchanché, Stéphanie
In this article, we explore how sub-Saharan African immigrant populations in France have been constructed as risk groups by media sources, in political rhetoric, and among medical professionals, drawing on constructs dating to the colonial period. We also examine how political and economic issues have been mirrored and advanced in media visibility and ask why particular populations and the diseases associated with them in the popular imagination have received more attention at certain historical moments. In the contemporary period we analyze how the bodies of West African women and men have become powerful metaphors in the politics of discrimination prevalent in France, in spite of Republican precepts that theoretically disavow cultural and social difference. PMID:25294650
Nsubuga, Peter; Johnson, Kenneth; Tetteh, Christopher; Oundo, Joseph; Weathers, Andrew; Vaughan, James; Elbon, Suzanne; Tshimanga, Mufuta; Ndugulile, Faustine; Ohuabunwo, Chima; Evering-Watley, Michele; Mosha, Fausta; Oleribe, Obinna; Nguku, Patrick; Davis, Lora; Preacely, Nykiconia; Luce, Richard; Antara, Simon; Imara, Hiari; Ndjakani, Yassa; Doyle, Timothy; Espinosa, Yescenia; Kazambu, Ditu; Delissaint, Dieula; Ngulefac, John; Njenga, Kariuki
As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competency-based training for field epidemiologists and public health laboratory scientists providing a master's degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a strategy to develop a locally trained public health workforce that can operate multi-disease surveillance and response systems. PMID:22187606
Narang, Ankita; Jha, Pankaj; Rawat, Vimal; Mukhopadhayay, Arijit; Dash, Debasis; Basu, Analabha; Mukerji, Mitali
Identification and study of genetic variation in recently admixed populations not only provides insight into historical population events but also is a powerful approach for mapping disease loci. We studied a population (OG-W-IP) that is of African-Indian origin and has resided in the western part of India for 500 years; members of this population are believed to be descendants of the Bantu-speaking population of Africa. We have carried out this study by using a set of 18,534 autosomal marker...
Full Text Available The larvae of the Old World genera Leucinodes Guenée, 1854 and Sceliodes Guenée, 1854 are internal feeders in the fruits of Solanaceae, causing economic damage to cultivated plants like Solanum melongena and S. aethiopicum. In sub-Saharan Africa five nominal species of Leucinodes and one of Sceliodes occur. One of these species, the eggplant fruit and shoot borer L. orbonalis Guenée, 1854, is regarded as regularly intercepted from Africa and Asia in Europe, North and South America and is therefore a quarantine pest on these continents. We investigate the taxonomy of African Leucinodes and Sceliodes based on morphological characters in wing pattern, genitalia and larvae, as well as mitochondrial DNA, providing these data for identification of all life stages. The results suggest that both genera are congeneric, with Sceliodes syn. n. established as junior subjective synonym of Leucinodes. L. orbonalis is described from Asia and none of the samples investigated from Africa belong to this species. Instead, sub-Saharan Africa harbours a complex of eight endemic Leucinodes species. Among the former nominal species of Leucinodes (and Sceliodes from Africa, only L. laisalis (Walker, 1859, comb. n. (Sceliodes is confirmed, with Leucinodes translucidalis Gaede, 1917, syn. n. as a junior subjective synonym. The other African Leucinodes species were unknown to science and are described as new: L. africensis sp. n., L. ethiopica sp. n., L. kenyensis sp. n., L. malawiensis sp. n., L. pseudorbonalis sp. n., L. rimavallis sp. n. and L. ugandensis sp. n. An identification key based on male genitalia is provided for the African Leucinodes species. Most imports of Leucinodes specimens from Africa into Europe refer to Leucinodes africensis, which has been frequently imported with fruits during the last 50 years. In contrast, L. laisalis has been much less frequently recorded, and L. pseudorbonalis as well as L. rimavallis only very recently in fruit imports from Uganda. Accordingly, interceptions of Leucinodes from Africa into other continents will need to be re-investigated for their species identity and will likely require, at least in parts, revisions of the quarantine regulations. The following African taxa are excluded from Leucinodes: Hyperanalyta Strand, 1918, syn. rev. as revised synonym of Analyta Lederer, 1863; Analyta apicalis (Hampson, 1896, comb. n. (Leucinodes; Lygropia aureomarginalis (Gaede, 1916, comb. n. (Leucinodes; Syllepte hemichionalis Mabille, 1900, comb. rev., S. hemichionalis idalis Viette, 1958, comb. rev. and S. vagans (Tutt, 1890, comb. n. (Aphytoceros. Deanolis iriocapna (Meyrick, 1938, comb. n. from Indonesia is originally described and misplaced in Sceliodes, and L. cordalis (Doubleday, 1843, comb. n. (Margaritia from New Zealand, L. raondry (Viette, 1981, comb. n. (Daraba from Madagascar as well as L. grisealis (Kenrick, 1912, comb. n. (Sceliodes from New Guinea are transferred from Sceliodes to Leucinodes. While Leucinodes is now revised from Africa, it still needs further revision in Asia.
Cause-specific mortality rates in sub-Saharan Africa and Bangladesh / Taux de mortalité par cause en Afrique subsaharienne et au Bangladesh / Tasas de mortalidad por causas específicas en el África subsahariana y en Bangladesh
Martin, Adjuik; Tom, Smith; Sam, Clark; Jim, Todd; Anu, Garrib; Yohannes, Kinfu; Kathy, Kahn; Mitiki, Mola; Ali, Ashraf; Honorati, Masanja; Ubaje, Adazu; Jahit, Sacarlal; Nurul, Alam; Adama, Marra; Adjima, Gbangou; Eleuther, Mwageni; Fred, Binka.
Full Text Available OBJETIVO: Aportar datos comparables internacionalmente sobre la frecuencia de las distintas causas de defunción. MÉTODOS: Analizamos las autopsias verbales obtenidas durante 1999 -2002 en 12 sitios de vigilancia demográfica del África subsahariana y de Bangladesh a fin de determinar las tasas de mor [...] talidad por causas y por edades. Los códigos de las causas de defunción utilizados por los distintos sitios fueron armonizados con arreglo al sistema de la CIE-10, y resumidos mediante el sistema de clasificación de la Carga Mundial de Morbilidad 2000 (versión 2). RESULTADOS: Las causas de defunción en África difieren marcadamente de las observadas en Bangladesh, donde los datos sugieren una transición sanitaria hacia las enfermedades no transmisibles, con pocos casos de malaria. La infección por VIH destaca entre las causas de mortalidad en los lugares de Sudáfrica analizados, que contrastan con las causas observadas en los lugares de alta endemicidad de malaria del resto del África subsahariana (incluso en el vecino Mozambique). La contribución del sarampión y de las enfermedades diarreicas a la mortalidad en el África subsahariana es inferior a la sugerida hasta ahora, mientras que la malaria tiene una importancia relativamente mayor. CONCLUSIÓN: Los diferentes perfiles de mortalidad que hemos observado podrían ser el resultado de los últimos cambios experimentados por la disponibilidad y la eficacia de las intervenciones sanitarias contra las enfermedades infecciosas infantiles más comunes. Abstract in english OBJECTIVE: To provide internationally comparable data on the frequencies of different causes of death. METHODS: We analysed verbal autopsies obtained during 1999 -2002 from 12 demographic surveillance sites in sub-Saharan Africa and Bangladesh to find cause-specific and age-specific mortality rates. [...] The cause-of-death codes used by the sites were harmonized to conform to the ICD-10 system, and summarized with the classification system of the Global Burden of Disease 2000 (Version 2). FINDINGS: Causes of death in the African sites differ strongly from those in Bangladesh, where there is some evidence of a health transition from communicable to noncommunicable diseases, and little malaria. HIV dominates in causes of mortality in the South African sites, which contrast with those in highly malaria endemic sites elsewhere in sub-Saharan Africa (even in neighbouring Mozambique). The contributions of measles and diarrhoeal diseases to mortality in sub-Saharan Africa are lower than has been previously suggested, while malaria is of relatively greater importance. CONCLUSION: The different patterns of mortality we identified may be a result of recent changes in the availability and effectiveness of health interventions against childhood cluster diseases.