Caldwell, J C; Caldwell, P
Case studies of the world's two poorest regions, sub-Saharan Africa and South Asia, were used to illustrate the compromised standard of living of the poor and environmental damage due to continued rapid population growth. The conclusion was that the livelihoods of the poor should not be endangered for preserving the living standards of richer people. Nations must not ignore the challenges of reducing population growth as fast as can be achieved. The transitional period over the next 50 years is the main concern, because population growth rates will be slowing. Rural population growth is expected to decline from 60% of total population growth in South Asia to 7% between 2000 and 2025; similarly the decline in sub-Saharan Africa would be from 50% to 15%. Over the past 30 years, food production in South Asia has kept pace with population growth. Sub-Saharan Africa has adopted food importation to meet demand. African problems are a low resource base, faster population growth, and the fact that governments and individuals are too poor to maintain soil fertility. Long-term studies of how much soil depletion will occur are not available for these regions, and local area studies are not as pessimistic. Transition policies are needed to put "people first in terms of engineered or directed population and ecological change." The six main issues are the following: 1) the Brundtland Commission appropriately identified poverty as the main cause and effect of environmental degradation because of the threat to survival; 2) the verdict is still out about whether food production will keep pace with population growth through economic growth and investment in agriculture; 3) empirical research is needed to examine local social and regulatory institutions and the possibility of reinforcing these mechanisms rather than instituting central controls; 4) central coercion or modernizing economic policies can destroy local level controls; 5) famine is a complex ecological phenomenon and the
Sally N Adebamowo
Full Text Available AbstractBackground: Diabetes is a leading risk factor for impaired kidney function, an indicator of chronic kidney disease. The aim of this study was to examine the association between type 2 diabetes (T2D and impaired kidney function among adults in sub-Saharan Africa (SSA. Methods: Participants were enrolled from Ghana, Kenya and Nigeria. Impaired kidney function was based on an estimated glomerular filtration rate (eGFR < 60 ml/min/1·73m2. Using logistic regression models, we conducted case-control analyses to estimate the multivariate adjusted association of T2D and kidney function.Results: We used data from 4,815 participants for whom the mean (SD age was 48 (15 years, 41% were male and 46% had T2D. Those with T2D were more likely to have impaired kidney function (13·4% [95% CI: 11·9 - 14·7] compared to those without T2D (4·8% [95% CI:4·0 - 5·6], p-value <0·001. The multivariate odds ratio of impaired kidney function among those with type 2 diabetes was 1·50 (95% CI: 1·17 - 1·91 p-value = 0.001, compared to those without T2D. Also, individuals with T2D who were at least 60 years old, obese, hypertensive or dyslipidemic were more likely to have impaired kidney function, compared to those without T2D. Conclusions: T2D was associated with 50% increased risk of impaired kidney function in this sample of adults from SSA. Interventions targeted at prevention, early diagnosis and management of T2D are likely to reduce the burden of kidney disease in SSA.
Gebreyes, Fisseha Mamo
Financial sustainability is one of the key challenges for public universities in both developed and developing countries. Using a resource dependence approach, this study explores the issue of revenue generation in Sub-Saharan African universities. It analyses the diversification strategies that four universities in three African countries (Ethiopia, Kenya, and South Africa) have implemented in order to improve their universities’ financial situation. Universities in Sub-Saharan Africa are fa...
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
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
understanding of the spread of HIV and other STDs in this rural sub-Saharan population.
Gebreyes, Fisseha Mamo
Financial sustainability is one of the key challenges for public universities in both developed and developing countries. Using a resource dependence approach, this study explores the issue of revenue generation in Sub-Saharan African universities. It analyses the diversification strategies that fou
MAHMOOD H. KHAN; Mohsin S. Khan
Agriculture remains a dominant sector in the economies of most African and several Asian countries. However, the poor performance of agriculture in Africa stands in sharp contrast to the robust agricultural growth in many Asian countries.2 In this regard, the experience of China is perhaps as impressive as it is relevant to many countries in Sub-Saharan Africa. A general observation is that the productivity of land and labour has to rise through intensive agriculture, given the limited area o...
Ly, Madani; Antoine, Martine; André, Fabrice; Callard, Patrice; Bernaudin, Jean-François; Diallo, Dapa A
Breast cancer is the second most frequent cancer in Sub-Saharan African women with an incidence of 15-53 per 100,000 women. Using PubMed, we reviewed all the articles published on this topic between 1989 and 2009. Breast cancer is usually diagnosed in women younger than in developed countries (mean age: 42-53 years), with later stages (III or IV, i.e. with axillary nodes and distant metastases). Reported tumors are mostly invasive ductal carcinomas with aggressive characteristics: grade III histoprognosis, absence of hormonal receptors or HER2 expression. According to the new breast cancer classification, nearly half of these tumors should be classified as triple negative. However, studies are rare and require confirmation. In conclusion, data on epidemiology and biology of breast cancer in Sub-Saharan African women are still scarce and need more extensive studies. In these countries, the pattern of breast cancer will likely change in the future, according to the evolution of lifestyle namely urbanisation. There is a great need for commitment of research and clinical resources in Sub-Saharan Africa in order to develop specific strategies. PMID:21700549
Full Text Available Abstract Background Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS is to increase the level of understanding and expand the baseline data on medical schools in the region. Methods The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable. Results Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate. An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64 increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68. The most significant reported barriers to increasing the number of
Abu-Amero, Khaled K; Cabrera, Vicente M; Larruga, José M; Osman, Essam A.; González, Ana M; Al-Obeidan, Saleh A.
Purpose To investigate whether different mitochondrial DNA (mtDNA) haplogroups have a role on the development of pseudoexfoliation glaucoma (PEG) in the Saudi Arab population. Methods The mtDNA regulatory region and coding regions comprising mtDNA haplogroup diagnostic polymorphisms were sequenced in patients with PEG (n=94), healthy matched controls (free of PEG; n=112) and a healthy Saudi Arab population group (n=810). Results The Eurasian haplogroup T and the Sub-Saharan African Haplogroup...
A growing number of countries in sub-Saharan Africa are considering legalizing the growth of genetically modified organisms (GMOs). Furthermore, several projects are underway to develop transgenic crops tailored to the region. Given the contentious nature of GMOs and prevalent anti-GMO sentiments in Africa, a robust ethical analysis examining the concerns arising from the development, adoption, and regulation of GMOs in sub-Saharan Africa is warranted. To date, ethical analyses of GMOs in the global context have drawn predominantly on Western philosophy, dealing with Africa primarily on a material level. Yet, a growing number of scholars are articulating and engaging with ethical theories that draw upon sub-Saharan African value systems. One such theory, Ubuntu, is a well-studied sub-Saharan African communitarian morality. I propose that a robust ethical analysis of Africa's agricultural future necessitates engaging with African moral theory. I articulate how Ubuntu may lead to a novel and constructive understanding of the ethical considerations for introducing GMOs into sub-Saharan Africa. However, rather than reaching a definitive prescription, which would require significant engagement with local communities, I consider some of Ubuntu's broader implications for conceptualizing risk and engaging with local communities when evaluating GMOs. I conclude by reflecting on the implications of using local moral theory in bioethics by considering how one might negotiate between universalism and particularism in the global context. Rather than advocating for a form of ethical relativism, I suggest that local moral theories shed light on salient ethical considerations that are otherwise overlooked. PMID:26481201
Frank Aragbonfoh Abumere
This paper is aimed at proposing a policy framework for the resolution or management of development-related conflicts in Sub-Saharan African countries. In many conflicts in SubSaharan Africa, development issues are contributory factors. In view of the linkage between conflicts and development issues in Sub-Saharan Africa, the paper asks whether there is any one resource, whether security apparatus or development policy, that is at once necessary and sufficient for the resolutio...
Kuipers, Remko S.; Luxwolda, Martine F.; Dijck-Brouwer, D. A. Janneke; Muskiet, Frits A. J.
Background: There are no data on the fatty acid (FA) compositions of preterm and term milks for sub-Saharan African populations with advancing lactation. However, it is generally acknowledged that our ancestors evolved in sub-Saharan East-Africa, where they inhabited the land-water ecosystems. Metho
Van Royen, Kathleen; Lachat, Carl; Holdsworth, Michelle; Smit, Karlien; Kinabo, Joyce; Roberfroid, Dominique; Nago, Houefa Eunice Sorel; Garimoi Orach, Christhopher; Kolsteren, Patrick
Optimal nutrition is critical for human development and economic growth. Sub-Saharan Africa is facing high levels of food insecurity and only few sub-Saharan African countries are on track to eradicate extreme poverty and hunger by 2015. Effective research capacity is crucial for addressing emerging challenges and designing appropriate mitigation strategies in sub-Saharan Africa. A clear understanding of the operating environment for nutrition research in sub-Saharan Africa is a much needed p...
Richards, Martin; Rengo, Chiara; Cruciani, Fulvio; Gratrix, Fiona; Wilson, James F; Scozzari, Rosaria; Macaulay, Vincent; Torroni, Antonio
We have analyzed and compared mitochondrial DNA variation of populations from the Near East and Africa and found a very high frequency of African lineages present in the Yemen Hadramawt: more than a third were of clear sub-Saharan origin. Other Arab populations carried approximately 10% lineages of sub-Saharan origin, whereas non-Arab Near Eastern populations, by contrast, carried few or no such lineages, suggesting that gene flow has been preferentially into Arab populations. Several lines of evidence suggest that most of this gene flow probably occurred within the past approximately 2,500 years. In contrast, there is little evidence for male-mediated gene flow from sub-Saharan Africa in Y-chromosome haplotypes in Arab populations, including the Hadramawt. Taken together, these results are consistent with substantial migration from eastern Africa into Arabia, at least in part as a result of the Arab slave trade, and mainly female assimilation into the Arabian population as a result of miscegenation and manumission. PMID:12629598
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...
Corsi, Daniel J.; Subramanian, S V
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 ec...
Wicherts, Jelte M.; Dolan, Conor V.; Carlson, Jerry S.; van der Maas, Han L. J.
This paper presents a systematic review of published data on the performance of sub-Saharan Africans on Raven's Progressive Matrices. The specific goals were to estimate the average level of performance, to study the Flynn Effect in African samples, and to examine the psychometric meaning of Raven's test scores as measures of general intelligence.…
Page, Randy M.; West, Joshua H.
Objectives: To determine if there is an association between psychosocial distress, health-risk behaviors and 12-month suicidal ideation among sub-Saharan African adolescents. Methods: Subjects included a cross-national sample of adolescents (N25,568) representing 7 African countries who completed the Global School-based Student Health Survey…
John Luiz; Harry Charalambouse
This research investigates the key elements that South African financial services firms consider before making foreign direct investments in Sub-Saharan African (SSA) markets. The results show that South African financial services firms are most strongly influenced by the political and economic stability of the country in question as well as the profitability and long-term sustainability of its specific markets. The degree of available infrastructure in terms of Information and Communication ...
Peters, J.T.P.; Driel, F.T.M. van; Jansen, W.H.M.
Sub-Saharan African women are affected disproportionately highly by AIDS, while experiencing lack of choice for devices which protect them against sexual transmitted diseases, including HIV. One should expect that global policy makers react positive to the female condom, a contraceptive device which
L.J. de Haan (Leo)
textabstractAbstract: 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
Lynn, Richard; Meisenberg, Gerhard
Wicherts, Dolan, and van der Maas (2009) contend that the average IQ of sub-Saharan Africans is about 80. A critical evaluation of the studies presented by WDM shows that many of these are based on unrepresentative elite samples. We show that studies of 29 acceptably representative samples on tests other than the Progressive Matrices give a…
Bothun, Gregory D.
Purpose: The purpose of this paper is to provide a case study report of the development of data networks and initial connectivity in the Sub-Saharan African (SSA) region and how that development evolved into the formation of research and education (R&E) networks that enable new collaborations and curriculum potential.…
Oakland, Thomas; Callueng, Carmelo
This cross-national research examined temperament style preferences among children in three sub-Saharan African countries (i.e., Nigeria, South Africa, and Zimbabwe) and possible differences between them on four bipolar temperament styles: extroverted-introverted, practical-imaginative, thinking-feeling, and organized-flexible. Children in these…
Élise Marsicano; Nathalie Lydié; Nathalie Bajos; Krystyna Horko
This article analyses the recomposition of gender relations in a migratory context from a specific viewpoint: the sexual debut of individuals who migrated from sub-Saharan Africa to France. It is based on a 2005 survey of 1,874 sub-Saharan African migrants in the Île-de-France region. The aim is to determine the impact of men?s and women?s migratory trajectories on their first sexual experiences, as well as any possible changes in sexual power relations after migration. The construction of mi...
During the 3 decades since independence, most sub-Saharan African countries have experienced accelerated demographic growth and increased migration from rural to urban areas. The 2 factors have considerably increased the costs of raising children, who have become more numerous and acquired new needs. In rural areas, families continue to fill much of their children's need for health care and employment. The declining ability of governments beset by economic crises and structural adjustment programs to do so has led some observers to predict that a new demand for smaller families and thus family planning will ensue. But in order for the declarations of intention made to foreign donors with increasing frequency by African governments to lead to significant fertility modifications, a combination of great political will, agreement of families with the new fertility objectives, and accessible family planning infrastructure would be required. Changes of this magnitude are at present difficult to visualize. Most African governments since the 1984 World Population Conference have stated their support of policies to slow demographic growth, but their true attitudes are often ambivalent. Many family planning programs receive only timid official help despite apparent encouragement. Authorities of some small countries concerned about the political implications of population size may hesitate to support family planning, and in all of Africa the desire to limit family size is contrary to deeply held social values. African family planning programs confront both political reticence and the fact that most Africans still consider a large family beneficial, not just through blind adherence to tradition but because for the 70% who support themselves in agriculture a large labor force is essential. Children provide security for the old and infirm. For much of the population, the conditions justifying high fertility in the past--high mortality rates and dependence of production on the
Full Text Available Scale-up of malaria preventive and control interventions over the last decade resulted in substantial declines in mortality and morbidity from the disease in sub-Saharan Africa and many other parts of the world. Sustaining these gains will depend on the health system performance. Treatment provides individual benefits by curing infection and preventing progression to severe disease as well as community-level benefits by reducing the infectious reservoir and averting emergence and spread of drug resistance. However many patients with malaria do not access care, providers do not comply with treatment guidelines, and hence, patients do not necessarily receive the correct regimen. Even when the correct regimen is administered some patients will not adhere and others will be treated with counterfeit or substandard medication leading to treatment failures and spread of drug resistance. We apply systems effectiveness concepts that explicitly consider implications of health system factors such as treatment seeking, provider compliance, adherence, and quality of medication to estimate treatment outcomes for malaria case management. We compile data for these indicators to derive estimates of effective coverage for 43 high-burden Sub-Saharan African countries. Parameters are populated from the Demographic and Health Surveys and other published sources. We assess the relative importance of these factors on the level of effective coverage and consider variation in these health systems indicators across countries. Our findings suggest that effective coverage for malaria case management ranges from 8% to 72% in the region. Different factors account for health system inefficiencies in different countries. Significant losses in effectiveness of treatment are estimated in all countries. The patterns of inter-country variation suggest that these are system failures that are amenable to change. Identifying the reasons for the poor health system performance and
Trade is an essential driver for sustained economic growth, and growth is necessary for poverty reduction. In Sub-Saharan Africa, where three-fourths of the poor live in rural areas, spurring growth and generating income and employment opportunities is critical for poverty reduction strategies. Seventy percent of the population lives in rural areas, where livelihoods are largely dependent ...
Affinnih, Yahya H
This article takes an international perspective on the drug problem in sub-Saharan Africa. This analysis borrows ideas from physical and economic geography as a heuristic device to conceptualize the global narcoscapes in which drug trafficking occurs. Both the legitimate and the illegal drug trade operate within the same global capitalist system and draw on the same technological innovations and business processes. Central to the paper's argument is evidence that sub-Saharan African countries are now integrated into the political economy of drug consumption due to the spill-over effect. These countries are now minor markets for "hard drugs" as the result of the activities of organizations and individual traffickers that use Africa as a staging point in their trade with Europe and the United States. As a result, sub-Saharan African countries have drug consumption problems that were essentially absent prior to 1980, along with associated health, social, and economic costs. The emerging drug problem has forced African countries to develop their own drug control policy. The sub-Saharan African countries mentioned below vary to some extent in the level of drug use and misuse problems: Burundi, Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Reunion, Rwanda, Seychelles, Somalia, Tanzania, Uganda, Zambia, Angola, Cameroon, Central African Republic, Chad, Congo, Congo (Zaire), Equatorial Guinea, Gabon, Sao Tome and Principe, Botswana, Lesotho, Namibia, South Africa, Swaziland, Benin, Burkina Faso, Cape Verde, Cote d'Ivoire, Gambia, Ghana, Guinea, Guinea Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, and Togo. As part of this effort, African countries are assessing the health, social, and economic costs of drug-use-related problems to pinpoint methods which are both effective and inexpensive, since their budgets for social programs are severely constrained. Many have progressed to the point of adopting anti
Noah Ndela Ntsama, Jean Frederic
This thesis examines the sources of business cycle fluctuations in a developing Sub-Saharan African economy. We develop an open economy dynamic stochastic general equilibrium model (DSGE), which is log-linearized, calibrated, and estimated with Bayesian techniques using South Africa macroeconomic data. The model incorporates various features such as external habit formation, internal investment adjustment cost, variable capacity utilization, domestically produced goods prices and wages sticki...
Ioraver N. Tsegba; Wilson E. Herbert; Emeka E. Ene
This paper investigates the relation between corporate ownership and corporate performance of listed companies in Nigeria, a foremost Sub-Saharan African country during the period 2002-2007. The data is obtained from the firms’ annual reports and accounts and the Nigerian Stock Exchange daily performance reports. The combination of 70 firms and six-year period studied provides a balanced panel with 420 observations for panel data analysis. The results from the ordinary least square (OLS) regr...
Crowther, Nigel J.; Norris, Shane A.
The waist circumference cut point for diagnosing the metabolic syndrome in sub-Saharan African subjects is based on that obtained from studies in European populations. The aim of this study was to measure the prevalence of obesity and related metabolic disorders in an urban population of African females, a group at high risk for such diseases, and to determine the appropriate waist cut point for diagnosing the metabolic syndrome. Anthropometry and fasting lipid, glucose and insulin levels wer...
Novignon Jacob; Nonvignon Justice
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. Me...
“What happens when an NGO admits failure ?” is the question asked by David Damberger, a member of Engineers Without Broaders, a canadian NGO. After the failure of his project in Malawi, he began to work on the learning of NGOs from possible failures. This project work will explore this idea of learning from some failures for western NGOs. The problem statement would be : “what and how NGOs can learn from their failure ?” It will focus only on projects in sub-saharan African countries beca...
Van Royen, Kathleen; Lachat, Carl; Holdsworth, Michelle; Smit, Karlien; Kinabo, Joyce; Roberfroid, Dominique; Nago, Eunice; Garimoi Orach, Christopher; Kolsteren, Patrick
Optimal nutrition is critical for human development and economic growth. Sub-Saharan Africa is facing high levels of food insecurity and only few sub-Saharan African countries are on track to eradicate extreme poverty and hunger by 2015. Effective research capacity is crucial for addressing emerging challenges and designing appropriate mitigation strategies in sub-Saharan Africa. A clear understanding of the operating environment for nutrition research in sub-Saharan Africa is a much needed prerequisite. We collected data on the barriers and requirements for conducting nutrition research in sub-Saharan Africa through semi-structured interviews with 144 participants involved in nutrition research in 35 countries in sub-Saharan Africa. A total of 133 interviews were retained for coding. The main barriers identified for effective nutrition research were the lack of funding due to poor recognition by policymakers of the importance of nutrition research and under-utilisation of research findings for developing policy, as well as an absence of research priority setting from within Africa. Current research topics were perceived to be mainly determined by funding bodies from outside Africa. Nutrition researchers argued for more commitment from policymakers at national level. The low capacity for nutrition research was mainly seen as a consequence of insufficient numbers of nutrition researchers, limited skills and a poor research infrastructure. In conclusion, African nutrition researchers argued how research priorities need to be identified by African stakeholders, accompanied by consensus building to enable creating a problem-driven national research agenda. In addition, it was considered necessary to promote interactions among researchers, and between researchers and policymakers. Multidisciplinary research and international and cross-African collaboration were seen as crucial to build capacity in sub-Saharan nutrition research. PMID:23776663
Kathleen Van Royen
Full Text Available Optimal nutrition is critical for human development and economic growth. Sub-Saharan Africa is facing high levels of food insecurity and only few sub-Saharan African countries are on track to eradicate extreme poverty and hunger by 2015. Effective research capacity is crucial for addressing emerging challenges and designing appropriate mitigation strategies in sub-Saharan Africa. A clear understanding of the operating environment for nutrition research in sub-Saharan Africa is a much needed prerequisite. We collected data on the barriers and requirements for conducting nutrition research in sub-Saharan Africa through semi-structured interviews with 144 participants involved in nutrition research in 35 countries in sub-Saharan Africa. A total of 133 interviews were retained for coding. The main barriers identified for effective nutrition research were the lack of funding due to poor recognition by policymakers of the importance of nutrition research and under-utilisation of research findings for developing policy, as well as an absence of research priority setting from within Africa. Current research topics were perceived to be mainly determined by funding bodies from outside Africa. Nutrition researchers argued for more commitment from policymakers at national level. The low capacity for nutrition research was mainly seen as a consequence of insufficient numbers of nutrition researchers, limited skills and a poor research infrastructure. In conclusion, African nutrition researchers argued how research priorities need to be identified by African stakeholders, accompanied by consensus building to enable creating a problem-driven national research agenda. In addition, it was considered necessary to promote interactions among researchers, and between researchers and policymakers. Multidisciplinary research and international and cross-African collaboration were seen as crucial to build capacity in sub-Saharan nutrition research.
Full Text Available Iron is an essential trace element subject to tight regulation to ensure adequate running of biological processes. In sub-Saharan Africa where hemoglobinopathies are common, iron homeostasis is likely to be impaired by these conditions. Here we assessed and compared key serum proteins associated with iron metabolism between sub-Saharan African children with sickle cell disease (SCD and their unaffected siblings. Complete blood counts and serum concentrations of four key proteins involved in iron regulation (ferritin, transferrin, sTfR and hepcidin were measured for 73 children with SCD and 68 healthy siblings in Benin, West Africa. We found significant differences in concentration of transferrin, sTfR and ferritin between the two groups. Hepcidin concentrations were found at unusually high concentrations but did not differ among the two groups. We found a significant negative correlation between hepcidin levels and both MCH and MCV in the SCD group and report that sTfR concentrations show a correlation with MCV and MHC in opposite directions in the two groups. These results highlight the unusually high levels of hepcidin in the Beninese population and the patterns of differential iron homeostasis taking place under sickle cell disease status. These results lay the foundation for a systematic evaluation of the underlying mechanisms deregulating iron homeostasis in populations with SCD or high prevalence of iron deficiency.
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
Pérez Perdomo, S.A.; Farrow, A.; Trienekens, J.H.; Omta, S.W.F.
The Sub-Saharan African smallholder agricultural sector faces multiple and usually complex challenges, which can potentially be overcome by collective action. Smallholder farmers and other value chain stakeholders can tackle temporal, structural and contextual challenges by joining multi-level innov
Olusanya Bolajoko O
Full Text Available Abstract Background Childhood immunisation is recognised worldwide as an essential component of health systems and an indispensable indicator of quality of care for vaccine-preventable diseases. While performance of immunisation programmes is more commonly measured by coverage, ensuring that every child is immunised at the earliest/appropriate age is an important public health goal. This study therefore set out to determine the pattern and predictors of Bacille de Calmette-Guérin (BCG immunisation delays in the first three months of life in a Sub-Saharan African community where BCG is scheduled at birth in order to facilitate necessary changes in current policy and practices for improved services. Methods A cross-sectional study in which immunisation delays among infants aged 0-3 months attending community-based BCG clinics in Lagos, Nigeria over a 2-year period from July 2005 to June 2007 were assessed by survival analysis and associated factors determined by multivariable logistic regression. Population attributable risk (PAR was computed for the predictors of delays. Results BCG was delayed beyond three months in 31.6% of all eligible infants. Of 5171 infants enrolled, 3380 (65.4% were immunised within two weeks and a further 1265 (24.5% by six weeks. A significantly higher proportion of infants born in hospitals were vaccinated in the first six weeks compared to those born outside hospitals. Undernourishment was predictive of delays beyond 2 and 6 weeks while treated hyperbilirubinaemia was associated with decreased odds for any delays. Lack of antenatal care and multiple gestations were also predictive of delays beyond 6 weeks. Undernourishment was associated with the highest PAR for delays beyond 2 weeks (18.7% and 6 weeks (20.8%. Conclusions BCG immunisation is associated with significant delays in this setting and infants at increased risk of delays can be identified and supported early possibly through improved maternal uptake of
Eskemose Andersen, Jørgen
Current definitions of urbanity lead to claims that a large proportion (75% according to UN Habitat) of Sub-Saharan Africa’s (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...... 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...
Collin F Payne; Mkandawire, James; Kohler, Hans-Peter
Editors' Summary Background The population of the world is getting older. In almost every country, the over-60 age group is growing faster than any other age group. In 2000, globally, there were about 605 million people aged 60 years or more; by 2050, 2 billion people will be in this age group. Much of this increase in the elderly population will be in low-income countries. In sub-Saharan Africa, for example, 10% of the population is currently aged 45 years or more, but by 2060, a quarter of ...
changes in the sub-Saharan African region as a whole and in some of the case countries in particular. Political leadership has changed in Ghana and Cote d'Ivoire with some course corrections in Ghana's health plans. Health sector financing in the region has become more dependent on external donors. The World Bank leads the external donor community in promoting policy-based lending. The complexity of a number of health problems has changed while the problems themselves remain the same as before. Essentially, building viable public health infrastructures to address basic public health needs must still be high on the agenda of action for most governments in the region. Thus, notwithstanding some course corrections and reasonable shifts in priorities, all the PHC principles are still applicable, indeed, much needed in the sub-Saharan African region. This study's findings, underscoring the fact that significant improvements in health are possible even where financial resources are limited, still hold true. PMID:10414831
Balding, Christopher; Feng, Yan; Atashband, Armita
The debate between pro- and anti-international adoption advocates relies heavily on rhetoric and little on data analysis. To better understand the state of orphans and potential adopters in this debate, we utilize the National Survey of Family Growth (NSFG) and the Demographic and Health Surveys (DHS) to study who adopts internationally and the status of orphaned children in sub-Saharan Africa. According to NSFG data adopters are church going, highly educated, stable families aware of the challenges faced by international adoption, with high rates of infertility and rates of child abuse half the population average. According to the DHS data, orphans in sub-Saharan Africa suffer from significantly higher deprivation, reduced schooling and increased levels of stunting and underweight reported than their cohort. Using this data, we estimate conservatively that that 1 50 000 orphans from our sample of sub-Saharan African countries died from their 5-year birth cohort. Given the large number of families seeking to adopt and the high number of orphan deaths, it seems counterproductive to restrict international adoptions given the significantly lower risks faced by children in adopted families compared with remaining orphaned. PMID:25769738
Berg, Gunhild; Fuchs, Michael
This paper provides an overview of the state of access to bank financing for SMEs in five Sub-Saharan African countries and analyzes the drivers behind banks' involvement with SMEs. The paper builds on data collected through five in-depth studies in Kenya, Nigeria, Rwanda, South Africa, and Tanzania between 2010 and 2012. The paper shows that the share of SME lending in the overall loan po...
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...
Pérez Perdomo, S.A.; Farrow, A.; Trienekens, J.H.; Omta, S.W.F.
The Sub-Saharan African smallholder agricultural sector faces multiple and usually complex challenges, which can potentially be overcome by collective action. Smallholder farmers and other value chain stakeholders can tackle temporal, structural and contextual challenges by joining multi-level innovation networks to benefit collectively from shared information, knowledge, improved capacities and economies of scale in a process of innovation. Ambidexterity is a capability of innovation network...
Watson, H K; Diaz-Chavez, R. A.
This paper synthesizes lessons learnt from research that aimed to identify land in the dryland regions of eight sub-Saharan African study countries where bioenergy feedstocks production has a low risk of detrimental environmental and socio-economic effects. The methodology involved using geographical information systems (GISs) to interrogate a wide range of datasets, aerial photograph and field verification, an extensive literature review, and obtaining information from a wide range of stakeh...
Jabbar, Mohammad A.; Grace, Delia
In order to understand the current of safety standards and problems for animal source foods, a study was conducted in six sub-Saharan African countries - Ethiopia, Ghana, Kenya, Mozambique, South Africa and Tanzania. The objective was to review food safety policy and regulations and their implementation, food safety status in terms of a number of criteria e.g. nature of public health problems and regularity of testing such problems, prevalence of food-borne diseases of international and devel...
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: 0.82–0.90 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.
The study seeks to examine the transition of international Sub-Saharan African students joining a UK University situated in the North of England. This research study examines the existing literature on the transition of international students into higher education; the factors that influence universities in recruiting international students; the motives of students to study in the UK; the issues prospective international Sub-Saharan African students experience in the process; and the sup...
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
Katherine E Center
Full Text Available Despite improved availability of simple, relatively inexpensive, and highly effective antiretroviral treatment for HIV/AIDS, the disease remains a major public health challenge for women in sub-Saharan Africa (SSA. Given the numerous barriers in access to care for women in this region, every health issue that brings them into contact with the health system should be optimized as an opportunity to integrate HIV/AIDS prevention. Because most non-condom forms of modern contraception require a clinical appointment for use, contraception appointments could provide a confidential opportunity for access to HIV counseling, testing, and referral to care. This study sought to investigate the relationship between contraceptive methods and HIV testing among women in SSA. Data from the Demographic and Health Survey from four African countries-Congo, Mozambique, Nigeria, and Uganda-was used to examine whether modern (e.g., pills, condom or traditional (e.g., periodic abstinence, withdrawal forms of contraception were associated with uptake of HIV testing. Data for the current analyses were restricted to 35,748 women with complete information on the variables of interest. Chi-square tests and logistic regression models were used to assess the relationship between uptake of HIV testing and respondents' baseline characteristics and contraceptive methods. In the total sample and in Mozambique, women who used modern forms of contraception were more likely to be tested for HIV compared to those who did not use contraception. This positive association was not demonstrated in Congo, Nigeria, or Uganda. That many women who access modern contraception are not tested for HIV in high HIV burden areas highlights a missed opportunity to deliver an important intervention to promote maternal and child health. Given the increasing popularity of hormonal contraception methods in low-income countries, there is an urgent need to integrate HIV counseling, testing, and treatment
Chinyere K Okoro
Full Text Available Two lineages of Salmonella enterica serovar Typhimurium (S. Typhimurium of multi-locus sequence type ST313 have been linked with the emergence of invasive Salmonella disease across sub-Saharan Africa. The expansion of these lineages has a temporal association with the HIV pandemic and antibiotic usage. We analysed the whole genome sequence of 129 ST313 isolates representative of the two lineages and found evidence of lineage-specific genome degradation, with some similarities to that observed in S. Typhi. Individual ST313 S. Typhimurium isolates exhibit a distinct metabolic signature and modified enteropathogenesis in both a murine and cattle model of colitis, compared to S. Typhimurium outside of the ST313 lineages. These data define phenotypes that distinguish ST313 isolates from other S. Typhimurium and may represent adaptation to a distinct pathogenesis and lifestyle linked to an-immuno-compromised human population.
Huang, Lucy; Jakobsson, Mattias; Pemberton, Trevor J.; Ibrahim, Muntaser; Nyambo, Thomas; Omar, Sabah; Pritchard, Jonathan K.; Tishkoff, Sarah A; Rosenberg, Noah A.
Sub-Saharan Africa has been identified as the part of the world with the greatest human genetic diversity. This high level of diversity causes difficulties for genome-wide association (GWA) studies in African populations—for example, by reducing the accuracy of genotype imputation in African populations compared to non-African populations. Here, we investigate haplotype variation and imputation in Africa, using 253 unrelated individuals from 15 Sub-Saharan African populations. We identify the...
Fofack, Hippolyte; Ndikumana, Leonce
Despite the substantial recent increase in capital flows to sub-Saharan Africa (SSA), the sub-continent remains largely marginalized in financial globalization and chronically dependent on official development aid. The current debate on resource mobilization for development financing in Africa has overlooked the problem of capital flight, which constitutes an important untapped source of funds. This paper argues that repatriation of flight capital deserves more attention on economic as well a...
Olatundun Janet Adelegan
This paper examines the role of the derivatives market in South Africa and provides policy options for promoting the development of derivatives markets in sub-Saharan Africa. South Africa's derivatives market has grown rapidly in recent years, supporting capital inflows and helping market participants to price, unbundle and transfer risk. There are tight regulations on asset allocations by insurance and pension funds to prevent excessive risk taking. The development of derivatives markets in ...
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
Nicholas I Brown
Full Text Available BACKGROUND: The worldwide neglect of immunotherapeutic products for the treatment of snakebite has resulted in a critical paucity of effective, safe and affordable therapy in many Third World countries, particularly in Africa. Snakebite ranks high among the most neglected global health problems, with thousands of untreated victims dying or becoming permanently maimed in developing countries each year because of a lack of antivenom-a treatment that is widely available in most developed countries. This paper analyses the current status of antivenom production for sub-Saharan African countries and provides a snapshot of the global situation. METHODS: A global survey of snake antivenom products was undertaken in 2007, involving 46 current and former antivenom manufacturers. Companies producing antivenom for use in sub-Saharan Africa were re-surveyed in 2010 and 2011. RESULTS: The amount of antivenom manufactured for sub-Saharan Africa increased between 2007 and 2010/11, however output and procurement remained far below that required to treat the estimated 300,000-500,000 snakebite victims each year. Variable potency and inappropriate marketing of some antivenoms mean that the number of effective treatments available may be as low as 2.5% of projected needs. Five companies currently market antivenom for sale in Africa; three others have products in the final stages of development; and since 2007 one has ceased production indefinitely. Most current antivenom producers possess a willingness and capacity to raise output. However inconsistent market demand, unpredictable financial investment and inadequate quality control discourage further production and threaten the viability of the antivenom industry. CONCLUSION: Financial stimulus is urgently needed to identify and develop dependable sources of high-grade antivenoms, support current and emerging manufacturers, and capitalise on existing unutilised production capacity. Investing to ensure a consistent
Tankwanchi, Akhenaten Benjamin Siankam; Sten H Vermund; Douglas D Perkins
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...
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.
Rippke, Ulrike; Ramirez-Villegas, Julian; Jarvis, Andy; Vermeulen, Sonja J.; Parker, Louis; Mer, Flora; Diekkrüger, Bernd; Challinor, Andrew J.; Howden, Mark
Climate change is projected to constitute a significant threat to food security if no adaptation actions are taken. Transformation of agricultural systems, for example switching crop types or moving out of agriculture, is projected to be necessary in some cases. However, little attention has been paid to the timing of these transformations. Here, we develop a temporal uncertainty framework using the CMIP5 ensemble to assess when and where cultivation of key crops in sub-Saharan Africa becomes unviable. We report potential transformational changes for all major crops during the twenty-first century, as climates shift and areas become unsuitable. For most crops, however, transformation is limited to small pockets (substitute crops, explore alternative livelihoods strategies, or relocate. To best align policies with production triggers for no-regret actions, monitoring capacities to track farming systems as well as climate are needed.
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.
Johnston, Lisa; Oumzil, Hicham; El Rhilani, Houssine; Latifi, Amina; Bennani, Aziza; Alami, Kamal
Morocco has experienced a dramatic increase of migration from sub-Sahara Africa during the past decade. Recently included among the most vulnerable populations cited in the Morocco National Strategic Plans on HIV/TB for 2012-2016, sub-Saharan Africa migrants living in an irregular administrative situation participated in a survey to provide baseline data about their socio-demographic, sexual and HIV testing behaviors and HIV and syphilis prevalence. Two surveys using respondent driven sampling were conducted in 2013 among males and females, ≥18 years, originating from sub-Saharan African countries and living and/or working in an irregular administrative situation in Rabat and residing at least 3 months in Morocco. Analysis was conducted to evaluate differences between the two samples and between females and males within each sample using the successive sampling estimator in RDS Analyst. Roughly 3 % of francophone and anglophone migrants were infected with HIV, whereas a statistically significantly higher percentage of francophone (2.8 %), compared to anglophone (0.3 %), migrants were infected with syphilis. Females were found to have HIV infection rates three times higher and past year sexually transmitted infection signs and symptoms more than two times higher than their male counterparts. Female migrants also had statistically significantly higher percentages of ever testing for HIV and HIV testing and receiving results in the past year compared to males. We found distinct and important differences between migrants depending on whether they come from francophone versus anglophone countries and whether they were male or female. Future research should continue to explore these differences, while policies and programs should note these differences to best allocate resources in providing social and health services to these populations. PMID:26122648
Breugelmans, J. Gabrielle; Makanga, Michael M.; Cardoso, Ana Lúcia V.; Mathewson, Sophie B.; Sheridan-Jones, Bethan R.; 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 ...
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 Woman’s 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 Woman’s Condom distribution program in 13 sub-Saharan African countries with HIV prevalence rates >4% among adults aged 15–49 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 Woman’s 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 Woman’s 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 Woman’s Condom, we found that the Woman’s 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 Woman’s Condom as an HIV prevention method than for contraception. Dual use of the Woman’s Condom increases the overall health impact. The Woman’s Condom was found to be very cost-effective in all 13 countries in our sample. Keywords
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
Lecher, Shirley; Ellenberger, Dennis; Kim, Andrea A; Fonjungo, Peter N; Agolory, Simon; Borget, Marie Yolande; Broyles, Laura; Carmona, Sergio; Chipungu, Geoffrey; De Cock, Kevin M; Deyde, Varough; Downer, Marie; Gupta, Sundeep; Kaplan, Jonathan E; Kiyaga, Charles; Knight, Nancy; MacLeod, William; Makumbi, Boniface; Muttai, Hellen; Mwangi, Christina; Mwangi, Jane W; Mwasekaga, Michael; Ng'Ang'A, Lucy W; Pillay, Yogan; Sarr, Abdoulaye; Sawadogo, Souleymane; Singer, Daniel; Stevens, Wendy; Toure, Christiane Adje; Nkengasong, John
To achieve global targets for universal treatment set forth by the Joint United Nations Programme on human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (UNAIDS), viral load monitoring for HIV-infected persons receiving antiretroviral therapy (ART) must become the standard of care in low- and middle-income countries (LMIC) (1). CDC and other U.S. government agencies, as part of the President's Emergency Plan for AIDS Relief, are supporting multiple countries in sub-Saharan Africa to change from the use of CD4 cell counts for monitoring of clinical response to ART to the use of viral load monitoring, which is the standard of care in developed countries. Viral load monitoring is the preferred method for immunologic monitoring because it enables earlier and more accurate detection of treatment failure before immunologic decline. This report highlights the initial successes and challenges of viral load monitoring in seven countries that have chosen to scale up viral load testing as a national monitoring strategy for patients on ART in response to World Health Organization (WHO) recommendations. Countries initiating viral load scale-up in 2014 observed increases in coverage after scale-up, and countries initiating in 2015 are anticipating similar trends. However, in six of the seven countries, viral load testing coverage in 2015 remained below target levels. Inefficient specimen transport, need for training, delays in procurement and distribution, and limited financial resources to support scale-up hindered progress. Country commitment and effective partnerships are essential to address the financial, operational, technical, and policy challenges of the rising demand for viral load monitoring. PMID:26605986
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.
Full Text Available Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org.During June 2011-December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC, Guinea, Uganda, Mozambique and Cote d'Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0-40% of suspected cases were aged under five years and from 0.3-86% had rice water stools. Within surveillance zones, 0-37% of suspected cases had confirmed cholera compared to 27-38% during outbreaks. Annual confirmed incidence per 10,000 population was <0.5 in surveillance zones, except Goma where it was 4.6. Goma and Conakry had corrected incidences of 20.2 and 5.8 respectively, while the other zones a median of 0.3. During outbreaks, corrected incidence varied from 2.6 to 13.0. Case fatality ratios ranged from 0-10% (median, 1% by country.Across different African epidemiological contexts, substantial variation occurred in cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use.
Full Text Available Extreme differences in allele frequency between West Africans and Eurasians were observed for a leucine-to-valine substitution (Leu372Val in the human intestinal zinc uptake transporter, ZIP4, yet no further evidence was found for a selective sweep around the ZIP4 gene (SLC39A4. By interrogating allele frequencies in more than 100 diverse human populations and resequencing Neanderthal DNA, we confirmed the ancestral state of this locus and found a strong geographical gradient for the derived allele (Val372, with near fixation in West Africa. In extensive coalescent simulations, we show that the extreme differences in allele frequency, yet absence of a classical sweep signature, can be explained by the effect of a local recombination hotspot, together with directional selection favoring the Val372 allele in Sub-Saharan Africans. The possible functional effect of the Leu372Val substitution, together with two pathological mutations at the same codon (Leu372Pro and Leu372Arg that cause acrodermatitis enteropathica (a disease phenotype characterized by extreme zinc deficiency, was investigated by transient overexpression of human ZIP4 protein in HeLa cells. Both acrodermatitis mutations cause absence of the ZIP4 transporter cell surface expression and nearly absent zinc uptake, while the Val372 variant displayed significantly reduced surface protein expression, reduced basal levels of intracellular zinc, and reduced zinc uptake in comparison with the Leu372 variant. We speculate that reduced zinc uptake by the ZIP4-derived Val372 isoform may act by starving certain pathogens of zinc, and hence may have been advantageous in Sub-Saharan Africa. Moreover, these functional results may indicate differences in zinc homeostasis among modern human populations with possible relevance for disease risk.
Caldwell, J C; Caldwell, P
The persistence of high fertility in sub-Saharan Africa, while all other world regions have been able to control population growth, represents a grave threat. Tradtional explanations for this phenomenon--e.g., lower levels of income, education, health, and urbanization--are not adequate, given the fact that many Asian countries have been able to reduce fertility in the face of the same obstacles. It is suggested, instead, that the primary cause of sub-Saharan Africa's high fertility can be found in its social and family patterns. Central cultural precepts include the notions that many descendents must be produced to ensure the survival of lineage, the equation of female virtue with the production of a large number of children, the stronger influence of the lineage than the nuclear family, and a belief in the power of ancestral spirits. Given the overriding importance of lineage and the relative weakness of emotional and economic conjugal links, the factors believed to be producing lowered birth rates in other developed countries (e.g., the high costs of child raising and the negative impact of large family size on the standard of living in that family) are not operable in sub-Saharan Africa. Most African fathers receive far more from their children, in terms of loyalty and support, than they expend on them, giving them little motivation to restrict fertility. Women's growing determination to extend their current economic independence into the domain of reproduction represents the most likely source of change in sub-Saharan Africa's fertility patterns. Also essential is reduced infant and child mortality through integrated health services-family planning programs. Progress can be expected to be slow, however, given the persistence of the African traditional social structure and belief system. PMID:2333491
HERMES, N; LENSINK, R
Most studies treat capital flight as an exclusively Latin American problem. This paper estimates capital flight for six African countries and shows that the emphasis on Latin American capital flight is not correct. It appears that the burden of capital flight is also important for many African count
J Gabrielle Breugelmans
Full Text Available 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.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 2003-2011. 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% (2007-2011. 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 2007-2011, 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 2003-2011 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.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
Protogerou, Cleo; Flisher, Alan J; Aarø, Leif Edvard; Mathews, Catherine
Amongst the psychological theories that have been used to help understand why people have unprotected sex, the Theory of Planned Behaviour (TPB: Ajzen 1991) has earned a prominent position. This article is a critical review of 11 peer-reviewed studies conducted in sub-Saharan Africa during 2001 to 2009, which used the TPB as a model of predicting sexual risk behaviour in young people. All the studies revealed the predictive ability of the TPB in urban, rural, and traditional African settings, with R (2) coefficients ranging between 0.14 and 0.67. With data comparing favourably to those obtained in the international literature, these studies indicate that the TPB can be used to study sexual risk intentions and behaviour in sub-Saharan African youth, and question arguments against the theory's use in non-Western settings. PMID:25865835
Abstract This paper argues that immigrant civic activism which may at first glance seem to focus on diasporic ties and ethnic community building, becomes often a lever for transcultural capital and transcultural community building. The study is explorative of new repertoires and forms of transnationalism among sub Saharan African immigrant activists in Europe. The findings suggest that immigrant civic activism even if limited in size proposes new types of transcultural societal net...
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 people’s 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 ...
Mumah, Joyce N.; Ziraba, Abdhalah K.; Sidze, Estelle M.
Background: Expanding access to antiretroviral therapy (ART) means that HIV is no longer a death sentence. This change has implications for reproductive decisions and behaviors of HIV-infected individuals.Design: Using multiple rounds of biomarker data from Demographic and Health Surveys (2004–2012) in nine sub-Saharan African countries, we compare patterns of associations between HIV status and fertility intention and between current use of modern contraception and HIV status in the context ...
Matimba, Alice; Woodward, Richmond; Tambo, Ernest; Ramsay, Michele; Gwanzura, Lovemore; Guramatunhu, Solomon
Tele-ophthalmology using portable retinal imaging technology, mobile phone and Internet connectivity offers a solution to improve access to diabetic retinopathy (DR) screening services in sub-Saharan African (SSA) countries where the burden of diabetes is increasing and there is limited access to eye care services and specialists. The Zimbabwe Retinopathy Telemedicine Project (ZRTP) established routine DR screening at a hospital-based diabetic clinic in the urban capital city, Harare. A handheld 'point and shoot' digital camera operated by a trained nurse was used to acquire retina images of 203 diabetic patients. A secured 'store-and forward' approach was set up and used for sharing and transfer of images to a retinal specialist at a remote site for reading. This method enabled detection of non-macular DR (11%), diabetic macular oedema (5%), cataract (5%) and glaucoma (6%) among the patients screened. ZRTP demonstrated the utility of tele-ophthalmology for routine retinal screening for diabetic patients in Zimbabwe who have limited access to eye care services. In addition, ZRTP showed how tele-ophthalmology services can provide an empirical framework for providing patient education, and a platform for research in the detection of DR. This approach could be used as a model to address the DR challenges in other countries in SSA. PMID:26407990
Watson, H K; Diaz-Chavez, R A
This paper synthesizes lessons learnt from research that aimed to identify land in the dryland regions of eight sub-Saharan African study countries where bioenergy feedstocks production has a low risk of detrimental environmental and socio-economic effects. The methodology involved using geographical information systems (GISs) to interrogate a wide range of datasets, aerial photograph and field verification, an extensive literature review, and obtaining information from a wide range of stakeholders. The GIS work revealed that Africa's drylands potentially have substantial areas available and agriculturally suitable for bioenergy feedstocks production. The other work showed that land-use and biomass dynamics in Africa's drylands are greatly influenced by the inherent 'disequilibrium' behaviour of these environments. This behaviour challenges the sustainability concept and perceptions regarding the drivers, nature and consequences of deforestation, land degradation and other factors. An assessment of the implications of this behaviour formed the basis for the practical guidance suggested for bioenergy feedstock producers and bioenergy policy makers. PMID:22482033
Full Text Available BACKGROUND: Untreated syphilis in pregnancy is associated with adverse clinical outcomes for the infant. Most syphilis infections occur in sub-Saharan Africa (SSA, where coverage of antenatal screening for syphilis is inadequate. Recently introduced point-of-care syphilis tests have high accuracy and demonstrate potential to increase coverage of antenatal screening. However, country-specific cost-effectiveness data for these tests are limited. The objective of this analysis was to evaluate the cost-effectiveness and budget impact of antenatal syphilis screening for 43 countries in SSA and estimate the impact of universal screening on stillbirths, neonatal deaths, congenital syphilis, and disability-adjusted life years (DALYs averted. METHODS AND FINDINGS: The decision analytic model reflected the perspective of the national health care system and was based on the sensitivity (86% and specificity (99% reported for the immunochromatographic strip (ICS test. Clinical outcomes of infants born to syphilis-infected mothers on the end points of stillbirth, neonatal death, and congenital syphilis were obtained from published sources. Treatment was assumed to consist of three injections of benzathine penicillin. Country-specific inputs included the antenatal prevalence of syphilis, annual number of live births, proportion of women with at least one antenatal care visit, per capita gross national income, and estimated hourly nurse wages. In all 43 sub-Saharan African countries analyzed, syphilis screening is highly cost-effective, with an average cost/DALY averted of US$11 (range: US$2-US$48. Screening remains highly cost-effective even if the average prevalence falls from the current rate of 3.1% (range: 0.6%-14.0% to 0.038% (range: 0.002%-0.113%. Universal antenatal screening of pregnant women in clinics may reduce the annual number of stillbirths by up to 64,000, neonatal deaths by up to 25,000, and annual incidence of congenital syphilis by up to 32
adverse events experienced and the proportion reporting drunkenness. Conclusions We find an association between experience of adverse childhood events and drunkenness among adolescents in four sub-Saharan African countries. The complex impacts of adverse childhood experiences on young people's development and behavior may have an important bearing on the effectiveness of interventions geared at reducing alcohol dependence among the youth.
Prathiba M. De Silva; Marshall, John M
Sub-Saharan Africa suffers by far the greatest malaria burden worldwide and is currently undergoing a profound demographic change, with a growing proportion of its population moving to urban areas. Urbanisation is generally expected to reduce malaria transmission; however the disease still persists in African cities, in some cases at higher levels than in nearby rural areas. Objective. This paper aims to collate and analyse risk factors for urban malaria transmission throughout sub-Saharan Af...
Chauvin, S.; GOLITIN, V.
Despite debt relief under the HIPC Initiative, African countries are still vulnerable to the risk of debt distress. The debt sustainability framework therefore remains an essential tool. The management of this tool must be flexible in order to take account of development goals and allow its adoption by emerging-country lenders.
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.
Moehl, J.; Machena, C.
The African Region consists of 48 countries and five island nations, most of which are practising some form of aquaculture, often at a very low level. Over half the countries report producing less than 100 mt annually. The largest producer is Nigeria (17 700 mt) followed by Madagascar (5 100 mt) and Zambia (4 700 mt). The 1997 combined aquaculture production of the region was 40 300 mt. Aquaculture is estimated to be 95 percent small scale, with fish ponds integrated into the m...
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 President’s 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 d’Ivoire, 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 country’s 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.
Ichoku, Charles M.
The northern sub-Saharan African (NSSA) region, extending from the southern fringes of the Sahara to the Equator, and stretching west to east from the Atlantic to the Indian ocean coasts, plays a prominent role in the distribution of Saharan dust and other airborne matter around the region and to other parts of the world, the genesis of global atmospheric circulation, and the birth of such major (and often catastrophic) events as hurricanes. Therefore, this NSSA region represents a critical variable in the global climate change equation. Recent satellite-based studies have revealed that the NSSA region 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 a major driver of the regional carbon, energy, and water cycles. We acknowledge that the rainy season in the NSSA region is from April to September while biomass burning occurs mainly during the dry season (October to March). Nevertheless, these two phenomena are indirectly coupled to each other through a chain of complex processes and conditions, including land-cover and surface-albedo changes, the carbon cycle, evapotranspiration, drought, desertification, surface water runoff, ground water recharge, and variability in atmospheric composition, heating rates, and circulation. In this presentation, we will examine the theoretical linkages between these processes, discuss the preliminary results based on satellite data analysis, and provide an overview of plans for more integrated research to be conducted over the next few years.
Nöstlinger, Christiana; Loos, Jasna
Community-based participatory research (CBPR) has received considerable attention during past decades as a method to increase community ownership in research and prevention. We discuss its application to epidemiological research using the case of second-generation surveillance conducted among sub-Saharan African (SSA) migrants in Antwerp city. To inform evidence-based prevention planning for this target group, this HIV-prevalence study used two-stage time-location sampling preceded by formative research. Extensive collaborative partnerships were built with community organizations, a Community Advisory Board provided input throughout the project, and community researchers were trained to participate in all phases of the seroprevalence study. Valid oral fluid samples for HIV testing were collected among 717 SSA migrants and linked to behavioural data assessed through an anonymous survey between December 2013 and August 2014. A qualitative content analysis of various data sources (extensive field notes, minutes of intervision, and training protocols) collected at 77 data collection visits in 51 settings was carried out to describe experiences with challenges and opportunities inherent to the CBPR approach at three crucial stages of the research process: building collaborative partnerships; implementing the study; dissemination of findings including prevention planning. The results show that CBPR is feasible in conducting scientifically sound epidemiological research, but certain requirements need to be in place. These include among others sufficient resources to train, coordinate, and supervise community researchers; continuity in the implementation; transparency about decision-taking and administrative procedures, and willingness to share power and control over the full research process. CBPR contributed to empowering community researchers on a personal level, and to create greater HIV prevention demand in the SSA communities. PMID:26885938
Nöstlinger, Christiana; Loos, Jasna
ABSTRACT Community-based participatory research (CBPR) has received considerable attention during past decades as a method to increase community ownership in research and prevention. We discuss its application to epidemiological research using the case of second-generation surveillance conducted among sub-Saharan African (SSA) migrants in Antwerp city. To inform evidence-based prevention planning for this target group, this HIV-prevalence study used two-stage time-location sampling preceded by formative research. Extensive collaborative partnerships were built with community organizations, a Community Advisory Board provided input throughout the project, and community researchers were trained to participate in all phases of the seroprevalence study. Valid oral fluid samples for HIV testing were collected among 717 SSA migrants and linked to behavioural data assessed through an anonymous survey between December 2013 and August 2014. A qualitative content analysis of various data sources (extensive field notes, minutes of intervision, and training protocols) collected at 77 data collection visits in 51 settings was carried out to describe experiences with challenges and opportunities inherent to the CBPR approach at three crucial stages of the research process: building collaborative partnerships; implementing the study; dissemination of findings including prevention planning. The results show that CBPR is feasible in conducting scientifically sound epidemiological research, but certain requirements need to be in place. These include among others sufficient resources to train, coordinate, and supervise community researchers; continuity in the implementation; transparency about decision-taking and administrative procedures, and willingness to share power and control over the full research process. CBPR contributed to empowering community researchers on a personal level, and to create greater HIV prevention demand in the SSA communities. PMID:26885938
Yue, Y.; Wang, J.; Ichoku, C. M.; Ellison, L.
Stretching from southern boundary of Sahara to the equator and expanding west to east from Atlantic Ocean coasts to the India Ocean coasts, the northern sub-Saharan African (NSSA) region has been subject to intense biomass burning. Comprised of savanna, shrub, tropical forest and a number of agricultural crops, the extensive fires burn belt covers central and south of NSSA during dry season (from October to March) contributes to one of the highest biomass burning rate per km2 in the world. Due to smoke particles' absorption effects of solar radiation, they can modify the surface and atmosphere temperature and thus change atmospheric stability, height of the boundary layer, regional atmospheric circulation, evaporation rate, cloud formation, and precipitation. Hence, smoke particles emitted from biomass burning over NSSA region has a significant influence to the air quality, weather and climate variability. In this study, the first version of this Fire Energetics and Emissions Research (FEER.v1) emissions of several smoke constituents including light-absorbing organic carbon (OC) and black carbon (BC) are applied to a state-of-science meteorology-chemistry model as NOAA Weather Research and Forecasting Model with Chemistry (WRF-Chem). We analyzed WRF-Chem simulations of surface and vertical distribution of various pollutants and their direct radiative effects in conjunction with satellite observation data from Moderate Resolution Imaging Spectroradiometer (MODIS) and Cloud-Aerosol Lidar data with Orthogonal Polarization (CALIPSO) to strengthen the importance of combining space measured emission products like FEER.v1 emission inventory with mesoscale model over intense biomass burning region, especially in area where ground-based air-quality and radiation-related observations are limited or absent.
Desgrees-du-Lou, Annabel; Pannetier, Julie; Ravalihasy, Andrainolo; Le Guen, Mireille; Gosselin, Anne; Panjo, Henri; Bajos, Nathalie; Lydie, Nathalie; Lert, France; Dray-Spira, Rosemary
Objectives: In Europe, sub-Saharan African migrants are a key population for HIV infection. We analyse how social hardships during settlement in France shape sexual partnerships and HIV risk. Design: PARCOURS is a life-event survey conducted in 2012–2013 in 74 health-care facilities in the Paris region, among three groups of sub-Saharan migrants: 926 receiving HIV care (296 acquired HIV in France), 779 with chronic hepatitis B, and 763 with neither HIV nor hepatitis B (reference group). Methods: Hardships (lack of residence permit, economic resources and housing) and sexual partnerships were documented for each year since arrival in France. For each sex, reported sexual partnerships were compared by group and their associations with hardships each year analysed with mixed-effects logistic regression models. Results: Hardships were frequent: more than 40% had lived a year or longer without a residence permit, and more than 20% without stable housing. Most of the migrants had nonstable and concurrent partnerships, more frequent among those who acquired HIV in France compared with reference group, as were casual partnerships among men (76.7 vs. 54.2%; P = 0.004) and women (52.4 vs. 30.5%; P = 0.02), concurrent partnerships among men (69.9 vs. 45.8%; P = 0.02), and transactional partnerships among women (8.6 vs. 2.3%; P = 0.006). Hardship increased risky behaviours: in women, lacking a residence permit increased casual and transactional partnerships [resp. odds ratio (OR) = 2.01(1.48–2.72) and OR = 6.27(2.25–17.44)]. Same trends were observed for lacking stable housing [OR = 3.71(2.75–5.00) and OR = 10.58 (4.68–23.93)]. Conclusion: Hardships faced by migrants increase HIV risks. Women, especially during the period without stable housing, appear especially vulnerable. PMID:26558722
Full Text Available BACKGROUND: Alcohol drinking is linked to the development of breast cancer. However, there is little knowledge about the impact of alcohol consumption on breast cancer risk among African women. METHODS: We conducted a case-control study among 2,138 women with invasive breast cancer and 2,589 controls in Nigeria, Cameroon, and Uganda from 1998 to 2013. A structured questionnaire was used to collect information on alcohol consumption, defined as consuming alcoholic beverages at least once a week for six months or more. Logistic regression was used to estimate adjusted odds ratio (aOR and 95% confidence interval (CI. RESULTS: Among healthy controls, the overall alcohol consumption prevalence was 10.4%, and the prevalence in Nigeria, Cameroon, and Uganda were 5.0%, 34.6%, and 50.0%, respectively. Cases were more likely to have consumed alcohol (aOR = 1.62, 95% CI: 1.33-1.97. Both past (aOR = 1.54; 95% CI: 1.19-2.00 and current drinking (aOR = 1.71; 95% CI: 1.30-2.23 were associated with breast cancer risk. A dose-response relationship was observed for duration of alcohol drinking (P-trend <0.001, with 10-year increase of drinking associated with a 54% increased risk (95% CI: 1.29-1.84. CONCLUSION: We found a positive relationship between alcohol consumption and breast cancer risk, suggesting that this modifiable risk factor should be addressed in breast cancer prevention programs in Africa.
Palha De Sousa, Chiquita A.; Brigham, Tracy; Chasekwa, Bernard; Mbuya, Mduduzi N. N.; Tielsch, James M.; Humphrey, Jean H.; PRENDERGAST, Andrew J.
The cornerstone of schistosomiasis control is mass praziquantel treatment in high prevalence areas. Adults are an important target population, given increasing recognition of the burden of male and female genital schistosomiasis. However, use of weighing scales to calculate praziquantel dosing in rural areas can be challenging. For school-age children, the World Health Organization (WHO) has approved a dose pole to simplify praziquantel dosing based on height. We modified the pediatric dose p...
Calderon, Cesar; Nguyen, Ha
This paper examines whether domestic output growth helps attract capital inflows and, in turn, capital inflows help boost output growth in a set of 38 Sub-Saharan African countries. Using a two-step approach to address reverse causality and omitted variable issues, the paper finds that output growth in countries in Sub-Saharan Africa does not attract capital inflows. However, aid and forei...
Hirai, Mitsuaki; Kim, Seung-Sup
Background It is estimated that more than two-thirds of the population in sub-Saharan Africa (SSA) must leave their home to collect water, putting them at risk for a variety of negative health outcomes. There is little research, however, quantifying who is most affected by long water collection times. Objectives This study aims to a) describe gender differences in water collection labor among both adults and children (water, disaggregated by urban and rural residence; and b) estimate the absolute number of adults and children affected by water collection times greater than 30 minutes in 24 SSA countries. Methods We analyzed data from the Demographic Health Survey (DHS) and the Multiple Indicator Cluster Survey (MICS) (2005–2012) to describe water collection labor in 24 SSA countries. Results Among households spending more than 30 minutes collecting water, adult females were the primary collectors of water across all 24 countries, ranging from 46% in Liberia (17,412 HHs) to 90% in Cote d’Ivoire (224,808 HHs). Across all countries, female children were more likely to be responsible for water collection than male children (62% vs. 38%, respectively). Six countries had more than 100,000 households (HHs) where children were reported to be responsible for water collection (greater than 30 minutes): Burundi (181,702 HHs), Cameroon (154,453 HHs), Ethiopia (1,321,424 HHs), Mozambique (129,544 HHs), Niger (171,305 HHs), and Nigeria (1,045,647 HHs). Conclusion In the 24 SSA countries studied, an estimated 3.36 million children and 13.54 million adult females were responsible for water collection in households with collection times greater than 30 minutes. We suggest that accessibility to water, water collection by children, and gender ratios for water collection, especially when collection times are great, should be considered as key indicators for measuring progress in the water, sanitation and hygiene sector. PMID:27248494
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
Afolabi, Adeoye Amuda
This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. Motivation:In the Sub-Saharan Africa countries there are several factors contributing to the collapse of firms. Most firms have failed due to poor corporate governance practices. The recent collapse of some firms in the financial and non-financial sectors in the Sub-region shows that there are challenges hindering effective corporate governance of firms in the Subregion. Consequently, this...
Torrance, Samantha; Morrissey, Oliver
This paper contributes to the literature on tax performance in sub-Saharan African countries. A standard model of the determinants of tax revenue is augmented to include measures of indigenous pre-independence institutional structure constructed from anthropological data on the characteristics of ethnic group organisation. We posit that if the three largest ethnic groups characterised by a clan-based organisational structure are a sufficiently large share of the population they are more likel...
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.
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 beklee’n 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
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.
Access to energy is known as a key issue for poverty reduction. Electrification rate of sub-Saharan countries is one of the lowest among the developing countries. However, this part of the world has natural energy resources that could help raising its access to energy, then its economic development. An original 'flexy-energy' concept of hybrid solar PV/diesel/biofuel power plant, without battery storage, is performed in this paper. This concept is developed in order to not only make access to energy possible for rural and peri-urban populations in Africa (by reducing the electricity generation cost) but also to make the electricity production sustainable in these areas. For landlocked countries like Burkina Faso, this concept could help them reducing their electricity bill (then their fuel consumption) and accelerate their rural and peri-urban electrification coverage. - Research highlights: → Design and load management Optimization are big concerns for hybrid systems. → Hybrid solar PV/Diesel is economically viable for remote areas and environmental friendly. → 'Flexy-energy' concept is a flexible hybrid solar PV/diesel/biomass suitable for remote areas. → 'Flexy-energy' concept is a flexible hybrid solar PV/diesel/biomass suitable for remote areas.
Carapinha, João L; Ross-Degnan, Dennis; Desta, Abayneh Tamer; Wagner, Anita K
Medicine benefits through health insurance programs have the potential to improve access to and promote more effective use of affordable, high quality medicines. Information is lacking about medicine benefits provided by health insurance programs in Sub-Saharan Africa. We describe the structure of medicine benefits and data routinely available for decision-making in 33 health insurance programs in Ghana, Kenya, Nigeria, Tanzania and Uganda. Most programs surveyed were private, for profit schemes covering voluntary enrollees, mostly in urban areas. Almost all provide both inpatient and outpatient medicine benefits, with members sharing the cost of medicines in all programs. Some programs use strategies that are common in high-income countries to manage the medicine benefits, such as formularies, generics policies, reimbursement limits, or price negotiation. Basic data to monitor performance in delivering medicine benefits are available in most programs, but key data elements and the resources needed to generate useful management information from the available data are typically missing. Many questions remain unanswered about the design, implementation, and effects of specific medicines policies in the emerging and expanding health insurance programs in Sub-Saharan Africa. These include questions about the most effective medicines policy choices, given different corporate and organizational structures and resources; impacts of specific benefit designs on quality and affordability of care and health outcomes; and ways to facilitate use of routine data for monitoring. Technical capacity building, strong government commitment, and international donor support will be needed to realize the benefits of medicines coverage in emerging and expanding health insurance programs in Sub-Saharan Africa. PMID:21167619
Dynes, Michelle; Tison, Laura; Johnson, Carla; Verani, Andre; Zuber, Alexandra; Riley, Patricia L
Sub-Saharan Africa carries the greatest burden of the HIV pandemic. Enhancing the supply and use of human resources through policy and regulatory reform is a key action needed to improve the quality of HIV services in this region. In year 3 of the African Health Profession Regulatory Collaborative for Nurses and Midwives (ARC), a President's Emergency Plan for AIDS Relief initiative, 11 country teams of nursing and midwifery leaders ("Quads") received small grants to carry out regulatory improvement projects. Four countries advanced a full stage on the Regulatory Function Framework (RFF), a staged capability maturity model used to evaluate progress in key regulatory functions. While the remaining countries did not advance a full stage on the RFF, important gains were noted. The year-3 evaluation highlighted limitations of the ARC evaluation strategy to capture nuanced progress and provided insight into how the RFF might be adapted for future use. PMID:27086189
This study entitled, Landfill gas capture opportunity in Sub-Saharan Africa, analyzes urban waste in both quantitative and qualitative terms in selected Sub-Saharan African (SSA) countries to find out if available methane from municipal waste could be used as a supplementary energy source and evaluate whether potential waste-to-energy (WTE) project candidates meet a certain level of cost e...
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
Akokpari, J K
Migration and refugee movements could significantly decline in sub-Saharan African countries. However, countries must redistribute meager resources equitably and engage in environmental protection. Refugee and migrant populations have increased in sub-Saharan Africa during 1969-95, from 700,000 to 6.8 million. This study examined the causes of migration and the implications for host countries. Doornbos (1990) identifies the root problem as the partisan nature of African politics and the incapacity to manage ecological degradation. The African state is wholly or partially responsible for the creation of conflicts. Examples abound in Zaire, South Africa, Sudan, Rwanda, Burundi, Somalia, Ethiopia, Liberia, Congo, and Chad. State partisanship is also evident in Angola, Mozambique, Uganda, and Sierra Leone. An estimated 10 million Africans, in 1985, left their homes due to wars, government repression, or the inability of land to support them. In 1994, USAID estimated that 11.6 million Africans in 10 countries were threatened by famine from drought. Environmental degradation has generated conflicts. Africa's marginalized economy results in recession, unemployment, inflation, and distributional conflicts. Democratization has brought conflicts between the state, civil society, and exiles. Refugees face homelessness, poverty, emotional distress, inadequate food, and disease. Host countries face security threats, pressure on limited resources, rebellions from refugees and their involvement with foreign mercenaries, local conflicts between native and refugee populations, and environmental degradation from refugees. PMID:12293796
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…
Full Text Available BACKGROUND: Availability of a Skilled Birth Attendant (SBA during childbirth is a key indicator for MDG5 and a strategy for reducing maternal and neonatal mortality in Africa. There is limited information on how SBAs and their functions are defined. The aim of this study was to map the cadres of health providers considered SBAs in Sub Saharan Africa (SSA; to describe which signal functions of Essential Obstetric Care (EmOC they perform and assess whether they are legislated to perform these functions. METHODS AND FINDINGS: Key personnel in the Ministries of Health, teaching institutions, referral, regional and district hospitals completed structured questionnaires in nine SSA countries in 2009-2011. A total of 21 different cadres of health care providers (HCP were reported to be SBA. Type and number of EmOC signal functions reported to be provided, varied substantially between cadres and countries. Parenteral antibiotics, uterotonic drugs and anticonvulsants were provided by most SBAs. Removal of retained products of conception and assisted vaginal delivery were the least provided signal functions. Except for the cadres of obstetricians, medical doctors and registered nurse-midwives, there was lack of clarity regarding signal functions reported to be performed and whether they were legislated to perform these. This was particularly for manual removal of placenta, removal of retained products and assisted vaginal delivery. In some countries, cadres not considered SBA performed deliveries and provided EmOC signal functions. In other settings, cadres reported to be SBA were able to but not legislated to perform key EmOC signal functions. CONCLUSIONS: Comparison of cadres of HCPs reported to be SBA across countries is difficult because of lack of standardization in names, training, and functions performed. There is a need for countries to develop clear guidelines defining who is a SBA and which EmOC signal functions each cadre of HCP is expected to
Full Text Available 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 <1.5% average annual reduction rate. All of these countries had at least three rounds of Demographic and Health Surveys (DHS before 2012. We measured rate ratios and differences, as well as relative and absolute concentration indices in order to examine within-country geographical and wealth-based inequalities in the utilization of ANC, FBD, and MC. In the countries which have made sufficient progress (i.e. Ethiopia, Madagascar, and Uganda, ANC use increased by 8.7, 9.3 and 5.7 percent, respectively, while the utilization of FBD increased by 4.7, 0.7 and 20.2 percent, respectively, over the last decade. By contrast, utilization of these services either plateaued or decreased in countries which did not make progress towards reducing maternal mortality, with the exception of Cameroon. Utilization of MC increased in all six countries but remained very low, with a high of 40.5% in Zimbabwe and low of 16.1% in Cameroon as of 2011. In general, relative measures of inequalities were found to have declined overtime in countries making progress towards reducing maternal mortality. In countries with insufficient progress towards maternal mortality reduction, these indicators remained stagnant or increased. Absolute measures for geographical and wealth-based inequalities remained high invariably in all six countries. The increasing trend in the utilization of maternal care services was found to concur with a steady decline in maternal mortality. Relative inequality declined overtime in countries
This study examines African populations` attitudes toward anti-corruption policies. Previous studies only look at individuals` experiences or attitudes with respect to corruption itself or its prevalence. Relying on micro data from six Sub-Saharan African countries and using ordered probit models, we show that social factors (education, employment, living conditions, etc.) significantly affect the citizens` attitudes toward anti-corruption strategies. We also highlight the importance of polit...
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
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.
Chiteng Kot, Felly
In the last few years, foreign institutions have increasingly sought to establish partnerships with African universities. Likewise, African universities have increasingly sought to establish linkages with foreign institutions. Different factors suggest that these partnerships will continue to be a major focus in the future. This study draws from a…
Naomi M. Seboni
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 discussions 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.
Sezonlin, Michel; Dupas, Stéphane; Le Ru, Bruno; Le Gall, Philippe; Moyal, Pascal; Calatayud, Paul-André; Giffard, I; Faure, N; Silvain, Jean-François
The population genetics and phylogeography of African phytophagous insects have received little attention. Some, such as the maize stalk borer Busseola fusca, display significant geographic differences in ecological preferences that may be congruent with patterns of molecular variation. To test this, we collected 307 individuals of this species from maize and cultivated sorghum at 52 localities in West, Central and East Africa during the growing season. For all collected individuals, we seque...
Domingues, Patricia Mariana; Gusmão, Leonor; da Silva, Dayse Aparecida; Amorim, António; Pereira, Rinaldo W; de Carvalho, Elizeu F
A male sample of 135 African descendents from the Rio de Janeiro population were typed for the 12 Y-chromosome short tandem repeat (STR) loci included in the PowerPlex Y System. A high haplotype diversity was observed (0.9971), with 91% of haplotypes being unique, demonstrating the usefulness and informative power of this Y-STR set in male lineage identification. Samples with shared haplotypes were additionally typed with the Yfiler kit, which includes five extra markers. The haplotype diversity when using the 17-Yfiler loci increased to (0.9998) with 97% unique haplotypes. The same set of Y-STRs was also typed in 135 father/son pairs and three single-step mutations were observed: one at DYS19 and two at DYS385. Genetic distance analysis showed highly significant differences in all pairwise comparisons between this sample of African descendents and the general population from Rio de Janeiro, as well as with Iberian and African samples from Portugal, Mozambique, Angola and Equatorial Guinea. Comparisons with samples from other regions in Brazil showed that heterogeneity does exist, indicating that a Y-haplotype database for the whole country should take into account the population sub-structure. Moreover, a strong European influence was detected, and thus, a Y-chromosome STR profile proves a rather poor indicator for the ethnic origin of an individual in Rio de Janeiro. PMID:17334737
Arrey, Agnes Ebotabe; Bilsen, Johan; Lacor, Patrick; Deschepper, Reginald
Spirituality/religion serves important roles in coping, survival and maintaining overall wellbeing within African cultures and communities, especially when diagnosed with a chronic disease like HIV/AIDS that can have a profound effect on physical and mental health. However, spirituality/religion can be problematic to some patients and cause caregiving difficulties. The objective of this paper was to examine the role of spirituality/religion as a source of strength, resilience and wellbeing among sub-Saharan African (SSA) migrant women with HIV/AIDS. A qualitative study of SSA migrant women was conducted between April 2013 and December 2014. Participants were recruited through purposive sampling and snowball techniques from AIDS Reference Centres and AIDS workshops in Belgium, if they were 18 years and older, French or English speaking, and diagnosed HIV positive more than 3 months beforehand. We conducted semi-structured interviews with patients and did observations during consultations and support groups attendances. Thematic analysis was used to analyse the data. 44 women were interviewed, of whom 42 were Christians and 2 Muslims. None reported religious/spiritual alienation, though at some point in time many had felt the need to question their relationship with God by asking “why me?” A majority reported being more spiritual/religious since being diagnosed HIV positive. Participants believed that prayer, meditation, regular church services and religious activities were the main spiritual/religious resources for achieving connectedness with God. They strongly believed in the power of God in their HIV/AIDS treatment and wellbeing. Spiritual/religious resources including prayer, meditation, church services, religious activities and believing in the power of God helped them cope with HIV/AIDS. These findings highlight the importance of spirituality in physical and mental health and wellbeing among SSA women with HIV/AIDS that should be taken into consideration
Pitman, J.P.; Wilkinson, R.L.; Basavaraju, S.V.; Von Finckenstein, B.G.; Sibinga, C.T.H.; Marfin, A.; Postma, M.J.; Mataranyika, M.N.; Tobias, J.L.
Background: Since 2004, several African countries, including Namibia, have received assistance from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). Aims: Gains have been documented in the safety and number of collected units in these countries, but the distribution of blood has not bee
Dhaneshwar Ghura; Michael T. Hadjimichael
The paper investigates empirically the determinants of economic growth for a large sample of sub-Saharan African countries during 1981-92. The results indicate that (i) an increase in private investment has a relatively large positive impact on per capita growth; (ii) growth is stimulated by public policies that lower the budget deficit in relation to GDP (without reducing government investment), reduce the rate of inflation, maintain external competitiveness, promote structural reforms, enco...
Victor Ombati; Ombati Mokua
This paper examines the issue of gender inequality in education in sub-Saharan Africa. It argues that in sub-Saharan African countries, the provision of education for boys and girls is uneven, and biased through gender, location, class and region- resulting to high illiteracy rates for girls and women. The paper concludes that political instability and violence, poverty and economical challenges, negative cultural values, female genital mutilation, early marriage, and sexual harassment are so...
The article examines the European share in large-scale land acquisitions in Sub-Saharan Africa. The paper aims to identify correlation between biofuels policy and large-scale land acquisitions in Sub-Saharan Africa and the consequences of this phenomenon. It first identifies the backgrounds that caused the increased interest in biofuel production and, consequently, African land acquisition in recent years. Then, it examines growth in the number of land transactions that take place on the cont...
Faye, Adama; Fournier, Pierre; Diop, Idrissa; Philibert, Aline; Morestin, Florence; Dumont, Alexandre
Background: In sub-Saharan Africa, lack of motivation and job dissatisfaction have been cited as causes of poor healthcare quality and outcomes. Measurement of health workers' satisfaction adapted to sub-Saharan African working conditions and cultures is a challenge. The objective of this study was to develop a valid and reliable instrument to measure satisfaction among health professionals in the sub-Saharan African context. Methods: A survey was conducted in Senegal and Mali in 2011 among 9...
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 (15°W–42°E, 13°S–17°N) and monthly averages of column PM2.5 loading, surface PM2.5 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. (paper)
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.
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.
Akhenaten Benjamin Siankam Tankwanchi
Full Text Available 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
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
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 world’s GDP and its share in world trade has fallen from 6% in 1980 to 2% today. The region’s exports remain dominated by primary goods (fuels, ores, and agricultural products. The roots of the region’s 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 UN’s 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
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 plantin...
McKenzie, Fiona; Zietsman, Annelle; Galukande, Moses; Anele, Angelica; Adisa, Charles; Cubasch, Herbert; Parham, Groesbeck; Anderson, Benjamin O; Abedi-Ardekani, Behnoush; Schuz, Joachim; dos Santos Silva, Isabel; McCormack, Valerie
Introduction Sub-Saharan African (SSA) women with breast cancer (BC) have low survival rates from this potentially treatable disease. An understanding of context-specific societal, health-systems and woman-level barriers to BC early detection, diagnosis and treatment are needed. Methods The African Breast Cancer—Disparities in Outcomes (ABC-DO) is a prospective hospital-based study of overall survival, impact on quality of life (QOL) and delays along the journey to diagnosis and treatment of BC in SSA. ABC-DO is currently recruiting in Namibia, Nigeria, South Africa, Uganda and Zambia. Women aged 18 years or older who present at participating secondary and tertiary hospitals with a new clinical or histocytological diagnosis of primary BC are invited to participate. For consented women, tumour characteristics, specimen and treatment data are obtained. Over a 2-year enrolment period, we aim to recruit 2000 women who, in the first instance, will be followed for between 1 and 3 years. A face-to-face baseline interview obtains information on socioeconomic, cultural and demographic factors, QOL, health and BC attitudes/knowledge, and timing of all prediagnostic contacts with caregivers in orthodox health, traditional and spiritual systems. Responses are immediately captured on mobile devices that are fed into a tailored mobile health (mHealth) study management system. This system implements the study protocol, by prompting study researchers to phone women on her mobile phone every 3 months and, failing to reach her, prompts contact with her next-of-kin. At follow-up calls, women provide updated information on QOL, care received and disease impacts on family and working life; date of death is asked of her next-of-kin when relevant. Ethics and dissemination The study was approved by ethics committees of all involved institutions. All participants provide written informed consent. The findings from the study will be published in peer-reviewed scientific journals
Prathiba M. De Silva
Full Text Available Sub-Saharan Africa suffers by far the greatest malaria burden worldwide and is currently undergoing a profound demographic change, with a growing proportion of its population moving to urban areas. Urbanisation is generally expected to reduce malaria transmission; however the disease still persists in African cities, in some cases at higher levels than in nearby rural areas. Objective. This paper aims to collate and analyse risk factors for urban malaria transmission throughout sub-Saharan Africa and to discuss their implications for control. Methods. A systematic search on malaria and urbanisation was carried out focusing on sub-Saharan Africa. Particular interest was taken in vector breeding sites in urban and periurban areas. Results. A variety of urban vector breeding sites were catalogued, the majority of which were artificial, including urban agriculture, tyre tracks, and ditches. Natural breeding sites varied according to location. Low socioeconomic status was a significant risk factor for malaria, often present in peri-urban areas. A worrying trend was seen in the adaptation of malaria vector species to the urban environment. Urban malaria is highly focused and control programs should reflect this. Conclusion. As urbanisation continues and vector species adapt, continued monitoring and control of urban malaria in sub-Saharan Africa is essential.
Pitman, John P.; Wilkinson, Robert; Liu, Yang; von Finckenstein, Bjorn; Sibinga, Cees Th. Smit; 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 deman
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, ‘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
Codjoe, Samuel N.A.; Owusu, George; Burkett, Virginia
Several recent international assessments have concluded that climate change has the potential to reverse the modest economic gains achieved in many developing countries over the past decade. The phenomenon of climate change threatens to worsen poverty or burden populations with additional hardships, especially in poor societies with weak infrastructure and economic well-being. The importance of the perceptions, experiences, and knowledge of indigenous peoples has gained prominence in discussions of climate change and adaptation in developing countries and among international development organizations. Efforts to evaluate the role of indigenous knowledge in adaptation planning, however, have largely focused on rural people and their agricultural livelihoods. This paper presents the results of a study that examines perceptions, experiences, and indigenous knowledge relating to climate change and variability in three communities of metropolitan Accra, which is the capital of Ghana. The study design is based on a three-part conceptual framework and interview process involving risk mapping, mental models, and individual stressor cognition. Most of the residents interviewed in the three communities of urban Accra attributed climate change to the combination of deforestation and the burning of firewood and rubbish. None of the residents associated climate change with fossil fuel emissions from developed countries. Numerous potential adaptation strategies were suggested by the residents, many of which have been used effectively during past drought and flood events. Results suggest that ethnic residential clustering as well as strong community bonds in metropolitan Accra have allowed various groups and long-settled communities to engage in the sharing and transmission of knowledge of weather patterns and trends. Understanding and building upon indigenous knowledge may enhance the design, acceptance, and implementation of climate change adaptation strategies in Accra and
Gilioli, Gianni; Caroli, Anna Maria; Tikubet, Getachew; Herren, Hans R; Baumgärtner, Johann
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
Henderson, J.Vernon; Roberts, Mark; Storeygard, Adam
In the past dozen years, a literature has developed arguing that urbanization has unfolded differently in post-independence Sub-Saharan Africa than in the rest of the developing world, with implications for African economic growth overall. While African countries are more urbanized than other countries at comparable levels of income, it is well-recognized that total and sector gross domest...
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.
Filmer, Deon; Fox, Louise
Sub-Saharan Africa has just experienced one of the best decades of growth since the 1960s. Between 2000 and 2012, gross domestic product (GDP) grew more than 4.5 percent a year on average, compared to around 2 percent in the prior 20 years (World Bank various years). In 2012, the region's GDP growth was estimated at 4.7 percent- 5.8 percent if South Africa is excluded (World Bank 2013). About one-quarter of countries in the region grew at 7 percent or better, and several African countries are...
Rosen, Stacey L.; Shapouri, Shahla
African Governments and international donors are focused on improving the regionâ€™s ability to grow food to mitigate projected long-term deterioration in food security. An ERS study shows that improving grain yields is the key to reducing food insecurity in Sub-Saharan Africa. Investment and technology adoption in Sub-Saharan Africa will be a challenge.
This report compares poverty levels and trends in sub - Saharan Africa with the rest of the world. It then uses national aggregate indicators to look at poverty trends and levels across African countries. This section makes use of demographic, economic and social indicators from the Bank's socioeconomic database and other international sources. The report then highlights the many faces of ...
Sunday E. Obalum
Full Text Available The paper provides an insight into the problem of land degradation in Sub-Saharan Africa, with emphasis on soil erosion and its effect on soil quality and productivity, and proposes a lowland-based rice-production technology for coping with the situation. Crop yields are, in addition to the degree of past and current erosion, determined by a number of interacting variables. This, coupled with the generally weak database on erosion-induced losses in crop yield in spite of the region’s high vulnerability to erosion, makes it difficult to attain a reliable inference on the cause-effect relationship between soil loss and productivity. Available data suggest, however, that the region is at risk of not meeting up with the challenges of agriculture in this 21st century. Based on the few studies reviewed, methodology appears to have an overwhelming influence on the erosion-productivity response, whereas issues bordering on physical environment and soil affect the shape of the response curve. We argue that the sawah ecotechnology has the potential of countering the negative agronomic and environmental impacts of land degradation in Sub-Saharan Africa. This is a farmer-oriented, low-cost system of managing soil, water, and nutrient resources for enhancing lowland rice productivity and realizing Green Revolution in the region.
Pauly, M.; Hoppe, E.; Mugisha, L.; Petrželková, 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.
Roč. 11, č. 25 (2014), s. 25. ISSN 1743-422X R&D Projects: GA ČR 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
Riziki M. Nyello
Full Text Available The Oil and Gas Sector in Africa is growing so fast due to the new discovery of Oil and Gas reserves and therefore attract the huge amount of Foreign Direct Investment (FDI. Considering its role in the African economy, several approaches both local and foreign have been introduced; however the anticipated economic benefits have not yet been realized. The study therefore focused on assessing the effectiveness of the selected approaches that were designed to ensure the economic benefits of oil and gas resources reach to the African local population, particularly the poor ones. The study surveyed various literatures to draw its conclusion. It was realized that the selected approaches have failed to ensure that Oil and Gas resources produce the anticipated economic benefits to the local African population. Among others, it was recommended that the approaches should be improved in order to promote the linkage between Oil and Gas Extractive firms and Small and Medium Enterprises. Additionally, they should be enforceable by law in order to ensure legal commitment among African governments and Oil and Gas Extractive firms to the local population.
Meyrowitsch, Dan Wolf; Pedersen, Erling Møller; Alifrangis, Michael;
) 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...
Araujo Bonjean, Catherine; Gérard CHAMBAS
The global public revenue level of numerous African countries is low and the tax burden is highly concentrated on modern sector firms. One of the most current explanations for the low level of public revenue is the under-taxation of the urban unrecorded activities. The aim of this paper is to define an appropriate strategy in order to collect additional public resources from unrecorded activities in Sub-Saharan African Countries. In order to define an adapted taxation strategy for the unrecor...
L.J. de Haan (Leo); P. Ton (Peter)
textabstractThis paper was written at the request of the Werkgemeenschap Afrika (Netherlands African Studies Association). lts main objective is to present a review of recent Dutch research on environmental issues in Sub-Saharan Africa.
Abiola Fatimah Adenowo
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 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.
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
Owili, Patrick Opiyo; Muga, Miriam Adoyo; Chou, Yiing-Jenq; Hsu, Yi-Hsin Elsa; Huang, Nicole; Chien, Li-Yin
Background Despite the progress in the Millennium Development Goals (MDGs) 4 and 5, inequity in the utilization of maternal, newborn and child health (MNCH) care services still remain high in sub-Saharan Africa (SSA). The continuum of care for MNCH that recognizes a tight inter-relationship between maternal, newborn and child health at different time periods and location is key towards reducing inequity in health. In this study, we explored the distributions in the utilization MNCH services i...
The introduction to this description of emigration dynamics in sub-Saharan Africa notes that the region is characterized by intensive migration caused by such factors as population growth, negative economic growth, ethnic conflict, and human rights abuses. The second section of the report discusses the fragmentary and incomplete nature of data on international migration in the region, especially data on conventional migration. Section 3 looks at demographic factors such as high population growth, illiteracy levels, HIV seroprevalence, and urbanization which lead to high unemployment and emigration. The fourth section considers the effects of the rapid expansion of education which is outstripping the absorptive capacity of the economies of many countries. Unemployment is a serious problem which is projected to become worse as increases in employment opportunities continue to lag behind increases in output. Sections five, six, and seven of the report describe relevant economic factors such as per capita income, income distribution, the economic resource base, and economic development; poverty; and the effects of economic adjustment programs, especially on employment opportunities and wages in the public and private sectors. The next section is devoted to sociocultural factors influencing migration both on the micro- and the macro-levels, including the influence of ethnicity and ethnic conflicts as well as the domination of leadership positions by members of minority groups. The political factors discussed in section 9 include women's status, repressive regimes, political instability which leads to underdevelopment, and the policies of the Organization of African Unity which broadened the definition of refugees and set inviolable borders of member states identical to those inherited upon independence. Section 10 outlines ecological factors contributing to migration, including the decline in acreage of arable land, soil deterioration, poor land management, and the
Serre Delcor, Núria; Maruri, Begoña Treviño; Arandes, Antoni Soriano; Guiu, Isabel Claveria; Essadik, Hakima Ouaarab; Soley, Mateu Espasa; Romero, Israel Molina; Ascaso, Carlos
Immigrants may be carriers of infectious diseases because of the prevalence of these diseases in their country of origin, exposure during migration, or conditions during resettlement, with this prevalence being particularly high in sub-Saharan Africans. We performed a retrospective review of 180 sub-Saharan immigrants screened for infectious diseases at an International Health Center from January 2009 to December 2012. At least one pathogenic infectious disease was diagnosed in 72.8% patients: 60.6% latent tuberculosis infection, 36.8% intestinal parasites (intestinal protozoa or helminths), 28.1% helminths, 14.8% hepatitis B surface antigen positive, 1.2% anti-hepatitis C virus positive, 1.2% human immunodeficiency virus-positive, and 1.2% malaria. Coinfections were present in 28.4%. There was significant association between eosinophilia (absolute count or percentage) or hyper-IgE and the presence of helminths (P< 0.001). Relative eosinophilia and hyper-IgE were better indicators of helminth infection than absolute eosinophilia, particularly for schistosomiasis and strongyloidiasis. We found a high prevalence of infectious diseases in sub-Saharan immigrants, which could lead to severe health problems (in the absence of prompt treatment), representing a high cost to the public health system and possible transmission in the host country. Accurate screening and tailored protocols for infectious diseases are recommended in sub-Saharan immigrants. PMID:26880782
Full Text Available Introduction: Individuals’ educational attainment has long been considered as a risk factor for HIV. However, little attention has been paid to the association between partner educational attainment and HIV infection. Methods: We conducted cross-sectional analysis of young women (aged 15–34 in 14 Demographic and Health Surveys from seven sub-Saharan Africa (SSA countries with generalized HIV epidemics. We measured the degree of similarity in educational attainment (partner homophily in 75,373 partnerships and evaluated the correlation between homophily and female HIV prevalence at the survey cluster level. We then used logistic regression to assess whether own and partner educational attainment was associated with HIV serostatus amongst 38,791 women. Results: Educational attainment was positively correlated within partnerships in both urban and rural areas of every survey (Newman assortativity coefficients between 0.09 and 0.44, but this correlation was not ecologically associated with HIV prevalence. At the individual level, larger absolute differences between own and partner educational attainment were associated with significantly higher HIV prevalence amongst women. This association was heterogeneous across countries, but not between survey waves. In contrast to other women, for those aged 25–34 who had secondary or higher education, a more-educated partner was associated with lower HIV prevalence. Conclusions: HIV prevalence amongst women in SSA is associated not only with one's own education but also with that of one's partner. These findings highlight the importance of understanding how partners place individuals at risk of infection and suggest that HIV prevention efforts may benefit from considering partner characteristics.
Gasmelseed, Nagla; Elsir, Afrah Awad; Deblasio, Pasquale; Biunno, Ida
Quality-assessed biomedical samples are essential for academia- and industry driven research on human diseases. The etiologies and the molecular genetic factors relevant in African diseases, including both infections and complex degenerative diseases as well as cancer, need to be studied using well annotated and well-preserved biosamples acquired from native African ethnic groups and compare the results with non-African populations and/or with Afro-Americans. However, a number of difficulties negatively impact on the possibility to obtain clinically annotated biological samples in most Sub-Saharan African countries. This is mainly due to major organizational problems, lack of clinical centres that can dedicate resources to research, as well as lack of facilities in which biomaterials can be properly processed and safely stored. Harmonization of biosample acquisition, storage phenotyping schemes and biocomputer infrastructures are the principal objectives of biological resource centers (BRCs). BRCs comprise biobanks of different formats (collection of blood, DNA, tissues, etc., annotated with medical, environmental, life-style and follow up data) a fundamental tool for molecular epidemiological studies aiming to increase excellence and efficacy of biomedical results, drug development and public health. BRCs provide large and highly controlled biomolecular resources necessary to meet the "omics" scientific platforms. Sudan may be a candidate nation to host such infrastructure, in view of its strategic geographical position and the already existing simple biobanking experiences connected with research groups in Central Sudan. Here, we describe the potential role of biobanks in African genetic studies aiming to dissect the eziopathogenesis of complex diseases in relation to environmental and life-style factors. PMID:21303714
This paper contributes to the aid effectiveness debate by applying a vector autore- gression model to a panel of Sub-Saharan African countries. This method avoids the need for instrumental variables and allows one to analyse the impact of foreign aid on human development and on economic development simultaneously. The full sample results indicate a small increase in economic growth following a fairly substantial aid shock. The size of the effect puts the result somewhere between the arguments...
After independence, every sub - Saharan African country, without exception, joined one or more regional integration schemes. Regional integration would have enabled the subcontinent to attain economic growth and prosperity by allowing individual countries to overcome the barriers of desperately small size and poor human and physical capital endowment - thus breaking away from the colonial pattern of trade, often characterized by a heavy reliance on an undiversified and vulnerable structure of...
Ariane Manuela AMIN; Choumert, Johanna
The current study seeks to provide a sound analysis of the relationship between economic development and species loss in Sub-Saharan African countries. The motivation is that a better understanding of the impact of economic development on species loss is of great relevance, given the current rapid extinction of species along with challenges born from the context of economic development in poor countries. The analysis draws on the most up-to-date data on threatened species from 48 sub-Saharan ...
Wada, Y.; Luan, Y.; Fischer, G.; Sun, L.; Shi, P.
Forcing with the population growth and consequently increasing food requirement, food security in sub-Saharan Africa is one of the most emergent and challenging issues. The purposes of this work are 1) what's the future food requirement and their food security status in each sub-Saharan African countries? What is the distance from current and future food security status, corresponding to the food requirement, to the targeted food security status? 2) To what extent Sub-Saharan countries could meet their present and future food requirement, and whether they have potential to improve their food insecurity status on currently cultivated land? 3) Whether or, if there have, how the pressures on land resources from meeting the food requirements? To figure those questions out, we firstly use socio-economic pathways datasets, and historical food diet pattern classification to forecast the 2010-2050 food commodity and feed calories demand per country. A new food security indicator, which considered the influences of both the food energy and quality intake, was used to evaluate the food insecurity status and the distances to different targeted statuses of the specific country. The latest Global Agro-Ecological Zones (GAEZ) databases were used to estimate the current and future crop yield gap and crop potential production. For current to future scenario analysis, we considered population growth, dietary change, climate change, agricultural input level, and target food security status. Then the balance of food requirement with the current and potential crop production was analyzed for different scenarios. Land requirements were calculated for meeting those food requirements, and the pressures on land resources are evaluated. Our works are hoping to provide scientific-based evidences for policy recommendations for local government to tackle food insecurity problems in Sub-Saharan Africa.
Hoeve ten, Marieke
Poverty reduction is one of the main Millennium Development Goals (United Nations, 2000). Sub-Saharan Africa is the region with the highest prevalence of poverty. Almost half the population lives in extreme poverty (Chen & Ravillion, 2004; UN, 2005). Pove
This paper argues that Sub-Saharan Africa needs to produce more journals indexed by ISI Web of Science (WoS). Researchers from the region should also publish in other ISI indexed, reputable and high impact journals such as Nature and Science. Inevitably, this will make Sub-Saharan African researchers visible and globally competitive. The Sub- Saharan African region has only about 40 journals out of over 12 000 journals that have been indexed by the ISI Web of Science (WoS). Arg...
Dillon, David G; Gurdasani, Deepti; Riha, Johanna;
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.......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....
Porter, G.; Hampshire, K; Abane, A.; Robson, E.; Munthali, A; Mashiri, M.; Tanle, A.; Maponya, A.; Dube, S
Young people’s mobility challenges in Western contexts have been the focus of research for some decades, principally – but not only – with reference to the school journey. By contrast, young people’s mobility in sub-Saharan Africa is remarkably under-researched, despite the vital significance of mobility (and immobility) to so many children’s lives. This is an extremely important omission, given that over half the population of many African countries consists of children and young people. Im...
Ademola Samson Adewoyin
Full Text Available Sickle cell disease (SCD predominates in sub-Saharan Africa, East Mediterranean areas, Middle East, and India. Nigeria, being the most populous black nation in the world, bears its greatest burden in sub-Saharan Africa. The last few decades have witnessed remarkable scientific progress in the understanding of the complex pathophysiology of the disease. Improved clinical insights have heralded development and establishment of disease modifying interventions such as chronic blood transfusions, hydroxyurea therapy, and haemopoietic stem cell transplantation. Coupled with parallel improvements in general supportive, symptomatic, and preventive measures, current evidence reveals remarkable appreciation in quality of life among affected individuals in developed nations. Currently, in Nigeria and other West African states, treatment and control of SCD are largely suboptimal. Improved knowledge regarding SCD phenotypes and its comprehensive care among Nigerian physicians will enhance quality of care for affected persons. This paper therefore provides a review on the aetiopathogenesis, clinical manifestations, and management of SCD in Nigeria, with a focus on its local patterns and peculiarities. Established treatment guidelines as appropriate in the Nigerian setting are proffered, as well as recommendations for improving care of affected persons.
Lo, Nathan C; Lowe, Anita; Bendavid, Eran
The President's Emergency Plan for AIDS Relief (PEPFAR) has been the largest funder of abstinence and faithfulness programming in sub-Saharan Africa, with a cumulative investment of over US $1.4 billion in the period 2004-13. We examined whether PEPFAR funding for abstinence and faithfulness programs, which aimed to reduce the risk of HIV transmission, was associated with a relative change in five outcomes indicative of high-risk sexual behavior: number of sexual partners in the past twelve months for men and for women, age at first sexual intercourse for men and for women, and teenage pregnancies. Using nationally representative surveys from twenty-two sub-Saharan African countries, we compared trends between people living in countries that received PEPFAR abstinence and faithfulness funding and those living in countries that did not in the period 1998-2013. We found no evidence to suggest that PEPFAR funding was associated with population-level reductions in any of the five outcomes. These results suggest that alternative funding priorities for HIV prevention may yield greater health benefits. PMID:27140992
Mabogunje, A L
Countries in sub-Saharan Africa are doing some rethinking, after decades of development that have resulted in continued poverty, international indebtedness, environmental degradation, and inappropriate Western models. Technological innovations, institutional developments, and family planning are key inputs. Development should shift to a focus on elimination of widespread poverty. Past development strategies in an African context of ample resources have harmed the environment without improving the average person's standard of living. Knowledge about Africa's environment and environmental degradation is inadequate. Recent studies have found, contrary to popular belief, that small shareholders made considerable investments in resource-based capital, which protected their farms from major environmental deterioration and negative impacts of intensification. In Nigeria field studies found that rising demand for fuelwood did not lead to greater deforestation or desertification. Severe degradation has occurred in places where density of population is greater than 500 persons per sq. km, where the land is physically or biologically vulnerable, and where socioeconomic conditions interfere with application of conservation measures. Reduced well-being and reduced food capacity is attributed to land tenure arrangements, misguided macroeconomic policies, and inadequate infrastructure. The issues of development, environment, and population are complex. Sustainable development is possible with appropriate investment priorities that will provide needed infrastructure, services, and education. Urban areas need safe water, solid waste disposal, and spatial planning to relieve congested spaces. Rural areas should focus on health education and basic sanitation. Regulatory measures and conservation measures are also important. Institutional development that promotes democracy, expands individual property rights, and increases the knowledge base offers the most hope for alleviating
Midling, Michael B
The majority of Africans still live in rural areas, and an astonishing one in three Africans, or 215 million people, are malnourished. At the same time, eleven African countries use less than half the arable land within their borders (Economist). 62% of Africa’s population (excluding South Africa) works in agriculture, generating 27% of these countries’ GDP. An astonishing 80% of Africans depend on subsistence agriculture to provide food for their families (Bunting). An agriculture-led strate...
González-Santos, Miguel; Montinaro, Francesco; Oosthuizen, Ockie; Oosthuizen, Erica; Busby, George B.J.; Anagnostou, Paolo; Destro-Bisol, Giovanni; Pascali, Vincenzo; Capelli, Cristian
The expansion of Bantu-speaking agropastoralist populations had a great impact on the genetic, linguistic, and cultural variation of sub-Saharan Africa. It is generally accepted that Bantu languages originated in an area around the present border between Cameroon and Nigeria approximately 5,000 years ago, from where they spread South and East becoming the largest African linguistic branch. The demic consequences of this event are reflected in the relatively high genetic homogeneity observed across most of sub-Saharan Africa populations. In this work, we explored genome-wide single nucleotide polymorphism data from 28 populations to characterize the genetic components present in sub-Saharan African populations. Combining novel data from four Southern African populations with previously published results, we reject the hypothesis that the “non-Bantu” genetic component reported in South-Eastern Africa (Mozambique) reflects extensive gene flow between incoming agriculturalist and resident hunter-gatherer communities. We alternatively suggest that this novel component is the result of demographic dynamics associated with the Bantu dispersal. PMID:26363465
Olurotimi A Adejumo
Full Text Available 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
Diaspora networks' role in supporting and stimulating entrepreneurial activities in Sub-Saharan African (SSA) economies need hardly be elaborated. For instance, some SSA countries have established government agencies to encourage diasporas to help local communities and provide policy advice. At the 2003 Extra-Ordinary Summit of the Assembly of Heads of State and Governments, the African Union (AU) amended Article Three of its Constitutive Act to invite and encourage African diaspora's active ...
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…
Shigeyuki Hamori; Ivohasina Razafimahefa
This paper empirically analyzes the determinants of foreign direct investment for Sub-Saharan African countries and other some developing countries. Our results suggest that both productivity-related policy and exchange rate policy can be effective in sharpening FDI competitiveness, i.e., in attracting foreign investments.
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 ...
Gruca, Marta; van Andel, Tinde; Balslev, Henrik
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...
Bryceson, Deborah Fahy
Drawing on research findings emanating from the De-Agrarianisation and Rural Employment (DARE) Research Programme, coordinated by the African Studies Centre, Leiden, this paper compares changing economic and social patterns in a wide variety of rural settlements in sub-Saharan Africa. Recently emerg
Rates of primary enrollment, female primary enrollment, private school enrollment, and literacy during 1960-92 were analyzed for 39 sub-Saharan African countries. Throughout the period, strongly Christian countries had higher enrollment and literacy rates than strongly Islamic countries, regardless of economic level, type of state, or colonial…
This contribution aims to analyze Sub-Saharan women’s migration with a special focus on highly skilled women in order to create a framework to better understand the different factors shaping migration patterns, such as the push and pull factors, the increase of flows and the complexity associated with them. In recent years the number of female Sub-Saharan migrants has grown at a rate much higher than the global average. In fact, in 2010 alone the number of female African migrants was 47.2%...
In this report, the author aims at highlighting the main success factors for a photovoltaic program in sub-Saharan Africa, and the benefits of this technology for African electricity operators. He first presents the electricity sector of Sub-Saharan Africa, its current situation, its scenarios of evolution, and the limitations of scenarios based on conventional energies. In a second part, he discusses the role photovoltaic solar energy could have within the energy mix of Sub-Saharan countries. He discusses how to calculate the cost of photovoltaic electricity production, and the value of photovoltaic electricity, discusses the main influencing parameters, and tries to identify when it becomes worth to choose photovoltaic electricity. He describes the implementation of an adapted legal and economic framework, the 'feed-in-tariff'. An appendix contains a proposition for Western Africa and analyses the case of Benin
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 Introduction: Antiretrovirals are available at low prices in sub-Saharan Africa, but these prices may not be consistently available for middle-income countries in other regions with large HIV epidemics. Over 30% of HIV infected people live in countries outside sub-Saharan Africa. Several key antiretrovirals are still on patent, with generic production restricted. We assessed price variations for key antiretroviral drugs inside versus outside sub-Saharan Africa. Methods: HIV drug prices used in national programmes (2010–2014 were extracted from the WHO Global Price Reporting Mechanism database for all reporting middle-income countries as classified by the World Bank. Treatment costs (branded and generic were compared for countries inside sub-Saharan Africa versus those outside. Five key second-line antiretrovirals were analysed: abacavir, atazanavir, darunavir, lopinavir/ritonavir, raltegravir. Results: Prices of branded antiretrovirals were significantly higher outside sub-Saharan Africa (p<0.001, adjusted for year of purchase (see Table 1. For example, the median (interquartile range price of darunavir from Janssen was $732 (IQR $732-806 per person-year in sub-Saharan Africa versus $4689 (IQR $4075-5717 in non-African middle-income countries, an increase of 541%. However, when supplied by generic companies, most antiretrovirals were similarly priced between countries in sub-Saharan Africa and other regions. Conclusions: Pharmaceutical companies are selling antiretrovirals to non-African middle-income countries at prices 74–541% higher than African countries with similar gross national incomes. However, generic companies are selling most of these drugs at similar prices across regions. Mechanisms to ensure fair pricing for patented antiretrovirals across both African and non-African middle-income countries need to be improved, to ensure sustainable treatment access.
Full Text Available Accounts by journalists of wars in several countries of sub-Saharan Africa in the 1990s have raised concern that ethnic cleavages and overlapping religious and racial affiliations may widen the inequalities in health and survival among ethnic groups throughout the region, particularly among children. Paradoxically, there has been no systematic examination of ethnic inequality in child survival chances across countries in the region. This paper uses survey data collected in the 1990s in 11 countries (Central African Republic, Côte d’Ivoire, Ghana, Kenya, Mali, Namibia, Niger, Rwanda, Senegal, Uganda, and Zambia to examine whether ethnic inequality in child mortality has been present and spreading in sub-Saharan Africa since the 1980s. The focus was on one or two groups in each country which may have experienced distinct child health and survival chances, compared to the rest of the national population, as a result of their geographical location. The factors examined to explain potential child survival inequalities among ethnic groups included residence in the largest city, household economic conditions, educational attainment and nutritional status of the mothers, use of modern maternal and child health services including immunization, and patterns of fertility and migration. The results show remarkable consistency. In all 11 countries there were significant differentials between ethnic groups in the odds of dying during infancy or before the age of 5 years. Multivariate analysis shows that ethnic child mortality differences are closely linked with economic inequality in many countries, and perhaps with differential use of child health services in countries of the Sahel region. Strong and consistent results in this study support placing the notion of ethnicity at the forefront of theories and analyses of child mortality in Africa which incorporate social, and not purely epidemiological, considerations. Moreover, the typical advantage of
Published by Palgrave Macmillan Over 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...
Ángel Pérez González
The contributions made by theory on democratic consolidation in Eastern Europe are also pertinent to analysis of processes of democratization and democratic consolidation in other areas, such as sub-Saharan Africa. The parameters of analysis highlight the importance of a strong state (organized, with legitimated institutions) and a structured society (whether multiethnic or not) as necessary conditions for democratization. On the assumption that the colonizing powers basically used two models...
The United Nations Millennium Development Goals (MDGs) project is coming to an end in 2015 and is being replaced by ambitious and aspirational Sustainable Development Goals (SDGs). Although the MDGs have been nearly achieved, this is not true in Sub-Saharan Africa where there is still unnecessarily high infant and childhood mortality and where there are many challenges to providing modern child health care. To achieve the SDGs in the next fifteen years, in low-income countries, national minis...
It is essential that the precautions that are advisable for travel in sub-Saharan Africa, including antimalarial prophylaxis, are supported by evidence. Sub-Saharan Africa accounts for 90% of global malaria cases and the more serious falciparum form predominates. The risk of malaria transmission is qualitatively much greater in rural than urban areas. However, there is little quantitative data on the risk in urban areas on which to base a risk assessment. Rapid urban population growth and trends of tourism to urban-only (rather than rural) areas both support the need to focus attention on the level of risk in malaria endemic African cities. There is evidence in urban settings that the reduced intensity of malaria transmission is due to a decline in the level of parasitism in the local population and reduced anophelism. The most useful evidence for an urban risk assessment is the entomological inoculation rate (EIR) which is generally below 30 infective bites per person per year. Transmission is acknowledged to be much lower in central urban areas compared with peri-urban areas or rural areas. Transmission is local and focal because the anopheles mosquito has a limited flight range of several kilometres. The risk assessment should examine nocturnal activities outside an air-conditioned environment (because the anopheline mosquito only bites between dusk and dawn) and the level of adherence to accompanying protective measures. Several studies have noted the protection air-conditioning provides against malaria. Evidence of low occupational risk for airline crew, unprotected by prophylaxis, from brief layovers of several nights in quality hotels in 8 endemic cities is explored. A literature search examines the evidence of environmental surveys and entomological inoculation rates. The limitations of the available data are discussed, including the highly focal nature of malaria transmission. PMID:17298922
Armando Barrientos, David Hulme and Miguel Nino-Zarazua
Historically social protection in sub-Saharan Africa has focused on risk management and in particular on food aid, food insecurity and famine or disaster relief. During the 1990s a ???Southern African model??? of social protection has evolved centred on non-contributory pensions for poor, elderly people (and their households). This has diffused from South Africa to neighbouring states and, in South Africa, has been extended into the Child Support Grant. The Southern African model is largely f...
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.
Buys, Piet; Deichmann, Uwe; Wheeler, David
Recent research suggests that isolation from regional and international markets has contributed significantly to poverty in many Sub-Saharan African countries. Numerous empirical studies identify poor transport infrastructure and border restrictions as significant deterrents to trade expansion. In response, the African Development Bank has proposed an integrated network of functional roads for the subcontinent. Drawing on new econometric results, the authors quantify the trade-expansion poten...
Schneider, William H; Drucker, Ernest
Blood transfusions transmit HIV more effectively than other means, yet there has been little examination of their role in the origins and early course of AIDS in sub-Saharan Africa. We review historical data in archives, government reports, and medical literature from African and European sources documenting the introduction, establishment, use, and growth of blood transfusions in sub-Saharan Africa. These data allow estimation of the geographic diffusion and growth of blood transfusions between 1940 and 1990. By 1955, 19 African colonies and countries reported transfusion programs-with national rates of 718 to 1372 per 100 000 by 1964, and urban rates similar to those in developed countries. We estimated 1 million transfusions per year in sub-Saharan Africa by 1970 and 2 million per year by the 1980s, indicating that transfusions were widely used throughout sub-Saharan Africa during the crucial period of 1950-1970, when all epidemic strains of HIV first emerged in this region. PMID:16670233
Walker, A R; Adam, F I
The World Health Organization (WHO) has stressed that 1.5 million infants die annually, unnecessarily, from deprival or from insufficiency of breast milk. Hence, the need for its maximal use, very particularly in impoverished populations, such as those in sub-Saharan Africa. In many developed populations, a generation ago the practice was very low, but now it has risen considerably. In contrast, in Africa and in most developing populations, despite the far greater need for breast-feeding, the practice is tending to decrease, especially among urban mothers. While the most common reasons given concern insufficiency of breast milk and employment of mothers, the latter, especially urban mothers, are under strong and increasing pressure to use proprietary replacement foods. These are often made up unsatisfactorily and are contaminated. Also influential are the often less than enthusiastic, and confusing, attitudes of staff at clinics and hospitals, albeit, due in part to their very heavy workloads. Additionally, there is society's relatively indifferent attitude to breast-feeding. Currently, a hugely adverse factor is the danger of human immunodeficiency virus (HIV) transference from seropositive mothers to their infants - in some African countries almost half of antenatal mothers are infected. Chances of early control of the infection are remote. However, apart from this danger, and from the pressure from replacement food companies, the outlook for breast-feeding practice in many African countries is unlikely to improve significantly until greater encouragement is given from State, local and other health authorities. PMID:10979148
.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¢Â€Âœmagic bulletÃ¢Â€Â 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.
Though evidencing a power demand which is amongst the lowest in the world, the sub-Saharan regions of Africa are blessed with an enormous hydroelectric power resource potential, which, if suitably developed and tapped, may become a source of economic electric energy for Europe. With the aid of numerous statistical supply and demand data, this paper surveys the marketing potential of this energy source in Africa. The analysis of future development prospects is carried out with reference to the local socio-economic framework
Husain, Ishrat; DEC
Trade, aid, and investment are more inextricably linked in sub-Saharan Africa than anywhere else in the world, contends the author, whose survey of sub-Saharan Africa's prospects for trade, aid, and investment lead to the following broad conclusions. Developing an outward orientation, improving competitiveness, and recapturing its lost share in world markets offers a higher potential payoff than any other strategy for growth and sustainable development in sub-Saharan countries. If the region ...
HASHIGUCHI, Yoshihiro; Hamori, Shigeyuki
This paper investigates the sustainability of trade balances in the Sub-Saharan African regions, using both the panel unit root (IPS) test proposed by Im et al. (2003) and the cross-sectionally augmented version of the IPS (CIPS test) suggested by Pesaran (2007), where the former test is based on the assumption of cross-section independence and the latter allows for it. On the one hand, the empirical results based on the IPS test indicate that the balance of trade in Sub-Saharan African regio...
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
Full Text Available The United Nations (UN was founded to ‘to save succeeding generations from the scourge of war’.1 However, the post-independence history of sub-Saharan Africa has demonstrated that the international community, or lack of an international society, has so far been unable to protect the African continent from this ‘scourge’, or indeed from itself. A number of reasons may be suggested for this, including the organisation of the international community into a number of sovereign independent states, the inability of some of these territorial sovereignties to act and function as states, the formal political and economic crisis and marginalisation of especially sub-Saharan Africa, and finally the history of the continent. Accordingly, this article has two major objectives. The article will illustrate how state failure and intrastate asymmetric warfare alters and undermines the Westphalian concept of state in sub-Saharan Africa. Furthermore it attempts to show that the way in which the concept of ‘national sovereignty’ is understood is changing, and that this might have instrumental implications for future interstate relations in sub-Saharan Africa.
Full Text Available This contribution aims to analyze Sub-Saharan women’s migration with a special focus on highly skilled women in order to create a framework to better understand the different factors shaping migration patterns, such as the push and pull factors, the increase of flows and the complexity associated with them. In recent years the number of female Sub-Saharan migrants has grown at a rate much higher than the global average. In fact, in 2010 alone the number of female African migrants was 47.2% (World Bank, 2012, showing an increase of 5.2% since the 1960’s when women constituted 42% of the total migration from Sub-Saharan Africa. The feminization of migration flows from Sub-Saharan Africa (SSA in recent years has also witnessed a diversification of the flows. One specific segment on the rise is labor migration, specifically, highly skilled migration, especially for tertiary students and physicians and nurses. The study explores social geography and the geography of migration. The author considers two dimensions of analysis: women’s migration patterns from SSA (with a special focus on the impacts of the flows and highly skilled migration from SSA.
Samuel Munalula Munjita
Full Text Available Noroviruses are a leading cause of acute sporadic gastroenteritis worldwide. In Sub-Saharan Africa, information regarding norovirus infections in children is scarce. A systematic review of studies performed between 1993 and June 2015 was conducted to establish the genotypic distribution and prevalence of norovirus infections in children (≤17 in Sub-Saharan Africa. Analysis of data from 19 studies involving 8,399 samples from children with symptomatic and nonsymptomatic gastroenteritis revealed prevalence of 12.6% (range 4.6% to 32.4%. The prevalence of norovirus infections was higher in symptomatic children (14.2% than asymptomatic children (9.2%. Genogroup II (GII was the most prevalent genogroup accounting for 76.4% of all the reported norovirus infections. The rest of the infections were GI (21.7% and GI/GII (1.9%. The most common genotypes were GII.4 (65.2%, GI.7 (33.3%, and GI.3 (21.3%. These statistics were calculated from studies carried out in 12 out of 48 Sub-Saharan African countries. Therefore, more studies involving several countries are required to determine fully the epidemiology of noroviruses and their contribution to childhood diarrhoea in Sub-Saharan Africa.
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
Ángel Pérez González
Full Text Available The contributions made by theory on democratic consolidation in Eastern Europe are also pertinent to analysis of processes of democratization and democratic consolidation in other areas, such as sub-Saharan Africa. The parameters of analysis highlight the importance of a strong state (organized, with legitimated institutions and a structured society (whether multiethnic or not as necessary conditions for democratization. On the assumption that the colonizing powers basically used two models –the French assimilationist model and the British indirect government model– the study of how these conditions were fulfilled in various sub-Saharan states leads to two conclusions: the first, the possibility of a process of democratization in those states where European (French colonization produced a total assimilation of the colonized society, including above all the colonizer’s political values; and the second, the possibility of processes of democratization in states produced by British colonization where the indigenous structures and those of the metropolis were superimposed, a phenomenon which allowed the application of democratic values by legitimated local institutions.
Schneider, William H
The adequacy and safety of blood transfusion in sub-Saharan Africa is the subject of much concern, yet there have been very few studies of its history. An overview of that record finds that transfusions were first reported in Africa (sub-Saharan and excluding South Africa) in the early 1920s, and organized transfusion practices were established before the Second World War. Blood transfusion grew rapidly after 1945, along with the construction of new hospitals and expanded health services in Africa. Significant differences existed between colonial powers in the organization of transfusion services, but these converged after independence as their use continued to grow and decentralized and hospital-based practices were adopted. It was only after the oil crisis in the mid-1970s that health spending declined and the collection, testing, and transfusion of blood began to level off. Thus, when the AIDS crisis hit transfusion services, they were already struggling to meet the needs of patients. At this time, foreign assistance as well as the World Health Organization and the League of Red Cross Societies helped respond to both the immediate problem of testing blood, and for some countries, support existed for the broader reorganization of transfusion. Overall, the history shows that transfusion was adopted widely and quickly, limited mainly by the availability of knowledgeable doctors and hospital facilities. There was less resistance than expected by Africans to receive transfusions, and the record shows a remarkable flexibility in obtaining blood. The dangers of disease transmission were recognized from an early date but were balanced against the potential lifesaving benefits of transfusion. PMID:22981696
Family planning programs in sub-Saharan Africa (42 countries and 450 million population), the fastest growing and poorest region in the world, need effective communications campaigns to educate people about the benefits of contraception, help change attitudes about fertility control and family size, and provide information about available…
Folasayo Fayose; Zhongjie Huan
Heat pump technology has been used for heating, ventilation, and air-conditioning in domestic and industrial sectors in most developed countries of the world including South Africa. However, heat pump drying (HPD) of fruits and vegetables has been largely unexploited in South Africa and by extension to the sub-Saharan African region. Although studies on heat pump drying started in South Africa several years ago, not much progress has been recorded to date. Many potential users view heat pump ...
Coneus, Katja; Mühlenweg, Andrea M.
In this paper, we examine how orphanhood affects children’s educational and health outcomes in eleven sub-Saharan African countries. Our analysis is based on a comparison of orphans and non-orphaned children living under the same conditions. We also examine the impacts of various family structures and compare social orphans (non-orphaned children not living with a biological parent) to orphans. Using household fixed-effects estimation, we provide evidence that children not living with a biolo...
Buijtenhuijs, Rob; Rijnierse, Elly
This report gives an overview of the literature on recent democratization processes in sub-Saharan Africa (1989-1992). The authors first deal with the basic features of African politics that can serve as a framework within which present-day democratization developments can be comprehended. Then they describe the fundamental debates on democracy in Africa which took place in the academic community in the period 1960-1989. These debates, whose origins lie in the independence movements, focused ...
At the heart of state sovereignty is a tension. On one hand it promises collective freedom and autonomy. On the other hand, sovereignty is laden with expectations. One of the most important of these, which comes from international society itself, is that states will pursue a project of national development. When the states of Sub-Saharan African achieved formal independence, they therefore became enmeshed in institutions and practices that demanded of them that they pursued a national develop...
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 ...
Gomes, Joseph Flavian
We show that ethnic distances can explain the ethnic inequalities in child mortality rates in Africa. Using individual level micro data from DHS surveys for fourteen Sub-Saharan African countries combined with a novel high resolution dataset on the spatial distribution of ethnic groups we show that children whose mothers have a higher linguistic distance from their neighbours have a higher probability of dying. Fractionalization reduces the probability of child death. We argue that fractional...
Foreign direct investment (FDI) in the apparel sector in several Sub-Saharan African (SSA) countries has experienced significant growth in the context of preferential market access. But expectations of FDI leading to spillovers to the local economy and the development of locally-embedded apparel export industries have not materialized. A shift from FDI attraction through fiscal incentives to more strategic industrial policies that target FDI spillovers, local value added and linkages is urgen...
Sjaastad, E.; Bromley, D.W.
Metadata only record We discuss the links between rights appropriation, tenure security, and investment demand in sub-Saharan Africa. Common assertions regarding indigenous tenure are: (a) insecurity of tenure leads to suboptimal investment incentives; and (b) appropriation of land rights in the public domain in rent-dissipating. We argue that land use and investment decisions among African farmers often have two motives--productivity and rights appropriation. The usual assertions thus see...
Background Armed conflict has been described as creating a public health problem and an important contributor to the social and political determinants of health and a driver of poverty and health inequity. Of the armed conflicts that have taken place since World War II, about 90% have been in developing countries, with Sub Saharan African (SSA) countries experiencing more conflicts than any other region of the world. The impact of these conflicts on health systems often extends beyond the ...
Lavallée, Emmanuelle; Razafindrakoto, Mireille; Roubaud, François
(english) This paper analyzes the impact of corruption on the extent of trust in political institutions using a rich collection of comparable data provided by the Afrobarometer surveys conducted in 18 sub-Saharan African countries. More specifically, we set out to test the “efficient grease” hypothesis that corruption can strengthen citizens’ trust since bribe paying and clientelism open the door to otherwise scarce and inaccessible services and subsidies, and that this increases institutiona...
In the light of the current global financial and economic crises, how would governments in sub-Saharan Africa (SSA) allocate their budgets across sectors in response to a binding debt-servicing constraint? Within a framework of public-expenditure choice, the present paper estimates constraint-consistent debt-service ratios and employs them in Seemingly Unrelated Regression involving five-year panel for up to 35 African countries over 1975-94, a period preceding the Highly Indebted Poor Coun...
Botswana, Ghana, Mauritius and South Africa are sub-Saharan African countries that stand out for their development progress. Each of these countries has succeeded against the odds, against expectations. This paper synthesizes the common ingredients of these countries' success, and derives lessons. It concludes that smallness, landlockedness, tropical location, distance from world markets, racism, colonialism and other challenges can be overcome through appropriate institutions, governance and...
Background More than 60 years ago the international community declared literacy a basic human right. Recognition of its intrinsic value and evidence of its social and economic benefits have motivated an expansive international effort to estimate the percentage of adults that can read, especially in low-income countries where educational opportunities are limited. Population data on adults' educational attainment is commonly used to approximate adult literacy rates. Though increasing evidence from school-based studies of pupils confirm literacy achievement is not universal - even at advanced grades - it remains unclear whether adults' educational attainment is reflective of their literacy. Objective This study leverages population-based data that include direct assessments of adults' literacy skills to provide a descriptive account of the proportion of adults that can read at each level of educational attainment. The study focuses on the Sub-Saharan African context, a world region where school participation has expanded rapidly in the last three decades. Because many African adults have discontinued their education at the primary level, the study focuses on basic reading skills at each level of primary school. The study focuses specifically on women, whose literacy has garnered extensive international interest. Results Demographic and Health Survey data from 31 African countries confirm that there are many instances in which women have several years of primary school but cannot read. In fact, in some countries, large proportions of African women who never went to school can read, even as some of their peers who have completed primary school cannot. The weak correlation between educational attainment and literacy is not specific to older cohorts of women, but is also observed among younger women. Conclusion The findings demonstrate that educational attainment is generally a poor proxy for literacy, highlighting the need to measure, theorize, and study literacy as
Chad, like many other sub-Saharan African countries, depends for most of its energy demand on woodfuels; 90% or more of the country's energy balance comes from biomass energy. Obvious environmental problems appear around cities because of their highly concentrated demand, and this threatens the sustainability of supply. But, this does not need to be a problem, and woodfuel can also be an engine of economic growth, particularly in rural areas. A few policy conditions will need to be satisfied and in Chad this appears to be the case. As a result, the woodfuel supply of the capital N'Djamena could become sustainable, thereby continuing to provide low-cost energy to the urban population for the foreseeable future while giving income generation opportunities in rural areas. A win-win situation?!
Mahmud, Ousman; Dates, Centdrika; Akil, Luma; Ahmad, Hafiz A
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 (PUnited States, but were significantly lower when compared to South Africa (PUnited 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. PMID:21776244
Climate change is projected to adversely impact different parts of the world to varying extents. Preliminary studies show that Sub-Saharan Africa is particularly vulnerable to climate change impacts, including changes to precipitation levels and temperatures. This work will analyse the effect of changes in temperature on critical systems such as energy supply and demand. Factors that determine energy demand include income, population, temperature (represented by cooling and heating degree days), and household structures. With many countries in Sub-Saharan Africa projected to experience rapid growth in both income and population levels, this study aims to quantify the amplified effects of these factors - coupled with temperature changes - on energy demand. The temperature effects will be studied across a range of scenarios for each of the factors mentioned above, and identify which of the factors is likely to have the most significant impact on energy demand in Sub-Saharan Africa. Results of this study can help set priorities for decision-makers to enhance the climate resilience of critical infrastructure in Sub-Saharan Africa.
Obiero, Walter; Marisa R Young; Robert C Bailey
Background Male circumcision (MC) reduces the risk of heterosexual HIV acquisition in men by approximately 60%. MC programs for HIV prevention are currently being scaled-up in fourteen countries in sub-Saharan Africa. The current standard surgical technique for MC in many sub-Saharan African countries is the forceps-guided male circumcision (FGMC) method. The PrePex male circumcision (PMC) method could replace FGMC and potentially reduce MC programming costs. We compared the potential costs o...
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..
Samanta Tresha Lalla-Edward
Full Text Available Truck drivers have unique health needs, and by virtue of their continuous travel, experience difficulty in accessing healthcare. Currently, planning for effective care is hindered by lack of knowledge about their health needs and about the impact of on-going programmes on this population's health outcomes. We reviewed healthcare programmes implemented for sub-Saharan African truck drivers, assessed the evaluation methods, and examined impact on health outcomes.We searched scientific and institutional databases, and online search engines to include all publications describing a healthcare programme in sub-Saharan Africa where the main clients were truck drivers. We consulted experts and organisations working with mobile populations to identify unpublished reports. Forest plots of impact and outcome indicators with unadjusted risk ratios and 95% confidence intervals were created to map the impact of these programmes. We performed a subgroup analysis by type of indicator using a random-effects model to assess between-study heterogeneity. We conducted a sensitivity analysis to examine both the summary effect estimate chosen (risk difference vs. risk ratio and model to summarise results (fixed vs. random effects.Thirty-seven publications describing 22 healthcare programmes across 30 countries were included from 5,599 unique records. All programmes had an HIV-prevention focus with only three expanding their services to cover conditions other primary healthcare services. Twelve programmes were evaluated and most evaluations assessed changes in input, output, and outcome indicators. Absence of comparison groups, preventing attribution of the effect observed to the programme and lack of biologically confirmed outcomes were the main limitations. Four programmes estimated a quantitative change in HIV prevalence or reported STI incidence, with mixed results, and one provided anecdotal evidence of changes in AIDS-related mortality and social norms. Most
Connell, John; Zurn, Pascal; Stilwell, Barbara; Awases, Magda; Braichet, Jean-Marc
Migration of skilled health workers from sub-Saharan African countries has significantly increased in this century, with most countries becoming sources of migrants. Despite the growing problem of health worker migration for the effective functioning of health care systems there is a remarkable paucity and incompleteness of data. Hence, it is difficult to determine the real extent of migration from, and within, Africa, and thus develop effective forecasting or remedial policies. This global overview and the most comprehensive data indicate that the key destinations remain the USA and the UK, and that major sources are South Africa and Nigeria, but in both contexts there is now greater diversity. Migrants move primarily for economic reasons, and increasingly choose health careers because they offer migration prospects. Migration has been at considerable economic cost, it has depleted workforces, diminished the effectiveness of health care delivery and reduced the morale of the remaining workforce. Countries have sought to implement national policies to manage migration, mitigate its harmful impacts and strengthen African health care systems. Recipient countries have been reluctant to establish effective ethical codes of recruitment practice, or other forms of compensation or technology transfer, hence migration is likely to increase further in the future, diminishing the possibility of achieving the United Nations millennium development goals and exacerbating existing inequalities in access to adequate health care. PMID:17316943
Prof. Wasiu A Olowu, MBBS; Prof. Abdou Niang, MD; Charlotte Osafo, MBChB; Prof. Gloria Ashuntantang, MD; Prof. Fatiu A Arogundade, MBBS; Prof. John Porter, MD; Prof. Saraladevi Naicker, MBChB; Dr. Valerie A Luyckx, MBBCh
Background: Access to diagnosis and dialysis for acute kidney injury can be life-saving, but can be prohibitively expensive in low-income settings. The burden of acute kidney injury in sub-Saharan Africa is presumably high but remains unknown. We did a systematic review to assess outcomes of acute kidney injury in sub-Saharan Africa and identify barriers to care. Methods: We searched PubMed, African Journals Online, WHO Global Health Library, and Web of Science for articles published betwe...
Microfinance is the provision of credit/loans to poor individuals for the purpose of income generation. The Sub-Saharan African region which is among the poorest areas in the world is thought to be one of the regions where the microfinance industry is dynamic and growing in terms of acceptance and patronage. Even though microfinance in the Sub-Saharan Africa region has received a lot of research attention, most have focused largely on the financial performance whilst there is no available inf...
Williams, Brian G.; de Vlas, Sake J.; Gouws, Eleanor; Gilks, Charles F.; Ghys, Peter D.; Nahlen, Bernard L.
We assessed the impact of HIV-1 on malaria in the sub-Saharan African population. Relative risks for malaria in HIV-infected persons, derived from literature review, were applied to the HIV-infected population in each country, by age group, stratum of CD4 cell count, and urban versus rural residence. Distributions of CD4 counts among HIV-infected persons were modeled assuming a linear decline in CD4 after seroconversion. Averaged across 41 countries, the impact of HIV-1 was limited (although quantitatively uncertain) because of the different geographic distributions and contrasting age patterns of the 2 diseases. However, in Botswana, Zimbabwe, Swaziland, South Africa, and Namibia, the incidence of clinical malaria increased by <28% (95% confidence interval [CI] 14%–47%) and death increased by <114% (95% CI 37%–188%). These effects were due to high HIV-1 prevalence in rural areas and the locally unstable nature of malaria transmission that results in a high proportion of adult cases. PMID:16229771
Early in the study of HIV/AIDS, culture was invoked to explain differences in the disease patterns between sub-Saharan Africa and Western countries. Unfortunately, in an attempt to explain the statistics, many of the presumed risk factors were impugned in the absence of evidence. Many cultural practices were stripped of their meanings, societal context and historical positioning and transformed into cofactors of disease. Other supposedly beneficial cultural traits were used to explain the absence of disease in certain populations, implicitly blaming victims in other groups. Despite years of study, assumptions about culture as a cofactor in the spread of HIV/AIDS have persisted, despite a lack of empirical evidence. In recent years, more and more ideas about cultural causality have been called into question, and often disproved by studies. Thus, in light of new evidence, a review of purported cultural causes of disease, enhanced by an understanding of the differences between individual and population risks, is both warranted and long overdue. The preponderance of evidence suggests that culture as a singular determinant in the African epidemic of HIV/AIDS falls flat when disabused of its biased and ethnocentric assumptions. PMID:23895330
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?.
Eberhard, Anton; Gratwick, Katharine; Morella, Elvira; Antmann, Pedro
Inadequate electricity services pose a major impediment to reducing extreme poverty and boosting shared prosperity in Sub-Saharan Africa. Simply put, Africa does not have enough power. Despite the abundant low-carbon and low-cost energy resources available to Sub-Saharan Africa, the region’s entire installed electricity capacity, at a little over 80 GW, is equivalent to that of the Republic of Korea. Looking ahead, Sub-Saharan Africa will need to ramp-up its power generation capacity sub...
Andel, van T.R.; Croft, S.; Loon, van E.E.; Quiroz Villarreal, D.K.; Towns, A.M.; Raes, N.
Sub-Saharan African human populations rely heavily on wild-harvested medicinal plants for their health. The trade in herbal medicine provides an income for many West African people, but little is known about the effects of commercial extraction on wild plant populations. Detailed distribution maps a
T.R. van Andel; S. Croft; E.E. van Loon; D. Quiroz; A.M. Towns; N. Raes
Sub-Saharan African human populations rely heavily on wild-harvested medicinal plants for their health. The trade in herbal medicine provides an income for many West African people, but little is known about the effects of commercial extraction on wild plant populations. Detailed distribution maps a
Full Text Available Over the last few decades, many states in sub-Saharan Africa have adopted draconian anti-migrant policies, leaving refugees and migrants vulnerable to violence, harassment, and economic exploitation. These policies represent a shift from the relatively hospitable attitude shown by many African nations in the immediate post-colonial period. Explanations at the local level do not adequately explain the pervasiveness of these changes or why many developing states are now replicating the migration discourse and practices of the global north. Drawing on scholarship and data from a number of states in the region, including Tanzania, Kenya, Ghana, and South Africa, this paper argues that owing to the widespread implementation of neoliberal economic policies, these states are now subject to many of the same incentives and constraints that operate in the developed north. As a result, political parties and business elites have used national migration policy as an instrument for enhancing their political and economic positions. Insofar as neoliberal globalization continues to exacerbate inequality within the developing world, the harsh measures taken by governments of developing countries against their refugee and migrant populations are likely to increase. It is therefore important that scholars of migration and human rights begin to reassess the prevailing, nearly exclusive emphasis in many globalization studies on the dehumanizing policies and exploitation of southern migrants by states in the global north, as such an emphasis risks obscuring the emergence of more complex patterns of migration and anti-migrant practices in the developing world.
Longitudinal studies and household surveys suggest that sub-Saharan Africa's (SSA's) HIV/AIDS crisis is not a pandemic of the poor but rather one of inequalities, where wealthier individuals are more likely to be infected as a result of greater mobility and multiple relationships (Fox, 2012). This is in sharp contrast to the situation in the United States, where HIV infections "are concentrated among the poor with very few people in the middle and upper social strata contracting HIV" (Pellowski, Kalichman, Matthews, & Adler, May-June 2013, p. 199). Yet from a global perspective, wherein SSA is the poorest region in the world, the pandemic is of course one of poverty as well as one with pronounced racial and gender disparities. Both the May-June 2013 special issue of the American Psychologist ("HIV/AIDS: Social Determinants and Health Disparities") and another American Psychologist special issue 25 years earlier ("Psychology and AIDS," November 1988) help shed light on Africa's HIV/AIDS crisis. PMID:24446856
Full Text Available The United Nations Millennium Development Goals (MDGs project is coming to an end in 2015 and is being replaced by ambitious and aspirational Sustainable Development Goals (SDGs. Although the MDGs have been nearly achieved, this is not true in Sub-Saharan Africa where there is still unnecessarily high infant and childhood mortality and where there are many challenges to providing modern child health care. To achieve the SDGs in the next fifteen years, in low-income countries, national ministries of health and community health leaders will need to set reasonable goals and quality improvement projects. Attention needs to paid to economical, evidence-based effective health care; to education of children and youth and of health professional; health promotion and prevention of illness; a balance between expensive health care in large urban hospitals and community health projects; and most importantly to the social determinants of health. But the SDGs are achievable with coordinated and sustained national commitments and increased financial commitments from Western countries.
Habte, Demissie; Dussault, Gilles; Dovlo, Delanyo
Sub-Saharan Africa and the international health community face a daunting challenge to deal with an extraordinary disease burden and improve the health status of Africans. Despite decades of effort to provide effective, equitable and affordable health care services, the health indices of Africans have stagnated and in some instances have deteriorated. Africa is the only continent that has not fully benefited from recent advances in biomedical sciences that brought health tools and technologies to tackle most of the disease burden. The emergence of the HIV/AIDS epidemic has confounded the health scene and posed further challenges. Several factors are responsible for this state of affairs: macro factors, that represent the broader socio-cultural environment that impact on health, and micro factors, which are largely health sector specific. There is increasing recognition that the major limiting factor to improved health outcomes is not lack of financial resources or health technologies but the lack of implementation capacity which depends on the presence of a functional health system. The drivers and architects of this are health workers, 'the most important of the health system's input'. The Commission on Macroeconomics and Health advocates a greatly increased investment in health rising in low income countries to a per capita expenditure of US $34 per year and states that the problem in implementing this recommendation is not difficulty in raising funds but the capacity of the health sector itself to absorb the increased flow. Yet, until fairly recently sufficient attention has not been directed to the role of the health workforce. The failure to develop and deploy an appropriate and motivated health workforce, and the environment necessary for the workforce to perform optimally is clearly a critical determinant of the health status of Africans. This paper summarizes key issues facing the workforce and outlines a framework to develop strategies to address them
Ehui, Simeon K.; Tsigas, Marinos E.
Sub-Saharan Africa (SSA) is the most important development challenge of the 21st century. Poverty is higher in most African countries than elsewhere in the developing world. According to the recently published Report of the Commission for Africa, economic growth in Africa is necessary for substantially reducing poverty. Among three proposed policy options, the Commission recommends that African countries invest significantly in agriculture. But policy makers in the region face a dilemma: whic...
Ellard, DR; Davies, D; Griffiths, F; Kandala, NB; Mazuguni, F.; Shemdoe, A.; Chimwaza, W; Chiwandira, C.; Mbaruku, G.; Bergström, S; Kamwendo, F; Mhango, C.; Peile, E; Quenby, S.; Simkiss, D
There is a chronic shortage of medical doctors in many Sub-Saharan African countries and indeed many of these countries have very little to spend on healthcare. As a consequence levels of maternal and neonatal mortality still very high and many are struggling to meet the WHO Millennium development goals. Many African countries like Malawi have a cadre of health workers called Non Physician Clinicians (NPCs) who are trained by the Ministry of Health and are often the most experienced health wo...
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 1985–2011 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
Norma C Ware
Full Text Available BACKGROUND: Individuals living with HIV/AIDS in sub-Saharan Africa generally take more than 90% of prescribed doses of antiretroviral therapy (ART. This number exceeds the levels of adherence observed in North America and dispels early scale-up concerns that adherence would be inadequate in settings of extreme poverty. This paper offers an explanation and theoretical model of ART adherence success based on the results of an ethnographic study in three sub-Saharan African countries. METHODS AND FINDINGS: Determinants of ART adherence for HIV-infected persons in sub-Saharan Africa were examined with ethnographic research methods. 414 in-person interviews were carried out with 252 persons taking ART, their treatment partners, and health care professionals at HIV treatment sites in Jos, Nigeria; Dar es Salaam, Tanzania; and Mbarara, Uganda. 136 field observations of clinic activities were also conducted. Data were examined using category construction and interpretive approaches to analysis. Findings indicate that individuals taking ART routinely overcome economic obstacles to ART adherence through a number of deliberate strategies aimed at prioritizing adherence: borrowing and "begging" transport funds, making "impossible choices" to allocate resources in favor of treatment, and "doing without." Prioritization of adherence is accomplished through resources and help made available by treatment partners, other family members and friends, and health care providers. Helpers expect adherence and make their expectations known, creating a responsibility on the part of patients to adhere. Patients adhere to promote good will on the part of helpers, thereby ensuring help will be available when future needs arise. CONCLUSION: Adherence success in sub-Saharan Africa can be explained as a means of fulfilling social responsibilities and thus preserving social capital in essential relationships.
Annie J Sasco
relatively small number of studies warrant further epidemiological investigations, taking into account other known risk factors for these tumors. CONCLUSION: Studies conducted in sub-Saharan Africa show that HIV infection is not only strongly associated with AIDS-classifying cancers but also provided some evidence of association for other neoplasia. African countries need now to implement well designed population-based studies in order to better describe the spectrum of AIDS-associated malignancies and the most effective strategies for their prevention, screening and treatment.
Katherine Tully; Clare Sullivan; Ray Weil; Pedro Sanchez
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 in...
Luca Rondi; Sabrina Sorlini; Maria Cristina Collivignarelli
In developing countries, the drinking water supply is still an open issue. In sub-Saharan Africa, only 68% of the population has access to improved sources of drinking water. Moreover, some regions are affected by geogenic contaminants (e.g., fluoride and arsenic) and the lack of access to sanitation facilities and hygiene practices causes high microbiological contamination of drinking water in the supply chain. The Water Safety Plan (WSP) approach introduced by the World Health Organisation...
Wang, Shr-Jie Sharlenna
Background An estimated 200 million persons in sub-Saharan Africa (SSA) live currently in urban centres in malaria endemic areas. The epidemiology and control of urban malaria poses a number of specific challenges in comparison to rural areas, most notably the heterogeneous spatial distribution of transmission and the low state of immunity in the population. Interestingly, much less is currently known about malaria in urban settings than in rural areas. As a result there is an ...
Wang, Shr-Jie Sharlenna
Background An estimated 200 million persons in sub-Saharan Africa (SSA) live currently in urban centres in malaria endemic areas. The epidemiology and control of urban malaria poses a number of specific challenges in comparison to rural areas, most notably the heterogeneous spatial distribution of transmission and the low state of immunity in the population. Interestingly, much less is currently known about malaria in urban settings than in rural areas. As a result there is an essential need ...
In this paper I ask how the ongoing processes of urban and local government development in Sub-Saharan Africa can and should benefit the countries, and what conditions must be met to achieve this favourable outcome. The region faces close to a doubling of the urban population in fifteen years. This urban transition poses an opportunity as well as a management challenge. Urban areas represent underutilised resources that concentrate much of the countries’ physical, financial, and intellectual ...