Mônica W.P., Carvalho; Ana P.M., Leboute; Silviene F., Oliveira; Sandra M.B., Sousa; Maria de Nazaré, Klautau-Guimarães; Aguinaldo L., Simões.
Full Text Available This study reports the frequencies of the CCR5D32 mutation of the beta-chemokine 5 gene and discusses the possible effects of past and recent gene flow in three quilombo remnants (Brazilians communities with anthropological African ancestry whose ancestors were escaped slaves): Rio das Rãs, Mocambo, [...] and São Gonçalo in the northeastern region of Brazil. The CCR5D32 allele frequency of the Mocambo population was significantly higher (5.6%) than that found in the Rio das Rãs (1%) and São Gonçalo (0.9%) populations. These differences may reflect different proportions of parental populations in the founders individuals, a founder-effect and/or different histories of inter-ethnic contact. The frequency of the CCR5D32 allele in the Mocambo sample is similar to that found in those urban Brazilian populations which have a large amount of European genetic input, indicating a European contribution to the gene pool of this population and suggesting that, perhaps since its foundation, Mocambo has had a high level of admixture or experienced a founder-effect.
Weaver, J. N.; Brownfield, M. E.; Bergin, M. J.
Coal has been reported in 11 of the 16 sub-Saharan countries discussed in this appraisal: Mauritania, Senegal, Mali, Niger, Benin, Nigeria, Cameroon, Central African Republic, Sudan, Ethiopia, and Somalia. No coal occurrences have been reported in Gambia, Togo, Burkina, Chad, and Djibouti but coal may be present within these countries because neighboring countries do contain coal-bearing rocks. Most of these countries are undergoing desertification or will in the near future. Wood, directly or in the form of charcoal, constitutes two-thirds of the fuel used in Africa. Destruction of forest and shrub lands for fuel is occurring at an increasing rate because of desertification and increasing energy demands. The decline in biological productivity, coupled with concentration of population in areas where water is available and crops may be grown, leads to increasing shortages of wood for fuel. Part of the present and future energy needs of the sub-Saharan region could be met by use of indigenous coal and peat. Nine sedimentary basins, completely or partially within the sub-Saharan region, have the potential of either coal and/or peat deposits of economic value: 1- Senegal Basin, 2- Taoudeni Basin and Gao Trough, 3- Niger Basin, 4- Chad Basin, 5- Chari Basin, 6- Benue Trough (Depression), 7- Sudan Trough, 8- Plateau and Rift Belt, and 9- Somali Basin. Niger and Nigeria are the only countries in sub-Saharan Africa in which coal is presently being mined as a fuel source for powerplants and domestic use. Peat occurs in the deltas, lower river, and interdunal basin areas of Senegal, Mauritania, and Sudan. Peat can be used as an alternate fuel source and is currently being tested as a soil amendment in the agricultural sector. Coal and peat exploration and development studies are urgently required and should be initiated so the coal and peat utilization potential of each country can be determined. The overall objective of these studies is to establish, within the sub-Saharan region, energy independent countries using indigenous coal and peat resources. These resources have the potential to replace wood and wood charcoal as domestic fueld in the urban centers, as well as producing electrical and industrial energy, thus reducing expensive oil imports and decreasing the rate of deforestation.
de Graft Aikins Ama
Full Text Available Abstract Background Most European countries are ethnically and culturally diverse. Globally, cardiovascular disease (CVD is the leading cause of death. The major risk factors for CVD have been well established. This picture holds true for all regions of the world and in different ethnic groups. However, the prevalence of CVD and related risk factors vary among ethnic groups. Methods This article provides a review of current understanding of the epidemiology of vascular disease, principally coronary heart disease (CHD, stroke and related risk factors among populations of Sub-Sahara African descent (henceforth, African descent in comparison with the European populations in Europe. Results Compared with European populations, populations of African descent have an increased risk of stroke, whereas CHD is less common. They also have higher rates of hypertension and diabetes than European populations. Obesity is highly prevalent, but smoking rate is lower among African descent women. Older people of African descent have more favourable lipid profile and dietary habits than their European counterparts. Alcohol consumption is less common among populations of African descent. The rate of physical activity differs between European countries. Dutch African-Suriname men and women are less physically active than the White-Dutch whereas British African women are more physically active than women in the general population. Literature on psychosocial stress shows inconsistent results. Conclusion Hypertension and diabetes are highly prevalent among African populations, which may explain their high rate of stroke in Europe. The relatively low rate of CHD may be explained by the low rates of other risk factors including a more favourable lipid profile and the low prevalence of smoking. The risk factors are changing, and on the whole, getting worse especially among African women. Cohort studies and clinical trials are therefore needed among these groups to determine the relative contribution of vascular risk factors, and to help guide the prevention efforts. There is a clear need for intervention studies among these populations in Europe.
Full Text Available Abstract Background The ability of the Y chromosome to retain a record of its evolution has seen it become an essential tool of molecular anthropology. In the last few years, however, it has also found use in forensic genetics, providing information on the geographic origin of individuals. This has been aided by the development of efficient screening methods and an increased knowledge of geographic distribution. In this study, we describe the development of single base extension assays used to resolve 61 Y chromosome haplogroups, mainly within haplogroups A, B and E, found in Africa. Results Seven multiplex assays, which incorporated 60 Y chromosome markers, were developed. These resolved Y chromosomes to 61 terminal branches of the major African haplogroups A, B and E, while also including a few Eurasian haplogroups found occasionally in African males. Following its validation, the assays were used to screen 683 individuals from Southern Africa, including south eastern Bantu speakers (BAN, Khoe-San (KS and South African Whites (SAW. Of the 61 haplogroups that the assays collectively resolved, 26 were found in the 683 samples. While haplogroup sharing was common between the BAN and KS, the frequencies of these haplogroups varied appreciably. Both groups showed low levels of assimilation of Eurasian haplogroups and only two individuals in the SAW clearly had Y chromosomes of African ancestry. Conclusions The use of these single base extension assays in screening increased haplogroup resolution and sampling throughput, while saving time and DNA. Their use, together with the screening of short tandem repeat markers would considerably improve resolution, thus refining the geographic ancestry of individuals.
Blanckenberg, Janine; Bardien, Soraya; Glanzmann, Brigitte; Okubadejo, Njideka U; Carr, Jonathan A
Parkinson's disease (PD) is under-studied in Black Sub-Saharan African (SSA) populations. To date, there have been only six prevalence and no incidence studies. The crude prevalence of PD in SSA varies from 7 to 20 per 100,000, which is appreciably lower than in Caucasian populations. There are a limited number of published studies (nine) on the genetic factors associated with PD in SSA populations. Mutations have been reported in the parkin gene, and are restricted to only three patients (two Black South Africans and one Zambian). No mutations have been identified in the LRRK2, SNCA, PINK, or DJ-1 genes. Given the unique ancestry of SSA populations, their inclusion in genetic studies may provide a substantial contribution to the identification of novel genetic factors and genetic-environmental interactions underlying this disorder. More initiatives are needed to drive further research on PD in these populations and to facilitate collaborative projects across Africa. PMID:24079843
Anthony Enisan Akinlo; Tajudeen Egbetunde
The paper examines the long run and causal relationship between financial developmentand economic growth for ten countries in sub-Saharan Africa. Using the vectorerror correction model (VECM), the study finds that financial development is cointegratedwith economic growth in the selected ten countries in sub-Saharan Africa. That is there isa long run relationship between financial development and economic growth in the selectedsub-Saharan African countries. The results show that financial deve...
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
Co, Catherine Y.
In the last decade, a large portion of capital goods imports of Sub-Saharan African countries is telecommunications equipment, and China is now the main source of equipment for 30 Sub-Saharan African countries. A connection between specific types of equipment imports and subsequent exports is found with elasticity estimates ranging from 0.2 to 1.2 per cent. Estimates show that controlling for price, the estimated quality of Sub-Saharan African countries' exports is lower than that of their pe...
Galactionova, Katya; Tediosi, Fabrizio; de Savigny, Don; Smith, Thomas; Tanner, Marcel
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 intervening to tackle them become key priority areas for malaria control and elimination policies in the region. PMID:26000856
Galactionova, Katya; Tediosi, Fabrizio; de Savigny, Don; Smith, Thomas; Tanner, Marcel
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 intervening to tackle them become key priority areas for malaria control and elimination policies in the region. PMID:26000856
Pandolfelli, Lauren E; Shandra, John M
We conduct a cross-national analysis to test the hypothesis that African Development Bank (AfDB) structural adjustment adversely impacts child mortality in Sub-Saharan Africa. We use generalized least square random effects regression models and two-step Heckman models that correct for selection bias using data on 35 nations with up to four time points (1990, 1995, 2000, and 2005). We find substantial support for our hypothesis, which indicates that Sub-Saharan African nations that receive an AfDB structural adjustment loan tend to have higher levels of child mortality than Sub-Saharan African nations that do not receive such a loan. This finding remains stable even when controlling for selection bias on whether or not a Sub-Saharan African nation receives an AfDB structural adjustment loan. We conclude by discussing the methodological implications of the article, policy suggestions, and possible directions for future research. PMID:23821909
Songul Kakilli, Acaravci; Ilhan, Ozturk; Ali, Acaravci.
Full Text Available In this paper we review the literature on the finance-growth nexus and investigate the causality between financial development and economic growth in sub-Saharan Africa for the period 1975-2005. Using panel co-integration and panel GMM estimation for causality, the results of the panel co-integratio [...] n analysis provide evidence of no long-run relationship between financial development and economic growth. The empirical findings in the paper show a bi-directional causal relationship between the growth of real GDP per capita and the domestic credit provided by the banking sector for the panels of 24 sub-Saharan African countries. The findings imply that African countries can accelerate their economic growth by improving their financial systems and vice versa.
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...
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 countr...
This paper focuses on how Sub-Saharan Africans present themselves as musicians in Chemnitz, an Eastern German town of around 200,000 citizens that is situated on the periphery of existing immigrant musicians' networks in Europe. Generally, immigration to Chemnitz has been rather limited; the quota of foreign nationals is 2.9 % for the whole city. I will explore what purposes Sub-Saharan African music and dance performances serve in this context both for the majority society as well as for the...
Hindin, Michelle J
Preventing unwanted adolescent pregnancy is key for keeping girls in school, leading to a more productive and healthier workforce in sub-Saharan Africa. Gender norms are an important indicator of the status of women and more conservative gender norms are associated with experiencing domestic violence, and poorer maternal and reproductive health care. This paper examines the association between adolescent childbearing and norms towards wife beating in sub-Saharan Africa, and the role of education in moderating this association. Data come from the most recent Demographic and Health Surveys-nationally representative cross-sectional surveys conducted every 5 years. Country-by-country multivariable logistic regressions were conducted in 25 countries, and country and regional estimates were obtained using meta-analytical techniques. More than half of sub-Saharan African adolescents have a child, with levels ranging from 23% in Rwanda to 69% in Niger. Between 12 and 87% of women believed wife beating is acceptable. In 20 of the 25 countries, women with a birth during adolescence were significantly more likely to believe wife beating is justified [OR = 1.39; 95% confidence interval (CI) 130-1.39]. After multivariate adjustment, the overall finding remains statistically significant [AOR = 1.09; 95% CI 105-1:13]. Education attenuates the observed association. Overall, the effects are strongest and most consistent in West Africa. Results suggest that women who have an adolescent birth more likely to hold more conservative attitudes. Working with adolescents to improve their attitudes on relationship expectations and the importance of furthering their education even after a pregnancy could be integrated into life skills and sexual education curricula. PMID:24158508
World Bank, Washington, DC.
The objective of the African Capacity Building Initiative is to build and strengthen local capabilities for policy analysis and development management in Sub-Saharan Africa. This report examines the nature and magnitude of the problem, which basically consists of a shortage of development management skills combined with weakness in the area of
Taiwo Akinlo; Olumuyiwa Tolulope Apanisile
This study examined the relationship between insurance and economic growth in sub-Saharan Africa over the period 1986-2011. Pooled OLS, Fixed Effect Model and Generalized Method of Moment Panel Model were employed in the estimation. The estimations of the dynamic panel-data results show that insurance has positive and significance impact on economic growth in sub-Saharan Africa. This shows that premium contributes to economic growth in sub-Saharan Africa which means tha...
Berthé, Abdramane; Berthé-Sanou, Lalla; Konaté, Blahima; Hien, Hervé; Tou, Fatoumata; Drabo, Maxime; Badini-Kinda, Fatoumata; Macq, Jean
Many people and financial institutions believe that the elderly are not a priority in sub-Saharan Africa, a region marked by serious economic, socio-political and health crises. The purpose of this paper is to describe and analyze the assumptions and arguments underlying this view and to demonstrate that the elderly are a vulnerable priority population ignored by all stakeholders and primarily by technical and financial partners. The premise is that development must be viewed as a whole. In addition to improving the living conditions of children, youth and women, efforts to promote development in Africa must also take into account the needs of the elderly. The paper argues that there are four main reasons for focusing on the elderly in sub-Saharan Africa: systemic reasons, ethical/humanitarian reasons, developmental reasons and/or the interests and future of youth and adults. PMID:24007913
Periasamy, Malini; Schafleitner, Roland; Muthukalingan, Krishnan; Ramasamy, Srinivasan
This study was undertaken to assess the genetic diversity and host plant races of M. vitrata population in South and Southeast Asia and sub-Saharan Africa. The cytochrome c oxidase subunit 1 (cox1) gene was used to understand the phylogenetic relationship of geographically different M. vitrata population, but previous studies did not include population from Southeast Asia, the probable center of origin for Maruca, and from east Africa. Extensive sampling was done from different host plant species in target countries. Reference populations from Oceania and Latin America were used. An amplicon of 658 bp was produced by polymerase chain reaction, and 64 haplotypes were identified in 686 M. vitrata individuals. Phylogenetic analysis showed no difference among the M. vitrata population from different host plants. However, the results suggested that M. vitrata has formed two putative subspecies (which cannot be differentiated based on morphological characters) in Asia and sub-Saharan Africa, as indicated by the high pairwise FST values (0.440.85). The extremely high FST values (?0.93) of Maruca population in Latin America and Oceania compared to Asian and African population seem to indicate a different species. On the continental or larger geographical region basis, the genetic differentiation is significantly correlated with the geographical distance. In addition, two putative species of Maruca, including M. vitrata occur in Australia, Indonesia and Papua New Guinea. The negative Tajimas D and Fus FS values showed the recent demographic expansion of Maruca population. The haplotype network and Automatic Barcode Gap Discovery analyses confirmed the results of phylogenetic analysis. Thus, this study confirmed the presence of three putative Maruca species, including one in Latin America, one in Oceania (including Indonesia) and M. vitrata in Asia, Africa and Oceania. Hence, the genetic differences in Maruca population should be carefully considered while designing the pest management strategies in different regions. PMID:25893977
Reinhart Kößler; Arnold-Bergstraesser-Institut
Review of the monograph:Joseph Patrick Ganahl, Corruption, Good Governance, and the African State: A Critical Analysis of the Political-Economic Foundations of Corruption in Sub-Saharan Africa, Potsdam: Potsdam University Press, 2013, ISBN 9783869562483, 300 pp.
Laan, H.L. van der; Haaren, W.T.M. van
Sum.: The economic policy of structural adjustment, which was initiated in most African countries during the 1980s, posed a serious threat to agricultural marketing boards in sub-Saharan Africa. Two elements of structural adjustment were particularly ominous: 'privatization' threatened the continued existence of marketing boards as public enterprises, and the 'liberalization of trade' worsened the conditions under which they operated. On the basis of an extensive study of the literature, this...
Degboe Arnold N; Taylor Kelly D; Iwelunmor Juliet; Okoror Titilayo A; BeLue Rhonda; Agyemang Charles; Ogedegbe Gbenga
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 th...
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...
Okoro, Chinyere K.; Kingsley, Robert A.; Connor, Thomas R.; Harris, Simon R.; Parry, Christopher M.; Al-mashhadani, Manar N.; Kariuki, Samuel; Msefula, Chisomo L.; Gordon, Melita A.; Pinna, Elizabeth; Wain, John; Heyderman, Robert S.; Obaro, Stephen; Alonso, Pedro L.; Mandomando, Inacio
A highly invasive form of non-typhoidal Salmonella (iNTS) disease has been recently documented in many countries in sub-Saharan Africa. The most common Salmonella enterica serovar causing this disease is Typhimurium. We applied whole-genome sequence-based phylogenetic methods to define the population structure of sub-Saharan African invasive Salmonella Typhimurium and compared these to global Salmonella Typhimurium isolates. Notably, the vast majority of sub-Saharan invasive Salmonella Typhim...
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.
Ichoku, Charles; Ellison, Luke
The northern sub-Saharan African (NSSA) region, bounded by the Sahara, Equator, and the West and East African coastlines, is subjected to intense biomass burning every year during the dry season. This is believed to be one of the drivers of the regional carbon and energy cycles, with serious implications for the water cycle anomalies that probably contribute to drought and desertification. In this presentation, we will discuss a new multi-disciplinary research in the NSSA region, review progress, evaluate preliminary results, and interact with the research and user communities to examine how best to coordinate with other research activities in order to address related environmental issues most effectively.
Many help-seeking torture survivors in sub-Saharan Africa report sudden or violent bereavements, as well as risk factors associated with complicated grief. This mixed-methods article reviews 85 therapeutic client files from torture treatment centers in 3 countries in sub-Saharan Africa. Thirty-nine clients had lost loved ones and were at greater risk for depression (effect size 0.65) and thoughts of suicide (OR = 4.99). Qualitative analysis of case histories and interviews with clients elaborate the links between torture and complicated grief. Recommendations are offered for the treatment of complicated grief in sub-Saharan torture survivors, and implications for assessment, timing, and treatment duration are discussed. PMID:25089758
Full Text Available This paper investigates the causal relationship between energy consumption and real GDP in 14 Sub-Saharan African countries over the period 1971-2004. The results of panel co-integration tests showed that energy consumption and real GDP do not have a stable long-run equilibrium relationship. We find [...] that for all members of the panel, there is homogenous causality from energy consumption to real GDP and vice versa. This bi-directional causality supports the feedback hypothesis.
Fabian, D K; Lack, J B; Mathur, V; Schlötterer, C; Schmidt, P S; Pool, J E; Flatt, T
Clines in life history traits, presumably driven by spatially varying selection, are widespread. Major latitudinal clines have been observed, for example, in Drosophila melanogaster, an ancestrally tropical insect from Africa that has colonized temperate habitats on multiple continents. Yet, how geographic factors other than latitude, such as altitude or longitude, affect life history in this species remains poorly understood. Moreover, most previous work has been performed on derived European, American and Australian populations, but whether life history also varies predictably with geography in the ancestral Afro-tropical range has not been investigated systematically. Here, we have examined life history variation among populations of D. melanogaster from sub-Saharan Africa. Viability and reproductive diapause did not vary with geography, but body size increased with altitude, latitude and longitude. Early fecundity covaried positively with altitude and latitude, whereas lifespan showed the opposite trend. Examination of genetic variance-covariance matrices revealed geographic differentiation also in trade-off structure, and QST -FST analysis showed that life history differentiation among populations is likely shaped by selection. Together, our results suggest that geographic and/or climatic factors drive adaptive phenotypic differentiation among ancestral African populations and confirm the widely held notion that latitude and altitude represent parallel gradients. PMID:25704153
Full Text Available Abstract Background There exists no consistent explanation for why some countries are successful in combating HIV/AIDS and others are not, and we need such an explanation in order to design effective policies and programmes. Research evaluating HIV interventions from a biomedical or public health perspective does not always take full account of the historical and organizational characteristics of countries likely to influence HIV outcomes. The analysis in this paper addresses this shortcoming by testing the impact of organizational and structural factors, particularly those resulting from population interventions, on HIV outcomes at the country level in sub-Saharan Africa. Methods The primary independent variables are factors that originated from efforts to slow population growth: whether a country has a long-time affiliate of the International Planned Parenthood Federation and whether a country has a population policy. Additional structural factors likely to impact HIV outcomes include the level of wealth, the level of cultural fractionalization, and the former colonial power. The present study uses multivariate regression techniques with countries in sub-Saharan Africa as the unit of analysis, and four measures of success in addressing HIV: the change in prevalence between 2001 and 2009; the change in incidence between 2001 and 2009; the level of overall antiretroviral coverage in 2009; and the level of antiretroviral coverage for prevention of vertical transmission in 2009. Results Countries with the greatest declines in HIV prevalence and incidence had older International Planned Parenthood Federation affiliates and had adopted population policies, even after controlling for age of epidemic, level of antiretroviral coverage, and funding for HIV. Population policies are also important predictors of levels of overall antiretroviral coverage and of coverage of HIV-positive pregnant women to prevent vertical transmission. Structural factors with significant impacts include wealth, cultural fractionalization and former colonial power. Conclusions The organizational and structural context of African countries is strongly predictive of HIV outcomes. This finding implies that policy and programmatic efforts should be put towards strengthening existing organizations and perhaps even creating new ones. The fact that cultural fractionalization also influences HIV outcomes suggests that efforts must be put towards identifying ways to reach political consensus in diverse societies.
Kufuor, Nana Kwabena
The actions of governments are instrumental in economic development, and an important lever of policy is fiscal policy. Taxation and spending cannot only promote economic development but inhibit progress and retard the process, and nowhere is this most evident than in sub-Saharan Africa (SSA), which is the focus of this study. Promoting economic development therefore requires that policies that inhibit the process are identified and addressed. In this light, this thesis investigates two commo...
Full Text Available This paper focuses on how Sub-Saharan Africans present themselves as musicians in Chemnitz, an Eastern German town of around 200,000 citizens that is situated on the periphery of existing immigrant musicians' networks in Europe. Generally, immigration to Chemnitz has been rather limited; the quota of foreign nationals is 2.9 % for the whole city. I will explore what purposes Sub-Saharan African music and dance performances serve in this context both for the majority society as well as for the immigrants, individually and as a community. In so doing, I use a case study on the yearly local "intercultural festival" and analyze what kind of local power structures, institutional and informal, economic and political, influence the Nigerian cultural association's festival performance. This analysis shows how immigrant networks or associations relate to expectations and ascriptions of "authenticity" in a small-scale city. With its focus on the local situation and its effects on the representation of immigrant groups, this paper builds on the work that Nina Glick Schiller and Ayse Caglar (2006, 2009 have done on the importance of locality for research on migration and immigrant incorporation.
Spatio-temporal analysis was applied on data representing urbanisation, slumisation, poverty, safe water/ sanitation in urban sub-Saharan Africa (SSA). The findings include: rapid rates of national population growth and urbanisation throughout SSA from 1980 to 2005, averaging 93.8% (range: 90.5% points), lowest and highest rates being 40% (Lesotho) and 130.5% (Niger), respectively; high national poverty rates, widespread in SSA: (>50% in about seven countries; it might have been similar in mo...
Kawooya, Michael G
The objectives of this review are to outline the needs, challenges, and training interventions for rural radiology (RR) training in Sub-Saharan Africa (SSA). Rural radiology may be defined as imaging requirements of the rural communities. In SSA, over 80% of the population is rural. The literature was reviewed to determine the need for imaging in rural Africa, the challenges, and training interventions. Up to 50% of the patients in the rural health facilities in Uganda may require imaging, la...
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.
Gaita, S. M.; Boman, J.; Gatari, M. J.; Pettersson, J. B. C.; Janhäll, S.
Sources of airborne particulate matter and their seasonal variation in urban areas in Sub-Saharan Africa are poorly understood due to lack of long-term measurement data. In view of this, filter samples of airborne particulate matter (particle diameter ?2.5 ?m, PM2.5) were collected between May 2008 and April 2010 at two sites (urban background site and suburban site) within the Nairobi metropolitan area. A total of 780 samples were collected and analyzed for particulate mass, black carbon (BC) and 13 trace elements. The average PM2.5 concentration at the urban background site was 21±9.5 ?g m-3, whereas the concentration at the suburban site was 13±7.3 ?g m-3. The daily PM2.5 concentrations exceeded 25 ?g m-3 (the World Health Organization 24 h guideline value) on 29% of the days at the urban background site and 7% of the days at the suburban site. At both sites, BC, Fe, S and Cl accounted for approximately 80% of all detected elements. Positive matrix factorization analysis identified five source factors that contribute to PM2.5 in Nairobi, namely traffic, mineral dust, industry, combustion and a mixed factor (composed of biomass burning, secondary aerosol and aged sea salt). Mineral dust and traffic factors were related to approximately 74% of PM2.5. The identified source factors exhibited seasonal variation, apart from the traffic factor, which was prominently consistent throughout the sampling period. Weekly variations were observed in all factors, with weekdays having higher concentrations than weekends. The results provide information that can be exploited for policy formulation and mitigation strategies to control air pollution in Sub-Saharan African cities.
Full Text Available Mercy Mvundura, Neeti Nundy, Maggie Kilbourne-Brook, Patricia S Coffey Technology Solutions Global Program, PATH, Seattle, WA, USA Background: Female condoms are the only currently available woman-initiated option that offers dual protection from pregnancy and sexually transmitted infections, including HIV. The Womans Condom is a new female condom designed to provide dual protection and to be highly pleasurable and acceptable. Objective: We sought to estimate the potential dual health impact and cost-effectiveness of a Womans Condom distribution program in 13 sub-Saharan African countries with HIV prevalence rates >4% among adults aged 1549 years. We used two separate, publicly available models for this analysis, the Impact 2 model developed by Marie Stopes International and the Population Services International disability-adjusted life years (DALY calculator program. We estimated the potential numbers of pregnancies and DALYs averted when the Womans Condom is used as a family planning method and the HIV infections and DALYs averted when it is used as an HIV prevention method. Results: Programming 100,000 Womans Condoms in each of 13 countries in sub-Saharan Africa during a 1-year period could potentially prevent 194 pregnancies and an average of 21 HIV infections in each country. When using the World Health Organization CHOosing Interventions that are Cost-Effective (WHO-CHOICE criteria as a threshold to infer the potential cost-effectiveness of the Womans Condom, we found that the Womans Condom would be considered cost-effective. Conclusion: This was a first and successful attempt to estimate the impact of dual protection of female condoms. The health impact is greater for the use of the Womans Condom as an HIV prevention method than for contraception. Dual use of the Womans Condom increases the overall health impact. The Womans Condom was found to be very cost-effective in all 13 countries in our sample. Keywords: female condoms, unintended pregnancy, HIV prevention, contraception, sub-Saharan Africa, cost-effectiveness
La construcción del proyecto migratorio y las razones para emigrar en la población de África subsahariana francófona. Un estudio intercontinental Europa - África / Construction of migration project and reasons for emigrating in sub-Saharan African francophone population. An intercontinental study Europe-Africa
Carlos Roberto, Velandia Torres; Marie-Françoise, Lacassagne.
Full Text Available Este estudio da cuenta de las razones de los ciudadanos de África subsahariana francófona para establecerse en Europa, y particularmente en Francia, mediante la creación de un marco comprensivo innovador que vincula tres ejes temáticos: la motivación, las migraciones, y África y sus relaciones con E [...] uropa. 155 participantes en ambos continentes respondieron a un cuestionario sobre su proyecto migratorio real o posible. Los resultados plantean un plano general de acercamiento a los imaginarios y la realidad de los migrantes en el contexto francés, marcado por la reflexión sobre la identidad nacional, los controles migratorios, un clima político reticente a la migración y un tejido social caracterizado por un creciente multiculturalismo. Abstract in english This study describes the motivations of citizens of sub-Saharan Africa francophone to establish in France thanks to the creation of an innovative framework for understanding with three key themes: motivation, migration and Africa and their relations with Europe. 155 participants from both continents [...] responded to a questionnaire about their actual or potential migration project. The results presented raise a general plan of approach to reality and imaginary of sub-Saharan African migrants in the French current context, marked by reflection on national identity, immigration and customs controls, a political climate reticent to migration and a social network characterized by a growing multiculturalism.
Full Text Available Basic provisions for design ground motions in seismic design codes of sub-Saharan African countries are critically reviewed. The seismic codes of Ethiopia, Kenya and Uganda are selected to represent the eastern region, Ghana to represent the west and South Africa to represent the south. The specific [...] provisions considered are those pertaining to site effect and the recurrence period of the design earthquake. The codes are also compared with one another and with selected current international codes from the US and Europe, with respect to selected provisions. The provisions are further viewed from the perspective of the state of the art and the state of the practice. It has been concluded that these basic provisions in most of the sub-Saharan African codes considered are inadequate in guaranteeing safety of human life and limiting damage to property, suggesting a need for immediate updating, an exception being the South African code.
Degboe Arnold N
Full Text Available Abstract Background Sub-Saharan African (SSA countries are currently experiencing one of the most rapid epidemiological transitions characterized by increasing urbanization and changing lifestyle factors. This has resulted in an increase in the incidence of non-communicable diseases, especially cardiovascular disease (CVD. This double burden of communicable and chronic non-communicable diseases has long-term public health impact as it undermines healthcare systems. Purpose The purpose of this paper is to explore the socio-cultural context of CVD risk prevention and treatment in sub-Saharan Africa. We discuss risk factors specific to the SSA context, including poverty, urbanization, developing healthcare systems, traditional healing, lifestyle and socio-cultural factors. Methodology We conducted a search on African Journals On-Line, Medline, PubMed, and PsycINFO databases using combinations of the key country/geographic terms, disease and risk factor specific terms such as "diabetes and Congo" and "hypertension and Nigeria". Research articles on clinical trials were excluded from this overview. Contrarily, articles that reported prevalence and incidence data on CVD risk and/or articles that report on CVD risk-related beliefs and behaviors were included. Both qualitative and quantitative articles were included. Results The epidemic of CVD in SSA is driven by multiple factors working collectively. Lifestyle factors such as diet, exercise and smoking contribute to the increasing rates of CVD in SSA. Some lifestyle factors are considered gendered in that some are salient for women and others for men. For instance, obesity is a predominant risk factor for women compared to men, but smoking still remains mostly a risk factor for men. Additionally, structural and system level issues such as lack of infrastructure for healthcare, urbanization, poverty and lack of government programs also drive this epidemic and hampers proper prevention, surveillance and treatment efforts. Conclusion Using an African-centered cultural framework, the PEN3 model, we explore future directions and efforts to address the epidemic of CVD risk in SSA.
Silva, Prathiba M.; 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...
Following a field survey in neighbourhoods and schools in the poor area of Brussels among adolescents from an African migrant background (Morocco and sub-Saharan Africa), this article examines young peoples attempts to rationalise the discrimination and injustice they experience. As well as their direct effects in terms of social success in particular, institutional discrimination and violence have repercussions on representations of oneself and of the world. The accumulation of experience...
Dandume, Muhammad Yusuf; A C, Dr Malarvizhi
This paper examines the linkage among financial liberalization, economic growth and poverty reduction in Sub-Saharan African countries (SSA). The study applies the recent panel Co-integration and vector error correction mechanism to address the heterogeneity and cross-border interdependence over the period of 1980 to 2010. The results reveal that economic growth is positively associated with poverty reduction and financial liberalization coefficients are positively related to economic growth....
Senanu, K. E.
Reforms of African educational systems with World Bank assistance are likely to fail unless they are based on a fundamentally African vision of society. This vision involves creating a habitat for human resource development, the use of intermediate technology, and space for the informal sector. (SK)
Full Text Available Abstract Background Consumption of alcohol is associated with acute and chronic adverse health outcomes. There is a paucity of studies that explore the determinants of alcohol use among adolescents in sub-Saharan Africa and, in particular, that examine the effects of adverse childhood experiences on alcohol use. Methods The paper draws on nationally-representative data from 9,819 adolescents aged 12-19 years from Burkina Faso, Ghana, Malawi, and Uganda. Logistic regression models were employed to identify correlates of self-reported past-year drunkenness. Exposure to four adverse childhood experiences comprised the primary independent variables: living in a food-insecure household, living with a problem drinker, having been physically abused, and having been coerced into having sex. We controlled for age, religiosity, current schooling status, the household head's sex, living arrangements, place of residence, marital status, and country of survey. All analyses were conducted separately for males and females. Results At the bivariate level, all independent variables (except for coerced sex among males were associated with the outcome variable. Overall, 9% of adolescents reported that they had been drunk in the 12 months preceding the survey. In general, respondents who had experienced an adverse event during childhood were more likely to report drunkenness. In the multivariate analysis, only two adverse childhood events emerged as significant predictors of self-reported past-year drunkenness among males: living in a household with a problem drinker before age 10, and being physically abused before age 10. For females, exposure to family-alcoholism, experience of physical abuse, and coerced sex increased the likelihood of reporting drunkenness in the last 12 months. The association between adverse events and reported drunkenness was more pronounced for females. For both males and females there was a graded relationship between the number of 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.
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
Arrey, Agnes Ebotabe; Bilsen, Johan; Lacor, Patrick; Deschepper, Reginald
Patients with HIV not only have to deal with the challenges of living with an incurable disease but also with the dilemma of whether or not to disclose their status to their partners, families and friends. This study explores the extent to which sub-Saharan African (SSA) migrant women in Belgium disclose their HIV positive status, reasons for disclosure/non-disclosure and how they deal with HIV disclosure. A qualitative study consisting of interviews with twenty-eight SSA women with HIV/AIDS was conducted. Thematic content analysis was employed to identify themes as they emerged. Our study reveals that these women usually only disclose their status to healthcare professionals because of the treatment and care they need. This selective disclosure is mainly due to the taboo of HIV disease in SSA culture. Stigma, notably self-stigma, greatly impedes HIV disclosure. Techniques to systematically incorporate HIV disclosure into post-test counseling and primary care services are highly recommended. PMID:25781906
Olawoye, Olusola O; Pasquale, Louis R; Ritch, Robert
The goal of this review is to estimate the burden of exfoliation syndrome (XFS) and exfoliation glaucoma (XFG) in sub-Saharan Africa and to identify the gaps in knowledge of disease prevalence in this region. PubMed, Medline, African Journals Online and Google engine search were carried out using the following terms "pseudoexfoliation" or "exfoliation syndrome Africa", "pseudoexfoliation" or "exfoliation syndrome" + "glaucoma Africa," "glaucoma prevalence Africa," "pattern of glaucoma presentation Africa," "pseudoexfoliation" or "exfoliation syndrome" + "cataract Africa," "ophthalmic conditions Africa." Studies were included if they described the proportion or prevalence/incidence of XFG and XFS in sub-Saharan Africa or if they investigated lysyl oxidase-like 1 (LOXL1) variants in XFS among Africans. 22 papers were identified and classified as clinic-based studies (n = 16) and population-based (n = 4) studies. Two other studies were considered important, and therefore, included in the review. Clinic-based studies demonstrate that XFS is a common cause of glaucoma, as is true in many other parts of the world. Furthermore, XFS often co-exists with cataract and climatic droplet keratopathy. Its prevalence ranged from 5.1 to 7.7 % in patients >40 years in population-based studies, a value that is considerably higher than that reported in African Americans. XFS was strongly associated with increasing age in the prevalence studies. The burden of XFS in sub-Saharan Africa is high. More investigation is needed to determine why clinic-based studies report virtually no XFS in some countries (Ghana and Tanzania), while nearby countries report greater proportions (Nigeria and Ethiopia). PMID:24844849
Eskemose Andersen, JØrgen
Current definitions of urbanity lead to claims that a large proportion (75% according to UN Habitat) of Sub-Saharan Africas (SSA) urban population is housed in informal settlements with almost all new housing stock provided informally in contradiction to the formal that is defined as planned and regulated by the state. In most cases in SSA cities urban development has no professional assistance in the form of architects or engineers, and what is characterised as disorder, as is the case with informal urbanisation, is considered as undesirable, inappropriate, dangerous, unhealthy and un-modern (Folkers 2009, Hardoy 1990, Jenkins 2011, Nielsen 2008, Nguluma 2003, Mitlin, D. 2004, Koolhaas 2006). In 2003 the UN adopted a new terminology for what over decades used to be labelled as informal-, squatter-, illegal-, unplanned-, spontaneous settlements, shanty towns with the term slum (UN habitat 2003). However, defining what slum implies is complex and this author consider the term as prejudiced and not covering the diversity most informal settlements represents Further the term stigmatises a remarkable share of any city population in SSA (Huchzermeyer 2011, Davis 2007, Harber 2011, Garau 2005).
Full Text Available The status of older adults in Africa occupies a small but rapidly expanding share of the global literature on ageing. The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) pandemic has generated a new focus on the changing role of the elderly in communities that have [...] been affected. In sub-Saharan Africa, where millions are projected to be infected with HIV and about two million deaths are recorded annually amongst the traditionally productive adults, such loss of parents and breadwinners means children and the elderly have had to take up unusual responsibilities. A literature review on the elderly and HIV and AIDS provided the data analysed for this article. Access to databases was mainly via EBSCO (http://www.ebsco.co), which allowed searches in major databases and search engines useful in an academic setting for finding and accessing articles in health and health-related academic journals, repositories and archived reports. Results showed that the AIDS pandemic has direct and indirect effects which have manifested in a set of interrelated social, economic and psychological dimensions that could ultimately impact on the health and well-being of the elderly. It is concluded that more needs to be done to articulate the knowledge base of the impact of HIV and AIDS in order to inform social, economic and political policies for the purpose of alleviating the problems that the pandemic is wreaking on the elderly African population.
Roger J. Chin, MA, MPA
Full Text Available Background: HIV and AIDS continue to have a calamitous effect on individuals living on the continent of Africa. U.S. President George W. Bush implemented the Presidents Emergency Plan for AIDS Relief (PEPFAR with the objective of committing approximately $15 billion from 2004 through 2008 to assist with the reduction of the HIV pandemic worldwide. The majority of the PEPFAR policy and funding focused on 12 countries in sub-Saharan Africa: Botswana, Cote dIvoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia. The policy question this research paper seeks to analyze is whether the PEPFAR funding (as a % of Gross Domestic Product (GDP allocated to the 12 countries in Africa had any effect on the decrease of HIV infection rates of males and females between the ages of 15 and 49. Methods: A fixed-effects panel regression analysis was conducted to determine if this association exists. This study examined the 12 African countries that received PEPFAR funding over the years 2002 to 2010; even though PEPFAR was only active from 2004 through 2008, this research included two years prior and two years after this timeframe in order to better estimate the effect of PEPFAR funding on HIV reduction. Results: The results illustrate that on average, ceteris paribus, for every 1 percentage point increase in PEPFAR funding per GDP a country received, the countrys HIV infection rate decreased by 0.355 percentage points. Conclusions and Global Health Implications: While the empirical findings in this study suggested that the correlation between PEPFAR funding and HIV reduction is statistically significant, the practical significance is perhaps less obvious. Arguably, the reduction rate should be higher given the extent of funding targeted to this project. The conclusion of this research provides suggestions on future research and the policy implications of PEPFAR.
Palha 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...
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 lint only of petroleum origin but is also linked with the drop of the export incomes (which itself is partially explained by the impact of petroleum shocks on the industrialized economies), with their bad insertion in the world economy, and with unsuitable domestic economies. The third part proposes some solutions to attenuate the energy and economical difficulties of these countries. It is necessary to implement an energy planning mainly based on the mastery of the demand and on a better management of local resources. The policies of stabilization and of structural adjustment are also presented with their effects on the different sectors. (J.S.)
Samba Michel Cyrille
Full Text Available This paper analyses the Feldstein-Horioka puzzle in 15 sub-Saharan African countries accounting for the correlation between inward and outward capital flows. Applying cross section, panel data, and even time series analyses, we show that our results are consistent with previous studies related to developing countries. More interesting, we confirm, for sub-Saharan African countries, the recent hypothesis of Georgepoulos and Hejazi (2009 that the Feldstein-Horioka home bias is unrelated to the correlation between inward and outward capital flows for developing countries. Although the saving-investment coefficient weakens in the correlation adjusted regression, we show that the coefficient on Flows, the variable which accounts for the correlation between inward and outward capital flows is always positive and insignificant. We argue that the downward movement in the saving-investment coefficient is due the omission of some factors (foreign aid and trade openness which are relevant for developing countries in the framework of the Feldstein-Horioka analysis. We also state that our results are more likely to reflect the poor financial structure of the countries in our sample. Therefore, we suggest that policymakers in Sub-Sahara Africa should put more emphasis in creating and developing efficient financial market which could favor portfolio diversification.
Eucebious Lekalakala- Mokgele
Full Text Available The status of older adults in Africa occupies a small but rapidly expanding share of the global literature on ageing. The human immunodeficiency virus (HIV and acquired immune deficiency syndrome (AIDS pandemic has generated a new focus on the changing role of the elderly in communities that have been affected. In sub-Saharan Africa, where millions are projected to be infected with HIV and about two million deaths are recorded annually amongst the traditionally productive adults, such loss of parents and breadwinners means children and the elderly have had to take up unusual responsibilities. A literature review on the elderly and HIV and AIDS provided the data analysed for this article. Access to databases was mainly via EBSCO (www.ebsco.co, which allowed searches in major databases and search engines useful in an academic setting for finding and accessing articles in health and health-related academic journals, repositories and archived reports. Results showed that the AIDS pandemic has direct and indirect effects which have manifested in a set of interrelated social, economic and psychological dimensions that could ultimately impact on the health and well-being of the elderly. It is concluded that more needs to be done to articulate the knowledge base of the impact of HIV and AIDS in order to inform social, economic and political policies for the purpose of alleviating the problems that the pandemic is wreaking on the elderly African population.
Die status van ouer volwassenes in Afrika bekleen klein, maar vinnig groeiende deel van die globale verouderings literatuur. Die menslike immuniteitsgebreksvirus (MIV en verworwe immuniteitsgebreksindroom (VIGS pandemie het n nuwe fokus op die veranderende rol van bejaardes in die gemeenskap wat deur VIGS beïnvloed word, gegenereer. In sub-Sahara Afrika waar na beraming miljoene geïnfekteer word met MIV, met sowat twee miljoen sterftes jaarliks gerekordeer onder die tradisoneel produktiewe volwassenes, word daar van die kinders en bejaardes verwag om ongewone verantwoordelikhede op hulle te neem as gevolg van die verlies aan ouers of broodwinners. n Literatuuroorsig wat handel oor bejaardes en MIV en VIGS het die geanaliseerde data voorsien vir hierdie artikel. Toegang tot die databasis was meestal deur EBSCO (www.ebsco.co wat soektog toegelaat het tot groot databasisse en soekenjins wat bruikbaar in die akademiese opset is en die vind van artikels aangaande gesondheid, gesondheidverwante akademiese joernale en argief verslae. Bevindings toon dat die VIGS pandemie direkte en indirekte effekte het. Hierdie effekte manifisteer in n stel sosiaal verwante, ekonomiese en psigologiese dimensies wat ten einde n impak op die gesondheid en welstand van bejaardes het. Daar is tot die gevolgtrekking gekom dat meer gedoen moet word om die kennis basis van MIV en VIGS te artikuleer om die sosiale, ekonomiese en politiese beleid in kennis te stel, om sodoende die resulterende probleme van MIV en VIGS op die bejaarde Afrika populasie te verlig.
How to cite this article: Lekalakala-Mokgele,E., 2011, A literature review of the impact of HIV and AIDS on the role of the elderly in the sub-Saharan African Community, Health SA Gesondheid 16(1, Art. #564, 6 pages. http://dx.doi.org/10:4102/hsag.v16i1.564
The characteristics of places where people live and work play an important role in explaining complex social, political, economic and demographic processes. In sub-Saharan Africa rapid urban growth combined with rising poverty is creating diverse urban environments inhabited by people with a wide variety of lifestyles. This research examines how spatial patterns of land cover in a southern portion of the West African country of Ghana are associated with particular characteristics of family organization and reproduction decisions. Satellite imagery and landscape metrics are used to create an urban context definition based on landscape patterns using a gradient approach. Census data are used to estimate fertility levels and household structure, and the association between urban context, household composition and fertility levels is modeled through OLS regression, spatial autoregressive models and geographically weighted regression. Results indicate that there are significant differences in fertility levels between different urban contexts, with below average fertility levels found in the most urbanized end of the urban context definition and above average fertility levels found on the opposite end. The spatial patterns identified in the association between urban context and fertility levels indicate that, within the city areas with lower fertility have significant impacts on the reproductive levels of adjacent neighborhoods. Findings also indicate that there are clear patterns that link urban context to living arrangements and fertility levels. Female- and single-headed households are associated with below average fertility levels, a result that connects dropping fertility levels with the spread of smaller nuclear households in developing countries. At the same time, larger extended family households are linked to below average fertility levels for highly clustered areas, a finding that points to the prevalence of extended family housing in the West African city.
Lindsay, K L
Pregnant women in countries of Sub-Saharan Africa (SSA) are at risk of poor nutritional status and adverse outcomes as a result of poverty, food insecurity, sub-optimal healthcare facilities, frequent infections and frequent pregnancies. Studies from Nigeria, for example, have revealed a high prevalence of both under- and over-nutrition, as well as nutrient deficiencies, including iron, folate, vitamin D and vitamin A. Subsequently, obstetric complications, including hypertension, anaemia, neural tube defects, night-blindness, low birth weight and maternal and perinatal mortality, are common. Migration patterns from SSA to the Western world are on the rise in recent years, with Nigerians now representing the most prevalent immigrant African population in many developed countries. However, the effect of immigration, if any, on the nutritional status and pregnancy outcomes of these women in their host countries has not yet been studied. Consequently, it is unknown to what extent the nutritional deficiencies and pregnancy complications occurring in Nigeria, and other countries of SSA, present in these women post-emigration. This may result in missed opportunities for appropriate antenatal care of a potential high-risk group in pregnancy. The present review discusses the literature regarding nutrition in pregnancy among SSA women, using Nigeria as an example, the common nutrition-related complications that arise and the subsequent obstetric outcomes. The concept of dietary acculturation among immigrant groups is also discussed and deficiencies in the literature regarding studies on the diets of pregnant immigrant women are highlighted.
Full Text Available Spatio-temporal analysis was applied on data representing urbanisation, slumisation, poverty, safe water/ sanitation in urban sub-Saharan Africa (SSA. The findings include: rapid rates of national population growth and urbanisation throughout SSA from 1980 to 2005, averaging 93.8% (range: 90.5% points, lowest and highest rates being 40% (Lesotho and 130.5% (Niger, respectively; high national poverty rates, widespread in SSA: (>50% in about seven countries; it might have been similar in more countries if a large number of SSA countries had reported their 1993 poverty rates; high urban/rural poverty ratios (1.05-1.79 points range between Nigeria and Benin Republics. High average rate (73% of slumisation in SSA in 2001 (range: 96%, lowest and highest rates being in Zimbabwe (3% and Chad/Ethiopia (99%, respectively. SSAs 2000 health adjusted life expectancy was generally low: 38.8 years (<40 years in 24 countries. Use of safe/improved water/sanitation services were poor almost throughout SSA: declined rapidly and ubiquitously from 72% (2000 to 55% (2002, minus 17% points decrease in three years within individual countries with alarming declines up to minus 69% points in Guinea. The policy implications of the findings include the urgent and imperative need to massively implement urban improvement programmes designed to provide health-inducing services/facilities across SSA.
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.
Henley, Phaedra; Lowthers, Megan; Koren, Gideon; Fedha, Pamela Tsimbiri; Russell, Evan; VanUum, Stan; Arya, Sumedha; Darnell, Regna; Creed, Irena F; Trick, Charles G; Bend, John R
Stress is known to contribute to overall health status. Many individuals in sub-Saharan Africa are believed to be stressed about their employment, income, and health. This study aimed to investigate hair cortisol as a biomarker of chronic stress in settlement communities in Kenya. Hair samples were collected from 108 volunteers from settlement communities in Kenya. An enzyme-linked immunosorbent assay technique was used to measure hair cortisol concentrations. In parallel, a health survey was completed. The mean ± SD for the cortisol concentration in the hair of volunteers from the settlement communities in Naivasha was 639 ± 300 ng/g, which was higher than found for a Caucasian reference group (299 ± 110 ng/g; one-way ANOVA, P = 0.0003). There were no differences in hair cortisol concentrations between members of slum settlements adjacent to large floriculture farms in Naivasha (Karagita, Kamere/Kwa Muhia/DCK, and Kasarani) compared with those well-removed from all floriculture in Mogotio (Mogotio and Westlands/Katorongot). However, hair cortisol concentrations were significantly higher in females, divorced volunteers, those who made below minimum wage, and those who reported feeling unsafe collecting water or using sanitation facilities within these 2 settlement groups. We found no evidence for increased chronic stress (measured by hair cortisol content) between members of slum settlements adjacent to versus distant to large floriculture farms. Cultural and socio-economic conditions that prevail in much of sub-Saharan Africa were found to be factors contributing to chronic stress. PMID:25083791
Meyrowitsch, Dan Wolf; Pedersen, Erling MØller
ABSTRACT: BACKGROUND: In sub-Saharan Africa (SSA), malaria caused by Plasmodium falciparum has historically been a major contributor to morbidity and mortality. Recent reports indicate a pronounced decline in infection and disease rates which are commonly ascribed to large-scale bed net programmes and improved case management. However, the decline has also occurred in areas with limited or no intervention. The present study assessed temporal changes in Anopheline populations in two highly malaria-endemic communities of NE Tanzania during the period 1998-2009. METHODS: Between 1998 and 2001 (1st period) and between 2003 and 2009 (2nd period), mosquitoes were collected weekly in 50 households using CDC light traps. Data on rainfall were obtained from the nearby climate station and was used to analyze the association between monthly rainfall and malaria mosquito populations. RESULTS: The average number of Anopheles gambiae and Anopheles funestus per trap decreased by 76.8% and 55.3%, respectively over the 1st period, and by 99.7% and 99.8% over the 2nd period. During the last year of sampling (2009), the use of 2368 traps produced a total of only 14 Anopheline mosquitoes. With the exception of the decline in An. gambiae during the 1st period, the results did not reveal any statistical association between mean trend in monthly rainfall and declining malaria vector populations. CONCLUSION: A longitudinal decline in the density of malaria mosquito vectors was seen during both study periods despite the absence of organized vector control. Part of the decline could be associated with changes in the pattern of monthly rainfall, but other factors may also contribute to the dramatic downward trend. A similar decline in malaria vector densities could contribute to the decrease in levels of malaria infection reported from many parts of SSA.
Rwegoshora Rwehumbiza T
Full Text Available Abstract Background In sub-Saharan Africa (SSA, malaria caused by Plasmodium falciparum has historically been a major contributor to morbidity and mortality. Recent reports indicate a pronounced decline in infection and disease rates which are commonly ascribed to large-scale bed net programmes and improved case management. However, the decline has also occurred in areas with limited or no intervention. The present study assessed temporal changes in Anopheline populations in two highly malaria-endemic communities of NE Tanzania during the period 1998-2009. Methods Between 1998 and 2001 (1st period and between 2003 and 2009 (2nd period, mosquitoes were collected weekly in 50 households using CDC light traps. Data on rainfall were obtained from the nearby climate station and were used to analyze the association between monthly rainfall and malaria mosquito populations. Results The average number of Anopheles gambiae and Anopheles funestus per trap decreased by 76.8% and 55.3%, respectively over the 1st period, and by 99.7% and 99.8% over the 2nd period. During the last year of sampling (2009, the use of 2368 traps produced a total of only 14 Anopheline mosquitoes. With the exception of the decline in An. gambiae during the 1st period, the results did not reveal any statistical association between mean trend in monthly rainfall and declining malaria vector populations. Conclusion A longitudinal decline in the density of malaria mosquito vectors was seen during both study periods despite the absence of organized vector control. Part of the decline could be associated with changes in the pattern of monthly rainfall, but other factors may also contribute to the dramatic downward trend. A similar decline in malaria vector densities could contribute to the decrease in levels of malaria infection reported from many parts of SSA.
Full Text Available Background: Debate on policy challenges associated with the health of older populations in sub-Saharan Africa (SSA has intensifi ed in recent years, centering on a concern about older persons vulnerability to ill-health and their exclusion from health services. Despite international policy calls and formal expressions of commitment on the part of SSA governments, comprehensive policy action has remained scant. The impasse refl ects a lack of political will and an uncertainty about required policy approaches, engendered by wide gaps in understanding of oldage-related health in the region.Purpose: The purpose of the paper is to pinpoint major approaches and areas of evidence needed as a priority to overcome the impasse in policy on ageing and health in SSA.Methodology: A critical review of relevant SSA and international scientific, policy and development literature conducted as part of a research project on Dimensions and determinants of health in old age in Kenya and Nigeria: implications for policy.Results: Six major areas of evidence and a spectrum of approaches are required to (i strengthen the case on why action on old age-related health should be pursued in the SSA setting and (ii clarify what concrete forms such action should take.Conclusion: A systematic research endeavour on the six areas is needed to advance policy and practice on the health of older populations in SSA. If accompanied by an explicit international comparative perspective such research also has the potential to significantly advance scientific debate on ageing and health globally.
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
As universal service in terms of ICTs provision cannot be achieved in the times agreed for several international bilateral and multilateral aid organizations. It is important to create mechanisms to reduce the lack of use of ICTs in sub-Saharan African countries. This paper specifically analyses the different ICT underdeveloped areas in the sub-Saharan African countries and the factors explain such status. At the same time, the paper proposes a set of policy guidelines that might help improvi...
Silva, Wilson Araújo; Bortolini, Maria Cátira; Schneider, Maria Paula Cruz; Marrero, Andrea; Elion, Jacques; Krishnamoorthy, Rajagopal; Zago, Marco Antonio
Seventy individuals from two African and four black Brazilian populations were studied for the first hypervariable segment of mtDNA. To delineate a more complete phylogeographic scenario of the African mtDNA haplogroups in Brazil and to provide additional information on the nature of the Atlantic slave trade, we analyzed our data together with previously published data. The results indicate different sources of African slaves for the four major Brazilian regions. In addition, the data revealed patterns that differ from those expected on the basis of historical registers, thus suggesting the role of ethnic sex differences in the slave trade. PMID:16900880
Alam, Nazmul; Hajizadeh, Mohammad; Dumont, Alexandre; Fournier, Pierre
To assess social inequalities in the use of antenatal care (ANC), facility based delivery (FBD), and modern contraception (MC) in two contrasting groups of countries in sub-Saharan Africa divided based on their progress towards maternal mortality reduction. Six countries were included in this study. Three countries (Ethiopia, Madagascar, and Uganda) had 4.5% average annual reduction rate while another three (Cameroon, Zambia, and Zimbabwe) had >550 MMR in 2010 with only <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 which made progress towards reducing maternal mortality. PMID:25853423
The need to decompose CO2 emission intensity is predicated upon the need for effective climate change mitigation and adaptation policies. Such analysis enables key variables that instigate CO2 emission intensity to be identified while at the same time providing opportunities to verify the mitigation and adaptation capacities of countries. However, most CO2 decomposition analysis has been conducted for the developed economies and little attention has been paid to sub-Saharan Africa. The need for such an analysis for SSA is overwhelming for several reasons. Firstly, the region is amongst the most vulnerable to climate change. Secondly, there are disparities in the amount and composition of energy consumption and the levels of economic growth and development in the region. Thus, a decomposition analysis of CO2 emission intensity for SSA affords the opportunity to identify key influencing variables and to see how they compare among countries in the region. Also, attempts have been made to distinguish between oil and non-oil-producing SSA countries. To this effect a comparative static analysis of CO2 emission intensity for oil-producing and non oil-producing SSA countries for the periods 1971-1998 has been undertaken, using the refined Laspeyres decomposition model. Our analysis confirms the findings for other regions that CO2 emission intensity is attributable to energy consumption intensity, CO2ergy consumption intensity, CO2 emission coefficient of energy types and economic structure. Particularly, CO2 emission coefficient of energy use was found to exercise the most influence on CO2 emission intensity for both oil and non-oil-producing sub-Saharan African countries in the first sub-interval period of our investigation from 1971-1981. In the second subinterval of 1981-1991, energy intensity and structural effect were the two major influencing factors on emission intensity for the two groups of countries. However, energy intensity effect had the most pronounced impact on CO2 emission intensity in non-oil-producing sub-Saharan African countries, while the structural effect explained most of the increase in CO2 emission intensity among the oil-producing countries. Finally, for the period 1991-1998, structural effect accounted for much of the decrease in intensity among non-oil-producers, while CO2 emission coefficient of energy use was the major force driving the decrease among oil-producing countries. The dynamic changes in the CO2 emission intensity and energy intensity effects for the two groups of countries suggest that fuel switching had been predominantly towards more carbon-intensive production in oil-producing countries and less carbon-intensive production in non-oil-producing SSA countries. In addition to the decomposition analysis, the article discusses policy implications of the results. We hope that the information and analyses provided here would help inform national energy and climate policy makers in SSA of the relative weaknesses and possible areas of strategic emphasis in their planning processes for mitigating the effects of climate change
Tully, K. L.; Russo, T.; Hickman, J. E.; Palm, C.
Nearly 80% of countries in sub-Saharan Africa (SSA) face problems of nitrogen (N) scarcity, which together with poverty causes food insecurity and malnutrition. The Alliance for a Green Revolution in Africa has set a goal of increasing fertilizer use in the region six-fold by 2015. While there is substantial evidence that greater N fertilizer use will improve crop yields, it could lead to increased N leaching and elevated nitrate (NO3-) concentrations in surface water and groundwater reservoirs. However, it is unclear what the magnitude of impacts will be in SSA given historically low nutrient additions (of less than 5 kg N/ha/yr), highly degraded soils (due to years of nutrient and soil organic matter depletion), and a wide range of soil types on which increased fertilizer use is occurring. Current estimates of N dynamics and balances in SSA agriculture now rely on data from other regions with different soil types, soil fertility, and land management practices. To understand the influence of increased fertilizer use on water quality requires data from representative areas in SSA. Experimental maize plots were established in a randomized complete block design in both western Kenya (clayey soil) and mid-western Tanzania (sandy soil). Plots were amended with 0, 50, 75, and 200 kg N/ha/yr as mineral fertilizer. Tension lysimeters were installed at three depths in each treatment, and water was collected throughout the maize growing season. Soil water solutions were analyzed for NO3--N. Flow through the soil column at each soil depth, was modeled using VS2DT, a variably saturated flow and solute transport model, and water flux values were multiplied by measured NO3--N concentrations to estimate seasonal N leaching flux. Soil texture was a major driver of N losses, altering both the pathways and magnitude of losses. Clayey soils in western Kenya show an enormous potential for loss of NO3--N immediately following the onset of rains as they trigger high rates of N mineralization and nitrification in the topsoil (known as the 'birch effect'). We did not observe this pulse in the sandy soils of central Tanzania. However, NO3- N concentrations in leachate were three times lower at 200 cm in clayey soils compared to sandy soils as a result of higher anion exchange capacity in clays. We show that while clayey soils lose NO3--N in a large pulse at the onset of rains, sandy soils lose large quantities of NO3--N over the course of the maize growing season. Results from this study can help inform recommended N application rates in similar soils (tropical Ultisols and Oxisols), to optimize yields while minimizing N leaching losses.
Naomi M., Seboni; Mabel K.M., Magowe; Leana R., Uys; Mary B, Suh; Komba N., Djeko; Haouaou, Moumouni.
Full Text Available To explore the role expectations of different stakeholders in the health care system on the roles and tasks that nurses and midwives perform, in order to clarify and strengthen these roles and shape the future of nursing education and practice in sub-Saharan Africa. Qualitative focus group discussio [...] ns were held with different stakeholders (nurses, health service managers, patients and their caregivers, community members and leaders and other health professionals) in eight African countries in order to establish their role expectations of nurses and midwives. Three questions about their role expectations and the interviews were taped, transcribed, and translated into English and analysed. There was consensus amongst the stakeholders regarding eight role functions: taking care of patients; giving health information; managing the care environment; advocating for patients; services and policies; providing emergency care; collaborating with other stakeholders; and providing midwifery care to women, infants and their families. There was disagreement amongst the stakeholders about the role of diagnosis and prescribing treatment. Nursing derives its mandate from communities it serves, and the roles expected must therefore form part of nursing regulation, education and practice standards. Health planners must use these as a basis for job descriptions and rewards. Once these are accepted in the training and regulation of nursing, they must be marketed so that recipients are aware thereof.
This study investigated the impact of energy consumption and CO2 emission on GDP (gross domestic product) growth and the financial development in thirty Sub Saharan African Countries. The panel model was used in this study from the period 1980 to 2008. The results showed that energy consumption had played an important role to increase both economic growth and the financial development in the investigated economies but with the consequence of high po llution. This study recommended that these countries should increase energy productivity by increasing energy efficiency, implementation of energy savings projects, energy conservation, and energy infrastructure outsourcing to achieve its financial development and GDP growth and to increase their investment on energy projects to achieve the full energy potential. -- Highlights: ? The impact of energy consumption, CO2 emission on GDP and the financial development in the SSA countries was investigated. ? The panel model was implied in this study from the period 1980 to 2008. ? The results show energy consumption increased economic growth and the financial development but with higher pollution.
Arrey, Agnes Ebotabe; Bilsen, Johan; Lacor, Patrick; Deschepper, Reginald
Patients with HIV not only have to deal with the challenges of living with an incurable disease but also with the dilemma of whether or not to disclose their status to their partners, families and friends. This study explores the extent to which sub-Saharan African (SSA) migrant women in Belgium disclose their HIV positive status, reasons for disclosure/non-disclosure and how they deal with HIV disclosure. A qualitative study consisting of interviews with twenty-eight SSA women with HIV/AIDS was conducted. Thematic content analysis was employed to identify themes as they emerged. Our study reveals that these women usually only disclose their status to healthcare professionals because of the treatment and care they need. This selective disclosure is mainly due to the taboo of HIV disease in SSA culture. Stigma, notably self-stigma, greatly impedes HIV disclosure. Techniques to systematically incorporate HIV disclosure into post-test counseling and primary care services are highly recommended. PMID:25781906
Imoisili, Omoye E.; Sumner, Anne E.
Obesity, hypertension, atherosclerosis, and type 2 diabetes mellitus are increasing in all regions of sub-Saharan Africa. The metabolic syndrome is a valuable tool in predicting atherosclerosis and type 2 diabetes in populations in Europe and North America. However, the applicability of the metabolic syndrome to African populations has not been studied. Prior to investing scarce funds into diagnosing and treating the metabolic syndrome, primary research needs to be designed to determine the p...
Okoro, Chinyere K.; Kingsley, Robert A.; Connor, Thomas R.; Harris, Simon R.; Parry, Christopher M.; Al-Mashhadani, Manar N; Kariuki, Samuel; Msefula, Chisomo L.; Gordon, Melita A.; de Pinna, Elizabeth; Wain, John; Heyderman, Robert S.; Obaro, Stephen; Alonso, Pedro L.; Mandomando, Inacio; MacLennan, Calman A.; Tapia, Milagritos D.; Levine, Myron M.; Tennant, Sharon M; Parkhill, Julian; Dougan, Gordon
A highly invasive form of non-typhoidal Salmonella (iNTS) disease has been recently documented in many countries in sub-Saharan Africa. The most common Salmonella enterica serovar causing this disease is Typhimurium. We applied whole-genome sequence-based phylogenetic methods to define the population structure of sub-Saharan African invasive Salmonella Typhimurium and compared these to global Salmonella Typhimurium isolates. Notably, the vast majority of sub-Saharan invasive Salmonella Typhimurium fell within two closely-related, highly-clustered phylogenetic lineages that we estimate emerged independently ~52 and ~35 years ago, in close temporal association with the current HIV pandemic. Clonal replacement of isolates of lineage I by lineage II was potentially influenced by the use of chloramphenicol for the treatment of iNTS disease. Our analysis suggests that iNTS disease is in part an epidemic in sub-Saharan Africa caused by highly related Salmonella Typhimurium lineages that may have occupied new niches associated with a compromised human population and antibiotic treatment. PMID:23023330
Full Text Available Published by Palgrave MacmillanOver the last decade the topic of energy security has reappeared on global policy agendas. Most analyses of international energy geopolitics examine the interests and behaviour of powerful energy-importing countries like the US and China. This chapter begins by examining foreign powers expanded exploitation of oil and uranium resources in Sub-Saharan Africa. It goes on to examine how energy importers efforts to enhance their energy security through Africa are impacting energy security within Africa. It assesses Sub-Saharan states attempts to increase consumption of local oil and uranium reserves. Observing the constraints on these efforts, it then outlines some alternative strategies that have been employed to enhance African energy security. It concludes that, while local community-based development projects have improved the well-being of many households, they are not a sufficient guarantor of energy security. Inadequate petroleum access, in particular, remains a development challenge. Foreign powers efforts to increase their oil security are undermining the energy security of Sub-Saharan African citizens.
Gnonlonfin, Gbemenou Joselin Benoit; Hell, K.
Mycotoxins contamination in some agricultural food commodities seriously impact human and animal health and reduce the commercial value of crops. Mycotoxins are toxic secondary metabolites produced by fungi that contaminate agricultural commodities pre- or postharvest. Africa is one of the continents where environmental, agricultural and storage conditions of food commodities are conducive of Aspergillus fungi infection and aflatoxin biosynthesis. This paper reviews the commodity-wise aetiology and contamination process of aflatoxins and evaluates the potential risk of exposure from common African foods. Possible ways of reducing risk for fungal infection and aflatoxin development that are relevant to the African context. The presented database would be useful as benchmark information for development and prioritization of future research. There is need for more investigations on food quality and safety by making available advanced advanced equipments and analytical methods as well as surveillance and awareness creation in the region.
Brian Kevin Reilly; Paul Andre DeGeorges
This is an historic overview of conservation in Sub-Saharan Africa from pre-colonial times through the present. It demonstrates that Africans practiced conservation that was ignored by the colonial powers. The colonial market economy combined with the human and livestock population explosion of the 21st century are the major factors contributing to the demise of wildlife and critical habitat. Unique insight is provided into the economics of a representative safari company, something that has ...
Kyongo, Jordan K; Crucitti, Tania; Menten, Joris; Hardy, Liselotte; Cools, Piet; Michiels, Johan; Delany-Moretlwe, Sinead; Mwaura, Mary; Ndayisaba, Gilles; Joseph, Sarah; Fichorova, Raina; van de Wijgert, Janneke; Vanham, Guido; Ariën, Kevin K; Jespers, Vicky
Data on immune mediators in the genital tract and the factors that modulate them in sub-Saharan women are limited. Cervicovaginal lavage (CVL) samples from 430 sexually active women from Kenya, South Africa, and Rwanda were analyzed for 12 soluble immune mediators using Bio-Plex and Meso Scale Discovery multiplex platforms, as well as single enzyme-linked immunosorbent assays. Ten bacterial species were quantified in vaginal swab samples. Bacterial vaginosis (BV) was defined by Nugent scoring. CVL samples from HIV-infected women showed a clear-cut proinflammatory profile. Pregnant women, adolescents, and women engaging in traditional vaginal practices differed in specific soluble markers compared to reference groups of adult HIV-negative women. Cervical mucus, cervical ectopy, abnormal vaginal discharge, and having multiple sex partners were each associated with an increase in inflammatory mediators. The levels of interleukin-1? (IL-1?), IL-1?, IL-6, IL-12(p70), and IL-8 were elevated, whereas the IL-1RA/IL-1(?+?) ratio decreased in women with BV. The level of gamma interferon-induced protein 10 was lower in BV-positive than in BV-negative women, suggesting its suppression as a potential immune evasion mechanism by BV-associated bacteria. Lactobacillus crispatus and Lactobacillus vaginalis were associated with decreased proinflammatory cytokines and each BV-associated species with increased proinflammatory cytokines. Remarkably, the in vitro anti-HIV activity of CVL samples from BV-positive women was stronger than that of BV-negative women. In conclusion, we found significant associations of factors, including vaginal microbiota, which can influence immune mediators in the vaginal environment in sexually active women. These factors need to be considered when establishing normative levels or pathogenic cutoffs of biomarkers of inflammation and associated risks in African women. PMID:25761460
Terreros, Maria C; Martinez, Laisel; Herrera, Rene J
Thorough assessment of modern genetic diversity and interpopulation affinities within the African continent is essential for understanding the processes that have been at work during the course of worldwide human evolution. Regardless of whether autosomal, Y-chromosome, or mtDNA markers are used, allele- or haplotype-frequency data from African populations are necessary in setting the framework for the construction of global population phylogenies. In the present study we analyze genetic differentiation and population structure in a data set of nine African populations using 12 polymorphic Alu insertions (PAls). Furthermore, to place our findings within a global context, we also examined an equal number of non-African groups. Frequency data from 456 individuals presented for the first time in this work plus additional data obtained from the literature indicate an overall pattern of higher intrapopulation diversity in sub-Saharan populations than in northern Africa, a prominent differentiation between these two locations, an appreciably high degree of transcontinental admixture in Egypt, and significant discontinuity between Morocco and the Iberian peninsula. Moreover, the topologies of our phylogenetic analyses suggest that out of the studied sub-Saharan groups, the southern Bantu population of Sotho/ Tswana presents the highest level of antiquity, perhaps as a result of ancestral or acquired Khoisan genetic signals. Close affinities of eastern sub-Saharan populations with Egypt in the phylogenetic trees may indicate the existence of gene flow along the Nile River. PMID:16596946
Khan, Zeyaur R; Midega, Charles A. O.; Pittchar, Jimmy O.; Murage, Alice W.; Birkett, Michael A.; Bruce, Toby J. A.; Pickett, John A.
Food insecurity is a chronic problem in Africa and is likely to worsen with climate change and population growth. It is largely due to poor yields of the cereal crops caused by factors including stemborer pests, striga weeds and degraded soils. A platform technology, pushpull, based on locally available companion plants, effectively addresses these constraints resulting in substantial grain yield increases. It involves intercropping cereal crops with a forage legume, desmodium, and plantin...
Access to safe water is currently a privilege for the citizens of many developing countries in Asia and Africa. In the last few decades changes in climate have increased concentrations of greenhouse gasses. The results of global warming have had a significant impact upon the hydrological cycle from freshwater resources to rising sea levels, flooding and precipitation changes. Population concentration and growth have also placed additional pressures on water resources resulting in changes to e...
Muideen O. Bakare
Full Text Available Sub-Saharan African (SSA population consists of about 45% children, while in Europe and North America children population is 10- 15%. Lately, attention has been directed at mitigating childhood infectious and communicable diseases to reduce under-five mortality. As the under-five mortality index in Sub-Saharan Africa has relatively improved over the last two decades, more Sub-Saharan African children are surviving beyond the age of five and, apparently, a sizeable percentage of this population would be living with one or more childhood neurodevelopmental disorders (NDD. The distribution of child mental health service resources across the world is unequal. This manifests in the treatment gap of major childhood onset mental health problems in SSA, with the gap being more pronounced for childhood NDD. It is important to balance the public health focus and research funding priorities in Sub-Saharan Africa. We urgently need to define the burden of childhood NDD in the region for healthcare planning and policy formulation.
Khan, Zeyaur R; Midega, Charles A O; Pittchar, Jimmy O; Murage, Alice W; Birkett, Michael A; Bruce, Toby J A; Pickett, John A
Food insecurity is a chronic problem in Africa and is likely to worsen with climate change and population growth. It is largely due to poor yields of the cereal crops caused by factors including stemborer pests, striga weeds and degraded soils. A platform technology, 'push-pull', based on locally available companion plants, effectively addresses these constraints resulting in substantial grain yield increases. It involves intercropping cereal crops with a forage legume, desmodium, and planting Napier grass as a border crop. Desmodium repels stemborer moths (push), and attracts their natural enemies, while Napier grass attracts them (pull). Desmodium is very effective in suppressing striga weed while improving soil fertility through nitrogen fixation and improved organic matter content. Both companion plants provide high-value animal fodder, facilitating milk production and diversifying farmers' income sources. To extend these benefits to drier areas and ensure long-term sustainability of the technology in view of climate change, drought-tolerant trap and intercrop plants are being identified. Studies show that the locally commercial brachiaria cv mulato (trap crop) and greenleaf desmodium (intercrop) can tolerate long droughts. New on-farm field trials show that using these two companion crops in adapted push-pull technology provides effective control of stemborers and striga weeds, resulting in significant grain yield increases. Effective multi-level partnerships have been established with national agricultural research and extension systems, non-governmental organizations and other stakeholders to enhance dissemination of the technology with a goal of reaching one million farm households in the region by 2020. These will be supported by an efficient desmodium seed production and distribution system in eastern Africa, relevant policies and stakeholder training and capacity development. PMID:24535391
Khan, Zeyaur R.; Midega, Charles A. O.; Pittchar, Jimmy O.; Murage, Alice W.; Birkett, Michael A.; Bruce, Toby J. A.; Pickett, John A.
Food insecurity is a chronic problem in Africa and is likely to worsen with climate change and population growth. It is largely due to poor yields of the cereal crops caused by factors including stemborer pests, striga weeds and degraded soils. A platform technology, pushpull, based on locally available companion plants, effectively addresses these constraints resulting in substantial grain yield increases. It involves intercropping cereal crops with a forage legume, desmodium, and planting Napier grass as a border crop. Desmodium repels stemborer moths (push), and attracts their natural enemies, while Napier grass attracts them (pull). Desmodium is very effective in suppressing striga weed while improving soil fertility through nitrogen fixation and improved organic matter content. Both companion plants provide high-value animal fodder, facilitating milk production and diversifying farmers income sources. To extend these benefits to drier areas and ensure long-term sustainability of the technology in view of climate change, drought-tolerant trap and intercrop plants are being identified. Studies show that the locally commercial brachiaria cv mulato (trap crop) and greenleaf desmodium (intercrop) can tolerate long droughts. New on-farm field trials show that using these two companion crops in adapted pushpull technology provides effective control of stemborers and striga weeds, resulting in significant grain yield increases. Effective multi-level partnerships have been established with national agricultural research and extension systems, non-governmental organizations and other stakeholders to enhance dissemination of the technology with a goal of reaching one million farm households in the region by 2020. These will be supported by an efficient desmodium seed production and distribution system in eastern Africa, relevant policies and stakeholder training and capacity development. PMID:24535391
Moens, Katrien; Siegert, Richard J.; Taylor, Steve; Namisango, Eve; Harding, Richard
Background Symptom research across conditions has historically focused on single symptoms, and the burden of multiple symptoms and their interactions has been relatively neglected especially in people living with HIV. Symptom cluster studies are required to set priorities in treatment planning, and to lessen the total symptom burden. This study aimed to identify and compare symptom clusters among people living with HIV attending five palliative care facilities in two sub-Saharan African countries. Methods Data from cross-sectional self-report of seven-day symptom prevalence on the 32-item Memorial Symptom Assessment Scale-Short Form were used. A hierarchical cluster analysis was conducted using Wards method applying squared Euclidean Distance as the similarity measure to determine the clusters. Contingency tables, X2 tests and ANOVA were used to compare the clusters by patient specific characteristics and distress scores. Results Among the sample (N=217) the mean age was 36.5 (SD 9.0), 73.2% were female, and 49.1% were on antiretroviral therapy (ART). The cluster analysis produced five symptom clusters identified as: 1) dermatological; 2) generalised anxiety and elimination; 3) social and image; 4) persistently present; and 5) a gastrointestinal-related symptom cluster. The patients in the first three symptom clusters reported the highest physical and psychological distress scores. Patient characteristics varied significantly across the five clusters by functional status (worst functional physical status in cluster one, pART (highest proportions for clusters two and three, p=0.012); global distress (F=26.8, p<0.001), physical distress (F=36.3, p<0.001) and psychological distress subscale (F=21.8, p<0.001) (all subscales worst for cluster one, best for cluster four). Conclusions The greatest burden is associated with cluster one, and should be prioritised in clinical management. Further symptom cluster research in people living with HIV with longitudinally collected symptom data to test cluster stability and identify common symptom trajectories is recommended. PMID:25966420
Sánchez-Quinto, Federico; Botigué, Laura R
One of the main findings derived from the analysis of the Neandertal genome was the evidence for admixture between Neandertals and non-African modern humans. An alternative scenario is that the ancestral population of non-Africans was closer to Neandertals than to Africans because of ancient population substructure. Thus, the study of North African populations is crucial for testing both hypotheses. We analyzed a total of 780,000 SNPs in 125 individuals representing seven different North African locations and searched for their ancestral/derived state in comparison to different human populations and Neandertals. We found that North African populations have a significant excess of derived alleles shared with Neandertals, when compared to sub-Saharan Africans. This excess is similar to that found in non-African humans, a fact that can be interpreted as a sign of Neandertal admixture. Furthermore, the Neandertal's genetic signal is higher in populations with a local, pre-Neolithic North African ancestry. Therefore, the detected ancient admixture is not due to recent Near Eastern or European migrations. Sub-Saharan populations are the only ones not affected by the admixture event with Neandertals.
The bulk of rural populations in sub-Saharan Africa have no access to electricity and are under-served by any other form of modern infrastructure. The cost of infrastructure to mainly scattered communities has been perennially cited as largely to blame. Quite often rural networks are overdesigned, resulting in under utilization and, therefore, costly overheads. One reason often cited for the overspecification is anticipation of load growth. In most sub-Sahara African rural areas, however, economic growth rates are low, and a designer has no justification in specifying an infrastructure capacity exceeding more than a few percent of existing consumer requirements. This paper proposes methods that critically look at the geometry of small grid network designs to address the construction challenges in rural sub-Saharan Africa
Eucebious Lekalakala- Mokgele
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 ...
Higher education in Sub-Saharan African countries is examined. Attention is directed to the development of higher education in sub-Saharan African countries since the early 1960s, as well as criticisms currently directed at the sector, and the economic and budgetary environment for resource allocation. The labor market for African college
The UNESCO Regional Office for Education in Africa has spearheaded development of a draft regional strategy for the implementation of the UNDESD in sub-Saharan Africa. The strategy aims to harmonize implementation of ESD; broaden public awareness; promote an education system that enhances African culture, especially when it contributes to
Schmutzhard Erich; Eide Geir; Hãggblom Amanda; Torsvik Malvin; Vetvik Kaare; Winkler Andrea
Abstract Background Diabetes mellitus is becoming increasingly common in sub-Saharan Africa. Autonomic dysfunction contributes to morbidity and mortality in diabetic patients. Data on autonomic dysfunction in the African population is scarce, and no reference values for standardized autonomic function tests are available. The aim of this study was to establish cut off values for five easy-to-use cardiovascular autonomic function tests that may be suitable for resource-poor settings. Methods W...
Pauly, M.; Hoppe, E.; Mugisha, L.; Petrelková, Klára Judita; Akoua-Koffi, C.; Couacy-Hymann, E.; Anoh, A. E.; Mossoun, A.; Schubert, G.; Wiersma, L.; Pascale, S.; Muyembe, J.-J.; Karhemere, S.; Weiss, S.; Leendertz, S. A.; Calvignac-Spencer, S.; Leendertz, F. H.; Ehlers, B.
Ro?. 11, ?. 25 (2014), s. 25. ISSN 1743-422X R&D Projects: GA ?R GA206/09/0927 Institutional support: RVO:68081766 Keywords : Adenoviridae * Human adenovirus D * Genotype * Sub-Saharan Africa * PCR Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 2.089, year: 2013
Abiola Fatimah, Adenowo; Babatunji Emmanuel, Oyinloye; Bolajoko Idiat, Ogunyinka; Abidemi Paul, Kappo.
Full Text Available Schistosomiasis, a neglected tropical disease of poverty ranks second among the most widespread parasitic disease in various nations in sub-Saharan Africa. Neglected tropical diseases are causes of about 534,000 deaths annually in sub-Saharan Africa and an estimated 57 million disability-adjusted li [...] fe-years are lost annually due to the neglected tropical diseases. The neglected tropical diseases exert great health, social and ?nancial burden on economies of households and governments. Schistosomiasis has profound negative effects on child development, outcome of pregnancy, and agricultural productivity, thus a key reason why the "bottom 500 million" inhabitants of sub-Saharan Africa continue to live in poverty. In 2008, 17.5 million people were treated globally for schistosomiasis, 11.7 million of those treated were from sub-Saharan Africa. This enervating disease has been successfully eradicated in Japan, as well as in Tunisia. Morocco and some Caribbean Island countries have made signi?cant progress on control and management of this disease. Brazil, China and Egypt are taking steps towards elimination of the disease, while most sub-Saharan countries are still groaning under the burden of the disease. Various factors are responsible for the continuous and persistent transmission of schistosomiasis in sub-Saharan Africa. These include climatic changes and global warming, proximity to water bodies, irrigation and dam construction as well as socio-economic factors such as occupational activities and poverty. The morbidity and mortality caused by this disease cannot be overemphasized. This review is an exposition of human schistosomiasis as it affects the inhabitants of various communities in sub-Sahara African countries. It is hoped this will bring a re-awakening towards efforts to combat this impoverishing disease in terms of vaccines development, alternative drug design, as well as new point-of-care diagnostics.
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
Washington Muzari; Wirimayi Gatsi; Shepherd Muvhunzi
This paper is a review article on the impacts of technology adoption on agricultural productivity in smallholder agriculture in the sub-Saharan African region. The use of agricultural technologies determines how the increase in agricultural output impacts on poverty levels and environmental degradation. Experience and evidence from countries within and around the sub-Saharan African region indicate that returns to agricultural technology development could be very high and far reaching. The fa...
Pitman, John P; Wilkinson, Robert; Liu, Yang; von Finckenstein, Bjorn; Smit Sibinga, Cees Th; Lowrance, David W; Marfin, Anthony A; Postma, Maarten J; Mataranyika, Mary; Basavaraju, Sridhar V
National blood use patterns in sub-Saharan Africa are poorly described. Although malaria and maternal hemorrhage remain important drivers of blood demand across Africa, economic growth and changes in malaria, HIV/AIDS, and noncommunicable disease epidemiology may contribute to changes in blood demand. We evaluated indications for blood use in Namibia, a country in southern Africa, using a nationally representative sample and discuss implications for the region. Clinical and demographic data related to the issuance of blood component units in Namibia were reviewed for a 4-year period (August 1, 2007-July 31, 2011). Variables included blood component type, recipient age and sex, and diagnosis. Diagnoses reported by clinicians were reclassified into International Statistical Classification of Diseases, 10th Revision categories. Multiple imputation methods were used to complete a data set missing age, sex or diagnosis data. Descriptive analyses were conducted to describe indications for transfusions and use of red blood cells (RBCs), platelets, and plasma. A total of 39,313 records accounting for 91,207 blood component units were analyzed. The median age of Namibian transfusion recipients was 45 years (SD, ±19). A total of 78,660 RBC units were issued in Namibia during the study period. Red blood cells transfused for "unspecified anemia" accounted for the single largest category of blood issued (24,798 units). Of the overall total, 38.9% were for diseases of the blood and blood-forming organs (D50-D89). Infectious disease (A00-B99), pregnancy (O00-O99), and gastrointestinal (K20-K93) accounted for 14.8%, 11.1%, and 6.1% of RBC units issued, respectively. Although a specific diagnosis of malaria accounted for only 2.7% of pediatric transfusions, an unknown number of additional transfusions for malaria may have been categorized by requesting physicians as unspecified anemia and counted under diseases of blood forming organs. During the study period, 9751 units of fresh-frozen plasma were issued. Nearly one-quarter of these units (23.1%) were issued for gastrointestinal (K20-K93) diagnoses. Malignant neoplasms (C00-C97) accounted for 38.1% of 2978 platelet units issued. Blood use in Namibia reflects changes in the health care system due to economic development, improvement in HIV/AIDS and malaria epidemiology, high rates of health care facility-based childbirth, and access to noncommunicable disease treatment. However, better documentation of the indications for transfusion is needed to confirm these observations. Changing patterns of health care will result in changing demands for blood components. Improved methods to evaluate blood use patterns in sub-Saharan Africa may help set realistic national blood collection goals. PMID:25573416
...beneficiary sub-Saharan African country. 4. Section...beneficiary sub-Saharan African country for purposes...beneficiary sub-Saharan African countries for purposes...of the International Bank for Reconstruction and Development. Termination is...
Oyedokun Agbeja; R.O. Salawu
In an increasingly digitalized world economy, there exists a digital gap between Sub-Saharan Africa and the rest of the world that translates into economic marginalization of the African region. Consequently, the following phases of development are crucial for the region: (1) the phase of massive digitalization during which the digital divide is bridged and (2) the phase of information and knowledge management in which information is systematically converted into knowledge and the latter into...
This paper contributes to the aid effectiveness debate by applying a vector autoregression 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 o...
Rudel, Thomas K.
For decades, the dynamics of tropical deforestation in sub-Saharan Africa (SSA) have defied easy explanation. The rates of deforestation have been lower than elsewhere in the tropics, and the driving forces evident in other places, government new land settlement schemes and industrialized agriculture, have largely been absent in SSA. The context and causes for African deforestation become clearer through an analysis of new, national-level data on forest cover change for SSA countries for the ...
Gabbert, T.; Ichoku, C. M.; Matsui, T.; Capehart, W. J.
The northern Sub-Saharan African region (NSSA) is an area of intense study due to the recent severe droughts that have dire consequences on the population, which relies mostly on rainfed agriculture for its food supply. This region's weather and hydrologic cycle are very complex and are dependent on the West African Monsoon. Different regional processes affect the West African Monsoon cycle and variability. One of the areas of current investigation is the water cycle response to the variability of land surface characteristics. Land surface characteristics are often altered in NSSA due to agricultural practices, grazing, and the fires that occur during the dry season. To better understand the effects of biomass burning on the hydrologic cycle of the sub-Saharan environment, an interdisciplinary team sponsored by NASA is analyzing potential feedback mechanisms due to the fires. As part of this research, this study focuses on the effects of land surface changes, particularly albedo and skin temperature, that are influenced by biomass burning. Surface temperature anomalies can influence the initiation of convective rainfall and surface albedo is linked to the absorption of solar radiation. To capture the effects of fire perturbations on the land surface, NASA's Unified Weather and Research Forecasting (NU-WRF) model coupled with NASA's Land Information System (LIS) is being used to simulate some of the fire-induced surface temperature anomalies and other environmental processes. In this presentation, we will report the strategy for these simulations, and show some preliminary results.
Jayshree Thakrar; Denise Zinn; Freda Wolfenden
The challenges to teacher educators in sub-Saharan Africa are acute. This paper describes how the Teacher Education in Sub-Saharan Africa (TESSA) consortium is working within institutional and national policy systems to support school-based teacher professional development. The TESSA consortium (13 African institutions and 5 international organisations delivering teacher education across 9 countries) designed and produced a bank of open educational resources (OERs) to guide teachers classr...
Oramasionwu, Christine U; Daniels, Kelly R; Labreche, Matthew J; Frei, Christopher R
The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) pandemic has caused far-reaching effects in sub-Saharan Africa. The pandemic has effectively diminished the workforce, increased poverty rates, reduced agricultural productivity, and transformed the structure of many rural households. HIV/AIDS further strains the already fragile relationship between livelihood and the natural and social environments of these regions. Therefore, the objective of this review is to characterize the impact of HIV/AIDS on the environment and the social infrastructure of rural sub-Saharan Africa. There are many aspects of rural life that contribute to disease transmission of HIV/AIDS and that pose unique challenges to the population dynamics in sub-Saharan Africa. Widespread AIDS-related mortality has caused a decrease in population growth for many African countries. In turn, these alterations in population dynamics have resulted in a decrease in the percentage of prime-age working adults, as well as a gender disparity, whereby, females carry a growing burden of household responsibilities. There is a rising proportion of older adults, often females, who assume the role of provider and caretaker for other dependent family members. These changing dynamics have caused many to exploit their natural surroundings, adopting less sustainable land use practices and utilizing protected resources as a primary means of generating revenue. PMID:21845169
Christopher R. Frei
Full Text Available The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS pandemic has caused far-reaching effects in sub-Saharan Africa. The pandemic has effectively diminished the workforce, increased poverty rates, reduced agricultural productivity, and transformed the structure of many rural households. HIV/AIDS further strains the already fragile relationship between livelihood and the natural and social environments of these regions. Therefore, the objective of this review is to characterize the impact of HIV/AIDS on the environment and the social infrastructure of rural sub-Saharan Africa. There are many aspects of rural life that contribute to disease transmission of HIV/AIDS and that pose unique challenges to the population dynamics in sub-Saharan Africa. Widespread AIDS-related mortality has caused a decrease in population growth for many African countries. In turn, these alterations in population dynamics have resulted in a decrease in the percentage of prime-age working adults, as well as a gender disparity, whereby, females carry a growing burden of household responsibilities. There is a rising proportion of older adults, often females, who assume the role of provider and caretaker for other dependent family members. These changing dynamics have caused many to exploit their natural surroundings, adopting less sustainable land use practices and utilizing protected resources as a primary means of generating revenue.
Sia, Drissa; Onadja, Yentéma; Nandi, Arijit; Foro, Anne; Brewer, Timothy
Within sub-Saharan Africa, women are disproportionately at risk for acquiring and having human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). It is important to clarify whether gender inequalities in HIV prevalence in this region are explained by differences in the distributions of HIV risk factors, differences in the effects of these risk factors or some combination of both. We used an extension of the Blinder-Oaxaca decomposition approach to explain gender inequalities in HIV/AIDS in Kenya, Lesotho and Tanzania using data from the demographic and health and AIDS indicator surveys. After adjusting for covariates using Poisson regression models, female gender was associated with a higher prevalence of HIV/AIDS in Kenya [prevalence ratio (PR) = 1.73, 95% confidence interval (CI) = 1.33, 2.23 in 2003] and Lesotho (PR = 1.39, 95% CI = 1.20, 1.62 in 2004/05), but not in Tanzania. Decomposition analyses demonstrated two distinct patterns over time. In Tanzania, the gender inequality in HIV/AIDS was explained by differences in the distributions of HIV risk factors between men and women. In contrast, in Kenya and Lesotho, this inequality was partly explained by differences in the effects across men and women of measured HIV/AIDS risk factors, including socio-demographic characteristics (age and marital status) and sexual behaviours (age at first sex); these results imply that gender inequalities in HIV/AIDS would persist in Kenya and Lesotho even if men and women had similar distributions of HIV risk factors. The production of gender inequalities may vary across countries, with inequalities attributable to the unequal distribution of risk factors among men and women in some countries and the differential effect of these factors between groups in others. These different patterns have important implications for policies to reduce gender inequalities in HIV/AIDS. PMID:24345343
This study examines how MNCs manage challenges when operating in sub-Saharan Africa (SSA). These are challenges such as uncertain environment because of bureaucracy and corruption and also difficulties to reach consumers because of poor infrastructure, dispersed population and cultural differences. The analysis of our case company ABB suggests that firms operating in SSA need to build long-term relationships, as well as long experience and a brand with well-attached references in order to rea...
Full Text Available The present-day Brazilian population is a consequence of the admixture of various peoples of very different origins, namely, Amerindians, Europeans and Africans. The proportion of each genetic contribution is known to be very heterogeneous throughout the country. The aim of the present study was to compare the male lineages present in two distinct Brazilian populations, as well as to evaluate the African contribution to their male genetic substrate. Thus, two Brazilian population samples from Manaus (State of Amazon and Ribeirão Preto (State of São Paulo and three African samples from Guinea Bissau, Angola and Mozambique were typed for a set of nine Y chromosome specific STRs. The data were compared with those from African, Amerindian and European populations. By using Y-STR haplotype information, low genetic distances were found between the Manaus and Ribeirão Preto populations, as well as between these and others from Iberia. Likewise, no significant distances were observed between any of the African samples from Angola, Mozambique and Guinea Bissau. Highly significant Rst values were found between both Brazilian samples and all the African and Amerindian populations. The absence of a significant Sub-Saharan African male component resulting from the slave trade, and the low frequency in Amerindian ancestry Y-lineages in the Manaus and Ribeirão Preto population samples are in accordance with the accentuated gender asymmetry in admixture processes that has been systematically reported in colonial South American populations.
Mónica, Carvalho; Pedro, Brito; Virgínia, Lopes; Lisa, Andrade; Mª João, Anjos; Francisco Corte, Real; Leonor, Gusmão.
Full Text Available The present-day Brazilian population is a consequence of the admixture of various peoples of very different origins, namely, Amerindians, Europeans and Africans. The proportion of each genetic contribution is known to be very heterogeneous throughout the country. The aim of the present study was to [...] compare the male lineages present in two distinct Brazilian populations, as well as to evaluate the African contribution to their male genetic substrate. Thus, two Brazilian population samples from Manaus (State of Amazon) and Ribeirão Preto (State of São Paulo) and three African samples from Guinea Bissau, Angola and Mozambique were typed for a set of nine Y chromosome specific STRs. The data were compared with those from African, Amerindian and European populations. By using Y-STR haplotype information, low genetic distances were found between the Manaus and Ribeirão Preto populations, as well as between these and others from Iberia. Likewise, no significant distances were observed between any of the African samples from Angola, Mozambique and Guinea Bissau. Highly significant Rst values were found between both Brazilian samples and all the African and Amerindian populations. The absence of a significant Sub-Saharan African male component resulting from the slave trade, and the low frequency in Amerindian ancestry Y-lineages in the Manaus and Ribeirão Preto population samples are in accordance with the accentuated gender asymmetry in admixture processes that has been systematically reported in colonial South American populations.
Gruca, Marta; van Andel, Tinde R.; Balslev, Henrik
Palms (Arecaceae) are prominent elements in African traditional medicines. It is, however, a challenge to find detailed information on the ritual use of palms, which are an inextricable part of African medicinal and spiritual systems. This work reviews ritual uses of palms within African ethnomedicine. We studied over 200 publications on uses of African palms and found information about ritual uses in 26 of them. At least 12 palm species in sub-Saharan Africa are involved in various ritual pr...
Charlson, Fiona J; Diminic, Sandra; Lund, Crick; Degenhardt, Louisa; Whiteford, Harvey A
The world is undergoing a rapid health transition, with an ageing population and disease burden increasingly defined by disability. In Sub-Saharan Africa the next 40 years are predicted to see reduced mortality, signalling a surge in the impact of chronic diseases. We modelled these epidemiological changes and associated mental health workforce requirements. Years lived with a disability (YLD) predictions for mental and substance use disorders for each decade from 2010 to 2050 for four Sub-Saharan African regions were calculated using Global Burden of Disease 2010 study (GBD 2010) data and UN population forecasts. Predicted mental health workforce requirements for 2010 and 2050, by region and for selected countries, were modelled using GBD 2010 prevalence estimates and recommended packages of care and staffing ratios for low- and middle-income countries, and compared to current staffing from the WHO Mental Health Atlas. Significant population growth and ageing will result in an estimated 130% increase in the burden of mental and substance use disorders in Sub-Saharan Africa by 2050, to 45 million YLDs. As a result, the required mental health workforce will increase by 216,600 full time equivalent staff from 2010 to 2050, and far more compared to the existing workforce. The growth in mental and substance use disorders by 2050 is likely to significantly affect health and productivity in Sub-Saharan Africa. To reduce this burden, packages of care for key mental disorders should be provided through increasing the mental health workforce towards targets outlined in this paper. This requires a shift from current practice in most African countries, involving substantial investment in the training of primary care practitioners, supported by district based mental health specialist teams using a task sharing model that mobilises local community resources, with the expansion of inpatient psychiatric units based in district and regional general hospitals. PMID:25310010
Bruges Armas, J; Destro-Bisol, G; López-Vazquez, A; Couto, A R; Spedini, G; Gonzalez, S; Battaggia, C; Peixoto, M J; Martinez-Borra, J; López-Larrea, C
We have studied the polymorphism of HLA class I in two West African Pygmy populations, namely, the Bakola from Cameroon and the Mbenzele from the Central African Republic. A unique number of HLA alleles and haplotypes showed specific patterns of these populations. In this study, we identify two alleles (B*37, B*41) and three haplotypes (A*30-B*37, A*66-B*41 and A*68-B*58) that appear to be 'private' or typical of Western Pygmies. These data reflect similarities with the AKA Pygmies from the Central African Republic. On the other hand, we failed to identify alleles that are found at high frequencies among other sub-Saharan populations (B*42, B*51). Allelic and haplotypic frequency distributions show differences between the two Pygmy groups, e.g. B*35 was very common in the Mbenzele but has been found to be absent in the Bakola. In contrast, B*53, which is found in the Bakola, has been found to be rare in the Mbenzele Pygmies. In order to analyse the genetic relationships of the Bakola and Mbenzele Pygmies with other sub-Saharan populations, HLA gene frequencies were subjected to the Neighbour-Joining tree analysis. The Mbenzele, Bakola and AKA were found to be relatively close to each other and isolated from other sub-African populations. However, both the genetic distances and the within-group variation suggests that the Bakola are more admixed with Bantu farmers than Mbenzele. PMID:12956877
Petria M. Theron
Full Text Available On the 2012 Corruption Perceptions Index of Transparency International, 89.6%of Sub-Saharan African countries received scores below 50, where a score of zero signifies that the country is highly corrupt and a score of 100 declares a country free of corruption. From these results, it seems as if Sub-Saharan African countries are quite vulnerable to corruption. In this article, the question whether certain traits in the Sub-Saharan African culture such as communalism, gift giving and a shame culture could in some situations influence peoples perception of, and their possible openness towards, certain forms of corruption was investigated. The research showed that cultural traits do influence peoples behaviour and that there are certain traits in the Sub-Saharan African culture that might sanction corruption. In response to these findings, some preliminary suggestions were proposed as to how Christians living in Africa could evaluate their cultural practices in the light of Gods Word and from a reformed theological paradigm. Instead of succumbing to the pressure posed by their culture to participate in immoral or corrupt activities, they could contribute to a moral regeneration on the African continent.
Gerrits, T.; Shaw, M.
Some sort of infertility treatments, including the use of advanced reproductive technologies (ARTs), is nowadays pro- vided at several places in sub-Saharan Africa. Yet, to date only a few studies have actually looked into the way these treatments are offered, used and experienced. In this review article the authors present and discuss empirical study findings that give insight into the way biomedical infertility care is provided, considered, experienced and/or used in sub-Saharan African cou...
Berman, Nicolas; Martin, Philippe
In the early stage of the 2008-2009 financial crisis, the conventional wisdom was that financial underdevelopment of sub Saharan African economies may have been a bless-ing in disguise because it insulated them from the direct effects of the crisis. This paper argues that this may also make African exporters, dangerously more dependent on the health of financial institutions in countries where they export. In the 2008-2009 financial crisis, we find that African exports to the US h...
Draughon, Jessica E; Sheridan, Daniel J
Both HIV and sexual assault remain major public health problems in Sub-Saharan Africa. This review examines the state of the science regarding provision of non- occupational post-exposure prophylaxis following sexual assault in Sub-Saharan African countries over the last 10 years. Specifically, rates of provision of HIV nPEP, the number of patients accepting nPEP, patients' rates of completing the HIV nPEP regimen as defined by the individual studies, and patients' perceptions of HIV nPEP from qualitative data. PMID:21635680
Omariba, D. Walter Rasugu; Boyle, Michael H.
This study applies multilevel logistic regression to Demographic and Health Survey data from 22 sub-Saharan African countries to examine whether the relationship between child mortality and family structure, with a specific emphasis on polygyny, varies cross-nationally and over time. Hypotheses were developed on the basis of competing theories on
Andernach, Iris E; Leiss, Lukas V; Tarnagda, Zekiba S; Tahita, Marc C; Otegbayo, Jesse A; Forbi, Joseph C; Omilabu, Sunday; Gouandjika-Vasilache, Ionela; Komas, Narcisse P; Mbah, Okwen P; Muller, Claude P
Hepatitis D virus (HDV) is a satellite of hepatitis B virus (HBV), and infection with this virus aggravates acute and chronic liver disease. While HBV seroprevalence is very high across sub-Saharan Africa, much less is known about HDV in the region. In this study, almost 2,300 blood serum samples from Burkina Faso (n=1,131), Nigeria (n=974), Chad (n=50), and the Central African Republic (n = 118) were screened for HBV and HDV. Among 743 HBsAg-positive serum samples, 74 were positive for HDV antibodies and/or HDV RNA, with considerable differences in prevalence, ranging from women from Burkina Faso) to 50% (liver patients from Central African Republic). HDV seems to be much more common in chronic liver disease patients in the Central African Republic (CAR) than in similar cohorts in Nigeria. In a large nested mother-child cohort in Burkina Faso, the prevalence of HDV antibodies was 10 times higher in the children than in their mothers, despite similar HBsAg prevalences, excluding vertical transmission as an important route of infection. The genotyping of 16 full-length and 8 partial HDV strains revealed clade 1 (17/24) in three of the four countries, while clades 5 (5/24) and 6 (2/24) were, at least in this study, confined to Central Nigeria. On the amino acid level, almost all our clade 1 strains exhibited a serine at position 202 in the hepatitis D antigen, supporting the hypothesis of an ancient African HDV-1 subgroup. Further studies are required to understand the public health significance of the highly varied HDV prevalences in different cohorts and countries in sub-Saharan Africa. PMID:24599979
Batini, Chiara; Ferri, Gianmarco; Destro-Bisol, Giovanni; Brisighelli, Francesca; Luiselli, Donata; Sánchez-Diz, Paula; Rocha, Jorge; Simonson, Tatum; Brehm, Antonio; Montano, Valeria; Elwali, Nasr Eldin; Spedini, Gabriella; D'Amato, María Eugenia; Myres, Natalie; Ebbesen, Peter; Comas, David; Capelli, Cristian
The study of Y chromosome variation has helped reconstruct demographic events associated with the spread of languages, agriculture, and pastoralism in sub-Saharan Africa, but little attention has been given to the early history of the continent. In order to overcome this lack of knowledge, we carried out a phylogeographic analysis of haplogroups A and B in a broad data set of sub-Saharan populations. These two lineages are particularly suitable for this objective because they are the two most deeply rooted branches of the Y chromosome genealogy. Their distribution is almost exclusively restricted to sub-Saharan Africa where their frequency peaks at 65% in groups of foragers. The combined high-resolution single nucleotide polymorphism analysis with short tandem repeats variation of their subclades reveals strong geographic and population structure for both haplogroups. This has allowed us to identify specific lineages related to regional preagricultural dynamics in different areas of sub-Saharan Africa. In addition, we observed signatures of relatively recent contact, both among Pygmies and between them and Khoisan speaker groups from southern Africa, thus contributing to the understanding of the complex evolutionary relationships among African hunter-gatherers. Finally, by revising the phylogeography of the very early human Y chromosome lineages, we have obtained support for the role of southern Africa as a sink, rather than a source, of the first migrations of modern humans from eastern and central parts of the continent. These results open new perspectives on the early history of Homo sapiens in Africa, with particular attention to areas of the continent where human fossil remains and archaeological data are scant. PMID:21478374
Dillon, David G; Gurdasani, Deepti
Sub-Saharan Africa (SSA) has the highest burden of HIV in the world and a rising prevalence of cardiometabolic disease; however, the interrelationship between HIV, antiretroviral therapy (ART) and cardiometabolic traits is not well described in SSA populations.
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
Noubiap, Jean Jacques N; Bigna, Jean Joel R; Nansseu, Jobert Richie N
Reduction in dietary salt intake and increase in potassium intake can make a major contribution to the prevention and control of hypertension and consequential cardiovascular disease, especially in sub-Saharan Africa (SSA) where prevalence rates are highest. African populations are going through a westernization of their traditional eating patterns, with a shift towards a US/Western-style diet, which contains an excessive amount of salt. Currently, the mean sodium intake in SSA populations is far above the recommended daily allowance. Besides, potassium intake is low, and, particularly, the supply of fruits and vegetables that are important sources of potassium is insufficient to meet current and growing population needs in SSA countries. Context-relevant strategies are needed for population-wide sodium intake reduction and increase in potassium intake. PMID:25382734
Squires-Parsons, Deborah; Gordon F. Bennett; Earle, Roy A.
Linear measurements and derived indices from striated trypanosomes in nine species of sub-Saharan birds representing seven families of the Passeriformes, were compared. The dimensions of the striated trypomastigotes from the Carduelinae, Estrildidae, Nectarinidae, Passeridae, Pycnonotidae, Turdinae and Zosteropidae were similar to each other as well as to those of the striated trypanosomes from the boreal owl (Strigidae). All these trypanosomes were considered to be Trypanosoma av...
Konstantin A. Pantserev
Full Text Available The paper devotes to the problem of overcoming of the digital divide in the Sub Saharan African States. On the example of Kenya the author speaks about the comparative success of the development of the information technologies in Africa and in turn underlines the most significant obstacles on the way of African states to the global information society and suggests the means how to overcome them.
Betlloch-Mas, I; Albares-Tendero, M P; Soro-Martínez, M P; Pérez-Crespo, M
Scalp hyperkeratosis of childhood is most often associated with atopic or seborrheic dermatitis. However, in black children can be associated with tinea capitis. We undertook a retrospective study in all Sub-Saharan children presenting with chronic scalp scaling between June 2010 and June 2013, to determine whether chronic desquamation of the scalp is a clinical manifestation of tinea capitis. The criterion used to diagnose tinea capitis was a positive mycolological culture. Of the 23 Sub-Saharan African children attended, 12 (43.4 %) presented with chronic scalp flaking. Mycological culture was performed in 9 of the 12 cases. The culture was positive in 6 out of 9, so 26 % of the Sub-Saharan African children attended were diagnosed with tinea capitis. In 52.1 % of the cases with persistent scalp scaling the culture was positive. In conclusion, chronic scaling of the scalp may well be the sole form of presentation of tinea capitis in Sub-Saharan children. PMID:24917241
Full Text Available Health systems played a key role in the dramatic rise in global life expectancy that occurred during the 20th century, and have continued to contribute enormously to the improvement of the health of most of the worldÃ¢ÂÂs population. The health workforce is the backbone of each health system, the lubricant that facilitates the smooth implementation of health action for sustainable socio-economic development. It has been proved beyond reasonable doubt that the density of the health workforce is directly correlated with positive health outcomes. In other words, health workers save lives and improve health. About 59 million people make up the health workforce of paid full-time health workers world-wide. However, enormous gaps remain between the potential of health systems and their actual performance, and there are far too many inequities in the distribution of health workers between countries and within countries. The Americas (mainly USA and Canada are home to 14% of the worldÃ¢ÂÂs population, bear only 10% of the worldÃ¢ÂÂs disease burden, have 37% of the global health workforce and spend about 50% of the worldÃ¢ÂÂs financial resources for health. Conversely, sub-Saharan Africa, with about 11% of the worldÃ¢ÂÂs population bears over 24% of the global disease burden, is home to only 3% of the global health workforce, and spends less than 1% of the worldÃ¢ÂÂs financial resources on health. In most developing countries, the health workforce is concentrated in the major towns and cities, while rural areas can only boast of about 23% and 38% of the countryÃ¢ÂÂs doctors and nurses respectively. The imbalances exist not only in the total numbers and geographical distribution of health workers, but also in the skills mix of available health workers. WHO estimates that 57 countries world wide have a critical shortage of health workers, equivalent to a global deficit of about 2.4 million doctors, nurses and midwives. Thirty six of these countries are in sub-Saharan Africa. They would need to increase their health workforce by about 140% to achieve enough coverage for essential health interventions to make a positive difference in the health and life expectancy of their populations. The extent causes and consequences of the health workforce crisis in Sub-Saharan Africa, and the various factors that influence and are related to it are well known and described. Although there is no Ã¢ÂÂmagic bulletÃ¢ÂÂ solution to the problem, there are several documented, tested and tried best practices from various countries. The global health workforce crisis can be tackled if there is global responsibility, political will, financial commitment and public-private partnership for country-led and country-specific interventions that seek solutions beyond the health sector. Only when enough health workers can be trained, sustained and retained in sub-Saharan African countries will there be meaningful socio-economic development and the faintest hope of attaining the Millennium Development Goals in the sub-continent.
Brinkhof, Martin; Boulle, Andrew; Weigel, Ralf; Messou, Euge?ne; Mathers, Colin; Orrell, Catherine; Dabis, Franc?ois; Pascoe, Margaret; Egger, Matthias
BACKGROUND: Mortality in HIV-infected patients who have access to highly active antiretroviral therapy (ART) has declined in sub-Saharan Africa, but it is unclear how mortality compares to the non-HIV-infected population. We compared mortality rates observed in HIV-1-infected patients starting ART with non-HIV-related background mortality in four countries in sub-Saharan Africa. METHODS AND FINDINGS: Patients enrolled in antiretroviral treatment programmes in Côte d'Ivoire, Malawi, South Afr...
Fourie, D.J. (David Johannes); Schoeman, R.E. (Ria Elizabeth)
The primary means of HIV transmission sexual intercourse has been known for over two decades, but that information does not prevent thousands of men and women from contracting the virus every day. The AIDS epidemic creates a high and ongoing mortality in the economic and social active sector of populations in sub-Saharan Africa. The epidemic is being driven by inequities and uneven development, exacerbating existing poverty and human misery. In hard-hit countries in sub-Saharan Africa...
Myskja, Kristin Langballe
Abstract Problem The positive relationship between HIV-prevalence and education in sub-Saharan Africa has been verified by several studies. However, this hypothesis has been challenged recently, and it is in this context that I place my thesis. The HIV-epidemic in sub-Saharan Africa is the only major epidemic that has rooted itself in the main population. The other large epidemics spread mainly in marginalized groups like injecting drug users, men who have sex with men and people involved in...
Sidibé, El Hassane
Thyroid gland diseases vary according to the environment. In sub-Saharan Africa, they are also influenced by population isolation and the absence of food self-sufficiency, both factors affecting the onset and persistence of iodine-deficiency goiters. More cosmopolitan diseases are now added to these thyroid disorders. Women are mainly affected (94.2%), most often with euthyroid goiters (54.7%), followed by Graves disease (13.1%), hypothyroidism (8.8%), thyroiditis (6.6%), toxic multinodular goiters (6.6 %) and unclassified goiters (10%) [Gabon]. The paucity of laboratories specializing in endocrinology and of nuclear medicine facilities, the delay in diagnosis that results in compressive or recurrent goiters, and endemic goiters are all typical in Africa. In children and adolescents, death rates increase with congenital or acquired thyroiditis as with delayed physical or mental development. In this environment, thyroiditis can also be pregnancy-related. Very recent surveys show a prevalence of endemic goiters of 28.6% in the community of Sekota, Ethiopia, 64-70% in Sahel-Sudan (population aged 10-20 years), 20-29% in KwaZulu-Natal (school children), 14.3-30.2% in Namibia (school children), 0.21% (congenital hypothyroidism or cretinism) in Plateau State, Nigeria, 55.2% at Zitenga, Burkina Faso (210 persons 0-45 years), and 10% in Hararé and Wedza, Zimbabwe (newborn TSH >10.1 microIU/mL). The prevalence of goiters is 43.6% in children emigrating from Ethiopia to Israel. Millet from semi-arid zones contains apigenin at a concentration of 150 mg/kg and luteolin at 350 mg/kg, both of which can interfere with thyroid function. The harmful effects of cassava (also known as manioc) are better known: milling cassava reduces its goitrogenic potential. In addition to iodine deficiency, selenium deficiency, and the effect of the thiocyanates in cassava, ion concentrations in soil and drinking water appear to play a role. The proportion of thyroid surgery indicated for hyperthyroidism has tripled, now accounting for 18.5% of all such operations. This disorder is found today in subjects older than 50 years, mainly from rural areas, and caused most often by Graves disease (25 of 51 cases). Graves disease in young women can cause serious problems during pregnancy; in such cases assessment of the minimal effective dose of antithyroid agents is essential. Carbimazole leads to remission in 61% of cases of Graves disease. Hypothyroidism can be auto-immune and often in patent forms because of insufficient screening in Africa: 24 cases in Dakar (1984) and 37 others noticed by us (1998). Single-nodule tumors were assessed in 89 patients in Khartoum: they were found to be simple goiters in 72% of cases, follicular adenoma in 13.5%, cancer in 13.5% (with 6 of the 12 cases follicular, 5 papillary, and 1 anaplastic). The sex ratio for thyroid cancer in Ouagadougou is 0.22, thus mainly women. It affects mainly women in their 30s. Thyroid cancer at Ibadan was found to be papillary carcinoma in 45.3% of cases; follicular forms were seen in 44.5% and this series includes 5% of medullary cancers (7 cases), with a mean age of 34 years. Already 4 other cases from Francophone sub-Saharan Africa have been noticed. Iodine deficiency is suggested to play a role because follicular cancer in southern Africa accounts for up to 55% of thyroid cancers. Thyroid cancers in Algeria are associated with low socioeconomic status and characterized by a high prevalence of cancers discovered at an advanced stage and of anaplastic carcinomas. Oral potassium iodate is recommended: 30 mg of iodate a month or 8 mg every two weeks. Iodized oil has been recommended by some authors, as well as a combination of iodine and sugar, and the iodation of drinking water; these are in addition to the proposed methods of opening up areas by new infrastructure). In conclusion, thyroid disease is due predominantly to iodine deficiency and goitrogenic products, but we also note the increasing emergence of hyperthyroidism, especially Graves disease, atrophic auto-immune hypothyroidism, an
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
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
Allegri, Manuela; Kouyate?, Bocar; Becher, Heiko; Gbangou, Adjima; Pokhrel, Subhash; Sanon, Mamadou; Sauerborn, Rainer
OBJECTIVE: To identify factors associated with decision to enrol in a community health insurance (CHI) scheme. METHODS: We conducted a population-based case-control study among 15 communities offered insurance in 2004 in rural Burkina Faso. For inclusion in the study, we selected all 154 enrolled (cases) and a random sample of 393 non-enrolled (controls) households. We used unconditional logistic regression (applying Huber-White correction to account for clustering at the community level) to ...
Sharp, Colin P.; Vermeulen, Marion; Nébié, Yacouba; Djoko, Cyrille F.; LeBreton, Matthew; Tamoufe, Ubald; Rimoin, Anne W.; Kayembe, Patrick K.; Carr, Jean K.; Servant-Delmas, Annabelle; Laperche, Syria; Harrison, G.L. Abby; Pybus, Oliver G.; Delwart, Eric; Wolfe, Nathan D.; Saville, Andrew; Lefrère, Jean-Jacques
Human parvovirus 4 infections are primarily associated with parenteral exposure in western countries. By ELISA, we demonstrate frequent seropositivity for antibody to parvovirus 4 viral protein 2 among adult populations throughout sub-Saharan Africa (Burkina Faso, 37%; Cameroon, 25%; Democratic Republic of the Congo, 35%; South Africa, 20%), which implies existence of alternative transmission routes. PMID:20875290
Sharp, Colin P.; Vermeulen, Marion; Nébié, Yacouba; Djoko, Cyrille F.; LeBreton, Matthew; Tamoufe, Ubald; Rimoin, Anne W.; Kayembe, Patrick K.; Carr, Jean K; Servant-Delmas, Annabelle; Laperche, Syria; Harrison, G. L. Abby; Pybus, Oliver G.; Delwart, Eric; Nathan D. Wolfe
Human parvovirus 4 infections are primarily associated with parenteral exposure in western countries. By ELISA, we demonstrate frequent seropositivity for antibody to parvovirus 4 viral protein 2 among adult populations throughout sub-Saharan Africa (Burkina Faso, 37%; Cameroon, 25%; Democratic Republic of the Congo, 35%; South Africa, 20%), which implies existence of alternative transmission routes.
Mbabazi, Jennifer; Milner, Chris; Morrissey, Oliver
The principal aim of this paper is to identify, in the context of the relationship between openness and growth, factors that can account for the poor growth performance of subSaharan African (SSA) countries. Including inequality as a broad measure of policy distortions, attention focuses on policy and non-policy barriers to trade, indicators of openness and resource endowments. The empirical analysis uses cross-section and panel econometric techniques to investigate the links between growth, ...
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...
Basedau, Matthias; Strüver, Georg; Vüllers, Johannes; Wegenast, Tim
Theoretically, the 'mobilization hypothesis' establishes a link between religion and conflict by arguing that religious structures such as overlapping ethnic and religious identities are prone to mobilization; once politicized, escalation to violent conflict becomes likelier. Yet, despite the religious diversity in sub-Saharan Africa and the religious overtones in a number of African armed conflicts, this assumption has not yet been backed by systematic empirical research on the religion-conf...
Heemskerk, W.; Nederlof, S.; Wennink, B.
As a result of policies outlined under NEPAD, outsourcing advisory services has become a key component of rural innovation systems in many African countries. In Sub-Saharan Africa and elsewhere, the public sector is looking for ways to involve the private sector in enhancing innovation systems with new knowledge, services and experiences. While it is generally thought that outsourcing will benefit poorer farmers by orienting services towards their needs, not much is known about the implicatio...
Ousman Mahmud; Centdrika Dates; Hafiz A. Ahmad; Luma Akil
Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) are two catastrophic diseases affecting millions of people worldwide every year; and are considered to be pandemic by the World Health Organization. This study aims to compare the recent trends in TB and HIV in the United States and Sub-Saharan African Countries. Data (incidence, prevalence and death rates of HIV and TB) for the United States, Cameroon, Nigeria, and South Africa were collected from The Joint United Nations Programme for...
Jane Morris, E.
Modern biotechnology, including the application of transgenic techniques to produce Genetically Modified Organisms (GMOs), can play a significant role in increasing agricultural production in a sustainable way, but its products need to be tailored for the developing world. In sub-Saharan Africa, the capacity to develop GMOs and ensure they meet stringent regulatory requirements is somewhat limited. Most African governments contribute little to science and technology either financially or thro...
Oronje Rose; Crichton Joanna; Theobald Sally; Lithur Nana; Ibisomi Latifat
Abstract Background The continued poor sexual and reproductive health (SRH) outcomes in sub-Saharan Africa highlight the difficulties in reforming policies and laws, and implementing effective programmes. This paper uses one international and two national case studies to reflect on the challenges, dilemmas and strategies used in operationalising sexual and reproductive health and rights (SRHR) in different African contexts. Methods The international case study focuses on the progress made by ...
d'Agostino, Giorgio; Pieroni, Luca; Scarlato, Margherita
This paper evaluates the effects of cash transfer (CT) programmes introduced during the 1990s and 2000s on food security in a sample of sub-Saharan African countries. We apply the synthetic control method to compare changes in the post-intervention food insecurity trajectories of economies affected by CT programmes relative to their unaffected counterparts. The results suggest that CT programmes exert differential effects on the prevalence of undernourishment. Although the estimates in the up...
Djurfeldt, Göran; Larsson, Rolf
This paper discusses food security and the African food crisis. By means of data from a survey of over 3000 farm households in eight sub-Saharan countries, the authors conclude that food security requires a broad integration of smallholders in the market. Subsistence orientation does not promote food security, while seed fertilizer technology does. Market integration of maize producers seems to be driven by the State, not by the market on its own. The diffusion of technology is stimulated by ...
Chien-Ping Chen; John Kagochi
International remittances comprise significant financial inflow for many Sub-Saharan African (SSA) countries and provide considerable disposable income for the receiving households. There has, however, been no consensus on the motivation in the part of sending migrants in which explanations are divided between altruism and self-interest. The study employs Autoregressive Distributed Lag (ARDL) model with co-integration approach to investigate whether international remittances to Kenya can be ...
This paper addresses the debate in the literature on how developing countries are affected by foreign monetary policy shocks. I analyze how contractionary monetary policy shocks originating in different regions, specifically the Euro Area (EU) and United States (US), affect a set of rarely investigated sub-Saharan African (SSA) countries. Foreign monetary policy shocks are identified using changes in central bank futures rates, and are inserted into a domestic structural vec...
Milner, Chris; Tandrayen, Verena
Since the late 1980's many Sub-Saharan African governments, under the auspices of the World Bank and IMF, have embarked on substantial reform programmes aimed at liberalising trade and expanding exports. There has been a large literature exploring aggregate export and growth response to trade liberalisation, but relatively little empirical work on the labour market effects of these programmes. This paper seeks to provide insights into the individual wage effects of the trade-status of firms. ...
Basedau, Matthias; Strüver, Georg; Vüllers, Johannes; Wegenast, Tim
Theoretically, the mobilization hypothesis establishes a link between religion and conflict by arguing that particular religious structures are prone to mobilization; once politicized, escalation to violent conflict becomes more likely. Yet, despite the religious diversity in sub-Saharan Africa and the religious overtones in a number of African conflicts, this assumption has not yet been backed by systematic empirical research on the religionconflict nexus in the region. The followin...
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?!
Qiu Jun; Maggie Zgambo; Kalembo, Fatch W.; Du Yukai
Sub-Saharan Africa has the highest number of mother to child transmissions of HIV. PMTCT programme plays a big role in reducing the MTCT nevertheless its effectiveness in Sub-Saharan Africa depends on involvement of male partners considering the fact that men are decision makers in African families. They make important decisions that have big impact on womens health. Male partner involvement has been seen to increase uptake of PMTCT services and their involvement underscores their importan...
This article provides an overview of the current state of the liquefied petroleum gases (LPG) market in sub Saharan Africa (SSA) and analyses the supply and demand patterns, the constraints on supply imposed by the insufficient output from refineries unable to meet the increasing demand, and institutional and regulatory issues. Details are given of the pricing policies, the economic benefits that could be obtained by increasing the scale of operations, the use of subsidies, private sector participation, and LPG activities in Angola, Cameroon, the Congo, and the Ivory Coast. The role of the World Bank in the Africa Gas Initiative to promote the use of natural gas reserves in SSA, and requirements for developing the LPG market are discussed
Full Text Available This article examines whether increased years of schooling exercised a consistent impact on delayed childbearing in sub-Saharan Africa. Data were drawn from Demographic and Health Surveys conducted in eight countries over the period 1987-1999. Multiple logistic regressions were used to assess trends and determinants in the probability of first birth during adolescence. Girls' education from about the secondary level onwards was found to be the only consistently significant covariate. No effect of community aggregate education was discernible, after controlling for urbanity and other individual-level variables. The results reinforce previous findings that improving girls' education is a key instrument for raising ages at first birth, but suggest that increases in schooling at lower levels alone bear only somewhat on the prospects for fertility decline among adolescents.
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...
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..
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?.
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
Full Text Available The challenges to teacher educators in sub-Saharan Africa are acute. This paper describes how the Teacher Education in Sub-Saharan Africa (TESSA consortium is working within institutional and national policy systems to support school-based teacher professional development. The TESSA consortium (13 African institutions and 5 international organisations delivering teacher education across 9 countries designed and produced a bank of open educational resources (OERs to guide teachers classroom practices in school-based teacher education. Drawing on examples from the TESSA consortium and from the University of Fort Hare, South Africa, the authors categorize the forms of TESSA OER integration as highly structured, loosely structured, or guided use. The paper concludes by outlining success factors for the integration of OERs: accessibility, adequate resources, support for teachers, accommodation of local cultural and institutional practices, and sustainable funding.
Kluth, Michael Friederich
This article argues that aspirations of maintaining a dominant influence over sub-Saharan security issues has spurred the French and British leadership of European Union (EU) foreign and security policy integration, just as it has informed military capability expansions by the armed forces of the main EU powers. While Europe's initial African focus was on stabilising a continent marred by state failure, civil wars and genocides, changes in the global security context, especially the shift towards multipolarity manifest in China's growing engagement, has prompted a complementary focus on deterring other powers from making military inroads into the subcontinent. Hence Europe's sub-Saharan security focus is shifting from stabilisation towards deterrence. This helps explain recent military procurements which, in spite of the extremely challenging fiscal position of most EU member states, feature large-scale investments in long-range deterrence capabilities.
Dobdinga Cletus Fonchamnyo
Full Text Available Remittances have become an important source of foreign exchange earnings in many countries as migrants continue to send income to relatives at home. However, the main motives for sending remittances remain controversial. This paper examines the relative importance of the socio-political and economic determinants of remittance inflow using an unbalance panel data of 36 economies in the Sub Saharan African Region in an attempt to assess the altruistic motive of remittance inflow. The results using a random effect estimation technique show that altruism is important for remitting, as the per capita income differential between host and home country and the age dependency ratio are positive and statistically significant. The level of per capita income of the home country is also found to be negative and statistically significant which also supports the altruistic motive of remittances. The results further suggest that the development of the financial sector and the proportion of Catholics in the population will encourage remittance inflow. These results are robust to the different specifications and estimation methodology.
Salomon Joshua A.
Full Text Available OBJECTIVE: To improve the methodological basis for modelling the HIV/AIDS epidemics in adults in sub-Saharan Africa, with examples from Botswana, Central African Republic, Ethiopia, and Zimbabwe. Understanding the magnitude and trajectory of the HIV/AIDS epidemic is essential for planning and evaluating control strategies. METHODS: Previous mathematical models were developed to estimate epidemic trends based on sentinel surveillance data from pregnant women. In this project, we have extended these models in order to take full advantage of the available data. We developed a maximum likelihood approach for the estimation of model parameters and used numerical simulation methods to compute uncertainty intervals around the estimates. FINDINGS: In the four countries analysed, there were an estimated half a million new adult HIV infections in 1999 (range: 260 to 960 thousand, 4.7 million prevalent infections (range: 3.0 to 6.6 million, and 370 thousand adult deaths from AIDS (range: 266 to 492 thousand. CONCLUSION: While this project addresses some of the limitations of previous modelling efforts, an important research agenda remains, including the need to clarify the relationship between sentinel data from pregnant women and the epidemiology of HIV and AIDS in the general population.
Bennett, G F; Earlé, R A; Squires-Parsons, D
Linear measurements and derived indices from striated trypanosomes in nine species of sub-Saharan birds representing seven families of the Passeriformes, were compared. The dimensions of the striated trypomastigotes from the Carduelinae, Estrildidae, Nectarinidae, Passeridae, Pycnonotidae, Turdinae and Zosteropidae were similar to each other as well as to those of the striated trypanosomes from the boreal owl (Strigidae). All these trypanosomes were considered to be Trypanosoma avium Danilewsky, 1885. A further 20 avian species were considered to harbour T. avium, thus greatly extending the reported host range of this trypanosome. Non-striated trypanosomes from the estrildid Uraeginthus angolensis closely resembled Trypanosoma bouffardi Leger & Blanchard, 1911 in appearance and dimensions, and were considered to be of this species. Additional host records for T. bouffardi from an additional nine avian species have been reported. The uniquely small and stumpy Trypanosoma everetti Molyneux, 1973 was reported from an additional 18 avian species. A large non-striated trypanosome from the laughing dove, Streptopelia senegalensis, was identified as Trypanosoma hannae Pittaluga, 1905 and this species was re-described. An infection of this parasite was also found in a single Streptopelia capicola and a single Streptopelia semitorquata. Two trypanosomes seen in the francolin, Francolinus natalensis, were identified as Trypanosoma calmettei Mathis & Léger, 1909. PMID:7596580
Achia, Thomas N. O.
Background Media utilization has been identified as an important determinant of tobacco use. We examined the association between self-reported tobacco use and frequency of mass media utilization by women and men in nine low-to middle-income sub-Saharan African countries. Methodology/Principal Findings Data for the study came from Demographic and Health Surveys conducted in Burkina Faso, Ethiopia, Liberia, Lesotho, Malawi, Swaziland, Uganda, Zambia and Zimbabwe over the period 20062011. Each survey population was a cross-sectional sample of women aged 1549 years and men aged 1559 years, with information on tobacco use and media access being obtained by face-to-face interviews. An index of media utilization was constructed based on responses to questions on the frequency of reading newspapers, frequency of watching television and frequency of listening to the radio. Demographic and socioeconomic variables were considered as potentially confounding covariates. Logistic regression models with country and cluster specific random effects were estimated for the pooled data. Results The risk of cigarette smoking increased with greater utilization to mass media. The use of smokeless tobacco and tobacco use in general declined with greater utilization to mass media. The risk of tobacco use was 5% lower in women with high media utilization compared to those with low media utilization [Adjusted Odds Ratio (AOR) = 0.95, 95% confidence interval (CI):0.821.00]. Men with a high media utilization were 21% less likely to use tobacco compared to those with low media utilization [AOR = 0.79, 95%CI = 0.730.85]. In the male sample, tobacco use also declined with the increased frequency of reading newspapers (or magazines), listening to radio and watching television. Conclusions Mass media campaigns, conducted in the context of comprehensive tobacco control programmes, can reduce the prevalence of tobacco smoking in sub-Saharan Africa. The reach, intensity, duration and type of messages are important aspects of the campaigns but need to also address all forms of tobacco use. PMID:25706131
Makulilo, Alex B.
Africa is by far the least developed continent in terms of protection of personal data. At present there are 11 countries out of 54 which have implemented comprehensive data privacy legislation. Nine of them namely, Angola, Benin, Burkina Faso, Cape Verde, Gabon, Ghana, Mauritius, Senegal and Seychelles belong to sub-Saharan Africa. The other two countries, Morocco and Tunisia, belong to North Africa. Yet, there are seven countries in sub-Saharan Africa with either Bills or drafts on data pri...
Stefanos, Xenarios; Paul, Pavelic.
Full Text Available Greater use of groundwater in Sub-Saharan Africa is a pre-requisite for improved human welfare; however, the costs associated with groundwater development are prohibitively high and poorly defined. This study identifies and disaggregates the costs of groundwater development in 11 Sub-Saharan African [...] countries, while the cost factors that most strongly affect drilling expenditures are traced. Further, the institutional and technical constraints impeding groundwater development are also explored while a time-series analysis forecasts future drilling expenditures. The results indicate that mobilisation and demobilisation costs, together with well development costs, factors that are difficult to change, are most significantly affecting the total costs of drilling. Further, the nature of the hydrogeological formation (which is largely a site characteristic), along with the often-aged machinery (which can be controlled), are also major impediments to lowering the cost of drilling. All countries are forecasted to have a slight to considerable drilling cost decrease for the next decade which offers encouragement for future groundwater development. Greater attention to the individual cost factors and to forecasting analysis could help to design more coherent and consistent groundwater development policies in Sub-Saharan Africa.
Zimkus, Breda M; Rödel, Mark-Oliver; Hillers, Annika
Puddle frogs (Anura: Phrynobatrachidae) are one of the most species-rich sub-Saharan amphibian groups, occupying an extraordinarily diverse range of habitats. We construct the first phylogeny of puddle frogs, utilizing mitochondrial (12S rRNA, valine-tRNA, and 16S rRNA) and nuclear (RAG-1) DNA. Phylogenetic analyses are conducted using separate and combined partitions under maximum parsimony, maximum likelihood, and Bayesian criterion. Monophyly of the Phrynobatrachidae is well supported, and three major clades of Phrynobatrachus are identified. We reconstructed a biogeographic history using habitat preference, elevation, and geographic distribution. Habitat niches appear to be conserved between sister species, with the majority of species favoring forest over savanna habitats and the most recent common ancestor of the Phrynobatrachidae reconstructed as a forest species. Analyses of elevational data identify three independent colonizations of highland regions, one in each of the three major clades. Ancestral reconstructions support an East African origination of puddle frogs. Most species are restricted to one of five sub-Saharan regions and are distributed within the Eastern, Central, and Western zones with far fewer species in Southern Africa. These results elucidate the complex patterns of spatial niche partitioning that have contributed to the diversification of this widely distributed, sub-Saharan genus. PMID:20034584
This study investigates the causality relationship between crude oil consumption and economic growth in twenty three Sub-Saharan African countries. We applied a multivariate panel Granger causality framework during 19852011 and we included crude oil price as the control variable of the model. The results indicate that in the short-run, there is a bi-directional causality relationship between crude oil consumption and economic growth in oil importing region and there is a uni-directional causality relationship from crude oil consumption to GDP in oil exporting region. However, in the long-run there is a bi-directional causality relationship between them in both regions. Therefore, reducing crude oil consumption without employing appropriate policies adversely impacts on economic growth of Sub-Saharan Africa. Hence, in order to reduce crude oil dependency of the region policymakers should pay more attention to the issue of energy efficiency programs. - Highlights: ? We examined Granger causality among oil consumption and GDP in Sub-Saharan Africa. ? Crude oil price is the control variable of the model. ? There is short run bi-directional causality among oil and GDP (oil importing). ? There is short run uni-directional causality from oil to GDP (oil exporting). ? There is a long run bi-directional causality among oil and GDP in both regions
Bloom, David E.; Humair, Salal; Rosenberg, Larry; Sevilla, J. P.; Trussell, James
Managing rapid population growth and spurring economic growth are among the most pressing policy challenges for Sub-Saharan Africa. We discuss the links between them and investigate the potential of family planning programs to address these challenges. Specifically, we estimate the impact of family planning programs on income per capita that can arise via the demographic dividend (DD), a boost to per capita income that operates through a chain of causality related to declining fertility. We d...
Luis Távora-Tavira, Rosa Teodósio, Jorge Seixas, Emília Prieto, Rita Castro, Filomena Exposto, Jorge Atouguia
Full Text Available Background: For geographical and recent historic reasons, Portugal is a gateway and home for immigration from sub-Saharan countries. Misconceptions related to these populations often lead to consider them as high-frequency clusters for dissemination of sexually transmitted infections (STIs. Epidemiological evidence-based data is needed to elucidate these issues and baseline prevalence studies are the starting point for this.Methodology: A prospective study was conducted in 220 African migrants (171 men and 49 women, recently arrived in Portugal, at the time of their first consultation. The presence of STIs was evaluated using a clinical syndromic approach and biological confirmation for gonorrhoea, Chlamydia trachomatis genital infection, syphilis, Hepatitis B and Human Immunodeficiency Virus (HIV infection.Results: Global prevalence of the targeted infections were 1.8% for gonorrhoea, 0 % for Chlamydia infection, 4.1% for Syphilis, 5.9% for HBsAg presence and 7.3% for HIV infection. Globally, 16.4% of the studied persons had at least one sexually transmitted infection.Conclusions: We concluded that prevalence rates encountered in this population is similar to that of non-migrant Portuguese populations with a high risk for sexually transmitted diseases. Therefore migration from sub-Saharan Africa doesnt seem to constitute a particularly critical isolated factor for public health risk of STIs in the community.
Full Text Available Tuberculosis (TB and Human Immunodeficiency Virus (HIV are two catastrophic diseases affecting millions of people worldwide every year; and are considered to be pandemic by the World Health Organization. This study aims to compare the recent trends in TB and HIV in the United States and Sub-Saharan African Countries. Data (incidence, prevalence and death rates of HIV and TB for the United States, Cameroon, Nigeria, and South Africa were collected from The Joint United Nations Programme for HIV/AIDS (UNAIDS, US Census Bureau and World Health Organization (WHO databases and analyzed using Statistical Analysis Software (SAS v 9.1. Analysis of Variance (ANOVA was performed to compare the variables of interest between the countries and across time. Results showed that percent rates of TB cases, TB deaths, HIV cases and HIV deaths were significantly different (P < 0.001 among these countries from 1993 to 2006. South Africa had the highest rates of HIV and TB; while US had the lowest rates of both diseases. Tuberculosis and HIV rates for Cameroon and Nigeria were significantly higher when compared to the United States, but were significantly lower when compared to South Africa (P < 0.001. There were significant differences (P < 0.001 in the prevalence of TB and HIV between the United States and the Sub-Saharan African countries, as well as differences within the Sub-Saharan African countries from 1993 to 2006. More analysis needs to be carried out in order to determine the prevalence and incidence of HIV and TB among multiple variables like gender, race, sexual orientation and age to get a comprehensive picture of the trends of HIV and TB.
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 (P<0.001) among these countries from 1993 to 2006. South Africa had the highest rates of HIV and TB; while US had the lowest rates of both diseases. Tuberculosis and HIV rates for Cameroon and Nigeria were significantly higher when compared to the United States, but were significantly lower when compared to South Africa (P<0.001). There were significant differences (P<0.001) in the prevalence of TB and HIV between the United States and the Sub-Saharan African countries, as well as differences within the Sub-Saharan African countries from 1993 to 2006. More analysis needs to be carried out in order to determine the prevalence and incidence of HIV and TB among multiple variables like gender, race, sexual orientation and age to get a comprehensive picture of the trends of HIV and TB. PMID:21776244
Hansen, Henrik; Rand, John
Based on firm level data from 16 Sub-Saharan African countries we show how three different measures of credit constraints lead to three different estimates of gender differences in manufacturing firms credit situation. Using a perception based credit constraint measure female owned firms appear relatively more constrained than male owned firms. Using formal financial access data we find no gender effect. Finally, using direct information on credit constraints, male owned small firms appear disadvantaged. Furthermore we show a strong size gradient in the gender gap for the two measures for which we find significant gender differences.
Smith, AD; Tapsoba, P; Peshu, N; Sanders, EJ; Jaffe, HW
Globally, men who have sex with men (MSM) continue to bear a high burden of HIV infection. In sub-Saharan Africa, same-sex behaviours have been largely neglected by HIV research up to now. The results from recent studies, however, indicate the widespread existence of MSM groups across Africa, and high rates of HIV infection, HIV risk behaviour, and evidence of behavioural links between MSM and heterosexual networks have been reported. Yet most African MSM have no safe access to relevant HIV/A...
Debats, S. R.; Fuchs, T. J.; Thompson, D. R.; Estes, L. D.; Evans, T. P.; Caylor, K. K.
Food production in sub-Saharan Africa is dominated by smallholder agriculture. Rainfed farming practices and the prevailing dryland conditions render crop yields vulnerable to increasing climatic variability. As a result, smallholder farmers are among the poorest and most food insecure groups among the region's population. Quantifying the distribution of smallholder agriculture across sub-Saharan Africa would greatly assist efforts to boost food security. Existing agricultural land cover data sets are limited to estimating the percentage of cropland within a coarse grid cell. The goal of this research is to develop a statistical machine learning algorithm to map individual agricultural fields, mirroring the accuracy of hand-digitization. For the algorithm, a random forest pixel-wise classifier learns by example from training data to distinguish between fields and non-fields. The algorithm then applies this training to classify previously unseen data. These classifications can then be smoothed into coherent regions corresponding to agricultural fields. Our training data set consists of hand-digitized boundaries of agricultural fields in South Africa, commissioned by its government in 2008. Working with 1 km x 1 km scenes across South Africa, the hand-digitized field boundaries are matched with satellite images extracted from Google Maps. To highlight different information contained within the images, several image processing filters are applied. The inclusion of Landsat images for additional training information is also explored. After training and testing the algorithm in South Africa, we aim to expand our mapping efforts across sub-Saharan Africa. Through Princeton's Mapping Africa project, crowdsourcing will produce additional training data sets of hand-digitized field boundaries in new areas of interest. This algorithm and the resulting data sets will provide previously unavailable information at an unprecedented level of detail on the largest and most vulnerable group of farmers in sub-Saharan Africa.
E. Jane Morris
Full Text Available Modern biotechnology, including the application of transgenic techniques to produce Genetically Modified Organisms (GMOs, can play a significant role in increasing agricultural production in a sustainable way, but its products need to be tailored for the developing world. In sub-Saharan Africa, the capacity to develop GMOs and ensure they meet stringent regulatory requirements is somewhat limited. Most African governments contribute little to science and technology either financially or through strong policies. This leaves the determination of research and development priorities in the hands of international funding agencies. Whereas funding from the United States is generally supportive of GM technology, the opposite is true of funding from European sources. African countries are thus pulled in two different directions. One alternative to this dilemma might be for countries in the sub-Saharan Africa region to develop stronger South-South collaborations, but these need to be supported with adequate funding. African governments as well as external funding agencies are urged to consider the important role that biotechnology, including GM technology, can play in contributing to sustainable development in Africa, and to provide adequate support to the development of capacity to research, develop and commercialize GMOs in the region.
Full Text Available There has been lingering contention on what development means in the African context. The meaning of development in the African context is crucial in order to know whether Africa is developing or not, particularly since 1970. This debate becomes critical when it is appreciated that Africa appears as the least developed continent in the world. This paper conceptualises development; in doing this, the paper considers both economic and political development, and looks into the complex question: Must economic development precede political development in Africa or vice-versa? In an attempt to address these issues, the paper considers and examines the views of many scholars and studies on these subject matters. While the paper recognises the rise and importance of recent global development paradigms, such as feminism, and green-environmentalism, it however, applies the long traditional approaches modernisation, liberalism, dependency and Marxism in analysing the meaning of development in Sub-Saharan African context. This is because this paper is concerned with the real development stage of this Sub continent of Africa, and not merely an intellectual exercise. The paper finally proffers a definition of development, which it believes to be germane in the context of real developmental stage of Sub-Saharan Africa.
Full Text Available Abstract Background Because of previously reported ethnic differences in determinants and markers of obesity and related metabolic disorders, we sought to investigate circulating levels of adiponectin and their correlates in a sub-Saharan African (sSA population. Subjects and Methods We studied 70 non-diabetic volunteers (33M/37F living in Yaoundé, Cameroon, aged 2469 yr, with BMI 2042 kg/m2. In all participants we measured waist circumference and total body fat by bioimpedance, and obtained a fasting venous blood sample for measurement of plasma glucose, serum insulin and adiponectin concentrations. We performed a euglycaemic hyperinsulinaemic clamp in 1/4 subjects, and HOMAIR was used as surrogate of fasting insulin sensitivity index since it best correlates to clamp measurements. Results Males had lower adiponectin levels than females (8.8 ± 4.3 vs. 11.8 ± 5.5 ?g/L. There was no significant correlation between adiponectin and total body fat (rs = -0.03; NS, whereas adiponectin was inversely correlated with waist circumference (rs = -0.39; p = 0.001. Adiponectin correlated negatively with insulin resistance (rs = -0.35; p = 0.01. In a regression analysis using fasting adiponectin concentration as the dependent variable, and age, HOMAIR, waist circumference, and fat mass as predictors, waist circumference (? = -3.30; p = 0.002, fat mass (? = -2.68; p = 0.01, and insulin resistance (? = -2.38; p = 0.02 but not age (? = 1.11; p = 0.27 were independent predictors of adiponectin. When considering gender, these relations persisted with the exception of waist circumference in females. Conclusion Adiponectin correlates in this study population are comparable to those observed in Caucasians with the exception of waist circumference in women. The metabolic significance of waist circumference is therefore questioned in sSA women.
Brian Kevin Reilly
Full Text Available This is an historic overview of conservation in Sub-Saharan Africa from pre-colonial times through the present. It demonstrates that Africans practiced conservation that was ignored by the colonial powers. The colonial market economy combined with the human and livestock population explosion of the 21st century are the major factors contributing to the demise of wildlife and critical habitat. Unique insight is provided into the economics of a representative safari company, something that has not been readily available to Community Based Natural Resources Management (CBNRM practitioners. Modern attempts at sharing benefits from conservation with rural communities will fail due to the low rural resource to population ratio regardless of the model, combined with the uneven distribution of profits from safari hunting that drives most CBNRM programs, unless these ratios are changed. Low household incomes from CBNRM are unlikely to change attitudes of rural dwellers towards Western approaches to conservation. Communities must sustainably manage their natural areas as "green factories" for the multitude of natural resources they contain as a means of maximizing employment and thus household incomes, as well as meeting the often overlooked socio-cultural ties to wildlife and other natural resources, which may be as important as direct material benefits in assuring conservation of wildlife and its habitat. For CBNRM to be successful in the long-term, full devolution of ownership over land and natural resources must take place. In addition, as a means of relieving pressure on the rural resource base, this will require an urbanization process that creates a middleclass, as opposed to the current slums that form the majority of Africas cities, through industrialization that transforms the unique natural resources of the subcontinent (e.g., strategic minerals, petroleum, wildlife, hardwoods, fisheries, wild medicines, agricultural products, etc. in Africa.
Utilizing the stochastic frontier approach, this study conducts a comparative analysis of profit efficiency and cost inefficiency of commercial banks operating in 29 sub-Saharan African (SSA) countries by bank ownership (domestic bank, SSA foreign bank or non-SSA foreign bank), as well as by the bank size during 2000-07. Tobit regressions are employed to assess the impact of environmental factors on the efficiency of commercial banks. The key findings of this empirical analysis suggest that f...
Ndikumana, Le?once; Verick, Sher
While the recent increase in foreign direct investment (FDI) to African countries is a welcome development, the question remains as to the impact of these resource inflows on economic development. This study posits that a key channel of the impact of FDI on development is through its effects on domestic factor markets, especially domestic investment and employment. In this context, this study analyses the two-way linkages between FDI and domestic investment in Sub-Saharan Africa. The results ...
Morris, Mike; Staritz, Cornelia; Plank, Leonhard
This paper shows the importance of ownership, end markets and regionalism within the global value chain (GVC) conceptual framework. This is done through unpacking the development trajectories of the major Sub Saharan African (SSA) apparel export industries (Mauritius, Madagascar, Kenya, Lesotho, Swaziland) against the backdrop of global and regional trade regime changes and the manner in which different supplier firms react to these opportunities and/or constraints. These trajectories demonst...
Financing of agriculture by commercial and non-commercial institutions in rural Sub-Saharan African in recent years has being relatively constant despite remarkable increase in the number of institutions operating within this area. This development may be attributed to how these institutions rate the business of agriculture and the risks involved. However the slow pace of financing sustainable agriculture such as bio-based economy in the presence of internationaliza...
Gyimah, Nana Afua Boamah; Tita, Bertrand Asongwe
One of the major reasons for political instability in Sub-Saharan Africa originates from the way elections are conducted. Most African countries have quite a handful of electoral malpractices which lead to political instability, civil wars and low economic growth. Electronic voting might be a solution to the election problems and thus bring in a stable political atmosphere which attracts investors. This thesis looks at the prospects and challenges of implementing e-voting in Ghana and Sub-S...
Twerefou, Daniel Kwabena; Adjei-mantey, Kwame; Strzepek, Niko Lazar
Climate change scenarios for many Sub-Saharan African countries including Ghana indicate that temperatures will increase while rainfall will either increase or decrease. The potential impact of climate change on economic systems is well-known. However, little has been done to assess its economic impact on road infrastructure. This work assesses the economic impact of climate change on road infrastructure using the stressor-response methodology. Our analysis indicates that it will cumulatively...
Jensen Jeffrey D
Full Text Available Abstract Background Levels of molecular diversity in Drosophila have repeatedly been shown to be higher in ancestral, African populations than in derived, non-African populations. This pattern holds for both coding and noncoding regions for a variety of molecular markers including single nucleotide polymorphisms and microsatellites. Comparisons of X-linked and autosomal diversity have yielded results largely dependent on population of origin. Results In an attempt to further elucidate patterns of sequence diversity in Drosophila melanogaster, we studied nucleotide variation at putatively nonfunctional X-linked and autosomal loci in sub-Saharan African and North American strains of D. melanogaster. We combine our experimental results with data from previous studies of molecular polymorphism in this species. We confirm that levels of diversity are consistently higher in African versus North American strains. The relative reduction of diversity for X-linked and autosomal loci in the derived, North American strains depends heavily on the studied loci. While the compiled dataset, comprised primarily of regions within or in close proximity to genes, shows a much more severe reduction of diversity on the X chromosome compared to autosomes in derived strains, the dataset consisting of intergenic loci located far from genes shows very similar reductions of diversities for X-linked and autosomal loci in derived strains. In addition, levels of diversity at X-linked and autosomal loci in the presumably ancestral African population are more similar than expected under an assumption of neutrality and equal numbers of breeding males and females. Conclusion We show that simple demographic scenarios under assumptions of neutral theory cannot explain all of the observed patterns of molecular diversity. We suggest that the simplest model is a population bottleneck that retains an ancestral female-biased sex ratio, coupled with higher rates of positive selection at X-linked loci in close proximity to genes specifically in derived, non-African populations.
Renzaho, Andre M. N.
Background Diabetes is one of the non-communicable diseases (NCDs) which is rising significantly across sub-Saharan African (SSA) countries and posing a threat to the social, economic, and cultural fabric of the SSA population. The inclusion of NCDs into the post-2015 development agenda along with the global monitoring framework provides an opportunity to monitor progress of development programmes in developing countries. This paper examines challenges associated with dealing with diabetes within the development agenda in SSA and explores some policy options. Design This conceptual review draws from a range of works published in Medline and the grey literature to advance the understanding of the post-2015 development agenda and how it relates to NCDs. The paper begins with the burden of diabetes in sub-Sahara Africa and then moves on to examine challenges associated with diabetes prevention, treatment, and management in Africa. It finishes by exploring policy implications. Results With regards to development programmes on NCDs in the SSA sub-continent, several challenges exist: 1) poor documentation of risk factors, 2) demographic transitions (rapid urbanisation and ageing), 3) the complementary role of traditional healers, 4) tuberculosis and the treatment of the acquired immunodeficiency syndrome as risk factors for diabetes, 5) diabetes in complex emergencies, 6) diabetes as an international development priority and not a policy agenda for many SSA countries, and 7) poorly regulated food and beverage industry. Conclusion For the post-2015 development agenda for NCDs to have an impact, sufficient investments will be needed to address legislative, technical, human, and fiscal resource constraints through advocacy, accountability, political leadership, and effective publicprivate partnership. Striking the right balance between competing demands and priorities, policies, and implementation strategies hold the key to an effective response to diabetes in SSA countries. PMID:25994288
Andre M. N. Renzaho
Full Text Available Background: Diabetes is one of the non-communicable diseases (NCDs which is rising significantly across sub-Saharan African (SSA countries and posing a threat to the social, economic, and cultural fabric of the SSA population. The inclusion of NCDs into the post-2015 development agenda along with the global monitoring framework provides an opportunity to monitor progress of development programmes in developing countries. This paper examines challenges associated with dealing with diabetes within the development agenda in SSA and explores some policy options. Design: This conceptual review draws from a range of works published in Medline and the grey literature to advance the understanding of the post-2015 development agenda and how it relates to NCDs. The paper begins with the burden of diabetes in sub-Sahara Africa and then moves on to examine challenges associated with diabetes prevention, treatment, and management in Africa. It finishes by exploring policy implications. Results: With regards to development programmes on NCDs in the SSA sub-continent, several challenges exist: 1 poor documentation of risk factors, 2 demographic transitions (rapid urbanisation and ageing, 3 the complementary role of traditional healers, 4 tuberculosis and the treatment of the acquired immunodeficiency syndrome as risk factors for diabetes, 5 diabetes in complex emergencies, 6 diabetes as an international development priority and not a policy agenda for many SSA countries, and 7 poorly regulated food and beverage industry. Conclusion: For the post-2015 development agenda for NCDs to have an impact, sufficient investments will be needed to address legislative, technical, human, and fiscal resource constraints through advocacy, accountability, political leadership, and effective publicprivate partnership. Striking the right balance between competing demands and priorities, policies, and implementation strategies hold the key to an effective response to diabetes in SSA countries.
Full Text Available Abstract Background Diabetes prevalence is increasing globally, and Sub-Saharan Africa is no exception. With diverse health challenges, health authorities in Sub-Saharan Africa and international donors need robust data on the epidemiology and impact of diabetes in order to plan and prioritise their health programmes. This paper aims to provide a comprehensive and up-to-date review of the epidemiological trends and public health implications of diabetes in Sub-Saharan Africa. Methods We conducted a systematic literature review of papers published on diabetes in Sub-Saharan Africa 1999-March 2011, providing data on diabetes prevalence, outcomes (chronic complications, infections, and mortality, access to diagnosis and care and economic impact. Results Type 2 diabetes accounts for well over 90% of diabetes in Sub-Saharan Africa, and population prevalence proportions ranged from 1% in rural Uganda to 12% in urban Kenya. Reported type 1 diabetes prevalence was low and ranged from 4 per 100,000 in Mozambique to 12 per 100,000 in Zambia. Gestational diabetes prevalence varied from 0% in Tanzania to 9% in Ethiopia. Proportions of patients with diabetic complications ranged from 7-63% for retinopathy, 27-66% for neuropathy, and 10-83% for microalbuminuria. Diabetes is likely to increase the risk of several important infections in the region, including tuberculosis, pneumonia and sepsis. Meanwhile, antiviral treatment for HIV increases the risk of obesity and insulin resistance. Five-year mortality proportions of patients with diabetes varied from 4-57%. Screening studies identified high proportions (> 40% with previously undiagnosed diabetes, and low levels of adequate glucose control among previously diagnosed diabetics. Barriers to accessing diagnosis and treatment included a lack of diagnostic tools and glucose monitoring equipment and high cost of diabetes treatment. The total annual cost of diabetes in the region was estimated at US$67.03 billion, or US$8836 per diabetic patient. Conclusion Diabetes exerts a significant burden in the region, and this is expected to increase. Many diabetic patients face significant challenges accessing diagnosis and treatment, which contributes to the high mortality and prevalence of complications observed. The significant interactions between diabetes and important infectious diseases highlight the need and opportunity for health planners to develop integrated responses to communicable and non-communicable diseases.
Hall, Victoria; Thomsen, Reimar W
ABSTRACT: BACKGROUND: Diabetes prevalence is increasing globally, and Sub-Saharan Africa is no exception. With diverse health challenges, health authorities in Sub-Saharan Africa and international donors need robust data on the epidemiology and impact of diabetes in order to plan and prioritise their health programmes. This paper aims to provide a comprehensive and up-to-date review of the epidemiological trends and public health implications of diabetes in Sub-Saharan Africa. METHODS: We conducted a systematic literature review of papers published on diabetes in Sub-Saharan Africa 1999-March 2011, providing data on diabetes prevalence, outcomes (chronic complications, infections, and mortality), access to diagnosis and care and economic impact. RESULTS: Type 2 diabetes accounts for well over 90% of diabetes in Sub-Saharan Africa, and population prevalence proportions ranged from 1% in rural Uganda to 12% in urban Kenya. Reported type 1 diabetes prevalence was low and ranged from 4 per 100,000 in Mozambique to 12 per 100,000 in Zambia. Gestational diabetes prevalence varied from 0% in Tanzania to 9% in Ethiopia. Proportions of patients with diabetic complications ranged from 7-63% for retinopathy, 27-66% for neuropathy, and 10-83% for microalbuminuria. Diabetes is likely to increase the risk of several important infections in the region, including tuberculosis, pneumonia and sepsis. Meanwhile, antiviral treatment for HIV increases the risk of obesity and insulin resistance. Five-year mortality proportions of patients with diabetes varied from 4-57%. Screening studies identified high proportions (>40%) with previously undiagnosed diabetes, and low levels of adequate glucose control among previously diagnosed diabetics. Barriers to accessing diagnosis and treatment included a lack of diagnostic tools and glucose monitoring equipment and high cost of diabetes treatment. The total annual cost of diabetes in the region was estimated at US$67.03 billion, or US$8836 per diabetic patient. CONCLUSION: Diabetes exerts a significant burden in the region, and this is expected to increase. Many diabetic patients face significant challenges accessing diagnosis and treatment, which contributes to the high mortality and prevalence of complications observed. The significant interactions between diabetes and important infectious diseases highlight the need and opportunity for health planners to develop integrated responses to communicable and non-communicable diseases.
Sunday A. Reju
Full Text Available Open educational resources (OERs have the potential to reduce costs, improve quality, and increase access to educational opportunities. OER development and deployment is one path that could contribute to achieving education for all. This article builds on existing information and communication technology (ICT implementation plans in Africa and on the experiences of organizations and initiatives such as the African Virtual University (AVU, OER Africa, the South African Institute of Distance Education (SAIDE, and the Teacher Education in Sub-Saharan Africa (TESSA Project, to present one view of the benefits, challenges, and steps that could be taken to realize the potential of OERs in sub-Saharan Africa. Thus, the article focuses on the factors necessary for creating and sustaining a vision for OER development and deployment; developing and distributing resources with an open license; improving technology infrastructure and reducing the cost of Internet access; establishing communities of educational collaborators; sustaining involvement in the OER initiative; producing resources in interoperable and open formats; establishing and maintaining the quality of OERs; providing local context to address national and regional needs and conditions; informing the public about OERs; and taking the initiative to build on the knowledge, skills, and experiences of others. In order to assist educators and decision makers, links to a variety of resources are provided.
Bram De Jonge
Full Text Available Sub-Saharan African countries, through their regional organizations, have embarked on the harmonisation of plant variety protection (PVP systems. These initiatives are largely modelled on the UPOV 1991 act, which claims to incentivize plant breeding and facilitate agricultural development. Civil Society Organisations (CSO, however, strongly criticise this process for being out of step with Sub-Saharan African agricultural realities, undermining smallholder farmers agricultural practices and, ultimately, threatening food security. Among their main concerns are the fear that the proposed regimes facilitate biopiracy and lack recognition of farmers rights. This article discussed three of the main CSO concerns in tandem with examples of alternative provisions from PVP systems from around the world. While it will be shown that the CSO concerns are not likely to be acted upon, this article aims to answer the pressing question whether a UPOV 91 based PVP system hampers farming practices in developing countries, and explores several legal avenues to accommodate the needs and traditions of smallholder farmers.
Full Text Available A growing body of scholarly literature suggests confluence or even convergence of organized crime and terrorism in various parts of the world. However, links remain somewhat nebulous at this stage and vary considerably, based on region and context. Africa has come under the spotlight due to perceived weaknesses in the criminal justice sector, limited law enforcement capacity, political and systemic corruption, poor border patrol and weak anti-terror and organized crime laws which are believed to provide an ideal environment for the terror-crime nexus to flourish. This article provides an African perspective on the links between organized crime and terror networks in Sub-Saharan Africa, with a particular focus on Southern Africa. The discussion begins with an overview of the theoretical discourse on the subject relying on African definitions of the contested concepts of terrorism and organized crime and will then narrow the analysis on the sub-Saharan case. It relies on an extensive literature review and concludes with empirical findings of a research project on organized crime in Southern Africa, which found no strong empirical links between criminal and terrorist organizations.
Smith, Adrian D; Tapsoba, Placide; Peshu, Norbert; Sanders, Eduard J; Jaffe, Harold W
Globally, men who have sex with men (MSM) continue to bear a high burden of HIV infection. In sub-Saharan Africa, same-sex behaviours have been largely neglected by HIV research up to now. The results from recent studies, however, indicate the widespread existence of MSM groups across Africa, and high rates of HIV infection, HIV risk behaviour, and evidence of behavioural links between MSM and heterosexual networks have been reported. Yet most African MSM have no safe access to relevant HIV/AIDS information and services, and many African states have not begun to recognise or address the needs of these men in the context of national HIV/AIDS prevention and control programmes. The HIV/AIDS community now has considerable challenges in clarifying and addressing the needs of MSM in sub-Saharan Africa; homosexuality is illegal in most countries, and political and social hostility are endemic. An effective response to HIV/AIDS requires improved strategic information about all risk groups, including MSM. The belated response to MSM with HIV infection needs rapid and sustained national and international commitment to the development of appropriate interventions and action to reduce structural and social barriers to make these accessible. PMID:19616840
Full Text Available Half of the 10 million children who die annually in the world are from Sub-Saharan Africa (SSA. The reasons are known, but lack of will and resources avoid the development of sustainable policies. Associated factors to the high infant mortality rate (IMR in SSA have been investigated in this research. An ecological multi-group study was designed comparing rates within SSA. The dependent variable is the IMR and health services, economic and development indicators are the independent variables. Information and data sources were WHO, World Bank, UNICEF and UNDP (1997-2007. IMR mean value is 92.2 (per 1000 live births and a relationship with several of the factors could be observed. In the bi-variate analysis direct relationship was observed with maternal mortality rate and an inverse relationship was observed with prenatal care coverage, births assisted by skilled health personnel, gross national income per capita, per capita government expenditure on health, social security expenditure, adult literacy rate, net primary school enrolment rate, population with access to safe drinking water (in urban and rural areas and with population with access to basic sanitation in rural areas. In the multi-variate analysis IMR had an inverse relationship with children under 5 years with diarrhoea who receive oral re-hydration, with social security expenditure as percentage of general government expenditure on health and with per capita government expenditure on health. The situation in SSA would change if their inhabitants received education and information to demand more equitable polices and better investments from their governments.
Full Text Available Abstract Background Diabetes mellitus is becoming increasingly common in sub-Saharan Africa. Autonomic dysfunction contributes to morbidity and mortality in diabetic patients. Data on autonomic dysfunction in the African population is scarce, and no reference values for standardized autonomic function tests are available. The aim of this study was to establish cut off values for five easy-to-use cardiovascular autonomic function tests that may be suitable for resource-poor settings. Methods We recruited 276 healthy African individuals, 156 men and 120 women, aged > 20 years. Participants were tested for (1 resting heart rate (HR, (2 HR variation in response to deep breathing, (3 HR response to standing, and (4 postural changes in systolic and diastolic blood pressure (SBP and DBP. Respective cut-off values were calculated according to the 95th or 5th percentile. Results Taking an association of the autonomic test results with gender and age into consideration, we defined the following cut-off values: resting HR (bpm ? 89 for men and ? 97 for women; HR (bpm in response to deep breathing ? 13, ? 11, ? 9, ? 8, and ? 7 for age groups 2029, 3039, 4049, 5059, and 60+ years, respectively; HR (bpm in response to standing ? 14 for 2029 years, and ? 11 for 30+ years; postural decreases in SBP ? 17 mmHg for all age groups; and postural decreases in DBP (mmHg ? 2 for men and ? 5 for women. Conclusion The test battery revealed cut-off values different from those measured in Caucasians. Further studies are recommended a to assess whether these cut off values are generally applicable, and b to establish population specific reference values for Africans.
Mutula, Stephen M.
Purpose: Seeks to argue that the peculiarities of sub-Saharan Africa, in terms of its socio-cultural diversity, low economic development, linguistic factors, HIV/AIDS pandemic, gender discrimination, low ICT awareness and so on, demand a new model of addressing the digital divide. Design/methodology/approach: Paper largely based on literature
Baker, David P.; Collins, John M.; Leon, Juan
Numerous epidemiological studies from the early years of the tragic HIV and AIDS pandemic in sub-Saharan Africa identified formal education as a risk factor increasing the chance of infection. Instead of playing its usual role as a preventative factor, as has been noted in many other public health cases, until the mid-1990s educated African men
Full Text Available Sub-Saharan Africa has the highest number of mother to child transmissions of HIV. PMTCT programme plays a big role in reducing the MTCT nevertheless its effectiveness in Sub-Saharan Africa depends on involvement of male partners considering the fact that men are decision makers in African families. They make important decisions that have big impact on womens health. Male partner involvement has been seen to increase uptake of PMTCT services and their involvement underscores their importance in reducing HIV infection in children. Recently many sub-Saharan countries adopted male partner involvement in PMTCT programme with an aim of increasing the uptake of PMTCT services. The programme has made some progress in improving the effectiveness of PMTCT services. On the other hand the strategy is facing a lot of challenges, the biggest being low male partner involvement. This article therefore seeks to review the successes and challenges faced by male involvement in Sub-Saharan Africa. It also proposes the way forward in order to improve its effectiveness. We used peer reviewed articles of research studies conducted in Sub-Saharan Africa and other related reliable sources of data to write the paper.
This thesis examines whether urbanization affects GDP per capita positively in Sub-Saharan Africa. Further investigations are done to study how the size of the prime city affects GDP per capita, as well as how the prime city as a percentage of urban population interacts with GDP per capita. The results show that urbaization and GDP per capita interact positively - that is, increase in urbaization increases GDP per capita. We also find that size of the prime city as a percentage of total popul...
Full Text Available Abstract Background The rapid urban malaria appraisal (RUMA methodology aims to provide a cost-effective tool to conduct rapid assessments of the malaria situation in urban sub-Saharan Africa and to improve the understanding of urban malaria epidemiology. Methods This work was done in Yopougon municipality (Abidjan, Cotonou, Dar es Salaam and Ouagadougou. The study design consists of six components: 1 a literature review, 2 the collection of available health statistics, 3 a risk mapping, 4 school parasitaemia surveys, 5 health facility-based surveys and 6 a brief description of the health care system. These formed the basis of a multi-country evaluation of RUMA's feasibility, consistency and usefulness. Results A substantial amount of literature (including unpublished theses and statistics was found at each site, providing a good overview of the malaria situation. School and health facility-based surveys provided an overview of local endemicity and the overall malaria burden in different city areas. This helped to identify important problems for in-depth assessment, especially the extent to which malaria is over-diagnosed in health facilities. Mapping health facilities and breeding sites allowed the visualization of the complex interplay between population characteristics, health services and malaria risk. However, the latter task was very time-consuming and required special expertise. RUMA is inexpensive, costing around 8,50013,000 USD for a six to ten-week period. Conclusion RUMA was successfully implemented in four urban areas with different endemicity and proved to be a cost-effective first approach to study the features of urban malaria and provide an evidence basis for planning control measures.
Full Text Available Although schools are generally regarded as a 'safe haven' for children, the reality for many girls is that schools can be a place of sexual discrimination, harassment and violence, perpetrated by fellow male students and teachers alike. The widespread problem of sexual and gender-based violence, par [...] ticularly sexual violence, in schools has been well-documented in a range of studies and reports in sub-Saharan Africa. Sexual and gender-based violence in schools not only violates girls' fundamental rights to dignity and equality, and their rights to be free from violence, but it also undermines their rights to education, particularly when, as is often the case, states fail to take measures to protect girls. Although there is a growing body of empirical research documenting the nature and extent of this problem, particularly in various sub-Saharan African countries, how regional and international human rights law applies to protect girls in this situation appears to have received limited consideration. This article attempts to fill this gap in the literature, by providing an analysis of the problem of sexual and gender-based violence in schools within the framework of regional and international human rights law. The article's objective is to identify and discuss rights-based legal strategies to combat this pervasive human rights violation, specifically within the sub-Saharan African context, with an emphasis on regional developments and regional responses.
Gurdasani, Deepti; Carstensen, Tommy; Tekola-Ayele, Fasil; Pagani, Luca; Tachmazidou, Ioanna; Hatzikotoulas, Konstantinos; Karthikeyan, Savita; Iles, Louise; Pollard, Martin O.; Choudhury, Ananyo; Ritchie, Graham R. S.; Xue, Yali; Asimit, Jennifer; Nsubuga, Rebecca N.; Young, Elizabeth H.; Pomilla, Cristina; Kivinen, Katja; Rockett, Kirk; Kamali, Anatoli; Doumatey, Ayo P.; Asiki, Gershim; Seeley, Janet; Sisay-Joof, Fatoumatta; Jallow, Muminatou; Tollman, Stephen; Mekonnen, Ephrem; Ekong, Rosemary; Oljira, Tamiru; Bradman, Neil; Bojang, Kalifa; Ramsay, Michele; Adeyemo, Adebowale; Bekele, Endashaw; Motala, Ayesha; Norris, Shane A.; Pirie, Fraser; Kaleebu, Pontiano; Kwiatkowski, Dominic; Tyler-Smith, Chris; Rotimi, Charles; Zeggini, Eleftheria; Sandhu, Manjinder S.
Given the importance of Africa to studies of human origins and disease susceptibility, detailed characterization of African genetic diversity is needed. The African Genome Variation Project provides a resource with which to design, implement and interpret genomic studies in sub-Saharan Africa and worldwide. The African Genome Variation Project represents dense genotypes from 1,481 individuals and whole-genome sequences from 320 individuals across sub-Saharan Africa. Using this resource, we find novel evidence of complex, regionally distinct hunter-gatherer and Eurasian admixture across sub-Saharan Africa. We identify new loci under selection, including loci related to malaria susceptibility and hypertension. We show that modern imputation panels (sets of reference genotypes from which unobserved or missing genotypes in study sets can be inferred) can identify association signals at highly differentiated loci across populations in sub-Saharan Africa. Using whole-genome sequencing, we demonstrate further improvements in imputation accuracy, strengthening the case for large-scale sequencing efforts of diverse African haplotypes. Finally, we present an efficient genotype array design capturing common genetic variation in Africa.
Full Text Available As Chinas footprint in African trade grows larger by the day, the need to contextualize this rise through comparative analysis becomes ever more necessary. This paper contrasts the sub-Saharan trade relations of both China and Europe with their respective designated stereotypes: those of a dragon and a dove. The article compares the trade dynamics on four levels: the policies and institutional mechanisms that shape the relationship; the composition of the trade flows; the geographic distribution of trade dominance; and the influence of norms and values on the trade pattern. It concludes that although there are empirical grounds behind these stereotypes, Chinese and European trade relations with sub-Saharan Africa are becoming more similar, partly due to a more hawkish European stance.
Zoumenou, E; Lokossou, T; Assouto, P; Chobli, M; de Waroux, B le Polain; Baele, Ph
Belgium has been collaborating with the French-speaking University of Abomey-Calavi in Cotonou (Republic of Benin) for 15 years to train anesthesiologists for Sub-Saharan French-speaking African countries. At the end of the nineties, Sub-Saharan Africa was the only part of the world with a decreasing number of anesthesiologists. Thanks to various financial supports coming mainly from Belgian governmental cooperation funds, the program has been successful in reversing the demographic trend and even started a multiplying effect through the creation of schools for nurse-anesthetists, and through the creation of new training centers for physician anesthesiologists. Sixty-nine anesthesiologists from 13 countries graduated from Cotonou, 59 (85.5%) of whom actually choose to work in Africa. At least 40 of them teach anesthesia, playing a key role in the creation of new schools and training centers. PMID:24191529
Full Text Available Abstract Background End of life (EoL care in sub-Saharan Africa still lacks the sound evidence-base needed for the development of effective, appropriate service provision. It is essential to make evidence from all types of research available alongside clinical and health service data, to ensure that EoL care is ethical and culturally appropriate. This article aims to synthesize qualitative research on EoL care in sub-Saharan Africa to inform policy, practice and further research. It seeks to identify areas of existing research; describe findings specifically relevant to the African context; and, identify areas lacking evidence. Methods Relevant literature was identified through eight electronic databases: AMED, British Nursing Index & Archive, CINAHL, EMBASE, IBSS, MEDLINE, PsycINFO, and the Social Sciences Citation Index; and hand searches. Inclusion criteria were: published qualitative or mixed-method studies in sub-Saharan Africa, about EoL care. Study quality was assessed using a standard grading scale. Relevant data including findings and practice recommendations were extracted and compared in tabular format. Results Of the 407 articles initially identified, 51 were included in the qualitative synthesis. Nineteen came from South Africa and the majority (38 focused on HIV/AIDS. Nine dealt with multiple or unspecified conditions and four were about cancer. Study respondents included health professionals, informal carers, patients, community members and bereaved relatives. Informal carers were typically women, the elderly and children, providing total care in the home, and lacking support from professionals or the extended family. Twenty studies focused on home-based care, describing how programmes function in practice and what is needed to make them effective. Patients and carers were reported to prefer institutional care but this needs to be understood in context. Studies focusing on culture discussed good and bad death, culture-specific approaches to symptoms and illness, and the bereavement process. Conclusions The data support or complement the findings from quantitative research. The review prompts a reconsideration of the assumption that in Africa the extended family care for the sick, and that people prefer home-based care. The review identifies areas relevant for a research agenda on socio-cultural issues at the EoL in sub-Saharan Africa.
Koelling, Fritz [Sustainable Energy and Environment, Karlsruhe (Germany); Gaul, Mirco; Schroeder, Miriam [SiNERGi Consultancy for Renewable Energies, Berlin (Germany)
The vast potential of mini and micro hydro power (MHP) in Sub-Saharan African countries is one promising option to cover increasing energy demand and to enable electricity access for remote rural communities. Based on the analysis of 6 African countries (Ethiopia, Kenya, Mozambique, Nigeria, Rwanda, South Africa), this study sheds light on some of the main barriers on the level of political and regulatory framework conditions which include gap between the national-level policies and regulations and local MHP project implementation, lack of financing and limited capacities for project planning, building and operation. The paper also identifies some promising practices employed in several SSA countries of how to overcome these barriers and concludes with recommendations of how to create positive feed-backs between ambitious policies and regulations and MHP financing and capacity development needs in order to scale up MHP deployment and MHP sector development. (orig.)
Porter, Gina; Hampshire, Kate; Bourdillon, Michael; Robson, Elsbeth; Munthali, Alister; Abane, Albert; Mashiri, Mac
This paper reflects on issues raised by work with children in an ongoing child mobility study in three sub-Saharan African countries: Ghana, Malawi and South Africa. There are now 70 school pupils of varying ages involved in the project, but the paper is particularly concerned with the participation of those children 14 years and under. We examine the significant ethical issues associated with working with younger child researchers, and linked questions concerning the spaces open to them in African contexts where local cultural constructions of childhood and associated economic imperatives (which commonly drive family and household endeavour) help shape the attitudes of adults to children's rights and responsibilities and inter-generational power relations. PMID:20532615
Full Text Available This study presents a summary overview of the carbon balance of Sub-Saharan Africa (SSA by synthesizing the available data from national communications to UNFCCC and first results from the project CarboAfrica (net ecosystem productivity and emissions from fires, deforestation and forest degradation, by field and model estimates. According to these preliminary estimates the overall carbon balance of SSA varies from 0.43 Pg C y?1 (using in situ measurements for savanna NEP to a much higher sink of 2.53 Pg C y?1 (using model estimates for savanna NEP. UNFCCC estimates lead to a moderate carbon sink of 0.58 Pg C y?1. Excluding anthropogenic disturbance and intrinsic episodic events, the carbon uptake by forests (0.98 Pg C y?1 and savannas (from 1.38 to 3.48 Pg C y?1, depending on the used methodology are the main components of the SSA sink effect. Fires (0.72 Pg C y?1, deforestation (0.25 Pg C y?1 and forest degradation (0.77 Pg C y?1 are the main contributors to the SSA carbon emissions, while the agricultural sector contributes only with 0.12 Pg C y?1. Notably, the impact of forest degradation is higher than that caused by deforestation, and the SSA forest net carbon balance is close to equilibrium. Savannas play a major role in shaping the SSA carbon balance, due to their large areal extent, their fire regime, and their strong interannual NEP variability, but they are also a major uncertainty in the overall budget. This paper shows that Africa plays a key role in the global carbon cycle system and probably could have a potential for carbon sequestration higher than expected, even if still highly uncertain. Further investigations are needed, particularly to better address the role of savannas and tropical forests. The current CarboAfrica network of carbon measurements could provide future unique data sets for better estimating the African carbon balance.
Full Text Available We assess the relative efficiency of health systems of 35 countries in sub-Saharan Africa using Data Envelopment Analysis. This method allows us to evaluate the ability of each country to transform its sanitary inputs into health outputs. Our results show that, on average, the health systems of these countries have an efficiency score between 72% and 84% of their maximum level. We also note that education and density of population are factors that affect the efficiency of the health system in these countries.
Lund, Troy C; Hume, Heather; Allain, Jean P; McCullough, Jeffrey; Dzik, Walter
Sub-Saharan Africa (SSA) is burdened with a growing population and poor health care resources. Transfusion medicine is uniquely affected for SSA as a result of a combination of factors which put tremendous pressure on the blood supply. In this review, we consider these factors including: malaria, sickle cell anemia, transfusion medicine infrastructure, and past transfusion medicine policies including those which are tied to foreign aid, such as a VNRD-only practice. We also consider how SSA can overcome some of these hurdles to achieve a safe and adequate blood supply for its people through the advent of new vaccines, medications, infrastructure development, policy changes, and education. PMID:23871466
Full Text Available The signatory countries of the Convention on Biological Diversity set the objective of halting the decline of biodiversity by 2010, but as the target date arrived and passed, the status of biodiversity on the planet remained dismal. With the dawn of the UN Decade for Biodiversity at the Rio+20 Earth Summit in June 2012 and as the UN Biodiversity Strategic Plan moves forward, this article contextualizes biodiversity prospects in sub-Saharan Africa by examining the history of interactions between African communities and the environment, from the pre-colonial period to today. It provides a critical analysis of the current biodiversity conservation planning methodologies and pinpoints several inherent obstacles, including the neo-Malthusianism that dominates the thinking of certain wildlife experts. Setting out an argument with far-reaching implications for the success of future conservation efforts all over the world, the author examines the basis of emerging conservation approaches in sub-Saharan Africa, focusing on the need to forge a more inclusive conservation practice and open up to the perceptions, representations and cultural universe of the Other.
Kofi B. Afful
Full Text Available This study examines the effectiveness of the state in stimulating stock market activity in sub-Saharan Africa (SSA using fiscal policy, governance quality and stock market as the main determinant variables. Using annual data from six selected sub-Saharan African economies and employing a dynamic panel data estimating technique, we find that government effectiveness stimulates capitalization while business regulations decrease it in SSA. In addition, we find that final consumption expenditure, interest rate spread and credit to the state increase capitalization whereas credit to the private sector and inflation had adverse effects. With respect to business regulations, our study reveals that starting a business, closing it and enforcing contracts engender stock market activity in SSA. Among the several variables that stimulate stock market activity; only foreign direct investment (FDI did increase capitalization. Thus, the study concludes that since not all government institutions and business regulations are critical to stock market development, various governments should be careful and selective in their economic stimulants if they want to develop their stock markets.
Verbeke, Frank; Karara, Gustave; Nyssen, Marc
This research explores to what extent Information and Communication Technology (ICT)-based information management methods can help to improve efficiency and effectiveness of health services in sub-Saharan hospitals and how clinical information can be made available for secondary use enabling non-redundant reporting of health- and care performance indicators. In the course of a 6 years research effort between 2006 and 2012, it was demonstrated that patient identification, financial management and structured reporting improved dramatically after implementation of well adapted ICT-tools in a set of 19 African health facilities. Real-time financial management metrics helped hospitals to quickly identify fraudulent practices and defective invoicing procedures. Out-patient case load significantly increased compared to the national average, average length of stay has been shortened in 15 of 19 health facilities and global hospital mortality decreased. Hospital workforce-evaluated impact of hospital information system implementation on local working conditions and quality of care was very positive. It was demonstrated that local sub-Saharan health professionals strongly believe in the importance of health information systems. PMID:23920609
Murunga, A N; Owira, P M O
The true incidence of diabetic ketoacidosis (DKA) in sub-Saharan Africa is unknown but unlike in the Western countries, DKA is also uniquely frequent among type 2 diabetes patients of African origin. Increased hyperglycaemia and hepatic ketogenesis lead to osmotic diuresis, dehydration and tissue hypoxia. Acute complications of DKA include cerebral oedema, which may be compounded by malnutrition, parasitic and microbial infections with rampant tuberculosis and HIV. Overlapping symptoms of these conditions and misdiagnosis of DKA contribute to increased morbidity and mortality. Inability of the patients to afford insulin treatment leads to poor glycemic control as some patients seek alternative treatment from traditional healers or use herbal remedies further complicating the disease process. Standard treatment guidelines for DKA currently used may not be ideal as they are adapted from those of the developed world. Children presenting with suspected DKA should be screened for comorbidities which may complicate fluid and electrolyte replacement therapy protocol. Patient rehabilitation should take into account concurrent treatment for infectious conditions to avoid possible life-threatening drug interactions. We recommend that health systems in sub-Saharan Africa leverage the Expanded Immunization Programme or TB/HIV/AIDS programmes, which are fairly well entrenched to support diabetes services. PMID:24112393
Debats, S. R.; Luo, D.; Estes, L. D.; Fuchs, T.; Caylor, K. K.
Sub-Saharan Africa is an important focus for food security research, because it is experiencing unprecedented population growth, agricultural activities are largely dominated by smallholder production, and the region is already home to 25% of the world's undernourished. One of the greatest challenges to monitoring and improving food security in this region is obtaining an accurate accounting of the spatial distribution of agriculture. Households are the primary units of agricultural production in smallholder communities and typically rely on small fields of less than 2 hectares. Field sizes are directly related to household crop productivity, management choices, and adoption of new technologies. As population and agriculture expand, it becomes increasingly important to understand both the distribution of field sizes as well as how agricultural communities are spatially embedded in the landscape. In addition, household surveys, a common tool for tracking agricultural productivity in Sub-Saharan Africa, would greatly benefit from spatially explicit accounting of fields. Current gridded land cover data sets do not provide information on individual agricultural fields or the distribution of field sizes. Therefore, we employ cutting edge approaches from the field of computer vision to map fields across Sub-Saharan Africa, including semantic segmentation, discriminative classifiers, and automatic feature selection. Our approach aims to not only improve the binary classification accuracy of cropland, but also to isolate distinct fields, thereby capturing crucial information on size and geometry. Our research focuses on the development of descriptive features across scales to increase the accuracy and geographic range of our computer vision algorithm. Relevant data sets include high-resolution remote sensing imagery and Landsat (30-m) multi-spectral imagery. Training data for field boundaries is derived from hand-digitized data sets as well as crowdsourcing.
Mereu, V.; Spano, D.; Gallo, A.; Carboni, G.
Agriculture in Sub-Saharan Africa (SSA) drives the economy of many African countries and it is mainly rain-fed agriculture used for subsistence. Increasing temperatures, changed precipitation patterns and more frequent droughts may lead to a substantial decrease of crop yields. The projected impacts of future climate change on agriculture are expected to be significant and extensive in the SSA due to the shortening of the growing seasons and the increasing of water-stress risk. Differences in Agro-Ecological Zones and geographical characteristics of SSA influence the diverse impacts of climate change, which can greatly differ across the continent and within countries. The vulnerability of African Countries to climate change is aggravated by the low adaptive capacity of the continent, due to the increasing of its population, the widespread poverty, and other social factors. In this contest, the assessment of climate change impact on agricultural sector has a particular interest to stakeholder and policy makers, in order to identify specific agricultural sectors and Agro-Ecological Zones that could be more vulnerable to changes in climatic conditions and to develop the most appropriate policies to cope with these threats. For these reasons, the evaluation of climate change impacts for key crops in SSA was made exploring climate uncertainty and focusing on short period monitoring, which is particularly useful for food security and risk management analysis. The DSSAT-CSM (Decision Support System for Agrotechnology Transfer - Cropping System Model) software, version 4.5 was used for the analysis. Crop simulation models included in DSSAT-CSM are tools that allow to simulate physiological process of crop growth, development and production, by combining genetic crop characteristics and environmental (soil and weather) conditions. For each selected crop, the models were used, after a parameterization phase, to evaluate climate change impacts on crop phenology and production. Multiple combinations of soils and climate conditions, crop management and varieties were considered for the different Agro-Ecological Zones. The climate impact was assessed using future climate prediction, statistically and/or dynamically downscaled, for specific areas. Direct and indirect effects of different CO2 concentrations projected for the future periods were separately explored to estimate their effects on crops. Several adaptation strategies (e.g., introduction of full irrigation, shift of the ordinary sowing/planting date, changes in the ordinary fertilization management) were also evaluated with the aim to reduce the negative impact of climate change on crop production. The results of the study, analyzed at local, AEZ and country level, will be discussed.
Eberhard, Anton, E-mail: firstname.lastname@example.org [University of Cape Town' s Graduate School of Business, Cape Town 8001 (South Africa); Gratwick, Katharine Nawaal [University of Cape Town' s Graduate School of Business, Cape Town 8001 (South Africa)
This study analyses the outcomes of independent power projects (IPPs) across Sub-Saharan Africa. Approximately 20 such projects have taken root to date, concentrated mainly in 8 countries. A suite of country level and project level factors play a critical role in determining project success, chief among them: the manner in which planning, procurement and contracting are coherently linked, the role of development finance institutions along with the development origins of firms and credit enhancements. - Highlights: > We analyse the outcomes of independent power projects (IPPs) across Sub-Saharan Africa. > Approximately 20 IPPs have taken root to date, concentrated mainly in 8 countries. > A suite of country level and project level factors play a critical role in determining project success. > Key success factors are the coherence of planning, procurement and contracting. > Also important is the role of DFIs, the development origins of firms, and credit enhancements.
This study analyses the outcomes of independent power projects (IPPs) across Sub-Saharan Africa. Approximately 20 such projects have taken root to date, concentrated mainly in 8 countries. A suite of country level and project level factors play a critical role in determining project success, chief among them: the manner in which planning, procurement and contracting are coherently linked, the role of development finance institutions along with the development origins of firms and credit enhancements. - Highlights: ? We analyse the outcomes of independent power projects (IPPs) across Sub-Saharan Africa. ? Approximately 20 IPPs have taken root to date, concentrated mainly in 8 countries. ? A suite of country level and project level factors play a critical role in determining project success. ? Key success factors are the coherence of planning, procurement and contracting. ? Also important is the role of DFIs, the development origins of firms, and credit enhancements.
Kaul, Rupert; Prodger, Jessica; Joag, Vineet; Shannon, Brett; Yegorov, Sergey; Galiwango, Ronald; McKinnon, Lyle
While the per-contact risk of sexual HIV transmission is relatively low, it is fourfold higher in sub-Saharan Africa, and this may partly explain the major global disparities that exist in HIV prevalence. Genital immune parameters are key determinants of HIV transmission risk, including epithelial integrity and the presence of highly HIV-susceptible intraepithelial or submucosal CD4+ T cell target cells. Biological parameters that may enhance mucosal HIV susceptibility in highly HIV-affected regions of sub-Saharan Africa include increased levels of mucosal inflammation, which can affect both epithelial integrity and target cell availability, as well as the increased mucosal surface area that is afforded by an intact foreskin, contraceptive choices, and intravaginal practices. There are multifactorial causes for increased mucosal inflammation, with the prevalence and nature of common co-infections being particularly relevant. PMID:25877253
Ogundipe, Adeyemi; Ogundipe, Oluwatomisin
This study examined the relationship between foreign aid and economic development in Sub Saharan Africa. The study seeks to examine the role of institutions in aid effectiveness in SSA countries by adopting a theoretical framework similar to the Endogenous/New Growth model and the System Generalized Method of Moments (GMM) technique of estimation in order to overcome the challenge of endogeneity perceived in the institution variables and Aid-Growth argument. It was observed that foreign aid d...
Graham, R.L.; Perlack, R.D.; Prasad, A.M.G.; Ranney, J.W.; Waddle, D.B.
Current and future carbon emissions from land-use change and energy consumption were analyzed for Sub-Saharan Africa. The energy sector analysis was based on UN energy data tapes while the land-use analysis was based on a spatially-explicit land-use model developed specifically for this project. The impacts of different energy and land-use strategies on future carbon emissions were considered. (A review of anthropogenic emissions of methane, nitrous oxides, and chlorofluorocarbons in Sub-Saharan Africa indicated that they were probably minor in both a global and a regional context. The study therefore was focused on emissions of carbon dioxide.) The land-use model predicts carbon emissions from land use change and the amount of carbon stored in vegetation (carbon inventory) on a yearly basis between 1985 and 2001. Emissions and inventory are modeled at 9000 regularly-spaced point locations in Sub-Saharan Africa using location-specific information on vegetation type, soils, climate and deforestation. Vegetation, soils, and climate information were derived from continental-scale maps while relative deforestation rates(% of forest land lost each year) were developed from country-specific forest and deforestation statistics (FAO Tropical Forest Resources Assessment for Africa, 1980). The carbon emissions under different land use strategies in Sub-Saharan Africa were analyzed by modifying deforestation rates and altering the amount of carbon stored under different land uses. The considered strategies were: preservation of existing forests, implementation of agroforestry, and establishment of industrial tree plantations. 82 refs., 16 figs., 25 tabs.
Bakewell, Oliver; Phillips, Nicola
Migration in sub-Saharan Africa, as in the rest of the world, has always been an essential element in the historical processes of social, political and economic change. Development (however defined) and migration are intertwined in a set of complex, heterogeneous, and changing relationships in which causality is never one way. In short, migration can be seen as a both a cause and consequence of development and, equally, development is both a cause and consequence of migration. ...
Berge, Zane; Leary, John
This paper explains the purposes, delivery methods, and program characteristics of successful distance education (DE) in sub-Saharan Africa (SSA). This paper investigates the design and delivery systems of these programs and identifies ways the DE programs are working to improve. There are about 150 formidable distance education programs working in SSA. They aim to increase and improve a variety of existing programs, including primary and high school education, college-level and graduate pro...
Recent years have seen a considerable shift in economic conditions in sub-Saharan Africa. Economic growth has been robust, international reserves are on the rise and levels of external debt are falling. Combined with the global boom in commodity prices, as well as expansion of Chinese interests in the region, international investors are increasingly viewing Africa as a serious investment option. As a result of these trends, the landscape in which foreign donors have operated is changing rapid...
Full Text Available Abstract Background Artesunate and amodiaquine (AS&AQ is at present the world's second most widely used artemisinin-based combination therapy (ACT. It was necessary to evaluate the efficacy of ACT, recently adopted by the World Health Organization (WHO and deployed over 80 countries, in order to make an evidence-based drug policy. Methods An individual patient data (IPD analysis was conducted on efficacy outcomes in 26 clinical studies in sub-Saharan Africa using the WHO protocol with similar primary and secondary endpoints. Results A total of 11,700 patients (75% under 5 years old, from 33 different sites in 16 countries were followed for 28 days. Loss to follow-up was 4.9% (575/11,700. AS&AQ was given to 5,897 patients. Of these, 82% (4,826/5,897 were included in randomized comparative trials with polymerase chain reaction (PCR genotyping results and compared to 5,413 patients (half receiving an ACT. AS&AQ and other ACT comparators resulted in rapid clearance of fever and parasitaemia, superior to non-ACT. Using survival analysis on a modified intent-to-treat population, the Day 28 PCR-adjusted efficacy of AS&AQ was greater than 90% (the WHO cut-off in 11/16 countries. In randomized comparative trials (n = 22, the crude efficacy of AS&AQ was 75.9% (95% CI 74.677.1 and the PCR-adjusted efficacy was 93.9% (95% CI 93.294.5. The risk (weighted by site of failure PCR-adjusted of AS&AQ was significantly inferior to non-ACT, superior to dihydroartemisinin-piperaquine (DP, in one Ugandan site, and not different from AS+SP or AL (artemether-lumefantrine. The risk of gametocyte appearance and the carriage rate of AS&AQ was only greater in one Ugandan site compared to AL and DP, and lower compared to non-ACT (p = 0.001, for all comparisons. Anaemia recovery was not different than comparator groups, except in one site in Rwanda where the patients in the DP group had a slower recovery. Conclusion AS&AQ compares well to other treatments and meets the WHO efficacy criteria for use against falciparum malaria in many, but not all, the sub-Saharan African countries where it was studied. Efficacy varies between and within countries. An IPD analysis can inform general and local treatment policies. Ongoing monitoring evaluation is required.
Flinkenflögel, Maaike; Essuman, Akye; Chege, Patrick; Ayankogbe, Olayinka; De Maeseneer, Jan
Background. Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. Objective. To explore the extent to which the Primafamed SouthSouth cooperative project contributed to the development of family medicine in sub-Saharan Africa. Methods. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. Results. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. Conclusions. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The SouthSouth cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels. PMID:24857843
Full Text Available Abstract Background HIV-related immune-suppression increases the risk of malaria (infection, disease and treatment failure and probably the circulating parasite biomass, favoring the emergence of drug resistance parasites. Methods The additional malaria parasite biomass related to HIV-1 co-infection in sub-Saharan Africa was estimated by a mathematical model. Parasite biomass was computed as the incidence rate of clinical malaria episodes multiplied by the number of parasites circulating in the peripheral blood of patients at the time symptoms appear. A mathematical model estimated the influence of HIV-1 infection on parasite density in clinical malaria by country and by age group, malaria transmission intensity and urban/rural area. In a multivariate sensitivity analysis, 95% confidence intervals (CIs were calculated using the Monte Carlo simulation. Results The model shows that in 2005 HIV-1 increased the overall malaria parasite biomass by 18.0% (95%CI: 11.626.9. The largest relative increase (134.9243.9% was found in southern Africa where HIV-1 prevalence is the highest and malaria transmission unstable. The largest absolute increase was found in Zambia, Malawi, the Central African Republic and Mozambique, where both malaria and HIV are highly endemic. A univariate sensitivity analysis shows that estimates are sensitive to the magnitude of the impact of HIV-1 infection on the malaria incidence rates and associated parasite densities. Conclusion The HIV-1 epidemic by increasing the malaria parasite biomass in sub-Saharan Africa may also increase the emergence of antimalarial drug resistance, potentially affecting the health of the whole population in countries endemic for both HIV-1 and malaria.
In the scope of future population support, agricultural productivity, in particular in sub-Saharan Africa, has to increase drastically to meet the UNs millennium development goals of eradicating extreme poverty and hunger by 2015. Water availability in the root-zone limits crop production in large parts of the developing world. As competition for fresh water increases, water of lower quality, for example saline or polluted water, is often used for irrigation. Low-cost drip systems are suit...
Full Text Available International remittances comprise significant financial inflow for many Sub-Saharan African (SSA countries and provide considerable disposable income for the receiving households. There has, however, been no consensus on the motivation in the part of sending migrants in which explanations are divided between altruism and self-interest. The study employs Autoregressive Distributed Lag (ARDL model with co-integration approach to investigate whether international remittances to Kenya can be explained by either altruistic or self-interest motive. We process the World Bank annual data from 1970 to 2010 and find that self-interest, not altruism, as the dominant motivation to determine remittances. The analysis also indicates that demand on housing and exchange rates are the two strong drivers of international remittances to Kenya in both short-run and long-run. The Kenyan government is supposed to facilitate savings from remittances through financial institutions to invest more in the small business sector for economic growth.
Full Text Available The present international approach to management of transboundary animal diseases (TADs is based on the assumption that most can be eradicated ; consequently, that is the usual objective adopted by international organizations concerned with animal health. However, for sub-Saharan Africa and southern Africa more particularly, eradication of most TADs is impossible for the foreseeable future for a variety of technical, financial and logistical reasons. Compounding this, the present basis for access to international markets for products derived from animals requires that the area of origin (country or zone is free from trade-influencing TADs. The ongoing development of transfrontier conservation areas (TFCAs, extending across huge areas of southern Africa, therefore presents a development conundrum because it makes creation of geographic areas free from TADs more difficult and brings development based on wildlife conservation on the one hand and that based on livestock production on the other into sharp conflict. Sub-Saharan Africa is consequently confronted by a complex problem that contributes significantly to retarded rural development which, in turn, impedes poverty alleviation. In southern Africa specifically, foot-and-mouth disease (FMD presents the greatest problem in relation to access to international markets for animal products. However, it is argued that this problem could be overcome by a combination between (1 implementation of a commodity-based approach to trade in products derived from animals and (2 amendment of the international standards for FMD specifically (i.e. the FMD chapter in the Terrestrial Animal Health Code of the World Organisation for Animal Health [OIE] so that occurrence of SAT serotype viruses in free-living African buffalo need not necessarily mean exclusion of areas where buffalo occur from international markets for animal products. This would overcome a presently intractable constraint to market access for southern African countries and enable conservation and livestock production to be more effectively integrated, to the benefit of both.
Although considerable achievements in the global reduction of hunger and poverty have been made, progress in Africa so far has been very limited. At present, a third of the African population faces widespread hunger and chronic malnutrition and is exposed to a constant threat of acute food crisis and famine. The most affected are rural households whose livelihood is heavily dependent on traditional rainfed agriculture. Rainfall plays a major role in determining agricultural production and hence the economic and social well being of rural communities. The rainfall pattern in sub-Saharan Africa is influenced by large-scale intra-seasonal and inter-annual climate variability including occasional El Niño events in the tropical Pacific resulting in frequent extreme weather event such as droughts and floods that reduce agricultural outputs resulting in severe food shortages. Households and communities facing acute food shortages are forced to adopt coping strategies to meet the immediate food requirements of their families. These extreme responses may have adverse long-term, impacts on households' ability to have sustainable access to food as well as the environment. The HIV/AIDS crisis has also had adverse impacts on food production activities on the continent. In the absence of safety nets and appropriate financial support mechanisms, humanitarian aid is required to enable households effectively cope with emergencies and manage their limited resources more efficiently. Timely and appropriate humanitarian aid will provide households with opportunities to engage in productive and sustainable livelihood strategies. Investments in poverty reduction efforts would have better impact if complemented with timely and predictable response mechanisms that would ensure the protection of livelihoods during crisis periods whether weather or conflict-related. With an improved understanding of climate variability including El Niño, the implications of weather patterns for the food security and vulnerability of rural communities have become more predictable and can be monitored effectively. The purpose of this paper is to investigate how current advances in the understanding of climate variability, weather patterns and food security could contribute to improved humanitarian decision-making. The paper will propose new approaches for triggering humanitarian responses to weather-induced food crises. PMID:16433102
Mathieu Couttenier; Raphael Soubeyran
In this paper, we show that drought has a positive effect on the incidence of civil war over the 1945-2005 period in Sub-Saharan Africa. We use the Palmer Drought Severity Index which is a richer measurement of drought than the measures used in the literature (rainfall and temperature) as it measures the accumulation of water in the soil in taking into account the temperature and the geological characteristics of the soil. We show that the risk of civil war increases by more than 42% from a '...
Gruca, Marta; van Andel, Tinde
Palms (Arecaceae) are prominent elements in African traditional medicines. It is, however, a challenge to find detailed information on the ritual use of palms, which are an inextricable part of African medicinal and spiritual systems. This work reviews ritual uses of palms within African ethnomedicine. We studied over 200 publications on uses of African palms and found information about ritual uses in 26 of them. At least 12 palm species in sub-Saharan Africa are involved in various ritual practices: Borassus aethiopum, Cocos nucifera, Dypsis canaliculata, D. fibrosa, D. pinnatifrons, Elaeis guineensis, Hyphaene coriacea, H. petersiana, Phoenix reclinata, Raphia farinifera, R. hookeri, and R. vinifera. In some rituals, palms play a central role as sacred objects, for example the seeds accompany oracles and palm leaves are used in offerings. In other cases, palms are added as a support to other powerful ingredients, for example palm oil used as a medium to blend and make coherent the healing mixture. A better understanding of the cultural context of medicinal use of palms is needed in order to obtain a more accurate and complete insight into palm-based traditional medicines.
Gruca, Marta; van Andel, Tinde R; Balslev, Henrik
Palms (Arecaceae) are prominent elements in African traditional medicines. It is, however, a challenge to find detailed information on the ritual use of palms, which are an inextricable part of African medicinal and spiritual systems. This work reviews ritual uses of palms within African ethnomedicine. We studied over 200 publications on uses of African palms and found information about ritual uses in 26 of them. At least 12 palm species in sub-Saharan Africa are involved in various ritual practices: Borassus aethiopum, Cocos nucifera, Dypsis canaliculata, D. fibrosa, D. pinnatifrons, Elaeis guineensis, Hyphaene coriacea, H. petersiana, Phoenix reclinata, Raphia farinifera, R. hookeri, and R. vinifera. In some rituals, palms play a central role as sacred objects, for example the seeds accompany oracles and palm leaves are used in offerings. In other cases, palms are added as a support to other powerful ingredients, for example palm oil used as a medium to blend and make coherent the healing mixture. A better understanding of the cultural context of medicinal use of palms is needed in order to obtain a more accurate and complete insight into palm-based traditional medicines. PMID:25056559
Ndeffo Mbah, Martial L; Parikh, Sunil; Galvani, Alison P
Artemisinin-based combination therapies (ACTs) are currently considered the first-line treatments for uncomplicated Plasmodium falciparum malaria. Among these, artemether-lumefantrine (AL) has been the most widely prescribed ACT in sub-Saharan Africa. Recent clinical trials conducted in sub-Saharan Africa have shown that dihydroartemisinin-piperaquine (DP), a most recent ACT, may have a longer post-treatment prophylactic period and post-treatment infection period (duration of gametocyte carriage) than AL. Using epidemiological and clinical data on the efficacy of AL and DP, we developed and parameterized a mathematical transmission model that we used to compare the population-level impact of AL and DP for reducing P. falciparum malaria transmission in sub-Saharan Africa. Our results showed that DP is likely to more effectively reduce malaria incidence of clinical episodes than AL. However in low P. falciparum transmission areas, DP and AL are likely to be equally effective in reducing malaria prevalence. The predictions of our model were shown to be robust to the empirical uncertainty summarizing the epidemiological parameters. DP should be considered as a replacement for AL as first-line treatment of uncomplicated malaria in highly endemic P. falciparum communities. To optimize the effectiveness of ACTs, it is necessary to tailor treatment policies to the transmission intensity in different settings. PMID:25624402
Isabel, Gentil García.
Full Text Available Justificación: La población inmigrante subsahariana es la más desconocida para los profesionales de la salud. Objetivo: Conocer, a través de sus voces, su cosmovisión que enmarca valores, creencias y prácticas sobre salud y enfermedad, centrándonos en el ser humano con enfoque holístico. Metodología [...] : Cualitativa, fenomenología. Resultados: Su concepción de la vida y del universo está impregnada de la religión más antigua del mundo: el animismo. Los antepasados que murieron siguen estando para protegerles. Aprecian la atención sanitaria española pero hay padecimientos que resuelve mejor la medicina tradicional africana. Aunque la atención es correcta puede despertarse susceptibilidad al no conocer los códigos culturales de la nueva sociedad. La solidaridad familiar es el valor fundamental. Conclusión: La solidaridad, valor ancestral en los humanos, debe seguir guiando a los profesionales de la salud comprometidos con la salud de la población, defendiendo el Estado de Bienestar frente a las voces que pretenden desmantelarlo. Abstract in english The population of sub-Saharan immigrants is unknown by health care professionals. Objective: know, across his voices, his cosmovision that frames values, beliefs and practices on health and disease, centring on the human being with holistic approach. Methodology qualitative, phenomenology. Results: [...] His conception of the life and of the universe is impregnated with the most ancient religion of the world: the animism. The forbears who died continue being to protect them. They estimate the sanitary Spanish attention though there are sufferings that there solves better the traditional African medicine. Though the attention is correct one can wake susceptibility up on not having known all the cultural codes of the new company. The familiar solidarity is a fundamental value. Conclusions: the ancient solidarity in the human beings must continue guiding the professionals of the health compromised with the health of the population, defending the Welfare state opposite to the voices they it tries to dismantle.
Munyambonera Ezra Francis
Full Text Available The central theme of this study was to investigate the determinants of commercial bank profitability in Sub-Saharan Africa. The analysis used an unbalanced panel of 216 commercial banks drawn from 42 countries in SSA for the period 1999 to 2006. Using the cost efficiency model, bank profitability was estimated using panel random effects method in static framework. The explanatory variables are growth in bank assets, growth in bank deposits, capital adequacy, operational efficiency (inefficiency, and liquidity ratio as well as the macroeconomic variables of growth in GDP and inflation. The findings clearly show that both bank-specific as well as macroeconomic factors explain the variation in commercial bank profitability over the study period. These findings demonstrate the importance of both bank level as well as macroeconomic factors in explaining commercial bank profitability in Sub-Saharan Africa. The policy implications drawn from this paper are that if banks are to attain profitability improvements, both bank level as well as macroeconomic factors are important.
Ekouevi, K; Adepoju, A
This discussion concludes that the economic crises of the 1980s resulted in a halt to the social and economic development of sub-Saharan Africa. Employment, health, and education sectors all deteriorated under structural adjustment programs (SAPs) and poor economic performance. SAPs are considered inadequate solutions to long-term problems. Economic crises were found to affect countries differently in their demographic impact. Delayed demographic transition occurred both through economic development as a prerequisite and as a result of poor economic development. Case studies of each country are considered the appropriate geographic unit of analysis of demographic change rather than regional or comparative studies. The economic crises in sub-Saharan Africa occurred due to both external (commodity prices, high real interest rates, and decreasing net capital flows) and internal distortions (strategies of development such as import substitution, neglect of the agricultural sector, and government control of prices and trade). The unfavorable external context reduced export prices and earnings while increasing the costs of imports. Internal controls were detrimental to farmers. During the 1970s and 1980s African countries experienced declines in both the volume and value of exports, increases in import volume, and imbalances in the balance of payments. Large domestic borrowing and foreign borrowing was done by governments, which was at the expense of the private sector. Economic management and corruption were rampant. SAPs restrained demand, reduced public expenditures, adjusted exchange rates, contracted the size of the public sector, liberalized trade, deregulated the interest rate, stimulated domestic production, and used market forces for balancing optimum allocation of resources. SAPs were the fix for trade imbalances and government debt. Development was slowed or stopped. During 1980-87 spending on health care, education, and infrastructure was drastically reduced. These already weak sectors were further weakened. Inflation rose. Public sector employment was reduced. Wages declined, which resulted in a massive demoralization, unemployment, and poverty. Manpower development was threatened by declines in education. PMID:12319912
Zotor, F B; Amuna, P
Food insecurity, chronic hunger, starvation and malnutrition continue to affect millions of individuals throughout the developing world, especially Sub-Saharan Africa. Various initiatives by African governments and International Agencies such as the UN, the industrial nations, the International Monetary Fund, the World Bank and the World Trade Organisation to boost economic development, have failed to provide the much-needed solution to these challenges. The impact of these economic shifts and the failures of structural adjustment programmes on the nutritional well-being and health of the most vulnerable members of poor communities cannot be over-emphasised. The use of ad hoc measures as an adjunct to community-based rural integrated projects have provided little success and will be unsustainable unless they are linked to harnessing available local resources. The present paper therefore focuses on exploring alternative ways of harnessing the scant agricultural resources by employing a scientific approach to food-related problem-solving. The food multimix (FMM) concept offers a scientific contribution alongside other attempts currently in use by the World Food Programme, WHO and FAO to meet the food insecurity challenges that confront most of the developing world in the twenty-first century. It is an innovative approach that makes better use of traditional food sources as a tool for meeting community nutritional needs. The FMM concept employs a food-based approach using traditional methods of food preparation and locally-available, cheap and affordable staples (fruits, pulses, vegetables and legumes) in the formulation of nutrient-enriched multimixes. Developed recipes can provide > or =40% of the daily nutritional requirements of vulnerable groups, including patients with HIV/AIDS and children undergoing nutrition rehabilitation. The FMM approach can also be used as a medium- to long-term adjunct to community-based rural integration projects aimed at health improvement and economic empowerment in Sub-Saharan Africa. PMID:18234137
Kanayo Ogujiuba; Fadila Jumare
Sub-Saharan African countries report high levels of growth and GDP per capita and yet they are unable to achieve the Millennium Development Goals (MDGs) such as quality education and health. The paper argued that GDP might not be sufficient for measuring development because the funds obtained may not necessarily be used to improve the quality of life of worse off communities. Even with a constituent level of GDP, the problem of poverty and underdevelopment is becoming more intractable in Sub-...
Vries, Nanne K.; Bart van den Borne; Mbonu, Ngozi C.
The aim of this literature review is to elucidate what is known about HIV/AIDS and stigma in Sub-Saharan Africa. Literature about HIV/AIDS and stigma in Sub-Saharan Africa was systematically searched in Pubmed, Medscape, and Psycinfo up to March 31, 2009. No starting date limit was specified. The material was analyzed using Gilmore and ...
...Committee of the Export-Import Bank of the United States (Ex-Im Bank) SUMMARY: The Sub-Saharan...programs designed to support the expansion of the Bank's financial commitments in Sub- Saharan Africa under the loan, guarantee, and...
Shanaube, Kwame; Bock, Peter
For the last three decades, sub-Saharan Africa has been the epicentre of the HIV epidemic. Some key drivers of the epidemic are specific to this region and there is an urgent need to develop context-specific strategies to reduce HIV-related burden. Implementation frameworks should endeavour to combine structural, behavioural and biomedical interventions and the future of the HIV response involves embracing different approaches for different populations; it is not 'one-size fits all approach'. Expanded use of community-based interventions will be key in expanding the role of antiretroviral treatment as prevention (TasP) in the region. For TasP to be effective, high antiretroviral therapy (ART) coverage rates need to be attained. Data from programmatic trials currently underway will provide crucial data to guide the future implementation of TasP. PMID:25929960
Lokossou, Th; Zoumenou, E; Secka, G; Bang'na, F Ouro; Le Polain de Waroux, B; Veyckemans, F; Baele, Ph; Chobli, M
The situation of Anesthesiology in Sub-Saharan Africa is unique in that nowhere else in the world has the absolute numbers of anesthesiologists decreased during the nineties. Most anesthesia services to the populations of these 17 poor countries are provided by nurse-anesthetists, either certified or trained on the job. Their mean age often exceeds 40, which leads to expect an acute shortage within fifteen years. Experienced anesthesiologists are now so few that, in most countries, the critical mass of knowledgeable specialists no longer exists to train new anesthesia professionals. This summary of local surveys provides a brief overview of current workforce, institutions, drugs and material constituting the daily environment of our colleagues. Challenges are outlined, with special emphasis on brain drain. Solutions are proposed, underlining the promising role of a few anesthesia schools, the need for young anesthesiologists to enter teaching, and the expectations they are supposed to meet. PMID:18018841
Müller, Christoph; Waha, Katharina; Bondeau, Alberte; Heinke, Jens
Development efforts for poverty reduction and food security in sub-Saharan Africa will have to consider future climate change impacts. Large uncertainties in climate change impact assessments do not necessarily complicate, but can inform development strategies. The design of development strategies will need to consider the likelihood, strength, and interaction of climate change impacts across biosphere properties. We here explore the spread of climate change impact projections and develop a composite impact measure to identify hotspots of climate change impacts, addressing likelihood and strength of impacts. Overlapping impacts in different biosphere properties (e.g. flooding, yields) will not only claim additional capacity to respond, but will also narrow the options to respond and develop. Regions with severest projected climate change impacts often coincide with regions of high population density and poverty rates. Science and policy need to propose ways of preparing these areas for development under climate change impacts. PMID:24796720
Barter Devra M
Full Text Available Abstract Background Tuberculosis (TB is known to disproportionately affect the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be particularly burdensome for TB-affected households in sub-Saharan Africa where poverty levels are high; these costs include the direct costs of medical and non-medical expenditures and the indirect costs of time utilizing healthcare or lost wages. In order to comprehensively assess the existing evidence on the costs that TB patients incur, we undertook a systematic review of the literature. Methods PubMed, EMBASE, Science Citation Index, Social Science Citation Index, EconLit, Dissertation Abstracts, CINAHL, and Sociological Abstracts databases were searched, and 5,114 articles were identified. Articles were included in the final review if they contained a quantitative measure of direct or indirect patient costs for treatment or care for pulmonary TB in sub-Saharan Africa and were published from January 1, 1994 to Dec 31, 2010. Cost data were extracted from each study and converted to 2010 international dollars (I$. Results Thirty articles met all of the inclusion criteria. Twenty-one studies reported both direct and indirect costs; eight studies reported only direct costs; and one study reported only indirect costs. Depending on type of costs, costs varied from less than I$1 to almost I$600 or from a small fraction of mean monthly income for average annual income earners to over 10 times average annual income for income earners in the income-poorest 20% of the population. Out of the eleven types of TB patient costs identified in this review, the costs for hospitalization, medication, transportation, and care in the private sector were largest. Conclusion TB patients and households in sub-Saharan Africa often incurred high costs when utilizing TB treatment and care, both within and outside of Directly Observed Therapy Short-course (DOTS programs. For many households, TB treatment and care-related costs were considered to be catastrophic because the patient costs incurred commonly amounted to 10% or more of per capita incomes in the countries where the primary studies included in this review were conducted. Our results suggest that policies to decrease direct and indirect TB patient costs are urgently needed to prevent poverty due to TB treatment and care for those affected by the disease.
Bekalu, Mesfin Awoke; Eggermont, Steven; Ramanadhan, Shoba; Viswanath, Kasisomayajula
It is known that HIV-related stigma hinders prevention efforts. Previous studies have documented that HIV-related stigma may be associated with socioeconomic and socioecological factors. Mass media use may moderate this association, but there is limited research addressing that possibility. In this study, based on cross-sectional data pooled from the 20062011 Demographic and Health Surveys of 11 sub-Saharan African countries (N?=?204,343), we investigated the moderating effects of exposure to mass media on HIV-related stigma. Hierarchical regression analysis indicated that HIV-related stigma tends to be higher among rural residents and individuals with low levels of education and HIV knowledge, as well as those who do not know people living with HIV. Media use was generally associated with low levels of HIV-related stigma, and attenuated the gap between individuals with high and low educational levels. However, the effect of mass media was found to be stronger among urbanites rather than among rural residents, which could lead to a widening gap between the two groups in endorsement of HIV-related stigma. The implication of this study regarding the effect of media use on HIV-related stigma in sub-Saharan Africa is twofold: 1) mass media may have the potential to minimize the gap in HIV-related stigma between individuals with high and low educational levels, and hence future efforts of reducing HIV-related stigma in the region may benefit from utilizing media; 2) due perhaps to low media penetration to rural sub-Saharan Africa, mass media could have the unintended effect of widening the urban-rural gap further unless other more customized and rural-focused communication interventions are put in place. PMID:24945251
Full Text Available African continent has significant importance for showing the inter-relation for that of military expenditure , war and underdevelopment all which demonstrate the relative data that poverty is created by divertion of economic sources to wars and domestic conflicts. When analizing the existing studies, it shows that military expenditure does not stimulate positive effect on the economy of subject group of countries. Diverting the economic sources which are already scarse, to military expenditures and not giving priorities to polical measures and strategies that help to achieve economic and social development caused the African countries to become underdeveloped socially and economicaly compared to rest of the world. Effect of Military expenditures on economic growth has been analyzed by using an exogenous economic growth model and panel data GLS method using data of 6 Sub-Saharan countries for 1990-2012 period. The result of analysis showed that military expenditures has so limited and minimal positive effect on economic growth which cannot be taken into consideration by macro economic means. Despite the fact that the result is positive; by amount and value wise it is not enough to set any political goal and to develope any strategy for the subject countries. It is not mistaken to say the short and long term effects on the whole economy will be much more beneficial if those expenditure is made to other sectors in subject countries.
José Luiz, Telles; Ana Paula Abreu, Borges.
Full Text Available A região Subsaariana do continente africano é onde se concentra a maior carga de doença do mundo e é a única região do planeta onde se espera que o número de pessoas pobres irá aumentar nas próximas décadas. Os países desta região, em diferentes graus, experimentam processo lento de envelhecimento p [...] opulacional, mas, ao mesmo tempo, é onde a população idosa mais cresce em números absolutos. A partir de revisão da bibliografia, buscou-se destacar a situação demográfica e social em que vivem as pessoas idosas na região subsaariana e os principais desafios que se impõem aos governos locais para a superação dos complexos problemas postos a toda a sociedade. Constatou-se que as políticas públicas voltadas para este segmento populacional na região não representam prioridade e, por conseguinte, dificilmente entram na agenda atual da cooperação internacional. Abstract in english The Sub-Saharan part of the African continent is the area that has the highest disease burden in the world and is the only region of the planet where it is expected that the number of poor people will increase in the coming decades. The countries of this region, to different degrees, experience slow [...] process of population aging but at the same time, it is the are where the elderly population grows fastest in absolute numbers. Based on a review of the literature, an attempt was made to highlight the social and demographic situation in which the elderly live in the Sub-Saharan region and the main challenges faced by local governments to overcome the complex problems affecting society as a whole. It was found that public policies geared to this segment of the population in the region do not represent a priority and, consequently, are unlikely to be included in the current agenda of international cooperation.
Podgorná, Elika; Soares, Pedro; Pereira, Luísa; Cerný, Viktor
The presence of sub-Saharan L-type mtDNA sequences in North Africa has traditionally been explained by the recent slave trade. However, gene flow between sub-Saharan and northern African populations would also have been made possible earlier through the greening of the Sahara resulting from Early Holocene climatic improvement. In this article, we examine human dispersals across the Sahara through the analysis of the sub-Saharan mtDNA haplogroup L3e5, which is not only commonly found in the Lake Chad Basin (?17%), but which also attains nonnegligible frequencies (?10%) in some Northwestern African populations. Age estimates point to its origin ?10 ka, probably directly in the Lake Chad Basin, where the clade occurs across linguistic boundaries. The virtual absence of this specific haplogroup in Daza from Northern Chad and all West African populations suggests that its migration took place elsewhere, perhaps through Northern Niger. Interestingly, independent confirmation of Early Holocene contacts between North Africa and the Lake Chad Basin have been provided by craniofacial data from Central Niger, supporting our suggestion that the Early Holocene offered a suitable climatic window for genetic exchanges between North and sub-Saharan Africa. In view of its younger founder age in North Africa, the discontinuous distribution of L3e5 was probably caused by the Middle Holocene re-expansion of the Sahara desert, disrupting the clade's original continuous spread. PMID:25069842
Ala, Fereydoun; Allain, Jean-Pierre
Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking.
Kuepfer, Irene; Burri, Christian
The urgent need for new, safe and sustainable interventions against diseases that disproportionally affect the poor is finally receiving global attention and the funding landscape for development projects has significantly improved during the past decade. For the development of new drug and vaccine candidates, clinical trials have become the most important tool to assess their safety and efficacy. Recently, there has been a seismic shift in the number of clinical trials conducted in resource-limited settings. We discuss the current framework of clinical research in sub-Saharan Africa, from building product pipelines to the capacities needed for the conduct of trials according the harmonised Good Clinical Practice (GCP) ICH E6 guideline. We place emphasis on clinical research in neglected tropical diseases which still frequently has to be conducted with limited financial, logistical and human resources. Given those short-comings we recommend minimum standards needed at the local, national and sponsor levels to provide GCP-compliant clinical research. PMID:19324048
Bove, Riley; Valeggia, Claudia
In this paper we review the literature on the association between polygyny and women's health in sub-Saharan Africa. We argue that polygyny is an example of "co-operative conflict" within households, with likely implications for the vulnerability of polygynous women to illness, and for their access to treatment. We begin with a review of polygyny and then examine vulnerability to sexually transmitted infections (STIs, including HIV) and differential reproductive outcomes. Polygyny is associated with an accelerated transmission of STIs, both because it permits a multiplication of sexual partners and because it correlates with low rates of condom use, poor communication between spouses, and age and power imbalances among other factors. Female fertility is affected by the interplay between marital rank, household status, and cultural norms in polygynous marriages. Finally, we present areas which have received only cursory attention: mental health and a premature, "social" menopause. Although data are scarce, polygyny seems to be associated with higher levels of anxiety and depression, particularly around stressful life events. It is our hope that the examples reviewed here will help build a framework for mixed method quality research, which in turn can inform decision makers on more appropriate, context-dependent health policies. PMID:18952335
Kuzvinetsa Peter, Dzvimbo; Kholeka Constance, Moloi.
Full Text Available In a shrinking world, in which a neo-liberal discourse has permeated sub-Saharan African higher education, critical reflection is required to assess the merits and demerits of globalisation. Research, intensive discussion and hearings conducted over a two-year period by the Task Force on Higher Educ [...] ation and Society, convened by the World Bank and United Nations Educational, Scientific, and Cultural Organization (UNESCO) for the purpose of exploring the future of higher education in the developing world, led to the conclusion that without more and better higher education, developing countries would find it increasingly difficult to benefit from the global knowledge economy. A decade later, we argue for a radical change in the traditional discourse on globalisation because of the emergence of countries such as China, South Africa, India, and Brazil as global players in the world economy. These emerging global powers, reframe the political and imperial philosophy at the epicentre of globalisation discourse - an economic creed, through their mutual consultation and coordination on significant political issues. Their economic and military capabilities enable them to influence the trade regime and thereby strengthen the voice of the developing world as a whole. In relation to this paper's inquiry, the cooperation of these emerging powers gives the free enfranchised people of the world an opportunity to choose a different path of international relations (internationalisation) formed on more liberal lines, as opposed to the neo-liberal economic rationality of globalisation. This paper therefore examines globalisation and internationalisation of higher education in sub-Saharan Africa, a field in which increased knowledge production and distribution open up opportunities for users, institutions and societies. Against a background of chronic economic uncertainty we examine the influence of major international institutions on the direction of higher education, in particular teacher education. Drawing on relevant literature and our own experience, reflexively, we argue that the tendency, towards free market regulation ideologies, privileges neo-liberal global knowledge discourses, such that they impose on higher education a need to respond across a range of fields.
Sub-Saharan African (SSA) countries rely heavily on donor assistance and international borrowing. The Official Development Assistance (ODA)/GNP ratio in SSA is expected to rise well into the next century. Increases or decreases of ODA, which is known to be the main source of SSA's investment, may depend on the type of global settlement expected to emerge in the post-cold war world. SSA has therefore a stake on the type of globalisation which may frame world economic policy and financial aid to it. Neo-liberal globalisation has no enthusiasm for massive financial transfers. The incipient globalising ideas which emerged from the Rio Summit in 1992 have suggested to increase ODAs in real terms and debt relief to control crushing debt service payments. Agenda 21 has created new and additional facilities formally for increasing donor assistance in the form of financial and investment transfers. The question is whether this new mechanism will make any difference to stem the SSA decline and can "incentivise" the region's renewal or renaissance. This article will focus on how globalisation may be related to increase or decrease of financial transfer to SSA. (C) 2000 Elsevier Science Ltd. All rights reserved.
Full Text Available There is a critical need for governments in the region to realize the magnitude of the challenge in order to proactively respond to it. This means that for the region to meet its sanitation goals, these governments must prioritize sanitation in their national budgets. While the scale of sanitation challenges differs from one country to another, common bottlenecks arise from the pace of demographic growth, rapid urbanization and growth of informal settlements. All these factors are further aggravated by poverty, a critical developmental challenge that has continued to undermine the efforts of most governments. The irony however, is the fact that sanitation can considerably alleviate poverty, but due to other competing priorities such as education, health, environment, gender equality and economic growth, sanitation is least prioritized at all levels of governance. This phenomenon explains why majority of African people cannot access basic sanitation. This paper examines the challenges of financing sanitation in sub-Saharan countries, focusing on (i what is to be financed (ii how much will it cost (iii policy shifts to remedy the situation. The paper concludes by suggesting pertinent recommendations.
Full Text Available This report presents the proceedings of the field research conducted in the framework of a doctoralresearch on the European Union (EU as an emerging coordinator in development cooperation.This research aims to seek in-depth and interpreted understanding of the paradox betweenthe EUs ambitions on the one hand and practice on the ground on the other by investigating theEUs role in four sub-Saharan African countries (Tanzania, Zambia, Burkina Faso and Senegal.As such, it aims to add empirical evidence to the debate on the role of the EU as a developmentactor. More specifically, it investigates how the ambitions of the EU are translated at country leveland in which situations the EU is more/less likely to act as a coordinator, making use of a pragmatistresearch approach. This approach is especially suited to problem-driven research that aims tounderstand a complex phenomenon. The article introduces the research question and the rationale,gives an overview of the research approach and the methodological considerations and endswith a summary of the research process and the preliminary findings of the field research.
Karou, Simplice D; Tchacondo, Tchadjobo; Ilboudo, Denise P; Simpore, Jacques
Rubiaceae family is a large family of 630 genera and about 13000 species found worldwide, especially in tropical and warm regions. These plants are not only ornamental but they are also used in African folk medicine to treat several diseases. Based on online published data and library bibliographic research, we herein reported accumulated information related to their traditional usages in sub-Saharan traditional medicine, their chemical composition and the screened pharmacological activities. Indeed, more than 60 species are used for more than 70 medicinal indications including malaria, hepatitis, eczema, oedema, cough, hypertension, diabetes and sexual weakness. Through biological screening following leads supplied with traditional healers, many of these plants exhibited antimalarial, antimicrobial, antihypertension, antidiabetic, antioxidant and anti-inflammatory activities. Bioactive compounds including indole alkaloids, terpenoids and anthraquinones have been isolated from these bioguided fractionation studies. It is evidence that great attention has been paid to species such as Nauclea latifolia, Morinda lucida, Mitragyna inermis and Crossopteryx febrifuga; however, several compounds should be waiting to be discovered since none of these plants has been systematically investigated for its biochemical composition. According the current global health context with the recrudescence of HIV, much effort should be oriented towards this virus when screening Rubiaceae. PMID:21870639
Downing Raymond V
Full Text Available Abstract Background The principles and practice of Family Medicine that arose in developed Western countries have been imported and adopted in African countries without adequate consideration of their relevance and appropriateness to the African context. In this study we attempted to elicit a priori principles of generalist medical practice from the experience of long-serving medical officers in a variety of African counties, through which we explored emergent principles of Family Medicine in our own context. Methods A descriptive study design was utilized, using qualitative methods. 16 respondents who were clinically active medical practitioners, working as generalists in the public services or non-profit sector for at least 5 years, and who had had no previous formal training or involvement in academic Family Medicine, were purposively selected in 8 different countries in southern, western and east Africa, and interviewed. Results The respondents highlighted a number of key issues with respect to the external environment within which they work, their collective roles, activities and behaviours, as well as the personal values and beliefs that motivate their behaviour. The context is characterized by resource constraints, high workload, traditional health beliefs, and the difficulty of referring patients to the next level of care. Generalist clinicians in sub-Saharan Africa need to be competent across a wide range of clinical disciplines and procedural skills at the level of the district hospital and clinic, in both chronic and emergency care. They need to understand the patient's perspective and context, empowering the patient and building an effective doctor-patient relationship. They are also managers, focused on coordinating and improving the quality of clinical care through teamwork, training and mentoring other health workers in the generalist setting, while being life-long learners themselves. However, their role in the community, was found to be more aspirational than real. Conclusions The study derived a set of principles for the practice of generalist doctors in sub-Saharan Africa based on the reported activities and approaches of the respondents. Patient-centred care using a biopsychosocial approach remains as a common core principle despite wide variations in context. Procedural and hospital care demands a higher level of skills particularly in rural areas, and a community orientation is desirable, but not widely practiced. The results have implications for the postgraduate training of family physicians in sub-Saharan Africa, and highlight questions regarding the realization of community-orientated primary care.
Background The principles and practice of Family Medicine that arose in developed Western countries have been imported and adopted in African countries without adequate consideration of their relevance and appropriateness to the African context. In this study we attempted to elicit a priori principles of generalist medical practice from the experience of long-serving medical officers in a variety of African counties, through which we explored emergent principles of Family Medicine in our own context. Methods A descriptive study design was utilized, using qualitative methods. 16 respondents who were clinically active medical practitioners, working as generalists in the public services or non-profit sector for at least 5 years, and who had had no previous formal training or involvement in academic Family Medicine, were purposively selected in 8 different countries in southern, western and east Africa, and interviewed. Results The respondents highlighted a number of key issues with respect to the external environment within which they work, their collective roles, activities and behaviours, as well as the personal values and beliefs that motivate their behaviour. The context is characterized by resource constraints, high workload, traditional health beliefs, and the difficulty of referring patients to the next level of care. Generalist clinicians in sub-Saharan Africa need to be competent across a wide range of clinical disciplines and procedural skills at the level of the district hospital and clinic, in both chronic and emergency care. They need to understand the patient's perspective and context, empowering the patient and building an effective doctor-patient relationship. They are also managers, focused on coordinating and improving the quality of clinical care through teamwork, training and mentoring other health workers in the generalist setting, while being life-long learners themselves. However, their role in the community, was found to be more aspirational than real. Conclusions The study derived a set of principles for the practice of generalist doctors in sub-Saharan Africa based on the reported activities and approaches of the respondents. Patient-centred care using a biopsychosocial approach remains as a common core principle despite wide variations in context. Procedural and hospital care demands a higher level of skills particularly in rural areas, and a community orientation is desirable, but not widely practiced. The results have implications for the postgraduate training of family physicians in sub-Saharan Africa, and highlight questions regarding the realization of community-orientated primary care. PMID:21726454
Alagidede, Paul; Adu, George; Frimpong, Prince Boakye
This paper is a contribution to the empirics of climate change and its effect on sustainable economic growth in Sub-Saharan Africa. Using data on two climate variables, temperature and precipitation, and employing panel cointegration techniques, we estimate the short- and long-run effects of climate change on growth. We establish that an increase in temperature significantly reduces economic performance in Sub-Saharan Africa. Furthermore, we show that the relationship between real gross domes...
Inoue, Takeshi; Hamori, Shigeyuki
This article empirically analyzes the role of finance in economic growth in Sub-Saharan Africa from the perspective of what is termed herein financial permeation. By estimating panel data on 37 countries in Sub-Saharan Africa between 2004 and 2010, we examine whether financial permeation through improved convenience and access to financial services has contributed to economic growth in this region. Empirical results clearly indicate that financial permeation has a statistically signific...
James J.F. Forest
Full Text Available This article examines the question whether Al-Qaeda has been able to develop significant influence in sub-Saharan Africa. After reviewing what the historical record indicates about activities which have some links to the Al-Qaeda network, and discussing what some observers have asserted, the article describes some key challenges that Al-Qaeda faces in its quest to gain influence in sub-Saharan Africa. It concludes with a brief look at policy implications.
James J.F Forest
This article examines the question whether Al-Qaeda has been able to develop significant influence in sub-Saharan Africa. After reviewing what the historical record indicates about activities which have some links to the Al-Qaeda network, and discussing what some observers have asserted, the article describes some key challenges that Al-Qaeda faces in its quest to gain influence in sub-Saharan Africa. It concludes with a brief look at policy implications.
Louise Leroux; Audrey Jolivot; Agnès Bégué; Danny Lo Seen; Bernardin Zoungrana
Accurate cropland maps at the global and local scales are crucial for scientists, government and nongovernment agencies, farmers and other stakeholders, particularly in food-insecure regions, such as Sub-Saharan Africa. In this study, we aim to qualify the crop classes of the MODIS Land Cover Product (LCP) in Sub-Saharan Africa using FAO (Food and Agricultural Organisation) and AGRHYMET (AGRiculture, Hydrology and METeorology) statistical data of agriculture and a sample of 55 very-high-resol...
This article provides a comparative summary of the findings of the survey of Business Ethics as field of Teaching, Training and Reserach across the four sub-regions in Sub-Saharan Africa ( Western Africa, Southern Africa, Eastern Africa and Francophone Africa). The article commences with a discussion on the terminology that is used to refer to Business and Economic Ethics in Sub-Saharan Africa. It Then provides an overview of the prevalence and distribution of Business Ethics as field of Teac...
Ayele, Atalay; Midzi, Vunganai; Ateba, Bekoa; Mulabisana, Thifhelimbilu; Marimira, Kwangwari; Hlatywayo, Dumisani J.; Akpan, Ofonime; Amponsah, Paulina; Georges, Tuluka M.; Durrheim, Ray
Large magnitude earthquakes have been observed in Sub-Saharan Africa in the recent past, such as the Machaze event of 2006 (Mw, 7.0) in Mozambique and the 2009 Karonga earthquake (Mw 6.2) in Malawi. The December 13, 1910 earthquake (Ms = 7.3) in the Rukwa rift (Tanzania) is the largest of all instrumentally recorded events known to have occurred in East Africa. The overall earthquake hazard in the region is on the lower side compared to other earthquake prone areas in the globe. However, the risk level is high enough for it to receive attention of the African governments and the donor community. The latest earthquake hazard map for the sub-Saharan Africa was done in 1999 and updating is long overdue as several development activities in the construction industry is booming allover sub-Saharan Africa. To this effect, regional seismologists are working together under the GEM (Global Earthquake Model) framework to improve incomplete, inhomogeneous and uncertain catalogues. The working group is also contributing to the UNESCO-IGCP (SIDA) 601 project and assessing all possible sources of data for the catalogue as well as for the seismotectonic characteristics that will help to develop a reasonable hazard model in the region. In the current progress, it is noted that the region is more seismically active than we thought. This demands the coordinated effort of the regional experts to systematically compile all available information for a better output so as to mitigate earthquake risk in the sub-Saharan Africa.
Coli?, Antoinette; Alessandrini, Marco; Pepper, Michael S
Abstract The CYP450 and UGT enzymes are involved in phase I and phase II metabolism of the majority of clinically prescribed drugs, including the non-nucleoside reverse transcriptase inhibitors, efavirenz and nevirapine, used in the treatment of HIV/AIDS. Variations in the activity of these enzymes due to gene polymorphisms can affect an individual's drug response or may lead to adverse drug reactions. There is an inter-ethnic distribution in the frequency of these polymorphisms, with African populations exhibiting higher genetic diversity compared to other populations. African specific alleles with clinical relevance have also emerged. Given the high prevalence of HIV/AIDS in sub-Saharan Africa, understanding the frequency of pharmacogenetically relevant alleles in populations of African origin, and their impact on efavirenz and nevirapine metabolism, is becoming increasingly critical. This review aims to investigate ethnic variation of CYP2B6, CYP2A6 and UGT2B7, and to understand the pharmacogenetic relevance when comparing frequencies in African populations to other populations worldwide. PMID:25391641
Lapworth, D. J.; MacDonald, A M; Bonsor, H. C.; Tijani, M.N; Calow , R.C.
In stark contrast to food scarcity, very little systematic data collection has been done to investigate the role water scarcity has on livelihoods within rural communities in sub-Saharan Africa, particularly during droughts or periods of water stress (Calow et al. 2009). The sustainable development and management of water resources in Africa, particularly perennial groundwater resources, remains a major priority, especially within the context of climate variability, population growth and pres...
Charlson, Fiona J.; Diminic, Sandra; Lund, Crick; Degenhardt, Louisa; Whiteford, Harvey A.
The world is undergoing a rapid health transition, with an ageing population and disease burden increasingly defined by disability. In Sub-Saharan Africa the next 40 years are predicted to see reduced mortality, signalling a surge in the impact of chronic diseases. We modelled these epidemiological changes and associated mental health workforce requirements. Years lived with a disability (YLD) predictions for mental and substance use disorders for each decade from 2010 to 2050 for four Sub-Sa...
Palm, Cheryl A; Smukler, Sean M; Sullivan, Clare C; Mutuo, Patrick K; Nyadzi, Gerson I; Walsh, Markus G
Potential interactions between food production and climate mitigation are explored for two situations in sub-Saharan Africa, where deforestation and land degradation overlap with hunger and poverty. Three agriculture intensification scenarios for supplying nitrogen to increase crop production (mineral fertilizer, herbaceous legume cover crops--green manures--and agroforestry--legume improved tree fallows) are compared to baseline food production, land requirements to meet basic caloric requirements, and greenhouse gas emissions. At low population densities and high land availability, food security and climate mitigation goals are met with all intensification scenarios, resulting in surplus crop area for reforestation. In contrast, for high population density and small farm sizes, attaining food security and reducing greenhouse gas emissions require mineral fertilizers to make land available for reforestation; green manure or improved tree fallows do not provide sufficient increases in yields to permit reforestation. Tree fallows sequester significant carbon on cropland, but green manures result in net carbon dioxide equivalent emissions because of nitrogen additions. Although these results are encouraging, agricultural intensification in sub-Saharan Africa with mineral fertilizers, green manures, or improved tree fallows will remain low without policies that address access, costs, and lack of incentives. Carbon financing for small-holder agriculture could increase the likelihood of success of Reducing Emissions from Deforestation and Forest Degradation in Developing Countries programs and climate change mitigation but also promote food security in the region. PMID:20453198
Hauffe, T.; Schultheiß, R.; Van Bocxlaer, B.; Prömmel, K.; Albrecht, C.
Species diversity and how it is structured on a continental scale is influenced by stochastic, ecological, and evolutionary driving forces, but hypotheses on determining factors have been mainly examined for terrestrial and marine organisms. The extant diversity of African freshwater mollusks is in general well assessed to facilitate conservation strategies and because of the medical importance of several taxa as intermediate hosts for tropical parasites. This historical accumulation of knowledge has, however, not resulted in substantial macroecological studies on the spatial distribution of freshwater mollusks. Here, we use continental distribution data and a recently developed method of random and cohesive allocation of species distribution ranges to test the relative importance of various factors in shaping species richness of Bivalvia and Gastropoda. We show that the mid-domain effect, that is, a hump-shaped richness gradient in a geographically bounded system despite the absence of environmental gradients, plays a minor role in determining species richness of freshwater mollusks in sub-Saharan Africa. The western branch of the East African Rift System was included as dispersal barrier in richness models, but these simulation results did not fit observed diversity patterns significantly better than models where this effect was not included, which suggests that the rift has played a more complex role in generating diversity patterns. Present-day precipitation and temperature explain richness patterns better than Eemian climatic condition. Therefore, the availability of water and energy for primary productivity during the past does not influence current species richness patterns much, and observed diversity patterns appear to be in equilibrium with contemporary climate. The availability of surface waters was the best predictor of bivalve and gastropod richness. Our data indicate that habitat diversity causes the observed species-area relationship, and hence, that environmental heterogeneity is a principal driver of freshwater mollusk richness on a continental scale.
Heather E. Thompson
Full Text Available In recent years it has become clear that climate change is an inevitable process. In Sub-Saharan Africa, the expectation is that climate change will have an especially negative impact, not only a result of projected warming and rainfall deficits, but also because of the vulnerability of the population. The impact upon food security will be of great significance, and may be defined as being composed of three components: availability, access, and utilization. To further investigate the link, a systematic literature review was done of the peer-reviewed literature related to climate change and food security, employing the realist review method. Analysis of the literature found consistent predictions of decreased crop productivity, land degradation, high market prices, negative impacts on livelihoods, and increased malnutrition. Adaptation strategies were heavily discussed as a means of mitigating a situation of severe food insecurity across the entire region. This is linked to issues of development, whereby adaptation is essential to counteract the negative impacts and improve the potential of the population to undergo development processes. Findings additionally revealed a gap in the literature about how nutrition will be affected, which is of importance given the links between poor nutrition and lack of productivity.
Currie, Thomas E.; Meade, Andrew; Guillon, Myrtille; Mace, Ruth
There is disagreement about the routes taken by populations speaking Bantu languages as they expanded to cover much of sub-Saharan Africa. Here, we build phylogenetic trees of Bantu languages and map them onto geographical space in order to assess the likely pathway of expansion and test between dispersal scenarios. The results clearly support a scenario in which groups first moved south through the rainforest from a homeland somewhere near the NigeriaCameroon border. Emerging on the south side of the rainforest, one branch moved south and west. Another branch moved towards the Great Lakes, eventually giving rise to the monophyletic clade of East Bantu languages that inhabit East and Southeastern Africa. These phylogenies also reveal information about more general processes involved in the diversification of human populations into distinct ethnolinguistic groups. Our study reveals that Bantu languages show a latitudinal gradient in covering greater areas with increasing distance from the equator. Analyses suggest that this pattern reflects a true ecological relationship rather than merely being an artefact of shared history. The study shows how a phylogeographic approach can address questions relating to the specific histories of certain groups, as well as general cultural evolutionary processes. PMID:23658203
Sexton Alexis R
Full Text Available Abstract Insecticide-treated bed nets are the preeminent malaria control means; though there is no consensus as to a best practice for large-scale insecticide-treated bed net distribution. In order to determine the paramount distribution method, this review assessed literature on recent insecticide treated bed net distribution programmes throughout sub-Saharan Eastern Africa. Inclusion criteria were that the study had taken place in sub-Saharan Eastern Africa, targeted malaria prevention and control, and occurred between 1996 and 2007. Forty-two studies were identified and reviewed. The results indicate that distribution frameworks varied greatly; and consequently so did outcomes of insecticide-treated bed net use. Studies revealed consistent inequities between urban and rural populations; which were most effectively alleviated through a free insecticide-treated bed net delivery and distribution framework. However, cost sharing through subsidies was shown to increase programme sustainability, which may lead to more long-term coverage. Thus, distribution should employ a catch up/keep up programme strategy. The catch-up programme rapidly scales up coverage, while the keep-up programme maintains coverage levels. Future directions for malaria should include progress toward distribution of long-lasting insecticide-treated nets.
Leon, Natalie; Sanders, David; Van Damme, Wim; Besada, Donela; Daviaud, Emmanuelle; Oliphant, Nicholas P; Berzal, Rocio; Mason, John; Doherty, Tanya
Community-based research on child survival in sub-Saharan Africa has focussed on the increased provision of curative health services by a formalised cadre of lay community health workers (CHWs), but we have identified a particular configuration, that deserves closer scrutiny. We identified a two-tiered CHW system, with the first tier being the lessor known or 'hidden' community/village level volunteers and the second tier being formal, paid CHWs, in Ethiopia, Mali, and Niger. Whilst the disease-focussed tasks of the formal CHW tier may be more amenable to classic epidemiological surveillance, we postulate that understanding the relationship between formalised CHWs and volunteer cadres, in terms of scope, location of practice and ratio to population, would be important for a comprehensive evaluation of child survival in these countries. We report on the findings from our joint qualitative and quantitative investigations, highlighting the need to recognise the 'hidden' contribution of volunteers. We need to better characterize the volunteers' interaction with community-based and primary care services and to better understand ways to improve the volunteer systems with the right type of investments. This is particularly important for considering the models for scale-up of CHWs in sub-Saharan Africa. PMID:25770090
Full Text Available Community-based research on child survival in sub-Saharan Africa has focussed on the increased provision of curative health services by a formalised cadre of lay community health workers (CHWs, but we have identified a particular configuration, that deserves closer scrutiny. We identified a two-tiered CHW system, with the first tier being the lessor known or hidden community/village level volunteers and the second tier being formal, paid CHWs, in Ethiopia, Mali, and Niger. Whilst the disease-focussed tasks of the formal CHW tier may be more amenable to classic epidemiological surveillance, we postulate that understanding the relationship between formalised CHWs and volunteer cadres, in terms of scope, location of practice and ratio to population, would be important for a comprehensive evaluation of child survival in these countries. We report on the findings from our joint qualitative and quantitative investigations, highlighting the need to recognise the hidden contribution of volunteers. We need to better characterize the volunteers interaction with community-based and primary care services and to better understand ways to improve the volunteer systems with the right type of investments. This is particularly important for considering the models for scale-up of CHWs in sub-Saharan Africa.
Leon, Natalie; Sanders, David; Van Damme, Wim; Besada, Donela; Daviaud, Emmanuelle; Oliphant, Nicholas P.; Berzal, Rocio; Mason, John; Doherty, Tanya
Community-based research on child survival in sub-Saharan Africa has focussed on the increased provision of curative health services by a formalised cadre of lay community health workers (CHWs), but we have identified a particular configuration, that deserves closer scrutiny. We identified a two-tiered CHW system, with the first tier being the lessor known or hidden community/village level volunteers and the second tier being formal, paid CHWs, in Ethiopia, Mali, and Niger. Whilst the disease-focussed tasks of the formal CHW tier may be more amenable to classic epidemiological surveillance, we postulate that understanding the relationship between formalised CHWs and volunteer cadres, in terms of scope, location of practice and ratio to population, would be important for a comprehensive evaluation of child survival in these countries. We report on the findings from our joint qualitative and quantitative investigations, highlighting the need to recognise the hidden contribution of volunteers. We need to better characterize the volunteers interaction with community-based and primary care services and to better understand ways to improve the volunteer systems with the right type of investments. This is particularly important for considering the models for scale-up of CHWs in sub-Saharan Africa. PMID:25770090
Wilunda, Calistus; Putoto, Giovanni; Riva, Donata Dalla; Manenti, Fabio; Atzori, Andrea; Calia, Federico; Assefa, Tigist; Turri, Bruno; Emmanuel, Onapa; Straneo, Manuela; Kisika, Firma; Tarmbulini, Giorgio
Background Gaps in coverage, equity and quality of health services hinder the achievement of the Millennium Development Goals 4 and 5 in most countries of sub-Saharan Africa as well as in other high-burden countries, yet few studies attempt to assess all these dimensions as part of the situation analysis. We present the base-line data of a project aimed at simultaneously addressing coverage, equity and quality issues in maternal and neonatal health care in five districts belonging to three African countries. Methods Data were collected in cross-sectional studies with three types of tools. Coverage was assessed in three hospitals and 19 health centres (HCs) utilising emergency obstetric and newborn care needs assessment tools developed by the Averting Maternal Death and Disability program. Emergency obstetrics care (EmOC) indicators were calculated. Equity was assessed in three hospitals and 13 HCs by means of proxy wealth indices and women delivering in health facilities were compared with those in the general population to identify inequities. Quality was assessed in three hospitals using the World Health Organizations maternal and neonatal quality of hospital care assessment tool which evaluates the whole range of aspects of obstetric and neonatal care and produces an average score for each main area of care. Results All the three hospitals qualified as comprehensive EmOC facilities but none of the HCs qualified for basic EmOC. None of the districts met the minimum requisites for EmOC indicators. In two out of three hospitals, there were major quality gaps which were generally greater in neonatal care, management of emergency and complicated cases and monitoring. Higher access to care was coupled by low quality and good quality by very low access. Stark inequities in utilisation of institutional delivery care were present in all districts and across all health facilities, especially at hospital level. Conclusion Our findings confirm the existence of serious issues regarding coverage, equity and quality of health care for mothers and newborns in all study districts. Gaps in one dimension hinder the potential gains in health outcomes deriving from good performances in other dimensions, thus confirm the need for a three-dimensional profiling of health care provision as a basis for data-driven planning. PMID:26000964
Donald P., King; Miki, Madi; Valerie, Mioulet; Jemma, Wadsworth; Caroline F., Wright; Bego& #241; a, Valdazo-González; Nigel P., Ferris; Nick J., Knowles; Jef, Hammond.
Full Text Available Using foot-and-mouth disease (FMD) as an example, this review describes new tools that can be used to detect and characterise livestock diseases. In recent years, molecular tests that can detect and characterise pathogens in a diverse range of sample types have revolutionised laboratory diagnostics. [...] In addition to use in centralised laboratories, there are opportunities to locate diagnostic technologies close to the animals with suspected clinical signs. Work in this area has developed simple-to-use lateral-flow devices for the detection of FMD virus (FMDV), as well as new hardware platforms to allow molecular testing to be deployed into the field for use by non-specialists. Once FMDV has been detected, nucleotide sequencing is used to compare field strains with reference viruses. Transboundary movements of FMDV are routinely monitored using VP1 sequence data, while higher resolution transmission trees (at the farm-to-farm level) can be reconstructed using full-genome sequencing approaches. New technologies such as next-generation sequencing technologies are now being applied to dissect the viral sequence populations that exist within single samples. The driving force for the use of these technologies has largely been influenced by the priorities of developed countries with FMD-free (without vaccination) status. However, it is important to recognise that these approaches also show considerable promise for use in countries where FMD is endemic, although further modifications (such as sample archiving and strain and serotype characterisation) may be required to tailor these tests for use in these regions. Access to these new diagnostic and sequencing technologies in sub-Saharan Africa have the potential to provide novel insights into FMD epidemiology and will impact upon improved strategies for disease control. Effective control of infectious diseases is reliant upon accurate diagnosis of clinical cases using laboratory tests, together with an understanding of factors that impact upon the epidemiology of the infectious agent. A wide range of new diagnostic tools and nucleotide sequencing methods are used by international reference laboratories to detect and characterise the agents causing outbreaks of infectious diseases. In the past, high costs (initial capital expenses, as well as day-to-day maintenance and running costs) and complexity of the protocols used to perform some of these tests have limited the use of these methods in smaller laboratories. However, simpler and more cost-effective formats are now being developed that offer the prospect that these technologies will be even more widely deployed into laboratories particularly those in developing regions of the world such as sub-Saharan Africa.
Rehfuess, Eva Annette; Tzala, L.; Best, N; Briggs, D. J.; Joffe, M
Background: Almost half of global child deaths due to acute lower respiratory infections (ALRIs) occur in sub- Saharan Africa, where three-quarters of the population cook with solid fuels. This study aims to quantify the impact of fuel type and cooking practices on childhood ALRI mortality in Africa, and to explore implications for public health interventions. Methods: Early-release World Health Survey data for the year 2003 were pooled for 16 African countries. Among ...
Allen, Franklin; Carletti, Elena; Cull, Robert; Qian, Jun; Senbet, Lemma; Valenzuela, Patricio
With extensive country- and firm-level data sets we first document that the financial sectors of most sub-Saharan African countries remain significantly underdeveloped by the standards of other developing countries. We also find that population density appears to be considerably more important for banking sector development in Africa than elsewhere. To better understand how countries can overcome the high costs of developing viable banking sectors outside large metropolitan areas, we focus on...
Neerinckx, Simon B; Peterson, Andrew T
Background Plague is a rapidly progressing, serious illness in humans that is likely to be fatal if not treated. It remains a public health threat, especially in sub-Saharan Africa. In spite of plague's highly focal nature, a thorough ecological understanding of the general distribution pattern of plague across sub-Saharan Africa has not been established to date. In this study, we used human plague data from sub-Saharan Africa for 1970-2007 in an ecological niche modeling framework to explore the potential geographic distribution of plague and its ecological requirements across Africa. Results We predict a broad potential distributional area of plague occurrences across sub-Saharan Africa. General tests of model's transferability suggest that our model can anticipate the potential distribution of plague occurrences in Madagascar and northern Africa. However, generality and predictive ability tests using regional subsets of occurrence points demonstrate the models to be unable to predict independent occurrence points outside the training region accurately. Visualizations show plague to occur in diverse landscapes under wide ranges of environmental conditions. Conclusion We conclude that the typical focality of plague, observed in sub-Saharan Africa, is not related to fragmented and insular environmental conditions manifested at a coarse continental scale. However, our approach provides a foundation for testing hypotheses concerning focal distribution areas of plague and their links with historical and environmental factors.
Full Text Available Abstract Background Plague is a rapidly progressing, serious illness in humans that is likely to be fatal if not treated. It remains a public health threat, especially in sub-Saharan Africa. In spite of plague's highly focal nature, a thorough ecological understanding of the general distribution pattern of plague across sub-Saharan Africa has not been established to date. In this study, we used human plague data from sub-Saharan Africa for 19702007 in an ecological niche modeling framework to explore the potential geographic distribution of plague and its ecological requirements across Africa. Results We predict a broad potential distributional area of plague occurrences across sub-Saharan Africa. General tests of model's transferability suggest that our model can anticipate the potential distribution of plague occurrences in Madagascar and northern Africa. However, generality and predictive ability tests using regional subsets of occurrence points demonstrate the models to be unable to predict independent occurrence points outside the training region accurately. Visualizations show plague to occur in diverse landscapes under wide ranges of environmental conditions. Conclusion We conclude that the typical focality of plague, observed in sub-Saharan Africa, is not related to fragmented and insular environmental conditions manifested at a coarse continental scale. However, our approach provides a foundation for testing hypotheses concerning focal distribution areas of plague and their links with historical and environmental factors.
Full Text Available Abstract Background The continued poor sexual and reproductive health (SRH outcomes in sub-Saharan Africa highlight the difficulties in reforming policies and laws, and implementing effective programmes. This paper uses one international and two national case studies to reflect on the challenges, dilemmas and strategies used in operationalising sexual and reproductive health and rights (SRHR in different African contexts. Methods The international case study focuses on the progress made by African countries in implementing the African Unions Maputo Plan of Action (for the Operationalisation of the Continental Policy Framework for Sexual and Reproductive Health and Rights and the experiences of state and non-state stakeholders in this process. The case was developed from an evaluation report of the progress made by nine African countries in implementing the Plan of Action, qualitative interviews exploring stakeholders experiences and perceptions of the operationalisation of the plan (carried out as part of the evaluation in Botswana and Nigeria, and authors reflections. The first national case study explores the processes involved in influencing Ghanas Domestic Violence Act passed in 2007; developed from a review of scientific papers and organisational publications on the processes involved in influencing the Act, qualitative interview data and authors reflections. The second national case study examines the experiences with introducing the 2006 Sexual Offences Act in Kenya, and it is developed from organisational publications on the processes of enacting the Act and a review of media reports on the debates and passing of the Act. Results Based on the three cases, we argue that prohibitive laws and governments reluctance to institute and implement comprehensive rights approaches to SRH, lack of political leadership and commitment to funding SRHR policies and programmes, and dominant negative cultural framing of womens issues present the major obstacles to operationalising SRH rights. Analysis of successes points to the strategies for tackling these challenges, which include forming and working through strategic coalitions, employing strategic framing of SRHR issues to counter opposition and gain support, collaborating with government, and employing strategic opportunism. Conclusion The strategies identified show future pathways through which challenges to the realisation of SRHR in Africa can be tackled.
The bulk of rural populations in sub-Saharan Africa have no access to electricity and are under-served by any other form of modern infrastructure. The cost of infrastructure to mainly scattered communities has been perennially cited as largely to blame. This is an undeniable truth, but only part of it. There are in addition, myriads of social, economic and political obstacles that play an unquantified and frequently unrecognized negative role. At the route of the problem lies a subdued role of the would-be recipients who in fact, unlike anybody else, are conversant with their problems. Consequently, a number of products may come as impositions or misplaced priorities. Consumer participation for sustainable development has been articulated at international forums and in publications as being advantageous. In practice however, the concept appears to be generally shunned and even when, occasionally, tried the needs of the consumers are presumed and their roles prescribed. This paper discusses a range of social, economic and political issues that constitute major obstacles to the realisation of sustainable rural development
Full Text Available The primary cause of soil degradation in sub-Saharan Africa (SSA is expansion and intensification of agriculture in efforts to feed its growing population. Effective solutions will support resilient systems, and must cut across agricultural, environmental, and socioeconomic objectives. While many studies compare and contrast the effects of different management practices on soil properties, soil degradation can only be evaluated within a specific temporal and spatial context using multiple indicators. The extent and rate of soil degradation in SSA is still under debate as there are no reliable data, just gross estimates. Nevertheless, certain soils are losing their ability to provide food and essential ecosystem services, and we know that soil fertility depletion is the primary cause. We synthesize data from studies that examined degradation in SSA at broad spatial and temporal scales and quantified multiple soil degradation indicators, and we found clear indications of degradation across multiple indicators. However, different indicators have different trajectoriespH and cation exchange capacity tend to decline linearly, and soil organic carbon and yields non-linearly. Future research should focus on how soil degradation in SSA leads to changes in ecosystem services, and how to manage these soils now and in the future.
Full Text Available The declining efficacy of acaricide treatment as a means of reducing the prevalence of Theileria parva infections in sub-Saharan Africa has intensified efforts to achieve control through immunization of susceptible cattle. The infection and treatment method of immunization has enjoyed a resurgence with the availability of more effective cold chain facilities, although concerns remain regarding the possibility of vaccine strains spreading in local tick populations. In addition, an in-depth understanding of protective mechanisms deployed by immune cattle and the antigens targeted by them has led to substantial progress in the development of candidate subunit vaccines against both sporozoite and schizont stages of the parasite. The likely success of these vaccines, as well as infection and treatment immunization, will ultimately depend on the extent to which they disturb the endemic status of the parasite. These issues are discussed in the light of recent information on the genotypic diversity of T. parva in the field and the extent to which this is compromised by the immune response.
Full Text Available The many headlines focusing on 'land grabbing' have distracted attention from the role that access to water plays in underpinning the projected productivity of foreign direct investment in acquisition of agricultural land in developing countries. This paper identifies questions that arise about the explicit and implicit water requirements for irrigation in agricultural projects on land that is subject to such foreign investment deals. It focuses particularly on land acquisition in sub-Saharan Africa (SSA, where, for savanna ecosystems that cover some two thirds of the region, rainfall uncertainty is the principal constraint to increased agricultural productivity. The paper argues that, even where land acquisition deals do not specify irrigation, choice of location and/or crop type indicates this is invariably an implicit requirement of projects. It is arguable that private investment in water infrastructure (e.g. for water storage could provide wider benefits to neighbouring small-scale producers, thus reducing the risk inherent in much of African agriculture. However, it is also possible that foreign investment may compete with existing water use, and some land deals have included provisions for priority access to water in cases of scarcity. Empirical studies are used to identify the mechanisms through which large-scale land investments influence water availability for smaller-scale land users. The paper concludes that, although effects on water resources may constitute one of the main impacts of land deals, this is likely to be obscured by the lack of transparency over water requirements of agricultural projects and the invisibility of much existing local agricultural water management to government planning agencies.
Ichoku, C. M.; Ellison, L.; Willmot, K. E.; Gatebe, C. K.; Matsui, T.; Wang, J.; Okonkwo, C.; Damoah, R.; Lee, J.; Adegoke, J. O.; Bolten, J. D.; Policelli, F. S.; Wilcox, E. M.; Habib, S.
The northern sub-Saharan African (NSSA) region, bounded on the north and south by the Sahara and the Equator, respectively, and stretching East-West across Africa, is very vulnerable because of the highly active environmental and meteorological processes associated with its unique location and human activities. Over the years, this region has suffered frequent severe droughts that have caused tremendous hardship and loss of life to millions of its inhabitants due to the rapid depletion of the regional water resources. On the other hand, the NSSA region shows one of the highest biomass-burning rates per unit land area among all regions of the world. Because of the high concentration and frequency of fires in this region, with the associated abundance of heat release and gaseous and particulate smoke emissions, biomass-burning activity is believed to be one of the drivers of the regional carbon and energy cycles, with serious implications for the water cycle and climate. An interdisciplinary research effort sponsored by NASA is presently being focused on the NSSA region, to better understand possible connections between the intense biomass burning observed from satellite year after year across the region and the water cycle, through associated changes in certain essential climate variables (ECVs) including land-cover, albedo, soil moisture, evapotranspiration, and atmospheric composition, which can drive changes in additional ECVs such as atmospheric water vapor and wind patterns, precipitation, surface runoff, and groundwater recharge. A combination of remote sensing and modeling approaches is being utilized to investigate these multiple processes to clarify possible links between them. We are finding significant relationships between biomass burning and many of the above-listed ECVs. In this presentation, we will discuss interesting results as well as the path toward improved understanding of the interrelationships and feedbacks between the water cycle components and the environmental change dynamics due to biomass burning and related processes in the NSSA region.
Full Text Available Abstract Background Despite growing HIV and cancer prevalence in Sub-Saharan Africa, and WHO advocacy for a public health approach to palliative care provision, opioid availability is severely limited. Uganda has achieved a morphine roll-out programme in partnership with the Ministry of Health. This study aimed to evaluate that programme by identifying challenges to implementation that may inform replication. Methods A multi-methods protocol appraised morphine regulation, storage, prescribing, and consumption in three phases: key informant interviews throughout the opioid supply chain, and direct observation and audit of clinical practice. Results Regulation had achieved its goal of preventing misuse and leakage from the supply chain. However, the Government felt that relaxation of regulation was now appropriate. Confusion and complexity in storage and authorisation rules led to discontinuation of opioid pain management at the patient level and also wasted service time in trying to obtain supplies to which they were entitled. Continued neglect to prescribe among clinicians and public fear of opioids led to under prescribing, and clinical skills showed some evidence of need for improvement with respect to physical assessment and follow-up. Conclusion The Ugandan programme offers a successful model for both advocacy and Governmental support in achieving opioid roll-out across health districts. Despite initial concerns, abuse of opioids has not been evident. Further work is required to ensure that available supplies of opioids are prescribed to those in need, and that clinical standards are met. However, the programme for roll-out has proved a useful model to expand opioid availability as the first step in improving patient care, and may prove a useful template for other Sub-Saharan African countries.
Full Text Available Abstract Background Violence against women, especially by intimate partners, is a serious public health problem that is associated with physical, reproductive and mental health consequences. Even though most societies proscribe violence against women, the reality is that violations against women's rights are often sanctioned under the garb of cultural practices and norms, or through misinterpretation of religious tenets. Methods We utilised data from 17 Demographic and Health Surveys (DHS conducted between 2003 and 2007 in sub-Saharan Africa to assess the net effects of socio-demographic factors on men's and women's attitudes toward intimate partner violence against women (IPVAW using multiple logistic regression models estimated by likelihood ratio test. Results IPVAW was widely accepted under certain circumstances by men and women in all the countries studied. Women were more likely to justify IPVAW than men. "Neglecting the children" was the most common reason agreed to by both women and men for justifying IPVAW followed by "going out without informing husband" and "arguing back with the husband". Increasing wealth status, education attainment, urbanization, access to media, and joint decision making were associated with decreased odds of justifying IPVAW in most countries. Conclusion In most Sub-Saharan African countries studied where IPVAW is widely accepted as a response to women's transgressing gender norms, men find less justification for the practice than do women. The present study suggests that proactive efforts are needed to change these norms, such as promotion of higher education and socio-demographic development. The magnitude and direction of factors associated with attitudes towards IPVAW varies widely across the countries, thus suggesting the significance of capitalizing on need-adapted interventions tailored to fit conditions in each country.
Jobson, Geoffrey; Struthers, Helen; McIntyre, James
Men who have sex with men (MSM) in sub-Saharan Africa (SSA) have been repeatedly found to have high risk of HIV infection, and in spite of the differing nature of the HIV epidemic in the general population between East and Southern Africa, and West and Central Africa, MSM are disproportionately affected by HIV across the entire region. Recent research has examined the drivers of HIV risk, and the dynamics of the MSM HIV epidemic in greater detail. However, this growing knowledge has generally not been translated into effective HIV prevention interventions. In part, this is due to the highly stigmatised and frequently criminalised nature of same-sex sexualities in much of the region. Without human-rights-based advocacy targeting governments and interventions aiming to decrease stigma and homophobia, translating research into effective HIV interventions for MSM in SSA at the scale needed to reduce HIV transmission in this population remains highly unlikely. PMID:25637162
BREGUET, Georges; Bütler, R; Bütler-Brunner, E; Sanchez-Mazas, Alicia
The aim of this investigation is to examine the distribution of the Ag immunological polymorphism in human populations on a worldwide scale and to look for possible explanations of this distribution in the field of modern human peopling history and Ag-system evolution. Extensive Ag-antigene typings were carried out on 13 human population samples, including sub-Saharan African, European, west and east Asiatic, Melanesian, Australian aborigine, and Amerindian groups. Complete Ag-haplotype frequ...
Riddell, P. J.; Westlake, Michael; Burke, Jacob J.
If irrigated production is to make a significant contribution to food security and economic growth in Sub Saharan Africa, it will have to be re-structured across the region as a whole. This is the main conclusion of a study undertaken by FAO to analyse the drivers of demand for irrigated production in Sub-Saharan Africa (SSA). Steeply rising commercial food import bills for staple crops across SSA are indicative of the level demand that is not being met from domestic production. The increase ...
Agreement between clinicians' and care givers' assessment of intelligence in Nigerian children with intellectual disability: 'ratio IQ' as a viable option in the absence of standardized 'deviance IQ' tests in sub-Saharan Africa
Aguocha Chinyere M; Okoroikpa Ifeoma N; Ubochi Vincent N; Bakare Muideen O; Ebigbo Peter O
Abstract Background There may be need to assess intelligent quotient (IQ) scores in sub-Saharan African children with intellectual disability, either for the purpose of educational needs assessment or research. However, modern intelligence scales developed in the western parts of the world suffer limitation of widespread use because of the influence of socio-cultural variations across the world. This study examined the agreement between IQ scores estimation among Nigerian children with intell...
Coburn, Carolyn; Restivo, Michael; Shandra, John M
We conduct a cross-national analysis to test the hypothesis that African Development Bank (AfDB) structural adjustment lending adversely impacts maternal mortality in Sub-Saharan Africa. We analyze data for thirty-five Sub-Saharan African nations with up to four time points (1990, 1995, 2000, and 2005) with generalized least squares random effects regression models and modified two-step Heckman models that correct for potential endogeneity regarding whether or not a Sub-Saharan African nations receives an AfDB structural adjustment loan. We find support for our hypothesis that indicates that Sub-Saharan African nations that receive an AfDB structural adjustment loan tend to have higher levels of maternal mortality than Sub-Saharan African nations that do not receive such a loan. This finding remains stable even when controlling for endogeneity. We conclude by talking about the theoretical and methodological implications along with possible directions for future research. PMID:25769869
...States (Export-Import Bank). SUMMARY: The Sub-Saharan...support the expansion of the Bank's [[Page 70260...Sub-Saharan Africa under the loan, guarantee, and insurance programs of the Bank. Further, the committee...the Bank's on-going business development...
Injuries are common and on increase in most developing countries, including sub-Saharan Africa. A large proportion of the injuries are caused by road traffic accidents, falls, burns, assaults, bites, stings and other animal-related injuries, poisonings, drownings/near-drownings and suicide. Globally, injuries are responsible for about five per cent of the total mortality, and the overall global annual costs were estimated in the late 1980s at around 500 billion US dollars. The burden and pattern of injuries in Africa and other developing areas are poorly known and not well studied. The incidence is on the increase, partly due to rapid growth of motorised transport and to expansion of industrial production without adequate safety precautions. This is a review of data on various kinds of injuries in developing countries with a focus on sub-Saharan Africa. A computerised search of the relevant literature published between 1985 and 1998 was conducted and a manual search of journals publishing texts on health in low-income countries and in tropical environments was also done. A few studies on injury prevention policy and on research related to injury epidemiology and prevention have also been identified and included. It is concluded that in a relatively typical East African area with a total mortality rate of 1,300/100,000/year, injuries are likely to cause around 100 of these deaths. The corresponding total rate of significant injuries is estimated at 40,000/100,000/year with a breakdown as tabulated below. [table: see text] Although a few surveys and other investigations of injuries have been conducted over the years, injury epidemiology and control remain under-researched and relatively neglected subject areas. Much needs to be done. Collection and analysis of injury data need to be standardised, for example regarding age groups, gender disaggregation and severity. Injuries and accidents should be subdivided in at least road traffic injury, fall, burn, assault, poisoning, drowning, suicide, homicide and others, and details regarding time and place, victim and main cause should be noted. Morbidity survey field staff should be informed that injuries are part of the illness concept and that questions should be asked accordingly. Details regarding the circumstances surrounding different injuries must be known to those who develop preventive programmes. Injury is a public health problem affecting some people more than others. Our ordinary environment--the home, the work-site, the street or road--represents various kinds of risk, and some of these are difficult to eliminate. Not only do we have to accept much of our environment with its existing houses, equipment, vehicles, transport systems, energy supply, toxic substances etcetera, many also suffer from various inherited or acquired conditions that increase the risk. We therefore need to develop safer and more "forgiving" living environments where ordinary people can live and move around safely. Injury control activities may focus on different categories of injury. Road safety measures often include information and education campaigns, improved driver training, road design and maintenance, regular vehicle safety checks, separation of pedestrians from vehicle traffic, speed limits, safety belt, air-bag and helmet use, special training and control of public service vehicle drivers, bicycle lane separation, road lighting, reflectorised materials on clothing, review of the road traffic related legislation and law enforcement, and emergency medical services improvement. Domestic injuries can be prevented for example with window guards, child barriers at stairs, smoke detectors, clothes and furniture in less flammable materials, replacement of open stoves, stabilising of open lamps, fire-fighting equipment and practice, child-proof poison packaging and storage, safe disposal of toxic waste, home safety education of parents, and strict building code enforcement. Occupational injuries can largely be prevented if well adapted to the work environment. Research is required in s
J, Edge; I, Buccimazza; H, Cubasch; E, Panieri.
Full Text Available Communicable diseases are the major cause of mortality in lower-income countries. Consequently, local and international resources are channelled mainly into addressing the impact of these conditions. HIV, however, is being successfully treated, people are living longer, and disease patterns are chan [...] ging. As populations age, the incidence of cancer inevitably increases. The World Health Organization has predicted a dramatic increase in global cancer cases during the next 15 years, the majority of which will occur in low- and middle-income countries. Cancer treatment is expensive and complex and in the developing world 5% of global cancer funds are spent on 70% of cancer cases. This paper reviews the challenges of managing breast cancer in the developing world, using sub-Saharan Africa as a model.
Nygaard, Ivan; Bindner, Henrik W.
Solar PV is one among other low carbon technologies for rural electrification in Sub Saharan Africa (SSA). Solar PV systems have for almost 30 years been disseminated in SSA, resulting in more than half a million installations concentrated in a few countries. While PV systems have technically matured and markets have gradually developed, PV for rural electrification has often been perceived with scepticism from potential users, donors, government officials and researchers, and solar PV has in many camps been labelled as donor driven, expensive and fragile technology mainly serving the richest parts of the populations and with little or no value for productive uses. However, feasibility for solar PV has improved in the last few years. Retail prices for solar photovoltaic modules are reduced by 20-30% since 2001, and although far from the peak in 2008, oil prices in the next two years to come are expected to settle at a level, which is about three times the world market average in the years from 1985-2003. Therefore, rather than being limited to a niche for populations living in dispersed settlements outside the reach of grid electrification, solar PV is expected to play an important role in mini grid rural electrification schemes based on hybrid solar PVdiesel generators. This may bring PV systems in line with fossil fuel based systems in terms of consumer cost and options for productive use and it changes the market for PV from mainly donor supported schemes into mainstream rural electrification schemes governed and financed by electric utilities and rural electrification agencies. Based on a literature review and the experience with a full scale hybrid wind/PV diesel system at RISØ DTU, this paper provides cost estimates for hybrid PV-diesel systems and policy recommendations to change the application of PV technologies for development in SSA.
Caradee Y., Wright; Mary, Norval; Beverley, Summers; Lester, Davids; Gerrie, Coetzee; Matthew O., Oriowo.
Full Text Available Photoprotection messages and 'SunSmart' programmes exist mainly to prevent skin cancers and, more recently, to encourage adequate personal sun exposure to elicit a vitamin D response for healthy bone and immune systems. Several developed countries maintain intensive research networks and monitor sol [...] ar UV radiation to support awareness campaigns and intervention development. The situation is different in sub-Saharan Africa. Adequate empirical evidence of the impact of solar UV radiation on human health, even for melanomas and cataracts, is lacking, and is overshadowed by other factors such as communicable diseases, especially HIV, AIDS and tuberculosis. In addition, the established photoprotection messages used in developed countries have been adopted and implemented in a limited number of sub-Saharan countries but with minimal understanding of local conditions and behaviours. In this review, we consider the current evidence for sun-related effects on human health in sub-Saharan Africa, summarise published research and identify key issues. Data on the prevalence of human diseases affected by solar UV radiation in all subpopulations are not generally available, financial support is insufficient and the infrastructure to address these and other related topics is inadequate. Despite these limitations, considerable progress may be made regarding the management of solar UV radiation related health outcomes in sub-Saharan Africa, provided researchers collaborate and resources are allocated appropriately.
Fuller, Colin W.; Junge, Astrid; Amaning, Jacob; Kaijage, Rogasian R.; Kaputa, John; Magwende, George; Pambo, Prince; Dvorak, Jiri
Objective: To assess the effectiveness of the FIFA 11 for Health programme in increasing children's knowledge about communicable and non-communicable diseases in five countries of Sub-Saharan Africa. Method: A prospective five-cohort study was implemented in schools in Ghana (17), Malawi (12), Namibia (11), Tanzania (18) and Zambia (11). The
My main contention in this article is that the nation-state paradigm for policies targeted at effecting development in sub-Saharan Africa is undermined by arbitrary colonial boundaries and porous borders and the challenges of transnationalism as part of the globalization phenomenon in late modernity. The nation-state paradigm is also the framework
Kula, Nothemba; Haines, Andy; Fryatt, Robert
Robert Fryatt and colleagues argue for more attention to climate change in sub-Saharan Africa, a region that has contributed the least greenhouse gas emissions to the world's total but is more vulnerable to the impacts of climate change than any other.
The choice of the language of instruction in Sub-Saharan Africa (SSA) is a fundamental educational issue with ramifications for educational access and effectiveness and ultimately national development. Indigenous SSA languages have suffered devaluation in colonial and post-colonial SSA education, and this devaluation alienates the majority of SSA
Caradee Y. Wright
Full Text Available Photoprotection messages and SunSmart programmes exist mainly to prevent skin cancers and, more recently, to encourage adequate personal sun exposure to elicit a vitamin D response for healthy bone and immune systems. Several developed countries maintain intensive research networks and monitor solar UV radiation to support awareness campaigns and intervention development. The situation is different in sub-Saharan Africa. Adequate empirical evidence of the impact of solar UV radiation on human health, even for melanomas and cataracts, is lacking, and is overshadowed by other factors such as communicable diseases, especially HIV, AIDS and tuberculosis. In addition, the established photoprotection messages used in developed countries have been adopted and implemented in a limited number of sub-Saharan countries but with minimal understanding of local conditions and behaviours. In this review, we consider the current evidence for sun-related effects on human health in sub-Saharan Africa, summarise published research and identify key issues. Data on the prevalence of human diseases affected by solar UV radiation in all subpopulations are not generally available, financial support is insufficient and the infrastructure to address these and other related topics is inadequate. Despite these limitations, considerable progress may be made regarding the management of solar UV radiation related health outcomes in sub-Saharan Africa, provided researchers collaborate and resources are allocated appropriately.
Altinyelken, Hulya K.
There has been an unprecedented interest in reforming pedagogical practices in sub-Saharan Africa in the past two decades. The reform efforts are often characterised by a move away from teacher-centred instruction to child-centred pedagogy (CCP). Uganda has been no exception to this trend as the new curriculum adopted the principles of CCP and
Dembele, Martial; Lefoka, Pulane
This article assumes that pedagogical renewal and teacher development are two sides of the same coin, and that the achievement of a universal primary education that is equitable and of acceptable quality in Sub-Saharan Africa will depend to a large extent on both. The need for pedagogical renewal stems from the evidence that (i) teaching is
Stephen, Foster; Albert, Tuinhof; Frank van, Steenbergen.
Full Text Available In numerous countries of Sub-Saharan Africa the strategic agenda of the water-sector is undergoing substantial change because of demographic pressure, climate change and economic transformation. Two new policy questions are arising from the need to make better use of available groundwater storage to [...] improve water-supply security:
Mutula, Stephen Mudogo
Purpose: This article aims to present experiences and the lessons learned from the University of Botswana (UB) library automation project. The implications of the project for similar libraries planning automation in sub Saharan Africa and beyond are adduced. Design/methodology/approach: The article is a case study of library automation at the
Investment in secondary schooling in sub-Saharan Africa has been neglected over the last two decades. Emphasis on universalising primary schooling has shaped national policy and flows of international assistance to favour rapid expansion at the first level of schooling. Though there are many good reasons for this emphasis, this has resulted in
Cross-sectional and repeated surveys from household components of Demographic and Health Surveys in sub-Saharan Africa were examined to determine whether household composition indicators for older adults (N = 52,573), involving offspring and grandchildren, correlated with national levels of AIDS mortality. One in 4 was living with a grandchild
Morell, Jonathan A., Ed.
Describes 14 evaluations of HIV and AIDS programs undertaken in sub-Saharan Africa over the last decade. These programs demonstrate the importance of enhancing program quality and providing national coverage, rooting programs in community, empowering young people, and developing partnerships to combat HIV and AIDS. (SLD)
Matemba, Yonah Hisbon
The argument in this paper is that in spite of the acknowledgement of plurality, many countries in sub-Saharan Africa seem reluctant to introduce multi-faith approaches preferring to maintain Christian confessionalism in religious education. Even in those countries where new approaches are being tried, there is some unwillingness to make wholesale
Shandera, Wayne Xavier
To investigate why Southern sub-Saharan Africa is more severely impacted by HIV and AIDS than other parts of sub-Saharan Africa, I conducted a review of the literature that assessed viral, host and transmission (societal) factors. This narrative review evaluates: 1) viral factors, in particular the aggregation of subtype-C HIV infections in Southern sub-Saharan Africa; 2) host factors, including unique behaviour patterns, concomitant high prevalence of sexually transmitted diseases, circumcision patterns, average age at first marriage and immunogenetic determinants; and, 3) transmission and societal factors, including levels of poverty, degrees of literacy, migrations of people, extent of political corruption, and the usage of contaminated injecting needles in community settings. HIV prevalence data and published indices on wealth, fertility, and governmental corruption were correlated using statistical software. The high prevalence of HIV in Southern sub-Saharan Africa is not explained by the unusual prevalence of subtype-C HIV infection. Many host factors contribute to HIV prevalence, including frequency of genital ulcerating sexually transmitted infections, absence of circumcision (compiled odds ratios suggest a protective effect of between 40% and 60% from circumcision), and immunogenetic loci, but no factor alone explains the high prevalence of HIV in the region. Among transmission and societal factors, the wealthiest, most literate and most educated, but also the most income-disparate, nations of sub-Saharan Africa show the highest HIV prevalence. HIV prevalence is also highest within societies experiencing significant migration and conflict as well as in those with government systems experiencing a high degree of corruption. The interactions between poverty and HIV transmission are complex. Epidemiologic studies currently do not suggest a strong role for the community usage of contaminated injecting needles. Areas meriting additional study include clade type, host immunogenetic determinants, the complex interrelationship of HIV with poverty, and the community usage of contaminated injecting needles. PMID:25866173
Brinkel, Johanna; Krämer, Alexander; Krumkamp, Ralf; May, Jürgen; Fobil, Julius
Whereas mobile phone-based surveillance has the potential to provide real-time validated data for disease clustering and prompt respond and investigation, little evidence is available on current practice in sub-Sahara Africa. The objective of this review was to examine mobile phone-based mHealth interventions for Public Health surveillance in the region. We conducted electronic search in MEDLINE, EMBASE, IEE Xplore, African Index Medicus (AIM), BioMed Central, PubMed Central (PMC), the Public Library of Science (PLoS) and IRIS for publications used in the review. In all, a total of nine studies were included which focused on infectious disease surveillance of malaria (n = 3), tuberculosis (n = 1) and influenza-like illnesses (n = 1) as well as on non-infectious disease surveillance of child malnutrition (n = 2), maternal health (n = 1) and routine surveillance of various diseases and symptoms (n = 1). Our review revealed that mobile phone-based surveillance projects in the sub-Saharan African countries are on small scale, fragmented and not well documented. We conclude by advocating for a strong drive for more research in the applied field as well as a better reporting of lessons learned in order to create an epistemic community to help build a more evidence-based field of practice in mHealth surveillance in the region. PMID:25396767
Daar Abdallah S; Simiyu Ken; Masum Hassan; Al-Bader Sara; Singer Peter A
Abstract In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation. This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive...
This paper examines the interface between work conditions of rural women in Africa and Western perceptions and interventions to address them. From a schematic review of Western attitudes towards African rural women's work, the paper moves on to consider donor intervention directed at improving rural women's status. The central question posed is how external donor agenciescan extend beyond localized project efforts to provide the material foundation for facilitating widespread change in women'...
Al-Bader, Sara; Masum, Hassan; Simiyu, Ken; Daar, Abdallah S; Singer, Peter A
In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation.This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive on-the-ground research in the form of four country case studies of health and biotechnology innovation, six studies of institutions within Africa involved in health product development, and one study of health venture funds in Africa. To the best of our knowledge it is the first extensive collection of empirical work on African science-based health innovation.The four country cases are Ghana, Rwanda, Tanzania and Uganda. The six case studies of institutions are A to Z Textiles (Tanzania), Acorn Technologies (South Africa), Bioventures venture capital fund (South Africa), the Malagasy Institute of Applied Research (IMRA; Madagascar), the Kenyan Medical Research Institute (KEMRI; Kenya), and Niprisan's development by Nigeria's National Institute for Pharmaceutical Research and Development and Xechem (Nigeria).All of the examples highlight pioneering attempts to build technological capacity, create economic opportunities, and retain talent on a continent significantly affected by brain drain. They point to the practical challenges for innovators on the ground, and suggest potentially helpful policies, funding streams, and other support systems.For African nations, health innovation represents an opportunity to increase domestic capacity to solve health challenges; for international funders, it is an opportunity to move beyond foreign aid and dependency. The shared goal is creating self-sustaining innovation that has both health and development impacts. While this is a long-term strategy, this series shows the potential of African-led innovation, and indicates how it might balance realism against opportunity. There is ample scope to learn lessons more systematically from cases like those we discuss; to link entrepreneurs, scientists, funders, and policy-makers into a network to share opportunities and challenges; and ultimately to better support and stimulate African-led health innovation. PMID:21144069
Daar Abdallah S
Full Text Available Abstract In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation. This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive on-the-ground research in the form of four country case studies of health and biotechnology innovation, six studies of institutions within Africa involved in health product development, and one study of health venture funds in Africa. To the best of our knowledge it is the first extensive collection of empirical work on African science-based health innovation. The four country cases are Ghana, Rwanda, Tanzania and Uganda. The six case studies of institutions are A to Z Textiles (Tanzania, Acorn Technologies (South Africa, Bioventures venture capital fund (South Africa, the Malagasy Institute of Applied Research (IMRA; Madagascar, the Kenyan Medical Research Institute (KEMRI; Kenya, and Niprisans development by Nigerias National Institute for Pharmaceutical Research and Development and Xechem (Nigeria. All of the examples highlight pioneering attempts to build technological capacity, create economic opportunities, and retain talent on a continent significantly affected by brain drain. They point to the practical challenges for innovators on the ground, and suggest potentially helpful policies, funding streams, and other support systems. For African nations, health innovation represents an opportunity to increase domestic capacity to solve health challenges; for international funders, it is an opportunity to move beyond foreign aid and dependency. The shared goal is creating self-sustaining innovation that has both health and development impacts. While this is a long-term strategy, this series shows the potential of African-led innovation, and indicates how it might balance realism against opportunity. There is ample scope to learn lessons more systematically from cases like those we discuss; to link entrepreneurs, scientists, funders, and policy-makers into a network to share opportunities and challenges; and ultimately to better support and stimulate African-led health innovation.
Lund, C; Alem, A; Schneider, M; Hanlon, C; Ahrens, J; Bandawe, C; Bass, J; Bhana, A; Burns, J; Chibanda, D; Cowan, F; Davies, T; Dewey, M; Fekadu, A; Freeman, M; Honikman, S; Joska, J; Kagee, A; Mayston, R; Medhin, G; Musisi, S; Myer, L; Ntulo, T; Nyatsanza, M; Ofori-Atta, A; Petersen, I; Phakathi, S; Prince, M; Shibre, T; Stein, D J; Swartz, L; Thornicroft, G; Tomlinson, M; Wissow, L; Susser, E
There is limited evidence on the acceptability, feasibility and cost-effectiveness of task-sharing interventions to narrow the treatment gap for mental disorders in sub-Saharan Africa. The purpose of this article is to describe the rationale, aims and methods of the Africa Focus on Intervention Research for Mental health (AFFIRM) collaborative research hub. AFFIRM is investigating strategies for narrowing the treatment gap for mental disorders in sub-Saharan Africa in four areas. First, it is assessing the feasibility, acceptability and cost-effectiveness of task-sharing interventions by conducting randomised controlled trials in Ethiopia and South Africa. The AFFIRM Task-sharing for the Care of Severe mental disorders (TaSCS) trial in Ethiopia aims to determine the acceptability, affordability, effectiveness and sustainability of mental health care for people with severe mental disorder delivered by trained and supervised non-specialist, primary health care workers compared with an existing psychiatric nurse-led service. The AFFIRM trial in South Africa aims to determine the cost-effectiveness of a task-sharing counselling intervention for maternal depression, delivered by non-specialist community health workers, and to examine factors influencing the implementation of the intervention and future scale up. Second, AFFIRM is building individual and institutional capacity for intervention research in sub-Saharan Africa by providing fellowship and mentorship programmes for candidates in Ethiopia, Ghana, Malawi, Uganda and Zimbabwe. Each year five Fellowships are awarded (one to each country) to attend the MPhil in Public Mental Health, a joint postgraduate programme at the University of Cape Town and Stellenbosch University. AFFIRM also offers short courses in intervention research, and supports PhD students attached to the trials in Ethiopia and South Africa. Third, AFFIRM is collaborating with other regional National Institute of Mental Health funded hubs in Latin America, sub-Saharan Africa and south Asia, by designing and executing shared research projects related to task-sharing and narrowing the treatment gap. Finally, it is establishing a network of collaboration between researchers, non-governmental organisations and government agencies that facilitates the translation of research knowledge into policy and practice. This article describes the developmental process of this multi-site approach, and provides a narrative of challenges and opportunities that have arisen during the early phases. Crucial to the long-term sustainability of this work is the nurturing and sustaining of partnerships between African mental health researchers, policy makers, practitioners and international collaborators. PMID:25833714
Sheppard Walter S.
Full Text Available Within the past 40 years, Africanized honey bees spread from Brazil and now occupy most areas habitable by the species Apis mellifera, from Argentina to the southwestern United States. The primary genetic source for Africanized honey bees is believed to be the sub-Saharan honey bee subspecies A. m. scutellata. Mitochondrial markers common in A. m. scutellata have been used to classify Africanized honey bees in population genetic and physiological studies. Assessment of composite mitochondrial haplotypes from Africanized honey bees, using 4 base recognizing restriction enzymes and COI-COII intergenic spacer length polymorphism, provided evidence for a more diverse mitochondrial heritage. Over 25% of the "African" mtDNA found in Africanized populations in Argentina are derived from non-A. m. scutellata sources.
This website created by the Philadelphia Museum of Art complements an exhibition that "surveys the artistic achievements of just a few of the many cultures of sub-Saharan Africa" organized by the Seattle Art Museum, using artifacts from its African collections. The largest section of the Web site, African Voices, features interviews with African artists, art historians and others, focusing on particular aspects of African cultures. For example, Hannah Kema Foday, a Mende woman from Segbwema, southwestern Sierra Leone, now living in New York city, speaks about Sowei masks and initiation for girls into womanhood. The other two sections - African Art in Motion and Contemporary African Art, show the expressive use of figures in African sculpture and the work of modern African artists, living in Africa and all over the world, respectively.
Bello, Shaibu O; Chika, Aminu; Abdulgafar, Jimoh O
The purpose of this study is to summarize the available data on the efficacy of Artesunate plus Amodiaquine (AS+AQ) versus Artemether -Lumefantrine (AL) for the treatment of uncomplicated Plasmodium falciparum malaria in sub-Saharan Africa using uncorrected parasitaemia as a clinically relevant endpoint. Studies and conference abstracts identified through Pubmed, Medline, Embase, Ansinet, AJOL, Bioline, Cochrane Infectious Diseases Group trials register, The Cochrane Controlled Trials Register, Science Citation Index, Lilacs, African Index Medicus, Clusty, Google, Yahoo and Microsoft search engines. Randomized controlled clinical trials comparing Artesunate-Amodiaquine versus Artemether-Lumefantrine, in Sub-Saharan Africa from January 2004 to June 2009, and which had at least 30 patients per study arm. The authors independently applied the inclusion criteria, assessed methodological quality and extracted data into a predesigned form. The outcome of interest was uncorrected day 28 parasitological failure. Data were then checked for agreement and double entered into RevMan version 5 for further analyses. Fifteen trials (4265 participants) met the inclusion criteria. Day 28 parasitological failure was lower for AL (286 of 2201 participants or 13.0 % failures) when compared with AS+AQ (446 of 2424 participants or 18.4% failures). The relative risk of parasitological failure with AS+AQ was higher when compared with AL (RR 1.65, 95% CI, 1.18-2.32). There were significant heterogeneity and inconsistencies in the studies. AL appears more effective at avoiding parasitological failure at days 28 than AS+AQ. PMID:23878697
Kamau, Edwin; Campino, Susana; Amenga-Etego, Lucas; Drury, Eleanor; Ishengoma, Deus; Johnson, Kimberly; Mumba, Dieudonne; Kekre, Mihir; Yavo, William; Mead, Daniel; Bouyou-Akotet, Marielle; Apinjoh, Tobias; Golassa, Lemu; Randrianarivelojosia, Milijaona; Andagalu, Ben; Maiga-Ascofare, Oumou; Amambua-Ngwa, Alfred; Tindana, Paulina; Ghansah, Anita; MacInnis, Bronwyn; Kwiatkowski, Dominic; Djimde, Abdoulaye A
Mutations in the Plasmodium falciparum K13-propeller domain have recently been shown to be important determinants of artemisinin resistance in Southeast Asia. This study investigated the prevalence of K13-propeller polymorphisms across sub-Saharan Africa. A total of 1212 P. falciparum samples collected from 12 countries were sequenced. None of the K13-propeller mutations previously reported in Southeast Asia were found, but 22 unique mutations were detected, of which 7 were nonsynonymous. Allele frequencies ranged between 1% and 3%. Three mutations were observed in >1 country, and the A578S was present in parasites from 5 countries. This study provides the baseline prevalence of K13-propeller mutations in sub-Saharan Africa. PMID:25367300
Lund, Henrik Hautop
This concept paper explores a technological building block approach to the development of a flexible rehabilitation tool that may address some of the needs in sub-Saharan Africa. We briefly outline some of the health challenges that lead us to suggest a concept for physical rehabilitation solutions to address many diverse patient groups (e.g. disabled children, cardiac, and stroke patients), to be used in both urban and rural areas, to be easily used in community based rehabilitation (e.g. by community rehabilitation workers), to motivate the users, and to be robust to failure (e.g. power failure) in remote areas. The concept leads to the implementation of modular interactive tiles for rehabilitation, and suggestions for future use in sub-Saharan Africa.
Adisa, Femi; Isabalija, Stephen R.
This paper discusses the need for IS research with a focus on SME adoption of enterprise systems in the context of Sub-Saharan Africa. Previous IS research into general adoption in several developing countries have shown that local context play a significant role in the successful implementation of any information system. SMEs constitute a majority of all organizations in most Sub Saharan economies, thus their importance to the socioeconomic development and empowerment of the region cannot be overemphasized. However, the absence of literature and focused research into factors that influence enterprise systems adoption and use that are particular to this region represents a huge gap for both researchers and practitioners. This call to action paper will attempt to present the implications of this deficiency and outline areas where future research can be most beneficial to stakeholders.
...of the Export-Import Bank of the United States (Export-Import Bank). SUMMARY: The Sub-Saharan...programs designed to support the expansion of the Bank's financial commitments...Saharan Africa under the loan, guarantee, and...
Agreement between clinicians' and care givers' assessment of intelligence in Nigerian children with intellectual disability: 'ratio IQ' as a viable option in the absence of standardized 'deviance IQ' tests in sub-Saharan Africa
Aguocha Chinyere M
Full Text Available Abstract Background There may be need to assess intelligent quotient (IQ scores in sub-Saharan African children with intellectual disability, either for the purpose of educational needs assessment or research. However, modern intelligence scales developed in the western parts of the world suffer limitation of widespread use because of the influence of socio-cultural variations across the world. This study examined the agreement between IQ scores estimation among Nigerian children with intellectual disability using clinicians' judgment based on International Classification of Diseases, tenth Edition (ICD - 10 criteria for mental retardation and caregivers judgment based on 'ratio IQ' scores calculated from estimated mental age in the context of socio-cultural milieu of the children. It proposed a viable option of IQ score assessment among sub-Saharan African children with intellectual disability, using a ratio of culture-specific estimated mental age and chronological age of the child in the absence of standardized alternatives, borne out of great diversity in socio-cultural context of sub-Saharan Africa. Methods Clinicians and care-givers independently assessed the children in relation to their socio-cultural background. Clinicians assessed the IQ scores of the children based on the ICD - 10 diagnostic criteria for mental retardation. 'Ratio IQ' scores were calculated from the ratio of estimated mental age and chronological age of each child. The IQ scores as assessed by the clinicians were then compared with the 'ratio IQ' scores using correlation statistics. Results A total of forty-four (44 children with intellectual disability were assessed. There was a significant correlation between clinicians' assessed IQ scores and the 'ratio IQ' scores employing zero order correlation without controlling for the chronological age of the children (r = 0.47, df = 42, p = 0.001. First order correlation controlling for the chronological age of the children showed higher correlation score between clinicians' assessed IQ scores and 'ratio IQ' scores (r = 0.75, df = 41, p = 0.000. Conclusion Agreement between clinicians' assessed IQ scores and 'ratio IQ' scores was good. 'Ratio IQ' test would provide a viable option of assessing IQ scores in sub-Saharan African children with intellectual disability in the absence of culture-appropriate standardized intelligence scales, which is often the case because of great diversity in socio-cultural structures of sub-Saharan Africa.
The many headlines focusing on 'land grabbing' have distracted attention from the role that access to water plays in underpinning the projected productivity of foreign direct investment in acquisition of agricultural land in developing countries. This paper identifies questions that arise about the explicit and implicit water requirements for irrigation in agricultural projects on land that is subject to such foreign investment deals. It focuses particularly on land acquisition in sub-Saharan...
Abstract Background In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomised by oil extraction in sub-Saharan Africa. Methods Based on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan), I propose a framework for an...
Awel, Ahmed Mohammed
This paper investigated the effect of terms of trade growth and its volatility on economic growth in Sub-Saharan Africa. I employed dynamic panel data models of difference and system GMM that could account biases associated with endogeneity of explanatory variables and problems induced by unobserved country specific characteristics. I used both net barter terms of trade and income terms of trade as a measure of terms of trade for the entire analysis of this paper. Using data from 1985 to 2010...
Full Text Available Epilepsy is a leading serious neurological condition worldwide and has particularly significant physical, economic and social consequences in SubSaharan Africa. This paper aims to contribute to the understanding of epilepsy prevalence in this region and how this varies by age and sex so as to inform understanding of the disease characteristics as well as the development of infrastructure, services and policies.
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 abs...
Thomson, G. R.
The present international approach to management of transboundary animal diseases (TADs) is based on the assumption that most can be eradicated ; consequently, that is the usual objective adopted by international organizations concerned with animal health. However, for sub-Saharan Africa and southern Africa more particularly, eradication of most TADs is impossible for the foreseeable future for a variety of technical, financial and logistical ...
Orosz, Matthew; Quoilin, Sylvain; Hemond, Harold
This paper examines technical and economic choices for rural electrification in Africa and presents the rationale for trigeneration (capability for electricity, heating, and cooling) in health and education applications. An archetypal load profile for a rural health clinic (25 kWhe/day and 118139 kWht) is described, and a regional analysis is performed for sub-Saharan Africa by aggregating NASA meteorological data (insolation, temperature, and heating and cooling degree-days) using correlate...
In the past decades, most of the countries in Sub-Saharan Africa have been affected by armed conflicts. By means of a time-series cross-sectional (TSCS) database, we attempt to measure the impact of war on a sample of 43 countries in Africa from 1950 to 2010. These conflicts, and especially civil wars, are shown to have a strong negative effect on
Oladimeji Idowu Oladele
This paper reviews the features of agricultural extension models and policy in selected sub- Saharan Africa countries. This is based on the premise that the discussion of extension policy in SSA countries can not be isolated from the extension models that are applied in these countries. While the models are direct products of the type of policy that has been adopted, the policy dictates the models to be used in each country. A major problem of organizing agricultural extension in developing c...
Milagrosa, A.; Frickenstein, J.
Despite acknowledgment of the significant role of women in economic growth, gender-biased development policies still persist worldwide. In this context, the paper reviews recent policy reforms in Sub-Saharan Africa that perpetuate gender inequality and female poverty for the already impoverished continent. Citing two reforms from the World Bank's Doing Business Reports, the paper analyses their possible negative effect on women entrepreneurs within the private sector. The paper argues that du...
Hassan, Rashid M.
Accelerating economic growth and social development is necessary to reduce the vulnerability and enhance the adaptive capacity of sub-Saharan Africa to cope with the consequences of predicted unfavorable future climate. This requires major investments and policy reforms to induce a needed radical transformation of the way development is currently pursued to a more climate-sensitive path of low carbon growth. Key gaps in the current knowledge base that call for major investments and urgent att...
Kodila-tedika, Oasis; Agbor, Julius
This paper investigates the effects of religion on a broad set of development outcomes in sub-Saharan Africa. We regroup these outcomes into three broad categories, namely, development process outcomes (growth, investment, conflict, and government quality), institutional outcomes (property rights and the rule of law) and social development outcomes (social and gender protection). Using two new measures of religion religious fractionalization (RELFRAC) and religious polarization (RELPOL), ...
Heemskerk, W.; Wennink, B.
The main objective of this bulletin is to help in laying a stronger foundation for the generation of truly client-driven agricultural innovation systems in sub-Saharan Africa (SSA) in order to facilitate greater efficiency and effectiveness in achieving the overarching agricultural development objectives of sustained productivity gains, improved profitability, and poverty alleviation. Pioneering experiences with the Farmer Research Group (FRG) approach in many parts of SSA show that the build...
Craig, MH; Snow, RW; le Sueur, D
Malaria remains the single largest threat to child survival in sub-Saharan Africa and warrants long-term investment for control. Previous malaria distribution maps have been vague and arbitrary. Marlies Craig, Bob Snow and David le Sueur here describe a simple numerical approach to defining distribution of malaria transmission, based upon biological constraints of climate on parasite and vector development. The model compared well with contemporary field data and historical 'expert opinion' m...
Picone, Gabriel; Kibler, Robyn; Apouey, Be?ne?dicte H.
This paper analyzes the effect of malaria prevalence and indoor residual spraying on the probability of sleeping under an insecticide-treated bed net in nine Sub-Saharan countries. Specifically, it examines whether bed net usage is elastic with respect to malaria prevalence and whether indoor residual spraying, which is a public intervention, crowds out bed net usage, which is a private behavior. Using data on individual bed net usage and household indoor residual spraying combined with local...
Diop, A.; Jaw, G.; Dieng, B.
In the Sub-Saharan Africa, drying remains one of the modes of food preservation used and the most important issue which is ensuring food self-sufficiency is not always guaranteed. In the process of drying the main variables to be measured are the masses, temperatures, air velocities, and the heating power and the quantities of water to be removed from the product. These values require good control for achieving a good dryer [1, 2].This work helps in providing answer...
Draper, Peter; Freytag, Andreas; Al Doyaili, Sarah
In recent years sub-Saharan Africa, notwithstanding the global financial crisis, has increased its share in global trade and investment flows. This has led to an appreciable improvement in development levels, albeit off a small base. However, these patterns are still dominated by commodity flows and investment, and remain marginal on the global stage. Increased trade and investment flows, particularly related to network services, would be of great benefit to the sub-continent. Yet many domest...
Eugene Sobngwi; Andre Pascal Kengne; Leopold Fezeu; Paschal Awah; Alain Lekoubou
Chronic diseases are becoming increasingly important in sub-Saharan Africa (SSA). The current density and distribution of health workforce suggest that SSA cannot respond to the growing demand for chronic disease care, together with the frequent infectious diseases. Innovative approaches are therefore needed to rapidly expand the health workforce. In this article, we discuss the evidences in support of nurse-led strategies for chronic disease management in SSA, with a focus on hypertension an...
Vastveit, Lene Kristin
This thesis examines two cases of Export Processing Zone (EPZ) programmes in sub-Saharan Africa (SSA), specifically in Kenya and Lesotho. Using data from the respective countries' EPZ programme authorities, central banks, relevant studies, and country reports, I show that although the programmes have facilitated employment generation and foreign exchange earnings from textile and apparel exports, such exports rely highly on preferential trade agreements such as the Africa...
Wright, Caradee Y.; Mary Norval; Beverley Summers; Lester Davids; Gerrie Coetzee; Oriowo, Matthew O.
Photoprotection messages and SunSmart programmes exist mainly to prevent skin cancers and, more recently, to encourage adequate personal sun exposure to elicit a vitamin D response for healthy bone and immune systems. Several developed countries maintain intensive research networks and monitor solar UV radiation to support awareness campaigns and intervention development. The situation is different in sub-Saharan Africa. Adequate empirical evidence of the impact of solar UV radiation on...
The principal objectives of this research were: · to develop a conceptual framework on sustainability and sustainable development and · to propose a strategy framework for sustainable industrial development in Sub-Saharan Africa (SSA). The research was done based on systems evolutionary approach having the following methodological principles as a guide. · The dynamic complexity of environmental and developmental issues can be better understood by utilizing transdisciplinary theories such a...
Smith, Robert J.; Hove-Musekwa, Senelani D
Indoor residual sprayingÃ¢ÂÂspraying insecticide inside houses to kill mosquitoesÃ¢ÂÂis an important method for controlling malaria vectors in sub-Saharan Africa. We propose a mathematical model for both regular and non-fixed spraying, using impulsive differential equations. First, we determine the stability properties of the nonimpulsive system. Next, we derive minimal effective spraying intervals and the degree of spraying effectiveness required to control mosquitoes wh...
This paper uses the data set from the fourth survey by UNIDO of manufacturing firms in Sub-Saharan Africa to identify whether foreign direct investment affects the behaviour of local firms with respect to investment, product innovation and process innovation. We look at the perception and response of 1,140 manufacturing firms in 9 sectors in 19 countries. Using Probit models the results suggest that, once controlling for firm's characteristics, there is a marked difference between perception ...
Blackden, Mark; Canagarajah, Sudharshan; Klasen, Stephan; Lawson, David
The study suggests that gender inequality acts as a significant constraint to growth in sub-Saharan Africa, and that removing gender-based barriers to growth will make a substantial contribution to realizing Africas economic potential. In particular we highlight gender gaps in education, related high fertility levels, gender gaps in formal sector employment, and gender gaps in access to assets and inputs in agricultural production as particular barriers reducing the ability of women to con...
Frank Chirowa; Stephen Atwood; Marc Van der Putten
Background: This article provided an analysis of gender inequality, health expenditure and itsrelationship to maternal mortality. Objective: The objective of this article was to explore gender inequality and its relationship with health expenditure and maternal mortality in sub-Saharan Africa (SSA). A unique analysis was used to correlate the Gender Inequality Index (GII), Health Expenditure and Maternal Mortality Ratio (MMR). The GII captured inequalities across three dimensions Reproduc...
Macdonald, A. M.; Davies, J.
Groundwater has proved the most reliable resource for meeting rural water demand in sub-Saharan Africa. There are four main hydrogeological environments in SSA. Each of these broad categories requires different methods for finding and abstracting groundwater. 1. Crystalline basement occupies 40% of the land area of SSA; 220 million people live in rural areas underlain by crystalline basement rocks. Groundwater is found where the rocks have been significantly weathered or in und...
Barter Devra M; Agboola Stephen O; Murray Megan B; Bärnighausen Till
Abstract Background Tuberculosis (TB) is known to disproportionately affect the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be particularly burdensome for TB-affected households in sub-Saharan Africa where poverty levels are high; these costs include the direct costs of medical and non-medical expend...
Donald Lee Sparks
In 2000 the largest gathering of world leaders in history met at the United Nations to endorse the Millennium Development Goals (MDGs) and these goals have received wide-spread attention since then. This paper examines these goals and also considers the larger issue of economic growth and development. For sub-Saharan Africas economies to grow, we need to recognize the role and functions of the informal ruling sector and also acknowledge the incentives involved. Equally important perhaps, w...
Vanlauwe, B.; Descheemaeker, K.; Giller, K. E.; Huising, J.; Merckx, R.; Nziguheba, G.; Wendt, J.; Zingore, S.
Intensification of smallholder agriculture in sub-Saharan Africa is necessary to address rural poverty and natural resource degradation. Integrated Soil Fertility Management (ISFM) is a means to enhance crop productivity while maximizing the agronomic efficiency (AE) of applied inputs, and can thus contribute to sustainable intensification. ISFM consists of a set of best practices, preferably used in combination, including the use of appropriate germplasm, the appropriate use of fertilizer an...
Technical, vocational education, and training has remained an explosive topic because it can create a divided society in terms of education and the benefits associated with it. Internationally, it has always been a complex and controversial topic compared to the general education strand. It has presented inconsistent arguments over the years, particularly in Sub-Saharan Africa were policies have too often prescribed it as the panacea to addressing youth unemployment. On the one hand, it seems...
Soil fertility management in sub-Saharan Africa is complex, diverse and dynamic. Farmers' investments are determined by a wide variety of factors, including bio-physical characteristics of the environment, access to resources and the institutional, and socio-economic context of farming and livelihood making. Within this context, defining soil fertility problems in general terms is not meaningful and proposing a limited number of standard interventions, aimed at the 'average' farmer is of limi...
Full Text Available Chronic diseases are becoming increasingly important in sub-Saharan Africa (SSA. The current density and distribution of health workforce suggest that SSA cannot respond to the growing demand for chronic disease care, together with the frequent infectious diseases. Innovative approaches are therefore needed to rapidly expand the health workforce. In this article, we discuss the evidences in support of nurse-led strategies for chronic disease management in SSA, with a focus on hypertension and diabetes mellitus.
Full Text Available Abstract Background As a result of widespread chloroquine and sulphadoxine-pyrimethamine (SP resistance, 90% of sub-Saharan African countries had adopted policies of artemisinin-based combination therapy (ACT for treatment of uncomplicated malaria by 2007. In Malawi, cessation of chloroquine use was followed by the re-emergence of chloroquine-susceptible malaria. It was expected that introduction of ACT would lead to a return in chloroquine susceptibility throughout Africa, but this has not yet widely occurred. This observation suggests that there is continuing use of ineffective anti-malarials in Africa and that persistent chloroquine-resistant malaria is due to ongoing drug pressure despite national policy changes. Methods To estimate drug use on a national level, 2006-2007 Demographic Health Survey and Multiple Indicator Cluster Survey data from 21 African countries were analysed. Resistance data were compiled by systematic review of the published literature on the prevalence of the Plasmodium falciparum chloroquine resistance transporter polymorphism at codon 76, which causes chloroquine resistance. Results Chloroquine was the most common anti-malarial used according to surveys from 14 of 21 countries analysed, predominantly in West Africa. SP was most commonly reported in two of 21 countries. Among eight countries with longitudinal molecular resistance data, the four countries where the highest proportion of children treated for fever received chloroquine (Uganda, Burkina Faso, Guinea Bissau, and Mali also showed no significant declines in the prevalence of chloroquine-resistant infections. The three countries with low or decreasing chloroquine use among children who reported fever treatment (Malawi, Kenya, and Tanzania had statistically significant declines in the prevalence of chloroquine resistance. Conclusions This study demonstrates that in 2006-2007, chloroquine and SP continued to be used at high rates in many African countries. In countries reporting sustained chloroquine use, chloroquine-resistant malaria persists. In contrast, a low level of estimated chloroquine use is associated with a declining prevalence of chloroquine resistance.
T. P., Masere; K. J., Duffy.
Full Text Available Achieving food security is a challenge for the developed and developing world. These challenges are greater for developing nations such as in Africa because of the severity of the problems. An important aspect of this is poor agricultural productivity. Worldwide, technology is being developed to inc [...] rease agricultural production. One aspect of this is the development of predictive computer models that enable farmers to optimise crops using management decision based on simulation scenarios. Most African farmers do not have the computer resources or expertise to implement these types of technology. Even extension offices in Africa, who provide much needed advice, can be under resourced in this way. We suggest here that simpler computer models that are cheaper and easier to use need to be developed. As a first step in this process we investigate here which factors are most cost effectively managed using computer simulations in semi-arid conditions pertinent to much of sub-Saharan Africa. Factors known to be important in crop farming are planting date, sowing density, variety, weeding, soils and fertiliser. We use qualitative arguments with simulations and conclude that interactions between rainfall, soil condition and fertiliser can benefitfrom simulations and thus should help in their management.
Madsen, Elizabeth Leahy; Kuang, Bernice; Ross, John
It is difficult to gauge the success of programmatic efforts to reduce unmet need for contraception without knowing whether individual women have had their need met and adopted contraception. However, the number of true longitudinal datasets tracking the transition of panels of individual women in and out of states of contraceptive use is limited. This study analyses changes in contraceptive use states using Demographic and Health Survey data for 22 sub-Saharan African countries. A cohort approach, tracking representative samples of five-year age groups longitudinally across surveys, as well as period-based techniques, are applied to indicate whether new users of contraception have been drawn from women who previously had no need and/or those who had unmet need for family planning. The results suggest that a greater proportion of increases in contraceptive use in recent years can be attributed to decreases in the percentage of women with no need, especially among younger women, than to decreases in the proportion with unmet need. PMID:24674653
Myles, Sean; Bouzekri, Nourdine; Haverfield, Eden; Cherkaoui, Mohamed; Dugoujon, Jean-Michel; Ward, Ryk
The process by which pastoralism and agriculture spread from the Fertile Crescent over the past 10,000 years has been the subject of intense investigation by geneticists, linguists and archaeologists. However, no consensus has been reached as to whether this Neolithic transition is best characterized by a demic diffusion (with a significant genetic input from migrating farmers) or a cultural diffusion (without substantial migration of farmers). Milk consumption and thus lactose tolerance are assumed to have spread with pastoralism and we propose that by looking at the relevant mutations in and around the lactase gene in human populations, we can gain insight into the origin(s) and spread of dairying. We genotyped the putatively causal allele for lactose tolerance (-13910T) and constructed haplotypes from several polymorphisms in and around the lactase gene (LCT) in three North African Berber populations and compared our results with previously published data. We found that the frequency of the -13910T allele predicts the frequency of lactose tolerance in several Eurasian and North African Berber populations but not in most sub-Saharan African populations. Our analyses suggest that contemporary Berber populations possess the genetic signature of a past migration of pastoralists from the Middle East and that they share a dairying origin with Europeans and Asians, but not with sub-Saharan Africans. PMID:15806398
AgMIP conducted the first set of comprehensive regional integrated assessments of climate change impacts on smallholder farmers in Sub-Saharan Africa and South Asia led by researchers from the regions themselves. The project developed new methods integrating climate, crop, livestock and economic models to conduct climate change impact assessments that characterize impacts on smallholder groups. AgMIP projections of climate change impacts on agriculture are more realistic than previous assessments because they take agricultural development into account. Using the best available data and models, the assessments directly evaluated yield, income, and poverty outcomes including the effects of adaptation packages and development pathways. Results show that even with agricultural development, climate change generally will exert negative pressure on yields of smallholder farmers in Sub-Saharan Africa and South Asia. Without adaptation, climate change leads to increased poverty in some locations in Sub-Saharan Africa and South Asia compared to a future in which climate change does not occur. Adaptation can significantly improve smallholder farmer responses to climate change. AgMIP expert teams identified improved varieties, sowing practices, fertilizer application, and irrigation applications as prioritized adaptation strategies. These targeted adaptation packages were able to overcome a portion of detrimental impacts but could not compensate completely in many locations. Even in cases where average impact is near zero, vulnerability (i.e., those at risk of loss) can be substantial even when mean impacts are positive.
Langevang, Thilde; Gough, Katherine
Shrinking public sectors and limited opportunities for gaining formal wage employment in the private sector have resulted in entrepreneurship being promoted as a means of generating youth employment. This discourse is being widely promoted within sub-Saharan Africa despite little being known about how best to support youth employment and entrepreneurship. This paper focuses on two of the main trades which young women in sub-Saharan Africa have typically entered: hairdressing and dressmaking. Through drawing on a qualitative case study of hairdressers and seamstresses in Ghana, it is shown how the two professions have fared quite differently in recent years: whereas hairdressing has boomed, dressmaking has been stagnating. The paper shows how these diverging trajectories can be attributed to three related factors. First, globalisation has affected the two trades differently; second, their respective trade associations have reacted differently to the new constraints and opportunities generated by globalisation and their training systems have undergone different degrees of professionalisation; and third, the prestige associated with the two professions has changed affecting the aspirations of young women to enter the professions and the experiences of those that do. As the paper shows, geographers potentially have much to contribute to employment and entrepreneurship debates by providing more contextualised studies which recognise the complex interplay between globalisation, institutions and individuals in particular places and acknowledge the ensuing diverse employment experiences. Such studies are highly relevant for policymakers who are facing the difficult challenge of how to create employment and stimulate entrepreneurship in sub-Saharan Africa.
Adjiwanou, Vissého; N'Bouke, Afiwa
We question the positive effect of intimate partner violence on women's modern contraceptive use in sub-Saharan Africa found in previous studies. The explanations offered for this counter-intuitive result are either that women make greater efforts to avoid childbearing in conflictual relationships, or that endogeneity bias exists. Endogeneity bias stems from the inability of researchers to attribute a specific cause to one variable when they are unable to control for related missing covariates. Demographic and Health Survey data from 13 countries in sub-Saharan Africa provide evidence for the latter but not the former. Indeed, using simple probit regression models, we observe a positive relationship between intimate partner violence and modern contraceptive use in Burkina Faso, Mali, Nigeria, Tanzania, and Zimbabwe. This effect remains unchanged when controlling for various measures of women's autonomy in the household, showing that these two variables interact with contraceptive use independently. However, the use of recursive bivariate probit and Rosenbaum bounds sensitivity analysis to control for endogeneity biases erodes the initial positive effect in the five countries, although only partially in Burkina Faso. Our research shows that the previously reported findings arise from poor model specification and highlights the need for more appropriate data to assess the effect of intimate partner violence on modern contraceptive use in sub-Saharan Africa. PMID:26059986
Steyn Nelia P
Full Text Available Abstract Background During the last century we have seen wide-reaching changes in diet, nutritional status and life expectancy. The change in diet and physical activity patterns has become known as the nutrition transition. At any given time, a country or region within a country may be at different stages within this transition. This paper examines a range of nutrition-related indicators for countries in Sub-Saharan Africa (SSA and attempts to develop a typical model of a country in transition. Methods Based on the availability of data, 40 countries in SSA were selected for analysis. Data were obtained from the World Health Organisation, Demographic and Health Surveys and the Food and Agriculture Organisation of the United Nations. Multiple linear regression analysis (MLRA was used to explore the determinants of infant mortality. A six point score was developed to identify each country's stage in the nutrition transition. Results MLRA showed that underweight-for-age, protein and the percentage of exclusively breastfed infants were associated with the infant mortality rate (IMR. The majority of countries (n = 26 used in the analysis had nutrition transition scores of zero and one. Most of them had a high prevalence of infant mortality, children that were stunted or underweight-for-age, small percentages of women that were overweight and obese, and low intakes of energy, protein, and fat. Countries with the highest scores include South Africa, Ghana, Gabon, Cape Verde and Senegal which had relatively low IMRs, high levels of obesity/overweight, and low levels of underweight in women, as well as high intakes of energy and fat. These countries display classic signs of a population well established in the nutrition-related non-communicable disease phase of the nutrition transition. Conclusions Countries in SSA are clearly undergoing a nutrition transition. More than half of them are still in the early stage, while a few have reached a point where changes in dietary patterns are affecting health outcomes in a large portion of the population. Those in the early stage of the transition are especially important, since primordial prevention can still be introduced.
Bruno, Lars C.
This thesis looks at the differences in economic growth between Sub-Saharan Africa and East Asia in the time period from 1960 until today. Three major causes are assessed which all are attempted linked to the governments role; i) Structural causes; ii) Economic policy; and iii) Institutional causes. The main results indicate that Sub-Saharan Africa suffered from worse structural effects than East Asia; and that East Asia had a more favourable institutional environment. The role of economic...
OLoughlin, John; Linke, Andrew M.; Witmer, Frank D. W.
A robust debate about the effects of climate change on conflict occurrences has attained wide public and policy attention, with sub-Saharan Africa generally viewed as most susceptible to increased conflict risk. Using a new disaggregated dataset of violence and climate anomaly measures (temperature and precipitation variations from normal) for sub-Saharan Africa 19802012, we consider political, economic, and geographic factors, not only climate metrics, in assessing the chances of increase...
HELSINKI SCHOOL OF ECONOMICS (HSE) ABSTRACT International Business, Masters Thesis 24.4.2009 Elias KahlaAbstract: EFFECTS OF INSTITUTIONAL CONSTRAINTS TO FOREIGN MARKET ENTRY STRATEGIES OF FINNISH ICT-COMPANIES IN SUB-SAHARAN AFRICA Abstract: Objectives of the research The aim of this study was to examine the effects of institutional constraints to Finnish ICT companies in sub-Saharan Africa. To be more specific, the aim was to investigate using institutional the...
Efforts at improving child-health and development initiatives in sub-Saharan Africa had focused on the physical health of children due to the neglect of child and adolescent mental health (CAMH) policy initiatives. A thorough and broad-based understanding of the prevalent child mental-health risk and vulnerability factors is needed to successfully articulate CAMH policies. In this discourse, we present a narrative on the child mental-health risk and vulnerability factors in sub-Saharan Africa...
Ww, Muhwezi; Lj, Kajula; Bastien S
Abstract Parent-child sexuality communication has been identified as a protective factor for adolescent sexual and reproductive health, including HIV infection. The available literature on this topic in sub-Saharan Africa is increasing; however a systematic review of studies has not been conducted. This article reviews the literature in the area of parental or caregiver and child communication about sexuality and HIV/AIDS in sub-Saharan Africa. A review of peer reviewed literature published b...
Yawson, Robert M.; Yawson, Ivy
This paper reviews the status of Agricultural Biotechnology in Sub-Saharan Africa. It addresses the potential economic benefits to Sub-Saharan Africa and the effect biotechnology policies may have on growth, production and poverty reduction. The extent to which agricultural biotechnology will compound or mitigate the constraints faced by smallholders/subsistence farmers is also discussed. The status of crop biotechnology research worldwide is reviewed and the influence of intellectual propert...
The years since 9/11 have been characterised by the increasing threat of terrorist action in the Middle East and South Asia. Yet Sub-Saharan Africa was has also become a region of concern. In 1998, it had been the scene of two Al-Qaeda attacks against US embassies; besides Africa is home to large Muslim populations. Since 9/11 African violent non-state groups unrelated to Al- Qaeda or to the wider Islamist movement have been recast as terrorist organisations. These groups primarily oper...
Overpeck, J.; Wheeler, W.; Beck, W.; Cole, J.; Scholz, C.; Arko, J.; Sharp, E.
Lake Bosumtwi is a small (8 km-dia.), deep (78 m), hydrologically-closed lake located in the lowland forest zone of southern Ghana, West Africa. The steep-walled meteorite crater basin (10.5 km-dia.) is particularly sensitive to subtle changes in the regional precipitation-evaporation balance, and thus has long been cited as a benchmark paleoenvironmental site for West Africa. In an effort to enhance the value of the Bosumtwi sediments in reconstructing decade to century-scale monsoon variability, we collected a new suite of freeze-cores, and subsequently determined (e.g., with two independent radiometric systems) that the finely laminated sediments represented annual varves (Wheeler et al., AGU Fall Meeting 2002). In light of previous studies, we hypothesized that the ratio of carbon to nitrogen in the lake sediments provides a proxy for changing lake area, and hence regional hydrologic balance and monsoon strength. We confirmed the reliability of this proxy by comparing the sediment based ratio of carbon to nitrogen (C:N) against the age of well-dated dead trees submerged in water depths of 10 to 20m, and then created the first near-annually dated record of West African rainfall extending back eight centuries. The 20th century has been the wettest of the last eight centuries, with the 19th century close behind. Prior to ca. 1800, the Lake Bosumtwi region was generally characterized by drought, with the periods prior to 1300, and 1640 to 1720 AD the driest. This contrasts with comparable records from East Africa, and indicates that much of the Little Ice Age, including some hypothesized periods of reduced solar output, did not result in synchronous enhanced precipitation across North Africa. Instead, it appears that the solar Maunder Minimum resulted in a megadrought in subtropical West Africa coincident with increased rainfall in the Sahel. Thus, the out-of-phase relationship that characterizes interannual variability may extend to longer time scales of variation as well. In addition, anomalously strong Atlantic trade winds and cool SSTs appear to have been associated with the 80-year 17th to 18th century West Africa megadrought.
Jonathan O. Nwiloh
Full Text Available Background: The majority of prospective cardiac surgical patients in sub Saharan Africa lack access to open heart surgery. We reviewed our midterm results to identify the obstacles to growth and challenges with sustainability. Methods: Records of patients undergoing heart surgery at LASUTH from December 2004 to March 2006 were retrospectively reviewed for clinical and outcome data. Results: Twenty four patients age 10-50, mean 28.0 +/? 10.49 years and 13 (54.2% males underwent surgery. 12 (50.0% patients had mechanical valve replacements, 11 (45.8% closure of septal defects and 1 (4.2% left atrial myxoma resection. Logistic euroscore for valve patients was 5.81 +/? 4.74 while observed mortality was 8.3% (1/12. Overall 30 days operative mortality was 8.3% (2/24 and major morbidity 4.2% (1/24. Patients with septal defects closure stopped clinic visits within a year. Valve patients follow up was complete in 90.1% with mean duration of 55.2 +/? 15.3 months. Late events occurred only in females with mitral valve replacements. The 5-year freedom from thromboembolism and bleeding was 74.0% and survival 82.0% in valve patients. Conclusion: Despite limited resources heart surgery can safely be performed with good outcomes by trained local personnel under supervision of visiting foreign teams until they are proficient to operate independently. Patients with less complex congenital defects have excellent postsurgical outcomes, while patients with rheumatic valve replacement are subject to ongoing valve related morbidity and mortality therefore require lifetime follow up. Choice of prosthetic valve for the mostly indigent and poorly educated population remains a challenge. We now prefer stented tissue valve despite its known limitations, in child bearing age females desirous of childbirth and others unlikely to comply with anticoagulation regimen. Barriers to sustainability include poor infrastructures, few skilled manpower, inadequate funding and restricted patient access due to inability to pay without third party insurance or government Medicaid.
Full Text Available OBJECTIVE: To assess the sensitivity, specificity and predictive value positive of the WHO threshold strategy for detecting meningococcal disease epidemics in sub-Saharan Africa and to estimate the impact of the strategy on an epidemic at district level. METHODS: Data on meningitis cases at the district level were collected weekly from health ministries, WHO country and regional offices, and nongovernmental organizations in countries where there were epidemics of meningococcal disease in 1997. An epidemic was defined as a cumulative district attack rate of at least 100 cases per 100 000 population from January to May, the period of epidemic risk. The sensitivity, specificity and predictive value positive of the WHO threshold rate were calculated, and curves of sensitivity against (1 - specificity were compared with alternatively defined threshold rates and epidemic sizes. The impact of the WHO strategy on a district epidemic was estimated by comparing the numbers of epidemic cases with cases estimated to have been prevented by vaccination. FINDINGS: An analysis was made of 48 198 cases reported in 174 districts in Benin, Burkina Faso, the Gambia, Ghana, Mali, Niger, and Togo. These cases were 80.3% of those reported from Africa to WHO during the 1997 epidemic period. District populations ranged from 10 298 to 573 908. The threshold rate was crossed during two consecutive weeks in 69 districts (39.7% and there were epidemics in 66 districts (37.9%. Overall, the sensitivity of the threshold rate for predicting epidemics was 97%, the specificity was 95%, and the predictive value positive was 93%. Taken together, these values were equivalent or better than the sensitivity, specificity and predictive value positive of alternatively defined threshold rates and epidemics, and remained high regardless of district size. The estimated number of potential epidemic cases decreased by nearly 60% in the age group targeted for vaccination in one district where the guidelines were followed in a timely manner. CONCLUSION: The use of the WHO strategy was sensitive and specific for the early detection of meningococcal disease epidemics in countries of sub-Saharan Africa during 1997 and had a substantial impact on a district epidemic. Nevertheless, the burden of meningococcal disease in these countries remains formidable and additional control measures are needed.
Full Text Available Abstract Background Mitochondrial DNA (mtDNA haplotypes have become popular tools for tracing maternal ancestry, and several companies offer this service to the general public. Numerous studies have demonstrated that human mtDNA haplotypes can be used with confidence to identify the continent where the haplotype originated. Ideally, mtDNA haplotypes could also be used to identify a particular country or ethnic group from which the maternal ancestor emanated. However, the geographic distribution of mtDNA haplotypes is greatly influenced by the movement of both individuals and population groups. Consequently, common mtDNA haplotypes are shared among multiple ethnic groups. We have studied the distribution of mtDNA haplotypes among West African ethnic groups to determine how often mtDNA haplotypes can be used to reconnect Americans of African descent to a country or ethnic group of a maternal African ancestor. The nucleotide sequence of the mtDNA hypervariable segment I (HVS-I usually provides sufficient information to assign a particular mtDNA to the proper haplogroup, and it contains most of the variation that is available to distinguish a particular mtDNA haplotype from closely related haplotypes. In this study, samples of general African-American and specific Gullah/Geechee HVS-I haplotypes were compared with two databases of HVS-I haplotypes from sub-Saharan Africa, and the incidence of perfect matches recorded for each sample. Results When two independent African-American samples were analyzed, more than half of the sampled HVS-I mtDNA haplotypes exactly matched common haplotypes that were shared among multiple African ethnic groups. Another 40% did not match any sequence in the database, and fewer than 10% were an exact match to a sequence from a single African ethnic group. Differences in the regional distribution of haplotypes were observed in the African database, and the African-American haplotypes were more likely to match haplotypes found in ethnic groups from West or West Central Africa than those found in eastern or southern Africa. Fewer than 14% of the African-American mtDNA sequences matched sequences from only West Africa or only West Central Africa. Conclusion Our database of sub-Saharan mtDNA sequences includes the most common haplotypes that are shared among ethnic groups from multiple regions of Africa. These common haplotypes have been found in half of all sub-Saharan Africans. More than 60% of the remaining haplotypes differ from the common haplotypes at a single nucleotide position in the HVS-I region, and they are likely to occur at varying frequencies within sub-Saharan Africa. However, the finding that 40% of the African-American mtDNAs analyzed had no match in the database indicates that only a small fraction of the total number of African haplotypes has been identified. In addition, the finding that fewer than 10% of African-American mtDNAs matched mtDNA sequences from a single African region suggests that few African Americans might be able to trace their mtDNA lineages to a particular region of Africa, and even fewer will be able to trace their mtDNA to a single ethnic group. However, no firm conclusions should be made until a much larger database is available. It is clear, however, that when identical mtDNA haplotypes are shared among many ethnic groups from different parts of Africa, it is impossible to determine which single ethnic group was the source of a particular maternal ancestor based on the mtDNA sequence.
Mhando, S; Lyamuya, S; Lakhoo, K
The aim of the present study is to report on the difficulties in developing paediatric surgery in a teaching hospital in Tanzania. The methods are as follows: (1) information on the demography and health services of Tanzania were obtained from the Ministry of Health and the 1998 consensus report; (2) hospital data was obtained from the Medical Director's Office and analysed; (3) the current delivery of surgical services for children at the Tumaini University Hospital and Kilimanjaro Christian Medical Centre (KCMC) is reported; (4) the local, national and international support for the development of surgical services for children is noted; (5) the teaching, training and research programmes are proposed. The results showed that (1) Tanzania has a population of 31 million with a total health expenditure of 10%. There is 1 doctor for 23,000 inhabitants and 1 hospital bed per 940. The infant mortality is 173 per thousand life births. (2) The bed capacity at KCMC is 500 with a staff of 40 consultants, 294 nurses, 246 health attendants and 38 clinical officers. (3) Forty-two percent of admissions to the surgical ward and 50% of surgical outpatients are children. Surgical newborns are cared for in the special care baby unit and there are no neonatal or paediatric ventilators. (4) Support to develop surgical services for children has been pledged for locally, nationally and internationally; however, delivery of the service has not had the equivalent momentum. (5) The proposed teaching and training programme has been approved by the University. There is a need for surgical services for children with encouraging support for this venture; however, the challenges remain in delivering the service. PMID:16596403
Full Text Available Accurate cropland maps at the global and local scales are crucial for scientists, government and nongovernment agencies, farmers and other stakeholders, particularly in food-insecure regions, such as Sub-Saharan Africa. In this study, we aim to qualify the crop classes of the MODIS Land Cover Product (LCP in Sub-Saharan Africa using FAO (Food and Agricultural Organisation and AGRHYMET (AGRiculture, Hydrology and METeorology statistical data of agriculture and a sample of 55 very-high-resolution images. In terms of cropland acreage and dynamics, we found that the correlation between the statistical data and MODIS LCP decreases when we localize the spatial scale (from R2 = 0.86 *** at the national scale to R2 = 0.26 *** at two levels below the national scale. In terms of the cropland spatial distribution, our findings indicate a strong relationship between the user accuracy and the fragmentation of the agricultural landscape, as measured by the MODIS LCP; the accuracy decreases as the crop fraction increases. In addition, thanks to the Pareto boundary method, we were able to isolate and quantify the part of the MODIS classification error that could be directly linked to the performance of the adopted classification algorithm. Finally, based on these results, (i a regional map of the MODIS LCP user accuracy estimates for cropland classes was produced for the entire Sub-Saharan region; this map presents a better accuracy in the western part of the region (43%70% compared to the eastern part (17%43%; (ii Theoretical user and producer accuracies for a given set of spatial resolutions were provided; the simulated future Sentinel-2 system would provide theoretical 99% user and producer accuracies given the landscape pattern of the region.
Jung, Minsoo; Lin, Leesa; Viswanath, Kasisomayajula
While several studies have examined the crucial role that parents' vaccination behaviors play in reducing disease spread and severity among children, few have evaluated the connection between parents' media use and their decision on whether or not to vaccinate their child, specifically in relation to the BCG (Bacillus Calmetter Guerin), DPT (Diptheria, Pertussis, Tetanus) polio, and measles vaccines. Media channels are a critical source of health information for parents, which is especially true in Sub-Saharan Africa, as there is often a dearth of local healthcare providers. The aim of this paper is to investigate the role that media use plays in a mothers' choice to vaccinate their infant children in sub-Saharan Africa, specifically focusing on whether media use is associated with socioeconomic status (SES) and a mothers' vaccination of their children. Cross-sectional data from the Demographic Health Surveys of 13 sub-Saharan countries (2004-2010) were pooled. A multivariate Poisson regression of 151,209 women was used to calculate adjusted relative ratios and 95% confidence intervals for the associations among SES, media use, and immunization. Education and wealth were found to be strongly and positively associated with vaccine-uptake behaviors. The effects of media use (radio and television) were found to be associated with the relationships between SES and vaccine uptake. However, it did not reduce the impact of SES on vaccination. These findings indicate that mass media may be an important tool for future efforts to reduce the health discrepancies between children from high- and low-socioeconomic backgrounds. Going forward, immunization strategies should include communication plans that will address and mitigate potential immunization disparities among parents of different SES backgrounds. PMID:25896379
In the past decades, most of the countries in sub-Saharan Africa have been affected by armed conflicts. By means of a time-series cross-sectional (TSCS) database, we attempt to measure the impact of war on a sample of 43 countries in Africa from 1950 to 2010. These conflicts, and especially civil wars, are shown to have a strong negative effect on the educational performances of the countries studied. The rate of children not attending school, as well as secondary school enrollment rates, see...
Weaver, J.N.; Landis, E.R.
Coal and peat are essentially unused and in some cases unknown in sub-Saharan Africa. However, they might comprise valuable alternative energy sources in some or all of the developing nations of the region. The 11 countries considered in this appraisal reportedly contain coal and peat. On the basis of regional geology, another five countries might also contain coal-bearing rocks. If the resource potential is adequate, coal and peat might be utilized in a variety of ways including substituting for fuelwood, generating electricity, supplying process heat for local industry and increasing agricultural productivity. -from Author
Full Text Available Open system-holistic family view of the macroeconomic sector sees collaborations and policy coordination between the monetary and fiscal subsystems fundamental and inalienable in the holistic family-macroeconomic sector. Full independence (isolation of the monetary subsystem from the fiscal subsystem is outlandish. The optimal point of independence shifts each time the system adapts to environmental factors but continues to lie between zero and full independence in the continuum of independence. This holistic view best describes the behaviour of modern macroeconomic sector in an ever increasingly globalized-digitalized economy. Sub-Saharan Africa can also inflation target by suitably embracing the prescribed monetary policy framework.
The decade leading up to the end of the last millennium saw systematic unbundling and privatisation of power utility companies in Sub-Saharan Africa. The new profit driven entrepreneurs have swiftly moved to consolidate in urban enclaves and put paid to any remote hope for future rural electrification. Consequently, rural communities have resorted to fending for themselves by adapting to off grid electrification. Most of these emerging installations are individual isolated units. This paper looks at various off gird electric system configurations in rural Kenya and suggests ways in which they could be reconfigured to be more energy efficient
Steyn Nelia P; Mchiza Zandile; Abrahams Zulfa
Abstract Background During the last century we have seen wide-reaching changes in diet, nutritional status and life expectancy. The change in diet and physical activity patterns has become known as the nutrition transition. At any given time, a country or region within a country may be at different stages within this transition. This paper examines a range of nutrition-related indicators for countries in Sub-Saharan Africa (SSA) and attempts to develop a typical model of a country in transiti...
Parker, Erin M.; Short, Susan E
The HIV/AIDS pandemic in sub-Saharan Africa has brought renewed attention to the role of grandmothers as caregivers of children. Using 2004 DHS data, we examine the relationship between co-residence with a grandmother and child schooling in Lesotho, a country with one of the highest rates of HIV infection. Results confirm the critical role grandmothers play in the event of maternal death. Maternal orphans who live with a grandmother are just as likely to be in school as children living with a...
Bodin, P.; Olin, S.; Pugh, T. A. M.; Arneth, A.
Food security can be defined as stable access to food of good nutritional quality. In Sub Saharan Africa access to food is strongly linked to local food production and the capacity to generate enough calories to sustain the local population. Therefore it is important in these regions to generate not only sufficiently high yields but also to reduce interannual variability in food production. Traditionally, climate impact simulation studies have focused on factors that underlie maximum productivity ignoring the variability in yield. By using Modern Portfolio Theory, a method stemming from economics, we here calculate optimum current and future crop selection that maintain current yield while minimizing variance, vs. maintaining variance while maximizing yield. Based on simulated yield using the LPJ-GUESS dynamic vegetation model, the results show that current cropland distribution for many crops is close to these optimum distributions. Even so, the optimizations displayed substantial potential to either increase food production and/or to decrease its variance regionally. Our approach can also be seen as a method to create future scenarios for the sown areas of crops in regions where local food production is important for food security.
Ngo, Nicole S.; Gatari, Michael; Yan, Beizhan; Chillrud, Steven N.; Bouhamam, Kheira; Kinney, Patrick L.
Few studies examine urban air pollution in sub-Saharan Africa (SSA), yet urbanization rates there are among the highest in the world. In this study, we measured 8-hr average occupational exposure levels of fine particulate matter (PM2.5), black carbon (BC), ultra violet active-particulate matter (UV-PM), and trace elements for individuals who worked along roadways in Nairobi, specifically bus drivers, garage workers, street vendors, and women who worked inside informal settlements. We found BC and re-suspended dust were important contributors to PM2.5 levels for all study populations, particularly among bus drivers, while PM2.5 exposure levels for garage workers, street vendors, and informal settlement residents were not statistically different from each other. We also found a strong signal for biomass emissions and trash burning, which is common in Nairobi's low-income areas and open-air garages. These results suggest that the large portion of urban residents in SSA who walk along roadways would benefit from air quality regulations targeting roadway emissions from diesel vehicles, dust, and trash burning. This is the first study to measure occupational exposure to urban air pollution in SSA and results imply that roadway emissions are a serious public health concern.
Full Text Available Abstract Background The DREAM Project operates within the framework of the national health systems of several sub-Saharan African countries and aims to introduce the essential components of an integrated strategy for the prevention and treatment of HIV/AIDS. The project is intended to serve as a model for a wide-ranging scale-up in the response to the epidemic. This paper aims to show DREAM's challenges and the solutions adopted. One of the solutions is the efficient management of the clinical data regarding the treatment of the patients and epidemiological analyses. Methods Specific software for the management of the patients' EMR has been created within the DREAM programme in order to deal with the challenges deriving from the context in which DREAM operates. Setting up a computer infrastructure in health centres, providing a power supply, as well as managing the data and the project resources efficiently and reliably, are some of the questions that have been analysed in this study. Results Over the years this software has proved that it is able to respond to the need for efficient management of the clinical data and organization of the health centres. Today it is used in 10 countries in sub-Saharan Africa by thousands of professionals and by now it has reached its fourth version. The medical files of over 73,000 assisted patients are managed by this software and the data collected with it have become essential for the epidemiological research that is carried out to improve the effectiveness of the therapy. Conclusion Sub-Saharan Africa is the region hardest hit by HIV and AIDS in the world. However, the resources and responses adopted so far, to confront the epidemic, have at times been rather minimalist. The DREAM project has faced the battle against the epidemic by equipping itself with qualitative standards comparable to Western ones. The experience of DREAM has revealed that it is indeed possible to guarantee levels of excellence in developing countries, also in the sphere of ICT (Information and Communication Technology, thus making the intervention even more effective and contributing to bridging the digital divide.
The Organization of African Unity (OAU), the African Development Bank (ADB) and the UN Economic Commission for Africa (ECA) have criticized African governments for not taking the problem of unchecked population growth seriously enough. "Until recently most African governments did not view rapid population growth as a matter for concern," said the OAU assistant secretary-general for political affairs, Machivenyika Mapuranga, at a seminar on 'population and development'. The OAU estimates that an annual average population increase of 3.1% far outstrips Africa's economic growth, which in 1992 was less than 1%. Mapuranga acknowledged that cutting the population increase is an uphill struggle, especially among rural communities. African agriculture is largely labor intensive, sustained by smallholders, which encourages farmers to have more children. Like other wage earners, African farmers look to support from their family when they grow old and, for that reason, the number of children also counts. But with agricultural production growing at an average annual rate of 2.5%, self-sufficiency in food remains an elusive goal. Cities in sub-Saharan Africa are growing much faster than the overall rate of population increase of 3.1% per year. Between 1980 and 1988 the region's urban population increased at the rate of 6.9% a year. Urban areas now account for nearly 30% of the sub-Saharan Africa population, currently put at 680 million. By 2025, approximately 700 million people are expected to live in urban areas. Despite migration to towns, the rural population is expected to rise more than 68%, reaching over 590 million. PMID:12287224
Mukanga, David; Tshimanga, Mufuta; Wurapa, Frederick; Binka, Fred; Serwada, David; Bazeyo, William; Pariyo, George; Wabwire-mangen, Fred; Gitta, Sheba; Chungong, Stella; Trostle, Murray; Nsubuga, Peter
In an effort to contain the frequently devastating epidemics in sub-Saharan Africa, the World Health Organization (WHO) Regional Office for Africa launched the Integrated Disease Surveillance and Response (IDSR) strategy in an effort to strengthen surveillance and response. However, 36 sub-Saharan African countries have been described as experiencing a human resource crisis by the WHO. Given this human resource situation, the challenge ...
Rees Helen V
Full Text Available Abstract Sub-Saharan Africa carries a massive dual burden of HIV and alcohol disease, and these pandemics are inextricably linked. Physiological and behavioural research indicates that alcohol independently affects decision-making concerning sex, and skills for negotiating condoms and their correct use. More than 20 studies in Africa have reported higher occurrence of HIV among people with problem drinking; a finding strongly consistent across studies and similar among women and men. Conflation of HIV and alcohol disease in these setting is not surprising given patterns of heavy-episodic drinking and that drinking contexts are often coterminous with opportunities for sexual encounters. HIV and alcohol also share common ground with sexual violence. Both perpetrators and victims of sexual violence have a high likelihood of having drunk alcohol prior to the incident, as with most forms of violence and injury in sub-Saharan Africa. Reducing alcohol harms necessitates multi-level interventions and should be considered a key component of structural interventions to alleviate the burden of HIV and sexual violence. Brief interventions for people with problem drinking (an important component of primary health care, must incorporate specific discussion of links between alcohol and unsafe sex, and consequences thereof. Interventions to reduce alcohol harm among HIV-infected persons are also an important element in positive-prevention initiatives. Most importantly, implementation of known effective interventions could alleviate a large portion of the alcohol-attributable burden of disease, including its effects on unsafe sex, unintended pregnancy and HIV transmission.
Deenanath, Evanie Devi; Iyuke, Sunny; Rumbold, Karl
Recently, interest in using bioethanol as an alternative to petroleum fuel has been escalating due to decrease in the availability of crude oil. The application of bioethanol in the motor-fuel industry can contribute to reduction in the use of fossil fuels and in turn to decreased carbon emissions and stress of the rapid decline in crude oil availability. Bioethanol production methods are numerous and vary with the types of feedstock used. Feedstocks can be cereal grains (first generation feedstock), lignocellulose (second generation feedstock), or algae (third generation feedstock) feedstocks. To date, USA and Brazil are the leading contributors to global bioethanol production. In sub-Saharan Africa, bioethanol production is stagnant. During the 1980s, bioethanol production has been successful in several countries including Zimbabwe, Malawi, and Kenya. However, because of numerous challenges such as food security, land availability, and government policies, achieving sustainability was a major hurdle. This paper examines the history and challenges of bioethanol production in sub-Saharan Africa (SSA) and demonstrates the bioethanol production potential in SSA with a focus on using bitter sorghum and cashew apple juice as unconventional feedstocks for bioethanol production. PMID:22536020
Renschler, John P.; Walters, Kelsey M.; Newton, Paul N.; Laxminarayan, Ramanan
Many antimalarials sold in sub-Saharan Africa are poor-quality (falsified, substandard, or degraded), and the burden of disease caused by this problem is inadequately quantified. In this article, we estimate the number of under-five deaths caused by ineffective treatment of malaria associated with consumption of poor-quality antimalarials in 39 sub-Saharan countries. Using Latin hypercube sampling our estimates were calculated as the product of the number of private sector antimalarials consumed by malaria-positive children in 2013; the proportion of private sector antimalarials consumed that were of poor-quality; and the case fatality rate (CFR) of under-five malaria-positive children who did not receive appropriate treatment. An estimated 122,350 (interquartile range [IQR]: 91,577154,736) under-five malaria deaths were associated with consumption of poor-quality antimalarials, representing 3.75% (IQR: 2.814.75%) of all under-five deaths in our sample of 39 countries. There is considerable uncertainty surrounding our results because of gaps in data on case fatality rates and prevalence of poor-quality antimalarials. Our analysis highlights the need for further investigation into the distribution of poor-quality antimalarials and the need for stronger surveillance and regulatory efforts to prevent the sale of poor-quality antimalarials. PMID:25897068
This paper analyses national, regional and international biofuels policies and strategies to assess whether these policies promote or undermine the development of biofuels sector in Africa. Despite having a huge comparative advantage in land, labour and good climatic conditions favourable for the growing of energy crops, few countries in Sub-Saharan Africa have included biofuels strategies in their energy or national development policies. Further results show that while developed countries commit huge financial resources for research, technology development and the provision of tax-incentives to both producers and consumers, there is little government support for promoting biofuels in Africa. Although the consequences of biofuels on food supply remain uncertain, the mandatory blending of biofuels with fossil fuels by industrialized countries will create demand for land in Africa for the growing of energy crops for biofuels. This paper urgently calls upon national governments in Sub-Saharan Africa to develop appropriate strategies and regulatory frameworks to harness the potential economic opportunities from biofuels sector development, while protecting the environment and rural communities from the adverse effects of land alienation from the mainstream agriculture towards the growing of energy crops for biofuels at the expense of traditional food crops.
Accelerating development in Sub-Saharan Africa will require massive expansion of access to electricity-currently reaching only about one third of households. This paper explores how essential economic development might be reconciled with the need to keep carbon emissions in check. We develop a geographically explicit framework and use spatial modeling and cost estimates from recent engineering studies to determine where stand-alone renewable energy generation is a cost effective alternative to centralized grid supply. Our results suggest that decentralized renewable energy will likely play an important role in expanding rural energy access. However, it will be the lowest cost option for a minority of households in Africa, even when likely cost reductions over the next 20 years are considered. Decentralized renewables are competitive mostly in remote and rural areas, while grid connected supply dominates denser areas where the majority of households reside. These findings underscore the need to decarbonize the fuel mix for centralized power generation as it expands in Africa. - Research highlights: ? Expansion of electricity access in Sub-Saharan Africa remains a development priority. ? Low carbon options are important to reduce GHG emissions growth and avoid lock-ins. ? Spatially explicit cost modeling guides choice of supply options. ? Decentralized renewables are lowest cost for a significant minority of households. ? Grid supply remains attractive, suggesupply remains attractive, suggesting focus on decarbonizing centralized supply.
Dembélé, Martial; Lefoka, Pulane
This article assumes that pedagogical renewal and teacher development are two sides of the same coin, and that the achievement of a universal primary education that is equitable and of acceptable quality in Sub-Saharan Africa will depend to a large extent on both. The need for pedagogical renewal stems from the evidence that (i) teaching is arguably the strongest school-level determinant of student achievement; (ii) teaching effect on student learning is reportedly higher in Sub-Saharan Africa than it is in high-income countries; (iii) learning achievement is considerably lower in the sub-continent's schools; and (iv) the kind of teaching that takes place in these schools confines students to a passive role and only fosters lower order skills. An overview of experiences with pedagogical renewal highlights the challenges involved in adopting open-ended instructional practices on the sub-continent. It further points to bilingual education as one of the most promising strategies. Regardless of the route taken for renewing pedagogy, the professional development of teacher educators/trainers must be considered a critical enabling condition.
Pamela Y. Collins
Full Text Available The 2010 Global Burden of Disease Study points to a changing landscape in which non-communicable diseases, such as mental, neurological, and substance use (MNS disorders, account for an increasing proportion of premature mortality and disability globally. Despite evidence of the need for care, a remarkable deficit of providers for MNS disorder service delivery persists in sub-Saharan Africa. This critical workforce can be developed from a range of non-specialist and specialist health workers who have access to evidence-based interventions, whose roles, and the associated tasks, are articulated and clearly delineated, and who are equipped to master and maintain the competencies associated with providing MNS disorder care. In 2012, the Neuroscience Forum of the Institute of Medicine convened a meeting of key stakeholders in Kampala, Uganda, to discuss a set of candidate core competencies for the delivery of mental health and neurological care, focusing specifically on depression, psychosis, epilepsy, and alcohol use disorders. This article discusses the candidate core competencies for non-specialist health workers and the complexities of implementing core competencies in low- and middle-income country settings. Sub-Saharan Africa, however, has the potential to implement novel training initiatives through university networks and through structured processes that engage ministries of health. Finally, we outline challenges associated with implementing competencies in order to sustain a workforce capable of delivering quality services for people with MNS disorders.
Chen Guanjie; Adeyemo Adebowale A; Chen Yuanxiu; Rotimi Charles
Abstract Background Africa contains the most genetically divergent group of continental populations and several studies have reported that African populations show a high degree of population stratification. In this regard, it is important to investigate the potential for population genetic structure or stratification in genetic epidemiology studies involving multiple African populations. The presences of genetic sub-structure, if not properly accounted for, have been reported to lead to spur...
Full Text Available Owing to its nutritional value, especially proteins, carbohydrates, vitamins and micronutrients, common bean (Phaseolus Vulgaris L. has been recognised as a crop that could ensure food security mostly, in Sub-Saharan Africa, where its productivity is low. Its low productivity is attributed to a milliard of constraints, of which low plant-available phosphorus (P and limited moisture in soil are among the major limiting factors. Synergistic effects of the two factors are accentuated in Sub-Saharan African region. This paper discloses the importance of the synergistic effects of plant-available P and moisture in soils on common bean production. It has been observed that studies investigating impacts of interactions of low P levels and moisture deficit conditions in soils are yet to be conducted. Identification of traits that contribute to high performance under low P availability and moisture deficit in the same genotypes remains a major research and development challenge. However, engineering new genotypes alone may not alleviate the problem of ensuring improvement of high bean yields. Root architecture and root exploration of the soil that enable the plant to access the two soil resources, traditional methods that preserve good status of organic matter in soils and moisture and soil preparation techniques are equally important. This, calls for holistic investigations that include soil plant-available P and moisture, common bean genotypes and their root systems, and agronomic measures to facilitate a comprehensive evaluation of impacts of deficiencies in soils on common bean yields. This paper explores and synthesizes existing research and development of common bean grown in soils deficient in plant-available P and moisture, aiming at designing future research to enhance common bean productivity.
Studies were performed to improve iodine deficiency control programs. Goitre rates and cassava processing practices were compared in three Central African Republic (CAR) populations. Short-cuts in cassava processing were associated with elevated urinary thiocyanate and increased goitre rates, suggesting a goitrogenic effect in one population. While improved cassava processing may be beneficial, the priority is to correct the iodine deficiency. The use of the urinary iodine/tiocyanate ratio a...
Environmental change and sustainable development present a challenge for all nations. Developed countries have to dismantle and change historic practice before progressing, whereas developing countries can move directly to new technology and new institutional frameworks. This chapter seeks to identify trends in energy supply and use that both improve sustainability and provide opportunities for commerce and industry. Worldwide experience is studied for application in sub-Saharan Africa (abbreviated as 'Africa' henceforward). Such application is central to UNIDO's programmes in energy and environment. These programmes consider both the supply and the demand sides, by the provision of energy for industry, use of renewable energy resources and improved industrial energy end-use efficiency. Key factors are de-linking intensity of energy use from economic growth and reducing environmental damage from energy supply and use The background for this chapter is 'Sustainable Energy Regulation and Policy-making for Africa', a set of 20 training-modules produced for UNIDO and REEEP (the Renewable Energy and Energy Efficiency Partnership). The modules will be used by governments, regulatory offices and industry in Africa for stimulating policy and commercial development in renewable energy and energy efficiency. Of particular relevance is the general trend to more liberalized electricity supplies, as regulated within new legislation. Within each country, institutional frameworks ca each country, institutional frameworks can be changed and improved for the benefit of both citizens and commerce alike. There is a common trend worldwide to include institutional mechanisms for the increase of renewable energy generation and the efficient use of energy within regulatory legislation, e.g. (Harrington et al., 2007). Government involvement and ministerial regulation is most common for electricity. In all countries, the introductory stages of electricity supply have been strongly influenced by national and local government action and ownership. However, once initiated, an established market economy, involving many competitive private companies, should produce electricity at less cost to the consumer and the nation, than if wholly owned and operated by government. Such improvement requires a carefully constructed legal framework, especially because there are many monopoly aspects of electricity supply. The administration and control of the legal objectives requires jurisdiction, usually by the appointment of a Regulator with a specialist and independent staff. Thus, hand-in-hand with the liberalization of energy supplies is the requirement for regulation. Since 1990, liberalization of energy supply, especially of electricity, has been introduced throughout Europe. The main actions have been at national level; consequently, individual national policies and methods dominate. Nevertheless, having an integrated European electricity grid encourages commonality throughout Europe. Associated with liberalization is the growth of private company participation and hence the need for legally enforceable regulation by a Regulator. The pattern of development in Europe is similar to many other world regions including North America. However, European electricity supply is older and the population more concentrated than in most other regions, therefore the opportunity for structured liberalization came first in Europe. Consequently, the European experience is important for formulating policy elsewhere, including Africa. However, without competition from several private companies for each contract, liberalization may well fail to deliver the improved services and reduced energy tariffs expected; chapter three considers such experience. Coincidentally with the trend to energy supply liberalization, has come the need for renewable energy supplies and increased energy efficiency. This change is promoted by several factors, including: sustainable development, new technology, reduced emissions and climate change. New technology enables improvements in the efficient g
Opinions and policies on the development of private education in Sub-Saharan Africa are changing. This book attempts to review existing literature, theories, and concepts related to recent trends in the development and financing of private education in Sub-Saharan countries. Eleven chapters address the following topics: (1) introduction; (2) a
Raji Abdulghafar Bello
Full Text Available Human immunodeficiency syndrome (HIV whose full-blown period is called acquired immunity deficiency syndrome (AIDS is today a terminal disease. While one weakens the body hormones, the other comes to claim the life with its accompanying opportunistic diseases. Several factors have been reviewed to be causing the infection and its prevalence as well as its socio-economic, scientific and cultural dimensions. The cost implication of this ailment is enormous when considered from individual, national or global perspective, especially when the cost of treatment and the cost of the disability adjusted life years (DALYs lost to incapacitation from HIV/AIDS is considered. This study has investigated the financial implications of treatment and the DALYs lost to HIV/AIDS from the perspective of sub-Saharan Africa covering thirty-five countries. Infected population of age 15-49 years were considered, being the active life year age group. Applying Morrows DALYs measurement, and Ainsworths per capita general rule method of costing HIV/AIDS, it was found that the cost of treatment of HIV/AIDS in any country depends on her economic strength on the one hand and the size of the infected population on the other, to the extent that no country spends or loses less than 3 percent of her national income on treatment and to DALYs. To any country, the financial cost of the DALYs lost to HIV/AIDS is much more than the cost of treatment per episode, mostly huge enough to develop a sector of the countrys economy. However, a single recommendation could be difficult as individual countries experience different effect, but different countries must pursue long-run anti-prevalence policies individually and as economic region or bloc.
Byass, Peter; Calvert, Clara; Miiro-Nakiyingi, Jessica; Lutalo, Tom; Michael, Denna; Crampin, Amelia; Gregson, Simon.; Takaruza, Albert; Robertson, Laura; Herbst, Kobus; Todd, Jim; Zaba, Basia
BACKGROUND: Reliable population-based data on HIV infection and AIDS mortality in sub-Saharan Africa are scanty, even though that is the region where most of the world's AIDS deaths occur. There is therefore a great need for reliable and valid public health tools for assessing AIDS mortality. OBJECTIVE: The aim of this article is to validate the InterVA-4 verbal autopsy (VA) interpretative model within African populations where HIV sero-status is recorded on a prospective basis, and examine t...
Full Text Available The United Nations Millennium Development Goals (MDGs are a series of 8 goals and 18 targets aimed at ending extreme poverty by 2015, and there are 48 quantifiable indicators for monitoring the process. Most of the MDGs are health or health-related goals. Though the MDGs might sound ambitious, it is imperative that the world, and sub-Saharan Africa in particular, wake up to the persistent and unacceptably high rates of extreme poverty that populations live in, and find lasting solutions to age-old problems. Extreme poverty is a cause and consequence of low income, food insecurity and hunger, education and gender inequities, high disease burden, environmental degradation, insecure shelter, and lack of access to safe drinking water and basic sanitation. It is also directly linked to unsound governance and inequitable distribution of public wealth. While many regions in the world will strive to attain the MDGs by 2015, most of the countries in sub-Saharan Africa, with major human development challenges associated with socio-economic disparities, will not. ZambiaÃ¢ÂÂs MDG progress reports of 2003 and 2005 show that despite laudable political commitment and some advances made towards achieving universal primary education, gender equality, improvement of child health and management of the HIV/AIDS epidemic, it is not likely that Zambia will achieve even half of the goals. ZambiaÃ¢ÂÂs systems have been weakened by high disease burden and excess mortality, natural and man-made environmental threats and some negative effects of globalization such as huge external debt, low world prices for commodities and the human resource Ã¢ÂÂbrain drainÃ¢ÂÂ, among others. Urgent action must follow political will, and some tried and tested strategies or Ã¢ÂÂquick winsÃ¢ÂÂ that have been proven to produce high positive impact in the short term, need to be rapidly embarked upon by Zambia and other countries in sub-Saharan Africa if they are to achieve the Millennium Development Goals.
Physical infrastructures are a set of interconnected structural elements whose function is to participate in attracting capital flows in order for the economy to function efficiently. They transfer capital flows that are able to ensure growth and stability. They also constitute a major challenge for growth and development. We have attempted in this paper to study the influence of physical infrastructures and financial development on foreign direct investments (FDIs) in the context of Sub-Saha...
Claudia L. McCalman
Full Text Available Understanding patients? cultural expectations could contribute to better health outcomes and decrease cultural health disparities. This qualitative pilot study objective was to explore experiences, perceptions, and expectations of males and females Angolan students as patients in America. Eighteen face-to-face interviews were conducted at a Midwestern university. Burgoon?s expectancy violation theory (1991 was the theoretical background. Results revealed as positive expectation violations an advanced technology, quality of services, medicine availability, and emphasis on preventive care. Negative expectation violations included high service costs, complicated insurance system, short medical encounters, and difficulty in building relational history with providers. The study also revealed that culturally related communication barriers as well as negative violations of expectations hinder the quality of intercultural clinical encounters and can affect health outcomes. Participants emphasized the importance of these interpersonal relations and their connection with perceptions of caregivers? professional competence. International patients/students revealed that they believe friendliness on the part of the caregiver is a signal that they are dealing with a good doctor or nurse. Intercultural competence is an important asset of caregivers who work in multicultural clinics and in college health. Practical implications emerged in international advising and clinician?s education.
Plambeck, Hauke Heinrich Friedrich
Africa: A continent is waking up. Not through aid or wealth from the exploitation of natural resources, but through a technological revolution. The access to affordable mobile telecommunication. Inspired by deregulation and pioneered by local champions who have taken a lead in what is today's fastest growing mobile market in the world. There is money to be made in these markets, attracting more and more operators from the northern hemisphere. However positive the short term impact of this ...
Novignon, Jacob; Nonvignon, Justice
The study argues that potential savings from efficiency could be effective alternative to increasing health system financing in SSA. Health system efficiency estimates were derived from the Data Envelopment Analysis and Stochastic Frontier Analysis and used to compute potential gains from efficiency. Data was sourced from the World Bank's world development indicators for 45 SSA countries in 2011. The results reveal that average potential saving in health expenditure from improved efficiency w...
Kamaldeen, Yakubu Zahrrah
The general purpose of this project is two in one; to analyze and assess gender mainstreaming and sustainable women development policies of the two main political parties in Ghana, and to evaluate the contribution of gender biased NGOs to the course of women empowerment in Ghana. This thesis, by applying the methodological techniques of qualitative content analysis and discourse analysis explores and examines the strength and weakness of the parties political manifestoes. It also explores...
Prevalences of dementia and cognitive impairment among older people in sub-Saharan Africa: a systematic review / : / Prevalence de la demence et des troubles cognitifs chez les personnes agees en Afrique sub-saharienne : une etude systematique / : / : / La prevalencia de la demencia y el deterioro cognitivo en las personas mayores en el Africa subsahariana: una revision sistematica
Angelique, Mavrodaris; John, Powell; Margaret, Thorogood.
Full Text Available Resumen Objetivo Realizar una revisión sistemática de la literatura sobre la prevalencia del deterioro cognitivo y la demencia en el África subsahariana. Métodos Se hicieron búsquedas en cinco bases de datos electrónicas a fin de hallar resúmenes pertinentes e identificar los documentos que cumpl [...] ieran con los requisitos para una revisión del texto completo. Los estudios se incluyeron cuando dos autores coincidían en que el diseño era de cohorte, de casos y controles o transversal y si presentaban los datos a nivel de población, si se limitaban a los adultos africanos negros mayores de 50 años o descritos como "personas mayores" o "ancianas", si incluían datos correspondientes a las personas que residen en el África subsahariana y si presentaban, al menos, un grado de deterioro cognitivo o resultados clínicos relevantes sobre el deterioro cognitivo. Se realizaron búsquedas de las referencias de los artículos incluidos en nuestro estudio a fin de identificar más publicaciones que cumplieran los requisitos, se arbitraron los desacuerdos sobre la inclusión en las discusiones que involucraban a todos los autores y se recogieron los datos de forma independiente por dos autores mediante un formulario desarrollado por los autores y probado en una muestra de trabajos. Resultados Se halló un total de 2320 documentos únicos y se revisó el texto completo de 87 de ellos. Se seleccionaron diecinueve documentos que incluían 11 estudios transversales, todos ellos publicados entre 1995 y 2011. Los estudios tuvieron lugar en Benin, Botswana, la República Centroafricana, el Congo y Nigeria, en los que se registraron aproximadamente 10 500 participantes. La prevalencia de la demencia varió del 0 % en Nigeria, al 10,1 % (intervalo de confianza del 95 %, IC: 8,06-11,08), también en Nigeria. La prevalencia del deterioro cognitivo varió del 6,3 % en Nigeria, al 25 % (IC del 95 %: 21,2 a 29,0) en la República Centroafricana. Conclusión La prevalencia de la demencia y el deterioro cognitivo en el África subsahariana variaron mucho, y fueron pocos los estudios publicados que se revelaron mediante la búsqueda bibliográfica. Abstract in english Objective To perform a systematic review of the literature on the prevalence of cognitive impairment and dementia in sub-Saharan Africa. Methods Five electronic databases were searched for relevant abstracts and to identify papers eligible for full-text review. A study was included if two authors [...] agreed that it had a cohort, casecontrol or cross-sectional design and reported population-level data; was limited to black African adults older than 50 years or described as elderly or old; reported data for individuals residing in sub-Saharan Africa; and reported at least one measure of cognitive impairment or clinical outcomes relevant to cognitive decline. References of papers included in our study were searched to identify additional candidate publications. Disagreements about inclusion were adjudicated during discussions involving all authors. Data were extracted independently by two authors, using a form developed by the authors and tested on a sample of papers. Findings A total of 2320 unique papers was found; the full text of 87 was reviewed. Nineteen papers featuring 11 cross-sectional studies were included; all were published during 19952011. Studies occurred in Benin, Botswana, the Central African Republic, the Congo and Nigeria and enrolled approximately 10?500 participants. The prevalence of dementia ranged from 0%, in Nigeria, to 10.1% (95% confidence interval, CI: 8.611.8), also in Nigeria. The prevalence of cognitive impairment ranged from 6.3%, in Nigeria, to 25% (95% CI: 21.229.0), in the Central African Republic. Conclusion Prevalences of dementia and cognitive impairment in sub-Saharan Africa varied widely, with few published studies revealed by the literature search.
Ngwa, Oneurine B.
In recent years, privatization has been a growing phenomenon in Sub-Saharan Africa. It is viewed as an instrument used by the public sector to reduce the role of the state in the economies while enhancing the scope of private ownership and participation of goods and services (Akram et al, 2011). Researchers have noted that the telecommunication
Omwami, Edith Mukudi; Keller, Edmond J.
Budgetary capacity that would allow for the public funding of the provision of universal access to primary education is lacking in many sub-Saharan economies. National revenues significantly lag behind the overall economic productivity measure of GDP. Analysis of data derived from UNESCO and UNDP for 2004 shows that governments in the region spend
...States (Export-Import Bank) SUMMARY: The Sub-Saharan...support the expansion of the Bank's financial commitments...Saharan Africa under the loan, guarantee, and insurance programs of the Bank. Further, the committee...the Bank's on-going business development...
...States (Export-Import Bank) SUMMARY: The Sub-Saharan...support the expansion of the Bank's financial commitments...Saharan Africa under the loan, guarantee, and insurance programs of the Bank. Further, the committee...the Bank's on-going business development...
Tadesse, T.; Haile, M.; Senay, G.; Wardlow, B.D.; Knutson, C.L.
Reducing the impact of drought and famine remains a challenge in sub-Saharan Africa despite ongoing drought relief assistance in recent decades. This is because drought and famine are primarily addressed through a crisis management approach when a disaster occurs, rather than stressing preparedness and risk management. Moreover, drought planning and food security efforts have been hampered by a lack of integrated drought monitoring tools, inadequate early warning systems (EWS), and insufficient information flow within and between levels of government in many sub-Saharan countries. The integration of existing drought monitoring tools for sub-Saharan Africa is essential for improving food security systems to reduce the impacts of drought and famine on society in this region. A proactive approach emphasizing integration requires the collective use of multiple tools, which can be used to detect trends in food availability and provide early indicators at local, national, and regional scales on the likely occurrence of food crises. In addition, improving the ability to monitor and disseminate critical drought-related information using available modern technologies (e.g., satellites, computers, and modern communication techniques) may help trigger timely and appropriate preventive responses and, ultimately, contribute to food security and sustainable development in sub-Saharan Africa. ?? 2008 United Nations.
Jasper M. Teboh
Full Text Available Remote sensors have a growing legacy for improving crop N use efficiency (NUE in several parts of the world. The technology employs crop spectral properties to determine fertilizer rates by matching crop N requirement based on midseason yield potential. Conclusions that the technology is inappropriate for Sub Saharan Africa (SSA because the farmers use little or no fertilizer, or cannot afford it, are reviewed. Opportunities and applicability using a model concept from the GreenSeeker® sensor ($4000 are presented. Because farmers in SSA inefficiently apply fertilizer through blanket recommendations, they must improve crop NUE to minimize cost. Application of this technology would enable refinement or development of N recommendation protocols for target groups of farmers based on site and delineated management field zones. With new developments of a prototype GreenSeeker®, the Optical Pocket Sensor (<$250, this technology will definitely be affordable and applicable, at least for institutional research purposes in SSA.
P, Pavelic; V, Smakhtin; G, Favreau; KG, Villholth.
Full Text Available Strategies for increasing the development and use of groundwater for agriculture over much of Sub-Saharan Africa (SSA) are urgently needed. Expansion of small-scale groundwater irrigation offers an attractive option to smallholder farmers to overcome unreliable wet-season rainfall and enhance dry-se [...] ason production. This paper presents a simple, generic groundwater-balance-based methodology that uses a set of type-curves to assist with decision making on the scope for developing sustainable groundwater irrigation supplies, and to help understand how cropping choices influence the potential areal extent of irrigation. Guidance to avoid over-exploitation of the resource is also provided. The methodology is applied to 2 sites in West Africa with contrasting climatic and subsurface conditions. At both sites the analysis reveals that there is significant potential for further groundwater development for irrigation whilst allowing provisions for other sectoral uses, including basic human needs and the environment.
This paper provides a test of the generalizability of the barriers approach (Rahat and Hazan, 2011) to the study of electoral system reform attempts. It does so by examining a set of recent attempts of electoral system change in four Sub-Saharan countries (South Africa, Lesotho, Kenya, and Zimbabwe), some of which were successful, while other were abortive. The conclusion reached is that the barriers approach is useful as a helpful framework for evaluating such reform attempts, even though it is also less convincing in some cases. Two of the barriers (actors vested interest and the superiority of the institutional status quo) appear to be more important than the other five barriers, i.e., what one would also expect from the outset.
Parker, Erin M; Short, Susan E
The HIV/AIDS pandemic in sub-Saharan Africa has brought renewed attention to the role of grandmothers as caregivers of children. Using 2004 DHS data, we examine the relationship between co-residence with a grandmother and child schooling in Lesotho, a country with one of the highest rates of HIV infection. Results confirm the critical role grandmothers play in the event of maternal death. Maternal orphans who live with a grandmother are just as likely to be in school as children living with a mother. The protective effect of living with a grandmother is also important for children whose mothers are alive but not affiliated with their households. The results of the analysis underscore the importance of attending to the simultaneous presence of mothers and grandmothers, as well as the circumstances associated with mother absence, when assessing the relationship between grandmother co-residence and child outcomes. PMID:23180901
Kluth, Michael Friederich; Pilegaard, Jess
Sub-Saharan Africa constitutes a distinct security region and hosts a high proportion of fragile and failed states presiding over territories with abundant resources but no indigenous great powers! Following offensive neorealist logic, the absence of local great powers explains the continued benign neglect of the US. External influence from European powers is nonetheless significant, albeit several BRIC countries are challenging the position of the former colonial masters. In response France and the United Kingdom (UK) have turned to European foreign and security policy integration to pool resources and promote burden sharing with other EU partners, in order to maintain power in the region. This European mobilization has kept rivals at bay but has also instigated balancing behaviour as revisionist suitors boost their conventional power projection capabilities.
Full Text Available Public health specialists and clinicians alike agree that Humanity faces a global pandemic of chronic diseases in the 21st century. In this article we discuss the implications of this pandemic on another global issue, the health workforce. Because both issues are particularly acute in Sub-Saharan Africa (SSA, we will focus on this region and use Cameroon as a case in point. We first gauge the epidemic of chronic conditions in SSA. We then discuss the implications of chronic conditions for the reshaping of health systems and the health workforce. We conclude by making a strong case for the building up and strengthening the health workforce, insisting on the crucial role of nurses, their training, and involvement in chronic disease management.
The purpose of this paper is to identify and develop potential solutions on how to facilitate the financing of bioenergy projects in Sub-Saharan Africa. We focus on four main areas that have been identified from empirical research in achieving this objective; these are: (i) financing, (ii) markets; (iii) trade and (iv) policy. The sources utilised consist of primary and secondary data compilation and analysis. Of particular relevance are the results of a market survey undertaken on funding opportunities, where the perspectives of both, project developers as well as project financiers are taken into account. Results indicate that the four areas cannot be treated autonomously, as they not only overlap but impact each other. There are a number of difficulties for biofuel ventures, not least the nature of the projects themselves, but also around the financing and political landscape of these enterprises. Common solutions which cross cut the four areas are the need to raise awareness and the skillsets, in areas including, financing opportunities, markets, policy, technical aspects among a range of stakeholders involved in biofuel ventures. There is also a necessity to create a supporting framework for the emerging carbon trading-related activities in Africa. - Highlights: ? We identify and develop potential solutions towards facilitating the financing of bioenergy projects in sub-Saharan Africa. ? We focus on four areas to achieve this objective; these are: (i) financithis objective; these are: (i) financing, (ii) markets; (iii) trade and (iv) policy. ? Common solutions which cross cut the four areas are the need to raise awareness and develop skillsets of stakeholders involved.
Full Text Available Background: In sub Saharan Africa, the cocktail of many advanced HIV-infected susceptible hosts, poor TB treatment success rates, a lack of airborne infection control, limited drug-resistance testing (DST have resulted in HIV-infected individuals being disproportionately represented in Multi drug resistant Tuberculosis (MDR-TB cases. The prevailing application of the WHO re-treatment protocol indiscriminately to all re-treatment cases sets the stage for an increase in mortality and MDR-TB nosocomial transmission. Method: A comprehensive search was performed of the Cochrane Infectious Diseases Group Specialized Register and Medline database including the bibliographies of the retrieved reference. Findings: The TB diagnosis paradigm which for decades relied on smear sputum and culture is likely to change with the advent of the point-of-care diagnostic, Xpert MTB/RIF assay. Until the new DST infrastructure is available, along with clinical trials for both, current and new approaches to retreatment TB in areas heavily affected by HIV and TB, there are cost effective administrative, environmental, and protective measures that may be immediately instituted. Conclusion: The severe lack of infection control practices in sub Saharan Africa may jeopardise the recent strides in MDR-TB management. Cost effective infection control measures must be immediately implemented, otherwise the development of further drug resistance may offset recent strides in MDR-TB management. Indiscriminate use of the WHO standardized retreatment protocol can lead to nosocomial transmission of MDR-TB by: -Precluding early diagnosis and prompt separation of patients who experienced treatment failure category and thereby more likely to have MDR-TB. -Leaving patients from the treatment failure category in health establishments on ineffective standard retreatment regimen until the DST results are known. -targeting only patients who have had prior TB therapy, new severely debilitated TB patients having primary unrecognized MDR-TB may continue spreading resistant organisms.
Schlag, Nicolai; Zuzarte, Fiona
In the developing nations of sub-Saharan Africa, providing households with modern energy services is a critical step towards development. A large majority of households in the region rely on traditional biomass fuels for cooking, which represent a significant proportion of energy used in the domestic setting. The disadvantages of these fuels are many: they are inefficient energy carriers and their heat is difficult to control; they produce dangerous emissions; and their current rate of extraction is not sustainable for forests. Transition to clean cooking fuels such as liquefied petroleum gas (LPG) or ethanol would resolve many of these issues as they do not produce dangerous particulate emissions, and are commercially viable, offering a number of socio-economic advantages over traditional options. Despite the benefits of fuel switching, clean cooking fuels are rarely used in households in sub-Saharan Africa. Their failure to attain widespread use can be attributed to a number of market barriers. One of the major issues is cost: clean cooking fuels are prohibitively expensive for many households, and the high price of compatible stoves further discourages their use. Besides the expense, many consumers are hesitant to adopt the new technology, reflecting the lack of public awareness of the relevant issues. At the same time, Africa's underdeveloped infrastructure prevents these fuels from being made available in many local marketplaces. To date, this combination of factors has largely stifled the transition to clean cooking fuels. National governments can adopt a number of strategies to address these issues. The creation of clean cooking-fuel initiatives at the national level would be an important first step, after which governments can begin to address the issues more effectively. The introduction of relevant financial instruments would help to tackle the economic barriers to clean cooking fuels, and public outreach and education could overcome socio-cultural obstacles. Through such a policy framework, national governments can play a significant role in encouraging the transition to clean cooking fuels
Although considerable achievements in the global reduction of hunger and poverty have been made, progress in Africa so far has been very limited. At present, a third of the African population faces widespread hunger and chronic malnutrition and is exposed to a constant threat of acute food crisis and famine. The most affected are rural households whose livelihood is heavily dependent on traditional rainfed agriculture. Rainfall plays a major role in determining agricultural production and hen...
Full Text Available Tuberculosis (TB today remains a global emergency affecting 9.0 million people globally. The African Region bears the highest global TB/HIV burden and over 50% of TB cases in SSA are co-infected with HIV. An estimated 1.5 million died from the TB globally in 2013. A large majority of the 360,000 HIV-positive TB cases who died were from sub-Saharan Africa. Research and development is an important pillar of the WHO post-2015 global TB strategy. Advances in development of diagnostics, drugs, host-directed therapies, and vaccines will require evaluation under field conditions through multi-centre clinical trials at different geographical locations. Thus it is critically important that these evaluations are fully supported by all African governments and the capacity, trained staff and infrastructure required to perform the research and evaluations is built and made available. This viewpoint article reviews the opportunities provided by recently launched second programme (2015-2024 of the European & Developing Countries Clinical Trials Partnership (EDCTP2 for tackling the TB epidemic in Africa through its magnanimous portfolio. The unique opportunities provided by EDCTP2 for leadership of scientific research in TB and other diseases fully devolving to Africa are also covered.
Kefi, Rym; Hsouna, Sana; Ben Halim, Nizar; Lasram, Khaled; Romdhane, Lilia; Messai, Habib; Abdelhak, Sonia
Tunisia is located at the crossroads of Europe, the Middle East and Sub-Saharan Africa. This position might lead to numerous waves of migrations, contributing to the current genetic landscape of Tunisians. In this study, we analyzed 815 mitochondrial DNA (mtDNA) sequences from Tunisia in order to characterize the mitochondrial DNA genetic structure of this region, to construct the processes for its composition and to compare it to other Mediterranean populations. To that end, additional 4206 mtDNA sequences were compiled from previous studies performed in African (1237), Near Eastern (231) and European (2738) populations. Both phylogenetic and statistical analyses were performed. This study confirmed the mosaic genetic structure of the Tunisian population with the predominance of the Eurasian lineages, followed by the Sub-Saharan and North African lineages. Among Tunisians, the highest haplogroup and haplotype diversity were observed in particular in the Capital Tunis. No significant differentiation was observed between both geographical (Northern versus Southern Tunisia) and different ethnic groups in Tunisia. Our results highlight the presence of outliers and most frequent unique sequences in Tunisia (10.2%) compared to 45 Mediterranean populations. Phylogenetic analysis showed that the majority of Tunisian localities were closer to North Africans and Near Eastern populations than to Europeans. The exception was found for Berbers from Jerba which are clustered with Sardinians and Valencians. PMID:24491098
Deployment of community health workers across rural sub-Saharan Africa: financial considerations and operational assumptions / Déploiement des agents de santé communautaires en Afrique rurale subsaharienne: considérations financières et hypothèses opérationnelles / Despliegue de trabajadores comunitarios de la salud en zonas rurales del África subsahariana: consideraciones financieras y supuestos operativos
Gordon C, McCord; Anne, Liu; Prabhjot, Singh.
Full Text Available OBJETIVO: Facilitar asesoramiento sobre los costes necesarios para desarrollar un sistema de trabajadores comunitarios de la salud (TCS) con capacidad para adaptarse a ámbitos locales y con flexibilidad a nivel nacional, en el marco de los sistemas sanitarios de atención primaria en el África subsah [...] ariana. MÉTODOS: Se estimaron los gastos anuales para la capacitación, el equipamiento y el despliegue de los trabajadores comunitarios de la salud en las zonas rurales del África subsahariana mediante el análisis de datos procedentes de la literatura, así como del Proyecto Aldeas del Milenio. Los supuestos del modelo son adecuados para permitir a los gobiernos nacionales adaptar el subsistema de los trabajadores comunitarios de la salud a las necesidades nacionales, así como para realizar un despliegue medio de un trabajador comunitario de la salud por cada 650 habitantes en las zonas rurales antes de 2015. El subsistema de trabajadores comunitarios de la salud descrito se calculó mediante el análisis de datos del sistema de información geográfica (GIS, por sus siglas en inglés) sobre la población, los territorios urbanos, la incidencia de enfermedades a nivel nacional y subnacional, así como los costes unitarios (en el campo de salarios y necesidades básicas). El modelo puede configurarse y reproducirse con facilidad. Los países pueden adaptarlo a los precios, los salarios, la densidad demográfica, así como a la carga de enfermedades locales en distintas áreas geográficas. RESULTADOS: Se estima que el coste medio anual por el despliegue de trabajadores comunitarios de la salud para prestar atención a toda la población de las zonas rurales del África subsahariana antes de 2015 sería de unos 2,6 billones (es decir, 2 600 millones) de dólares estadounidenses (US$). Dicha suma, que será cubierta tanto por los gobiernos nacionales como por los socios donantes, se traduce en US$ 6,86 anuales por habitante, cubierta por el subsistema de trabajadores comunitarios de la salud, y en US$ 2,72 anuales por habitante. Asimismo, la capacitación, el equipamiento y el apoyo a cada TCS supondría una media anual de US$ 3750. CONCLUSIÓN: Se pueden desplegar subsistemas integrales de trabajadores comunitarios de la salud en todo el África subsahariana por un coste modesto, si se compara con los costes previstos para un sistema de atención sanitaria primaria. A juzgar por los éxitos documentados, estos ofrecen un sólido complemento para la atención en servicios sanitarios en entornos rurales de África. Abstract in english OBJECTIVE: To provide cost guidance for developing a locally adaptable and nationally scalable community health worker (CHW) system within primary-health-care systems in sub-Saharan Africa. METHODS: The yearly costs of training, equipping and deploying CHWs throughout rural sub-Saharan Africa were c [...] alculated using data from the literature and from the Millennium Villages Project. Model assumptions were such as to allow national governments to adapt the CHW subsystem to national needs and to deploy an average of 1 CHW per 650 rural inhabitants by 2015. The CHW subsystem described was costed by employing geographic information system (GIS) data on population, urban extents, national and subnational disease prevalence, and unit costs (from the field for wages and commodities). The model is easily replicable and configurable. Countries can adapt it to local prices, wages, population density and disease burdens in different geographic areas. FINDINGS: The average annual cost of deploying CHWs to service the entire sub-Saharan African rural population by 2015 would be approximately 2.6 billion (i.e. 2600 million) United States dollars (US$). This sum, to be covered both by national governments and by donor partners, translates into US$ 6.86 per year per inhabitant covered by the CHW subsystem and into US$ 2.72 per year per inhabitant. Alternatively, it would take an annual average of US$ 3750 to train, equip and support each CHW. CONCLUSION: Comprehensive CHW subsy
C, Steffen; F, Debellut; BD, Gessner; FC, Kasolo; AA, Yahaya; N, Ayebazibwe; O, Bassong; Y, Cardoso; S, Kebede; S, Manoncourt; KA, Vandemaele; AW, Mounts.
Full Text Available SITUACIÓN: Existe poca información sobre la carga de morbilidad de la gripe en el África subsahariana. La vigilancia rutinaria de la gripe es clave para poder entender mejor el impacto de las infecciones respiratorias agudas en las poblaciones del África subsahariana. ENFOQUE: Se inició un proyecto [...] conocido como SISA, Strengtheninginfluenza sentinel surveillance in Africa, (Refuerzo de la vigilancia centinela de la gripe en África) en Angola, Camerún, Ghana, Nigeria, Ruanda, Senegal, Sierra Leona y Zambia para ayudar a mejorar la vigilancia centinela de la gripe, incluida la recopilación de datos epidemiológicos y virológicos, y para desarrollar mecanismos de información rutinarios a nivel nacional, regional e internacional. Estos países recibieron asistencia técnica por medio de supervisión remota y visitas directas. Los consultores trabajaron estrechamente con los ministerios de sanidad, la Organización Mundial de la Salud, los laboratorios nacionales de gripe y otros interesados relacionados con la vigilancia de la gripe. MARCO REGIONAL: Los sistemas de vigilancia de la gripe en los países objetivo se encontraban en diferentes fases de desarrollo cuando se implementó el proyecto SISA. Por ejemplo, en Senegal se había llevado a cabo la vigilancia virológica durante años, mientras que en Sierra Leona no se había realizado ninguna actividad de vigilancia. CAMBIOS IMPORTANTES: Se desarrollaron o actualizaron los documentos de trabajo, como protocolos y procedimientos de vigilancia nacional, y se organizaron cursos para el personal centinela in situ y para los administradores de datos. LECCIONES APRENDIDAS: La asistencia específica para los países puede ayudar a los mismos a reforzar la vigilancia de la gripe a nivel nacional, pero solo se puede conseguir una sostenibilidad a largo plazo con financiación externa y con un fuerte liderazgo gubernamental nacional. Abstract in english PROBLEM: Little is known about the burden of influenza in sub-Saharan Africa. Routine influenza surveillance is key to getting a better understanding of the impact of acute respiratory infections on sub-Saharan African populations. APPROACH: A project known as Strengthening Influenza Sentinel Survei [...] llance in Africa (SISA) was launched in Angola, Cameroon, Ghana, Nigeria, Rwanda, Senegal, Sierra Leone and Zambia to help improve influenza sentinel surveillance, including both epidemiological and virological data collection, and to develop routine national, regional and international reporting mechanisms. These countries received technical support through remote supervision and onsite visits. Consultants worked closely with health ministries, the World Health Organization, national influenza laboratories and other stakeholders involved in influenza surveillance LOCAL SETTING: Influenza surveillance systems in the target countries were in different stages of development when SISA was launched. Senegal, for instance, had conducted virological surveillance for years, whereas Sierra Leone had no surveillance activity at all. RELEVANT CHANGES: Working documents such as national surveillance protocols and procedures were developed or updated and training for sentinel site staff and data managers was organized. LESSONS LEARNT: Targeted support to countries can help them strengthen national influenza surveillance, but long-term sustainability can only be achieved with external funding and strong national government leadership.
Diap, Graciela; Amuasi, John; Boakye, Isaac; Sevcsik, Ann-Marie; Pecoul, Bernard
At a recent meeting (Sept 18, 2009) in which reasons for the limited access to artemisinin-based combination therapy (ACT) in sub-Saharan Africa were discussed, policy and market surveys on anti-malarial drug availability and accessibility in Burundi and Sierra Leone were presented in a highly interactive brainstorming session among key stakeholders across private, public, and not-for-profit sectors. The surveys, the conduct of which directly involved the national malaria control programme managers of the two countries, provides the groundwork for evidence-based policy implementation. The results of the surveys could be extrapolated to other countries with similar socio-demographic and malaria profiles. The meeting resulted in recommendations on key actions to be taken at the global, national, and community level for better ACT accessibility. At the global level, both public and private sectors have actions to take to strengthen policies that lead to the replacement of loose blister packs with fixed-dose ACT products, develop strategies to ban inappropriate anti-malarials and regulate those bans, and facilitate technology and knowledge transfer to scale up production of fixed-dose ACT products, which should be readily available and affordable to those patients who are in the greatest need of these medicines. At the national level, policies that regulate the anti-malarial medicines market should be enacted and enforced. The public sector, including funding donors, should participate in ensuring that the private sector is engaged in the ACT implementation process. Research similar to the surveys discussed is important for other countries to develop and evaluate the right incentives at a local level. At the community level, community outreach and education about appropriate preventive and treatment measures must continue and be strengthened, with service delivery systems developed within both public and private sectors, among other measures, to decrease access to ineffective and inappropriate anti-malarial medicines. What was clear during the meeting is that continuing commitment, strengthened interaction and transparency among various stakeholders, with focus on communities, national governments, and evidence-based policy and action are the only way to sustainably address the control of malaria, a disease which continues to have a significant health and socio-economic impact worldwide, particularly in sub-Saharan Africa. Details on the methodology employed in carrying out the studies discussed at this meeting, as well as more detailed results, data analysis and discussion of the studies are soon to be published. PMID:20423536
Gwenzi, Willis; Chaukura, Nhamo; Mukome, Fungai N D; Machado, Stephen; Nyamasoka, Blessing
Sub-Saharan Africa (SSA) experiences soil degradation, food and livelihood insecurity, environmental pollution and lack of access to energy. Biochar has gained international research attention, but few studies have investigated the potential of biochar to address the challenges in SSA. This paper seeks to identify and evaluate generic potential opportunities and constraints associated with biochar application in sub-Saharan Africa using Zimbabwe as case study. Specific objectives were to; (1) identify and quantify feedstocks for biochar production; (2) review literature on the biochar properties, and evaluate its potential applications in agriculture, environmental remediation and energy provision, and (3) identify research gaps, risks and constraints associated with biochar technology. Biochar feedstocks in Zimbabwe were estimated to be 9.9 Mton yr(-1), predominantly derived from manure (88%) and firewood (10%). This will yield 3.5, 1.7 and 3.1 Mton yr(-1) of biochar, bio-oil and synthetic gas, respectively. Land application of the 3.5 Mton yr(-1) of biochar (?63% C) would sequester approximately 2.2 Mton yr(-1) of soil carbon in Zimbabwe alone, while simultaneously minimizing the environmental and public health risks, and greenhouse gas emissions associated with solid organic wastes. Biochar potentially enhances soil and crop productivity through enhanced nutrient and soil moisture availability, amelioration of acidic soils and stimulation of microbial diversity and activity. Due to its excellent adsorption properties, biochar has potential applications in industrial and environmental applications including water and wastewater treatment, remediation and revegetation of contaminated soils and water. Biochar products have energy values comparable or higher than those of traditional biomass fuels; thereby making them ideal alternative sources of energy especially for poor households without access to electricity. Before the benefits of biochar can be realized in SSA, there is need to overcome multiple risks and constraints such as lack of finance, socio-economic constraints including negative perceptions and attitudes among both researchers and consumers, and environmental and public health risks. Therefore, there is need to conduct fundamental research to demonstrate the benefits of biochar applications, and develop policy framework and criteria for its production and subsequent adoption. PMID:25521347
Full Text Available Abstract At a recent meeting (Sept 18, 2009 in which reasons for the limited access to artemisinin-based combination therapy (ACT in sub-Saharan Africa were discussed, policy and market surveys on anti-malarial drug availability and accessibility in Burundi and Sierra Leone were presented in a highly interactive brainstorming session among key stakeholders across private, public, and not-for-profit sectors. The surveys, the conduct of which directly involved the national malaria control programme managers of the two countries, provides the groundwork for evidence-based policy implementation. The results of the surveys could be extrapolated to other countries with similar socio-demographic and malaria profiles. The meeting resulted in recommendations on key actions to be taken at the global, national, and community level for better ACT accessibility. At the global level, both public and private sectors have actions to take to strengthen policies that lead to the replacement of loose blister packs with fixed-dose ACT products, develop strategies to ban inappropriate anti-malarials and regulate those bans, and facilitate technology and knowledge transfer to scale up production of fixed-dose ACT products, which should be readily available and affordable to those patients who are in the greatest need of these medicines. At the national level, policies that regulate the anti-malarial medicines market should be enacted and enforced. The public sector, including funding donors, should participate in ensuring that the private sector is engaged in the ACT implementation process. Research similar to the surveys discussed is important for other countries to develop and evaluate the right incentives at a local level. At the community level, community outreach and education about appropriate preventive and treatment measures must continue and be strengthened, with service delivery systems developed within both public and private sectors, among other measures, to decrease access to ineffective and inappropriate anti-malarial medicines. What was clear during the meeting is that continuing commitment, strengthened interaction and transparency among various stakeholders, with focus on communities, national governments, and evidence-based policy and action are the only way to sustainably address the control of malaria, a disease which continues to have a significant health and socio-economic impact worldwide, particularly in sub-Saharan Africa. Details on the methodology employed in carrying out the studies discussed at this meeting, as well as more detailed results, data analysis and discussion of the studies are soon to be published.
Villholth, Karen G.; Ganeshamoorthy, Jegan
A simple but comprehensive framework for analysing the potential for and constraints to groundwater development for irrigated agriculture in sub-Saharan Africa is proposed. The framework, based on food value chain principles, is applied to the sub-Saharan context and a specific catchment in Tanzania, the Usangu plains, where groundwater has been proposed as a strategic resource for augmenting food production and smallholder livelihoods and to alleviate seasonal water scarcity. The novel contribution of the work is the presentation of a tool that can be applied to support an interdisciplinary approach to systematically identify most significant barriers and most critical water management and development interventions for sustainable development of groundwater irrigation. The result of the case study shows that farmer economics, capacity, and pump and well drilling market constraints limit groundwater irrigation in the Usangu plains rather than hydrogeological conditions.
Geoff, Harris; Claire, Vermaak.
Full Text Available This article examines whether the close association of income inequality and violence identified for high income countries applies also to sub-Saharan Africa and, in particular, to South Africa. Cross sectional analysis across sub-Saharan countries provided no evidence of such an association. Howeve [...] r, using homicide rates and several measures of inequality across South Africa's 52 districts does provide evidence of a significant positive relationship between homicide rates and expenditure inequality. A one per cent increase in inequality is associated with an increase in the homicide rate of 2.3 to 2.5 per cent. This relationship remains significant after controlling for other characteristics of the district.
Fatusi, Adesegun; Blum, Robert W
Adolescent Health in an International Context: The Challenge of Sexual and Reproductive Health in Sub-Saharan Africa Adesegun Fatusi, Robert W. Blum Today's young people are growing up in a world that is rapidly changing and vastly different from that of previous generations. The health challenges confronting them are also significantly different and vary greatly around the world. This article presents an overview of the health of young people in an international context and highlights the factors that have shaped the lives of young people in recent times. It draws attention to the patterns and variations in the major causes of mortality and morbidity. A special focus is given to sub-Saharan Africa, where HIV/AIDS and reproductive health challenges are the greatest. PMID:20653206
Dzik, Walter H
Severe anemia in children is a leading indication for blood transfusion worldwide. Severe anemia, defined by the World Health Organization as a hemoglobin level?<5 g/dL, is particularly common throughout sub-Saharan Africa. Analysis of data from the Fluid Expansion as Supportive Therapy (FEAST) trial offers new insights into the importance of blood transfusion for children with severe anemia. The principal findings of this analysis include the observations that life-threatening anemia in children is a frequent presenting condition in East Africa; that delays in transfusion therapy are lethal; and that inadequate transfusion is probably more common than currently recognized. The findings of this new study highlight the need for changes in blood inventory management in sub-Saharan hospitals and the need for more research on transfusion therapy for children in peril. PMID:25640864
Baumgärtner Johann; Bieri Markus; Buffoni Giuseppe; Gilioli Gianni; Gopalan Hiremagalur; Greiling Jürgen; Tikubet Getachew; Van Schayk Ingeborg
A concept of an ecosystem approach to human health improvement in Sub-Saharan Africa is presented here. Three factors mainly affect the physical condition of the human body: the abiotic environment, vector-transmitted diseases, and natural resources. Our concept relies on ecological principles embedded in a social context and identifies three sets of subsystems for study and management: human disease subsystems, natural resource subsystems, and decision-support subsystems. To control human di...
Full Text Available With the proposal to search for universal cooperation in the field of Medicinal Chemistry, the IUPAC group has elaborated a line of work divided into two phases: a- An Awareness of the true situation of Medicinal Chemistry in the different geographic areas of the world; b- A proposal of actions as to achieve more effective cooperation. This first report presents and discusses the actual situation in South and Central America as well as in sub-Saharan Africa.
Full Text Available With the proposal to search for universal cooperation in the field of Medicinal Chemistry, the IUPAC group has elaborated a line of work divided into two phases: a- An Awareness of the true situation of Medicinal Chemistry in the different geographic areas of the world; b- A proposal of actions as t [...] o achieve more effective cooperation. This first report presents and discusses the actual situation in South and Central America as well as in sub-Saharan Africa.
Economists have a long argue that institutions and implementation of good governance are important for economic growth. The main objective of this research is to demonstrate that one of positive institutions effects is its ability to mitigate the negative effect of economic vulnerability linked to terms of trade fluctuations on economic growth. The impact of the economic vulnerability and implementation of good governance are estimated for a panel of 15 Sub-Saharan-Africa countries over the p...
Ngo, Nicole S.; Gatari, Michael; Yan, Beizhan; CHILLRUD, STEVEN N.; Bouhamam, Kheira; Kinneym, Patrick L.
Few studies examine urban air pollution in sub-Saharan Africa (SSA), yet urbanization rates there are among the highest in the world. In this study, we measured 8-hr average occupational exposure levels of fine particulate matter (PM2.5), black carbon (BC), ultra violet active-particulate matter (UV-PM), and trace elements for individuals who worked along roadways in Nairobi, specifically bus drivers, garage workers, street vendors, and women who worked inside informal settlements. We found B...
Frey, Leo; Volz, Ulrich
This paper examines the effects of political agreements on regional financial integration (RFI) on financial market development and access to and cost of finance in Sub-Saharan Africa. Our results suggest that RFI positively affects financial development - measured very broadly as the size of the financial sector, including the liabilities of the central banks - when combined with a sufficient level of institutional quality. If institutional quality is below a threshold level, RFI apparently ...
Elst, H. J.
Despite isolated progress there seems to be no clear-cut guideline or solution to the collective eradication of extreme poverty in sub-Saharan Africa. In an attempt to overcome the above reality, the objective of the Millennium Development Goals (MDGs) is short term poverty relief to the poorest of the poor by 2015. This is to be achieved through the realisation of eight pro-poor objectives. Since 2000 there has been notable progress. Developmental organisations such as the Wor...
Ben Jebli, Mehdi; Ben Youssef, Slim; Ozturk, Ilhan
Based on the Environmental Kuznets Curve (EKC) hypothesis, this paper uses panel cointegration techniques to investigate the short and the long-run relationship between CO2 emissions, economic growth, renewable energy consumption and trade openness for a panel of 24 Sub-Saharan Africa countries over the period 1980-2010. The validity of the EKC hypothesis has not been supported for these countries. Short-run Granger causality results reveal that there is a bidirectional causality between emis...
Nsubuga, Peter; Johnson, Kenneth; Tetteh, Christopher; Oundo, Joseph; Weathers, Andrew; Vaughan, James; Elbon, Suzanne; Tshimanga, Mufuta; Ndugulile, Faustine; Ohuabunwo, Chima; Evering-Watley, Michele; Mosha, Fausta; Oleribe, Obinna; Nguku, Patrick; Davis, Lora
As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these ...
Ndebele, Paul; Wassenaar, Douglas; Benatar, Solomon; Fleischer, Theodore; Kruger, Mariana; Adebamowo, Clement; Kass, Nancy; Hyder, Adnan A.; Meslin, Eric M.
The last fifteen years have witnessed a significant increase in investment in research ethics capacity development throughout the world. We examine nine research ethics training programs that are focused on Sub-Saharan Africa and supported by the US National Institutes of Health. We collected data from grants awards documents and annual reports supplemented by questionnaires completed by the training program directors. Together, these programs provided long-term training in research ethics...
Agricultural research management in the public sector in Sub Saharan Africa suffers from a lack of relevant, timely and accurate information on which to base decision-making. Developments in Management information systems over the past several years have been dramatic and can offer research managers in developing countries a great deal of help in the orderly capture, processing and presentation of information for decision-making. This thesis describes case study research on institutionalizati...
Olesen, Tina Bech; Munk, Christian
BACKGROUND: We performed a systematic review and meta-analysis to summarise the available data on the prevalence of human papillomavirus (HPV) among men in sub-Saharan Africa. METHODS: PubMed and Embase were searched up to 10 March 2014. Random effects meta-analyses were used to calculate a pooled prevalence of any HPV and high-risk (HR) HPV. RESULTS: A total of 11 studies comprising 9342 men were identified. We found that HPV is very common among men in sub-Saharan Africa, the prevalence of any HPV ranging between 19.1% and 100%. Using random effects meta-analysis, the pooled prevalence of any HPV was 78.2% (95% CI 54.2 to 91.6) among HIV-positive and 49.4% (95% CI 30.4 to 68.6) among HIV-negative men (p=0.0632). When restricting the analyses to PCR-based studies, the pooled prevalence of any HPV was 84.5% (95% CI 74.2 to 91.2) among HIV-positive and 56.4% (95% CI 49.7 to 62.9) among HIV-negative men (p<0.0001). Of the HPV types included in the nine-valent HPV vaccine, the most common HR HPV types were HPV16 and HPV52, and HPV6 was the most common low-risk HPV type. When examining the prevalence of HPV in relation to age no clear trend was observed. CONCLUSIONS: The prevalence of HPV is high among men in sub-Saharan Africa, which could contribute to the high rates of penile and cervical cancer in this part of the world. Implementation of the prophylactic HPV vaccines could potentially help prevent this large burden of HPV and HPV-associated disease in sub-Saharan Africa. CLINICALTRIALS.GOV IDENTIFIER: NCT00932009.
The delivery of HIV counseling and testing programs throughout Sub-Saharan Africa relies on the work performed by trained HIV counselors. These individuals occupy a critical position: they are intermediaries between the rule-making of international and national policymakers, and the norms of the communities in which they live and work. This paper explains when, how and why HIV counselors adapt Western testing guidelines (the 3Cs- consent, confidentiality and counseling) to local concerns, a...
Akpan, E. E.; Ekpenyong, C. E.
The growing trend of obesity worldwide and in sub-Saharan Africa can be linked to theurbanization drift experienced in recent years both in developed and developing countrieslike Nigeria, at four pivotal points namely: physical activity level, socio-economic status(SES), nutritional and psychosocial factors. Literature search was done usingMedline/PubMed and Google Scholar for published studies on the urbanization rate, andthe prevalence of overweight and obesity in Nigeria. The socio-demogra...
Robbins John B.; Schneerson Rachel; Gotschlich Emil C.; Mohammed Idris; Nasidi Abdulsalami; Chippaux Jean-Philippe; Bernardino Luis; Maiga Moussa A.
Endemic and epidemic group A meningococcal meningitis remains a major cause of morbidity and mortality in sub-Saharan Africa, despite the availability of the safe and inexpensive group A meningococcal polysaccharide vaccine, which is protective at all ages when administered as directed. Despite optimal therapy, meningococcal meningitis has a 10% fatality rate and at least 15% central nervous system damage. WHO's policy of epidemic containment prevents, at best, about 50% of cases and ignores ...
Land clearing and forest sector residues, notably the wastewood generated on large timber plantations, can provide a sizeable and hitherto neglected source of woodfuel. This article highlights experience in Malawi where wastewood from pine plantations is converted into charcoal that is sold to residential, industrial and agro-industrial users. Similar initiatives proposed in other countries of sub-Saharan Africa indicate that comprehensive utilization of wastewood resources could help to reduce regional and local imbalances. (author). 19 refs
Seale, AC; Mwaniki, M; Newton, CR; Berkley, JA
Maternal and child health are high priorities for international development. Through a Review of published work, we show substantial gaps in current knowledge on incidence (cases per live births), aetiology, and risk factors for both maternal and early onset neonatal bacterial sepsis in sub-Saharan Africa. Although existing published data suggest that sepsis causes about 10% of all maternal deaths and 26% of neonatal deaths, these are likely to be considerable underestimates because of method...
Moosa, S.; Wojczewski, S.; Hoffmann, K.; Poppe, A.; Nkomazana, O.; Peersman, W.; Willcox, M.; Derese, A.; Mant, D.
BACKGROUND: Many low-income and middle-income countries globally are now pursuing ambitious plans for universal primary care, but are failing to deliver adequate care quality because of intractable human resource problems. AIM: To understand why migrant nurses and doctors from sub-Saharan Africa did not wish to take up available posts in primary and first-contact care in their home countries. DESIGN AND SETTING: Qualitative study of migrant health workers to Europe (UK, Belgium, and Austria) ...
Racovita, Monica; Obonyo, Dennis Ndolo; Abdallah, Roshan; Anguzu, Robert; Bamwenda, Gratian; Kiggundu, Andrew; Maganga, Harrison; Muchiri, Nancy; Nzeduru, Chinyere; Otadoh, Jane; Rumjaun, Anwar; Suleiman, Iro; Sunil, Manjusha; Tepfer, Mark; Timpo, Samuel; van der Walt, Wynand; Kaboré-Zoungrana, Chantal; Nfor, Lilian; Craig, Wendy
In tackling agricultural challenges, policy-makers in sub-Saharan Africa (SSA) have increasingly considered genetically modified (GM) crops as a potential tool to increase productivity and to improve product quality. Yet, as elsewhere in the world, the adoption of GM crops in SSA has been marked by controversy, encompassing not only the potential risks to animal and human health, and to the environment, but also other concerns such as ethical issues, public participation in decision-making, socio-economic factors and intellectual property rights. With these non-scientific factors complicating an already controversial situation, disseminating credible information to the public as well as facilitating stakeholder input into decision-making is essential. In SSA, there are various and innovative risk communication approaches and strategies being developed, yet a comprehensive analysis of such data is missing. This gap is addressed by giving an overview of current strategies, identifying similarities and differences between various country and institutional approaches and promoting a way forward, building on a recent workshop with risk communicators working in SSA. PMID:23090016
Mitchard, Edward T A; Flintrop, Clara M
We review the literature and find 16 studies from across Africa's savannas and woodlands where woody encroachment dominates. These small-scale studies are supplemented by an analysis of long-term continent-wide satellite data, specifically the Normalized Difference Vegetation Index (NDVI) time series from the Global Inventory Modeling and Mapping Studies (GIMMS) dataset. Using dry-season data to separate the tree and grass signals, we find 4.0% of non-rainforest woody vegetation in sub-Saharan Africa (excluding West Africa) significantly increased in NDVI from 1982 to 2006, whereas 3.52% decreased. The increases in NDVI were found predominantly to the north of the Congo Basin, with decreases concentrated in the Miombo woodland belt. We hypothesize that areas of increasing dry-season NDVI are undergoing woody encroachment, but the coarse resolution of the study and uncertain relationship between NDVI and woody cover mean that the results should be interpreted with caution; certainly, these results do not contradict studies finding widespread deforestation throughout the continent. However, woody encroachment could be widespread, and warrants further investigation as it has important consequences for the global carbon cycle and land-climate interactions. PMID:23878342
Davidson, O.; Halsnæs, K.
This paper explores an alternative approach to future climate policies in developing countries. Although climate change seems marginal compared to the pressing issues of poverty alleviation and economic development, it is becoming clear that the realisation of development goals may be hampered by climate change. However, development can be shaped in such a way as to achieve its goals and at the same time reduce vulnerability to climate change, thereby facilitating sustainable development that realises economic, social, local and global environmental goals. This approach has been coined the 'development first approach', in which a future climate regime should focus on development strategies with ancillary climate benefits and increase the capability of developing countries to implement these. This is anticipated to offer a possible positive way out of the current deadlock between North and South in the climate negotiations. First, elements are presented for an integrated approach to development and climate; second, the approach is elaborated for food and energy security in sub-Saharan Africa; and third, possibilities are outlined for international mechanisms to support such integrated development and climate strategies. (C) 2003 Elsevier Ltd. All rights reserved.
This paper explores an alternative approach to future climate policies in developing countries. Although climate change seems marginal compared to the pressing issues of poverty alleviation and economic development, it is becoming clear that the realisation of development goals may be hampered by climate change. However, development can be shaped in such a way as to achieve its goals and at the same time reduce vulnerability to climate change, thereby facilitating sustainable development that realises economic, social, local and global environmental goals. This approach has been coined the 'development first approach', in which a future climate regime should focus on development strategies with ancillary climate benefits and increase the capability of developing countries to implement these. This is anticipated to offer a possible positive way out of the current deadlock between North and South in the climate negotiations. First, elements are presented for an integrated approach to development and climate; second, the approach is elaborated for food and energy security in sub-Saharan Africa; and third, possibilities are outlined for international mechanisms to support such integrated development and climate strategies
Full Text Available In the Sub-Saharan Africa, drying remains one of the modes of food preservation used and the most important issue which is ensuring food self-sufficiency is not always guaranteed. In the process of drying the main variables to be measured are the masses, temperatures, air velocities, and the heating power and the quantities of water to be removed from the product. These values require good control for achieving a good dryer [1, 2].This work helps in providing answers to the following specific questions: what dryer (type, size, and power is to be used? What are the optimal conditions (wind speed, temperature, humidity, water body to remove ... of its operations? The use of sensors (manipulation, reading? What is the drying time? The answer to all these questions is the basis of a possible development of research on the case study «drying of Local products" . Our contribution is to optimize the drying conditions of the product by varying the speed of the air which should have a good ability to absorb water vapor released by the product of a function of variation of heating power. This variation in air speed achieved in our experiment stand is based on the variation of the supply voltage of the fan. This device guides the choice of blowing speed and optimum power to be used for drying a product knowledge temperature drying of a product.
There is a more and more emerging consensus claiming universal access to health care in order to achieve the desired Millennium Development Goals related to health in Africa. Unfortunately, the debate of the universal coverage has focussed so far mainly on financial affordability, while it is also a human resource matter. Many countries in sub-Saharan Africa are experiencing severe shortages of skilled health care workers. There are several causes, the importance of which varies by country, but one of the most significant factors is brain drain. In those countries, scarcity of doctors increases the distance between a doctor and patients, and bridging that increased distance implies costs, both time and money. Adequate number of qualified health personnel is then vital to increase coverage and improve the quality of care. In as much as access to health services is also determined by access to qualified health workers, any reflection on the universal health coverage has to also consider the inequities in qualified health personnel distribution throughout the world. PMID:22384301
Lema, V M
Lack of access to quality reproductive health services is the main contributor to the high maternal mortality and morbidity in sub-Saharan Africa (SSA). This is partly due to a shortage of qualified and experienced health care providers. However conscientious objection amongst the available few is a hitherto undocumented potential factor influencing access to health care in SSA. Provision of certain reproductive health services goes counter to some individual's religious and moral beliefs and practices. Health providers sometimes refuse to participate in or provide such services to clients/patients on moral and/or religious grounds. While the rights to do so are protected by the principles of freedom of religion, among other documents, their refusal exposes clients/patients to the risk of reproductive health morbidity as well as mortality. Such providers are required to refer the clients/patients to other equally qualified and experienced providers who do not hold similar conscientious objection. Access to high quality and evidence-based reproductive health services by all in need is critical to attaining MDG5. In addressing factors contributing to delay in attaining MDG5 in SSA it is instructive to consider the role of conscientious objection in influencing access to quality reproductive health care services and strategies to address it. PMID:22783664
Randy Trinity Nijkamp
Full Text Available This study was conducted to evaluate root exudates from sub-Saharan indigenous weed species to induce germination of Striga hermonthica (Del. Beth., a root parasitic weed. Significant variation in Striga seed germination was observed, ranging from an absence to the induction of 74.1% Striga seeds. Direct compa-rison of Striga germination was obscured by differences in weed root biomass as within most of the species, a direct proportional relation between Striga seed germination and weed root dry weight was observed. Expression of Striga seed germination in % g-1 root dry weight (GIC was found a suitable solution as stable values for GIC were obtained despite considerable variation in root dry weight. GIC was significant for 25 species and highest with Commelina forskalaei and Sesamum alatum (9.91; 9.78 % g-1 dry root, respectively. Striga seeds did not germinate following application of exudates from Mitracarpus scaber and Phyllanthus pentrandus. These results show that a substantial number of indigenous weed species may serve as alternative trap crops to control the parasites seed bank. Furthermore, the timing of weeds in the cropping system may provide a (partial explanation for the erratic infestation levels found across fields and years that have dazed researchers for many years.
McCoy, David; Bennett, Sara; Witter, Sophie; Pond, Bob; Baker, Brook; Gow, Jeff; Chand, Sudeep; Ensor, Tim; McPake, Barbara
Public-sector health workers are vital to the functioning of health systems. We aimed to investigate pay structures for health workers in the public sector in sub-Saharan Africa; the adequacy of incomes for health workers; the management of public-sector pay; and the fiscal and macroeconomic factors that impinge on pay policy for the public sector. Because salary differentials affect staff migration and retention, we also discuss pay in the private sector. We surveyed historical trends in the pay of civil servants in Africa over the past 40 years. We used some empirical data, but found that accurate and complete data were scarce. The available data suggested that pay structures vary across countries, and are often structured in complex ways. Health workers also commonly use other sources of income to supplement their formal pay. The pay and income of health workers varies widely, whether between countries, by comparison with cost of living, or between the public and private sectors. To optimise the distribution and mix of health workers, policy interventions to address their pay and incomes are needed. Fiscal constraints to increased salaries might need to be overcome in many countries, and non-financial incentives improved. PMID:18295025
This paper outlines policies to secure and reduce the cost of oil supplies in Sub-Saharan Africa (SSA), taking into account the existing forces at play: limited foreign exchange, competition for increasingly scarce funds, and the likely emergence of Africa as the fastest growing centre of energy demand over the coming decade. It identifies major inefficiencies in petroleum procurement, refining and distribution, and analyses the specific bottlenecks at each stage of the supply chain. Many of the diseconomies, estimated to yield savings of US$ 1.4 per year, are traced to an inefficient regulatory set-up in SSA countries, as well as unnecessary government interference in the downstream petroleum sector. In particular, price controls, small topping refineries, monopolistic agencies, government subsidies and opaque management structures prevent the working of efficient market mechanisms. The paper discusses the importance of policy reform, outlining what changes need to be implemented on the levels of institutional arrangements, closing of inefficient units, petroleum pricing and encouraging foreign investment in the sector. (author). 1 ref., 7 figs
Cheng, Sheung-Tak; Siankam, Benjamin
This study investigates whether socioeconomic development and the HIV/AIDS pandemic are associated with living arrangement patterns in older persons in 23 sub-Saharan African countries. Country-level aggregate data were taken from previous household surveys and information provided by the United Nations, the World Bank, and the World Health Organization. Results showed that 13.5% of older persons (aged 60 years or over) were living with grandchildren but not adult children (i.e., skipped generation households). Countries higher in HIV/AIDS prevalence had more skipped generation households, and also more older persons living with spouse only and fewer older persons living with other relatives. Countries with higher socioeconomic development had fewer older persons living with children younger than 25 years old and more living with spouse only or with other relatives and unrelated persons. The pandemic and socioeconomic development combine to accelerate the breakdown of the extended family structure so that older persons are less and less likely to reside with, and to receive support from, their children. PMID:19543825
It is broadly accepted that agricultural growth is essential for Sub-Saharan Africas development, in support of economic growth and a structural transformation of the economy towards industrialization, food security and poverty reduction. Many believe that genetically modified crops have the potential to produce higher yields in many of Sub-Saharan Africas unfavourable climatic conditions and can therefore help in providing food security to the region. While some countries in Sub-Sahara...
Financial Sector and Economic Development: How Institutions, Financial Markets, and Prudential Oversight can be Enhanced to Accelerate Economic Growth and Sustainable Development in Sub-Saharan Africa
Chea, Ashford C.
The author began the paper with a brief historical perspective of financial development and economic growth in general and in Sub-Saharan Africa in particular. He then presented the methodology employed during the research. This was followed by the review of the literature. Next the researcher outlined his findings preceded by analysis and policy implications for decision-makers in Sub-Saharan Africa. The writer ended the paper with some policy recommendations to accelerate the development of...
Background: Uptake of programmatic maternal and childhood preventive interventions continue to be sub-optimal in sub-Saharan Africa with wide variations within and across the countries. There is evidence suggestive of socioeconomic inequities in access to and coverage of preventive health intervention. In the context of maternal and child health (MCH) in sub-Saharan Africa, women and children among the poor are more disadvantaged in terms of access to life saving preven...
Simplice A, Asongu
In examining some big questions on African development, we provide evidence that dynamics of some development indicators could support both endogenous and neoclassical growth theories in the convergence debate. This paper investigates convergence in real per capita GDP and inequality adjusted human development in African countries, disaggregated into 11 homogenous panels based on regions(Sub-Saharan and North Africa), income-levels(low, middle, lower-middle and upper-middle), legal-origins(En...
Oberholzer, Michael; Lopez, Miguel A.; Mclelland, Bryce T.; Hill, Kent L.
African trypanosomes are devastating human and animal pathogens that cause significant human mortality and limit economic development in sub-Saharan Africa. Studies of trypanosome biology generally consider these protozoan parasites as individual cells in suspension cultures or in animal models of infection. Here we report that the procyclic form of the African trypanosome Trypanosoma brucei engages in social behavior when cultivated on semisolid agarose surfaces. This behavior is characteriz...
Wittemyer, George; Daballen, David; Douglas-hamilton, Iain
Knowledge of population processes across various ecological and management settings offers important insights for species conservation and life history. In regard to its ecological role, charisma and threats from human impacts, African elephants are of high conservation concern and, as a result, are the focus of numerous studies across various contexts. Here, demographic data from an individually based study of 934 African elephants in Samburu, Kenya were summarized, providing detailed inspec...
Nsubuga, Peter; Johnson, Kenneth; Tetteh, Christopher; Oundo, Joseph; Weathers, Andrew; Vaughan, James; Elbon, Suzanne; Tshimanga, Mufuta; Ndugulile, Faustine; Ohuabunwo, Chima; Evering-Watley, Michele; Mosha, Fausta; Oleribe, Obinna; Nguku, Patrick; Davis, Lora; Preacely, Nykiconia; Luce, Richard; Antara, Simon; Imara, Hiari; Ndjakani, Yassa; Doyle, Timothy; Espinosa, Yescenia; Kazambu, Ditu; Delissaint, Dieula; Ngulefac, John; Njenga, Kariuki
As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competency-based training for field epidemiologists and public health laboratory scientists providing a master's degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a strategy to develop a locally trained public health workforce that can operate multi-disease surveillance and response systems. PMID:22187606
Cause-specific mortality rates in sub-Saharan Africa and Bangladesh / Taux de mortalité par cause en Afrique subsaharienne et au Bangladesh / Tasas de mortalidad por causas específicas en el África subsahariana y en Bangladesh
Martin, Adjuik; Tom, Smith; Sam, Clark; Jim, Todd; Anu, Garrib; Yohannes, Kinfu; Kathy, Kahn; Mitiki, Mola; Ali, Ashraf; Honorati, Masanja; Ubaje, Adazu; Jahit, Sacarlal; Nurul, Alam; Adama, Marra; Adjima, Gbangou; Eleuther, Mwageni; Fred, Binka.
Full Text Available OBJETIVO: Aportar datos comparables internacionalmente sobre la frecuencia de las distintas causas de defunción. MÉTODOS: Analizamos las autopsias verbales obtenidas durante 1999 -2002 en 12 sitios de vigilancia demográfica del África subsahariana y de Bangladesh a fin de determinar las tasas de mor [...] talidad por causas y por edades. Los códigos de las causas de defunción utilizados por los distintos sitios fueron armonizados con arreglo al sistema de la CIE-10, y resumidos mediante el sistema de clasificación de la Carga Mundial de Morbilidad 2000 (versión 2). RESULTADOS: Las causas de defunción en África difieren marcadamente de las observadas en Bangladesh, donde los datos sugieren una transición sanitaria hacia las enfermedades no transmisibles, con pocos casos de malaria. La infección por VIH destaca entre las causas de mortalidad en los lugares de Sudáfrica analizados, que contrastan con las causas observadas en los lugares de alta endemicidad de malaria del resto del África subsahariana (incluso en el vecino Mozambique). La contribución del sarampión y de las enfermedades diarreicas a la mortalidad en el África subsahariana es inferior a la sugerida hasta ahora, mientras que la malaria tiene una importancia relativamente mayor. CONCLUSIÓN: Los diferentes perfiles de mortalidad que hemos observado podrían ser el resultado de los últimos cambios experimentados por la disponibilidad y la eficacia de las intervenciones sanitarias contra las enfermedades infecciosas infantiles más comunes. Abstract in english OBJECTIVE: To provide internationally comparable data on the frequencies of different causes of death. METHODS: We analysed verbal autopsies obtained during 1999 -2002 from 12 demographic surveillance sites in sub-Saharan Africa and Bangladesh to find cause-specific and age-specific mortality rates. [...] The cause-of-death codes used by the sites were harmonized to conform to the ICD-10 system, and summarized with the classification system of the Global Burden of Disease 2000 (Version 2). FINDINGS: Causes of death in the African sites differ strongly from those in Bangladesh, where there is some evidence of a health transition from communicable to noncommunicable diseases, and little malaria. HIV dominates in causes of mortality in the South African sites, which contrast with those in highly malaria endemic sites elsewhere in sub-Saharan Africa (even in neighbouring Mozambique). The contributions of measles and diarrhoeal diseases to mortality in sub-Saharan Africa are lower than has been previously suggested, while malaria is of relatively greater importance. CONCLUSION: The different patterns of mortality we identified may be a result of recent changes in the availability and effectiveness of health interventions against childhood cluster diseases.
Butt, C. R. M.; Bristow, A. P. J.
The geomorphology of much of sub-Saharan West Africa is dominated by the presence of plateaux and plains with ferruginous and, locally, aluminous (bauxitic) duricrusts. The plateaux occur at different elevations and have been correlated as two or more palaeosurfaces across much of the region. The duricrusts have generally been considered to be residual, formed by conformable erosion and chemical wasting of immediately underlying bedrock. This concept has been central to interpretations as diverse as the formation and evolution of the landscape and the development of geochemical exploration models. Recent regolith landform mapping, field observations and experience from mineral exploration in southern Mali and Burkina Faso, however, demonstrate that the duricrusts are mainly ferricretes, i.e., Fe oxide-cemented sediments. These observations require a re-interpretation of the geomorphological evolution of the region during the Cenozoic. The landscape has evolved by several cycles of weathering and erosion-deposition, triggered by climatic, tectonic or other environmental changes. It is proposed that an initial bauxitic/lateritic regolith was partly eroded following uplift and/or a change to a more arid climate, and that the detritus, rather than being removed, was deposited on slopes and valleys. During a subsequent humid period of lateritic weathering, Fe oxide cementation of this detritus formed ferricrete. Dehydration and hardening of the ferricrete after further uplift or aridity increased its resistance to erosion, resulting in relief inversion, with the detritus, in turn, being deposited downslope. This too has been weathered and cemented, to form a younger ferricrete. The occurrence of ferricrete landforms in adjacent countries, noted by field observation and inferred from satellite imagery, demonstrates that relief inversion is a very widespread and important phenomenon in southern Mali, Burkina Faso and adjacent countries in semi-arid West Africa.
Brown, Molly E.
Food security and nutrition in sub-Saharan Africa have long been affected by variations in the weather. Vulnerability to these hazards, along with economic shocks and an adverse political environment, is often uneven in a community. Some individuals and households are more susceptible to emergencies or crises than others, and thus determining who is most vulnerable are and how they are responding to a shock or crises is essential to understand the impact on food security. Daily, quantitative and global observations derived from satellite remote sensing instruments can contribute to understanding how food production has declined due to drought, flood or other weather-related hazard, but it can say nothing about the likelihood that the people living in that area are suffering food insecurity as a result. As Amartya Sen argued, a famine can occur even when there is an absolute surplus of food in a region. Thus organizations like the US Agency for International Development's Famine Early Warning Systems Network (FEWS NET) work to integrate biophysical and socio-economic indicators together with on-the ground assessments to estimate the food security consequences of a variety of events. Climate change is likely to restructure local, regional and global agricultural systems and commodity markets. Although remote sensing information has been used to identify seasonal production declines for the past two decades, new ways of using the data will need to be developed in order to understand, document and respond to the impact of climate change on food security as it is manifested in shorter term shocks. In this article, the contribution of remote sensing is explained, along with the other factors that affect food security
Full Text Available As a result of persistent development crisis, there is anexplosive growth in the presence of multi-lateral Western NonGovernmental Organizations (NGOS and other privately fundedcharitable organizations in the developing world, particularly in sub-Saharan Africa. Although the objective of the various developmentagencies is to reduce poverty and foster development for marginalpopulations, the effectiveness of their mission is ultimately dependent on thenderlying framework of neoliberalism. Essentially, the global conomic system of neoliberalism is not equipped as an all inclusivesystem that seeks to bridge social-economic inequality but is instead, abiased system which Porter and Craig (2004 describe as geneticallyoriented to protecting existing property rights and providing for theirexpansion. Given the prejudicial nature of the economic system therefore,it is difficult to see the work of NGOS as anything more than temporaryand ineffective band-aid solutions to Africas recurring nightmare ofpoverty and underdevelopment. In this vain, this paper argues that it isimperative to question whether the recent upsurge of developmentinitiatives is a genuine call for development, or just another tacticalmaneuver that favors the propertied and the powerful at the expense of thepoor. The Poverty Reduction Strategy Papers (PRSPS and theMillennium Development Goals (MDGS have hereby been used as themost recent frames of reference for multi-lateral developmentinterventions in Africa. I question whether these development policies,infused with apoliticized language that everyone agrees with, will offerany real hope for a different world free from poverty. Overall, this papergives a short historical account of neoliberalism in Africa as auniversalizing discourse whose fundamentals have historically taken forgranted socio-economic and cultural diversities. It also discusses recentneoliberal social engineering as a carefully organized system that istaking place against the backdrop of global political-economic continuity,thereby maintaining neoliberal economic fundamentals and fulfilling thecapitalist goal of constant acquisition for newer markets. The paperconcludes that development agencies create heavy reliance on externalmarkets, furthering the goal of capitalist expansion and acquisition fornewer markets.
Full Text Available Background Over the past few decades diabetes has emerged as an important non-communicable disease in SubSaharan Africa (SSA. Sight loss from Diabetic Retinopathy (DR can be prevented with screening and early treatment. The objective of this paper is to outline the required actions and considerations in the planning and development of DR screening services. Methods A multiple-case study approach was used to analyse five DR screening services in Botswana, Ghana, Tanzania and Zambia. Cases included: two regional screening programmes, two hospital-based screening services and one nationwide screening service. Data was collected using qualitative methodologies including: document analysis, indepth interviews and observation. The World Health Organization (WHO Health Systems Framework was adopted as the conceptual framework for analysis. Results Planning for a sustainable and integrated DR screening programme demanded a health systems approach. Collaboration with representatives from a variety of ministerial departments and professional bodies was required. Evolution of DR screening services may occur in a variety of ways including: increasing geographical coverage, integration into the general healthcare system, and stepwise progression from a passive, opportunistic service to one that systematically and proactively seeks to prevent DR. Lessons learned from the implementation of cervical cancer prevention programmes in resource-poor settings may assist the development of DR programmes in similar settings. Conclusion To promote good planning of DR screening services and ensure limited resources are used effectively, there is a need to learn from screening programmes in other medical specialities and a need to share experiences between newly-developing DR programmes in resource-poor countries. The WHO Health Systems Framework presents an invaluable tool to ensure a systematic approach to planning DR screening services.
Full Text Available Abstract Background Mortality from trauma remains a major public health issue as it is the leading cause of death in persons aged 5 to 44 years .Uncontrolled hemorrhage and coagulopathy is responsible for over 50% of all trauma related deaths within the first 48hrs of admission. Coagulation profiles are not routinely done among trauma patients in resource limited settings and there is a paucity of data on acute traumatic coagulopathy (ATC in sub Saharan Africa. The study was conducted to evaluate the prothrombin time and partial thromboplastin time (PT/PTT as predictors of mortality and morbidity among major trauma patients. Methods A prospective cohort study was carried out, in which major trauma patients admitted in A&E department between December 2011 to April 2012 were recruited. Five (5 mls of venous blood was drawn from a convenient vein within 10 minutes of the patients arrival at A&E for analysis of PT/PTT. Patients were stratified into two groups by the presence/absence of coagulopathy then followed up for a 2 week period for morbidity and mortality. Results A total of 182 major trauma patients were recruited; 149 (81.9% were males, the mean age was 29.5 years (SD 9.8. Prevalence of coagulopathy was 54% (98/182. The mean ISS for the ATC group was 36.9 and the non ATC group was 26.9 (p=0.001. Patients with ATC stayed longer in hospital 11.24 days than non ATC patients 8 days (p=0.001. ATC was strongly associated with ARI (p= 0.003. Mortality was more in the ATC group 29 deaths compared to 9 deaths in the non ATC group. PTT was a strong independent predictor of mortality. Conclusion A significant proportion of major trauma patients were coagulopathic. Initial coagulation profile is useful in predicting outcomes for major trauma patients.
Full Text Available Abstract Background In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomised by oil extraction in sub-Saharan Africa. Methods Based on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan, I propose a framework for analysing the effects of the resource curse on the structure of health systems at sub-national levels. Qualitative attributes are emphasised. The role of the corporate sector, the influence of conflicts, and the value of classical mitigation measures (such as health impact assessments are further examined. Results Health systems in a resource curse environment are classically fractured into tripartite components, including governmental health agencies, non-profit non-governmental organisations, and the corporate extractive sector. The three components entertain a range of contractual relationships generally based on operational considerations which are withdrawn from social or community values. Characterisation of agencies in this system should also include: values, operating principles, legitimacy and operational spaces. From this approach, it appears that community health is at the same time marginalised and instrumentalised toward economic and corporate interests in resource curse settings. Conclusion From a public health point of view, the resource curse represents a fundamental failure of dominant development theories, rather than a delay in creating the proper economy and governance environment for social progress. The scope of research on the resource curse should be broadened to include more accurate or comprehensive indicators of destitution (including health components and more open perspectives on causal mechanisms.
Full Text Available A significant proportion of vulnerable people in sub-Saharan Africa (SSA remain at risk for contracting diarrhoeal diseases due to the presence of many risk factors facilitating their transmission. A systematic review of published articles from the SSA region was done to determine the prevalence and types of diarrhoeal pathogens in circulation, based on a search of databases, including EBSCO host, PubMed, Scopus, Science Direct, Google scholar and Web of Science was done between September 2009 and December 2010. Data were summarized from 27 studies, with pooled data analysed and reported. Pathogens were isolated from between 26.8-65.6% of cases, with an overall isolation rate of 55.7% (95% CI, 48.2-62.9%. Isolation rates were highest amongst adult cases followed by children, and the odds of isolating a pathogen was greater in diarrhoeal cases (Odds Ratio 4.93 (95% CI, 1.99 to 12.23, than in asymptomatic controls. Overall isolation ranged from 8% to 99%; and heterogeneity testing suggests differences between age groups (Q=5.806; df=2, P=0. 055. Mixed E. coli spp., (29.95%, Cryptosporidium (21.52%, Cyclospora (18%, Entamoeba, (13.8%, Shigella spp. (10.49%, Salmonella spp. (8.36%, and Campylobacter spp. (8.33%, were most commonly reported, and rotavirus was the most common virus isolated. This is the first review to look at the range of enteric pathogens circulating in SSA, and has confirmed high rates of isolation of pathogens from diarrhoeal cases. Public health practitioners can use this information to understanding the challenges related to diarrhoeal illness and set priorities for their prevention and control.
Nyaga, Martin M; Jere, Khuzwayo C; Esona, Mathew D; Seheri, Mapaseka L; Stucker, Karla M; Halpin, Rebecca A; Akopov, Asmik; Stockwell, Timothy B; Peenze, Ina; Diop, Amadou; Ndiaye, Kader; Boula, Angeline; Maphalala, Gugu; Berejena, Chipo; Mwenda, Jason M; Steele, A Duncan; Wentworth, David E; Mphahlele, M Jeffrey
Group A rotaviruses (RVA) are among the main global causes of severe diarrhea in children under the age of 5years. Strain diversity, mixed infections and untypeable RVA strains are frequently reported in Africa. We analysed rotavirus-positive human stool samples (n=13) obtained from hospitalised children under the age of 5years who presented with acute gastroenteritis at sentinel hospital sites in six African countries, as well as bovine and porcine stool samples (n=1 each), to gain insights into rotavirus diversity and evolution. Polyacrylamide gel electrophoresis (PAGE) analysis and genotyping with G-(VP7) and P-specific (VP4) typing primers suggested that 13 of the 15 samples contained more than 11 segments and/or mixed G/P genotypes. Full-length amplicons for each segment were generated using RVA-specific primers and sequenced using the Ion Torrent and/or Illumina MiSeq next-generation sequencing platforms. Sequencing detected at least one segment in each sample for which duplicate sequences, often having distinct genotypes, existed. This supported and extended the PAGE and RT-PCR genotyping findings that suggested these samples were collected from individuals that had mixed rotavirus infections. The study reports the first porcine (MRC-DPRU1567) and bovine (MRC-DPRU3010) mixed infections. We also report a unique genome segment 9 (VP7), whose G9 genotype belongs to lineage VI and clusters with porcine reference strains. Previously, African G9 strains have all been in lineage III. Furthermore, additional RVA segments isolated from humans have a clear evolutionary relationship with porcine, bovine and ovine rotavirus sequences, indicating relatively recent interspecies transmission and reassortment. Thus, multiple RVA strains from sub-Saharan Africa are infecting mammalian hosts with unpredictable variations in their gene segment combinations. Whole-genome sequence analyses of mixed RVA strains underscore the considerable diversity of rotavirus sequences and genome segment combinations that result from a complex evolutionary history involving multiple host species. PMID:25701122
Sensitivity and specificity of typhoid fever rapid antibody tests for laboratory diagnosis at two sub-Saharan African sites / Sensibilité et spécificité des tests d'anticorps rapides de la fièvre typhoïde pour le diagnostic biologique de deux sites d'Afrique subsaharienne / Sensibilidad y especificidad de las pruebas rápidas de anticuerpos de fiebre tifoidea para el diagnóstico clínico en dos centros del África subsahariana
Karen H, Keddy; Arvinda, Sooka; Maupi E, Letsoalo; Greta, Hoyland; Claire Lise, Chaignat; Anne B, Morrissey; John A, Crump.
Full Text Available OBJETIVO: Evaluar tres pruebas comerciales rápidas de anticuerpos tifoideos para detectar anticuerpos de Salmonella typhi en pacientes de los que se sospecha que sufren fiebre tifoidea en Mpumalanga, Sudáfrica y Moshi, República Unida de Tanzania. MÉTODOS: Se evaluó la precisión diagnóstica del Crom [...] otest® (pruebas semicuantitativas de aglutinación en laminas y de Widal en tubo único), el TUBEX® y el Typhidot®, en comparación con el hemocultivo. Se elaboraron modelos de funcionamiento de los supuestos, con probabilidades de las pruebas iniciales del 5% y el 50%. RESULTADOS: Se reclutó a un total de 92 pacientes: 53 (57,6%) de Sudáfrica y 39 (42,4%) de la República Unida de Tanzania. La Salmonella typhi se aisló en la sangre de 28 pacientes (30,4%). Las pruebas semicuantitativas de aglutinación en lámina y de Widal en tubo único ofrecieron valores predictivos positivos (VPP) del 25,0% (intervalo de confianza [IC] del 95%: 0,6-80,6) y del 20,0% (IC del 95%: 2,5-55,6), respectivamente. Las pruebas rápidas de anticuerpos tifoideos más novedosas presentaron VPP comparables: TUBEX®, 54,1% (IC del 95%: 36,9-70,5); Typhidot® IgM, 56,7% (IC del 95%: 37,4-74,5); Typhidot® IgM, 54,3% (IC del 95%: 36,6-71,2). Para una probabilidad de la prueba inicial del 5%, los VPP fueron: TUBEX®, 11,0% (IC del 95%: 6,6-17,9); Typhidot® IgM, 9,1% (IC del 95%: 5,8-14,0) y Typhidot® IgG, 11,0% (6,3-18,4). Para una probabilidad de la prueba inicial del 50%, los VPP fueron:TUBEX®, 70,2% (IC del 95%: 57,3-80,5); Typhidot® IgM, 65,6% (IC del 95%: 54,0-75,6); y Typhidot® IgM, 70,0% (IC del 95%: 56,0-81,1). CONCLUSIÓN: Las pruebas semicuantitativas de aglutinación en lámina y de Widal en tubo único no funcionaron bien.TUBEX® y Typhidot® podrían ser aptos cuando la probabilidad de la prueba inicial es alta y los hemocultivos no están disponibles, pero su funcionamiento no justifica su uso en los centros de asistencia sanitaria habituales en el África subsahariana. Abstract in english 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.
Full Text Available Abstract Background Analysis of severe maternal morbidity (maternal near misses provides information on the quality of care. We assessed the prevalence/incidence of maternal near miss, maternal mortality and case fatality ratio through systematic review of studies on severe maternal morbidity in sub-Saharan Africa. Methods We examined studies that reported prevalence/incidence of severe maternal morbidity (maternal near misses during pregnancy, childbirth and postpartum period between 1996 and 2010. We evaluated the quality of studies (objectives, study design, population studied, setting and context, definition of severe acute obstetric morbidity and data collection instruments. We extracted data, using a pre-defined protocol and criteria, and estimated the prevalence or incidence of maternal near miss. The case-fatality ratios for reported maternal complications were estimated. Results We identified 12 studies: six were cross-sectional, five were prospective and one was a retrospective review of medical records. There was variation in the setting: while some studies were health facility-based (at the national referral hospital, regional hospital or various district hospitals, others were community-based studies. The sample size varied from 557 women to 23,026. Different definitions and terminologies for maternal near miss included acute obstetric complications, severe life threatening obstetric complications and severe obstetric complications. The incidence/prevalence ratio and case-fatality ratio for maternal near misses ranged from 1.1%-10.1% and 3.1%-37.4% respectively. Ruptured uterus, sepsis, obstructed labor and hemorrhage were the commonest morbidities that were analyzed. The incidence/prevalence ratio of hemorrhage ranged from 0.06% to 3.05%, while the case fatality ratio for hemorrhage ranged from 2.8% to 27.3%. The prevalence/incidence ratio for sepsis ranged from 0.03% to 0.7%, while the case fatality ratio ranged from 0.0% to 72.7%. Conclusion The incidence/prevalence ratio and case fatality ratio of maternal near misses are very high in studies from sub-Saharan Africa. Large differences exist between countries on the prevalence/incidence of maternal near misses. This could be due to different contexts/settings, variation in the criteria used to define the maternal near misses morbidity, or rigor used carrying out the study. Future research on maternal near misses should adopt the WHO recommendation on classification of maternal morbidity and mortality.
Munodawafa, Davison; Phori, Peter Malekele; Varenne, Benoit; Alisalad, Abdikamal
Reduction of salt intake is an important and cost-effective way for reducing hypertension and the risk of cardiovascular diseases (CVDs). Current global salt intakes are estimated at around 10 g/day, well above the World Health Organization (WHO) recommended level of hypertension of 46% among adults aged 25 and over and therefore strategies to reduce salt intake are necessary. This requires an understanding of salt intake behaviors in the population along with government commitment to increase awareness and take actions that would create an enabling environment. It is also important to have the food industry and other key stakeholders on board. A review of the developed WHOs norms and guidelines, technical support provided to countries by WHO as well as country initiatives shows that countries in the African region are at different stages in the implementation of salt reduction interventions. For example, South Africa has enacted legislation to make the food industry reduce the salt content of a number of its products while Mauritius is requesting bakery owners to reduce salt in bread. A number of countries are currently undertaking studies to measure salt intake in the populations. Overall progress is slow as the region experiences a double burden of communicable and noncommunicable diseases, competing health priorities and limited resources for health.
Leonard E.G., Mboera; Sayoki G., Mfinanga; Esron D., Karimuribo; Susan F., Rumisha; Calvin, Sindato.
Full Text Available In sub-Saharan Africa, communicable diseases (CDs) are the leading public health problems and major causes of morbidity and mortality. CDs result in significant individual suffering, disrupting daily life, threatening livelihoods and causing one-third of the years lost to illness or death worldwide. [...] This paper aims to analyse the current strategies in the control and prevention of CDs in sub-Saharan Africa and proposes an ecohealth approach in relation to current changing epidemiological profiles. Whilst in recent years the burden of HIV and AIDS, tuberculosis and malaria have helped to mobilise large amounts of funding and expertise to help address them, many CDs, particularly those affecting the poor, have been neglected. People living in rural areas are also likely to be politically marginalised and living in degraded environments. They often lack assets, knowledge and opportunities to gain access to health care or protect themselves from infections. New diseases are also emerging at unprecedented rates and require attention. Many CDs are rooted in environmental and livelihood conditions and mediated by social and individual determinants. It is now increasingly recognised that a much broader, coordinated and multi-sectoral ecohealth approach is required to address CDs in sub-Saharan Africa. An ecohealth approach has been shown to be more robust in public health interventions than the traditional medical approach. The approach helps to generate an understanding of ecosystem factors that influence the emergence and spread of both old and new diseases, considers temporal and spatial dimensions of disease infection and allows systems thinking. In conclusion, establishing intersectoral and multisectoral linkages is important to facilitate joint efforts to address CDs at the national, district and community levels.
Highlights: ? Thermal comfort in sleeping environments in the sub-Saharan Africa is presented. ? Comfort charts for the dry-tropical regions were established. ? Total insulation values for bedding systems range between 0.81 clo and 0.94 clo. ? Thermoneutral operative temperature ranges between 29.5 °C and 31.7 °C. ? Thermoneutral air temperature ranges between 27.1 °C and 29.6 °C. - Abstract: A human being spends approximately one-third of his/her life in sleep. For an efficient and peaceful rest, he/she therefore needs some level of comfort. This includes acceptable environmental parameters as well as suitable bedding systems. While the theories of thermal comfort in workplaces at daytime are currently well established, research on thermal comfort for sleeping environment at night is limited. Further studies in relation with sleep are needed. This paper presents an investigation on thermal comfort in sleeping environments in the sub-Saharan Africa region. The comfort equation used is based on the energy balance of the human body derived from Fangers comfort model. Comfort charts for the dry-tropical sub-Saharan Africa region were established using indoor climatic conditions collected over five years in Ouagadougou (12°22?N, 1°32?W). Results obtained show that the suitable monthly total insulation values for bedding systems in the dry-tropical regions range between 0.81 clo and 0.94 clo. The thermoneutral operative temperature range between 29 e range between 29 °C and 32 °C, while the thermoneutral air temperature range between 27 °C and 30 °C.
Carla, Araújo; Ana, Azevedo; Albertino, Damasceno; Nuno, Lunet.
Full Text Available O consumo de tabaco é a principal causa de morbilidade e mortalidade a nível mundial. Na África Subsariana, o consumo de cigarros manufacturados é em geral mais frequente nos meios urbanos enquanto os habitantes de zonas rurais adoptam mais frequentemente formas tradicionais de consumo de tabaco. A [...] migração para as zonas urbanas é um fenómeno demográfico com importância crescente na África Subsariana, e esta transição deverá contribuir para uma evolução no sentido dos estádios mais avançados da epidemia tabágica mais rapidamente do que se observou nos países mais afluentes. A generalização do consumo de cigarros manufacturados nos países menos desenvolvidos contribuirá previsivelmente para acentuar as disparidades entre nações relativamente ao estado de saúde das populações. A compreensão dos padrões e dinâmica do consumo de tabaco na África Subsariana é essencial para o desenvolvimento e monitorização de estratégias de controlo a nível local. Abstract in english Tobacco smoking is the single most important determinant of avoidable morbidity and mortality worldwide. In Sub-Saharan Africa smoking of manufactured cigarettes tends to be more frequent among urban dwellers while subjects living in rural areas are more often consumers of smokeless tobacco and hand [...] -rolled cigarettes. The rural-to-urban migration is an important demographic phenomenon in Sub-Saharan Africa, and this shift will contribute to a faster transition through the stages of the tobacco epidemic than has been observed in higher-income countries. The widespread diffusion of cigarette smoking in developing settings will expectedly exacerbate worldwide health disparities between nations. The understanding of the patterns and dynamics of tobacco consumption in Sub-Saharan Africa is essential to develop and monitor locale-specific control strategies.
Cheraghi, Maryam; SchØtt, Thomas
Purpose The purpose of the paper is to understand whether the vocational choices among youth in Sub-Saharan Africa i.e. to be an entrepreneur or pursue other occupations are affected by their parents occupation. Specifically, are parents occupations affecting young persons vocational intention whether to become an entrepreneur? Method A survey of the youth has been conducted in Sub-Saharan Africa, as part of the Global Entrepreneurship Monitor Survey during 2012/13. The survey was conducted in ten countries, which fairly represent the region. Interviews were conducted with a random sample of the youth in each of the ten countries, amounting to 24,342 persons age 18 to 34 years old. The youth reported on both their own and their parents occupations as well as their vocation intentions. Their responses are analyzed by multivariate statistical models. Findings Young people are more likely to be self-employed when their parents are or were self-employed. Young people are more likely to be employees when parents are or were employees and young people are more likely to be unemployed when parents are or were unemployed. The social inheritance of occupation, however, is not totally pervasive, as a number of young people are not directly influenced by their parents occupational but select other occupational avenues. Young people, whose parents are or were employees or were unemployed, are as likely as young persons, whose parents are or were self-employed, to intend to become entrepreneurs. Young peoples vocational intention to become an entrepreneur, is not socially inherited, but seems to be independent of parents occupations. Value This study is the first account of occupational inheritance and young persons vocational intentions, whether to become an entrepreneur, which is generalizable to Sub-Saharan Africa.
Full Text Available Irrigation development is rapidly expanding in mostly rainfed Sub-Saharan Africa. This expansion underscores the need for a more comprehensive understanding of water resources beyond surface water. Gravity Recovery and Climate Experiment (GRACE satellites provide valuable information on spatio-temporal variability of water storage. The objective of this study was to calibrate and evaluate a semi-distributed regional-scale hydrological model, or a large-scale application of the Soil and Water Assessment Tool (SWAT model, for basins in Sub-Saharan Africa using seven-year (20022009 10-day GRACE data. Multi-site river discharge data were used as well, and the analysis was conducted in a multi-criteria framework. In spite of the uncertainty arising from the tradeoff in optimizing model parameters with respect to two non-commensurable criteria defined for two fluxes, it is concluded that SWAT can perform well in simulating total water storage variability in most areas of Sub-Saharan Africa, which have semi-arid and sub-humid climates, and that among various water storages represented in SWAT, the water storage variations from soil, the vadose zone, and groundwater are dominant. On the other hand, the study also showed that the simulated total water storage variations tend to have less agreement with the GRACE data in arid and equatorial humid regions, and the model-based partition of total water storage variations into different water storage compartments could be highly uncertain. Thus, future work will be needed for model enhancement in these areas with inferior model fit and for uncertainty reduction in component-wise estimation of water storage variations.
Full Text Available Irrigation development is rapidly expanding in mostly rainfed Sub-Saharan Africa. This expansion underscores the need for a more comprehensive understanding of water resources beyond surface water. Gravity Recovery and Climate Experiment (GRACE satellites provide valuable information on spatio-temporal variability in water storage. The objective of this study was to calibrate and evaluate a semi-distributed regional-scale hydrologic model based on the Soil and Water Assessment Tool (SWAT code for basins in Sub-Saharan Africa using seven-year (July 2002April 2009 10-day GRACE data and multi-site river discharge data. The analysis was conducted in a multi-criteria framework. In spite of the uncertainty arising from the tradeoff in optimising model parameters with respect to two non-commensurable criteria defined for two fluxes, SWAT was found to perform well in simulating total water storage variability in most areas of Sub-Saharan Africa, which have semi-arid and sub-humid climates, and that among various water storages represented in SWAT, water storage variations in soil, vadose zone and groundwater are dominant. The study also showed that the simulated total water storage variations tend to have less agreement with GRACE data in arid and equatorial humid regions, and model-based partitioning of total water storage variations into different water storage compartments may be highly uncertain. Thus, future work will be needed for model enhancement in these areas with inferior model fit and for uncertainty reduction in component-wise estimation of water storage variations.
Murimi, Mary; Chrisman, Matthew S.; McAllister, Tiffany; McDonald, Olevia D.
Approximately 8.3% of the U.S. population (25.8 million people) is affected by type 2 diabetes. The burden of diabetes is disproportionately greater in the African American community. Compared with non-Hispanic Caucasian adults, the risk of diagnosed type 2 diabetes was 77% higher among non-Hispanic Blacks, who are 27% more likely to die of
houdou Ndambendia; Moussa Njoupouognigni
In this paper we investigate the long-run relationship between foreign aid, foreign direct investment and economic growth in 36 Sub-Saharan Africa countries over the period 1980-2007. Following the recent dynamic panel data of mean group (MG), pooled mean group estimator (PMG), and dynamic fixed effect (DFE) proposed by Pesaran et al. (1999), we found strong evidence of a positive impact of foreign aid and foreign direct investment on economic growth. However, the effect of foreign aid on gro...
This paper investigates the impacts and responses of macroeconomic shocks in some domestic economies in Sub-Saharan Africa over the period 1961-99; more specifically, it seeks to answer the question of whether there are any systematic differences in the responses of the CFA franc zones and the non-CFA franc zone countries to macroeconomic shocks. Based on the Blanchard-Quah methodology, we identify shocks to the changes in real exchange rate and output using a structural VAR (SVAR) model for ...
Henley, John; Kratzsch, Stefan; Ku?lu?r, Mithat; Tandogan, Tamer
The burgeoning literature on outward foreign direct investment from emerging markets has largely focused on analysing the motives of investors as reported by parent companies. This paper, instead, focuses on firm-level investments originating from China, India or South Africa in fifteen host countries in sub-Saharan Africa (SSA). The analysis is based on a sub-set of firms drawn from the overall sample of 1,216 foreign-owned firms participating in the UNIDO Africa Foreign Investor Survey, car...
Milla?n-lou, Mari?a Isabel; Alonso, Henar; Gavi?n, Patricia; Herna?ndez-febles, Melissa; Campos-herrero, Mari?a Isolina; Copado, Rodolfo; Can?as, Fernando; Kremer, Kristin; Caminero, Jose? Antonio; Marti?n, Carlos; Samper, Sofi?a
The development of a rapid test to identify Mycobacterium tuberculosis Beijing isolates and specifically strain GC1237, coming from a sub-Saharan country, is needed due to its alarming wide spread on Gran Canaria Island (Spain). A rapid test that detects IS6110 present between dnaA and dnaN in the Beijing strains and in a specific site for GC1237 (Rv2180c) has been developed. This test would be a useful tool in the surveillance of subsequent cases.