Full Text Available The Sub-Saharan Africa belongs to the most underdeveloped regions in the world economy. This region consists of forty nine countries but it’s world GDP share is only a small percentage. There are some very resource rich countries in this region. One of them is Angola. This former Portuguese colony has one of the largest inventories of oil among all African countries. Angola recorded one of the highest growth of GDP between 2004-2008 from all countries in the world economy and nowadays is the third biggest economy in Sub-Saharan Africa after Nigeria and South Africa. The essential problem of Angola is the one-way oriented economy on oil and general on natural resources. Angola will be forced to change their one-way oriented economy to be more diversified and competitive in the future.
Impact of China on sub-Saharan Africa : Country Case Studies. China is emerging as a major power in the global economy. The broad-based nature of its industrial development has generated a sustained and high demand for oil and raw materials, a significant reason for the current strength of oil and other commodity ...
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…
.... This report from Sub-Saharan Africa, Benin, Botswana, Burkina, Cameroon, Chad, Comoros, Ethiopia, Ghana, Guinea, Kenya, Liberia, Madagascar, Mauritius, Mozambique, Sierra Leone, Somalia, South Africa...
.... This report on Sub-Saharan Africa, Angola, Botswana, Burkina, Cameroon, Ghana, Ivory Coast, Liberia, Madagascar, Malawi, Mali, Mozambique, Namibia, Senegal, South Africa, and Swaziland, contains...
.... This report from Sub-Saharan Africa, Angola, Benin, Botswana, Burundi, Ghana, Lesoto, Liberia, Malawi, Namibia, Nigeria, Senegal, Seychelles, South Africa, Tanzania and Zimbabwe, contains articles...
.... This report contains articles from Sub-Saharan Africa, Angola, Ethiopia, Ghana, Mozambique, Namibia, Sierra Leone, Togo, Zambia, and South Africa, the articles deal mainly with Politics, Sociology...
Full Text Available The recognition of Foreign Direct Investment (FDI as a source of funding to foster economic development in both developed and developing countries has been in ascendancy. The prime purpose of this study is to empirically investigate the determinants of FDI for the “landlocked countries” in Sub-Saharan Africa over the period 1995–2013. By employing panel data analysis, the result of the study revealed that domestic investment, trade (openness, human capital, political constraint, natural resource endowment and the market size (with the GDP growth as proxy as having positive impact on determining FDI flow into the sample countries with only the countries’ tax policies seen otherwise. Our study not only contributes to existing literature on FDI determinants by investigating landlocked countries of Sub-Saharan Africa (SSA for the first time but also includes natural resources that the landlocked countries are endowed with, tax policies and political constraints in such countries for the stipulated period.
Partial Contents: Sub Saharan Africa, Military Exercise, Radio Commentary, Stock Exchange, Prime Minister, Economic, Domestic Service, Armed Forces, Health, Organizations, Death, International Service, Foreign Policy...
Countries in sub-Saharan Africa are some of the poorest and least developed in the world, with deplorable health and education levels. One way intended to promote better living standards in this region has been through development aid. This study examines the determinants of multilateral aid inflows to sub-Saharan Africa to determine whether it is directed to the least developed countries. I use panel data about 22 countries in sub-Saharan Africa from the 1995-2004 period to estimate a regres...
Rjoub, Husam; Aga, Mehmet; Alrub, Ahmad Abu; Bein, Murad
The recognition of Foreign Direct Investment (FDI) as a source of funding to foster economic development in both developed and developing countries has been in ascendancy. The prime purpose of this study is to empirically investigate the determinants of FDI for the “landlocked countries” in Sub-Saharan Africa over the period 1995–2013. By employing panel data analysis, the result of the study revealed that domestic investment, trade (openness), human capital, political constraint, natural res...
Full Text Available The continuous increase in the rate of poverty in Sub-Saharan Africa can be linked to the inadequate management and use of international financial assistance such as foreign aid. Using a cross-country data, this paper examines the relationship between foreign aid and poverty reduction in Sub-Saharan Africa (SSA. The result obtained indicates that foreign aid has no significant influence on poverty reduction in SSA, because of the countries’ weak economic management evidenced by high levels of corruption, bad governance, and political and economic instability. To improve the performance of foreign aid directed at poverty reduction, the paper suggests the implementation of measures directed at good governance, macroeconomic and political stability.Incentives in Nigeria’s food manufacturing industries and their impact on output and prices
Ntokozo Patrick Nzimande
Full Text Available Substantial amount of studies have examined the validity of mean-reversion onthe real exchange rate. However very limited studies of this nature have beenconducted in Sub-Saharan Africa countries, particularly energy exportingcountries, hence this study endeavors to find evidence for or against the mean-reversion of the real exchange rate. There is, however inadequate data requiredfor the statistical significance for Sub-Saharan African currencies. Hence thisstudy uses a panel of 5 energy exporting countries, i.e. South Africa,Mozambique, Congo Republic, Nigeria and Angola, to examine the validity of thepurchasing power parity. Relying on the Im, Pesaran and Shin and the Fisher ADFproposed panel unit root tests the study fails to reject the null hypothesis of a unitroot when small sample size is employed however by extending sample size andemploying different price index, i.e. traded goods prices instead of GDP deflatorsthe study reject the null hypothesis of a unit root and hence concludes thepurchasing power parity holds in Sub-Saharan African energy exporting countriesconsidered in the study.
This is Sub Saharan Africa Report. It contains the issues with different topics on Inter African Affairs, Angola, Cameroon, Cape Verde, Chad, Congo, Ethiopia, Gambia, Ghana, Guinea, Guinea Bissau, Kenya, madagascar, Mozambique...
Koye Gerry Bokana
Full Text Available This study aimed to analyse the productivity effects of higher education enrolment (HEE, higher education output (HEO and the associated productivity gap (GP on selected countries in Sub-Saharan Africa (SSA over the period between 1981 and 2014. It was hypothesized in the study that HEE and HEO had statistically significant positive impact on productivity in the selected sub-Saharan Africa countries over the stated period. Fixed effect Least Square Dummy Variable (LSDV and a robust version of System Generalized Methods of Moment (SYSGMM were adopted as model estimating techniques. Results from the LSDV model indicated that HEE had no statistically significant positive impact on productivity growth in the twenty-one SSA countries. This non-significance was corrected in the dynamic model, but with negative effects on the growth rate of total factor productivity (TFP. The study further compared the worldwide technological frontier with those of the SSA countries under investigation and discovered that countries like Gabon, Mauritius and Swaziland ranked high, while Burundi needs to improve on its productivity determinants. The major conclusion of this study is therefore that higher education human capital should be supported with strong policy implementation, as this can have a positive impact on productivity growth.
Mateen, Farrah J; Clark, Sarah J; Borzello, Mia; Kabore, Jean; Seidi, Osheik
To provide a comprehensive understanding of neurology training from the sub-Saharan African perspective. A 40-question survey was distributed to attendees of the 7th annual sub-Saharan African neurology teaching course in Khartoum, Sudan (2015). Themes included the student body, faculty, curriculum, assessment and examinations, technology, and work hours and compensation. Of 19 responding countries, 10 had no formal neurology training programs; Burkina Faso, Cameroon, Republic of the Congo, and Mozambique had an adult neurology program; Ethiopia, Madagascar, Nigeria, Senegal, and South Africa had adult and pediatric neurology programs (training duration range = 3-6 years). There was a median of 2.5 full-time neurologists on the teaching faculty at the respondents' training institutions (neurologists on-faculty:in-country ratio = 0.48), with the lowest ratios in Sudan and Nigeria. Neurology was perceived to be a competitive specialty for entrance in 57% of countries, with 78% of respondents reporting a requisite entrance examination. Ninety-five percent had access to a personal smartphone, 62% used the Internet more than occasionally, and 60% had access to online neurology journals. The average number of weekly work hours was 51 (range = 40-75), and average monthly salary among those earning income was 1,191 USD (range = 285-3,560). Twenty percent of respondents reported paying for training. The most common barriers to neurology postgraduate education were few training programs and lack of training in neurodiagnostic tests. Among 17 reporting countries, there is an estimated average of 0.6 neurologists per million people. Neurology training programs in sub-Saharan Africa are relatively limited in number and have several unmet needs including a small cadre of faculty and an opportunity to standardize curricula and financing of programs. Ann Neurol 2016;79:871-881. © 2016 American Neurological Association.
Simmons, Bryony; Hill, Andrew; Ford, Nathan; Ruxrungtham, Kiat; Ananworanich, Jintanat
Antiretrovirals are available at low prices in sub-Saharan Africa, but these prices may not be consistently available for middle-income countries in other regions with large HIV epidemics. Over 30% of HIV infected people live in countries outside sub-Saharan Africa. Several key antiretrovirals are still on patent, with generic production restricted. We assessed price variations for key antiretroviral drugs inside versus outside sub-Saharan Africa. HIV drug prices used in national programmes (2010-2014) were extracted from the WHO Global Price Reporting Mechanism database for all reporting middle-income countries as classified by the World Bank. Treatment costs (branded and generic) were compared for countries inside sub-Saharan Africa versus those outside. Five key second-line antiretrovirals were analysed: abacavir, atazanavir, darunavir, lopinavir/ritonavir, raltegravir. Prices of branded antiretrovirals were significantly higher outside sub-Saharan Africa (psub-Saharan Africa versus $4689 (IQR $4075-5717) in non-African middle-income countries, an increase of 541%. However, when supplied by generic companies, most antiretrovirals were similarly priced between countries in sub-Saharan Africa and other regions. Pharmaceutical companies are selling antiretrovirals to non-African middle-income countries at prices 74-541% higher than African countries with similar gross national incomes. However, generic companies are selling most of these drugs at similar prices across regions. Mechanisms to ensure fair pricing for patented antiretrovirals across both African and non-African middle-income countries need to be improved, to ensure sustainable treatment access.
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?.
van Gemert, Frederik A; Kirenga, Bruce J; Gebremariam, Tewodros Haile; Nyale, George; de Jong, Corina; van der Molen, Thys
INTRODUCTION: In most low and middle-income countries, chronic obstructive pulmonary disease (COPD) is on the rise. Areas covered: Unfortunately, COPD is a neglected disease in these countries. Taking sub-Saharan Africa as an example, in rural areas, COPD is even unknown regarding public awareness
Adepoju, Aderanti; Naerssen, Ton van; Zoomers, Annelies
This book aims at achieving a better understanding of the implications of international migration for national development from the perspective of the sending countries, with an emphasis on sub-Saharan Africa. More specifically, the volume explores (1) current perceptions of the links between
This paper is concerned with the relationship between safety and mobile phones with particular reference to Sub-Saharan Africa; and looks at a range of geographical contexts: non-violent, conflict and post-conflict situations. The main part of the paper reports on recent findings of extensive
Worku, T.; Mendoza Rodriguez, J.P.; Wielhouwer, J.L.
Multilateral organizations recommend sub-Saharan African (SSA) countries to increase international trade in order to attain sustainable economic growth. The benefits of trade can be hampered, however, by tariff evasion. Using trade data from 2008–2014 of 31 SSA countries, we examine how the
Full Text Available The main purpose of this paper is to investigate the causality relationship between energy consumption and economic growth in four low-income countries in Sub-Saharan Africa using the econometrics in time-series methods. Along the estimation process, I use the annual data on energy consumption and real GDP per capita over the years of 1971 and 2011. The results of the ADF unit root test show that the time series are not stationary for all countries at levels, but log of economic growth in Benin and Congo become stationary after taking the differences of the data, and log of energy consumption become stationary for all countries and LGR in Kenya and Zimbabwe are found to be stationary after taking the second differences of the time-series. The findings of the Johansen co-integration test demonstrate that the variables LEC and LGR are not co-integrated for the cases of Kenya and Zimbabwe, so no long-run relationship between the variables arises in any country. The Granger causality test indicates that there is a unidirectional causality running from energy use to economic growth in Kenya and no causality linkage between EC and GR in Benin, Congo and Zimbabwe.
Social Education, 1997
Presents a wealth of statistical, geographic, and economic information on Sub-Saharan Africa arranged and displayed for easy and immediate access. Lists all of the countries of the region along with pertinent information including religious affiliation, capital, Gross National Product, main exports, population growth, education, and literacy. (MJP)
Wahlers, Kerstin; Menezes, Colin N.; Wong, Michelle L.; Zeyhle, Eberhard; Ahmed, Mohammed E.; Ocaido, Michael; Stijnis, Cornelis; Romig, Thomas; Kern, Peter; Grobusch, Martin P.
Cystic echinococcosis is regarded as endemic in sub-Saharan Africa; however, for most countries only scarce data, if any, exist. For most of the continent, information about burden of disease is not available; neither are data for the animal hosts involved in the lifecycle of the parasite, thus
Materu, Peter; Righetti, Petra
This article assesses the status and practice of higher education quality assurance in sub-Saharan Africa, focusing on degree-granting tertiary institutions. A main finding is that structured national-level quality assurance processes in African higher education are a very recent phenomenon and that most countries face major capacity constraints.…
Agho, Augustine O; John, Emmanuel B
Sub-Saharan Africa (SSA) countries are faced with the challenge of educating a critical mass of occupational therapists (OTs) and physiotherapists (PTs) to meet the growing demand for health and rehabilitation services. The World Federation of Occupational Therapy (WFOT) and World Confederation of Physical Therapy (WCPT) have argued for the need of graduate-level training for OTs and PTs for decades. However, very few studies have been conducted to determine the availability of OT and PT training programs and practitioners in SSA countries. Initial data were collected and compiled from an extensive literature search conducted using MEDLINE and PubMed to examine the availability of OT and PT education and training programs in SSA countries. Additional data were collected, compiled, and collated from academic institutions, ministries of health, health professions associations, and licensing authorities in SSA countries. Secondary data were also collected from the websites of organizations such as the World Bank, World Health Organization (WHO), WFOT, and WCPT. This investigation revealed that there are limited number of OT and PT training programs and that these training programs in Anglophone SSA countries are offered at or below the bachelor's level. More than half of the countries do not have OT or PT training programs. The number of qualified OTs and PTs appears to be insufficient to meet the demand for rehabilitation services. Nigeria and South Africa are the only countries offering post-entry-level masters and doctoral-level training programs in physiotherapy and occupational therapy. Higher learning institutions in SSA countries need to collaborate and partner with other regional and foreign universities to elevate the educational training and increase the supply of PTs and OTs in the region.
Full Text Available Africa is a rising star - one of the most desirable investment destinations in the world. Nonetheless, economic growth is uneven among African countries, and many obstacles must be overcome in order to realize the full potential of opportunity. To achieve long-term sustainable investment results, and ultimately progress towards Sustainable Development goals, many risks must be isolated, analyzed, and mitigated. This paper introduces the concept of Sustainability Risk, identifying a set of major risk components for Sub-Saharan Africa and building an integral measure to quantify the degree of remoteness of the forty-six Sub-Saharan Africa countries from the total set of threats considered. The countries are separated into distinct groups with similar characteristics in terms of Sustainability Risk, and an analysis for potential decision-making, based on the visualization of the countries' position in relation to the major sustainability threats, is performed for each group. The research identifies risks with maximum impacts.
Short, Susan E; Goldberg, Rachel E
In sub-Saharan Africa many children live in extreme poverty and experience a burden of illness and disease that is disproportionately high. The emergence of HIV and AIDS has only exacerbated long-standing challenges to improving children's health in the region, with recent cohorts experiencing pediatric AIDS and high levels of orphan status, situations which are monitored globally and receive much policy and research attention. Children's health, however, can be affected also by living with HIV-infected adults, through associated exposure to infectious diseases and the diversion of household resources away from them. While long recognized, far less research has focused on characterizing this distinct and vulnerable population of HIV-affected children. Using Demographic and Health Survey data from 23 countries collected between 2003 and 2011, we estimate the percentage of children living in a household with at least one HIV-infected adult. We assess overlaps with orphan status and investigate the relationship between children and the adults who are infected in their households. The population of children living in a household with at least one HIV-infected adult is substantial where HIV prevalence is high; in Southern Africa, the percentage exceeded 10% in all countries and reached as high as 36%. This population is largely distinct from the orphan population. Among children living in households with tested, HIV-infected adults, most live with parents, often mothers, who are infected; nonetheless, in most countries over 20% live in households with at least one infected adult who is not a parent. Until new infections contract significantly, improvements in HIV/AIDS treatment suggest that the population of children living with HIV-infected adults will remain substantial. It is vital to on-going efforts to reduce childhood morbidity and mortality to consider whether current care and outreach sufficiently address the distinct vulnerabilities of these children.
Susan E Short
Full Text Available In sub-Saharan Africa many children live in extreme poverty and experience a burden of illness and disease that is disproportionately high. The emergence of HIV and AIDS has only exacerbated long-standing challenges to improving children's health in the region, with recent cohorts experiencing pediatric AIDS and high levels of orphan status, situations which are monitored globally and receive much policy and research attention. Children's health, however, can be affected also by living with HIV-infected adults, through associated exposure to infectious diseases and the diversion of household resources away from them. While long recognized, far less research has focused on characterizing this distinct and vulnerable population of HIV-affected children.Using Demographic and Health Survey data from 23 countries collected between 2003 and 2011, we estimate the percentage of children living in a household with at least one HIV-infected adult. We assess overlaps with orphan status and investigate the relationship between children and the adults who are infected in their households.The population of children living in a household with at least one HIV-infected adult is substantial where HIV prevalence is high; in Southern Africa, the percentage exceeded 10% in all countries and reached as high as 36%. This population is largely distinct from the orphan population. Among children living in households with tested, HIV-infected adults, most live with parents, often mothers, who are infected; nonetheless, in most countries over 20% live in households with at least one infected adult who is not a parent.Until new infections contract significantly, improvements in HIV/AIDS treatment suggest that the population of children living with HIV-infected adults will remain substantial. It is vital to on-going efforts to reduce childhood morbidity and mortality to consider whether current care and outreach sufficiently address the distinct vulnerabilities of these
Kidman, Rachel; Palermo, Tia
There are compelling reasons to believe that orphans – many millions due to the AIDS epidemic – are more likely to be sexually victimized during childhood. Few studies have empirically investigated sexual violence disparities, and those that do suffer from methodological limitations and limited geographic scope. We used nationally-representative data on female adolescents (15-17 years) from 13 countries in sub-Saharan Africa. We built multilevel logistic models to test for an association betw...
van Gemert, Frederik A; Kirenga, Bruce J; Gebremariam, Tewodros Haile; Nyale, George; de Jong, Corina; van der Molen, Thys
In most low and middle-income countries, chronic obstructive pulmonary disease (COPD) is on the rise. Areas covered: Unfortunately, COPD is a neglected disease in these countries. Taking sub-Saharan Africa as an example, in rural areas, COPD is even unknown regarding public awareness and public health planning. Programs for the management of COPD are poorly developed, and the quality of care is often of a low standard. Inhaled medication is often not available or not affordable. Tobacco smoking is the most common encountered risk factor for COPD. However, in sub-Saharan Africa, household air pollution is another major risk factor for the development of COPD. Communities are also exposed to a variety of other risk factors, such as low birth weight, malnutrition, severe childhood respiratory infections, occupational exposures, outdoor pollution, human-immunodeficiency virus and tuberculosis. All these factors contribute to the high burden of poor respiratory health in sub-Saharan Africa. Expert commentary: A silent growing epidemic of COPD seems to be unravelling. Therefore, prevention and intervention programs must involve all the stakeholders and start as early as possible. More research is needed to describe, define and inform treatment approaches, and natural history of biomass-related COPD.
The United Nations Millennium Development Goals (MDGs) project is coming to an end in 2015 and is being replaced by ambitious and aspirational Sustainable Development Goals (SDGs). Although the MDGs have been nearly achieved, this is not true in Sub-Saharan Africa where there is still unnecessarily high infant and childhood mortality and where there are many challenges to providing modern child health care. To achieve the SDGs in the next fifteen years, in low-income countries, national minis...
Full Text Available It is not clear whether between-country health inequity in Sub-Saharan Africa has been reduced over time due to economic development and increased foreign investments. We used the World Health Organization’s data about 46 nations in Sub-Saharan Africa to test if under-5 mortality rate (U5MR and life expectancy (LE converged or diverged from 1990 to 2011. We explored whether the standard deviation of selected health indicators decreased over time (i.e., sigma convergence, and whether the less developed countries moved toward the average level in the group (i.e., beta convergence. The variation of U5MR between countries became smaller from 1990 to 2001. Yet this sigma convergence trend did not continue after 2002. Life expectancy in Africa from 1990–2011 demonstrated a consistent convergence trend, even after controlling for initial differences of country-level factors. The lack of consistent convergence in U5MR partially resulted from the fact that countries with higher U5MR in 1990 eventually performed better than those countries with lower U5MRs in 1990, constituting a reversal in between-country health inequity. Thus, international aid agencies might consider to reassess the funding priority about which countries to invest in, especially in the field of early childhood health.
Jin, Jiajie; Liang, Di; Shi, Lu; Huang, Jiayan
It is not clear whether between-country health inequity in Sub-Saharan Africa has been reduced over time due to economic development and increased foreign investments. We used the World Health Organization's data about 46 nations in Sub-Saharan Africa to test if under-5 mortality rate (U5MR) and life expectancy (LE) converged or diverged from 1990 to 2011. We explored whether the standard deviation of selected health indicators decreased over time (i.e., sigma convergence), and whether the less developed countries moved toward the average level in the group (i.e., beta convergence). The variation of U5MR between countries became smaller from 1990 to 2001. Yet this sigma convergence trend did not continue after 2002. Life expectancy in Africa from 1990-2011 demonstrated a consistent convergence trend, even after controlling for initial differences of country-level factors. The lack of consistent convergence in U5MR partially resulted from the fact that countries with higher U5MR in 1990 eventually performed better than those countries with lower U5MRs in 1990, constituting a reversal in between-country health inequity. Thus, international aid agencies might consider to reassess the funding priority about which countries to invest in, especially in the field of early childhood health.
Jin, Jiajie; Liang, Di; Shi, Lu; Huang, Jiayan
It is not clear whether between-country health inequity in Sub-Saharan Africa has been reduced over time due to economic development and increased foreign investments. We used the World Health Organization’s data about 46 nations in Sub-Saharan Africa to test if under-5 mortality rate (U5MR) and life expectancy (LE) converged or diverged from 1990 to 2011. We explored whether the standard deviation of selected health indicators decreased over time (i.e., sigma convergence), and whether the less developed countries moved toward the average level in the group (i.e., beta convergence). The variation of U5MR between countries became smaller from 1990 to 2001. Yet this sigma convergence trend did not continue after 2002. Life expectancy in Africa from 1990–2011 demonstrated a consistent convergence trend, even after controlling for initial differences of country-level factors. The lack of consistent convergence in U5MR partially resulted from the fact that countries with higher U5MR in 1990 eventually performed better than those countries with lower U5MRs in 1990, constituting a reversal in between-country health inequity. Thus, international aid agencies might consider to reassess the funding priority about which countries to invest in, especially in the field of early childhood health. PMID:27338435
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.
.... In reassessing United States interests and security policy in Sub-Saharan Africa in the Post Cold War era, it is important to understand modern Africa's past and the peculiar relationship of politics...
Adenutsi, Deodat E.
An attempt has been made in this paper to examine the impact of international remittances on poverty and income inequality in sub-Saharan Africa (SSA). In carrying out the study, 34 SSA countries for which relevant data are available, between 1980 and 2009, were sampled for the poverty analysis whilst a sample size of 36 was used in the remittances-income inequality exploration. A set of dynamic panel-data models was estimated using system Generalized Method of Moments. It was found that remi...
The end of the Cold War and dissolution of the Soviet Union and Warsaw Pact caused the United States and its allies to reevaluate its national interests and strategy in and toward the countries of sub-Saharan Africa...
Full Text Available There is a growing interest in using Information and Communication Technologies (ICTs to support poverty reduction efforts and strategies in the framework of the Millennium Development Goals (MDGs. These interest ended up revealing how much the Poverty Reduction Strategy Papers (PRSPs of many african nations have underestimated the importance of ICTs as a development tool. The fact that so little was mentionned about the use of ICTs for poverty alleviation and creation of employment highlighted the confusion, and uncertainty of decision makers. At the country level, ICT is still to be effectively integrated into national poverty alleviation and development strategies. The question then is how ICTs can help achieve those objectives. How can ICTs be used as tools to fight against poverty? Poverty is widely recognized as multidimensional, encompassing food security, health, education, rights, security and dignity, amongst others as stressed by Bachelor and al in a model showing the intricate linkages between ICTs and most PRSP goals. The link between ICTs and poverty reduction strategy is therefore not that obvious. Although, researchers and development partners involved in poverty alleviation recognize more easily the linkage between ICT and poverty reduction strategies. In any case, it is a prerequisite to have a conducive environment and country readiness for ICTs implementation. Unfortunately, in many Sub-Saharan Africa countries, there is not yet a clear and effective policy and strategy for the use of ICT.
EPA’s environmental program in Sub-Saharan Africa is focused on addressing Africa’s growing urban and industrial pollution issues, such as air quality, water quality, electronics waste and indoor air from cookstoves.
Arndt, Channing; McKay, Andrew; Tarp, Finn
While the economic growth renaissance in sub-Saharan Africa is widely recognized, much less is known about progress in living conditions. This book comprehensively evaluates trends in living conditions in 16 major sub-Saharan African countries, corresponding to nearly 75% of the total population. A striking diversity of experience emerges. While monetary indicators improved in many countries, others are yet to succeed in channeling the benefits of economic growth into the pockets of the poor....
Blum, Robert W
Sub-Saharan Africa is going through rapid social, political, and economic transformations that have a profound impact on youth. The present review explores trends and outcomes as they relate to education, family formation and sexual and reproductive health and the interrelationships among these areas. It is based on both published and unpublished reports. Over the past 20 years, school enrollment has increased for much of the subcontinent; although the gender gap has narrowed, females remain educationally disadvantaged. Likewise, marriage is occurring later today than a generation ago, posing new challenges of out-of-wedlock births, clandestine abortions, and an increased likelihood of engaging in premarital sex. So, too, although there has been a slowing of the population growth in much of the region, in many countries of sub-Saharan Africa, the population is doubling every 30 years. Although acquired immunodeficiency syndrome is the predominant cause of death among youth, maternal mortality remains a major risk of death for youth--in some countries 600 times greater than that of peers in the industrialized world.
Marinucci, Francesco; Majigo, Mtebe; Wattleworth, Matthew; Paterniti, Antonio Damiano; Hossain, Mian Bazle; Redfield, Robert
Effective implementation and sustainability of quality laboratory programmes in Sub-Saharan Africa relies on the development of appropriate staff retention strategies. Assessing the factors responsible for job satisfaction and retention is key for tailoring specific interventions aiming at improving the overall impact of health programmes. A survey was developed to assess these factors among 224 laboratorians working in the laboratory programme the University of Maryland implemented in seven Sub-Saharan African countries. Lack of professional development was the major reason for leaving the previous job for 28% of interviewees who changed jobs in the past five years. Professional development/training opportunities was indicated by almost 90% (195/224) of total interviewees as the most important or a very important factor for satisfaction at their current job. Similarly, regular professional development/opportunities for training was the highest rated incentive to remain at their current job by 80% (179/224). Laboratory professionals employed in the private sector were more likely to change jobs than those working in the public sector (P = 0.002). The findings were used for developing specific strategies for human resources management, in particular targeting professional development, aiming at improving laboratory professionals within the University of Maryland laboratory programme and hence its long-term sustainability.
Fjelde, Hanne; Höglund, Kristine
Political violence remains a pervasive feature of electoral dynamics in many countries in Sub-Saharan Africa, even where multiparty elections have become the dominant mode of regulating access to political power. With cross-national data on electoral violence in Sub-Saharan African elections between 1990 and 2010, this article develops and tests a theory that links the use of violent electoral tactics to the high stakes put in place by majoritarian electoral institutions. It is found that ele...
Hisako KAI; Shigeyuki HAMORI
This paper examines the relationship between globalization, financial deepening, and inequality in sub-Saharan Africa between 1980 and 2002. We provide the first detailed econometric analysis in this regard covering the entire sub-Saharan African region; such an analysis has hardly been conducted owing to the lack of relevant data. We find that while globalization deteriorates inequality, its disequalizing effect depends on the level of development of the country. Further, this paper confirms...
Full Text Available Background: Large prospective epidemiologic studies are vital in determining disease etiology and forming national health policy. Yet, such studies do not exist in sub-Saharan Africa (SSA notwithstanding the growing burden of chronic diseases. Objective: We explored the feasibility of establishing a large-scale multicountry prospective study at five sites in four sub-Saharan countries. Design: Based on country-specific considerations of feasibility, Nigeria enrolled health care professionals, South Africa and Tanzania enrolled teachers, and Uganda enrolled village residents at one rural and one periurban site each. All sites used a 6-month follow-up period but different approaches for data collection, namely standardized questionnaires filled out by participants or face-to-face interviews. Results: We enrolled 1415 participants from five sites (range 200–489 with a median age of 41 years. Approximately half had access to clean-burning cooking fuel and 70% to piped drinking water, yet 92% had access to a mobile phone. The prevalence of chronic diseases was 49% among 45- to 54-year-olds and was dominated by hypertension (21.7% overall – ranging from 4.5 to 31.2% across sites – and a serious injury in the past 12 months (12.4% overall. About 80% of participants indicated willingness to provide blood samples. At 6-month follow-up, 68% completed a questionnaire (45 to 96% across sites with evidence that mobile phones were particularly useful. Conclusions: Our pilot study indicates that a large-scale prospective study in SSA is feasible, and the burden of chronic disease in SSA may already be substantial necessitating urgent etiologic research and primary prevention.
Magadi, Monica Akinyi
Women in sub-Saharan Africa bear a disproportionate burden of human immunodeficiency virus (HIV) infections, which is exacerbated by their role in society and biological vulnerability. The specific objectives of this article are to (i) determine the extent of gender disparity in HIV infection; (ii) examine the role of HIV/acquired immune deficiency syndrome (AIDS) awareness and sexual behaviour factors on the gender disparity and (iii) establish how the gender disparity varies between individuals of different characteristics and across countries. The analysis involves multilevel logistic regression analysis applied to pooled Demographic and Health Surveys data from 20 countries in sub-Saharan Africa conducted during 2003–2008. The findings suggest that women in sub-Saharan Africa have on average a 60% higher risk of HIV infection than their male counterparts. The risk for women is 70% higher than their male counterparts of similar sexual behaviour, suggesting that the observed gender disparity cannot be attributed to sexual behaviour. The results suggest that the risk of HIV infection among women (compared to men) across countries in sub-Saharan Africa is further aggravated among those who are younger, in female-headed households, not in stable unions or marital partnerships or had an earlier sexual debut. PMID:21545443
.... Unlike the period from 1960 to 1973, when economic growth in sub-Saharan Africa was relatively strong, since 1973 the countries of sub-Saharan Africa have grown at rates well below other developing countries...
Lee, Seohyun; Begley, Charles E; Morgan, Robert; Chan, Wenyaw; Kim, Sun-Young
As an innovative solution to poor access to care in low- and middle-income countries (LMICs), m-health has gained wide attention in the past decade. Despite enthusiasm from the global health community, LMICs have not demonstrated high uptake of m-health promoting policies or public investment. To benchmark the current status, this study compared m-health policy readiness scores between sub-Saharan Africa and high-income Organization for Economic Cooperation and Development (OECD) countries using an independent two-sample t test. In addition, the enabling factors associated with m-health policy readiness were investigated using an ordinal logistic regression model. The study was based on the m-health policy readiness scores of 112 countries obtained from the World Health Organization Third Global Survey on e-Health. The mean m-health policy readiness score for sub-Saharan Africa was statistically significantly lower than that for OECD countries (p = 0.02). The enabling factors significantly associated with m-health policy readiness included information and communication technology development index (odds ratio [OR] 1.57; 95% confidence interval [CI] 1.12-2.2), e-health education for health professionals (OR 4.43; 95% CI 1.60-12.27), and the location in sub-Saharan Africa (OR 3.47; 95% CI 1.06-11.34). The findings of our study suggest dual policy goals for m-health in sub-Saharan Africa. First, enhance technological and educational support for m-health. Second, pursue global collaboration for building m-health capacity led by sub-Saharan African countries with hands-on experience and knowledge. Globally, countries should take a systematic and collaborative approach in pursuing m-health policy with the focus on technological and educational support.
Bosker, Maarten; Garretsen, Harry
Sub-Saharan Africas (SSA) physical geography is often blamed for its poor economic performance. A countrys geographical location does, however, not only determine its agricultural conditions or disease environment. It also pins down a countrys relative position vis--vis other countries, affecting
Background Development of human resources for eye health (HReH) is a major focus of the Global Action Plan 2014 to 2019 to reduce the prevalence of avoidable visual impairment by 25% by the year 2019. The eye health workforce is thought to be much smaller in sub-Saharan Africa than in other regions of the world but data to support this for policy-making is scarce. We collected HReH and cataract surgeries data from 21 countries in sub-Sahara to estimate progress towards key suggested population-based VISION 2020 HReH indicators and cataract surgery rates (CSR) in 2011. Methods Routinely collected data on practitioner and surgery numbers in 2011 was requested from national eye care coordinators via electronic questionnaires. Telephone and e-mail discussions were used to determine data collection strategies that fit the national context and to verify reported data quality. Information was collected on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and ‘mid-level refractionists’ and combined with publicly available population data to calculate practitioner to population ratios and CSRs. Associations with development characteristics were conducted using Wilcoxon rank sum tests and Spearman rank correlations. Results HReH data was not easily available. A minority of countries had achieved the suggested VISION 2020 targets in 2011; five countries for ophthalmologists/cataract surgeons, four for ophthalmic nurses/clinical officers and two for CSR. All countries were below target for optometrists, even when other cadres who perform refractions as a primary duty were considered. The regional (sample) ratio for surgeons (ophthalmologists and cataract surgeons) was 2.9 per million population, 5.5 for ophthalmic clinical officers and nurses, 3.7 for optometrists and other refractionists, and 515 for CSR. A positive correlation between GDP and CSR as well as many practitioner ratios was observed
Palmer, Jennifer J; Chinanayi, Farai; Gilbert, Alice; Pillay, Devan; Fox, Samantha; Jaggernath, Jyoti; Naidoo, Kovin; Graham, Ronnie; Patel, Daksha; Blanchet, Karl
Development of human resources for eye health (HReH) is a major focus of the Global Action Plan 2014 to 2019 to reduce the prevalence of avoidable visual impairment by 25% by the year 2019. The eye health workforce is thought to be much smaller in sub-Saharan Africa than in other regions of the world but data to support this for policy-making is scarce. We collected HReH and cataract surgeries data from 21 countries in sub-Sahara to estimate progress towards key suggested population-based VISION 2020 HReH indicators and cataract surgery rates (CSR) in 2011. Routinely collected data on practitioner and surgery numbers in 2011 was requested from national eye care coordinators via electronic questionnaires. Telephone and e-mail discussions were used to determine data collection strategies that fit the national context and to verify reported data quality. Information was collected on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and 'mid-level refractionists' and combined with publicly available population data to calculate practitioner to population ratios and CSRs. Associations with development characteristics were conducted using Wilcoxon rank sum tests and Spearman rank correlations. HReH data was not easily available. A minority of countries had achieved the suggested VISION 2020 targets in 2011; five countries for ophthalmologists/cataract surgeons, four for ophthalmic nurses/clinical officers and two for CSR. All countries were below target for optometrists, even when other cadres who perform refractions as a primary duty were considered. The regional (sample) ratio for surgeons (ophthalmologists and cataract surgeons) was 2.9 per million population, 5.5 for ophthalmic clinical officers and nurses, 3.7 for optometrists and other refractionists, and 515 for CSR. A positive correlation between GDP and CSR as well as many practitioner ratios was observed (CSR P = 0
... the increasingly important role of these councils in national science systems. ... that will contribute to economic and social development in Sub-Saharan Africa. ... Initiative for Sub-Saharan Africa's website to learn more about the initiative.
Kidman, Rachel; Palermo, Tia
There are compelling reasons to believe that orphans – many millions due to the AIDS epidemic – are more likely to be sexually victimized during childhood. Few studies have empirically investigated sexual violence disparities, and those that do suffer from methodological limitations and limited geographic scope. We used nationally-representative data on female adolescents (15-17 years) from 13 countries in sub-Saharan Africa. We built multilevel logistic models to test for an association between the dependent variables (orphanhood and parental absence) and sexual violence, both within countries and pooled across all countries. Approximately 10% of adolescent girls reported past experiences of sexual violence; a third of those victimized were 14 years or younger at the time of their first forced encounter. Paternal orphaning (OR 1.36, p ≤ .01), double orphaning (OR 1.47, p ≤ .05), and paternal absence (OR 1.28; p ≤.05) were significantly associated with experiencing sexual violence in pooled analyses. Fewer findings reached significance within individual countries. Our findings suggest that the lack of a father in the home (due to death or absence) places girls at heightened risk for childhood sexual abuse; further research identifying pathways of vulnerability and resilience specific to this population is needed. Our findings also indicate that abuse often starts at an early age; thus promising programs should be adapted for younger age groups and rigorously tested. PMID:26631421
Rivera-Santos, M.; Holt, D.; Littlewood, D.; Kolk, A.
Responding to calls for a better understanding of the relationship between social enterprises and their environments, this article focuses on contextual influences on social entrepreneurship in sub-Saharan Africa. We identify four predominantly African contextual dimensions, i.e., acute poverty,
Domatob, J K
Given the heavy Western metropolitan bias of the media in sub-Saharan Africa, the ideology of neocolonialism continues to exert a dominant influence on economic, social, political, and cultural life. This neocolonial influence is further reinforced by advertising that champions a consumerist culture centered around Western goods. The capital of multinational firms plays a crucial role in the strategy of media imperialism. The dramatic growth of monopolies and the creation of military-industrial-information conglomerates in the 1970s and 1980s have been reflected in the international exchange of information and the interlinkage of mass communication systems in sub-Saharan Africa. Another media strategy that reinforces neocolonialism is the use of satellite communication. If cultural autonomy is defined as sub-Saharan Africa's capacity to decide on the allocation of its environmental resources, then cultural synchronization is a massive threat to that autonomy. Few African nations have the resources or expertise necessary to design, establish, or maintain communication systems that could accurately reflect their own culture. Nonetheless, there are some policy options. Personnel can be trained to respect African values and to recognize the dangers of neocolonial domination. The production of indigenous programs could reduce the media's foreign content. The incorporation of traditional drama and dance in the media could enhance this process. Above all, a high degree of planning is necessary if sub-Saharan African states intend to tackle the media and its domination by neocolonialist ideology.
Adrian H. Flores
Conclusion: In this study, overall utilisation of US in the diagnosis of EP was found to be low. In this population, patients presented late and critically ill, obviating the need for US in many cases. However, studies in Sub-Saharan Africa in populations of patients with similar rates of late presentations have shown a substantial increase in the diagnosis of unruptured EP with the routine use of US.
Jorge Fernández Ruiz
Full Text Available In recent years, the rate of growth of tourism in Sub-Saharan Africa has continued apace at almost twice the rate of the rest of the globe. In this paper we examine some economic consequences of this growth focusing our attention on two Sub-Saharan countries with important tourist sectors: Cape Verde and Gambia. We examine the factors driving the growth of tourism in these countries and those affecting whether or not this increase can help promote broader economic development and increase the overall welfare of the citizens of these two countries.
Deforestation has been a complex phenomenon to study in sub-Saharan Africa. The average annual deforestation rate in the region is by far higher than the world average. What causes and drives deforestation in the region are debated to date. The present paper is motivated by this debate. It attempts to test whether the maintained hypotheses on the causes of deforestation can give answer to the problem in sub-Saharan Africa. It used average cross-national data of forty eight countries in the re...
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. Copyright © 2015 Elsevier Editora Ltda. All rights
Abiola Fatimah Adenowo
Full Text Available Schistosomiasis, a neglected tropical disease of poverty ranks second among the most widespread parasitic disease in various nations in sub-Saharan Africa. Neglected tropical diseases are causes of about 534,000 deaths annually in sub-Saharan Africa and an estimated 57 million disability-adjusted life-years are lost annually due to the neglected tropical diseases. The neglected tropical diseases exert great health, social and financial burden on economies of households and governments. Schistosomiasis has profound negative effects on child development, outcome of pregnancy, and agricultural productivity, thus a key reason why the “bottom 500 million” inhabitants of sub-Saharan Africa continue to live in poverty. In 2008, 17.5 million people were treated globally for schistosomiasis, 11.7 million of those treated were from sub-Saharan Africa. This enervating disease has been successfully eradicated in Japan, as well as in Tunisia. Morocco and some Caribbean Island countries have made significant progress on control and management of this disease. Brazil, China and Egypt are taking steps towards elimination of the disease, while most sub-Saharan countries are still groaning under the burden of the disease. Various factors are responsible for the continuous and persistent transmission of schistosomiasis in sub-Saharan Africa. These include climatic changes and global warming, proximity to water bodies, irrigation and dam construction as well as socio-economic factors such as occupational activities and poverty. The morbidity and mortality caused by this disease cannot be overemphasized. This review is an exposition of human schistosomiasis as it affects the inhabitants of various communities in sub-Sahara African countries. It is hoped this will bring a re-awakening towards efforts to combat this impoverishing disease in terms of vaccines development, alternative drug design, as well as new point-of-care diagnostics.
.... This report from Sub-Sahara Africa, Angola, Cameroon, Equatorial Guinea, Ethiopia, Gambia, Kenya, Malawi, Namibia, Mozambique, Niger, Nigeria, Senegal, Sierra Leone, South Africa, Tanzania, Uganda...
de Vries, Sophia G; Visser, Benjamin J; Nagel, Ingeborg M; Goris, Marga G A; Hartskeerl, Rudy A; Grobusch, Martin P
Leptospirosis is an emerging zoonotic infection worldwide, possibly due to climate change and demographic shifts. It is regarded as endemic in Sub-Saharan Africa; however, for most countries scarce epidemiological data, if any, exist. The primary objectives were to describe the prevalence of leptospirosis in countries in Sub-Saharan Africa, and to develop options for prevention and control in the future. A systematic review was conducted to determine the prevalence of leptospirosis in Sub-Saharan Africa; the PRISMA guidelines were followed. Medline/PubMed, Embase, The Cochrane Library, Web of Science, BIOSIS Previews, the African Index Medicus, AJOL, and Google Scholar were searched. Information about the prevalence and incidence of leptospirosis in humans is available, but remains scarce for many countries. Data are unavailable or outdated for many countries, particularly those in Central Africa. Most data are available from animals, probably due to the economic losses caused by leptospirosis in livestock. In humans, leptospirosis is an important cause of febrile illness in Sub-Saharan Africa. It concerns numerous serogroups, harboured by many different animal carriers. A wide variety of data was identified. Prevalence rates vary throughout the continent and more research, especially in humans, is needed to reliably gauge the extent of the problem. Preventive measures need to be reconsidered to control outbreaks in the future.
Monden, Christiaan W S; Smits, Jeroen
Sub-Saharan Africa has the world's highest under-5 and neonatal mortality rates as well as the highest naturally occurring twin rates. Twin pregnancies carry high risk for children and mothers. Under-5 mortality has declined in sub-Saharan Africa over the last decades. It is unknown whether twins have shared in this reduction. We pooled data from 90 Demographic and Health Surveys for 30 sub-Saharan Africa countries on births reported between 1995 and 2014. We used information on 1 685 110 singleton and 56 597 twin livebirths to compute trends in mortality rates for singletons and twins. We examined whether the twin-singleton rate ratio can be attributed to biological, socioeconomic, care-related factors, or birth size, and estimated the mortality burden among sub-Saharan African twins. Under-5 mortality among twins has declined from 327·7 (95% CI 312·0-343·5) per 1000 livebirths in 1995-2001 to 213·0 (196·7-229·2) in 2009-14. This decline of 35·0% was much less steep than the 50·6% reduction among singletons (from 128·6 [95% CI 126·4-130·8] per 1000 livebirths in 1995-2001 to 63·5 [61·6-65·3] in 2009-14). Twins account for an increasing share of under-5 deaths in sub-Saharan Africa: currently 10·7% of under-5 mortality and 15·1% of neonatal mortality. We estimated that about 315 000 twins (uncertainty interval 289 000-343 000) die in sub-Saharan African each year. Excess twin mortality cannot be explained by common risk factors for under-5 mortality, including birthweight. The difference with singletons was especially stark for neonatal mortality (rate ratio 5·0, 95% CI 4·5-5·6). 51·7% of women pregnant with twins reported receiving medical assistance at birth. The fate of twins in sub-Saharan Africa is lagging behind that of singletons. An alarming one-fifth of twins in the region dies before age 5 years, three times the mortality rate among singletons. Twins account for a substantial and growing share of under-5 and neonatal
Manne-Goehler, Jennifer; Atun, Rifat; Stokes, Andrew; Goehler, Alexander; Houinato, Dismand; Houehanou, Corine; Hambou, Mohamed Msaidie Salimani; Mbenza, Benjamin Longo; Sobngwi, Eugène; Balde, Naby; Mwangi, Joseph Kibachio; Gathecha, Gladwell; Ngugi, Paul Waweru; Wesseh, C Stanford; Damasceno, Albertino; Lunet, Nuno; Bovet, Pascal; Labadarios, Demetre; Zuma, Khangelani; Mayige, Mary; Kagaruki, Gibson; Ramaiya, Kaushik; Agoudavi, Kokou; Guwatudde, David; Bahendeka, Silver K; Mutungi, Gerald; Geldsetzer, Pascal; Levitt, Naomi S; Salomon, Joshua A; Yudkin, John S; Vollmer, Sebastian; Bärnighausen, Till
Despite widespread recognition that the burden of diabetes is rapidly growing in many countries in sub-Saharan Africa, nationally representative estimates of unmet need for diabetes diagnosis and care are in short supply for the region. We use national population-based survey data to quantify diabetes prevalence and met and unmet need for diabetes diagnosis and care in 12 countries in sub-Saharan Africa. We further estimate demographic and economic gradients of met need for diabetes diagnosis and care. We did a pooled analysis of individual-level data from nationally representative population-based surveys that met the following inclusion criteria: the data were collected during 2005-15; the data were made available at the individual level; a biomarker for diabetes was available in the dataset; and the dataset included information on use of core health services for diabetes diagnosis and care. We first quantified the population in need of diabetes diagnosis and care by estimating the prevalence of diabetes across the surveys; we also quantified the prevalence of overweight and obesity, as a major risk factor for diabetes and an indicator of need for diabetes screening. Second, we determined the level of met need for diabetes diagnosis, preventive counselling, and treatment in both the diabetic and the overweight and obese population. Finally, we did survey fixed-effects regressions to establish the demographic and economic gradients of met need for diabetes diagnosis, counselling, and treatment. We pooled data from 12 nationally representative population-based surveys in sub-Saharan Africa, representing 38 311 individuals with a biomarker measurement for diabetes. Across the surveys, the median prevalence of diabetes was 5% (range 2-14) and the median prevalence of overweight or obesity was 27% (range 16-68). We estimated seven measures of met need for diabetes-related care across the 12 surveys: (1) percentage of the overweight or obese population who received a
Barasa, L.; Kinyanjui, B.; Knoben, Joris; Kimuyu, P.; Vermeulen, P.A.M.
Our study seeks to examine the bi-directional relationship between innovation and exporting in four countries in Sub-Saharan Africa. We hypothesize that there is a positive relationship between innovation and subsequent exporting, and that this relationship is mediated by market creation. We also
This initiative seeks to strengthen the capacities of science granting councils in East Africa and other selected sub-Saharan African countries. The goal is to contribute to economic and social development in the region through research and evidence-based policies. About the science granting councils initiative The Science ...
Information and Networks in Asia and Sub-Saharan Africa: Strengthening Research Capacity ... credible, high-quality evidence on the influence of digital initiatives in the areas of ... use of digital information networks and economic growth, democratic reform, and increased educational opportunities in developing countries.
David E. Sahn; H. Alderman
Sub-Saharan Africa (SSA) has had an aggregate malnutrition rate of nearly 30 percent for the last decade. While malnutrition prevalence has decreased significantly in most other developing countries in the last decade, it has been nearly static for SSA. This static trend in the percentage of malnourished children, however, does not fully reflect the rapidly rising numbers of malnourished c...
GrOW is a five-year, multi-funder partnership of the United Kingdom's Department for International Development, The William and Flora Hewlett Foundation, and IDRC. With a focus on low-income countries in sub-Saharan Africa and South Asia, GrOW aims to support policies and interventions that improve women's ...
Romig, T.; Omer, R. A.; Zeyhle, E.; Hüttner, M.; Dinkel, A.; Siefert, L.; Elmahdi, I. E.; Magambo, J.; Ocaido, M.; Menezes, C. N.; Ahmed, M. E.; Mbae, C.; Grobusch, M. P.; Kern, P.
Cystic echinococcosis occurs in most regions of sub-Saharan Africa, but the frequency of this zoonosis differs considerably among and within countries. Especially human cases seem to be focally distributed. A number of environmental and behavioural factors partially explain this pattern, i.e.
Result and Conclusion: Neonatal hypothermia is a major condition of public health importance in countries of sub- Saharan Africa. Awareness of the burden of the disease is still low in some communities. Risk factors for neonatal hypothermia in the region include poverty, home delivery, low birthweight, early bathing of ...
de Vries, Sophia G.; Visser, Benjamin J.; Nagel, Ingeborg M.; Goris, Marga G. A.; Hartskeerl, Rudy A.; Grobusch, Martin P.
Leptospirosis is an emerging zoonotic infection worldwide, possibly due to climate change and demographic shifts. It is regarded as endemic in Sub-Saharan Africa; however, for most countries scarce epidemiological data, if any, exist. The primary objectives were to describe the prevalence of
Ellis, S.D.K.; Haar, Gerrie ter
In the considerable number of countries in sub-Saharan Africa in which political institutions have largely broken down, religious discourse can be seen as an attempted remedy by means of a reordering of power. The numerous popular texts on witchcraft and other perceived forms of evil reflect the
Delfin Go; Denis Nikitin; Xiongjian Wang; Heng-fu Zou
This paper surveys the literature and assesses the magnitude, persistence, and depth of poverty and inequality in Sub-Saharan Africa using empirical analysis. Our analysis explores linkages between three key facts about development in Sub-Saharan Africa: poor economic growth, poor performance in terms of public health indicators, and resilient high-income inequality. Most of the differential between growth rates in Sub-Saharan Africa and other developing countries can be explained by two meas...
By the year 2015, Sub-Saharan Africa's population will probably rise from a 1985 level of about 460 million to about 1.1 billion. Today Africa's population is growing at a rate of roughly 3% a year, with exceptionally high growth rates in some countries. The leaders of Africa, and those who wish to help Africa, confront difficult and urgent problems of drought, political and military conflict, accumulated debt, lower commodity prices, and other factors of immediate and important concern. Africa has given education a high priority and should be as well known for its success in increasing school enrollment as it is for its relative failures in other areas. A projected population of 1.1 billion people and a fertility rate down to 30/1000 by the year 2015 suggests that the number of children old enough to enter primary school will be of the order of 30 million a year at this time. The working-age population will grow from 235 million now to perhaps 600 million in 30 years. The urban population has been growing at about 6% a year--twice the pace of population increase. All of these situations will have an effect on environment, water, and health. Coping with Africa's burgeoning population in terms of children in school, the demand on health systems, the need for jobs, achieving an adequate diet, the provision of basic urban services, and all the rest, is an extraordinary challenge. While the government's role is critical, success at the sectoral level almost always means cost recovery, administration decentralized to the community or to the private sector, and program implementation that does not burden the budget.
Apergis, Nicholas; Ben Jebli, Mehdi
This paper employs a number of panel methodological approaches to explore the link between per capita carbon dioxide emissions, per capita real income, renewable energy consumption and health expenditures for a panel of 42 sub-Saharan African countries, spanning the period 1995-2011. The empirical findings provide supportive of a long-run relationship among the variables. Granger causality reveals the presence of a short-run unidirectional causality running from real GDP to CO2 emissions, a b...
Partial Contents: Subsaharan Africa, Railway Development, Arrests, International Reports, Lends Funds, Refugees, Investment Tax, Territory, Evidence, Leadership, Journalists, Credit LIne, Soliderity, Foreign Trades...
Partial Contents: Subsaharan Africa, Resolution, Settlement, Leaderships, Election Fraud, Political, Propaganda War, Guerilla War, Commonwealth President, Warns Officers, National Youth Corps, Diversity, Unemployment...
Sub-Saharan Africa (SSA) is the region with the world's highest rates of HIV and other sexually transmissible infections (STIs), yet numerous studies show that condom use is generally rare. This suggests a need for a better understanding of how condoms fit within sexual practices and relationships in SSA. This paper seeks to address this need by reviewing research published between the late 1980s and 2011 on use and factors influencing use of male condoms in SSA. What is evident from this research is that condom use involves complex social and interpersonal dynamics, with structural and cultural conditions exerting an influence through framing social cognitions and setting boundaries on autonomy that make the apparently irrational choice of eschewing condoms a rational decision. The influences of poverty; relationships with parents, peers and partners; limited, insufficient or absent information especially in rural areas and among men who have sex with men; gender and sexual norms, and the dynamics of gendered power; and beliefs and attitudes about HIV, condoms and sexuality all have been shown to work against condom use for a large proportion of Africa's people. However, promising results are shown in trends towards increased condom use among single women in numerous countries, increasing acceptance and use of condoms among some university students, successes in producing potentially sustainable condom use resulting from select interventions, and resistance to succumbing to the dominant gender-power dynamics and structural-cultural impediments that women in groups have mobilised.
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...
Full Text Available The United Nations Millennium Development Goals (MDGs project is coming to an end in 2015 and is being replaced by ambitious and aspirational Sustainable Development Goals (SDGs. Although the MDGs have been nearly achieved, this is not true in Sub-Saharan Africa where there is still unnecessarily high infant and childhood mortality and where there are many challenges to providing modern child health care. To achieve the SDGs in the next fifteen years, in low-income countries, national ministries of health and community health leaders will need to set reasonable goals and quality improvement projects. Attention needs to paid to economical, evidence-based effective health care; to education of children and youth and of health professional; health promotion and prevention of illness; a balance between expensive health care in large urban hospitals and community health projects; and most importantly to the social determinants of health. But the SDGs are achievable with coordinated and sustained national commitments and increased financial commitments from Western countries.
Odimegwu, Clifford; Mkwananzi, Sibusiso
This study aimed to assess the contextual factors associated with teenage pregnancy in sub-Saharan Africa. Using DHS data we modelled females aged 15-19 with multilevel logistic regression to establish the independent influence of social disadvantage on teenage pregnancy in West, East and Southern Africa with aid of the MLwiN programme. Results showed teenage pregnancy decreased in East Africa, plateaued in West Africa and increased slightly in Southern Africa between 1992 and 2011. Multilevel multivariate regression revealed teenage pregnancy was associated with family disruption (0.39; 0.40: Ppoverty (1.01; 1.02: PAfrica, while only community poverty (1.01; PAfrica. Our findings emphasise the necessity of creating regional-specific interventions and prevention campaigns to address multilevel factors such as family disruption as well as the need for governments to address issues of unemployment, poverty and inequality.
Monden, C.W.S.; Smits, J.P.J.M.; Monden, C.
BACKGROUND - Sub-Saharan Africa has the world's highest under-5 and neonatal mortality rates as well as the highest naturally occurring twin rates. Twin pregnancies carry high risk for children and mothers. Under-5 mortality has declined in sub-Saharan Africa over the last decades. It is unknown
The research will be carried out as a collaborative effort in which senior African scholars and their counterparts outside Africa interact with African policymakers who are engaged in various ways with China and India. The idea is to better understand the implications of economic relations with China for African development ...
about DM30 million to Mozambique. This money will be used toward the rehabilitation of the industrial and financial estate [ parque ], invest- ments in...26 Industrial Sector Prioritized Under SFEM (NEW NIGERIAN, 24 Oct 86) 28 Cocoa Inspection Controls To Tighten (AFRICA ECONOMIC DIGEST, 1-7...86) 101 Briefs White Urbanites Spending Cuts 103 Black/White Consumer Confidence IO3 Coastal Industry Expansion Urged 104 Corn to Lesotha 104
Africa "governed by the votes of some 900 000 White men and women admitted to the franchise (because) they had a white skin and an age of :21 years’V...what they are doing now." /9317 CSO: 3400/848 111 KX$ vS ;:; sxv£ .WfflE’iUÄiJ**»ÜÄ5Jau«ÄftBd!Effli iMMWWflnttfta&tt •ÖSE *V5äi&a?.W- -■-: SOUTH...deregula- tion". The SBDC is calling for a freer economy with more visible gains from entrepreneurship . Says Woolford: "You cannot expect
Jul 1, 2013 ... its trade and education ties with the three countries. In Accra, the Governor ... and malnutrition; a project that uses modern techniques to produce new .... The project targets traditional and local authorities, judicial institutions ...
field of develop their agriculture viewing relations between sports especially in other parallel to other sector., of the two countries at the spots...licy.the protein requirement siness, a new policy that h District’s Animal of the country. lays emphasis on the Husbandry Officer, Mr This. was...without the discontent felt by many pea - sants with regard to certain local party officials, the RENAMO would have been unable to find any support in
Health reforms in the region have been influenced largely by the poor performance of the health systems, particularly with regard to the quality of health services. Most countries have taken due cognizance of the deficiencies on their health systems in the design of their health reform programmes and they have made some ...
Sub-Saharan Africa is home to some of the most nutritionally insecure people in the world. Poor infrastructure and limited resources compounded with conflict, HIV, and poor access to health services are factors that contribute to the staggering levels of malnutrition and food insecurity on the continent. Despite these enormous challenges, some countries in Africa are making progress towards food and nutrition security and there has never been a better time to work towards improved human devel...
renovated and modernized with the help of the European Investment Bank (EIB), Luxembourg, which has granted a conditional loan of 12 million ECU (1 ECU...implementation of Portuguese know-how, occupational training programs, and technological renovation ." Rocha de Matos was also of the opinion that this...newspapers and magazines (for example, ENERGIA and NOVEMBRO) appear only sporadically, and the students want to have regular news about our country
Obowna, Marios; Abuka, Charles Augustine
Uganda faced a number of challenges at the time of embarking on financial sector reforms. These challenges were complicated by decades of economic mismanagement and political instability that had prevailed in the country. In particular, there were concerns about the inadequacy of a critical mass of skilled and experienced financial sector players. This shortcoming inherently induced undue impediments to Uganda's corporate reporting regime. Further shortcoming were related to the lack of compr...
Nthumba, Peter M
Burns are important preventable causes of morbidity and mortality, with a disproportionate incidence in sub-Saharan Africa. The management of these injuries in sub-Saharan Africa is a challenge because of multiple other competing problems such as infectious diseases (HIV/AIDS, tuberculosis and malaria), terrorist acts and political instability. There is little investment in preventive measures, pre-hospital, in-hospital and post-discharge care of burns, resulting in high numbers of burns, high morbidity and mortality. Lack of data that can be used in legislation and policy formulation is a major hindrance in highlighting the problem of burns in this sub-region. An online search of publications on burns from sub-Saharan countries was performed. A total of 54 publications with 32,862 patients from 14 countries qualified for inclusion in the study. The average age was 15.3 years. Children aged 10 years and below represented over 80% of the burn patient population. Males constituted 55% of those who suffered burns. Scalds were the commonest cause of thermal injuries, accounting for 59% of all burns, while flame burns accounted for 33%. The burn mortality averaged 17%, or the death of one of every five burn victims. These statistics indicate the need for an urgent review of burn policies and related legislation across the sub-Saharan region to help reduce burns, and provide a safe environment for children. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.
Chinsembu, Kazhila C
Although the burden of malaria is decreasing, parasite resistance to current antimalarial drugs and resistance to insecticides by vector mosquitoes threaten the prospects of malaria elimination in endemic areas. Corollary, there is a scientific departure to discover new antimalarial agents from nature. Because the two antimalarial drugs quinine and artemisinin were discovered through improved understanding of the indigenous knowledge of plants, bioprospecting Sub-Saharan Africa's enormous plant biodiversity may be a source of new and better drugs to treat malaria. This review analyses the medicinal plants used to manage malaria in Sub-Saharan Africa. Chemical compounds with antiplasmodial activity are described. In the Sub-Saharan African countries cited in this review, hundreds of plants are used as antimalarial remedies. While the number of plant species is not exhaustive, plants used in more than one country probably indicate better antimalarial efficacy and safety. The antiplasmodial data suggest an opportunity for inventing new antimalarial drugs from Sub-Saharan-African flora. Copyright © 2015 Elsevier B.V. All rights reserved.
Garve, Roland; Garve, Miriam; Türp, Jens C; Fobil, Julius N; Meyer, Christian G
Various forms of body modification may be observed in sub-Saharan Africa. Hypotheses and theories of scarification and tribal marking in sub-Saharan Africa are described, plus the procedure of scarification, examples from several African countries, assumed effects in prevention and treatment of diseases, and the medical risks resulting from unsterile manipulation. © 2017 John Wiley & Sons Ltd.
van Gemert, Frederik; van der Molen, Thys; Jones, Rupert; Chavannes, Niels
Background: Many countries in sub-Saharan Africa have the highest risk of developing chronic diseases and are the least able to cope with them. Aims: To assess the current knowledge of the prevalence and impact of asthma and chronic obstructive pulmonary disease (COPD) in sub-Saharan Africa.
Richter, Kerry; Phillips, Steven C; McInnis, Amy M; Rice, Debora A
This paper examines whether a multi-country workplace peer education HIV prevention program is effective in influencing knowledge, attitudes and behavior in a highly educated and technically skilled workforce. Self-administered surveys were used to measure change among N=993 male and female workers exposed to a comprehensive and culturally-appropriate program. Most knowledge indicators and all attitude indicators showed significant improvement between baseline and post-intervention. The odds ratio was 2.48 for reporting confidence in using condoms correctly after exposure to the program compared with the baseline survey. The results on changes in practice were mixed; while respondents were more likely to report being tested for HIV post-intervention, they were also more likely to self-report risky behavior. The findings suggest that peer education prevention programs in the workplace may create a climate of open discussion about sexual issues that increases self-reporting of risk behavior. Reinforcement of the messages contained in the program is therefore extremely important for influencing future behavior change.
Eberhard, Anton; Gratwick, Katharine Nawaal
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.
Selected socioeconomic barriers of education in Sub-Saharan Africa Abstract The aim of bachelor thesis is to describe and understand the process of education in Sub-Saharan Africa and analyze components that cause limited access to education. The first part of the thesis describes the process of education in Sub-Saharan Africa using selected indicators. The second main part focuses on the description and possible relations between selected socioeconomic barriers and literacy. Selected barrier...
Asgari, Mahdi; Nogueira, Lia
Countries successful in achieving growth and equity throughout their development process could provide continuing gross flow of resources to agriculture in the form of technical, educational, and financial elements combined with proper institutions and policies to increase agricultural productivity. The main purpose of this study is to analyze the impact of institutional differences in governance, health and markets on the overall agricultural performance of Sub-Saharan Africa countries. Gove...
Lilyan E. Fulginiti; Richard K. Perrin; Bingxin Yu
Agricultural productivity in 41 Sub-Saharan Africa (SSA) countries from 1960 to 1999 is examined by estimating a semi-nonparametric Fourier production frontier. Over the four decades the estimated rate of productivity change was 0.83% per year, although the average rate from 1985-99 was a strong 1.90% per year. Former UK colonies exhibited significantly higher productivity gains than others, while Liberia and countries that had been colonies of Portugal or Belgium exhibited net reductions in ...
Hosseinpoor, Ahmad Reza; Victora, Cesar G; Bergen, Nicole; Barros, Aluisio J D; Boerma, Ties
To measure within-country wealth-related inequality in the health service coverage gap of maternal and child health indicators in sub-Saharan Africa and quantify its contribution to the national health service coverage gap. Coverage data for child and maternal health services in 28 sub-Saharan African countries were obtained from the 2000-2008 Demographic Health Survey. For each country, the national coverage gap was determined for an overall health service coverage index and select individual health service indicators. The data were then additively broken down into the coverage gap in the wealthiest quintile (i.e. the proportion of the quintile lacking a required health service) and the population attributable risk (an absolute measure of within-country wealth-related inequality). In 26 countries, within-country wealth-related inequality accounted for more than one quarter of the national overall coverage gap. Reducing such inequality could lower this gap by 16% to 56%, depending on the country. Regarding select individual health service indicators, wealth-related inequality was more common in services such as skilled birth attendance and antenatal care, and less so in family planning, measles immunization, receipt of a third dose of vaccine against diphtheria, pertussis and tetanus and treatment of acute respiratory infections in children under 5 years of age. The contribution of wealth-related inequality to the child and maternal health service coverage gap differs by country and type of health service, warranting case-specific interventions. Targeted policies are most appropriate where high within-country wealth-related inequality exists, and whole-population approaches, where the health-service coverage gap is high in all quintiles.
The introduction to this description of emigration dynamics in sub-Saharan Africa notes that the region is characterized by intensive migration caused by such factors as population growth, negative economic growth, ethnic conflict, and human rights abuses. The second section of the report discusses the fragmentary and incomplete nature of data on international migration in the region, especially data on conventional migration. Section 3 looks at demographic factors such as high population growth, illiteracy levels, HIV seroprevalence, and urbanization which lead to high unemployment and emigration. The fourth section considers the effects of the rapid expansion of education which is outstripping the absorptive capacity of the economies of many countries. Unemployment is a serious problem which is projected to become worse as increases in employment opportunities continue to lag behind increases in output. Sections five, six, and seven of the report describe relevant economic factors such as per capita income, income distribution, the economic resource base, and economic development; poverty; and the effects of economic adjustment programs, especially on employment opportunities and wages in the public and private sectors. The next section is devoted to sociocultural factors influencing migration both on the micro- and the macro-levels, including the influence of ethnicity and ethnic conflicts as well as the domination of leadership positions by members of minority groups. The political factors discussed in section 9 include women's status, repressive regimes, political instability which leads to underdevelopment, and the policies of the Organization of African Unity which broadened the definition of refugees and set inviolable borders of member states identical to those inherited upon independence. Section 10 outlines ecological factors contributing to migration, including the decline in acreage of arable land, soil deterioration, poor land management, and the
Ana Paula F. Mendes
Full Text Available This article aims to contribute to the understanding of the process of import substitution in Sub-Saharan Africa. The process of industrialization in Sub-Saharan Africa occurred in two phases: a first step, even very early during the colonial regime began around the 1920s and ended in the late forties; a second phase of industrialization began in the late fifties and gained momentum in the sixties, when import substitution was implemented more widely. Although these countries were the last to embark on the strategy of import substitution, they followed the same steps of Latin American countries, and as the structural domestic and external constraints were too strong, the failure of the policy of import substitution arrived early and the negative impact on these economies had a greater magnitude.
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 ...
Motivated by sustainable development challenges in Sub-Saharan Africa, this study assesses the comparative persistence of environmental unsustainability in a sample of 44 countries in the sub-region for the period 2000 to 2012. The empirical evidence is based on Generalised Method of Moments. Of the six hypotheses tested, it is not feasible to assess the hypothesis on resource-wealth because of issues in degrees of freedom. As for the remaining hypotheses, the following findings are establis...
Joseph Ato Forson; Theresa Yaaba Baah-Ennumh; Ponlapat Buracom; Guojin Chen; Peng Zhen
This study explores the causes of corruption in 22 countries in sub-Saharan Africa from 1996 to 2013. The sources of corruption are grouped into three main thematic areas – historical roots, contemporary causes and institutional causes to make way for subjective and objective measures. The subjective measures allow for assessment of the effectiveness of anticorruption policies. Using pooled OLS, fixed-effect and instrumental-variable approaches, and focusing on the perceived level of corrupti...
Abdulai, Awudu; Barrett, Christopher B.; Hazell, Peter
"Food aid remains significant for food availability in many low-income countries in sub-Saharan Africa, helping to reduce the gap between food consumption needs and supply from domestic production and inventories and commercial imports. Food aid remains a contentious subject, however, and there have been many recent pleas for more effective use of the resource. This study explores how food aid might be used for domestic food market development to facilitate poverty alleviation and economic gr...
Sub-Saharan Africa's long-term growth performance will need to improve significantly for the region to visibly reduce poverty and raise the standard of living to an acceptable level. Appropriate actions will also be needed to ensure that an adequate share of the growing income is devoted to reducing poverty. The key policy question for these countries and their development partners is how ...
Cools, Sara; Kotsadam, Andreas
Combining DHS data for 580,000 women from 30 different countries in Sub-Saharan Africa, we analyze how both the incidence and the acceptance of intimate partner violence vary across time and space, in a region with record high levels of violence against women. We review the existing literature regarding the impact of resources on intimate partner violence, extracting testable and often conflicting hypotheses at the micro and macro level, and on the interaction across levels. We propose to ext...
This article begins by emphasizing that the number and intensity of armed conflict has fallen substantially but that military expenditure levels in sub-Saharan Africa have nonetheless increased, largely as a result of South African expenditure. The article attempts to answer two questions. First, how can the budget of the security sector be allocated so as to result in effective and efficient security outcomes? Second, how can an appropriate level of military expenditure for a country be dete...
Koosimile, Anthony T.; Suping, Shanah M.
This paper takes the view that the emergence of some trends and practices in science education mirrors the influence of the process of globalisation in Anglophone Sub-Saharan Africa. Through a literature review, an attempt is made to link science education and globalisation by answering the question: 'What influence does globalisation have on science education in countries in Anglophone Sub-Saharan Africa?' The findings of the study show some significant convergence of what is valued in science education in Sub-Saharan Africa in areas such as pedagogy; English language as a medium of instruction; assessment of learning; mobility of students in the region; and in the frameworks for collaborative engagements among stakeholders in Sub-Saharan Africa. The paper concludes with a reflective end-piece calling for more case studies to help scrutinise further the influence of globalisation on science education in Sub-Saharan Africa.
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
Okpala, Comfort O.
Although literacy rates have improved somehow in recent years, there are still large numbers of people that are illiterates in developing countries. This paper examines the impact of severe economic decline and demographic pressures on youth literacy rate in Sub-Saharan Africa. In this study, a cross-sectional data of 39 Sub-Saharan African…
Boosting food security in sub-Saharan Africa through cassava production: a case study of Nigeria. ... Nigerian Journal of Economic History ... The paper argues that cassava which is widely grown in Sub-Saharan Africa with a lot of variety of food derivatives from it can reduce to the barest minimum the present state of food ...
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.
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..
Lucy S Tusting
Full Text Available Improvements to housing may contribute to malaria control and elimination by reducing house entry by malaria vectors and thus exposure to biting. We tested the hypothesis that the odds of malaria infection are lower in modern, improved housing compared to traditional housing in sub-Saharan Africa (SSA.We analysed 15 Demographic and Health Surveys (DHS and 14 Malaria Indicator Surveys (MIS conducted in 21 countries in SSA between 2008 and 2015 that measured malaria infection by microscopy or rapid diagnostic test (RDT. DHS/MIS surveys record whether houses are built with finished materials (e.g., metal or rudimentary materials (e.g., thatch. This information was used to develop a binary housing quality variable where houses built using finished wall, roof, and floor materials were classified as "modern", and all other houses were classified as "traditional". Conditional logistic regression was used to determine the association between housing quality and prevalence of malaria infection in children aged 0-5 y, adjusting for age, gender, insecticide-treated net (ITN use, indoor residual spraying, household wealth, and geographic cluster. Individual survey odds ratios (ORs were combined to determine a summary OR using a random effects meta-analysis. Of 284,532 total children surveyed, 139,318 were tested for malaria infection using microscopy (n = 131,652 or RDT (n = 138,540. Within individual surveys, malaria prevalence measured by microscopy ranged from 0.4% (Madagascar 2011 to 45.5% (Burkina Faso 2010 among children living in modern houses and from 0.4% (The Gambia 2013 to 70.6% (Burkina Faso 2010 in traditional houses, and malaria prevalence measured by RDT ranged from 0.3% (Senegal 2013-2014 to 61.2% (Burkina Faso 2010 in modern houses and from 1.5% (The Gambia 2013 to 79.8% (Burkina Faso 2010 in traditional houses. Across all surveys, modern housing was associated with a 9% to 14% reduction in the odds of malaria infection (microscopy
Mohale, Hlengiwe; Sweet, Linda; Graham, Kristen
Increasing global migration is resulting in a culturally diverse population in the receiving countries. In Australia, it is estimated that at least four thousand Sub-Saharan African women give birth each year. To respond appropriately to the needs of these women, it is important to understand their experiences of maternity care. The study aimed to examine the maternity experiences of Sub-Saharan African women who had given birth in both Sub-Saharan Africa and in Australia. Using a qualitative approach, 14 semi-structured interviews with Sub-Saharan African women now living in Australia were conducted. Data was analysed using Braun and Clark's approach to thematic analysis. Four themes were identified; access to services including health education; birth environment and support; pain management; and perceptions of care. The participants experienced issues with access to maternity care whether they were located in Sub-Saharan Africa or Australia. The study draws on an existing conceptual framework on access to care to discuss the findings on how these women experienced maternity care. The study provides an understanding of Sub-Saharan African women's experiences of maternity care across countries. The findings indicate that these women have maternity health needs shaped by their sociocultural norms and beliefs related to pregnancy and childbirth. It is therefore arguable that enhancing maternity care can be achieved by improving women's health literacy through health education, having an affordable health care system, providing respectful and high quality midwifery care, using effective communication, and showing cultural sensitivity including family support for labouring women. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Melito, Thomas; Thomas, Phillip J; Bray, Carol; Chen, Ming; Chung, Debbie; De Alteriis, Martin; DeWolf, Leah; Dowling, Mark; Finkler, Etana; Hudson Acknowledgments, Melinda
.... The gap between the average grain yield in sub- Saharan Africa compared with the rest of the world's developing countries has widened over the years, and, by 2006, the yield in sub-Saharan Africa...
Weaver, J.N.; Brownfield, M.E.; Bergin, M.J. (United States Geological Survey, Denver, CO (USA))
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 neighbouring countries do contain coal-bearing rocks. Most of these countries are undergoing desertification. Destruction of forest and shrub lands for fuel is occurring at an increasing rate because of desertification and increasing energy demands. 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 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. The overall objective of these studies is to establish, within the sub-Saharan region, energy independent countries using indigeneous coal and peat resources. These resources have the potential to replace wood and wood charcoal as domestic fuel in the urban centres, as well as producing electrical and industrial energy, thus reducing expensive oil imports and decreasing the rate of deforestation. 31 refs., 16 figs., 1 tab.
Full Text Available Africa belongs to important regions of the world economy with specific problems distinguishing this part of the world from other regions. The region is suffering because of limited economy structure and high level of poverty. Low economic performance ranks most of African countries among the worldwide poorest ones (both from the point of view of total economy performance and also individuals living standards; the development is hindered by political instability and also by other accompanied problems as high level of corruption, deficit of democracy, low level of education, limited investments, criminality, local conflicts, civil wars etc. On the other hand, African natural, economy and social resources and unexploited opportunities in many areas offer a potential for a considerable economic development. Understanding the current economic position of African states thus may reveal causes of problematic development and outline ways to overcome existing shortcomings. The aim of the paper is to analyze main changes in area of GDP structure formation (agricultural, industrial and services sector share in GDP and value performance which have occurred in selected African (Sub-Saharan countries. Changes are analyzed both in relation to the total GDP and GDP per capita. The authors identify main trends of economic development in the Sub-Saharan region and to specify differences among Sub-Saharan countries with the intention to identify particular groups of African countries according to their economic structure and to identify differences in their GDP formation.
A growing number of countries in sub-Saharan Africa are considering legalizing the growth of genetically modified organisms (GMOs). Furthermore, several projects are underway to develop transgenic crops tailored to the region. Given the contentious nature of GMOs and prevalent anti-GMO sentiments in Africa, a robust ethical analysis examining the concerns arising from the development, adoption, and regulation of GMOs in sub-Saharan Africa is warranted. To date, ethical analyses of GMOs in the global context have drawn predominantly on Western philosophy, dealing with Africa primarily on a material level. Yet, a growing number of scholars are articulating and engaging with ethical theories that draw upon sub-Saharan African value systems. One such theory, Ubuntu, is a well-studied sub-Saharan African communitarian morality. I propose that a robust ethical analysis of Africa's agricultural future necessitates engaging with African moral theory. I articulate how Ubuntu may lead to a novel and constructive understanding of the ethical considerations for introducing GMOs into sub-Saharan Africa. However, rather than reaching a definitive prescription, which would require significant engagement with local communities, I consider some of Ubuntu's broader implications for conceptualizing risk and engaging with local communities when evaluating GMOs. I conclude by reflecting on the implications of using local moral theory in bioethics by considering how one might negotiate between universalism and particularism in the global context. Rather than advocating for a form of ethical relativism, I suggest that local moral theories shed light on salient ethical considerations that are otherwise overlooked. © 2015 John Wiley & Sons Ltd.
Ba-Diop, Awa; Marin, Beno?t; Druet-Cabanac, Michel; Ngoungou, Edgard B; Newton, Charles R; Preux, Pierre-Marie
Epilepsy is a common neurological disease in tropical countries, particularly in sub-Saharan Africa. Previous work on epilepsy in sub-Saharan Africa has shown that many cases are severe, partly a result of some specific causes, that it carries a stigma, and that it is not adequately treated in many cases. Many studies on the epidemiology, aetiology, and management of epilepsy in sub-Saharan Africa have been reported in the past 10 years. The prevalence estimated from door-to-door studies is a...
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
Russell, Louise B; Bhanot, Gyan; Kim, Sun-Young; Sinha, Anushua
To explore the use of cluster analysis to define groups of similar countries for the purpose of evaluating the cost-effectiveness of a public health intervention-maternal immunization-within the constraints of a project budget originally meant for an overall regional analysis. We used the most common cluster analysis algorithm, K-means, and the most common measure of distance, Euclidean distance, to group 37 low-income, sub-Saharan African countries on the basis of 24 measures of economic development, general health resources, and past success in public health programs. The groups were tested for robustness and reviewed by regional disease experts. We explored 2-, 3- and 4-group clustering. Public health performance was consistently important in determining the groups. For the 2-group clustering, for example, infant mortality in Group 1 was 81 per 1,000 live births compared with 51 per 1,000 in Group 2, and 67% of children in Group 1 received DPT immunization compared with 87% in Group 2. The experts preferred four groups to fewer, on the ground that national decision makers would more readily recognize their country among four groups. Clusters defined by K-means clustering made sense to subject experts and allowed a more detailed evaluation of the cost-effectiveness of maternal immunization within the constraint of the project budget. The method may be useful for other evaluations that, without having the resources to conduct separate analyses for each unit, seek to inform decision makers in numerous countries or subdivisions within countries, such as states or counties.
Parkin, Donald Maxwell; Stefan, Cristina
Measurement of incidence rates of childhood cancer in Africa is difficult. The study 'Cancer of Childhood in sub Saharan Africa' [Stefan C, Bray F, Ferlay J, Parkin DM and Liu B (2017) Cancer of Childhood in sub-Saharan Africa ecancer 11 (755)] brings together results from 16 population-based registries which, as members of the African Cancer Registry Network (AFCRN), have been evaluated as achieving adequate coverage of their target population. The cancers are classified according to the third revision of the International Classification of Childhood Cancer (ICCC-3) and recorded rates in Africa are compared with those in childhood populations in the UK, France, and the USA. It is clear that, in many centres, lack of adequate diagnostic and treatment facilities, leads to under-diagnosis (and enumeration) of leukaemias and brain cancers. However, for several childhood cancers, incidence rates in Africa are higher than those in high income countries. This applies to infection-related cancers such as Kaposi sarcoma, Burkitt lymphoma, Hodgkin lymphoma and hepatocellular carcinoma, and also to two common embryonal cancers-retinoblastoma and nephroblastoma. These (and other) observations are unlikely to be artefact, and are of considerable interest when considering possible aetiological factors, including ethnic differences in risk (and hence genetic/familial antecedents). The data reported are the most extensive so far available on the incidence of cancer in sub Saharan Africa, and clearly indicate the need for more resources to be devoted to cancer registration, especially in the childhood age range, as part of an overall programme to improve the availability of diagnosis and treatment of this group of cancers, many of which have-potentially-an excellent prognosis.
McGill, P E; Oyoo, G O
To review prevalence of rheumatic disorders in Sub-saharan Africa and in the context of current medical practice in the region assess the need for service and educational provision. Medline, (English, French). Pre-Medline literature review from the 1950's (Current contents). Various conference reports including attendance at all three AFLAR (African League Against Rheumatism) congresses in the 1990's. Author's personal database. All cited references read in full. The evidence shows rheumatoid arthritis and systemic lupus erythematosus to be increasing in frequency in the indigenous populations of East, Central and South Africa but remaining rare in West Africans. Gout is now more prevalent than ever throughout the subcontinent. HIV has spawned a variety of previously rare spondyloarthropathies (reactive arthritis, psoriatic arthritis, enthesopathy) and changed the epidemiology of pyomyositis and osteomyelitis. Osteoarthritis is a universal problem. Juvenile chronic arthritis is not rare and rheumatic fever is common. Acute and chronic locomotor problems associated with diverse entities such as leprosy, brucellosis, meningococcus, alpha viruses, parasites, fluorosis, rickets and haemoglobinopathies enhance diagnostic diversity and therapeutic and educational requirements. Suggestions made to address the challenge posed by the burden of rheumatic disorders.
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.
This reviews aims to provide an insight and update of the state of biogas technology research in some selected sub-Saharan African countries in peer reviewed literature. This paper also aims to highlight the sub-Saharan countries' strengths and weaknesses in biogas research and development capacity. An attempt is ...
Kuznik, Andreas; Habib, Abdulrazaq G; Manabe, Yukari C; Lamorde, Mohammed
Untreated syphilis in pregnancy is associated with adverse clinical outcomes to the infant. The study aimed to estimate the public health burden resulting from adverse pregnancy outcomes due to syphilis infection among pregnant women not screened for syphilis in 43 countries in sub-Saharan Africa. Estimated country-specific incidence of syphilis was generated from annual number of live births, the proportion of women with at least 1 antenatal care (ANC) visit, the syphilis prevalence rate, and the proportion of women screened for syphilis during ANC.Adverse pregnancy outcome data (stillbirth, neonatal death, low birth weight, and congenital syphilis) were obtained from published sources. Disability-adjusted life-year (DALY) estimates were calculated using undiscounted local life expectancy, the neonatal standard loss function, and relevant disability weights. The model assessed the potential impact of raising ANC coverage to at least 95% and syphilis screening to at least 95% (World Health Organization targets). For all 43 sub-Saharan Africa countries, the estimated incidence of adverse pregnancy outcomes was 205,901 (95% confidence interval [CI], 113,256-383,051) per year, including stillbirth (88,376 [95% CI, 60,854-121,713]), neonatal death (34,959 [95% CI, 23,330-50,076]), low birth weight (22,483 [95% CI, 0-98,847]), and congenital syphilis (60,084 [95% CI, 29,073-112,414]), resulting in approximately 12.5 million DALYs. Countries with the greatest burden are (in DALYs, millions) Democratic Republic of the Congo (1.809), Nigeria (1.598), Ethiopia (1.466), and Tanzania (0.961). Attaining World Health Organization targets could reduce the burden by 8.5 million DALYs. Substantial infant mortality and morbidity results from maternal syphilis infection concentrated in countries with low access to ANC or low rates of syphilis screening.
Full Text Available Most of the countries of sub-Saharan Africa belong to the most underdeveloped and poorest countries in the world economy. This region consists of forty-nine countries but at world GDP, world export, world import and inflow of foreign direct investment share only by small percent. There are some positive facts in the recent history of sub- Saharan Africa. Sub-Saharan Africa has grown faster than the world economy in the past ten years. The predictions are also positive. There is an expectation of another growth till the 2020. If the sub-Saharan countries want to keep the growth in the future they have to invest to infrastructure, in educational system, in research and science to make their economies more competitive.
Hypothermia is a major factor in neonatal morbidity and mortality in developing countries. High prevalence of hypothermia has been reported widely even from warmer tropical countries. In spite of the World Health Organization's recommendation of maintenance of warm chain in newborn care, hypothermia continues to be a common neonatal condition which has remained under-recognized, under-documented, and poorly-managed. This review aims at providing the incidence of and risk factors for neonatal hypothermia as well as provides a pathophysiological overview and management options for neonates with the condition in sub-Saharan Africa. All available published literature on neonatal hypothermia was searched electronically and manually. The principal electronic reference libraries and sites searched were PubMed, Embase, Ajol, Cochrane Reference Libraries and Google Scholar. The search terms used included 'neonatal hypothermia,' 'Cold stress in newborn' 'thermal care of the newborn,' 'neonatal thermogenesis,' 'neonatal cold injury,' among others. Pertinent books and monographs were accessed. Data in formats inaccessible to the reviewer were excluded. Neonatal hypothermia is a major condition of public health importance in countries of sub- Saharan Africa. Awareness of the burden of the disease is still low in some communities. Risk factors for neonatal hypothermia in the region include poverty, home delivery, low birthweight, early bathing of babies, delayed initiation of breastfeeding and inadequate knowledge among health workers. Low-tech facilities to prevent heat losses and provide warmth are available in sub-Saharan Africa and are thus recommended as well as continuous efforts at sensitizing caregivers on the thermal needs of newborns.
sub-Saharan cities, particularly where contraceptive use is low and access to ... other regions, sub-Saharan women nevertheless exercise ... kinship networks to share the costs and benefits of .... developing countries in contraceptive use among married .... The report includes case studies of ..... Tours, France, July 2005.
Telisinghe, Lilanganee; Charalambous, Salome; Topp, Stephanie M; Herce, Michael E; Hoffmann, Christopher J; Barron, Peter; Schouten, Erik J; Jahn, Andreas; Zachariah, Rony; Harries, Anthony D; Beyrer, Chris; Amon, Joseph J
Given the dual epidemics of HIV and tuberculosis in sub-Saharan Africa and evidence suggesting a disproportionate burden of these diseases among detainees in the region, we aimed to investigate the epidemiology of HIV and tuberculosis in prison populations, describe services available and challenges to service delivery, and identify priority areas for programmatically relevant research in sub-Saharan African prisons. To this end, we reviewed literature on HIV and tuberculosis in sub-Saharan African prisons published between 2011 and 2015, and identified data from only 24 of the 49 countries in the region. Where data were available, they were frequently of poor quality and rarely nationally representative. Prevalence of HIV infection ranged from 2·3% to 34·9%, and of tuberculosis from 0·4 to 16·3%; detainees nearly always had a higher prevalence of both diseases than did the non-incarcerated population in the same country. We identified barriers to prevention, treatment, and care services in published work and through five case studies of prison health policies and services in Zambia, South Africa, Malawi, Nigeria, and Benin. These barriers included severe financial and human-resource limitations and fragmented referral systems that prevent continuity of care when detainees cycle into and out of prison, or move between prisons. These challenges are set against the backdrop of weak health and criminal-justice systems, high rates of pre-trial detention, and overcrowding. A few examples of promising practices exist, including routine voluntary testing for HIV and screening for tuberculosis upon entry to South African and the largest Zambian prisons, reforms to pre-trial detention in South Africa, integration of mental health services into a health package in selected Malawian prisons, and task sharing to include detainees in care provision through peer-educator programmes in Rwanda, Zimbabwe, Zambia, and South Africa. However, substantial additional investments are
Key words: food, constraints, mechanization, Sub-Saharan Africa, food security. Introduction ... ensure all-year-round food production. Agricultural .... her citizens to travel to the United States to ... downsize in the intake of students into these.
In addition, sub-Saharan Africa suffers the most impact from the HIV ... Our work in Benin has resulted in agricultural improvements and stronger local leadership. ... has stimulated better agriculture, health care, and anti-poverty programs.
Microwork and Virtual Production Networks in Sub-Saharan Africa and Southeast Asia ... content posted to social media sites; -categorizing products in online shops; or, ... that have realized that entry-level workers can be efficient and effective.
Azam, Jean-Paul; Thelen, Véronique
The incidence of civil war in Sub-Saharan Africa since the turn of the century is less than half of what it was on average in the last quarter of the 20th century. This paper shows that the aid boom triggered by 9/11 played a key role in achieving purposefully this result using panel data for 46 African countries over four decades. It applies a nearidentification approach to test the aid-conflict tradeoff, taking due account of asymmetric information between the donors and the econometrician....
Inoue, Takeshi; Hamori, Shigeyuki
This article empirically analyzes the role of finance in economic growth in Sub-Saharan Africa from the perspective of what is termed herein “financial permeation”. By estimating panel data on 37 countries in Sub-Saharan Africa between 2004 and 2010, we examine whether financial permeation through improved convenience and access to financial services has contributed to economic growth in this region. Empirical results clearly indicate that financial permeation has a statistically significant ...
Janda, Karel; Quarshie, Gregory
This paper takes a critical look at the natural resource curse in countries in sub-Saharan Africa and it highlights the role of institutionalised authority. The paper first provides a comprehensive literature review of natural resource curse, Dutch disease and the role of oil resources in resource curse. This is follow by the description of the relevant economic factors in sub-Saharan Africa, which is taken as prime example of the region with both important oil and other natural resources and...
Francis M. Kemegue; Reneé van Eyden; Emmanuel Owusu-Sekyere
This paper investigates the effect of remittance inflows on real exchange rates in sub-Saharan Africa (SSA) using annual data from 1980 to 2008 for 34 countries, the method of moments estimator developed by Arellano and Bover (1995) and the feasible generalized least squares estimator developed by Parks (1967) and Kmenta (1986). We find that when cross-sectional dependence and individual effects are controlled for, remittances to sub-Saharan Africa as a whole increase the underlying real exch...
Natural resources in sub-Saharan Africa suffer from a bad reputation. Oil and diamonds, particularly, have been blamed for a number of Africa’s illnesses such as poverty, corruption, dictatorship and war. This paper outlines the different areas and transmission channels of how this so-called “resource curse” is said to materialize. By assessing empirical evidence on sub-Saharan Africa it concludes that the resource curse theory fails to sufficiently explain why and how several countries have ...
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. ...
Jeon, Yongil; Rhyu, Sang-Young; Shields, Michael P.
Fertility has begun to fall in Sub-Saharan Africa but it remains high on average and particularly for a few countries. This paper examines African fertility using a panel data set of 47 Sub-Saharan countries between 1962 and 2003. Fixed and random country effect estimates are made in models where the explanatory variables are suggested by the theory of the demographic transition as modified by Caldwell. Special attention is paid to the economic status of women, urbanization, the poverty level...
Smigelsky, Melissa A; Aten, Jamie D; Gerberich, Stacy; Sanders, Mark; Post, Rachael; Hook, Kimberly; Ku, Angie; Boan, David M; Monroe, Phil
Trauma is a widely acknowledged problem facing individuals and communities in developing countries. In sub-Saharan Africa-a region that is home to some of the world's worst human rights violations, ethnic and civil conflicts, disease epidemics, and conditions of poverty-trauma is an all-too-common experience in citizens' daily lives. In order to address these conditions effectively, the impact of trauma must be understood. The authors reviewed recent literature on the cost and consequences of psychological trauma in sub-Saharan Africa to provide a substantive perspective on how trauma affects individuals, communities, and organizations and to inform the effort to determine a method for measuring the impact of trauma in sub-Saharan Africa and the efficacy of trauma interventions in the region. Several recommendations are offered to help broaden and deepen the current approaches to conceptualizing trauma, evaluating its cost, and intervening on behalf of those impacted by trauma in sub-Saharan Africa.
Rothe, C; Schlaich, C; Thompson, S
Healthcare-associated infections (HCAIs) are the most frequent adverse consequences of healthcare worldwide, threatening the health of both patients and healthcare workers (HCWs). The impact of HCAI is particularly felt in resource-poor countries, with an already overstretched health workforce and a high burden of community-acquired infection. To provide an overview of the current situation in sub-Saharan Africa with regards to the spectrum of HCAI, antimicrobial resistance, occupational exposure and infection prevention. We reviewed the literature published between 1995 and 2013 and from other sources such as national and international agencies. Sparse data suggest that HCAIs are widespread in sub-Saharan Africa, with surgical site being the dominant focus of infection. Nosocomial transmission of multidrug-resistant tuberculosis is a considerable concern, as is the prevalence of meticillin-resistant S. aureus and resistant Enterobacteriaceae. In HCWs, vaccination rates against vaccine-preventable occupational hazards are low, as is reporting and subsequent human immunodeficiency virus-testing after occupational exposure. HCWs have an increased risk of tuberculosis relative to the general population. Compliance with hand hygiene is highly variable within the region. Injection safety in immunization programmes has improved over the past decade, mainly due to the introduction of autodestruct syringes. Despite the scarcity of data, the burden of HCAI in sub-Saharan Africa appears to be high. There is evidence of some improvement in infection prevention and control, though widespread surveillance data are lacking. Overall, measures of infection prevention and occupational safety are scarce. Copyright © 2013 The Healthcare Infection Society. All rights reserved.
Cherewick, Megan L; Cherewick, Steven D; Kushner, Adam L
In 2015, it was estimated that approximately 36.7 million people were living with HIV globally and approximately 25.5 million of those people were living in sub-Saharan Africa. Limitations in the availability and access to adequate operative care require policy and planning to enhance operative capacity. Data estimating the total number of persons living with HIV by country, sex, and age group were obtained from the Joint United Nations Programme on HIV/AIDS (UNAIDS) in 2015. Using minimum proposed surgical rates per 100,000 for 4, defined, sub-Saharan regions of Africa, country-specific and regional estimates were calculated. The total need and unmet need for operative procedures were estimated. A minimum of 1,539,138 operative procedures were needed in 2015 for the 25.5 million persons living with HIV in sub-Saharan Africa. In 2015, there was an unmet need of 908,513 operative cases in sub-Saharan Africa with the greatest unmet need in eastern sub-Saharan Africa (427,820) and western sub-Saharan Africa (325,026). Approximately 55.6% of the total need for operative cases is adult women, 38.4% are adult men, and 6.0% are among children under the age of 15. A minimum of 1.5 million operative procedures annually are required to meet the needs of persons living with HIV in sub-Saharan Africa. The unmet need for operative care is greatest in eastern and western sub-Saharan Africa and will require investments in personnel, infrastructure, facilities, supplies, and equipment. We highlight the need for global planning and investment in resources to meet targets of operative capacity. Copyright © 2016 Elsevier Inc. All rights reserved.
Liwa, Anthony C; Smart, Luke R; Frumkin, Amara; Epstein, Helen-Ann B; Fitzgerald, Daniel W; Peck, Robert N
Hypertension is increasingly common in sub-Saharan Africa, and rates of hypertension control are low. Use of traditional herbal medicines (THM) is common among adults in sub-Saharan Africa and may affect hypertension therapy. We searched Ovid MEDLINE, Ovid EMBASE, and Web of Knowledge in June 2013 to find studies about THM use among hypertensive patients living in sub-Saharan Africa. Two independent reviewers evaluated titles and abstracts. Qualifying references were reviewed in full text. Data were extracted using a standardized questionnaire. Four hundred and eighty-one references were retrieved, and four articles from two countries met criteria for inclusion. The prevalence of THM use was 25-65% (average 38.6%). THM was the most common type of complementary and alternative medicines used by patients (86.7-96.6%). Among THM users, 47.5% concomitantly used both allopathic medicine and THM. Increased age (psupernatural cause of hypertension (RR 2.11), and family history of hypertension (OR 1.78) were positively associated with THM use, while belief that hypertension is preventable was negatively associated with THM use (OR 0.57). More than one-third of adults with hypertension in sub-Saharan Africa use THM. Half of these patients use THM concurrently with allopathic medicine. Healthcare workers in sub-Saharan Africa must discuss THM use with their hypertensive patients. More research is urgently needed to define the impact of THM use on hypertension control and outcomes in sub-Saharan Africa.
HIV/AIDS is a real threat for Sub-Saharan Countries. It increased adult mortality substantially. HIV/AIDS pandemic causes the death of the most productive part of affected population. Human capital passing on to future generations is limited. Low economic performance and income inequality induce higher HIV vulnerability. Contra wise HIV/AIDS has significant negative effect on the welfare of affected population. The sources of pandemic in Sub-Saharan Africa are not only social and cultural. He...
Basu, Sanjay; McKee, Martin; Lurie, Mark
Objectives. We estimated the relationship between mining and tuberculosis (TB) among countries in sub-Saharan Africa. Methods. We used multivariate regression to estimate the contribution of mining activity to TB incidence, prevalence, and mortality, as well as rates of TB among people living with HIV, with control for economic, health system, and population confounders. Results. Mining production was associated with higher population TB incidence rates (adjusted b = 0.093; 95% confidence interval [CI] = 0.067, 0.120; with an increase of mining production of 1 SD corresponding to about 33% higher TB incidence or 760 000 more incident cases), after adjustment for economic and population controls. Similar results were observed for TB prevalence and mortality, as well as with alternative measures of mining activity. Independent of HIV, there were significant associations between mining production and TB incidence in countries with high HIV prevalence (≥ 4% antenatal HIV prevalence; HIV-adjusted B = 0.066; 95% CI = 0.050, 0.082) and between log gold mining production and TB incidence in all studied countries (HIV-adjusted B = 0.053; 95% CI = 0.032, 0.073). Conclusions. Mining is a significant determinant of countrywide variation in TB among sub-Saharan African nations. Comprehensive TB control strategies should explicitly address the role of mining activity and environments in the epidemic. PMID:20516372
Hernandez-Villafuerte, Karla; Li, Ryan; Hofman, Karen J
Collaboration between Sub-Saharan African researchers is important for the generation and transfer of health technology assessment (HTA) evidence, in order to support priority-setting in health. The objective of this analysis was to evaluate collaboration patterns between countries. We conducted a rapid evidence assessment that included a random sample of health economic evaluations carried out in 20 countries (Angola, Botswana, Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe, Ghana, Kenya, Nigeria, Ethiopia, Uganda). We conducted bibliometric network analysis based on all first authors with a Sub-Saharan African academic affiliation and their co-authored publications ("network-articles"). Then we produced a connection map of collaboration patterns among Sub-Saharan African researchers, reflecting the number of network-articles and the country of affiliation of the main co-authors. The sample of 119 economic evaluations mostly related to treatments of communicable diseases, in particular HIV/AIDS (42/119, 35.29 %) and malaria (26/119, 21.85 %). The 39 first authors from Sub-Saharan African institutions together co-authored 729 network-articles. The network analysis showed weak collaboration between health economic researchers in Sub-Saharan Africa, with researchers being more likely to collaborate with Europe and North America than with other African countries. South Africa stood out as producing the highest number of health economic evaluations and collaborations. The development and evaluation of HTA research networks in Sub-Saharan Africa should be supported, with South Africa central to any such efforts. Organizations and institutions from high income countries interested in supporting priority setting in Sub-Saharan Africa should include promoting collaboration as part of their agendas, in order to take advantage of the potential transferability of results and methods of the
Full Text Available Deforestation has been a complex phenomenon to study in sub-Saharan Africa. The average annual deforestation rate in the region is by far higher than the world average. What causes and drives deforestation in the region are debated to date. The present paper is motivated by this debate. It attempts to test whether the maintained hypotheses on the causes of deforestation can give answer to the problem in sub-Saharan Africa. It used average cross-national data of forty eight countries in the region. The data are retrieved from international sources. The Spearman’s rank correlation coefficients between two deforestation indicators and five often-cited causes of deforestation were computed. The role of public forest ownership, share of forest and agricultural products in total exports, and the year of forest laws enacted are also discussed. However, it finds no clear, strong, and systematic pattern to argue that population density, rural population, rural poverty, industrial logging for exports, economic growth, late enactment of forest laws, and public ownership of forests are underlying causes of deforestation in the region. The trends of forestland in Rwanda and Zimbabwe vividly present the finding. Therefore, future studies related to the topic in the region shall focus on sub-national panel data.
Kimokoti, Ruth W; Hamer, Davidson H
The proportion of the population that is > or = 60 years of age in sub-Saharan Africa (SSA) is increasing rapidly and is likely to constrain healthcare systems in the future. Nevertheless, the elderly are not a health policy priority for African countries. This paper reviews the nutritional and health status of older adults in SSA and their determinants. Literature was abstracted through the Medline, Google Scholar, and Dogpile databases using the following search terms: sub-Saharan Africa, older adults, nutrition, health. Findings showed that up to half (6-48%) of elderly Africans in SSA are underweight and almost a quarter (2.5-21%) are overweight, while 56% of older South Africans are obese. Low-quality diets contribute to poor nutritional status. Poverty, HIV/AIDS, and complex humanitarian emergencies are major determinants of undernutrition. Effective interventions need to consider socioeconomic, health, and demographic factors; social pensions may be the most cost-effective option for improving the health and nutritional status of the elderly in SSA.
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...
Palmer, Jennifer J; Chinanayi, Farai; Gilbert, Alice; Pillay, Devan; Fox, Samantha; Jaggernath, Jyoti; Naidoo, Kovin; Graham, Ronnie; Patel, Daksha; Blanchet, Karl
Development of human resources for eye health (HReH) is a major global eye health strategy to reduce the prevalence of avoidable visual impairment by the year 2020. Building on our previous analysis of current progress towards key HReH indicators and cataract surgery rates (CSRs), we predicted future indicator achievement among 16 countries of sub-Saharan Africa by 2020. Surgical and HReH data were collected from national eye care programme coordinators on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and 'mid-level refractionists' and combined them with publicly available population data to calculate practitioner-to-population ratios and CSRs. Data on workforce entry and exit (2008 to 2010) was used to project practitioner population and CSR growth between 2011 and 2020 in relation to projected growth in the general population. Associations between indicator progress and the presence of a non-physician cataract surgeon cadre were also explored using Wilcoxon rank sum tests and Spearman rank correlations. In our 16-country sample, practitioner per million population ratios are predicted to increase slightly for surgeons (ophthalmologists/cataract surgeons, from 3.1 in 2011 to 3.4 in 2020) and ophthalmic nurses/clinical officers (5.8 to 6.8) but remain low for refractionists (including optometrists, at 3.6 in 2011 and 2020). Among countries that have not already achieved target indicators, however, practitioner growth will be insufficient for any additional countries to reach the surgeon and refractionist targets by year 2020. Without further strategy change and investment, even after 2020, surgeon growth is only expected to sufficiently outpace general population growth to reach the target in one country. For nurses, two additional countries will achieve the target while one will fall below it. In 2011, high surgeon practitioner ratios were associated with high CSR, regardless of the type
Goliber, T J
The population of sub-Saharan Africa, estimated at 434 million in 1984, is expected to reach 1.4 billion by 2025. The birth rate, currently 48/1000 population, continues to increase, and the death rate, 17/1000, is declining. Rapid population growth has curtailed government efforts to provide adequate nutrition, preserve the land base essential for future development, meet the demand for jobs, education, and health services, and address overcrowding in urban areas. Low education, rural residence, and low incomes are key contributors to the area's high fertility. Other factors include women's restricted roles, early age at marriage, a need for children as a source of security and support in old age, and limited knowledge of and access to modern methods of contraception. Average desired family size, which is higher than actual family size in most countries, is 6-9 children. Although government leaders have expressed ambivalence toward development of population policies and family planning programs as a result of the identification of such programs with Western aid donors, the policy climat is gradually changing. By mid-1984, at least 13 of the 42 countries in the region had indicated that they consider current fertility rates too high and support government and/or private family planning programs to reduce fertility. In addition, 26 countries in the region provide some government family planning services, usually integrated with maternal and child health programs. However, 10 countries in the region do not support family planning services for any reason. Unfortunately, sub-Saharan Africa has not yet produced a family planning program with a measurable effect on fertility that could serve as a model for other countries in the region. Social and economic change is central to any hope of fertility reduction in sub-Saharan Africa. Lower infant and child mortality rates, rising incomes, higher education, greater economic and social opportunities for women, and increased
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.
Guerra Arias, Maria; Nove, Andrea; Michel-Schuldt, Michaela; de Bernis, Luc
The WHO African region, covering the majority of Sub-Saharan Africa, faces the highest rates of maternal and neonatal mortality in the world. This study uses data from the State of the World's Midwifery 2014 survey to cast a spotlight on the WHO African region, highlight the specific characteristics of its sexual, reproductive, maternal and newborn health (SRMNH) workforce and describe and compare countries' different trajectories in terms of meeting the population need for services. Using data from 41 African countries, this study used a mathematical model to estimate potential met need for SRMNH services, defined as "the percentage of a universal SRMNH package that could potentially be obtained by women and newborns given the composition, competencies and available working time of the SRMNH workforce." The model defined the 46 key interventions included in this universal SRMNH package and allocated them to the available health worker time and skill set in each country to estimate the potential met need. Based on the current and projected potential met need in the future, the countries were grouped into three categories: (1) 'making or maintaining progress' (expected to meet more, or the same level, of the need in the future than currently): 14 countries including Ghana, Senegal and South Africa, (2) 'at risk' (currently performing relatively well but expected to deteriorate due to the health workforce not keeping pace with population growth): 6 countries including Gabon, Rwanda and Zambia, and (3) 'low performing' (not performing well and not expected to improve): 21 countries including Burkina Faso, Eritrea and Sierra Leone. The three groups face different challenges, and policy solutions to increasing met need should be tailored to the specific context of the country. National health workforce accounts should be strengthened so that workforce planning can be evidence-informed.
Chan, Brian T; Tsai, Alexander C
HIV-related stigma is associated with increased risk-taking behavior, reduced uptake of HIV testing, and decreased adherence to antiretroviral therapy (ART). Although ART scale-up may reduce HIV-related stigma, the extent to which levels of stigma in the general population have changed during the era of ART scale-up in sub-Saharan Africa is unknown. Social distance and anticipated stigma were operationalized using standard HIV-related stigma questions contained in the Demographic and Health Surveys and AIDS Indicator Surveys of 31 African countries between 2003 and 2013. We fitted multivariable linear regression models with cluster-correlated robust standard errors and country fixed effects, specifying social distance or anticipated stigma as the dependent variable and year as the primary explanatory variable of interest. We estimated a statistically significant negative association between year and desires for social distance (b = -0.020; P stigma (b = 0.023; P stigma in the general population increased despite a decrease in social distancing toward people living with HIV. Although ART scale-up may help reduce social distancing toward people living with HIV, particularly in high-prevalence countries, other interventions targeting symbolic or instrumental concerns about HIV may be needed.
Austin, G.; Frankema, E.H.P.; Jerven, M.
This chapter reviews the ‘long twentieth-century’ development of ‘modern’ manufacturing in Sub-Saharan Africa from colonization to the present. It argues that classifying Africa generically as a ‘late industrializer’ is inaccurate. To understand the distinctively African pattern of manufacturing
Schneider, William H
The adequacy and safety of blood transfusion in sub-Saharan Africa is the subject of much concern, yet there have been very few studies of its history. An overview of that record finds that transfusions were first reported in Africa (sub-Saharan and excluding South Africa) in the early 1920s, and organized transfusion practices were established before the Second World War. Blood transfusion grew rapidly after 1945, along with the construction of new hospitals and expanded health services in Africa. Significant differences existed between colonial powers in the organization of transfusion services, but these converged after independence as their use continued to grow and decentralized and hospital-based practices were adopted. It was only after the oil crisis in the mid-1970s that health spending declined and the collection, testing, and transfusion of blood began to level off. Thus, when the AIDS crisis hit transfusion services, they were already struggling to meet the needs of patients. At this time, foreign assistance as well as the World Health Organization and the League of Red Cross Societies helped respond to both the immediate problem of testing blood, and for some countries, support existed for the broader reorganization of transfusion. Overall, the history shows that transfusion was adopted widely and quickly, limited mainly by the availability of knowledgeable doctors and hospital facilities. There was less resistance than expected by Africans to receive transfusions, and the record shows a remarkable flexibility in obtaining blood. The dangers of disease transmission were recognized from an early date but were balanced against the potential lifesaving benefits of transfusion. Copyright © 2013 Elsevier Inc. All rights reserved.
Larson, Paul R; Chege, Patrick; Dahlman, Bruce; Gibson, Christine; Evensen, Ann; Colon-Gonzalez, Maria C; Onguka, Stephanie; Lamptey, Roberta; Cayley, William E; Nguyen, Bich-May; Johnson, Brian; Getnet, Sawra; Hasnain, Memoona
Reducing the shortage of primary care physicians in sub-Saharan Africa requires expansion of training programs in family medicine. Challenges remain in preparing, recruiting, and retaining faculty qualified to teach in these pioneering programs. Little is known about the unique faculty development needs of family medicine faculty within the sub-Saharan African context. The purpose of this study was to assess the current status and future needs for developing robust family medicine faculty in sub-Saharan Africa. The results are reported in two companion articles. A cross-sectional study design was used to conduct a qualitative needs assessment comprising 37 in-depth, semi-structured interviews of individual faculty trainers from postgraduate family medicine training programs in eight sub-Saharan African countries. Data were analyzed according to qualitative description. While faculty development opportunities in sub-Saharan Africa were identified, current faculty note many barriers to faculty development and limited participation in available programs. Faculty value teaching competency, but institutional structures do not provide adequate support. Sub-Saharan African family physicians and postgraduate trainee physicians value good teachers and recognize that clinical training alone does not provide all of the skills needed by educators. The current status of limited resources of institutions and individuals constrain faculty development efforts. Where faculty development opportunities do exist, they are too infrequent or otherwise inaccessible to provide trainers the necessary skills to help them succeed as educators.
Full Text Available Africa belongs to the poorest regions of the world. This statement may be applied especially to its sub-Saharan part. The paper analyses some basic structural characteristics related to the economic development of sub-Saharan region. The article reveals existing differences between countries and regions of sub-Saharan Africa and analyses key problems which influence economic development of individual states. An emphasis is placed on analysing an unsuitable GDP structure and on external economic relations which affect this structure. Results of an investigation show that the GDP of sub-Saharan countries is to a large extend generated by the primary sector of their economies, which is dominant in the total GDP value and its position is continuously strengthening due to a high dynamics of its growth. Having regard to the external environment, there can be stated that the foreign trade has contributed to the GDP growth of the whole region only to a limited degree (this does not apply to all countries seen as individuals. The integration process in sub-Saharan Africa may be characterized as questionable. Many integration groupings are operating in the region, but their influence on economic growth is limited due a low potential for mutual cooperation based on specialisation and use of comparative advantages. The economies of sub-Saharan countries are very sensitive to changes in their external economic environment. In this regard, there is important to highlight the very strong sensitivity of the GDP in the sub-Saharan region in relation to the World GDP (mainly to European and US GDP because both regions belong to the most important trading partners of Africa as a whole.
Lema, Valentino M
Unconsummated marriage is a condition where newly married couples are unable to achieve penile-vaginal intercourse for variable periods despite desire and several attempts to do so. Its exact cause(s) is/are unknown, but performance anxiety resulting from or leading to other conditions is reportedly the major etiological factor. It is thought to be more prevalent in traditional and conservative religious communities where premarital sexual exposure is strictly prohibited. Most publications on unconsummated marriage have originated from North America, European and Middle Eastern countries. There have not been any such reports from sub-Saharan Africa, which is home to diverse cultures and traditions regarding premarital sex and marriage. This paper presents a sample of four cases with unconsummated marriage managed by the author in his private clinic based in the city of Nairobi Kenya, over the past five years. Possible etiological factors and management approaches are discussed, with a review of relevant literature.
Ameh, Emmanuel A; Ameh, Nkeiruka
Advances in neonatal intensive care, total parenteral nutrition and improvements in technology have led to a greatly improved outcome of neonatal surgery in developed countries. In many parts of sub-Saharan Africa, however, neonatal surgery continues to pose wide-ranging challenges. Delivery outside hospital, delayed referral, poor transportation, and lack of appropriate personnel and facilities continue to contribute to increased morbidity and mortality in neonates, particularly under emergency situations. Antenatal supervision and hospital delivery needs to be encouraged in our communities. Adequate attention needs to be paid to providing appropriate facilities for neonatal transport and support and training of appropriate staff for neonatal surgery. Neonates with surgical problems should be adequately resuscitated before referral where necessary but surgery should not be unduly delayed. Major neonatal surgery should as much as possible be performed by those trained to operate on neonates. Appropriate research and international collaboration is necessary to improve neonatal surgical care in the environment.
This is a preliminary survey of the laws and statutes that determine governance arrangements for higher education systems as well as individual institutions in 24 countries of Sub-Saharan Africa. Following an overview of recent higher education governance trends within Africa, it describes the current range of practice and most common approaches…
Narenda P. Sharma; Simon Reitbergen; Claude R. Heimo; Joti Patel
The note summarizes the findings of the Africa Forest Strategy Paper, which responded to the problems confronting forest resources in the Sub-Saharan Africa (SSA), providing a comprehensive overview, and analysis of the forest sector, and mapping a set of actions for consideration by African countries. The diagnosis highlights the nexus between rapid population growth, environmental degrad...
Cailhol, Johann; Craveiro, Isabel; Madede, Tavares; Makoa, Elsie; Mathole, Thubelihle; Parsons, Ann Neo; Van Leemput, Luc; Biesma, Regien; Brugha, Ruairi; Chilundo, Baltazar; Lehmann, Uta; Dussault, Gilles; Van Damme, Wim; Sanders, David
Global Health Initiatives (GHIs), aiming at reducing the impact of specific diseases such as Human Immunodeficiency Virus (HIV), have flourished since 2000. Amongst these, PEPFAR and GFATM have provided a substantial amount of funding to countries affected by HIV, predominantly for delivery of antiretroviral therapy (ARV) and prevention strategies. Since the need for additional human resources for health (HRH) was not initially considered by GHIs, countries, to allow ARV scale-up, implemented short-term HRH strategies, adapted to GHI-funding conditionality. Such strategies differed from one country to another and slowly evolved to long-term HRH policies. The processes and content of HRH policy shifts in 5 countries in Sub-Saharan Africa were examined. A multi-country study was conducted from 2007 to 2011 in 5 countries (Angola, Burundi, Lesotho, Mozambique and South Africa), to assess the impact of GHIs on the health system, using a mixed methods design. This paper focuses on the impact of GFATM and PEPFAR on HRH policies. Qualitative data consisted of semi-structured interviews undertaken at national and sub-national levels and analysis of secondary data from national reports. Data were analysed in order to extract countries' responses to HRH challenges posed by implementation of HIV-related activities. Common themes across the 5 countries were selected and compared in light of each country context. In all countries successful ARV roll-out was observed, despite HRH shortages. This was a result of mostly short-term emergency response by GHI-funded Non-Governmental Organizations (NGOs) and to a lesser extent by governments, consisting of using and increasing available HRH for HIV tasks. As challenges and limits of short-term HRH strategies were revealed and HIV became a chronic disease, the 5 countries slowly implemented mid to long-term HRH strategies, such as formalisation of pilot initiatives, increase in HRH production and mitigation of internal migration of HRH
The changed role of rail in Africa over the last thirty years has seen it move from a situation where many of the systems were carrying a high share of their country's traffic to one in which their market share has declined, their assets have steadily deteriorated, their quality of service has reduced, and they are in many instances only a minor contributor to solving the transport problem...
Emoungu, Paul-Albert N.
The 1988 World Bank report on education in sub-Saharan Africa overstates the regional "crisis" in educational quality and recommends unrealistic strategies, ignoring the fact that basic human needs such as education are unmet because political elites corruptly privatize much of the wealth generated by their nations' economies. (SV)
This paper discusses the potentials of meeting the wood demand and achieving SFM in Sub-Saharan Africa (SSA) through the establishment of forest plantations. The paper reviews forest plantation ownership and distribution patterns in SSA and the factors –silvicultural, ecological, and economic that affect supply and ...
A SWOT Analysis framework was used to assess the situational analysis of antenatal care programmes in sub-Saharan Africa while the Walt and Gilson policy analysis triangle was used to analyse the feasibility of introducing the new WHO ANC model into the sub-region. The content of the WHO model may need to be ...
Early Marriage and Motherhood in Sub-Saharan Africa. Thérèse Locoh. Abstract. (African Environment: 3-4 (39-40): 31-42). Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...
Venot, J.P.J.N.; Hirvonen, M.
This article draws from the fields of anthropology of development and sociology of science to bring new light on the discourses and dynamics of agricultural water management in Sub-Saharan Africa. Specifically, it investigates the persistence of a long-standing and apparently contradictory narrative
Serdeczny, Olivia; Adams, Sophie; Baarsch, Florent; Coumou, Dim; Robinson, Alexander; Hare, William; Schaeffer, Michiel; Perrette, Mahé; Reinhardt, Julia
The repercussions of climate change will be felt in various ways throughout both natural and human systems in Sub-Saharan Africa. Climate change projections for this region point to a warming trend, particularly in the inland subtropics; frequent occurrence of extreme heat events; increasing
Considers the relevance for sub-Saharan Africa of electronic information systems in terms of the segments of the population that would benefit from such services, as opposed to a broader library role of advancing literacy to the general population. (Author/CLB)
Brook, Diane L.
Articulates many reasons to teach about Sub-Saharan Africa in social studies classes. Although the region will become increasingly important because of global interdependence, it suffers widespread misunderstanding concerning its history and culture. Discusses the region's need for economic development and the quest for political democracy. (MJP)
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…
Kroesen, J.O.; Romijn, H.A.; Kroesen, J.O.
This paper takes a capability approach to analyze the role of entrepreneurship in the socio-economic development of present-day sub-Saharan Africa. The paper zooms in on the nature of the capabilities that are built through the development of entrepreneurship; the key challenges to the development
Kroesen, J.O.; Romijn, H
This paper takes a capability approach to analyze the role of entrepreneurship in the socio-economic development of present-day Sub Saharan Africa. The paper zooms in on the nature of the capabilities that are built through the development of entrepreneurship; the key challenges to the development
This report identifies the strategic factors that should propel the African youth to benefit from the opportunities that lie ahead, in particular, economic growth, ... In addition, better focus on information and communications technology could bridge the digital divide between sub-Saharan Africa and the West while making the ...
Meerman, J; Cochrane, S H
The authors argue that sub-Saharan Africa, given its present institutions and endowments of capital and technology, is already dangerously close to overpopulation. Specifically, they suggest that projected rapid population growth will have disastrous effects on the region's ability to increase exports and provide people with goods.
Based on available evidence, this review article posits that contemporary use of abortion in sub-Saharan Africa often substitutes for and sometimes surpasses modern contraceptive practice. Some studies and some data sets indicate that this occurs not only among adolescents but also within older age groups. In several ...
Oral Health Challenges for Sub-Saharan Africa. IS Danfillo. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...
This book has been nominated for the Conover-Porter Award 2008 - This bibliography on Islam in contemporary Sub-Saharan Africa has been prepared as part of the African Studies Centre/Centre d'Étude d'Afrique Noire project entitled "Islam, the Disengagement of the State, and Globalization in
sub-region one of the poorest in the world with 46.4 percent of its people living on ... variables on the level of poverty as observed in Sub-Saharan Africa, using a ... Studies by UNDP also advocate the use of Human Development Index (HDI) and .... Gdisi = gender discrimination proxy by low women status relative to men.
This book has been nominated for the Conover-Porter Award 2008 - This bibliography on Islam in contemporary Sub-Saharan Africa has been prepared as part of the African Studies Centre/Centre d'Etude d'Afrique Noire project entitled "Islam, the Disengagement of the State, and Globalization in
Griffin, Rosarii, Ed.
In the drive to achieve universal primary education as one of the Millennium Development Goals, there is an increasing recognition of the urgency of focusing on teacher education to both meet the demand for more than one million qualified teachers required to achieve this goal within sub-Saharan Africa, as well as to combat the sometimes poor…
Calderón, César; Servén, Luis
An adequate supply of infrastructure services has long been viewed by both academics and policy makers as a key ingredient for economic development. Sub-Saharan Africa ranks consistently at the bottom of all developing regions in terms of infrastructure performance, and an increasing number of observers point to deficient infrastructure as a major obstacle for growth and poverty reduction ...
This project seeks to provide capacity-building support to develop and implement the Information and Networks in Asia and Sub-Saharan Africa (INASSA) research program. INASSA is focused on producing credible, high-quality evidence on the influence of digital initiatives in the areas of governance, science, learning, ...
Patrick Opiyo Owili
Full Text Available Inhalation of secondhand smoke from tobacco results in serious health outcomes among under-five children, and yet, few studies have assessed its effect on under-five mortality. We investigated the association between frequency of exposure to household tobacco smoke and risk of under-five mortality in sub-Saharan Africa (SSA.Demographic Health Survey data of under-five children from 23 SSA countries (n = 787,484 were used. Cox proportional hazard models described the association between exposure to tobacco smoke and the risk of under-five mortality in each country, with age as the time-to-event indicator. Meta-analysis was used to investigate the overall effect of tobacco smoke in SSA.The association between tobacco smoke exposure and the risk of under-five mortality attenuated in eight countries (Burkina Faso, Benin, Congo, Gabon, Guinea, Liberia, Togo, and Zambia after adjustment, while the hazard ratios (HR of daily exposure to tobacco smoke in Kenya (HR = 1.40; 95% CI, 1.16-1.70 and Namibia (HR = 1.40; 1.07-1.83 grew. The children in rural areas in SSA were 1.08 (95% CI, 1.04-1.13 times more likely to die than their urban peers. In general, the exposure to household tobacco smoke was associated with an increased risk of under-five mortality in SSA (HR = 1.09; 95% CI, 1.06-1.13.This study provided evidence of a positive association between exposure to household tobacco smoke and risk of under-five mortality in SSA. Policymakers in low- and middle-income countries, where tobacco control as a child health issue is relatively neglected, should integrate tobacco control measures with other child health promotion policies.
Owili, Patrick Opiyo; Muga, Miriam Adoyo; Pan, Wen-Chi; Kuo, Hsien-Wen
Inhalation of secondhand smoke from tobacco results in serious health outcomes among under-five children, and yet, few studies have assessed its effect on under-five mortality. We investigated the association between frequency of exposure to household tobacco smoke and risk of under-five mortality in sub-Saharan Africa (SSA). Demographic Health Survey data of under-five children from 23 SSA countries (n = 787,484) were used. Cox proportional hazard models described the association between exposure to tobacco smoke and the risk of under-five mortality in each country, with age as the time-to-event indicator. Meta-analysis was used to investigate the overall effect of tobacco smoke in SSA. The association between tobacco smoke exposure and the risk of under-five mortality attenuated in eight countries (Burkina Faso, Benin, Congo, Gabon, Guinea, Liberia, Togo, and Zambia) after adjustment, while the hazard ratios (HR) of daily exposure to tobacco smoke in Kenya (HR = 1.40; 95% CI, 1.16-1.70) and Namibia (HR = 1.40; 1.07-1.83) grew. The children in rural areas in SSA were 1.08 (95% CI, 1.04-1.13) times more likely to die than their urban peers. In general, the exposure to household tobacco smoke was associated with an increased risk of under-five mortality in SSA (HR = 1.09; 95% CI, 1.06-1.13). This study provided evidence of a positive association between exposure to household tobacco smoke and risk of under-five mortality in SSA. Policymakers in low- and middle-income countries, where tobacco control as a child health issue is relatively neglected, should integrate tobacco control measures with other child health promotion policies.
Owili, Patrick Opiyo; Muga, Miriam Adoyo; Pan, Wen-Chi
Background Inhalation of secondhand smoke from tobacco results in serious health outcomes among under-five children, and yet, few studies have assessed its effect on under-five mortality. We investigated the association between frequency of exposure to household tobacco smoke and risk of under-five mortality in sub-Saharan Africa (SSA). Methods Demographic Health Survey data of under-five children from 23 SSA countries (n = 787,484) were used. Cox proportional hazard models described the association between exposure to tobacco smoke and the risk of under-five mortality in each country, with age as the time-to-event indicator. Meta-analysis was used to investigate the overall effect of tobacco smoke in SSA. Results The association between tobacco smoke exposure and the risk of under-five mortality attenuated in eight countries (Burkina Faso, Benin, Congo, Gabon, Guinea, Liberia, Togo, and Zambia) after adjustment, while the hazard ratios (HR) of daily exposure to tobacco smoke in Kenya (HR = 1.40; 95% CI, 1.16–1.70) and Namibia (HR = 1.40; 1.07–1.83) grew. The children in rural areas in SSA were 1.08 (95% CI, 1.04–1.13) times more likely to die than their urban peers. In general, the exposure to household tobacco smoke was associated with an increased risk of under-five mortality in SSA (HR = 1.09; 95% CI, 1.06–1.13). Conclusions This study provided evidence of a positive association between exposure to household tobacco smoke and risk of under-five mortality in SSA. Policymakers in low- and middle-income countries, where tobacco control as a child health issue is relatively neglected, should integrate tobacco control measures with other child health promotion policies. PMID:28542166
Lindsay, K L; Gibney, E R; McAuliffe, F M
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. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.
Bridging the Atlantic is a descriptive study of Brazil's involvement with counterparts in Sub-Saharan Africa through knowledge exchange, trade, and investments. The objective of the study is to understand these relations better with the intent to forge concrete and mutually beneficial partnerships between Brazil and Sub-Saharan Africa. Brazil and Sub-Saharan Africa are natural partners, wi...
The purpose of this article is to discuss how best to finance higher education in low-income countries of sub-Saharan Africa, drawing on benefits and drawbacks of the prevalent models of higher education finance, and lessons to be learned from countries which have seen greater expansion of their higher education systems in recent decades. Two main…
Mavhungu Abel Mafukata
Full Text Available Since Sub-Saharan Africa's first independence in Ghana, the region has experienced massive and costly political and bureaucratic corruption within public service and administration. The causes of the corruption, its nature and form are wide and intertwined. In Sub-Saharan Africa, efforts to curb corruption have failed to discard it. The paper focused on the period from Nkruma in Ghana to Mutharika the 2nd in Malawi. This paper reviewed existing literature on political and bureaucratic corruption in Sub-Saharan Africa while on the other hand the paper employed key informant interviews to gather the required data to investigate, analyse and profile the genesis and evolution of corruption in Sub-Saharan Africa. The key informant interviews were employed to solicit public views and opinion from nineteen key informant participants (n=19 selected from 11 countries in Sub-Saharan Africa. The paper found that corruption is legendary; has entrenched itself to becoming some sort of culture in the region, and has become the most difficult socio-economic challenge to resolve in the region despite the various anti-corruption efforts employed by stakeholders to curb it. It emerged through the study that law-enforcement efforts against corruption need some reinforcement in order to be effective and eficient in uprooting corruption in the region. If Sub-Saharan Africa fails to address its corruption challenge, its development prospects would seriously curtailed.
Ichoku, H E; Ifelunini, A I
This article reviews the changing political undercurrent in health service delivery in Sub-Saharan Africa, chronicling the ideological shift in orientation toward neoliberalism in the health sector, an ideology crafted and introduced into Sub-Saharan Africa by the International Monetary Fund and the World Bank. The article examines the implication of this neoliberal reform on the efficiency in health care provision and on the quality and accessibility of health services by the poor and vulnerable. Drawing inference from countries like Nigeria, the authors argue that the ascendency of neoliberalism in the health systems of Sub-Saharan Africa has engendered unethical practices and introduced elements of moral hazard in the health sector, reducing the incentive for governments to develop effective service delivery over the long term. The authors therefore advocate for a rejection of neoliberal ideology in favor of a universal coverage principle if an inclusive health system is to be developed.
Full Text Available This was the first microbicide trial conducted in Africa to evaluate an antiretroviral-containing vaginal ring as an HIV prevention technology for women.The trial assessed and compared the safety, acceptability and adherence to product use of a 4-weekly administered vaginal ring containing the antiretroviral microbicide, dapivirine, with a matching placebo ring among women from four countries in sub-Saharan Africa.280 Healthy, sexually active, HIV-negative women, aged 18 to 40 years were enrolled with 140 women randomised to a dapivirine vaginal ring (25 mg and 140 women to a matching placebo ring, inserted 4-weekly and used over a 12-week period. Safety was evaluated by pelvic examination, colposcopy, clinical laboratory assessments, and adverse events. Blood samples for determination of plasma concentrations of dapivirine were collected at Weeks 0, 4 and 12. Residual dapivirine levels in returned rings from dapivirine ring users were determined post-trial. Participant acceptability and adherence to ring use were assessed by self-reports.No safety concerns or clinically relevant differences were observed between the dapivirine and placebo ring groups. Plasma dapivirine concentrations immediately prior to ring removal were similar after removal of the first and third ring, suggesting consistent ring use over the 12-week period. No clear relationship was observed between the residual amount of dapivirine in used rings and corresponding plasma concentrations. Self-reported adherence to daily use of the vaginal rings over the 12-week trial period was very high. At the end of the trial, 96% of participants reported that the ring was usually comfortable to wear, and 97% reported that they would be willing to use it in the future if proven effective.The dapivirine vaginal ring has a favourable safety and acceptability profile. If proven safe and effective in large-scale trials, it will be an important component of combination HIV prevention approaches
Nel, Annalene; Bekker, Linda-Gail; Bukusi, Elizabeth; Hellstrӧm, Elizabeth; Kotze, Philip; Louw, Cheryl; Martinson, Francis; Masenga, Gileard; Montgomery, Elizabeth; Ndaba, Nelisiwe; van der Straten, Ariane; van Niekerk, Neliëtte; Woodsong, Cynthia
This was the first microbicide trial conducted in Africa to evaluate an antiretroviral-containing vaginal ring as an HIV prevention technology for women. The trial assessed and compared the safety, acceptability and adherence to product use of a 4-weekly administered vaginal ring containing the antiretroviral microbicide, dapivirine, with a matching placebo ring among women from four countries in sub-Saharan Africa. 280 Healthy, sexually active, HIV-negative women, aged 18 to 40 years were enrolled with 140 women randomised to a dapivirine vaginal ring (25 mg) and 140 women to a matching placebo ring, inserted 4-weekly and used over a 12-week period. Safety was evaluated by pelvic examination, colposcopy, clinical laboratory assessments, and adverse events. Blood samples for determination of plasma concentrations of dapivirine were collected at Weeks 0, 4 and 12. Residual dapivirine levels in returned rings from dapivirine ring users were determined post-trial. Participant acceptability and adherence to ring use were assessed by self-reports. No safety concerns or clinically relevant differences were observed between the dapivirine and placebo ring groups. Plasma dapivirine concentrations immediately prior to ring removal were similar after removal of the first and third ring, suggesting consistent ring use over the 12-week period. No clear relationship was observed between the residual amount of dapivirine in used rings and corresponding plasma concentrations. Self-reported adherence to daily use of the vaginal rings over the 12-week trial period was very high. At the end of the trial, 96% of participants reported that the ring was usually comfortable to wear, and 97% reported that they would be willing to use it in the future if proven effective. The dapivirine vaginal ring has a favourable safety and acceptability profile. If proven safe and effective in large-scale trials, it will be an important component of combination HIV prevention approaches for women
Nel, Annalene; Bekker, Linda-Gail; Bukusi, Elizabeth; Hellstrӧm, Elizabeth; Kotze, Philip; Louw, Cheryl; Martinson, Francis; Masenga, Gileard; Montgomery, Elizabeth; Ndaba, Nelisiwe; van der Straten, Ariane; van Niekerk, Neliëtte; Woodsong, Cynthia
Background This was the first microbicide trial conducted in Africa to evaluate an antiretroviral-containing vaginal ring as an HIV prevention technology for women. Objectives The trial assessed and compared the safety, acceptability and adherence to product use of a 4-weekly administered vaginal ring containing the antiretroviral microbicide, dapivirine, with a matching placebo ring among women from four countries in sub-Saharan Africa. Methods 280 Healthy, sexually active, HIV-negative women, aged 18 to 40 years were enrolled with 140 women randomised to a dapivirine vaginal ring (25 mg) and 140 women to a matching placebo ring, inserted 4-weekly and used over a 12-week period. Safety was evaluated by pelvic examination, colposcopy, clinical laboratory assessments, and adverse events. Blood samples for determination of plasma concentrations of dapivirine were collected at Weeks 0, 4 and 12. Residual dapivirine levels in returned rings from dapivirine ring users were determined post-trial. Participant acceptability and adherence to ring use were assessed by self-reports. Results No safety concerns or clinically relevant differences were observed between the dapivirine and placebo ring groups. Plasma dapivirine concentrations immediately prior to ring removal were similar after removal of the first and third ring, suggesting consistent ring use over the 12-week period. No clear relationship was observed between the residual amount of dapivirine in used rings and corresponding plasma concentrations. Self-reported adherence to daily use of the vaginal rings over the 12-week trial period was very high. At the end of the trial, 96% of participants reported that the ring was usually comfortable to wear, and 97% reported that they would be willing to use it in the future if proven effective. Conclusions The dapivirine vaginal ring has a favourable safety and acceptability profile. If proven safe and effective in large-scale trials, it will be an important component of
Chisumpa, Vesper H.; Odimegwu, Clifford O.; De Wet, Nicole
Place of death remains an issue of growing interest and debate among scholars as an indicator of quality of end-of-life care in developed countries. In sub-Saharan Africa, however, variations in place of death may suggest inequalities in access to and the utilization of health care services that should be addressed by public health interventions. Limited research exists on factors associated with place of death in sub-Saharan Africa. The study examines factors associated with the place of dea...
Calabrese, Maurizio D
Determining the conditions that lead to the formation of radical Islamist groups will help analysts and policymakers prioritize countries within sub-Saharan Africa that may need monitoring to prevent...
Full Text Available This paper employs a generalized mixture model approach to empiricallydetermine if Sub-Saharan African countries henceforth (SSA follow ahomogenous growth pattern based on the conditional distribution of their growthrates. Latent effects are employed to determine the growth experience of SSAcountries and to examine the structural characteristics of the clusters if any exist.Affirmation of clusters might imply significant productivity divergence amongSub-Saharan economies, helping explaining the structural imbalances in theregion. Results strongly buttress the existence of clusters and little evidence of acommon growth path, implying divergence among Sub-Saharan economies andspecific economic reforms are required in the identified clusters to guaranteesustainability and equality of growth in the SSA region. We also observed apositive and significant effect of investment even though the estimated long runeffects of investment on economic growth are smaller than expected
Berde, Anselm S; Ozcebe, Hilal
To examine the risk factors of prelacteal feeding (PLF) among mothers in sub-Saharan Africa (SSA). We pooled data from Demographic and Health Surveys in twenty-two SSA countries. The key outcome variable was PLF. A multilevel logistic regression model was used to explore factors associated with PLF. Demographic and Health Surveys in twenty-two SSA countries. Mother-baby pairs (n 95348). Prevalence of PLF in SSA was 32·2 %. Plain water (22·1 %), milk other than breast milk (5·0 %) and sugar or glucose water (4·1 %) were the predominant prelacteal feeds. In the multivariable analysis, mothers who had caesarean section delivery had 2·25 times the odds of giving prelacteal feeds compared with mothers who had spontaneous vaginal delivery (adjusted OR=2·25; 95 % CI 2·06, 2·46). Other factors that were significantly associated with increased likelihood of PLF were mother's lower educational status, first birth rank, fourth or above birth rank with preceding birth interval less than or equal to 24 months, lower number of antenatal care visits, home delivery, multiple birth, male infant, as well as having an average or small sized baby at birth. Mothers aged 20-34 years were less likely to give prelacteal feeds compared with mothers aged ≤19 years. Belonging to the second, middle or fourth wealth quintile was associated with lower likelihood of PLF compared with the highest quintile. To achieve optimal breast-feeding, there is a need to discourage breast-feeding practices such as PLF. Breast-feeding promotion programmes should target the at-risk sub-population groups discovered in our study.
Guliani, Harminder; Sepehri, Ardeshir; Serieux, John
While much has been written on the determinants of prenatal care attendance in low-income countries, comparatively little is known about the determinants of the frequency of prenatal visits in general and whether there are separate processes generating the decisions to use prenatal care and the frequency of use. Using the Demographic and Health Surveys data for 32 low-income countries (across Asia, Sub-Saharan Africa and Latin America) and appropriate two-part and multilevel models, this article empirically assesses the influence of a wide array of observed individual-, household- and community-level characteristics on a woman's decision to use prenatal care and the frequency of that use, while controlling for unobserved community level factors. The results suggest that, though both the decision to use care and the number of prenatal visits are influenced by a range of observed individual-, household- and community-level characteristics, the influence of these determinants vary in magnitude for prenatal care attendance and the frequency of prenatal visits. Despite remarkable consistency among regions in the association of individual, household and community indicators with prenatal care utilization, the estimated coefficients of the risk factors vary greatly across the three world regions. The strong influence of household wealth, education and regional poverty on the use of prenatal care suggests that safe motherhood programmes should be linked with the objectives of social development programmes such as poverty reduction, enhancing the status of women and increasing primary and secondary school enrolment rate among girls. Finally, the finding that teenage mothers and unmarried women and those with unintended pregnancies are less likely to use prenatal care and have fewer visits suggests that safe mother programmes need to pay particular attention to the disadvantaged and vulnerable subgroups of population whose reproductive health issues are often fraught with
van Huis, Arnold
The number of termite species in the world is more than 2500, and Africa with more than 1000 species has the richest intercontinental diversity. The family Termitidae contains builders of great mounds up to 5 m high. Colonies are composed of casts: a queen, a king, soldiers and workers. Some species of termite cultivate specialised fungi to digest cellulose. Termites constitute 10% of all animal biomass in the tropics. The purpose of the study was to make an overview of how termites are utilized, perceived and experienced in daily life across sub-Saharan Africa. Ethno-entomological information on termites (Isoptera) in sub-Saharan Africa was collected by: (1) interviews with more than 300 people from about 120 ethnic groups from 27 countries in the region; (2) library studies in Africa, London, Paris and Leiden. Vernacular names relate to mounds, insects as food, the swarming, and the behaviour of termites. Swarming reproductive, soldiers and queens are collected as food. There are many different ways to harvest them. Termites can also be used as feed for poultry or as bait to catch birds and fish. The mushrooms that grow each year from the fungus gardens on the termite mounds are eaten. The soldiers, the fungus gardens and the soil of termite mounds are used for multiple medicinal purposes. Mounds and soil of termites have numerous functions: for geochemical prospecting, making bricks, plastering houses, making pots, and for storage. Termite soil is often used as fertilizer. The act of eating soil (geophagy) among women, especially those that are pregnant, is practised all over Africa. The mounds can serve as burying places and are often associated with the spiritual world, especially containing the spirits of ancestors. Termites also play a role as oracle, in superstitious beliefs, in art and literature. The following characteristics make termites so appealing: the dominance in the landscape, the social organization, the destructive power, and the provision of
such as Angola, Sudan, Chad, Equatorial Guinea, Nigeria , and South Africa.83 Until 2005, Sudan was the top recipient of Chinese non- financial overseas...compared to standard reporting by the IMF and World Bank. This study dissects the market sector competition generated by China’s investment...corruption, and erode U.S. political relevance in sub-Saharan Africa. China has empowered private enterprises, which can monopolize African market sectors
Elizabeth Asiedu; James Freeman
Many of the empirical studies that analyze the impact of corruption on investment have three common features: they employ aggregate (country-level) data on investment, corruption is measured at the country-level, and data for countries from several regions are pooled together. This paper uses firm-level data on investment and measures corruption at the firm and country-level, and allows the effect of corruption to vary by region. Our dependent variable is firms’ investment growth and we emplo...
Bello-Manga, Halima; DeBaun, Michael R; Kassim, Adetola A
Sickle cell disease (SCD) is the most common inherited hemoglobinopathy in the world, with the majority of cases in sub-Saharan Africa. Concomitant nutritional deficiencies, infections or exposure to environmental toxins exacerbate chronic anemia in children with SCD. The resulting relative anemia is associated with increased risk of strokes, poor cognitive function and impaired growth. It may also attenuate optimal response to hydroxyurea therapy, the only effective and practical treatment option for SCD in sub-Saharan Africa. This review will focus on the epidemiology, clinical sequelae, and treatment of relative anemia in children with SCD living in low and middle-income countries in sub-Saharan Africa. Areas covered: The causes and treatment of relative anemia in children with SCD in sub-Saharan Africa. The MEDLINE database was searched using medical subject headings (MeSH) and keywords for articles regarding relative anemia in children with SCD in sub-Saharan Africa. Expert commentary: Anemia due to nutritional deficiencies and infectious diseases such as helminthiasis and malaria are prevalent in sub-Saharan Africa. Their co-existence in children with SCD increases morbidity and mortality. Therefore, preventing, diagnosing and treating the underlying cause of this relative anemia will improve SCD-related outcomes in children in sub-Saharan Africa.
Deaton, Angus S.; Tortora, Robert
The health of people in sub-Saharan Africa is a major global concern. However, data are weak, and little is known about how people in the region perceive their health or their health care. We used data from the Gallup World Poll in 2012 to document sub-Saharan Africans’ perceived health status, their satisfaction with health care, their contact with medical professionals, and the priority they attach to health care. In comparison to other regions of the world, sub-Saharan Africa has the lowest ratings for well-being and the lowest satisfaction with health care. It also has the second lowest perception of personal health, after only the former Soviet Union and its satellites. HIV prevalence is positively correlated with perceived improvements in health care in countries with high prevalence. This is consistent with an improvement in at least some health care services as a result of the largely aid-funded rollout of antiretroviral treatment. Even so, sub-Saharan Africans do not prioritize health care as a matter of policy, although donors are increasingly shifting their aid efforts in sub-Saharan Africa toward health. PMID:25715657
Poverty Reduction Strategy Paper (PRSP) countries in Sub-Saharan Africa have shown strong signs of growth resilience in the aftermath of the recent global crisis. Yet, this paper finds evidence that growth has more than proportionately benefited the top quintile during PRSP implementation. It finds that PRSP implementation has neither reduced poverty headcount nor raised the income share of the poorest quintile in Sub-Saharan Africa. While countries in other regions have been more successful ...
This paper studies tax policies as currently pursued in a number of sub-Saharan African countries against the backdrop of increasing worldwide economic integration and the pressure this puts on revenues from trade taxes and taxes on mobile production factors. This contrasts with existing (growing)
African Journal of Reproductive Health ... Data are analyzed here from 95 surveys conducted since 1980 in 38 sub-Saharan African countries, to determine past injectable trends in the context of alternative ... Most use is supplied through the public sector, which raises long term cost issues for health ministries and donors.
Mboumba Bouassa, Ralph-Sydney; Prazuck, Thierry; Lethu, Thérèse; Jenabian, Mohammad-Ali; Meye, Jean-François; Bélec, Laurent
Infections caused by high-risk human papillomavirus (HPV) are responsible for 7.7% of cancers in developing countries, mainly cervical cancer. This disease is steadily increasing in sub-Saharan Africa, with more than 75,000 new cases and 50,000 deaths yearly, further increased by HIV infection. Areas covered: The current status of cervical cancer associated with HPV in sub-Saharan Africa has been systematically revised. The main issues discussed here are related to the public health burden of cervical cancer in sub-Saharan Africa and predictions for the coming decades, including molecular epidemiology and determinants of HPV infection in Africa, and promising prevention measures currently being evaluated in Africa. Expert commentary: By the year 2030, cervical cancer will kill more than 443,000 women yearly worldwide, most of them in sub-Saharan Africa. The increase in the incidence of cervical cancer in Africa could counteract the progress made by African women in reducing maternal mortality and longevity. Nevertheless, cervical cancer is a potentially preventable noncommunicable disease, and intervention strategies to eliminate cervical cancer as a public health concern should be urgently implemented.
Meerman, J; Cochrane, S H
It is argued in this article that sub-Saharan Africa, given its present institutions and endowments of capital and technology, is already dangerously close to overpopulation. The rapid growth of its population projected for the next decades will greatly increase human misery and depress economic development. Specifically, rapid population growth will have disastrous effects on the region's ability to increase exports and provide people with food. There must be a search for new ways in which these effects could be mitigated. In sub-Saharan Africa fertility either continues to be very high or is increasing, in part due to some decline in traditional practices that reduce fertility, such as prolonged breastfeeding. This situation and the expectation of declining mortality imply that African population growth may increase further. Currently, population in sub-Saharan Africa is about half that of India and a third of China. There are 2 main reasons why reduced fertility in the next few decades is unlikely in sub-Saharan Africa as a whole: Africa has low literacy, high infant and child mortality, and low urbanization; and average African fertility rates may even increase for the next 20 years or so. The question that arises is what are the implications of continuing and rapid population growth for the African food supply. The region's cereal production is largely restricted to 4 grains, i.e., millet, sorghum, maize, and rice. The volume of grain production is less, by weight, than 60% of the production of roots and tubers. There are 2 main differences between the output of these crops in sub-Saharan Africa and the rest of the world: yields/hectare are lower in Africa than in elsewhere; and yields have generally been decreasing or largely constant in Africa. The low productivity has several causes. Today, population pressure has brought diminishing returns to traditional agriculture in much of the Sahel and the savanna, in parts of East Africa, Southern Africa, and parts
The report presents findings, and the way forward in respect of the Knowledge and Research (KAR) Project on vehicle operations in Sub-Saharan Africa, basically undertaken in Uganda and Ghana. In the first phase, the study identified problems faced by transport operators in both countries, and analyzed their impact on vehicle operating costs, as well as examining transport regulations, and ...
Moon, Bob; Villet, Charmaine
Sub-Saharan Africa, more than any other part of the world, is experiencing a crisis in finding sufficiently qualified teachers to meet the needs of expanding school systems. The professional development support provided to serving teachers is also inadequate in most countries. The most recent data on learner outcomes has revealed a worrying…
Huth, M J
Population projections for nine Sub-Saharan African countries (excluding southern Africa) are reviewed for the period to the year 2020. Consideration is given to the determinants of fertility and to the consequences of rapid population growth. Suggestions for population policies that will resolve population-related development problems are discussed.
Tilak, Jandhyala B. G.
Worsening economic conditions, reflected in mounting external debt, debt service, and structural adjustment processes have forced governments to reveal their expenditure priorities, which are largely against human capital investment activities like education. This paper examines this phenomenon, using cross-country data for Sub-Saharan Africa.…
Beaudoin, Michael F.
Many countries identified with the developing world, such as those in sub-Saharan Africa, have been recipients of aid programs over the past five decades totaling billions of dollars and aimed at fostering social and economic development to achieve global parity with the industrialized world. Much of this activity has been focused on building…
Bemelmans, Marielle; Baert, Saar; Goemaere, Eric; Wilkinson, Lynne; Vandendyck, Martin; van Cutsem, Gilles; Silva, Carlota; Perry, Sharon; Szumilin, Elisabeth; Gerstenhaber, Rodd; Kalenga, Lucien; Biot, Marc; Ford, Nathan
Further scale-up of antiretroviral therapy (ART) to those in need while supporting the growing patient cohort on ART requires continuous adaptation of healthcare delivery models. We describe several approaches to manage stable patients on ART developed by Médecins Sans Frontières together with Ministries of Health in four countries in sub-Saharan Africa.
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 Lesotho Demographic and Health Survey data, the authors examine the relationship between coresidence with a grandmother and child schooling in Lesotho, a country with one of the highest rates of HIV infection.…
View Point: Economic growth and child health in Sub Saharan Africa. BA O'Hare, N Bar-Zeev, L Chiwaula. Abstract. After independence most African countries witnessed growth in their economies and decreases in child mortality. However both economic growth and the gains in under 5 mortality slowed dramatically in the ...
Onywera, Vincent O; Blanchard, Claire
Road traffic injuries (RTIs) continue to be a major cause of death and disability throughout low- and middle-income countries (LMICs). The aim of this commentary is highlight some of the major causes of RTIs in sub-Saharan Africa and suggests strategies for better road safety as well as suggestions on how to reduce road accidents in LMICs.
This commentary discusses the three articles in this (2017) issue. The articles expand the published research base on the effectiveness of early education in the sub-Saharan Africa countries of Zambia, Kenya, and the Democratic Republic of Congo (DRC). Each of the three articles employs rigorous methods to better understand the impact of…
Adema, Yvonne; Sterken, Elmer
We analyze the interrelation between monetary stability and financial structure in 20 Sub-Saharan economies. Using a panel data set we estimate the impact of monetary stability and financial development on income per capita. Special interest is given to the conditions of the so-called CFA-countries,
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…
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 2000-2005 period. The recent dynamic in SSA varies from dry to wet biomes. Deforestation occurred at faster rates in nations with predominantly dry forests. The wetter Congo basin countries had lower rates of deforestation, in part because tax receipts from oil and mineral industries in this region spurred rural to urban migration, declines in agriculture and increased imports of cereals from abroad. In this respect, the Congo basin countries may be experiencing an oil and mineral fuelled forest transition. Small farmers play a more important role in African deforestation than they do in southeast Asia and Latin America, in part because small-scale agriculture remains one of the few livelihoods open to rural peoples.
Brockerhoff, M; Yang, X
Much lower levels of fertility in urban than rural areas throughout sub-Saharan Africa imply that fertility decline in the region may be facilitated by rapid urbanization and rural-to-urban migration. The present study uses data from Demographic and Health Surveys in six countries--Ghana, Kenya, Mali, Senegal, Togo and Uganda--to assess the impact of long-term rural-urban female migration on fertility. Results of logit analyses indicate that in most countries women who leave the countryside represent the higher fertility segment of the rural population in the years before migration. Migrants' risk of conception declines dramatically in all countries around the time of migration and remains lower in the long run among most migrant groups than among rural and urban nonmigrants. Descriptive analyses suggest that the decline in migrant fertility is related to the rapid and pronounced improvement in standard of living experienced by migrants after settling in the urban area and may be due in part to temporary spousal separation.
De Paolis, M R
An analysis of 46 posters from 27 countries of Sub-Saharan Africa allowed the values conveyed by this medium to be defined, the status of the announcer and the recipient to be clarified, and their relationship and the attendant social consequences to be brought out. One of the primary characteristics of this sample was that the vast majority of the posters contained drawings and only a limited number used photos. The family was the theme most commonly represented by the image and the text: information on family planning necessarily involved the family, the synonym of fertility. The majority of posters represented the traditional, nuclear family of the Western world, comprising the father, mother, and children. It was interesting to observe that this image did not necessarily reflect reality in Africa, where traditionally the extended family, including the grandparents, uncles and aunts, is more widespread. The message most commonly conveyed the image of the nuclear family. The number of children shown varied from 1 to 4, with an average of 2. The most widely used message strategies in this sample of posters involved three types of announcer: authoritarian, nonauthoritarian, and character announcer. The authoritarian type announcer was not visually depicted but consisted of messages that were written orders or threats. The nonauthoritarian announcer, also not depicted, gave messages that contained no orders or threats. The character announcer was one the characters portrayed in the picture.
Voeten, Hélène A C M; Vissers, Debby C J; Gregson, Simon; Zaba, Basia; White, Richard G; de Vlas, Sake J; Habbema, J Dik F
Enormous variation exists in HIV prevalence between countries in sub-Saharan Africa. The contribution of migration to the spread of HIV has long been recognized, but its effect at the population level has never been assessed. In this ecological analysis, we explore how much variation in HIV prevalence in urban sub-Saharan Africa is explained by in-migration. We performed a linear regression to analyze the association between the proportion of recent in-migrants and HIV prevalence for men and women in urban areas, using 60 data points from 28 sub-Saharan African countries between 1987 and 2005. We found a strong association between recent in-migration and HIV prevalence for women (Pearson R = 57%, P Africa (R = 50%, P = 0.003). For both genders, the association was strongest between 1985 and 1994, slightly weaker between 1995 and 1999, and nonexistent as from 2000. The overall association for both men and women was not confounded by the developmental indicators GNI per capita, income inequalities, or adult literacy. Migration explains much of the variation in HIV spread in urban areas of sub-Saharan Africa, especially before the year 2000, after which HIV prevalences started to level off in many countries. Our findings suggest that migration is an important factor in the spread of HIV, especially in rapidly increasing epidemics. This may be of relevance to the current HIV epidemics in China and India.
Full Text Available Keneni Gutema Negeri,1 Damen Halemariam,21School of Public and Environmental Health, Health Service Management Unit, College of Medicine and Health Sciences, Hawassa University, Hawassa, 2College of Medicine and Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia Introduction: Data on the effect of health aid on the health status in developing countries are inconclusive. Moreover, studies on this issue in sub-Saharan Africa are scarce. Therefore, this study aims to analyze the effect of health development aid in sub-Saharan Africa. Methods: Using panel data analytic method, as well as infant mortality rate as a proxy for health status, this study examines the effect of health aid on infant mortality rate in sub-Saharan Africa. The panel was constructed from data on 43 countries for the period 1990–2010. Fixed effect, random effect, and first difference generalized method of moments estimator were used for estimation. Results: Health development aid has a statistically significant positive effect. A 1% increase of health development assistance per capita saves the lives of two infants per 1,000 live births (P=0.000 in the region. Conclusion: Contrary to health aid pessimists’ view, this study observes the fact that health development assistance has strong favorable effect in improving health status in sub-Saharan Africa. Keywords: health aid, infant mortality, developing countries, panel data
Butler, Ivan Harry
Study of food value chains in East Africa as a preliminary study. The paper wishes to underline a few under-researched assumptions about esepcially protein deficiencies, allergies etc. to establish what enablers and constraints exist when trying to supply food from e.g. Europe to e.g. East Africa....
there was general consensus that the “democratic experiment” had taken root in Africa ... African Charter on Democracy, Elections and Governance is of particular importance in this context. The .... of governmental work through results in the interests of citizens. ... declarations impact on the reality of political rule in Africa?
Olesen, Tina Bech; Munk, Christian; Christensen, Jane
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...... 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...
Derrick Ssewanyana; Derrick Ssewanyana; Byron Bitanihirwe
Gambling is a cross-cultural and global activity which typically involves the wagering of money or an item of monetary value on an outcome that is governed by chance. Although gambling is positioned as a legitimate recreational and leisure activity within sub-Saharan Africa (SSA), there is widespread recognition among healthcare professionals and policy-makers that gambling has the capacity to become dysfunctional in a minority. Emerging knowledge suggests that problem gambling is rapidly evo...
Mathieu Couttenier; Raphael Soubeyran
We show that civil war is strongly related to drought in sub-Saharan Africa. We consider the e ect of variations in the Palmer Drought Severity Index (Palmer 1965) - a cumulative index that combines precipitation, temperature and the local characteristics of the soil - on the risk of civil war. While the recent, contentious debate on the link between climate and civil war has mainly focused on precipitation and temperature, without obtaining converging results, the Palmer index describes soci...
Spearman, C Wendy; Sonderup, Mark W
Disparities in health reflect the differences in the incidence, prevalence, burden of disease and access to care determined by socio-economic and environmental factors. With liver disease, these disparities are exacerbated by a combination of limited awareness and preventable causes of morbidity and mortality in addition to the diagnostic and management costs. Sub-Saharan Africa, comprising 11% of the world's population, disproportionately has 24% of the global disease burden, yet allocates health. It has 3% of the global healthcare workforce with a mean of 0.8 healthcare workers per 1000 population. Barriers to healthcare access are many and compounded by limited civil registration data, socio-economic inequalities, discrepancies in private and public healthcare services and geopolitical strife. The UN 2014 report on the Millennium Development Goals suggest that sub-Saharan Africa will probably not meet several goals, however with HIV/AIDS and Malaria (goal 6), many successes have been achieved. A 2010 Global Burden of Disease study demonstrated that cirrhosis mortality in sub-Saharan Africa doubled between 1980 and 2010. Aetiologies included hepatitis B (34%), hepatitis C (17%), alcohol (18%) and unknown in 31%. Hepatitis B, C and alcohol accounted for 47, 23 and 20% of hepatocellular carcinoma respectively. In 10%, the underlying aetiology was not known. Liver disease reflects the broader disparities in healthcare in sub-Saharan Africa. However, many of these challenges are not insurmountable as vaccines and new therapies could comprehensively deal with the burden of viral hepatitis. Access to and affordability of therapeutics remains the major barrier. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Ernest Aryeetey; Christopher Udry
Gross domestic savings in Africa averaged only 8 percent of GDP in the 1980s, compared to 23 percent for Southeast Asia and 35 percent in the Newly Industrialized Economies. Aside from being generally low, saving rates in most of Africa have shown consistent decline over the last thirty years. These savings figures must be considered tentative, because they are derived as a residual in the national accounts from expenditure and production data that are themselves quite unreliable. Notwithstan...
Bankole, Akinrinola; Ahmed, Fatima H; Neema, Stella; Ouedraogo, Christine; Konyani, Sidon
Using data from the 2004 National Adolescent Surveys, this paper undertook a detail analysis of knowledge of correct condom use and consistency of use, as well as their covariates, among adolescents in Burkina Faso, Ghana, Malawi and Uganda. The strongest predictor of knowledge of correct condom use among both male and female adolescents is exposure to a condom use demonstration. In Burkina Faso, Ghana and Uganda, adolescents who have seen a condom demonstration are 2 to 5 times as likely as those who have not to have good knowledge of correct condom use. Age, ever received sex education in school, ever attended school and exposure to the radio are also significant predictors of knowledge of correct use, particularly among men. As indicated by behavior among young men, the extent to which adolescents use the condom consistently varies across countries. Yet, it is nowhere near the required 100% level. The proportion reporting consistent use of the method in the 3 months preceding the survey is 38% in Burkina Faso, 47% in Ghana, 20% in Malawi and 36% in Uganda. Age difference between partners is a major determinant of consistent use of condoms: young men whose partner is 0-4 years younger are about two and a half times more likely to use condoms consistently than those who whose partner is 5-9 years younger. Other important predictors of consistent condom use are residence, education, living arrangement and exposure to mass media, specifically the radio and newspaper. Findings from this study point to areas that policy and program can address to provide adolescents access to the kinds of information and service they need to achieve healthy sexual and reproductive lives.
Slayton, Rachel B; Date, Kashmira A; Mintz, Eric D
Emerging data on the epidemiologic, clinical and microbiologic aspects of typhoid fever in sub-Saharan Africa call for new strategies and new resources to bring the regional epidemic under control. Areas with endemic disease at rates approaching those in south Asia have been identified; large, prolonged and severe outbreaks are occurring more frequently; and resistance to antimicrobial agents, including fluoroquinolones is increasing. Surveillance for typhoid fever is hampered by the lack of laboratory resources for rapid diagnosis, culture confirmation and antimicrobial susceptibility testing. Nonetheless, in 2010, typhoid fever was estimated to cause 725 incident cases and 7 deaths per 100,000 person years in sub-Saharan Africa. Efforts for prevention and outbreak control are challenged by limited access to safe drinking water and sanitation and by a lack of resources to initiate typhoid immunization. A comprehensive approach to typhoid fever prevention including laboratory and epidemiologic capacity building, investments in water, sanitation and hygiene and reconsideration of the role of currently available vaccines could significantly reduce the disease burden. Targeted vaccination using currently available typhoid vaccines should be considered as a short- to intermediate-term risk reduction strategy for high-risk groups across sub-Saharan Africa.
Sawers, Larry; Isaac, Alan
A widely accepted explanation for the exceptionally high HIV prevalence in sub-Saharan Africa is the practice of long-term overlapping heterosexual partnering. This article shows that long-duration concurrent partnering can be protective against HIV transmission rather than promoting it. Monogamous partnering prevents sexual transmission to anyone outside the partnership and, in an initially concordant-seronegative partnership, prevents sexual acquisition of HIV by either partner. Those protections against transmission and acquisition last as long as the partnership persists without new outside partnerships. Correspondingly, these two protective effects characterise polygynous partnerships, whether or not the polygyny is formal or informal, until a partner initiates a new partnership. Stable and exclusive unions of any size protect against HIV transmission, and more durable unions provide a longer protective effect. Survey research provides little information on partnership duration in sub-Saharan Africa and sheds no light on the interaction of duration, concurrency, and HIV. This article shows how assumptions about partnership duration in individual-based sexual-network models affect the contours of simulated HIV epidemics. Longer mean partnership duration slows the pace at which simulated epidemics grow. With plausible assumptions about partnership duration and at levels of concurrency found in the region, simulated HIV epidemics grow slowly or not at all. Those results are consistent with the hypothesis that long-duration partnering is protective against HIV and inconsistent with the hypothesis that long-term concurrency drives the HIV epidemics in sub-Saharan Africa.
Cresswell, Jenny A; Campbell, Oona M R; De Silva, Mary J; Slaymaker, Emma; Filippi, Veronique
To quantify maternal obesity as a risk factor for Caesarean delivery in sub-Saharan Africa. Multivariable logistic regression analysis using 31 nationally representative cross-sectional data sets from the Demographic and Health Surveys (DHS). Maternal obesity was a risk factor for Caesarean delivery in sub-Saharan Africa; a clear dose-response relationship (where the magnitude of the association increased with increasing BMI) was observable. Compared to women of optimal weight, overweight women (BMI 25-29 kg/m(2) ) were significantly more likely to deliver by Caesarean (OR: 1.54; 95% CI: 1.33, 1.78), as were obese women (30-34.9 kg/m(2) (OR: 2.39; 95%CI: 1.96-2.90); 35-39.9 kg/m(2) (OR: 2.47 95%CI: 1.78-3.43)) and morbidly obese women (BMI ≥40 kg/m(2) OR: 3.85; 95% CI: 2.46-6.00). BMI is projected to rise substantially in sub-Saharan Africa over the next few decades and demand for Caesarean sections already exceeds available capacity. Overweight women should be advised to lose weight prior to pregnancy. Furthermore, culturally appropriate prevention strategies to discourage further population-level rises in BMI need to be designed and implemented. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
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…
Turkson, J.K.; Wohlgemuth, N.
As part of the current liberalisation process sweeping sub-Saharan Africa, power sectors across the region are being scrutinised and restructured. A critical aspect of the reform is improving access to electricity by large segments of the population. Many in the continent are, therefore,looking a......As part of the current liberalisation process sweeping sub-Saharan Africa, power sectors across the region are being scrutinised and restructured. A critical aspect of the reform is improving access to electricity by large segments of the population. Many in the continent are, therefore......, on average, 30-40 per cent of the region's population, the authors discuss the issues involved, drawing on the experiences of other countries whether there are any apparent 'preconditions' for success. Second, the role renewable energy can play in this process and the extent to which lessons from other parts...... of the world might be transferable to the countries of sub-Saharan Africa is assessed. The paper concludes by investigating the prospects for distributed generation in power sector reform in sub-Saharan Africa, arguing that though lessons from other parts of the world will be helpful, they cannot be all...
Peptic ulcer disease is a significant cause of morbidity and mortality worldwide, with a significant burden in low- and middle-income countries. However, there is limited information regarding management of peptic ulcer disease in these countries. This study describes surgical interventions for peptic ulcer disease in sub-Saharan Africa. A systematic review was performed using PubMed, EMBASE, and African Index Medicus for studies describing surgical management of peptic ulcer disease in sub-Saharan Africa. From 55 published reports, 6594 patients underwent surgery for peptic ulcer disease. Most ulcers (86%) were duodenal with the remainder gastric (14%). Thirty-five percent of operations were performed for perforation, 7% for bleeding, 30% for obstruction, and 28% for chronic disease. Common operations included vagotomy (60%) and primary repair (31%). The overall case fatality rate for peptic ulcer disease was 5.7% and varied with indication for operation: 13.6% for perforation, 11.5% for bleeding, 0.5% for obstruction, and 0.3% for chronic disease. Peptic ulcer disease remains a significant indication for surgery in sub-Saharan Africa. Recognizing the continued role of surgery for peptic ulcer disease in sub-Saharan Africa is important for strengthening surgical training programs and optimizing allocation of resources.
Atun, Rifat; Silva, Sachin; Ncube, Mthuli; Vassall, Anna
In 2015 around 15 million people living with HIV were receiving antiretroviral treatment (ART) in sub-Saharan Africa. Sustained provision of ART, though both prudent and necessary, creates substantial long-term fiscal obligations for countries affected by HIV/AIDS. As donor assistance for health remains constrained, novel financing mechanisms are needed to augment funding domestic sources. We explore how Innovative Financing has been used to co-finance domestic HIV/AIDS responses. Based on analysis of non-health sectors, we identify innovative financing instruments that could be used in the HIV response. We undertook a systematic review to identify innovative financing instruments used for (1) domestic HIV/AIDS financing in sub-Saharan Africa (2) international health financing and (3) financing in non-health sectors. We analyzed peer-reviewed and grey literature published between 2002 and 2014. We examined the nature and volume of funds mobilized with innovative financing, then in consultation with leading experts, identified instruments that held potential for financing the HIV response. Our analysis revealed three innovative financing instruments in use: Zimbabwe's AIDS Trust Fund (a tax/levy-based instrument), Botswana's National HIV/AIDS Prevention Support (BNAPS) International Bank for Reconstruction and Development (IBRD) Buy-Down (a debt conversion instrument), and Côte d'Ivoire's Debt2Health Debt Swap Agreement (a debt conversion instrument). Zimbabwe's AIDS Trust Fund generated US$ 52.7 million between 2008 and 2011, Botswana's IBRD Buy-Down generated US$ 20 million, and Côte d'Ivoire's Debt2Health Debt Swap Agreement generated US$ 27 million, at least half of which was to be invested in HIV/AIDS programs. Four additional categories of innovative financing instruments met our criteria for future use: (1) remittances and diaspora bonds (2) social and development impact bonds (3) sovereign wealth funds (4) risk and credit guarantees. A limited number of
Owili, Patrick Opiyo; Muga, Miriam Adoyo; Chou, Yiing-Jenq; Hsu, Yi-Hsin Elsa; Huang, Nicole; Chien, Li-Yin
Despite the progress in the Millennium Development Goals (MDGs) 4 and 5, inequity in the utilization of maternal, newborn and child health (MNCH) care services still remain high in sub-Saharan Africa (SSA). The continuum of care for MNCH that recognizes a tight inter-relationship between maternal, newborn and child health at different time periods and location is key towards reducing inequity in health. In this study, we explored the distributions in the utilization MNCH services in 12 SSA countries and further investigated the associations in the continuum of care for MNCH. Using Demographic and Health Surveys data of 12 countries in SSA, structural equation modeling approach was employed to analyze the complex relationships in continuum of care for MNCH model. The Full Information Maximum Likelihood estimation procedure which account for the Missing at Random (MAR) and Missing Completely at Random (MCAR) assumptions was adopted in LISREL 8.80. The distribution of MNCH care utilization was presented before the estimated association in the continuum of care for MNCH model. Some countries have a consistently low (Mali, Nigeria, DR Congo and Rwanda) or high (Namibia, Senegal, Gambia and Liberia) utilization in at least two levels of MNCH care. The path relationships in the continuum of care for MNCH from 'adequate antenatal care' to 'adequate delivery care' (0.32) and to 'adequate child's immunization' (0.36); from 'adequate delivery care' to 'adequate postnatal care' (0.78) and to 'adequate child's immunization' (0.15) were positively associated and statistically significant at p < 0.001. Only the path relationship from 'adequate postnatal care' to 'adequate child's immunization' (-0.02) was negatively associated and significant at p < 0.001. In conclusion, utilization of each level of MNCH care is related to the next level of care, that is - antenatal care is associated with delivery care which is then associated with postnatal and subsequently with child
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.
Sonderup, Mark W; Afihene, Mary; Ally, Reidwaan; Apica, Betty; Awuku, Yaw; Cunha, Lina; Dusheiko, Geoffrey; Gogela, Neliswa; Lohouès-Kouacou, Marie-Jeanne; Lam, Phillip; Lesi, Olufunmilayo; Mbaye, Papa Saliou; Musabeyezu, Emmanuel; Musau, Betty; Ojo, Olesegun; Rwegasha, John; Scholz, Barbara; Shewaye, Abate B; Tzeuton, Christian; Kassianides, Chris; Spearman, C Wendy
In 2016, WHO adopted a strategy for the elimination of viral hepatitis by 2030. Africa, and more specifically, sub-Saharan Africa, carries a substantial portion of the global burden of viral hepatitis, especially chronic hepatitis B and hepatitis C virus infections. The task that lies ahead for sub-Saharan Africa to achieve elimination is substantial, but not insurmountable. Major developments in the management of hepatitis C have put elimination within reach, but several difficulties will need to be navigated on the path to elimination. Many of the challenges faced are unique to sub-Saharan Africa and the development of strategies is complicated by a scarcity of good data from countries and regions within sub-Saharan Africa. However, this hindrance should not act as a barrier to delay interventions in screening, detection, and linkage to care. Moreover, by sharing experiences from across sub-Saharan Africa, countries can create supranational synergies to develop their programmes and work together in a more cohesive manner to tackle the burden of hepatitis C in sub-Saharan Africa. In this Series paper, several issues related to hepatitis C in sub-Saharan Africa are addressed, including prevalence, risk factors, and fibrosis assessment, and recommendations are given by experts from across the region. Simplified diagnostic algorithms and treatment regimens for both HIV co-infected and hepatitis C mono-infected patients are suggested. The recommendations are consensus based and provided to guide the development of programmes in sub-Saharan Africa. Political will and appropriate funding will be required to provide impetus to implement these recommendations. Copyright © 2017 Elsevier Ltd. All rights reserved.
Hartemink, A.E.; Keulen, van H.
Soil degradation in Sub-Sahara Africa has been much debated in the past decades. Although there are many different views, at the extremes there are those who are of the opinion that the problem is very serious and the main cause for the poverty and food crises and those that are convinced that it is
Naoussi , Claude Francis; Tripier , Fabien
This article explores the role of trend shocks in explaining the specificities of business cycles in Sub-Saharan African (SSA) countries using the methodology introduced by Aguiar and Gopinath (2007) [Emerging Market Business Cycles: The Cycle Is the Trend Journal of Political Economy 115(1)]. We specify a small open economy model with transitory and trend shocks on productivity to replicate the differences in the business cycle behavior of output and consumption across countries, especially ...
The intricate interrelationships between population and development in sub-Saharan Africa are examined and the prospects are considered for converting the abundant human resources into an effective development asset. The demographic trends that characterize the sub-Saharan region at this time differ markedly from what is happening in other parts of the developing world. In Africa, death rates have come down slightly (17/1000 in 1980-85 in contrast to 20/1000 in 1970-75); there has been practically no change in the birthrate. Consequently, population growth rates are on the rise throughout Africa although there are differences within the regions. The various factors responsible for high fertility in African societies and the consequences of the continuing high fertility often are mutually reinforcing. For example, low health and educational standards are likely to lead women to have large numbers of children, but these conditions are themselves the result of the population growth, which requires an expansion of health care and educational facilities that hard-pressed national budgets cannot provide. In Africa, the growth rate of the youth population is increasing even faster than that of the population as a whole -- from 3.1% in 1980-85 to an estimated 3.4% in 1990-95. The most critical problem posed by such growth rates is an increased demand for food. Countries which cannot adequately feed their growing populations are unlikely to be significantly more successful in satisfying their other basic needs. Whether educated or healthy or not, Africa's growing numbers of children represent major economic problems for countries with a low level of economic growth. There is little hope of effectively absorbing all the new entrants who swell the labor market each year, and the indirect consequences for the economy of rapid demographic growth are no less serious. Presently, Africa is the scene of major and particularly distressing movements of population as the drought has
Begins Housing Sales to Blacks (Johannesburg Domestic Service, 1 Jul 83) 79 Roles of Black Farmers, U.S. Firms Discussed (SAPA, 7 Jul 83...advanced technology and superpowers. Yet how many in Africa will share his sentiment if only because it is a necessary subject about which to talk and...some of the shocks, and prevent a dangerous internationalisation . Col. Mengistu, the new OAU Chairman, who has entered the fray to criticise Zaire’s
anti-colonial movements across the continent. As one historical study notes: In 1955, the Soviet Union made its first major arms transfer to an...arrange- ments with Pretoria to keep mineral prices high did not prevent it attacking South Africa’s Western busi- ness partners for doing business...Sudan, South Africa, Namibia, etc.); • Construction of power facilities—hydroelec- tric power plants on the River Congo (Angola, Zambia
Schrijner, Sandor; Smits, Jeroen
Globally an estimated 159 million children under 5 years of age are being too short for one's age (stunted). More than one third of these children is living in Africa. Given the substantial number of sub-Saharan African (SSA) children living in households with co-residing grandparents and the negative effects of stunting on productivity and economic growth, gaining insight into the role grandparents play for children's stunting, has become increasingly important. By applying multilevel logistic regression analysis on a database with information on 344,748 children aged 6-60 months living in 31 SSA countries, the strength of the relationship between grandparental co-residence and children's stunting is examined. Interaction analysis is used to explore how this relationship is moderated by characteristics of the household and of the context in which the household is situated. Children in households with a co-residing grandmother have significantly lower odds of being stunted than other children, provided that the grandmother is in the 50-75 age range. When the grandmother is very young or very old, the likelihood of being stunted is higher. For grandfathers, no significant overall relationship is found, but our findings show that co-residence of a grandfather is associated with less stunting of girls, in poor households and in polygamous households. Copyright © 2018 Elsevier Ltd. All rights reserved.
McCullough, Ellen B
Drawing on a new set of nationally representative, internationally comparable household surveys, this paper provides an overview of key features of structural transformation - labor allocation and labor productivity - in four African economies. New, micro-based measures of sector labor allocation and cross-sector productivity differentials describe the incentives households face when allocating their labor. These measures are similar to national accounts-based measures that are typically used to characterize structural change. However, because agricultural workers supply far fewer hours of labor per year than do workers in other sectors in all of the countries analyzed, productivity gaps shrink by half, on average, when expressed on a per-hour basis. Underlying the productivity gaps that are prominently reflected in national accounts data are large employment gaps, which call into question the productivity gains that laborers can achieve through structural transformation. Furthermore, agriculture's continued relevance to structural change in Sub-Saharan Africa is highlighted by the strong linkages observed between rural non-farm activities and primary agricultural production.
Joseph Ato Forson
Full Text Available This study explores the causes of corruption in 22 countries in sub-Saharan Africa from 1996 to 2013. The sources of corruption are grouped into three main thematic areas – historical roots, contemporary causes and institutional causes to make way for subjective and objective measures. The subjective measures allow for assessment of the effectiveness of anticorruption policies. Using pooled OLS, fixed-effect and instrumental-variable approaches, and focusing on the perceived level of corruption as the dependent variable, we find that ethnic diversity, resource abundance and educational attainment are markedly less associated with corruption. In contrast, wage levels of bureaucrats and anticorruption measures based on government effectiveness and regulatory quality breed substantial corruption. Press freedom is found to be variedly associated with corruption. On the basis of these findings, we recommend that the fight against corruption on the continent needs to be reinvented through qualitative and assertive institutional reforms. Anticorruption policy decisions should focus on existing educational systems as a conduit for intensifying awareness of the devastating effect of corruption on sustainable national development.
Dodoo, Alexander; Hugman, Bruce
In this narrative review, a brief summary of theoretical approaches to risk perception is followed by an analysis of some of the special factors influencing risk perception and risk communication in sub-Saharan Africa. Examples of recent and emergent local medicines and vaccine controversies in several countries are given along with evidence and analysis of how they were managed. These demonstrate, among other things, the extent to which ethnic, religious and cultural issues influence popular perception, and the power of rumour and anecdote in shaping public opinion and official responses to events. Where safety monitoring systems exist, they are in their infancy, with limited capacity for data collection, credible scientific review, effective public communication and robust crisis management. Although increasing democratic freedoms, including less restricted media, and evolving health systems are addressing the challenges and give hope for further progress, there are still deep and intractable issues that inhibit transparent and effective risk communication and stand in the way of African populations comprehending medicines and their risks in safer and more balanced ways. Some proposals for future change and action are offered, including the pursuit of a deeper understanding of local and national values, assumptions and beliefs that drive risk perception; tailoring public health planning and communications to specifically-targeted regions and populations; strengthening of safety surveillance and data-collection systems; giving higher priority to medicines safety issues in healthcare training and public education.
Ramil Ravilevich Asmyatullin
Full Text Available This article is dedicated to the development of the higher education in Sub-Saharan countries, particularly to the topic of internationalization of education. Most African countries have underdeveloped education systems. The quality and availability of higher education is a formidable obstacle for economic and social development. There is a growing demand for higher education in the SSA, but national education systems can’t cope fully with it. Hence many students go abroad, mostly in other African countries. The article focuses on the position of South Africa in the global and regional education market. As it’s a regional leader in this field South Africa attracts more than a half of international students within the Sub-Saharan Africa. The main reasons why African students choose South Africa are geographic proximity, familiar culture, lack of wanted higher education programs in their countries. However, there are as well disadvantages like xenophobia and race discrimination. South Africa has become a leader in Africa in the field of higher education, but it plays still small part at a global scale.
Climate change is projected to adversely impact different parts of the world to varying extents. Preliminary studies show that Sub-Saharan Africa is particularly vulnerable to climate change impacts, including changes to precipitation levels and temperatures. This work will analyse the effect of changes in temperature on critical systems such as energy supply and demand. Factors that determine energy demand include income, population, temperature (represented by cooling and heating degree days), and household structures. With many countries in Sub-Saharan Africa projected to experience rapid growth in both income and population levels, this study aims to quantify the amplified effects of these factors - coupled with temperature changes - on energy demand. The temperature effects will be studied across a range of scenarios for each of the factors mentioned above, and identify which of the factors is likely to have the most significant impact on energy demand in Sub-Saharan Africa. Results of this study can help set priorities for decision-makers to enhance the climate resilience of critical infrastructure in Sub-Saharan Africa.
Matthews, William G.
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
Vanhecke, C; Le-Gall, P; Le Breton, M; Malvy, D
Pentastomiasis is a rare zoonotic infection but it is frequently observed in Africa and Asia. Most human infections are caused by members of the Armillifer armillatus species. They are responsible for visceral pentastomiasis in Western and Central Africa. Humans may be infected by eating infected undercooked snake meat or by direct contact with an infected reptile. An increasing number of infections are being reported in Congo, Nigeria, and Cameroon. Despite an occasionally high number of nymphs observed in human viscera, most infections are asymptomatic and often diagnosed by accident during surgery or autopsy. The clinical presentation of pentastomiasis is quite varied and depends on infected tissues. The liver, lungs, and pleura are most frequently involved. Abdominal emergencies have been reported. Diagnostic delays always occur and diagnosis focuses on the patient's lifestyle and living environment. It is mainly based on the morphological description of the parasite's calcified cuticle, the site of the lesion, and the parasite's region of origin. Most patients do not require any treatment. Personal measures such as avoidance of contact with snake droppings are recommended to prevent transmission. Imported pentastomiasis has been observed in African migrants. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Full Text Available This paper examines the dynamics of food supply per capita and undernourishment in Sub-Saharan Africa SSA for a panel of 42 countries. The dataset was constructed from the FAO and the World Bank global databases for four rounds in five-year intervals. Ordinal measures of national food supply status were generated from daily calorie supply per capita of SSA countries. Regional and inter-temporal dynamics of food supply status very low low medium transition rates and the associated forces underpinning this dynamic process were analyzed and stylized by parametric and non-parametric measures. Economic and socio-demographic factors and regional heterogeneities determining the dynamics of food supply situation in SSA were identified by random-effects ordered probit model. The empirical findings indicate that the food supply level of SSA countries was enhanced by agricultural production and industrial value added as a proxy for structural transformation. However it was adversely affected by military expenditure inflation level of consumer prices proportion of rural population age dependency ratio and regional heterogeneities. The likelihood of SSA countries to face incidence of very low low and medium calorie per capita supply was 23 percent 61 percent and 16 percent respectively. To improve the level of food supply per capita and thereby to reduce food poverty situation SSA countries and other stakeholders need to focus on policies designed to enhance economic growth through agricultural production creation of employment opportunities with structural transformation enhancing health care services improving their demographic structure through family planning and controlling national and regional shocks and instabilities.
Chidarikire, S; Cross, M; Skinner, I; Cleary, M
To identify the treatments and interventions available and their impact on people living with schizophrenia in Sub-Saharan Africa. Help-seeking behaviour and the choice of treatment are largely influenced by socio-cultural factors and beliefs about the causes of mental illness. This review addresses the gap in knowledge regarding the treatment options available to people living with schizophrenia in Sub-Saharan Africa. Adapted realist literature review. Electronic databases searched in June 2016 included PubMed, EMBASE, PsycINFO, ProQuest and CINAHL. The adapted realist review approach used to synthesize the published research involved identifying the review aim, searching and selecting relevant studies, extracting, iteratively analysing and synthesizing relevant data and reporting results. Forty studies from eight countries were reviewed. Most people were treated by both faith/traditional healers and modern psychiatry. Common treatments included antipsychotics, electroconvulsive therapy and psychosocial interventions. Few treatment options were available outside major centres, there was poor adherence to medication and families reported a high level of burden associated with caring for a relative. Major limitations of this review were the lack of studies, variable quality and low level of evidence available from most countries from Sub-Saharan Africa and lack of generalizability. People living with schizophrenia in Sub-Saharan Africa were treated by faith, traditional healers and modern psychiatry, if at all. Further research is needed to better understand the local situation and the implications for caring for people from this region. Mental health services in Sub-Saharan Africa are limited by fiscal shortages, lack of mental health services and qualified mental health professionals. This review provides evidence to inform nursing and healthcare policy, including recruiting and training mental health professionals and ensuring access to evidence-based, person
Monekosso, G L
Developments in medical education in Sub-Saharan Africa over the past 100 years have been characterized by the continent's unique history. During the first half of the 20th century, the Europeans effectively installed medical education in their African colonies. The years 1950 to 1960 were distinguished by successful movements for independence, with new governments giving priority to medical education. By 1980, there were 51 medical schools in Sub-Saharan Africa. The period from 1975 to 1990 was problematic both politically and economically for Sub-Saharan Africa, and medical schools did not escape the general difficulties. War, corruption, mounting national debts, and political instability were characteristics of this period. In many countries, maintaining medical school assets--faculty members, buildings, laboratories, libraries--became difficult, and emigration became the goal of many health professionals. In contrast, the past 20 years have seen rapid growth in the number of medical schools in Sub-Saharan Africa. Economic growth and political stability in most Sub-Saharan African countries augur well for investment in health systems strengthening and in medical education. There are, nonetheless, major problem areas, including inadequate funding, challenges of sustainability, and the continuing brain drain. The 20th century was a time of colonialism and the struggle for independence during which medical education did not advance as quickly or broadly as it did in other regions of the world. The 21st century promises a different history, one of rapid growth in medical education, leading to better care and better health for the people of Africa.
de-Graft Aikins, Ama; Dzokoto, Vivian A; Yevak, Earl
Genital shrinking is a recurring phenomenon with about 180 reported cases in sub-Saharan Africa over the last two decades. Transcending national boundaries, it results in distress for victims, mob violence against accused perpetrators and mass panic which law enforcement agencies struggle to contain. This article examines mass media construction and framing of genital shrinking within a social representations theory framework. Our analysis suggests the following: (1) mass media reports are informed by lay and expert perspectives; (2) three stocks of knowledge are drawn on interchangeably, with culture constituting a core representation; (3) lay and expert perspectives overlap on cultural and common-sense explanations of genital shrinking; and (4) scientific explanations are limited to individual pathophysiology and psychopathology and do not inform public opinion. We consider the implications of understanding genital shrinking for improving mass media constructions and dissemination of information on 'socio-psychological epidemics' that may have scientific explanations. © The Author(s) 2015.
cadres in Soviet higher educational institutions, occupational training of members of the Congolese cooperative movement , granting of material assistance...final analysis, our country’s young cooperative movement has always enjoyed the active support of the Soviet cooperative members, and benefits greatly
and cancer surveillance in many resource-poor countries where HBV is endemic ... common cancer among females [5, 6 ]. ... treatment of viral hepatitis and HCC are major limiting factors in ... HBV treatment that is accessible and affordable to all .... Government Medical College, Calicut, Kerala, India. george_lenx@ yahoo.
Loans (TIMES OF ZAMBIA, 7 Apr 83) 55 IFC Suing Prime Minister for Alleged Failure To Repay 1974 Loan (DAILY MAIL, 7 Apr 83) 57 Zulu Calls...Partner’ 60 Indian Trade Delegation 60 FAO Famine Relief Donation 60 SIDO Members to FRG 60 Wage Increase Request 61 Zulu Warns Against Threats 61...deteriorat- ing rangelands of most countries in the near future, according to Dr. David Hop- craft, founder and managing director of Game Ranch
jocularity within them. Despite his fulminations and vows to resist to the death, it’s difficult to imagine Oom Sarel quitting SWA. It’s not...Swazi traditionalism with an awareness that his backward little country needed to catch up with the 20th century. He tried himself to synthesise ... synthesis after his death. One was to reconstitute the Liqoqo and greatly increase its powers. Sobhuza named 17 members to the traditionalist
Kwon Sik Kim
Full Text Available Major countries, such as the United States, Japan, and China have already recognized the potential of Africa’s markets. Korea has also taken notice of Africa's diverse export markets recently. However, Africa is comprised of 53 different countries and, as a result, entry into the region poses a formidable strategic challenge. Korean authorities and export groups have suggested a "3 plus 2 Country Strategy" in order to make inroads into the African region. This paper contributes to discussions of this strategy by comparing the effects of economic growth in South Africa and Nigeria on Sub-Saharan Africa. In addition, because economic power in Africa is concentrated in a small number of countries, whose market characteristics are different from those of integrated unions, the determinants of economic growth in Africa as a whole and unions may be different. This paper investigates whether or not this is, in fact, the case. The empirical results can be summarized as follows: First, the effects of South Africa's economic growth on Sub-Saharan Africa and the SADC (a representative union of South Africa are much larger than the effects of Nigeria's growth on Sub-Saharan Africa and the ECOWAS (a representative union of Nigeria. These empirical results imply that the preferred country to pursue economic cooperation with is South Africa. Second, we confirm that determinants of economic growth are different for Africa and the unions. The main determinant of growth in African countries may be the population ratio, but in the SADC, growth appears to be determined by ratio trade volumes of GDP. Finally, we also find that the ratio investments of GDP have a positive influence on the economic growth of both Africa and SADC.
Asaolu, Ibitola O; Gunn, Jayleen K; Center, Katherine E; Koss, Mary P; Iwelunmor, Juliet I; Ehiri, John E
In spite of a high prevalence of HIV infection among adolescents and young adults in sub-Saharan Africa, uptake of HIV testing and counseling among youth in the region remains sub-optimal. The objective of this study was to assess factors that influence uptake of HIV testing and counseling among youth aged 15-24 years in sub-Saharan Africa. This study used the Demographic and Health Survey (DHS) data from countries that represent four geographic regions of sub-Saharan Africa: Congo (Brazzaville), representing central Africa (DHS 2011-2012); Mozambique, representing southern Africa (DHS 2011); Nigeria, representing western Africa (DHS 2013); and Uganda, representing eastern Africa (DHS 2011). Analyses were restricted to 23,367 male and female respondents aged 15-24 years with complete data on the variables of interest. Chi-square tests and logistic regression models were used to assess predictors of HIV testing. Statistical significance was set at psub-Saharan Africa for HIV testing continues to be a challenge. Public health programs that seek to increase HIV counseling and testing among youth should pay particular attention to efforts that target high-risk subpopulations of youth. The results further suggest that these initiatives would be strengthened by including strategies to increase HIV comprehensive knowledge.
Galan, Deise I; Kim, Seung-Sup; Graham, Jay P
In sub-Saharan Africa, it is estimated that 215 million people continue to engage in open defecation. This practice facilitates the transmission of diarrheal diseases - one of the leading causes of mortality in children under 5 in sub-Saharan Africa. The main purpose of this study is to: estimate changes in open defecation prevalence between 2005 and 2010 across countries in sub-Saharan Africa; examine the association between national level indices and changes in open defecation prevalence; and assess how many countries can achieve 'open defecation free status' by 2015. After applying selection criteria, this study analyzed country-level data for 34 sub-Saharan African countries. Seven country-level indices were collected: 1) presence of a national sanitation policy; 2) budget line for sanitation; 3) budget allocated to sanitation; 4) annual per capita GDP; 5) GDP growth; 6) implementation of total sanitation approaches; and 7) per capita aid disbursement for water supply and sanitation. The relationships between these country-level indices and the change in open defecation from 2005 to 2010 were investigated using Wilcoxon Signed-Rank test and Spearman's rank correlation test. Only 3 countries (i.e. Ethiopia, Angola and Sao Tome and Principe) decreased open defecation by 10% or more between 2005 and 2010. No significant associations were observed between the change in open defecation prevalence and all of national level indices except per capita aid disbursement. Per capita aid disbursement for water and sanitation was positively associated with a reduction in open defecation (p-value = 0.02) for a subset of 29 low-income countries from 2005 to 2010. Only one country in our analysis, Angola, is on track to end open defecation by 2015 based on their performance between 2000 and 2010. Most of the national level indices, including a country's economic status, were not associated with the change in the open defecation prevalence. Based on current trends, the goal
Armah, George E; Sow, Samba O; Breiman, Robert F; Dallas, Michael J; Tapia, Milagritos D; Feikin, Daniel R; Binka, Fred N; Steele, A Duncan; Laserson, Kayla F; Ansah, Nana A; Levine, Myron M; Lewis, Kristen; Coia, Michele L; Attah-Poku, Margaret; Ojwando, Joel; Rivers, Stephen B; Victor, John C; Nyambane, Geoffrey; Hodgson, Abraham; Schödel, Florian; Ciarlet, Max; Neuzil, Kathleen M
Rotavirus gastroenteritis causes many deaths in infants in sub-Saharan Africa. Because rotavirus vaccines have proven effective in developed countries but had not been tested in developing countries, we assessed efficacy of a pentavalent rotavirus vaccine against severe disease in Ghana, Kenya, and Mali between April, 2007, and March, 2009. In our multicentre, double-blind, placebo-controlled trial, undertaken in rural areas of Ghana and Kenya and an urban area of Mali, we randomly assigned infants aged 4-12 weeks without symptoms of gastrointestinal disorders in a 1:1 ratio to receive three oral doses of pentavalent rotavirus vaccine 2 mL or placebo at around 6 weeks, 10 weeks, and 14 weeks of age. Infants with HIV infection were not excluded. Randomisation was done by computer-generated randomisation sequence in blocks of six. We obtained data for gastrointestinal symptoms from parents on presentation to health-care facilities and clinical data were obtained prospectively by clinicians. The primary endpoint was severe rotavirus gastroenteritis (Vesikari score >or=11), detected by enzyme immunoassay, arising 14 days or more after the third dose of placebo or vaccine to end of study (March 31, 2009; around 21 months of age). Analysis was per protocol; infants who received scheduled doses of vaccine or placebo without intervening laboratory-confirmed naturally occurring rotavirus disease earlier than 14 days after the third dose and had complete clinical and laboratory results were included in the analysis. This study is registered with ClinicalTrials.gov, number NCT00362648. 5468 infants were randomly assigned to receive pentavalent rotavirus vaccine (n=2733) or placebo (n=2735). 2357 infants assigned to vaccine and 2348 assigned to placebo were included in the per-protocol analysis. 79 cases of severe rotavirus gastroenteritis were reported in 2610.6 person-years in the vaccine group, compared with 129 cases in 2585.9 person-years in the placebo group, resulting
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 people’s perception of, and their possible openness towards, certain forms of corruption was investigated. The research showed that cultural traits do influence people’s 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 God’s 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.
Yakubu, Ibrahim; Salisu, Waliu Jawula
Background Adolescent pregnancy has been persistently high in sub-Saharan Africa. The objective of this review is to identify factors influencing adolescent pregnancies in sub-Saharan Africa in order to design appropriate intervention program. Methods A search in MEDLINE, Scopus, Web of science, and Google Scholar databases with the following keywords: determinants, factors, reasons, sociocultural factors, adolescent pregnancy, unintended pregnancies, and sub- Saharan Africa. Qualitative and ...
education opportunities for aspiring sub-Saharan Africa leaders, improve drinking water , and protect forests—all of which is an interesting foreign...ANALYSIS OF UNITED STATES AND CHINESE ECONOMIC ENGAGEMENT IN SUB-SAHARAN AFRICA by James Housley Furman, Jr. March 2016 Thesis Advisor...ENGAGEMENT IN SUB-SAHARAN AFRICA 5. FUNDING NUMBERS 6. AUTHOR(S) James Housley Furman, Jr. 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES
Larson, Paul R; Chege, Patrick; Dahlman, Bruce; Gibson, Christine; Evensen, Ann; Colon-Gonzalez, Maria C; Onguka, Stephanie; Lamptey, Roberta; Cayley, William E; Nguyen, Bich-May; Johnson, Brian; Getnet, Sawra; Hasnain, Memoona
High-quality family medicine education is needed in sub-Saharan Africa to facilitate the future growth of primary care health systems. Current faculty educators recognize the value of dedicated teacher training and ongoing faculty development. However, they are constrained by inadequate faculty development program availability and institutional support. A cross-sectional study design was used to conduct a qualitative needs assessment comprised of 37 in-depth, semi-structured interviews of individual faculty trainers from postgraduate family medicine training programs in eight sub-Saharan African countries. Data were analyzed according to qualitative description. Informants described desired qualities for a family medicine educator in sub-Saharan Africa: (1) pedagogical expertise in topics and perspectives unique to family medicine, (2) engagement in self-directed, lifelong learning, and (3) exemplary character and behavior that inspires others. Informant recommendations to guide the development of faculty development programs include: (1) sustainability, partnership, and responsiveness to the needs of the institution, (2) intentional faculty development must begin early and be supported with high-quality mentorship, (3) presumptions of teaching competence based on clinical training must be overcome, and (4) evaluation and feedback are critical components of faculty development. High-quality faculty development in family medicine is critically important to the primary care workforce in sub-Saharan Africa. Our study describes specific needs and recommendations for family medicine faculty development in sub-Saharan Africa. Next steps include piloting and evaluating innovative models of faculty development that respond to specific institutional or regional needs.
Adjei, Jones K; Saewyc, Elizabeth M
Research on youth sexual exploitation in Africa has largely neglected the experiences of exploited boys. To date, much of the research in sub-Saharan Africa continues to consider boys mainly as exploiters but not as exploited. Using the only publicly available population-based surveys from the National Survey of Adolescents, conducted in four sub-Saharan African countries - Burkina Faso, Ghana, Malawi, and Uganda-we assessed factors associated with transactional sexual behaviour among never-married adolescent boys and girls. We also examined whether boys' reported sexual exploitation was linked to similar risky sexual behaviours as has been noted among girls in sub-Saharan Africa. Results from our analyses indicated that even though adolescent girls have a somewhat higher likelihood of reporting sexual abuse and exploitation, the odds of trading sex were significantly elevated for previously traumatized boys (that is those with a history of sexual and physical abuse) but not for their female counterparts. Just like adolescent girls, transactional sexual behaviour was associated with the risk of having concurrent multiple sexual partners for boys. These findings support the reality of boys' sexual exploitation within the African context, and further highlight the importance of including males in general and boys in particular in population-based studies on sexual health, risk, and protective factors in the sub-Saharan African region. Understanding the factors linked to sexual exploitation for both boys and girls will help in developing policies and programs that could improve the overall sexual and reproductive health outcomes among adolescents and youth in sub-Saharan Africa. Copyright © 2017 Elsevier Ltd. All rights reserved.
Dunlop, Catherine L; Benova, Lenka; Campbell, Oona
Increasing access to skilled birth attendance, usually via childbirth in health facilities, is a key intervention to reduce maternal and perinatal mortality and morbidity. Yet, in some countries of sub-Saharan Africa, the uptake is Health Surveys from 34 sub-Saharan African countries were used to assess women's delivery locations. 72 772 women having their first birth in the 5 years preceding the surveys were included in the analysis. Proportions and 95% CIs of facility-based deliveries were estimated overall and by country. Multivariable logistic regression was used to calculate the odds of facility-based delivery for different maternal age groups (15-19, 20-24 and ≥25 years) for a pooled sample of all countries. 59.9% of women had a facility-based delivery for their first birth (95% CI 58.6 to 61.2), ranging from 19.4% in Chad to 96.6% in Rwanda. Compared with women aged 15-19 years, the adjusted odds of having a facility-based delivery for those aged 20-24 was 1.4 (95% CI 1.3 to 1.5, psub-Saharan Africa. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Lepère, P; Tchounga, B; Ekouevi, D-K
Digital health has the potential to strengthen health systems and empower patients to prevent ill health and manage their own care. To confirm this potential, however, it is urgent to shift from pilot studies to the implementation of programs at a sufficient scale, with interoperable solutions and integrated into the national health system, while respecting human rights. It is also important to plan for studies to demonstrate the impact and produce the necessary evidence. Francophone sub-Saharan Africa can catch up in this area.
Jones, Edward Samuel; Tarp, Finn
Should policy-makers, including foreign donors, focus employment strategies in sub-Saharan Africa on strengthening access to formal wage employment or on raising productivity in the informal sector? We examine the evidence in Mozambique and show that crude distinctions between formality...... and informality are not illuminating. The observed welfare advantage of formal sector workers essentially derives from differences in endowments and local conditions. Non-agricultural informal work can yield higher returns than formal work. The implication is that the informal sector must not be marginalized......; and raising productivity in agriculture must be accorded a central place in boosting employment....
Full Text Available This paper investigates the effect of remittance inflows on real exchange rates in sub-Saharan Africa (SSA using annual data from 1980 to 2008 for 34 countries, the method of moments estimator developed by Arellano and Bover (1995 and the feasible generalized least squares estimator developed by Parks (1967 and Kmenta (1986. We find that when cross-sectional dependence and individual effects are controlled for, remittances to sub-Saharan Africa as a whole increase the underlying real exchange rates of recipient countries. However, this real exchange rate appreciation is mitigated by monetary policy interventions and the direction of fiscal expenditures towards tradable goods. Thus, the real exchange rate appreciation does not lead to the loss of export competitiveness or a worsening of the trade deficit in the countries in the panel.
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 8,500–13,000 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 This paper analyses the channels through which the economic and financial crisis of 2008–2009 was transmitted to Sub-Saharan Africa, with a focus on countries in situation of fragility. Trade stands out as the main direct channel, even though intra-Africa remittances play a relevant role, given that most migrants in Sub-Saharan Africa cannot afford the cost of migrating to Europe or to the United States and stay close, remaining in the continent. Whether reduced aid flows also act as a crisis transmission channel remains an open question, even though preliminary estimates suggest that, at least in the medium run, OECD countries are likely to lower aid, with potentially very damaging effects. The paper also shows that many African countries in a situation of fragility are characterised by very low resilience and capacity to cope with shocks. It concludes, by highlighting how Sub-Saharan Africa (fragile countries’ policymakers’ room for manoeuver is limited in periods of crisis because of low fiscal space and limited institutional capacity. It advocates that the right response to the crisis would be to mobilise domestic resources, although this will require functional institutions able to offset the potential trade-offs between adverse short-term shocks and a long-term perspective.
Conclusion: HIV infected children and their families in sub-Saharan Africa face myriad of complex medical and psychosocial issues. A holistic health promotional approach is being advocated as the required step for eradication of pediatric HIV in Africa. Keywords: Pediatric HIV, sub-Saharan Africa, Challenges.
Zymelman, Manuel, Ed.
This guide to assessing engineering education in Sub-Saharan Africa consists of three sections, covering: (1) assessment of qualitative and quantitative needs; (2) assessment of the engineering education institution in developing countries; and (3) methods of forecasting demand for engineers; assessment of the efficiency of engineering training…
A complex relationship exists between population growth and economic development. The historical quantitative evidence is also ambiguous. Many social scientists consider rapid population growth in developing countries to be a major obstacle to development. There are, however, many ways in which population growth can foster development. There are also several rational reasons why families in developing countries may decide to bear many children. Theories on population and development are discussed. Using sub-Saharan Africa as its reference region, the paper describes how rapid population growth can impede development. Current demographic and economic trends in sub-Saharan Africa and the consequences of rapid population growth in terms of economic, environmental, and sociopolitical change, capital widening, the labor force, and trade are presented.
Petroni, Suzanne; Steinhaus, Mara; Fenn, Natacha Stevanovic; Stoebenau, Kirsten; Gregowski, Amy
Despite increasing global attention and commitments by countries to end the harmful practice of child marriage, each year some 15 million girls marry before the age of 18. The preponderance of the evidence produced historically on child marriage comes from South Asia, where the vast majority of child brides live. Far less attention has been paid to child marriage in sub-Saharan Africa, where prevalence rates remain high. The International Center for Research on Women (ICRW) recently conducted research in Kenya, Senegal, Uganda, and Zambia to contribute to greater understanding of the drivers of child marriage in each of these contexts. Synthesizing findings from 4 diverse countries provides a useful opportunity to identify similarities and differences, as well as understandings that may be applicable to and helpful for preventing child marriage across these and other settings. Across the 4 countries, ICRW's research echoes the existing literature base in affirming that child marriage is rooted in inequitable gender norms that prioritize women's roles as wives, mothers, and household caretakers, resulting in inadequate investments by families in girls' education. These discriminatory norms interact closely with poverty and a lack of employment opportunities for girls and young women to perpetuate marriage as a seemingly viable alternative for girls. We found in the African study sites that sexual relations, unplanned pregnancy, and school dropout often precede child marriage, which differs from much of the existing evidence on child marriage from South Asia. Further, unlike in South Asia, where family members typically determine the spouse a girl will marry, most girls in the Africa study settings have greater autonomy in partner choice selection. In Senegal, increasing educational attainment and labor migration, particularly by young women, has contributed to reduced rates of child marriage for girls. Our findings suggest that improving gender equitable norms and
Burgess, Philip I; Msukwa, Gerald; Beare, Nicholas A V
Sub-Saharan Africa faces an epidemic of diabetes. Diabetes causes significant morbidity including visual loss from diabetic retinopathy, which is largely preventable. In this resource-poor setting, health systems are poorly organized to deliver chronic care with multiple system involvement. The specific skills and resources needed to manage diabetic retinopathy are scarce. The costs of inaction for individuals, communities and countries are likely to be high. Screening for and treatment of diabetic retinopathy have been shown to be effective, and cost-effective, in resource-rich settings. In sub-Saharan Africa, clinical services for diabetes need to be expanded with the provision of effective, integrated care, including case-finding and management of diabetic retinopathy. This should be underpinned by a high quality evidence base accounting for differences in diabetes types, resources, patients and society in Africa. Research must address the epidemiology of diabetic retinopathy in Africa, strategies for disease detection and management with laser treatment, and include health economic analyses. Models of care tailored to the local geographic and social context are most likely to be cost effective, and should draw on experience and expertise from other continents. Research into diabetic retinopathy in Africa can drive the political agenda for service development and enable informed prioritization of available health funding at a national level. Effective interventions need to be implemented in the near future to avert a large burden of visual loss from diabetic retinopathy in the continent. An increase in visual loss from diabetic retinopathy is inevitable as the diabetes epidemic emerges in sub-Saharan Africa. This could be minimized by the provision of case-finding and laser treatment, but how to do this most effectively in the regional context is not known. Research into the epidemiology, case-finding and laser treatment of diabetic retinopathy in sub-Saharan
Van Royen, Kathleen; Lachat, Carl; Holdsworth, Michelle; Smit, Karlien; Kinabo, Joyce; Roberfroid, Dominique; Nago, Eunice; Garimoi Orach, Christopher; Kolsteren, Patrick
Optimal nutrition is critical for human development and economic growth. Sub-Saharan Africa is facing high levels of food insecurity and only few sub-Saharan African countries are on track to eradicate extreme poverty and hunger by 2015. Effective research capacity is crucial for addressing emerging challenges and designing appropriate mitigation strategies in sub-Saharan Africa. A clear understanding of the operating environment for nutrition research in sub-Saharan Africa is a much needed prerequisite. We collected data on the barriers and requirements for conducting nutrition research in sub-Saharan Africa through semi-structured interviews with 144 participants involved in nutrition research in 35 countries in sub-Saharan Africa. A total of 133 interviews were retained for coding. The main barriers identified for effective nutrition research were the lack of funding due to poor recognition by policymakers of the importance of nutrition research and under-utilisation of research findings for developing policy, as well as an absence of research priority setting from within Africa. Current research topics were perceived to be mainly determined by funding bodies from outside Africa. Nutrition researchers argued for more commitment from policymakers at national level. The low capacity for nutrition research was mainly seen as a consequence of insufficient numbers of nutrition researchers, limited skills and a poor research infrastructure. In conclusion, African nutrition researchers argued how research priorities need to be identified by African stakeholders, accompanied by consensus building to enable creating a problem-driven national research agenda. In addition, it was considered necessary to promote interactions among researchers, and between researchers and policymakers. Multidisciplinary research and international and cross-African collaboration were seen as crucial to build capacity in sub-Saharan nutrition research.
Kathleen Van Royen
Full Text Available Optimal nutrition is critical for human development and economic growth. Sub-Saharan Africa is facing high levels of food insecurity and only few sub-Saharan African countries are on track to eradicate extreme poverty and hunger by 2015. Effective research capacity is crucial for addressing emerging challenges and designing appropriate mitigation strategies in sub-Saharan Africa. A clear understanding of the operating environment for nutrition research in sub-Saharan Africa is a much needed prerequisite. We collected data on the barriers and requirements for conducting nutrition research in sub-Saharan Africa through semi-structured interviews with 144 participants involved in nutrition research in 35 countries in sub-Saharan Africa. A total of 133 interviews were retained for coding. The main barriers identified for effective nutrition research were the lack of funding due to poor recognition by policymakers of the importance of nutrition research and under-utilisation of research findings for developing policy, as well as an absence of research priority setting from within Africa. Current research topics were perceived to be mainly determined by funding bodies from outside Africa. Nutrition researchers argued for more commitment from policymakers at national level. The low capacity for nutrition research was mainly seen as a consequence of insufficient numbers of nutrition researchers, limited skills and a poor research infrastructure. In conclusion, African nutrition researchers argued how research priorities need to be identified by African stakeholders, accompanied by consensus building to enable creating a problem-driven national research agenda. In addition, it was considered necessary to promote interactions among researchers, and between researchers and policymakers. Multidisciplinary research and international and cross-African collaboration were seen as crucial to build capacity in sub-Saharan nutrition research.
Van Royen, Kathleen; Lachat, Carl; Holdsworth, Michelle; Smit, Karlien; Kinabo, Joyce; Roberfroid, Dominique; Nago, Eunice; Garimoi Orach, Christopher; Kolsteren, Patrick
Optimal nutrition is critical for human development and economic growth. Sub-Saharan Africa is facing high levels of food insecurity and only few sub-Saharan African countries are on track to eradicate extreme poverty and hunger by 2015. Effective research capacity is crucial for addressing emerging challenges and designing appropriate mitigation strategies in sub-Saharan Africa. A clear understanding of the operating environment for nutrition research in sub-Saharan Africa is a much needed prerequisite. We collected data on the barriers and requirements for conducting nutrition research in sub-Saharan Africa through semi-structured interviews with 144 participants involved in nutrition research in 35 countries in sub-Saharan Africa. A total of 133 interviews were retained for coding. The main barriers identified for effective nutrition research were the lack of funding due to poor recognition by policymakers of the importance of nutrition research and under-utilisation of research findings for developing policy, as well as an absence of research priority setting from within Africa. Current research topics were perceived to be mainly determined by funding bodies from outside Africa. Nutrition researchers argued for more commitment from policymakers at national level. The low capacity for nutrition research was mainly seen as a consequence of insufficient numbers of nutrition researchers, limited skills and a poor research infrastructure. In conclusion, African nutrition researchers argued how research priorities need to be identified by African stakeholders, accompanied by consensus building to enable creating a problem-driven national research agenda. In addition, it was considered necessary to promote interactions among researchers, and between researchers and policymakers. Multidisciplinary research and international and cross-African collaboration were seen as crucial to build capacity in sub-Saharan nutrition research. PMID:23776663
Bvumbwe, Thokozani; Mtshali, Ntombifikile
The Lancet Commission and the Global Health Workforce Alliance reported that professional education has generally not kept up the pace of health care challenges. Sub Saharan Africa needs an effective and efficient nursing education system to build an adequate, competent and relevant nursing workforce necessary for the achievement of Sustainable Development Goals. The Plan of Action for Scaling up Quality Nursing and Midwifery Education and Practice for the African Region 2012 - 2022 provided a framework for scale up of nurses and midwives. This integrative review examined literature on nursing education challenges and solutions in Sub Saharan Africa to inform development of a model for improving the quality, quantity and relevance of nursing education at local level. A search of PubMed, Medline on EBCSOhost and Google Scholar was conducted using key words: nursing education, challenges, solutions and/ or Africa. Published works from 2012 to 2016 were reviewed to explore reports about challenges and solution in nursing education in Sub Saharan Africa. Full texts of relevant studies were retrieved after reading the tittles and abstracts. Critical appraisal was undertaken and the findings of the relevant studies were analysed using thematic analysis. Twenty articles and five grey sources were included. Findings of the review generally supports World Health Organisation framework for transformative and scale up of health professions education. Six themes emerged; curriculum reforms, profession regulation, transformative teaching strategies, collaboration and partnership, capacity building and infrastructure and resources. Challenges and solutions in nursing education are common within countries. The review shows that massive investment by development partners is resulting in positive development of nursing education in Sub Saharan Africa. However, strategic leadership, networking and partnership to share expertise and best practices are critical. Sub Saharan Africa
The successful efforts in the 1980s to redress nutrition problems in sub-Saharan Africa are being eroded. Countries in eastern and southern Africa are now facing serious food shortages because of recurrent droughts, floods, civil wars, and the concomitant growing poverty. The potential for biotechnology to alleviate hunger holds promise if the new technology can be adapted to the prevailing sociocultural context in Africa. Agronomists and biotechnologists need to work together to ensure that the biotechnology agenda for Africa is responsive to the food and nutrition needs of its people.
Robert Dibie; Josephine Dibie
This article examines the nature of the paralysis of public governance, leadership, conflict and economic development in selected countries in sub-Saharan Africa. It argues that ineffective political leadership and conflict will serve as a lever to poor economic growth and social development. Servant leadership and democratic representation are the continuous process of development that could be accomplished through the participation of the citizens in their own development. The dynamics of d...
Adeniyi Jimmy Adedokun
Full Text Available Foreign aid strategies have undergone restructuring as donors adopt aid selectivity practice to improve aid effectiveness. This study investigates the impact of aid selectivity practice on aid effectiveness (aid-growth relationship in Sub-Saharan Africa (SSA and several groups of countries within SSA from 1980 to 2012. Employing system generalized methods of moments (system GMM technique; the study produces strong evidence that there is significant improvement in aid effectiveness due to aid selectivity practice.
Adedokun, Adeniyi Jimmy; Abiodun O. Folawewo, Abiodun O.
Foreign aid strategies have undergone restructuring as donors adopt aid selectivity practice to improve aid effectiveness. This study investigates the impact of aid selectivity practice on aid effectiveness (aid-growth relationship) in Sub-Saharan Africa (SSA) and several groups of countries within SSA from 1980 to 2012. Employing system generalized methods of moments (system GMM) technique; the study produces strong evidence that there is significant improvement in aid effectiveness due to a...
This article deals with the problems and prospects of development of the digital economy of Sub-Saharan Africa. The work will examine the relationship between the development of new information and communication technologies (ICT) and the formation of civil society in the region. The stages of implementation of Internet technologies will be explored. The development in different countries according to national circumstances, understand the basic functions of the new ICT in the development of ...
Sub-Saharan Africa economies introduced extensive reforms of their tax systems in the last two decades. In most of these countries taxes are now remitted through the self-assessment system that relies on quasi voluntary compliance and audit selection by risk. However, the revenues from direct taxes remained fairly stable and tax/GDP ratios lack behind the industrialized world. Several scholars argue that corruption is one of the major obstacles to increase tax revenues but focus on perceived ...
Ibrahim, Muazu; Kumi, Emmanuel; Yeboah, Thomas
Corruption is a pervasive challenge confronting the world more especially countries in sub-Saharan Africa. This paper investigates the effect of corruption on economic growth in the subregion using data spanning 1998 to 2011. By employing the pooled estimated generalized least squares (EGLS) and two stage least squares (2SLS), we find that corruption is inimical toeconomic growth through its indirect effect on gross fixed capital formation and labour force. The results are not only robust to ...
Negeri, Gutema; Haile Mariam,Damen
Keneni Gutema Negeri,1 Damen Halemariam,21School of Public and Environmental Health, Health Service Management Unit, College of Medicine and Health Sciences, Hawassa University, Hawassa, 2College of Medicine and Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia Introduction: Data on the effect of health aid on the health status in developing countries are inconclusive. Moreover, studies on this issue in sub-Saharan Africa are scarce. Therefore, this stud...
Cappuccio, Francesco Paolo; Miller, Michelle Avril
Cardiovascular disease, including stroke, heart failure and kidney disease, have been common in sub-Saharan Africa for many years and rapid urbanization is causing an upsurge of ischaemic heart disease and metabolic disorders. At least two thirds of cardiovascular deaths\\ud now occur in low-and-middle-income countries, bringing a double burden of disease to poor and developing world economies. High blood pressure (or hypertension) is by far the commonest underlying risk factor for cardiovascu...
Casterline, John B; El-Zeini, Laila O
This study assesses how changes in unmet need for family planning have contributed to contemporary fertility declines, and the implications of this historical record for further fertility decline, especially in sub-Saharan Africa. We examine joint trends at the national level in fertility, unintended fertility, and unmet need. We bring unintended fertility into the analysis because the underlying rationale for reducing unmet need is to avert unintended pregnancies and births. The association over time between unmet need and fertility is investigated using survey data from 45 countries in Africa, Asia, and Latin America and the Caribbean from the mid-1970s to the present. The empirical analysis finds that reduction in unmet need, especially unmet need for limiting, is strongly associated with fertility decline in Latin America and the Caribbean and in Asia and North Africa. Fertility decline in sub-Saharan Africa is weakly associated with trends in unmet need (and satisfaction of demand). We propose that the stark regional difference is due to measurement problems and to the fundamentally different character of fertility decline in sub-Saharan Africa, itself reflective of basic differences in pretransition reproductive regimes. © 2013 The Population Council, Inc.
Vancampfort, Davy; Stubbs, Brendon; Probst, Michel; Mugisha, James
Background There is a need for psychosocial interventions to address the escalating mental health burden in Sub-Saharan Africa (SSA). Physiotherapists could have a central role in reducing the burden and facilitating recovery within the multidisciplinary care of people with mental health problems. The aim of this systematic review was to explore the role of physiotherapists within the current mental health policies of SSA countries and to explore the current research evidence for physiotherap...
Ngaroua; Ngah, Joseph Eloundou; Bénet, Thomas; Djibrilla, Yaouba
Surgical Site Infections (SSI) cause morbi-mortality and additional healthcare expenditures. Developing countries are the most affected. The objective was to estimate the pooled incidence of SSI in Sub-Saharan Africa and describe its major risk factors. Systematic review and meta-analysis were conducted using the databases of the World Health Organization Regional Office for Africa, PubMed and standard search to select electronic articles published between 2006 and 2015. Only articles investigating SSI impact and risk factors in Sub-Saharan African countries were retained. Out of 95 articles found, 11 met the inclusion criteria. Only 9 countries out of 45 have contributed, with a huge amount of information coming from Nigeria (5 articles out of 11). The impact of SSI ranged from 6.8% to 26% with predominance in general surgery. The pooled incidence of SSI was 14.8% (95% CI: 15,5-16,2%) with significant heterogeneity according to the specialty and the method of monitoring. Most cited risk factors were long procedure length and categories 3 and 4 of Altemeier contamination class. Other factors included hospital environment, inadequate care practices and underlying pathologies. SSI incidence is high in Sub-Saharan Africa. Studies in this area could improve knowledge, prevention and control of these multiple risk factors.
Patrick T. Sekoai
Full Text Available In recent years, biofuels have emerged as a suitable alternative to hydrocarbon fuel due to their foreseen potential of being a future energy resource. Biofuel development initiatives have been successfully implemented in countries like Brazil, United States of America, European Union, Canada, Australia, and Japan. However, such programmes have been stagnant in Africa due to various constraints, such as financial barriers, technical expertise, land availability, and government policies. Nonetheless, some countries within the continent have realized the potential of biofuels and have started to introduce similar programmes and initiatives for their development. These include the bioethanol production initiatives and the plantation of jatropha oil seeds in most Sub-Saharan African countries for biodiesel production. Therefore, this paper examines the biofuel development initiatives that have been implemented in several countries across Sub-Saharan Africa over the past few years. It also discusses the opportunities and challenges of having biofuel industries in the continent. Finally, it proposes some recommendations that could be applied to accelerate their development in these Sub-Saharan African countries.
Adefeso Hammed Adetola
Full Text Available This study examined the effect of government expenditure on its disaggregated level on economic growth in a sample of 20 sub-Saharan African Countries over the period of 1980-2010 in a dynamic panel data model. The result from Generalised Method of Moments (GMM revealed an inverse relationship between productive government expenditure and economic growth in sub-Sahara Africa. Also, productive government expenditures were not actually productive most especially when financed by non-distortonary government tax revenue in sub-Saharan African countries. The study concluded that the productive government expenditure and its corresponding source of the mode of financing were counterproductive for economic performance in the African countries.
Cappuccio, Francesco Paolo; Miller, Michelle Avril
Cardiovascular disease, including stroke, heart failure and kidney disease, has been common in sub-Saharan Africa for many years, and rapid urbanization is causing an upsurge of ischaemic heart disease and metabolic disorders. At least two-thirds of cardiovascular deaths now occur in low- and middle-income countries, bringing a double burden of disease to poor and developing world economies. High blood pressure (or hypertension) is by far the commonest underlying risk factor for cardiovascular disease. Its prevention, detection, treatment and control in sub-Saharan Africa are haphazard and suboptimal. This is due to a combination of lack of resources and health-care systems, non-existent effective preventive strategies at a population level, lack of sustainable drug therapy, and barriers to complete compliance with prescribed medications. The economic impact for loss of productive years of life and the need to divert scarce resources to tertiary care are substantial.
Chan, Brian T; Tsai, Alexander C
HIV-related stigma hampers treatment and prevention efforts worldwide. Effective interventions to counter HIV-related stigma are greatly needed. Although the "contact hypothesis" suggests that personal contact with persons living with HIV (PLHIV) may reduce stigmatizing attitudes in the general population, empirical evidence in support of this hypothesis is lacking. Our aim was to estimate the association between personal contact with PLHIV and HIV-related stigma among the general population of sub-Saharan Africa. Social distance and anticipated stigma were operationalized using standard HIV-related stigma questions contained in the Demographic and Health Surveys and AIDS Indicator Surveys of 26 African countries between 2003 and 2008. We fitted multivariable logistic regression models with country-level fixed effects, specifying social distance as the dependent variable and personal contact with PLHIV as the primary explanatory variable of interest. We analyzed data from 206,717 women and 91,549 men living in 26 sub-Saharan African countries. We estimated a statistically significant negative association between personal contact with PLHIV and desires for social distance (adjusted odds ratio [AOR] = 0.80; p interventions should be developed and tested to reduce the stigma of HIV.
Full Text Available Abstract Background Maternal health is one of the major worldwide health challenges. Currently, the unacceptably high levels of maternal mortality are a common subject in global health and development discussions. Although some countries have made remarkable progress, half of the maternal deaths in the world still take place in Sub-Saharan Africa where little or no progress has been made. There is no single simple, straightforward intervention that will significantly decrease maternal mortality alone; however, there is a consensus on the importance of a strong health system, skilled delivery attendants, and women's rights for maternal health. Our objective was to describe and determine different factors associated with the maternal mortality ratio in Sub-Saharan countries. Methods An ecological multi-group study compared variables between many countries in Sub-Saharan Africa using data collected between 1997 and 2006. The dependent variable was the maternal mortality ratio, and Health care system-related, educational and economic indicators were the independent variables. Information sources included the WHO, World Bank, UNICEF and UNDP. Results Maternal mortality ratio values in Sub-Saharan Africa were demonstrated to be high and vary enormously among countries. A relationship between the maternal mortality ratio and some educational, sanitary and economic factors was observed. There was an inverse and significant correlation of the maternal mortality ratio with prenatal care coverage, births assisted by skilled health personnel, access to an improved water source, adult literacy rate, primary female enrolment rate, education index, the Gross National Income per capita and the per-capita government expenditure on health. Conclusions Education and an effective and efficient health system, especially during pregnancy and delivery, are strongly related to maternal death. Also, macro-economic factors are related and could be influencing the others.
Ba-Diop, Awa; Marin, Benoît; Druet-Cabanac, Michel; Ngoungou, Edgard B; Newton, Charles R; Preux, Pierre-Marie
Epilepsy is a common neurological disease in tropical countries, particularly in sub-Saharan Africa. Previous work on epilepsy in sub-Saharan Africa has shown that many cases are severe, partly a result of some specific causes, that it carries a stigma, and that it is not adequately treated in many cases. Many studies on the epidemiology, aetiology, and management of epilepsy in sub-Saharan Africa have been reported in the past 10 years. The prevalence estimated from door-to-door studies is almost double that in Asia, Europe, and North America. The most commonly implicated risk factors are birth trauma, CNS infections, and traumatic brain injury. About 60% of patients with epilepsy receive no antiepileptic treatment, largely for economic and social reasons. Further epidemiological studies should be a priority to improve understanding of possible risk factors and thereby the prevention of epilepsy in Africa, and action should be taken to improve access to treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.
Santmyire, B R
The impact of the human immunodeficiency virus (HIV) epidemic in sub-Saharan Africa on future mortality rates of infants, children, and mothers, life expectancy, and economic growth is profound. Vertical transmission of HIV, transmission from mother to child, is a major factor in the increasing rates of HIV infection in sub-Saharan Africa. Vertical transmission of HIV occurs in utero, intrapartum during labor and delivery, and postpartum during breast-feeding. Because of the large numbers of HIV-infected mothers in developing countries, the majority trials regarding prevention of vertical transmission of HIV have been conducted in sub-Saharan Africa. Thus, sub-Saharan Africa has become a human laboratory, which demonstrates both the successes and failures of preventative methods to reduce vertical transmission of HIV. This review summarizes the body of research dedicated to understanding the pathophysiology of vertical transmission of HIV and pharmacology of inhibition of vertical transmission of HIV. While many debate the ethics of conducting trials in developing countries where effective prevention modalities have been slow to be implemented for economic, social and political reasons, studies continue and researchers continue to discover therapies and preventative methods, which may reduce the future devastation of HIV both in sub-Saharan Africa and throughout the world.
Chakravarty, Shubha; Das, Smita; Vaillant, Julia
Although the ratio of female to male labor force participation rates is higher in Sub-Saharan Africa than in any other region, these high rates of female labor force participation mask underlying challenges for women. A large majority of employed women work in vulnerable employment. In addition, youth unemployment rates in Sub-Saharan Africa are double those of adult unemployment, and unem...
Calzadilla, Alvaro; Zhu, Tingju; Rehdanz, Katrin; Tol, Richard S J; Ringler, Claudia
Two possible adaptation scenarios to climate change for Sub-Saharan Africa are analyzed under the SRES B2 scenario. The first scenario doubles the irrigated area in Sub-Saharan Africa by 2050, compared to the baseline, but keeps total crop area constant. The second scenario increases both rainfed
Background: The failure to stem HIV in sub-Saharan Africa and the unique epidemiological modes of infection within this region have demonstrated that unique strategies for combatting the virus are required. This review article discusses why international AIDS campaigns in sub- Saharan Africa have largely been ...
Rosen, Stacey L.; Shapouri, Shahla
African Governments and international donors are focused on improving the regionâ€™s ability to grow food to mitigate projected long-term deterioration in food security. An ERS study shows that improving grain yields is the key to reducing food insecurity in Sub-Saharan Africa. Investment and technology adoption in Sub-Saharan Africa will be a challenge.
Thakrar, Jayshree; Zinn, Denise; Wolfenden, Freda
The challenges to teacher educators in sub-Saharan Africa are acute. This paper describes how the Teacher Education in Sub-Saharan Africa (TESSA) consortium is working within institutional and national policy systems to support school-based teacher professional development. The TESSA consortium (13 African institutions and 5 international…
Over the past decade, the largest growth in Sub-Saharan Africa's private higher education has been among institutions with religious affiliations. This article examines the rise of private, religious higher education in Sub-Saharan Africa with international affiliations. Using an analysis of multiple stakeholders from the region and international…
Byigero, Alfred D.; Clancy, Joy S.; Skutsch, Margaret
To what extent can capacity-building activities under the Nairobi Framework (NF) Initiative overcome barriers to the Clean Development Mechanism (CDM) in sub-Saharan Africa and, in particular, the East African region? The level of CDM penetration into sub-Saharan Africa is compared with CDM market
As HIV treatment programs in sub-Saharan Africa mature, there are rising concerns about the long-term sustainability and quality of these programs. Increasing levels of HIV drug resistance have been measured in sub-Saharan Africa, and could jeopardize long-term treatment success. This thesis
Colleen V Chien
Full Text Available BACKGROUND: Significant quantities of antiretroviral drugs (ARVs to treat HIV/AIDS have been procured for Sub-Saharan Africa for the first time in their 20-year history. This presents a novel opportunity to empirically study the roles of brand and generic suppliers in providing access to ARVs. METHODOLOGY/PRINCIPAL FINDINGS: An observational study of brand and generic supply based on a dataset of 2,162 orders of AIDS drugs for Sub-Saharan Africa reported to the Global Price Reporting Mechanism at the World Health Organization from January 2004-March 2006 was performed. Generic companies supplied 63% of the drugs studied, at prices that were on average about a third of the prices charged by brand companies. 96% of the procurement was of first line drugs, which were provided mostly by generic firms, while the remaining 4%, of second line drugs, was sourced primarily from brand companies. 85% of the generic drugs in the sample were manufactured in India, where the majority of the drugs procured were ineligible for patent protection. The remaining 15% was manufactured in South Africa, mostly under voluntary licenses provided by brand companies to a single generic company. In Sub-Saharan African countries, four first line drugs in the dataset were widely patented, however no general deterrent to generic purchasing based on a patent was detected. CONCLUSIONS/SIGNIFICANCE: Generic and brand companies have played distinct roles in increasing the availability of ARVs in Sub-Saharan Africa. Generic companies provided most of the drugs studied, at prices below those charged by brand companies, and until now, almost exclusively supplied several fixed-dose combination drugs. Brand companies have supplied almost all second line drugs, signed voluntary licenses with generic companies, and are not strictly enforcing patents in certain countries. Further investigation into how price reductions in second line drugs can be achieved and the cheapest drugs can
Full Text Available To evaluate the performance and to identify predictive factors of performance in prevention of mother-to-child HIV transmission programs (PMTCT in sub-Saharan African countries.From 2000 to 2011, PMTCT programs included in the Viramune Donation Programme (VDP were prospectively followed. Each institution included in the VDP provided data on program implementation, type of management institution, number of PMTCT sites, key programs outputs (HIV counseling and testing, NVP regimens received by mothers and newborns. Nevirapine Coverage Ratio (NCR, defined as the number of women who should have received nevirapine (observed HIV prevalence x number of women in antenatal care, was used to measure performance. Included programs were followed every six months through progress reports.A total of 64 programs in 25 sub-Saharan African countries were included. The mean program follow-up was 48.0 months (SD = 24.5; 20,084,490 women attended in antenatal clinics were included. The overall mean NCR was 0.52 (SD = 0.25, with an increase from 0.37 to 0.57 between the first and last progress reports (p<.0001; NCR increased by 3.26% per year-program. Between the first and the last report, the number of women counseled and tested increased from 64.3% to 86.0% (p<.0001, the number of women post-counseled from 87.5% to 91.3% (p = 0.08. After mixed linear regression analysis, type of responsible institution, number of women attended in ANC, and program initiation in 2005-2006 were significant predictive factors associated with the NCR. The effect of the time period increased from earlier to later periods.A longitudinal assessment of large PMTCT programs shows that scaling-up of programs was increased in sub-Saharan African countries. The PMTCT coverage increased throughout the study period, especially after 2006. Performance may be better for programs with a small or medium number of women attended in ANC. Identification of factors that predict PMTCT program
Curry, Leslie; Taylor, Lauren; Chen, Peggy Guey-Chi; Bradley, Elizabeth
Leadership is widely regarded as central to effective health-care systems, and resources are increasingly devoted to the cultivation of strong health-care leadership. Nevertheless, the literature regarding leadership capacity building has been developed primarily in the context of high-income settings. Less research has been done on leadership in low-income settings, including sub-Saharan Africa, particularly in health care, with attention to historical, political and sociocultural context. We sought to characterize the experiences of individuals in key health-care leadership roles in sub-Saharan Africa. We conducted a qualitative study using in-person interviews with individuals (n = 17) in health-care leadership roles in four countries in sub-Saharan Africa: the Federal Democratic Republic of Ethiopia, the Republic of Ghana, the Republic of Liberia and the Republic of Rwanda. Individuals were identified by their country's minister of health as key leaders in the health sector and were nominated to serve as delegates to a global health leadership conference in June 2010, at Yale University in the United States. Interviews were audio recorded and professionally transcribed. Data analysis was performed by a five-person multidisciplinary team using the constant comparative method, facilitated by ATLAS.ti 5.0 software. Five key themes emerged as important to participants in their leadership roles: having an aspirational, value-based vision for improving the future health of the country, being self-aware and having the ability to identify and use complementary skills of others, tending to relationships, using data in decision making, and sustaining a commitment to learning. Current models of leadership capacity building address the need for core technical and management competencies. While these competencies are important, skills relevant to managing relationships are also critical in the sub-Saharan African context. Developing such skills may require more time and
Haggblade, Steven; Duodu, Kwaku G; Kabasa, John D; Minnaar, Amanda; Ojijo, Nelson K O; Taylor, John R N
Sub-Saharan Africa is the last region to undergo a nutrition transition and can still avoid its adverse health outcomes. The article explores emerging responses to "bend the curve" in sub-Saharan Africa's nutrition transition to steer public health outcomes onto a healthier trajectory. Early responses in 3 countries at different stages of food system transformation are examined: South Africa-advanced, Ghana-intermediate, and Uganda-early. By comparing these with international experience, actions are proposed to influence nutrition and public health trajectories as Africa's food systems undergo rapid structural change. Arising from rapid urbanization and diet change, major public health problems associated with overweight are taking place, particularly in South Africa and among adult women. However, public health responses are generally tepid in sub-Saharan Africa. Only in South Africa have policy makers instituted extensive actions to combat overweight and associated noncommunicable diseases through regulation, education, and public health programs. Elsewhere, in countries in the early and middle stages of transition, public health systems continue to focus their limited resources primarily on undernutrition. Related pressures on the supply side of Africa's food systems are emerging that also need to be addressed. Three types of intervention appear most feasible: maternal and child health programs to simultaneously address short-term undernutrition problems while at the same time helping to reduce future tendencies toward overweigh; regulatory and fiscal actions to limit access to unhealthy foods; and modernization of Africa's agrifood food system through job skills training, marketing reforms, and food industry entrepreneurship. © The Author(s) 2016.
Songul Kakilli 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-integration 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.
Hohmann, Sophie; Garenne, Michel
The study investigates the magnitude of differences in child and adult mortality by wealth in Uzbekistan, a former soviet country of Central Asia, and compares it with similar indicators from sub-Saharan Africa. Data were derived from Demographic and Health Surveys. An "Absolute Wealth Index" was built from data on goods owned by households and quality of housing, and scaled from 0 to 12. Wealth was distributed evenly in Uzbekistan, with a symmetric distribution around a mean of 5.5 modern goods. In sub-Saharan Africa, on the contrary, the wealth distribution had a lower mean (2.5) and was highly skewed towards the left, revealing a high proportion of very poor people. Adult and child mortality levels were lower in Uzbekistan. Despite these major differences, the relationships between mortality indicators and the wealth index were similar in the two cases. The magnitude of mortality differentials by wealth was of the same order in both cases, with gradients ranging from 2.5 to 1 for child mortality and 1.5 to 1 for adult mortality (poorest versus richest). However, mortality levels remained lower in Uzbekistan than in sub-Saharan Africa at the same level of wealth for both children and adults. A similar relationship was found between nutritional status and wealth index in both cases. On the contrary, there were no differences by wealth in use of health services and level of education in Uzbekistan, whereas wealth gradients were steep for the same variables in sub-Saharan Africa. The study suggests that mortality differentials were primarily due to nutritional status, and not to access and use of health services or to education. The discussion focuses on health and social policies during the colonial and post-colonial period that have produced these patterns. Copyright © 2010 Elsevier B.V. All rights reserved.
Sacolo, Hlengiwe; Chimbari, Moses; Kalinda, Chester
Schistosomiasis remains a global health problem with an estimated 250 million people in 78 countries infected, of whom 85% live in Sub-Saharan Africa. Preventive chemotherapy remains the key public health strategy to combat schistosomiasis worldwide. Recently the WHO emphasized on the use of integrative approaches in the control and elimination of schistosomiasis. However, a detailed understanding of sociocultural factors that may influence the uptake of the intended health activities and services is vital. Thus, our study sought to understand the knowledge, attitudes, perceptions, beliefs and practices about schistosomiasis in various communities in Sub-Saharan Africa. A systematic search of literature for the period 2006-2016 was done on Medline, PubMed, CINAHL, Psych info and Google Scholar using the following key words "Schistosomiasis, S. mansoni, S. haematobium, knowledge, attitudes, perceptions, beliefs and practices in Sub-Saharan Africa" in combination with Bolean operators (OR, AND). In this context, we reviewed studies conducted among school children, community members and caregivers of preschool children. Thematic analysis was utilised for the overall synthesis of the selected studies. This was done after reading the articles in depth. Themes were identified and examined for similarities, differences and contradictions. Gaps in schistosomiasis related knowledge and sociocultural barriers towards the uptake of preventive and treatment services among communities in Sub-Saharan Africa were identified. In addition to limited knowledge and negative attitudes, risky water related practices among community members, school children and caregivers of preschool children were identified as key factors promoting transmission of the disease. The study concluded that a comprehensive health education programme using contextual and standardised training tools may improve peoples' knowledge, attitudes and practices in relation to schistosomiasis prevention and control
Dubbink, Jan Henk; Verweij, Stephan P; Struthers, Helen E; Ouburg, Sander; McIntyre, James A; Morré, Servaas A; Peters, Remco Ph
Chlamydia trachomatis and Neisseria gonorrhoeae constitute major public health problems among women, but the burden of infection in sub-Saharan Africa is poorly documented. We conducted a structured review of the prevalence and incidence of genital, oral and anal C. trachomatis and N. gonorrhoeae infection in women in sub-Saharan Africa. We searched Medline, EMBASE and Web of Science over a 10-year period for studies on epidemiology of genital, oral and anal chlamydial infection and gonorrhoea in women in all countries of sub-Saharan Africa. We assessed geographic and demographic differences in prevalence and incidence of infection; weighted mean prevalence estimates were calculated with a random-effect model. A total of 102 study results were included, with data available for 24/49 of sub-Saharan countries. The weighted prevalence of chlamydial infection was lower among women in community-based studies (3.9%; 95% CI: 2.9-5.1%) than for women recruited at primary healthcare facilities (6.0%; 95% CI: 4.2-8.4%, p sub-Saharan Africa. Better control strategies are warranted to reduce the burden of infection and to prevent long-term complications of these infections.
Feldacker, Caryl; Jacob, Sheena; Chung, Michael H; Nartker, Anya; Kim, H Nina
Limitations in healthcare worker (HCW) capacity compound the burden of dual TB and HIV epidemics in sub-Saharan Africa. To fill gaps in knowledge and skills, effective continuing profession development (CPD) initiatives are needed to support practicing HCWs reach high standards of care. e-learning opportunities can bring expert knowledge to HCWs in the field and provide a flexible learning option adaptable to local settings. Few studies provide insight into HCW experiences with online CPD in the developing country context. An online survey using both close-ended and free response was conducted to HCWs in sub-Saharan Africa who completed the University of Washington (UW) School of Medicine online graduate course, "Clinical Management of HIV." Associations between respondent characteristics (age, gender, rural/urban, job title) and learning preferences, course barriers, and facilitators with an emphasis on online courses were examined using chi-square. Covariates significant at the p online course from work, noting that slow (55%) or limited (41%) internet as well as lack of time (53%) were barriers to course completion. Women (p online courses by noting the knowledge gains, the flexibility of format, a desire for recognition of course completion, and a request for additional online coursework. Online CPD opportunities were accepted across a diverse group of HCWs from sub-Saharan Africa and should be expanded to provide more flexible opportunities for self-initiated learning; however, these need to be responsive to the limited resources of those who seek these courses.
Karan, Abraar; Hartford, Emily; Coates, Thomas J
The HIV/AIDS epidemic has become a point of important political concern for governments especially in Sub-Saharan Africa. Clinical and public health interventions to curb the epidemic can be greatly enhanced with the strategic support of political leaders. We analyzed the role of national political leadership in large-scale HIV/AIDS communications campaigns in 14 countries in Sub-Saharan Africa. We primarily reviewed grey and white literature published from 2005-2014. We further triangulated data from in-person and phone interviews with key public health figures. A number of themes emerged supporting political leaders' efforts toward HIV/AIDS program improvement, including direct involvement of public officials in campaign spearheading, the acknowledgment of personal relationship to the HIV epidemic, and public testing and disclosure of HIV status. Areas for future improvement were also identified, including the need for more directed messaging, increased transparency both nationally and internationally and the reduction of stigmatizing messaging from leaders. The political system has a large role to play within the healthcare system, particularly for HIV/AIDS. This partnership between politics and the health must continue to strengthen and be leveraged to effect major change in behaviors and attitudes across Sub-Saharan Africa.
Adebamowo, Sally N; Tekola-Ayele, Fasil; Adeyemo, Adebowale A; Rotimi, Charles N
Sub-Saharan Africa (SSA) is experiencing a growing burden of cardiometabolic disorders, including diabetes, dyslipidemia, hypertension, obesity, coronary heart disease, and stroke. The increasing trends are expected to accelerate as SSA continues to experience economic progress, population growth, and the shift from communicable to noncommunicable diseases. These complex disorders are caused by multiple, potentially interacting, environmental, and genetic factors. While considerable progress has been made in the identification of the sociocultural, demographic, and lifestyle risk factors for cardiometabolic disorders, many genetic factors that underlie individual susceptibility to these diseases remain largely unknown. Although progress in genomic technologies has allowed for systematic characterization of genome-wide genetic diversity in health and disease in European and Asian ancestry populations, conduct of genetic studies in SSA has been underwhelming until recently. Here, we summarize recent understanding of the body of knowledge and highlight research opportunities on the genomics of cardiometabolic disorders in SSA. Published by S. Karger AG, Basel.
James R. Ochwa-Echel
Full Text Available This article reviews the history of university development in Sub-Saharan Africa (SSA and discusses the impact of neoliberal policies. This will be followed by an examination of the problems facing universities in the region. The following questions will be explored: (a Are the existing universities in SSA serving the development needs of the region? (b Are these universities up to the task of moving SSA out of the predicaments it faces such as famine, HIV/AIDS, poverty, diseases, debt, and human rights abuses? Finally, the article argues that for universities to play a role in the development of the region, a new paradigm that makes university education a public good should be established.
Evans, Ruth; Skovdal, Morten
and UNCRC concerns about “hazardous” and “harmful” work are highlighted through examining the situation of children providing unpaid domestic and care support to family members in the private space of their own or a relative’s home. Differing perspectives toward young caregiving have been adopted to date....... A contextual, multi-sectorial approach to young caregiving is needed that seeks to understand children’s, family members’, and community members’ perceptions of what constitutes inappropriate caring responsibilities within particular cultural contexts and how these should best be alleviated.......This chapter explores the spatialities of children’s rights through a focus on how children’s paid and unpaid work in sub-Saharan Africa intersects with wider debates about child labor, child domestic work, and young caregiving. Several tensions surround the universalist and individualistic nature...
Nozyechi Ngulube Chidumayo
Full Text Available Abstract Background Dogs have a close association with humans providing companionship, security and a source of dietary protein. However, dogs are also potential carriers of zoonotic pathogens. Dogs, therefore, pose a public health risk and a good understanding of canine diseases is important for planning and implementing control measures. The aim of this study was to characterise canine helminthiasis in sub-Saharan Africa using a systematic approach. Methods Pubmed and Google Scholar were searched for relevant primary studies published from 2000. Forty-one eligible studies were included in the meta-analysis. Pooled prevalences were estimated using the quality effects model. Results and conclusions Twenty-six genera of enteric helminths were reported and the pooled estimate of canine helminthiasis was 71% (95% CI: 63–79%. Species of Ancylostoma and Toxocara, causative agents of larva migrans in humans, were the most frequently reported helminths with pooled estimated prevalences of 41% (95% CI: 32–50% and 22% (95% CI: 16–29%, respectively. Dipylidium caninum and Taenia spp. were the most frequently reported cestodes with pooled estimated prevalences of 20% (95% CI: 12–29% and 9% (95% CI: 5–15%, respectively. Trematodes were rarely reported. There was a high level of heterogeneity in most pooled estimates (I2 ˃ 80%. The results of this study show that canine helminthiasis is highly prevalent in sub-Saharan Africa and there is need for regular deworming programmes to improve the health status of the dogs and minimise the potential health risk to humans.
This study explores the impact of fossil fuels consumption, solid fuels consumption for cooking purposes, economic growth, and carbon emissions on human health, with a key emphasis on the occurrence of tuberculosis and the high mortality rate in Sub-Saharan Africa. For its practical insights, the study develops a system Generalized Method of Moment (GMM) for a panel of 34 middle- and lower-middle-income countries from 1995 to 2015. The study adopts a flexible methodology to tackle endogeneity in the variables. The robust results report that the use of solid fuels (charcoal, peat, wood, wood pellets, crop residues) for cooking purposes and the consumption of fossil fuels (oil, coal, gas) are significantly increasing the occurrence of tuberculosis. In addition, the results highlight that the consumption of both solid fuels and fossil fuels has adverse affects on life expectancy by increasing the mortality rate in Sub-Saharan African countries. Results report that renewable energy sources like sun, wind, and water (all with potential to prevent households from direct exposure to particulate matters and harmful gases) as well as a rise in economic growth serve as helping factors to control the occurrence of tuberculosis and to decrease the mortality rate. Moreover, the use of renewable energy sources is serving to lessen emissions of carbon dioxide, nitrogen dioxides, and particulate matters, which can ultimately decrease the mortality rate and extend the life expectancy in Sub-Saharan Africa.
Mills, Edward J; Kanters, Steve; Hagopian, Amy; Bansback, Nick; Nachega, Jean; Alberton, Mark; Au-Yeung, Christopher G; Mtambo, Andy; Bourgeault, Ivy L; Luboga, Samuel; Hogg, Robert S; Ford, Nathan
To estimate the lost investment of domestically educated doctors migrating from sub-Saharan African countries to Australia, Canada, the United Kingdom, and the United States. Human capital cost analysis using publicly accessible data. Sub-Saharan African countries. Nine sub-Saharan African countries with an HIV prevalence of 5% or greater or with more than one million people with HIV/AIDS and with at least one medical school (Ethiopia, Kenya, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe), and data available on the number of doctors practising in destination countries. The financial cost of educating a doctor (through primary, secondary, and medical school), assuming that migration occurred after graduation, using current country specific interest rates for savings converted to US dollars; cost according to the number of source country doctors currently working in the destination countries; and savings to destination countries of receiving trained doctors. In the nine source countries the estimated government subsidised cost of a doctor's education ranged from $21,000 (£13,000; €15,000) in Uganda to $58,700 in South Africa. The overall estimated loss of returns from investment for all doctors currently working in the destination countries was $2.17bn (95% confidence interval 2.13bn to 2.21bn), with costs for each country ranging from $2.16m (1.55m to 2.78m) for Malawi to $1.41bn (1.38bn to 1.44bn) for South Africa. The ratio of the estimated compounded lost investment over gross domestic product showed that Zimbabwe and South Africa had the largest losses. The benefit to destination countries of recruiting trained doctors was largest for the United Kingdom ($2.7bn) and United States ($846m). Among sub-Saharan African countries most affected by HIV/AIDS, lost investment from the emigration of doctors is considerable. Destination countries should consider investing in measurable training for source countries and strengthening of their
... EXPORT-IMPORT BANK Postponement Notice of Open Special Meeting of the Sub-Saharan Africa Advisory Committee of the Export-Import Bank of the United States (Ex-Im Bank) SUMMARY: The Sub-Saharan Africa... of the Bank's financial commitments in Sub- Saharan Africa under the loan, guarantee, and insurance...
Wright, Caradee Y; Norval, Mary; Hertle, Richard W
Oculocutaneous albinism (OCA) is a genetically inherited autosomal recessive condition. Individuals with OCA lack melanin and therefore are susceptible to the harmful effects of solar ultraviolet radiation, including extreme sun sensitivity, photophobia and skin cancer. OCA is a grave public health issue in sub-Saharan Africa with a prevalence as high as 1 in 1000 in some tribes. This article considers the characteristics and prevalence of OCA in sub-Saharan African countries. Sun-induced adverse health effects in the skin and eyes of OCA individuals are reviewed. Sun exposure behavior and the use of photoprotection for the skin and eyes are discussed to highlight the major challenges experienced by these at-risk individuals and how these might be best resolved. © 2014 The American Society of Photobiology.
Full Text Available Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of nonphysician clinicians (NPCs, resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary – for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system.
Eyal, Nir; Cancedda, Corrado; Kyamanywa, Patrick; Hurst, Samia A
Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of non-physician clinicians (NPCs), resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary - for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system. © 2016 by Kerman University of Medical Sciences.
Norma C Ware
Full Text Available Individuals living with HIV/AIDS in sub-Saharan Africa generally take more than 90% of prescribed doses of antiretroviral therapy (ART. This number exceeds the levels of adherence observed in North America and dispels early scale-up concerns that adherence would be inadequate in settings of extreme poverty. This paper offers an explanation and theoretical model of ART adherence success based on the results of an ethnographic study in three sub-Saharan African countries.Determinants of ART adherence for HIV-infected persons in sub-Saharan Africa were examined with ethnographic research methods. 414 in-person interviews were carried out with 252 persons taking ART, their treatment partners, and health care professionals at HIV treatment sites in Jos, Nigeria; Dar es Salaam, Tanzania; and Mbarara, Uganda. 136 field observations of clinic activities were also conducted. Data were examined using category construction and interpretive approaches to analysis. Findings indicate that individuals taking ART routinely overcome economic obstacles to ART adherence through a number of deliberate strategies aimed at prioritizing adherence: borrowing and "begging" transport funds, making "impossible choices" to allocate resources in favor of treatment, and "doing without." Prioritization of adherence is accomplished through resources and help made available by treatment partners, other family members and friends, and health care providers. Helpers expect adherence and make their expectations known, creating a responsibility on the part of patients to adhere. Patients adhere to promote good will on the part of helpers, thereby ensuring help will be available when future needs arise.Adherence success in sub-Saharan Africa can be explained as a means of fulfilling social responsibilities and thus preserving social capital in essential relationships.
McCord, Gordon C; Liu, Anne; Singh, Prabhjot
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. The yearly costs of training, equipping and deploying CHWs throughout rural sub-Saharan Africa were calculated 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. 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. Comprehensive CHW subsystems can be deployed across sub-Saharan Africa at cost that is modest compared with the projected costs of the primary-health-care system. Given their documented successes, they offer a strong complement to facility-based care in rural African settings.
Sileo, Katelyn M; Fielding-Miller, Rebecca; Dworkin, Shari L; Fleming, Paul J
Men living with HIV/AIDS in sub-Saharan Africa are less likely to test for HIV than women. We conducted a scoping review in May of 2016 to identify how masculine norms influence men's HIV testing in sub-Saharan Africa. Our review yielded a total of 13 qualitative studies from 8 countries. Masculine norms create both barriers and facilitators to HIV testing. Barriers included emotional inexpression, gendered communication, social pressures to be strong and self-reliant, and the fear that an HIV positive result would threaten traditional social roles (i.e., husband, father, provider, worker) and reduce sexual success with women. Facilitators included perceptions that HIV testing could restore masculinity through regained physical strength and the ability to re-assume the provider role after accessing treatment. Across sub-Saharan Africa, masculinity appears to play an important role in men's decision to test for HIV and further research and interventions are needed to address this link.
Dec 18, 2017 ... Science Diplomacy Awards recognize outstanding achievements in South Africa's ... SGCI was recognized for its work with 15 public funding agencies in sub-Saharan Africa, as well as several science and ... Knowledge.
Gunzinger, Mark A; Thomas, David L
Extending from the urban centers of South Africa to the lesser-developed regions of the arid Sahel, Sub-Saharan Africa spans the post-Cold War spectrum of political, economic, and military challenges...
The purpose of this thesis is to define the poaching problem in sub-Saharan Africa, to provide for the development of solutions, and to illustrate the significance of the problem to both Africa and the United States...
Remington, Jeff; Henderson, Ron
... a challenge to the United States that appears almost insurmountable. Huge problems in Africa, especially Sub-Saharan Africa, can lead to huge threats to the national security of the United States...
Kilonzo, Nduku; Ndung'u, Njoki; Nthamburi, Nerida; Ajema, Caroline; Taegtmeyer, Miriam; Theobald, Sally; Tolhurst, Rachel
Six sub-Saharan African countries currently have laws on sexual violence, including Kenya, and eight others have provisions on sexual violence in other legislation. Effective legislation requires functioning medico-legal linkages to enable both justice to be done in cases of sexual violence and the provision of health services for survivors of sexual violence. The health sector also needs to provide post-rape care services and collect and deliver evidence to the criminal justice system. This paper reviews existing data on sexual violence in sub-Saharan Africa, and summarises the content of sexual violence legislation in the region and the strengths and weaknesses of existing medico-legal linkages, using Kenya as a case study. Many sub-Saharan African countries do not yet have comprehensive post-rape care services, nor substantial co-ordination between HIV and sexual and reproductive health services, the legal and judicial systems, and sexual violence legislation. These need to be integrated by cross-referrals, using standardised referral guidelines and pathways, treatment protocols, and medico-legal procedures. Common training approaches and harmonised information across sectors, and common indicators, would facilitate government accountability. Joint and collaborative planning and working at country level, through sharing of information and data between the different systems remain key to achieving this.
Bashiri Behmiri, Niaz; Pires Manso, José R.
This study investigates the causality relationship between crude oil consumption and economic growth in twenty three Sub-Saharan African countries. We applied a multivariate panel Granger causality framework during 1985–2011 and we included crude oil price as the control variable of the model. The results indicate that in the short-run, there is a bi-directional causality relationship between crude oil consumption and economic growth in oil importing region and there is a uni-directional causality relationship from crude oil consumption to GDP in oil exporting region. However, in the long-run there is a bi-directional causality relationship between them in both regions. Therefore, reducing crude oil consumption without employing appropriate policies adversely impacts on economic growth of Sub-Saharan Africa. Hence, in order to reduce crude oil dependency of the region policymakers should pay more attention to the issue of energy efficiency programs. - Highlights: ► We examined Granger causality among oil consumption and GDP in Sub-Saharan Africa. ► Crude oil price is the control variable of the model. ► There is short run bi-directional causality among oil and GDP (oil importing). ► There is short run uni-directional causality from oil to GDP (oil exporting). ► There is a long run bi-directional causality among oil and GDP in both regions
McFarland, Ditsapelo M; Gueldner, Sarah M; Mogobe, Keitshokile D
The aim of this study was to review published studies to identify and describe barriers to Papanicolaou (Pap) smear screening among women in sub-Saharan Africa. Guided by Cooper's integrative review methodology, studies published between 2006 and 2015 were identified by searching electronic databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, MEDLINE, ProQuest, and PsycINFO using specified search terms. Using this strategy, 224 articles were identified and screened for duplication and by reading titles, abstracts, and full texts. Seventeen articles met the inclusion criteria and were appraised using relevant tools for qualitative and quantitative designs. No relevant articles published in 2006, 2007, and 2014 were found. All 17 articles had good methodological quality and were included in the review. The studies were from 10 sub-Saharan countries and from different settings. Content analysis of the data revealed three major themes coded as client, provider, and system barriers. The most common client barriers were lack of knowledge and awareness about Pap smear screening, fear of cancer, belief of not being at risk for cervical cancer, and that a Pap smear is not important unless one is ill and cultural or religious factors. Provider barriers were failure to inform or encourage women to screen. Major system barriers were unavailability and inaccessibility of the Pap test. The review provided evidence of barriers to Pap smear screening among sub-Saharan women. Although there were some variations from country to country, sub-Saharan countries share similar constraints to Pap smear screening. These findings have important implications for practice and policy. Understanding the client, provider, and system barriers to cervical cancer screening could guide development of effective interventions. © 2016 Sigma Theta Tau International.
Full Text Available This paper highlights the first attempt by researchers at Stellenbosch University to model freight flows between and for 17 countries in sub-Saharan Africa (SSA. The model will be informed by and linked to the South African surface Freight Demand Model (FDM given these dimensions. By analysing and collating available datasets and developing a freight flow model, a better understanding of freight movements between countries can be obtained and then used for long-term planning efforts. A simple methodology is envisaged that will entail a high-level corridor classification that links a major district in the country with a similar district in another country. Existing trade data will be used to corroborate new base-year economic demand and supply volumetric data that will be generated from social accounting matrices for each country. The trade data will also provide initial flow dynamics between countries that will be refined according to the new volumes. The model can then generate commodity-level corridor flows between SSA countries, and between SSA countries and the rest of the world, as well as intra-country rural and metropolitan flows, using a gravity-based modelling approach. This article outlines efforts to harmonise trade data between the 17 countries identified, as well as between these countries and the rest of the world as a first step towards developing a freight demand model for sub-Saharan Africa.
Nearly all of the sex life satisfaction literature has dealt with developed-country settings, and nothing has been published on sex life satisfaction in sub-Saharan Africa. Not only is sub-Saharan African a substantively relevant area in its own right, but it also provides a useful point of comparison for patterns and relations found in developed-world contexts. A brief descriptive and exploratory study of sex life satisfaction in sub-Saharan Africa was conducted using the World Gallup Poll, a dataset with representative sex life satisfaction data for 31 countries and 25,483 cases. In general, there was little variation in weighted averages across countries, and most of the samples surveyed were satisfied with their sex lives, with the modal score being a perfect 10. Furthermore, what variation did exist could not be attributed to level of economic development or gender inequality. Within countries, sociodemographic associations generally comported with patterns found in other contexts: income, education, and being partnered were generally associated with sex life satisfaction, and for two of the four UN subregions (West Africa and East Africa), males were significantly more satisfied with their sex lives than women. The relationship with age demonstrated a curvilinear relationship, with the peak age of sexual satisfaction in the late 20s to early 30s depending on the geographic region. The age pattern was not due to health differences, but combining estimators after a seemingly unrelated regression suggests that 4-12% of the effect of income on sex life satisfaction was attributable to better health. In general, religiosity and perceived gravity of the HIV/AIDS problem in one's country were not significantly related to sexual satisfaction.
Schroer, D. J
This case study will examine decision making in U.S. Military Assistance Programs in the form of C-l3OB transfers to the Sub-Saharan countries of Zimbabwe, Botswana and South Africa from 1994 to present...
Nweze Justus Amuche
Full Text Available The problem of HIV/AIDS was sort of a fairy tale and mere information till the immunological disorder was scientifically confirmed. Today, HIV/AIDS has continued to be a serious international health concern, and sub-Saharan Africa remains the most affected region. Over 25.6 million persons are currently living with HIV in sub-Saharan Africa. This accounts for two-thirds of the recent overall world HIV infections and more than 70 percent of all AIDSrelated deaths. In 2015, Eastern and Southern Africa had about 7.1% adult HIV prevalence rate (about 19 million HIV patients, while Western and Central Africa accounted for about 2.2% (about 6.5 million HIV patients. Few countries now boast of numerous signs of gradual to moderate declines in HIV occurrence. However, HIV prevalence rate has continued to increase in countries like Lesotho (22.7%, Botswana (22.2% and South Africa (19.2%. The nature, procedure and result of the scourge in this region have been fashioned by a mind-boggling interaction of traditional, behavioural, social and material factors. Even if there are notably strong prevention, treatment and care programmes, too many sexual partners are engaging in risky sexual practices. The aim of this article is to discuss the current trends of HIV/AIDS in sub-Saharan Africa, the factors that might have contributed to high prevalence of the virus in the region, the effect of the HIV/AIDS scourge, the prevention programmes and the way forward.
Jumbe, Charles B.L.; Msiska, Frederick B.M.; Madjera, Michael
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.
Jumbe, Charles B.L., E-mail: email@example.com [University of Malawi, Centre for Agricultural Research and Development, Bunda College, P.O. Box 219, Lilongwe (Malawi); Msiska, Frederick B.M., E-mail: firstname.lastname@example.org [Ministry of Agriculture and Food Security, P.O. Box 30134, Lilongwe 3 (Malawi); Madjera, Michael, E-mail: email@example.com [Evangelical Church in Middle Germany, P.O. Box 1424, 39004 Magdeburg (Germany)
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.
Jumbe, Charles B.L. [University of Malawi, Centre for Agricultural Research and Development, Bunda College, P.O. Box 219, Lilongwe (Malawi); Msiska, Frederick B.M. [Ministry of Agriculture and Food Security, P.O. Box 30134, Lilongwe 3 (Malawi); Madjera, Michael [Evangelical Church in Middle Germany, P.O. Box 1424, 39004 Magdeburg (Germany)
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. (author)
Neerinckx, Simon B; Peterson, Andrew T; Gulinck, Hubert
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...
Barker, Catherine; Dutta, Arin; Klein, Kate
Rapid scale-up of antiretroviral therapy (ART) in the context of financial and health system constraints has resulted in calls to maximize efficiency in ART service delivery. Adopting differentiated care models (DCMs) for ART could potentially be more cost-efficient and improve outcomes. However, no study comprehensively projects the cost savings across countries. We model the potential reduction in facility-level costs and number of health workers needed when implementing two types of DCMs while attempting to reach 90-90-90 targets in 38 sub-Saharan African countries from 2016 to 2020. We estimated the costs of three service delivery models: (1) undifferentiated care, (2) differentiated care by patient age and stability, and (3) differentiated care by patient age, stability, key vs. general population status, and urban vs. rural location. Frequency of facility visits, type and frequency of laboratory testing, and coverage of community ART support vary by patient subgroup. For each model, we estimated the total costs of antiretroviral drugs, laboratory commodities, and facility-level personnel and overhead. Certain groups under four-criteria differentiation require more intensive inputs. Community-based ART costs were included in the DCMs. We take into account underlying uncertainty in the projected numbers on ART and unit costs. Total five-year facility-based ART costs for undifferentiated care are estimated to be US$23.33 billion (95% confidence interval [CI]: $23.3-$23.5 billion). An estimated 17.5% (95% CI: 17.4%-17.7%) and 16.8% (95% CI: 16.7%-17.0%) could be saved from 2016 to 2020 from implementing the age and stability DCM and four-criteria DCM, respectively, with annual cost savings increasing over time. DCMs decrease the full-time equivalent (FTE) health workforce requirements for ART. An estimated 46.4% (95% CI: 46.1%-46.7%) fewer FTE health workers are needed in 2020 for the age and stability DCM compared with undifferentiated care. Adopting DCMs can
Odekunle, Florence Femi; Odekunle, Raphael Oluseun; Shankar, Srinivasan
Poor health information system has been identified as a major challenge in the health-care system in many developing countries including sub-Saharan African countries. Electronic health record (EHR) has been shown as an important tool to improve access to patient information with attendance improved quality of care. However, EHR has not been widely implemented/adopted in sub-Saharan Africa. This study sought to identify factors that affect the adoption of an EHR in sub-Saharan Africa and stra...
...-Import Bank Transactions in Sub-Saharan Africa. Public Participation: The meeting will be open to public... EXPORT-IMPORT BANK Notice of Open Special Meeting of the Sub-Saharan Africa Advisory Committee (SAAC) of the Export-Import Bank of the United States (Export-Import Bank). SUMMARY: The Sub-Saharan...
Barr, Bill; Daoud, Beshir
The history of Africa is of a continent colonized and deeply exploited by European powers In the late 1940's, only four countries in Africa were independent Egypt, Liberia, Ethiopia and South Africa...
David Shapiro; Andrew Hinde
Background: This descriptive finding examines the comparative pace of fertility decline in sub-Saharan Africa, relative to Asia, Latin America and the Caribbean, and Northern Africa.Objective: We seek to determine if fertility decline has been slower in sub-Saharan Africa than elsewhere in the developing world.Methods: United Nations 2017 estimates of national fertility are used in assessing the comparative pace of fertility decline, and the four regions are compared in terms of how far they ...
Frankema, Ewout; Bolt, Jutta
Cross-country research on educational inequality presents contrasting views on the extent of educational inequality in Latin America and Sub-Saharan Africa. The differences in opinion also concern the relation between educational inequality and income inequality. This paper argues that part of the
Hassler, Bjoern; Hennessy, Sara; Hofmann, Riikka
Developing sustainable and scalable educational initiatives is a key challenge in low-income countries where donor-funded short-term projects are limited by both contextual factors and programme design. In this commentary we examine some of the issues related to in-service teacher development in the context of sub-Saharan Africa, grounded…
Frelat, Romain; Lopez-Ridaura, Santiago; Giller, K.E.; Herrero, Mario; Douxchamps, Sabine; Djurfeldt, Agnes Andersson; Erenstein, Olaf; Henderson, Ben; Kassie, Menale; Paul, B.K.; Rigolot, Cyrille; Ritzema, Randall S.; Rodriguez, Daniel; Asten, Van P.J.A.; Wijk, Van M.T.
We calculated a simple indicator of food availability using data from 93 sites in 17 countries across contrasted agroecologies in sub-Saharan Africa (>13,000 farm households) and analyzed the drivers of variations in food availability. Crop production was the major source of energy,
Mwanri, A.W.; Kinabo, J.L.; Ramaiya, K.; Feskens, E.J.M.
Objective We systematically reviewed publications on prevalence and risk factors for gestational diabetes mellitus (GDM) in the 47 countries of sub-Saharan Africa. Methods We conducted a systematic search in PUBMED and reviewed articles published until June 2014 and searched the references of
Nchise, Abinwi C.
The exponential growth of the Internet and mobile phone usage in sub-Saharan Africa (SSA) within the last decade has created many different platforms for citizens' political participation. This appears to be changing the political landscape of most countries within the region as governments are increasingly held responsible for their actions.…
Braunstein, Sarah L.; van de Wijgert, Janneke H. H. M.; Nash, Denis
HIV incidence estimation is increasingly being incorporated into HIV/AIDS surveillance activities in both resource-rich and developing countries. We conducted a systematic review to assess the availability of HIV incidence data from sub-Saharan Africa. We examined peer-reviewed articles, conference
Lewin, Keith M.; Sabates, Ricardo
This paper explores changing patterns of access to basic education in six Sub-Saharan Africa countries using data from Demographic and Health Surveys at two points in time. In general the analysis confirms that participation of children in schooling has increased over the last decade. However, access to education remains strongly associated with…
Muller, Bernadette; Haller, Max
It is widely recognised that higher education is crucial for socio-economic growth in developing countries. Sub-Saharan Africa (SSA) is lagging behind in this regard in spite of a strong expansion of universities in the last decades. However, this growth may have led to a deterioration of the quality of higher education. There is no dearth of…
Malakpa, Sakui W. G.
Despite genuine efforts, countries in sub-Saharan Africa significantly lag behind sister nations of the world in providing basic education and more so in providing special education and rehabilitation services for students with disabilities. This work gives an overview of the magnitude of this problem and outlines some of its causes. In addition,…
Laan, van der H.L.; Haaren, van W.T.M.
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
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. However, 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.
Ibitola O Asaolu
Full Text Available In spite of a high prevalence of HIV infection among adolescents and young adults in sub-Saharan Africa, uptake of HIV testing and counseling among youth in the region remains sub-optimal. The objective of this study was to assess factors that influence uptake of HIV testing and counseling among youth aged 15-24 years in sub-Saharan Africa.This study used the Demographic and Health Survey (DHS data from countries that represent four geographic regions of sub-Saharan Africa: Congo (Brazzaville, representing central Africa (DHS 2011-2012; Mozambique, representing southern Africa (DHS 2011; Nigeria, representing western Africa (DHS 2013; and Uganda, representing eastern Africa (DHS 2011. Analyses were restricted to 23,367 male and female respondents aged 15-24 years with complete data on the variables of interest. Chi-square tests and logistic regression models were used to assess predictors of HIV testing. Statistical significance was set at p< 0.01.The analysis revealed that a majority of the respondents were female (78.1% and aged 20-24-years (60.7%. Only a limited proportion of respondents (36.5% had ever tested for HIV and even fewer (25.7% demonstrated comprehensive knowledge of HIV/AIDS. There was a significant association between HIV testing and respondents' gender, age, age at sexual debut, and comprehensive knowledge of HIV in the pooled sample. Older youth (adjusted OR (aOR = 2.19; 99% CI = 1.99-2.40 and those with comprehensive knowledge of HIV (aOR = 1.98; 1.76-2.22 had significantly higher odds of ever being tested for HIV than younger respondents and those with limited HIV/AIDS knowledge respectively. Furthermore, men had lower odds of HIV testing than women (aOR = 0.32; 0.28-0.37.Reaching youth in sub-Saharan Africa for HIV testing continues to be a challenge. Public health programs that seek to increase HIV counseling and testing among youth should pay particular attention to efforts that target high-risk subpopulations of youth
Akinyemi, Joshua O; Chisumpa, Vesper H; Odimegwu, Clifford O
The household dynamics of childhood mortality in rural areas of sub-Saharan Africa is less researched despite the fact that mortality rates are almost two times that of urban settings. This study aimed to investigate the influence of household structure on childhood mortality while controlling for household and maternal characteristics in rural sub-Saharan Africa. Eight countries with recent demographic and health survey data not earlier than the year 2010 were selected, two from each sub-region of sub-Saharan Africa. The outcome variables were risk of infant and child death while the main independent variables included sex of household head and household structure. Descriptive statistics were generated for all variables. Mortality rates disaggregated by sex of household head and household structure were estimated using the Kaplan-Meier method. Cox proportional hazard regression models were fitted to investigate the relationship between the outcome and explanatory variables in each country. The percentage of children living in female-headed households (FHHs) ranged from 5.2% in Burkina Faso to 49.1% in Namibia while those living in extended family households ranged from 27.4% in Rwanda to 59.9% in Namibia. Multivariate hazard regression showed that, in the majority of the countries, there was no significant relationship between living in FHHs and childhood mortality, but the direction and magnitude of effect varied across countries. A significant negative effect of FHHs on infant mortality was observed in Burkina Faso (HR=1.64, 95% confidence interval (CI): 1.09-2.48) and Zambia (HR=1.49, 95%CI: 1.02-2.17). Likewise, children in extended family households had a higher risk of child mortality in Burkina Faso (HR=1.33, 95%CI: 1.04-1.69) and Zambia (HR=1.59, 95%CI: 1.02-2.49). There was not much difference in the effect of FHHs between infancy (0-11 months) and childhood (12-59 months) in the other countries. The pooled adjusted hazard ratio (HR) showed that the risk
Full Text Available Background: This descriptive finding examines the comparative pace of fertility decline in sub-Saharan Africa, relative to Asia, Latin America and the Caribbean, and Northern Africa. Objective: We seek to determine if fertility decline has been slower in sub-Saharan Africa than elsewhere in the developing world. Methods: United Nations 2017 estimates of national fertility are used in assessing the comparative pace of fertility decline, and the four regions are compared in terms of how far they are into their fertility transition. Results: The data shows clearly that fertility decline in sub-Saharan Africa, still at a comparatively early stage, has been considerably slower than the earlier declines in Asia, Latin America and the Caribbean, and Northern Africa at comparable stages of the transition, and displays less within-region heterogeneity than the transitions in these other regions. Conclusions: The slower pace of fertility decline in sub-Saharan Africa, in conjunction with the high current fertility levels in the region, means that in the absence of policies seeking to accelerate fertility decline, sub-Saharan Africa will continue to experience rapid population growth that in turn will constrain its development. Contribution: Presentation of data in a novel way (Figures 2‒4, and associated calculations unambiguously demonstrates the slow pace of fertility decline in sub-Saharan Africa compared with other regions of the world.
Buor, Daniel; Bream, Kent
To establish what population characteristics affect the high maternal mortality rate in the sub-Saharan Africa region and to propose possible solutions to reduce this rate. This study is a secondary analysis of existing data sources from the World Bank, the World Health Organization (WHO), as well as direct and indirect sources from UNAIDS, the United Nations, Demographic and Health Surveys (DHS), Macro International, and national statistical offices. Instead of looking at continentwide or individual nation models, it develops a regional model. Sociodemographic population variables are used as independent variables to predict the dependent variable, maternal mortality. Additionally, a new country-specific political stability independent variable is introduced into the model. Data from 28 sub-Saharan African countries are used. Bivariate correlations are used to establish associations among the variables, whereas cross-tabulations, using Kendall's tau-c values, and regression lines are used to establish impacts. In the sub-Saharan Africa region, births attended by skilled health personnel and life expectancy at birth strongly correlate with maternal mortality. Gross national product (GNP) per capita and health expenditure per capita also have strong association with maternal mortality. The availability of skilled delivery personnel, life expectancy, national economic wealth, and health expenditure per capita predict the maternal mortality rate of a country. Based on these findings, it is recommended that structural arrangements be made to train skilled health personnel to take care of maternal health problems. In view of the high cost of training physicians, middle-level health personnel may offer an affordable alternative to handle emergency obstetrical cases to address the shortage of physicians. In addition, the allocation of adequate resources to the health sector could improve maternal mortality. The economic wealth of a country and life expectancy at birth are
Ssewanyana, Derrick; Bitanihirwe, Byron
Gambling is a cross-cultural and global activity which typically involves the wagering of money or an item of monetary value on an outcome that is governed by chance. Although gambling is positioned as a legitimate recreational and leisure activity within sub-Saharan Africa (SSA), there is widespread recognition among healthcare professionals and policy-makers that gambling has the capacity to become dysfunctional in a minority. Emerging knowledge suggests that problem gambling is rapidly evolving in to a public health concern in SSA, especially among youth. This article focuses on problem gambling among young people in SSA with an emphasis on three key themes: (1) gambling behavior and patterns in SSA; (2) public health and socioeconomic implications of gambling in SSA; and (3) public health policies and interventions for addressing this issue. We believe that collaborative efforts between government, prevention specialists, legislators, researchers, treatment providers, and other stake holders can influence the uptake of research findings necessary to implement social policies and design effective public health intervention options to combat problem gambling and its associated implications among young people in SSA.
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.
Kraus, S; Ogunbanjo, G; Sliwa, K; Ntusi, N A B
Despite medical advances, heart failure (HF) remains a global health problem and sub-Saharan Africa (SSA) is no exception, with decompensated HF being the most common primary diagnosis for patients admitted to hospital with heart disease. In SSA the in-hospital mortality rate of decompensated HF is up to 8.3%. HF is a clinical syndrome that is caused by a diverse group of aetiologies, each requiring unique management strategies, highlighting the need for diagnostic certainty and a broad understanding of the complex pathophysiology of this condition. While there are a number of advanced medical, device and surgical interventions being tailored for HF internationally, the fundamental basic principles of HF management, such as patient education, effective management of congestion and initiation of disease-modifying medical therapies, remain a challenge on our continent. This review addresses both the epidemiology of HF in SSA and principles of management that focus specifically on symptom relief, prevention of hospitalisation and improving survival in this population.
Guilpart, Nicolas; Grassini, Patricio; van Wart, Justin; Yang, Haishun; van Ittersum, Martin K.; van Bussel, Lenny G. J.; Wolf, Joost; Claessens, Lieven; Leenaars, Johan G. B.; Cassman, Kenneth G.
There is a persistent narrative about the potential of Sub-Saharan Africa (SSA) to be a ‘grain breadbasket’ because of large gaps between current low yields and yield potential with good management, and vast land resources with adequate rainfall. However, rigorous evaluation of the extent to which soils can support high, stable yields has been limited by lack of data on rootable soil depth of sufficient quality and spatial resolution. Here we use location-specific climate data, a robust spatial upscaling approach, and crop simulation to assess sensitivity of rainfed maize yields to root-zone water holding capacity. We find that SSA could produce a modest maize surplus but only if rootable soil depths are comparable to that of other major breadbaskets, such as the US Corn Belt and South American Pampas, which is unlikely based on currently available information. Otherwise, producing surplus grain for export will depend on expansion of crop area with the challenge of directing this expansion to regions where soil depth and rainfall are supportive of high and consistent yields, and where negative impacts on biodiversity are minimal.
Thomas J. Betjeman
Full Text Available Mobile phone penetration rates have reached 63% in sub-Saharan Africa (SSA and are projected to pass 70% by 2013. In SSA, millions of people who never used traditional landlines now use mobile phones on a regular basis. Mobile health, or mHealth, is the utilization of short messaging service (SMS, wireless data transmission, voice calling, and smartphone applications to transmit health-related information or direct care. This systematic review analyzes and summarizes key articles from the current body of peer-reviewed literature on PubMed on the topic of mHealth in SSA. Studies included in the review demonstrate that mHealth can improve and reduce the cost of patient monitoring, medication adherence, and healthcare worker communication, especially in rural areas. mHealth has also shown initial promise in emergency and disaster response, helping standardize, store, analyze, and share patient information. Challenges for mHealth implementation in SSA include operating costs, knowledge, infrastructure, and policy among many others. Further studies of the effectiveness of mHealth interventions are being hindered by similar factors as well as a lack of standardization in study design. Overall, the current evidence is not strong enough to warrant large-scale implementation of existing mHealth interventions in SSA, but rapid progress of both infrastructure and mHealth-related research in the region could justify scale-up of the most promising programs in the near future.
Full Text Available Gambling is a cross-cultural and global activity which typically involves the wagering of money or an item of monetary value on an outcome that is governed by chance. Although gambling is positioned as a legitimate recreational and leisure activity within sub-Saharan Africa (SSA, there is widespread recognition among healthcare professionals and policy-makers that gambling has the capacity to become dysfunctional in a minority. Emerging knowledge suggests that problem gambling is rapidly evolving in to a public health concern in SSA, especially among youth. This article focuses on problem gambling among young people in SSA with an emphasis on three key themes: (1 gambling behavior and patterns in SSA; (2 public health and socioeconomic implications of gambling in SSA; and (3 public health policies and interventions for addressing this issue. We believe that collaborative efforts between government, prevention specialists, legislators, researchers, treatment providers, and other stake holders can influence the uptake of research findings necessary to implement social policies and design effective public health intervention options to combat problem gambling and its associated implications among young people in SSA.
Dillon, David G; Gurdasani, Deepti; Riha, Johanna
Sub-Saharan Africa (SSA) has the highest burden of HIV in the world and a rising prevalence of cardiometabolic disease; however, the interrelationship between HIV, antiretroviral therapy (ART) and cardiometabolic traits is not well described in SSA populations....
Gunzinger, Mark A; Thomas, David L
... for the United States Generally viewed as lagging in the effort to develop stable governments and self-sustaining economies, Sub-Saharan Africa is, with the exception of a few bright spots, caught...
The Tourism–Development Nexus in sub-Saharan Africa: Progress and Prospects. ... discussed concerning the impacts of differentiated kinds of tourism: tourism and ... finally, questions around tourism, climate change and the green economy.
Ojji, Dike B; Ojji, Dike B Ojji; Lamont, Kim; Sliwa, Karen; Ojji, Olubunmi I; Egenti, Bibiana Nonye; Sliwa, Karen
Summary Cardiovascular disease (CVD) is the frontrunner in the disease spectrum of sub-Saharan Africa, with stroke and ischaemic heart disease ranked seventh and 14th as leading causes of death, respectively, on this sub-continent. Unfortunately, this region is also grappling with many communicable, maternal, neonatal and nutritional disorders. Limited resources and the high cost of CVD treatment necessitate that primary prevention should have a high priority for CVD control in sub- Saharan Africa. One major challenge of such an approach is how to equip primary care to respond promptly and effectively to this burden. We present a practical approach on how primary care in sub-Saharan Africa could effectively address the prevention, treatment and control of CVD on the subcontinent. For effective prevention, control and treatment of CVD in sub-Saharan Africa, there should be strategic plans to equip primary care clinics with well-trained allied healthcare workers who are supervised by physicians. PMID:28752890
Alexander C Tsai; David R Bangsberg; Sheri D Weiser
Alexander Tsai and colleagues highlight the complex relationship between poverty and HIV stigma in sub-Saharan Africa, and discuss possible ways to break the cycle. Please see later in the article for the Editors' Summary.
Hoeve ten, Marieke
Poverty reduction is one of the main Millennium Development Goals (United Nations, 2000). Sub-Saharan Africa is the region with the highest prevalence of poverty. Almost half the population lives in extreme poverty (Chen & Ravillion, 2004; UN, 2005). Pove
Ala, Fereydoun; Allain, Jean-Pierre; Bates, Imelda; Boukef, Kamel; Boulton, Frank; Brandful, James; Dax, Elizabeth M.; El Ekiaby, Magdy; Farrugia, Albert; Gorlin, Jed; Hassall, Oliver; Lee, Helen; Loua, André; Maitland, Kathryn; Mbanya, Dora; Mukhtar, Zainab; Murphy, William; Opare-Sem, Ohene; Owusu-Ofori, Shirley; Reesink, Henk; Roberts, David; Torres, Oscar; Totoe, Grace; Ullum, Henrik; Wendel, Silvano
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
Full Text Available 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.
Ala, Fereydoun; Allain, Jean-Pierre; Bates, Imelda; Boukef, Kamel; Boulton, Frank; Brandful, James; Dax, Elizabeth M.; El Ekiaby, Magdy; Farrugia, Albert; Gorlin, Jed; Hassall, Oliver; Lee, Helen; Loua, André; Maitland, Kathryn; Mbanya, Dora
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.
Gunzinger, Mark A; Thomas, David L
... in a vicious cycle of conflict, deteriorating infrastructures and humanitarian disasters Despite this apparent gloomy prognosis, Sub-Saharan Africa is one of the richest regions in the world in human...
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...
Full Text Available This study tries to quantify the economic effects of Economic Partnership Agreements (EPAs which have been negotiating between sub-Saharan Africa (SSA and European Union (EU. The study addresses the following questions: How are African countries likely to gain or lose from a bilateral trade liberalisation between Africa and the EU?, what are the welfare implications for the African countries from the EPAs?, how will the formation of EPAs affect trade expansion through trade creation and trade diversion effects?, what are the potential fiscal implications of the EPAs. Even though the full reciprocity principle appears to be trade expanding (singularly infavour of EU, this study indicates that it will pose serious implications for deepening of regional integration in Africa because of trade diversion effect between African countries. Another key finding is welfare effect through the way of trade expantion between EU and SSA.
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 to 275 African professionals, strengthened research ethics committees in 19 countries in Sub-Saharan Africa, and created research ethics curricula at many institutions and bioethics centers within Africa. Trainees’ leadership resulted in new national systems and policies on research ethics, human tissue storage and export, and methods of monitoring compliance with research ethics guidelines. Training programs adapted to challenges that arose due to varied trainees’ background knowledge in ethics, duration of time available for training, spoken and written English language skills, administrative obstacles, and the need to sustain post-training research ethics activities. Our report showcases the development of awareness of research ethics and building/strengthening of basic research ethics infrastructure in Sub-Saharan Africa. Nevertheless, the increasing amount and complexity of health research being conducted in Sub-Saharan Africa suggests the need for continued investment in research ethics capacity development in this region. This paper is part of a collection of papers analyzing the Fogarty International Center’s International Research Ethics Education and Curriculum Development program. PMID:24782070
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 to 275 African professionals, strengthened research ethics committees in 19 countries in Sub-Saharan Africa, and created research ethics curricula at many institutions and bioethics centers within Africa. Trainees' leadership resulted in new national systems and policies on research ethics, human tissue storage and export, and methods of monitoring compliance with research ethics guidelines. Training programs adapted to challenges that arose due to varied trainees' background knowledge in ethics, duration of time available for training, spoken and written English language skills, administrative obstacles, and the need to sustain post-training research ethics activities. Our report showcases the development of awareness of research ethics and building/strengthening of basic research ethics infrastructure in Sub-Saharan Africa. Nevertheless, the increasing amount and complexity of health research being conducted in Sub-Saharan Africa suggests the need for continued investment in research ethics capacity development in this region. This paper is part of a collection of papers analyzing the Fogarty International Center's International Research Ethics Education and Curriculum Development program.
This paper is a comparative study of the role of agriculture in economic development in sub-Saharan Africa and Asia. Popular notions of economic duality and agricultural squeeze in sub-Saharan Africa are re-examined, and new explanations in terms of agrarian structures and resource availabilities are put forward to account for the apparent economic duality in that continent. Comparison with surplus labour economies of Asia highlights the constraints posed by the prevailing agrarian structures...
Ala, Fereydoun; Allain, Jean-Pierre; Bates, Imelda
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.......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....
A new dataset by Bazzi and Blattman (2014) allows examining the effects of international commodity prices on the risk of civil war outbreak with more comprehensive data. I find that international commodity price downturns sparked civil wars in Sub-Saharan Africa. Another finding with the new dataset is that commodity price downturns also sparked civil wars beyond Sub-Saharan Africa since 1980. Effects are sizable relative to the baseline risk of civil war outbreak. My conclusions contrast wit...
Full Text Available Heat pump technology has been used for heating, ventilation, and air-conditioning in domestic and industrial sectors in most developed countries of the world including South Africa. However, heat pump drying (HPD of fruits and vegetables has been largely unexploited in South Africa and by extension to the sub-Saharan African region. Although studies on heat pump drying started in South Africa several years ago, not much progress has been recorded to date. Many potential users view heat pump drying technology as fragile, slow, and high capital intensive when compared with conventional dryer. This paper tried to divulge the principles and potentials of heat pump drying technology and the conditions for its optimum use. Also, various methods of quantifying performances during heat pump drying as well as the quality of the dried products are highlighted. Necessary factors for maximizing the capacity and efficiency of a heat pump dryer were identified. Finally, the erroneous view that heat pump drying is not feasible economically in sub-Saharan Africa was clarified.
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.
Mensah, George A
Reliable data on risk factor levels, exposure history, and population distribution can help inform policies and programs for disease prevention and control. With rare exception however, ideal local data on major risk factors and causes of death and disease burden have been scarce in sub-Saharan Africa (SSA). Basic community surveys in some countries and recent systematic analysis of disease burden attributable to 67 risk factors and risk factor clusters in 21 regions of the world provide an opportunity to examine and relate diabetes and cardiovascular risk factors to mortality and burden in SSA. Rising body mass index, especially in women in Southern Africa; and rising systolic blood pressure in East Africa for both sexes, and in West Africa for women are the major cardiometabolic risk factors. Harmful use of alcohol, especially in Southern SSA, tobacco use, and physical inactivity are also important. Improving vital registration and risk factor surveillance remain major challenges. © 2013.
Chen, Candice; Baird, Sarah; Ssentongo, Katumba; Mehtsun, Sinit; Olapade-Olaopa, Emiola Oluwabunmi; Scott, Jim; Sewankambo, Nelson; Talib, Zohray; Ward-Peterson, Melissa; Mariam, Damen Haile; Rugarabamu, Paschalis
Physician tracking systems are critical for health workforce planning as well as for activities to ensure quality health care - such as physician regulation, education, and emergency response. However, information on current systems for physician tracking in sub-Saharan Africa is limited. The objective of this study is to provide information on the current state of physician tracking systems in the region, highlighting emerging themes and innovative practices. This study included a review of the literature, an online search for physician licensing systems, and a document review of publicly available physician registration forms for sub-Saharan African countries. Primary data on physician tracking activities was collected as part of the Medical Education Partnership Initiative (MEPI) - through two rounds over two years of annual surveys to 13 medical schools in 12 sub-Saharan countries. Two innovations were identified during two MEPI school site visits in Uganda and Ghana. Out of twelve countries, nine had existing frameworks for physician tracking through licensing requirements. Most countries collected basic demographic information: name, address, date of birth, nationality/citizenship, and training institution. Practice information was less frequently collected. The most frequently collected practice fields were specialty/degree and current title/position. Location of employment and name and sector of current employer were less frequently collected. Many medical schools are taking steps to implement graduate tracking systems. We also highlight two innovative practices: mobile technology access to physician registries in Uganda and MDNet, a public-private partnership providing free mobile-to-mobile voice and text messages to all doctors registered with the Ghana Medical Association. While physician tracking systems vary widely between countries and a number of challenges remain, there appears to be increasing interest in developing these systems and many
Full Text Available Background: This study described the current conditions of work of paediatric surgeons in Francophone sub-Saharan Africa (FSSA and set the debate at the level of the humanist thinking in medicine. Patients and Methods: This was a multicentre study from 1 st May to 30 th October 2008. The African Society of paediatric surgeons′ directory was used to identify paediatric surgeons in the Francophone′s countries in Sub Saharan Africa. The parameters studied were number of surgeons per country, means of training, working conditions, remunerations, needs for continuous training and the research. Results: A total of 41 paediatric surgeons (68.33% responded. The average number of paediatric surgeons per country was 5. The means of training included government scholarships among 7 paediatric surgeons (17.07%, scholarship from a non-governmental organisations in 14 (34.15% and self-sponsorships in 20 (48.78%. The average salary was 450 Euros (€ (range: 120-1 400 Euros. Most of the paediatric surgeons (68.29% had internet services for continuous update courses and research. Thirty six paediatric surgeons (87.80% had no subscription to specialised scientific journals. Conclusion: The paediatric surgeon in FSSA faces many problems related to his working and living conditions that may have a negative impact on their competences.
Brockerhoff, M; Hewett, P
Accounts by journalists of wars in several countries of sub-Saharan Africa in the 1990s have raised concern that ethnic cleavages and overlapping religious and racial affiliations may widen the inequalities in health and survival among ethnic groups throughout the region, particularly among children. Paradoxically, there has been no systematic examination of ethnic inequality in child survival chances across countries in the region. This paper uses survey data collected in the 1990s in 11 countries (Central African Republic, Côte d'Ivoire, Ghana, Kenya, Mali, Namibia, Niger, Rwanda, Senegal, Uganda, and Zambia) to examine whether ethnic inequality in child mortality has been present and spreading in sub-Saharan Africa since the 1980s. The focus was on one or two groups in each country which may have experienced distinct child health and survival chances, compared to the rest of the national population, as a result of their geographical location. The factors examined to explain potential child survival inequalities among ethnic groups included residence in the largest city, household economic conditions, educational attainment and nutritional status of the mothers, use of modern maternal and child health services including immunization, and patterns of fertility and migration. The results show remarkable consistency. In all 11 countries there were significant differentials between ethnic groups in the odds of dying during infancy or before the age of 5 years. Multivariate analysis shows that ethnic child mortality differences are closely linked with economic inequality in many countries, and perhaps with differential use of child health services in countries of the Sahel region. Strong and consistent results in this study support placing the notion of ethnicity at the forefront of theories and analyses of child mortality in Africa which incorporate social, and not purely epidemiological, considerations. Moreover, the typical advantage of relatively small, clearly
As a result of two years of constructive dialogue between the World Bank (WB), government agencies and grassroots' associations involved in the advancement of women, a workshop for the Promotion of the societal status of women in Francophone Sub-Saharan Africa was organized in March 1998 in Cotonou by the Association of Women Jurists (AFJB) with WB technical and financial assistance. From ...
Delaire, Caroline; Peletz, Rachel; Kumpel, Emily; Kisiangani, Joyce; Bain, Robert; Khush, Ranjiv
Microbial water quality monitoring is crucial for managing water resources and protecting public health. However, institutional testing activities in sub-Saharan Africa are currently limited. Because the economics of water quality testing are poorly understood, the extent to which cost may be a barrier to monitoring in different settings is unclear. This study used cost data from 18 African monitoring institutions (piped water suppliers and health surveillance agencies in six countries) and estimates of water supply type coverage from 15 countries to assess the annual financial requirements for microbial water testing at both national and regional levels, using World Health Organization recommendations for sampling frequency. We found that a microbial water quality test costs 21.0 ± 11.3 USD, on average, including consumables, equipment, labor, and logistics, which is higher than previously calculated. Our annual cost estimates for microbial monitoring of piped supplies and improved point sources ranged between 8 000 USD for Equatorial Guinea and 1.9 million USD for Ethiopia, depending primarily on the population served but also on the distribution of piped water system sizes. A comparison with current national water and sanitation budgets showed that the cost of implementing prescribed testing levels represents a relatively modest proportion of existing budgets (water sources in sub-Saharan Africa would cost 16.0 million USD per year, which is minimal in comparison to the projected annual capital costs of achieving Sustainable Development Goal 6.1 of safe water for all (14.8 billion USD).
Ojji, Dike B; Ojji, Dike B Ojji; Lamont, Kim; Sliwa, Karen; Ojji, Olubunmi I; Egenti, Bibiana Nonye; Sliwa, Karen
Summary Cardiovascular disease (CVD) is the frontrunner in the disease spectrum of sub-Saharan Africa, with stroke and ischaemic heart disease ranked seventh and 14th as leading causes of death, respectively, on this sub-continent. Unfortunately, this region is also grappling with many communicable, maternal, neonatal and nutritional disorders. Limited resources and the high cost of CVD treatment necessitate that primary prevention should have a high priority for CVD control in sub- Saharan A...
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.
A major obstacle to the development of sustainable democratic systems of government in contemporary sub-Saharan African states is the difficulty in articulating an adequate conception of social justice to serve as a guiding principle in these polities. This difficulty is a consequence of the ethnically heterogeneous character ...
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...
Addison, Tony; Pikkarainen, Ville; Rönkkö, Risto
This paper puts sub-Saharan Africa’s economic development into perspective. While much did not go as hoped for at independence, much of the region has been on a more promising development trajectory since the mid-1990s, as we illustrate using growth, poverty, and human development indicators. We...
Multiple pathways to gender-sensitive budget support in the education sector: Analysing the effectiveness of sex-disaggregated indicators in performance assessment frameworks and gender working groups in (education) budget support to Sub-Saharan Africa countries
Holvoet, Nathalie; Inberg, Liesbeth
In order to correct for the initial gender blindness of the Paris Declaration and related aid modalities as general and sector budget support, it has been proposed to integrate a gender dimension into budget support entry points. This paper studies the effectiveness of (joint) gender working groups and the integration of sex-disaggregated indicators and targets in performance assessment frameworks in the context of education sector budget support delivered to a sample of 17 Sub-Saharan Africa...
Adema, Yvonne; Sterken, Elmer
Abstract We analyze the interrelation between monetary stability and financial structure in 20 Sub-Saharan economies. Using a panel data set we estimate the impact of monetary stability and financial development on income per capita. Special interest is given to the conditions of the so-called
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 people’s perception of, and their possible openness towards, certain forms of corruption was investigated. The research showed that cultural traits do influence people’s 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 God’s 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. Volgens Transparency International se 2012-CorruptionPerceptions Index het 89.6% van Afrikalande suid van die Sahara ’n telling van minder as 50 gekry, waar ’n telling van nul op hoë korrupsie dui en ’n telling van 100 aandui dat ’n land vry van korrupsie is. Hieruit blyk dat hierdie lande kwesbaar is vir korrupsie. In hierdie artikel word die moontlikheid ondersoek dat daar sekere eienskappe in die kultuur van hierdie lande is wat mense se persepsie van, en moontlike deelname aan, sekere vorme van korrupsie kan beïnvloed. Aandag word aan aspekte soos kommunalisme, die gee van geskenke en ’n ‘skandekultuur’ gegee. Die navorsing toon dat kultuur wel mense se gedrag beïnvloed en dat daar sekere eienskappe in die kultuur van
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.
Evanie Devi Deenanath
Full Text Available 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.
Collins, Pamela Y.; Musisi, Seggane; Frehywot, Seble; Patel, Vikram
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. PMID:25783229
Vesper H. Chisumpa
Full Text Available Place of death remains an issue of growing interest and debate among scholars as an indicator of quality of end-of-life care in developed countries. In sub-Saharan Africa, however, variations in place of death may suggest inequalities in access to and the utilization of health care services that should be addressed by public health interventions. Limited research exists on factors associated with place of death in sub-Saharan Africa. The study examines factors associated with the place of death among Zambian adults aged 15–59 years using the 2010–2012 sample vital registration with verbal autopsy survey (SAVVY data, descriptive statistics and multivariate logistic regression analysis. Results show that more than half of the adult deaths occurred in a health facility and two-fifths died at home. Higher educational attainment, urban versus rural residence, and being of female gender were significant predictors of the place of death. Improvement in educational attainment and investment in rural health facilities and the health care system as a whole may improve access and utilization of health services among adults.
Dos Santos, S; Adams, E A; Neville, G; Wada, Y; de Sherbinin, A; Mullin Bernhardt, E; Adamo, S B
For the next decade, the global water crisis remains the risk of highest concern, and ranks ahead of climate change, extreme weather events, food crises and social instability. Across the globe, nearly one in ten people is without access to an improved drinking water source. Least Developed Countries (LDCs) especially in sub-Saharan Africa (SSA) are the most affected, having disproportionately more of the global population without access to clean water than other major regions. Population growth, changing lifestyles, increasing pollution and accelerating urbanization will continue to widen the gap between the demand for water and available supply especially in urban areas, and disproportionately affect informal settlements, where the majority of SSA's urban population resides. Distribution and allocation of water will be affected by climate-induced water stresses, poor institutions, ineffective governance, and weak political will to address scarcity and mediate uncertainties in future supply. While attempts have been made by many scientists to examine different dimensions of water scarcity and urban population dynamics, there are few comprehensive reviews, especially focused on the particular situation in Sub-Saharan Africa. This paper contributes to interdisciplinary understanding of urban water supply by distilling and integrating relevant empirical knowledge on urban dynamics and water issues in SSA, focusing on progress made and associated challenges. It then points out future research directions including the need to understand how alternatives to centralized water policies may help deliver sustainable water supply to cities and informal settlements in the region. Copyright © 2017 Elsevier B.V. All rights reserved.
Chisumpa, Vesper H; Odimegwu, Clifford O; De Wet, Nicole
Place of death remains an issue of growing interest and debate among scholars as an indicator of quality of end-of-life care in developed countries. In sub-Saharan Africa, however, variations in place of death may suggest inequalities in access to and the utilization of health care services that should be addressed by public health interventions. Limited research exists on factors associated with place of death in sub-Saharan Africa. The study examines factors associated with the place of death among Zambian adults aged 15-59 years using the 2010-2012 sample vital registration with verbal autopsy survey (SAVVY) data, descriptive statistics and multivariate logistic regression analysis. Results show that more than half of the adult deaths occurred in a health facility and two-fifths died at home. Higher educational attainment, urban versus rural residence, and being of female gender were significant predictors of the place of death. Improvement in educational attainment and investment in rural health facilities and the health care system as a whole may improve access and utilization of health services among adults.
Ntouda, Julien; Sikodf, Fondo; Ibrahim, Mohamadou; Abba, Ibrahim
Water is at the center of the plant and animal life, the foundation upon which the health of human settlement and development of civilizations rely on. In tropical regions, 80% of diseases are transmitted either by germs in the water, or by vectors staying in it. In Sub-Saharan Africa, statistics show particularly high levels of unmet needs of populations in access to drinking water in a context of socioeconomic development. For this purpose, this study aims to determine the influence of access to drinking water on the health of populations in Sub-Saharan Africa. Using data from Demographic and Health Surveys (DHS) from Cameroon, Senegal and Chad, it is clear from the descriptive analysis that 60% (Cameroon), and 59% (Chad) of the cases of childhood diarrhea in these two countries are due to the consumption of dirty water. In terms of explanatory analysis, we note that when a household in Cameroon, Senegal or Chad does not have access to drinking water, children under 5 years old residing there are respectively 1.29, 1.27 and 1.03 times more likely to have diarrhea than those residing in households with easy access to drinking water. In view of these results, it is recommended to increase access to drinking water in particular by reducing disparities between the rich and poor people. Copyright © 2013 Académie des sciences. All rights reserved.
Sood, Neeraj; Wagner, Zachary
Although diarrheal mortality is cheaply preventable with oral rehydration therapy (ORT), over 700,000 children die of diarrhea annually and many health providers fail to treat diarrheal cases with ORT. Provision of ORT may differ between for-profit and public providers. This study used Demographic and Health Survey data from 19,059 children across 29 countries in sub-Saharan Africa from 2003 to 2011 to measure differences in child diarrhea treatment between private for-profit and public health providers. Differences in treatment provision were estimated using probit regression models controlling for key confounders. For-profit providers were 15% points less likely to provide ORT (95% confidence interval [CI] 13-17) than public providers and 12% points more likely to provide other treatments (95% CI 10-15). These disparities in ORT provision were more pronounced for poorer children in rural areas. As private healthcare in sub-Saharan Africa continues to expand, interventions to increase private sector provision of ORT should be explored.
Full Text Available There is a growing interest and concern for understanding the interaction among human population growth and the sustainability of natural resources. In fact, many agrarian societies experienced an increasing frequency of wars, famines and epidemics during the periods of resource depletion. People from Sub-Saharan Africa (SSA have suffered the demographic consequences of famines, civil wars and political instabilities during the last fifty years.. Almost half of the countries of Sub-Saharan Africa have undergone some form of demographic crisis over the past fifty years. Our analysis indicate that despite that environmental conditions were positively correlated with crop production across SSA, Malthusian factors correlated inversely with cultivation intensity, which in turn translated into a higher magnitude of depopulation suffered during the past fifty years. In this paper, we provide empirical evidence that population collapses in SSA during the last fifty years have been multifactorial, although more closely associated with Malthusian factors as proximal drivers. Other proximal drivers such as economic indicators, political stability and environmental determinants did not explain as much variance as Malthusian forces, suggesting that explanations of collapse magnitude in SSA are embedded in a complex multi-causal chain, in which demographic factors may play a modulating role yet to be explored in more depth.
Amoah, Abena S; Boakye, Daniel A; Yazdanbakhsh, Maria; van Ree, Ronald
Epidemiological studies from Sub-Saharan Africa indicate that allergies are on the rise in this region especially in urban compared to rural areas. This increase has been linked to improved hygiene, lifestyle changes, and lower exposure to pathogens in childhood. Reduced exposure to parasitic worm (helminth) infections and allergy outcomes has been the focus of a number of population studies over the years. Paradoxically, there are parallels in the immune responses to helminths and to allergies. Both conditions are associated with elevated levels of immunoglobulin E, high numbers of T helper 2 cells, eosinophils, and mast cells. These immune parallels have meant that the diagnosis of allergies in parts of the world where helminths are endemic can be hampered. The aim of this review is to examine observations from population studies conducted in Sub-Saharan Africa that demonstrate how helminth infections influence the parameters used to diagnose allergy outcomes in this region. We explore specifically how helminth infections hinder the in vitro diagnosis of allergic sensitization, influence the clinical manifestations of allergy, and also the effect of anthelmintic treatment on allergy outcomes. Advancing our understanding of how helminths influence allergy diagnosis is imperative for the development of improved tools to assess, diagnose, and treat allergic disorders in both helminth-endemic and non-endemic countries worldwide.
Heterosexual exposure accounts for most HIV transmission in sub-Saharan Africa, and this mode, as a proportion of new infections, is escalating globally. The scientific evidence accumulated over more than 20 years shows that among the strategies advocated during this period for HIV prevention, male circumcision is one of, if not, the most efficacious epidemiologically, as well as cost-wise. Despite this, and recommendation of the procedure by global policy makers, national implementation has been slow. Additionally, some are not convinced of the protective effect of male circumcision and there are also reports, unsupported by evidence, that non-sex-related drivers play a major role in HIV transmission in sub-Saharan Africa. Here, we provide a critical evaluation of the state of the current evidence for male circumcision in reducing HIV infection in light of established transmission drivers, provide an update on programmes now in place in this region, and explain why policies based on established scientific evidence should be prioritized. We conclude that the evidence supports the need to accelerate the implementation of medical male circumcision programmes for HIV prevention in generalized heterosexual epidemics, as well as in countering the growing heterosexual transmission in countries where HIV prevalence is presently low. PMID:22014096
Full Text Available Background: This article provided an analysis of gender inequality, health expenditure and its relationship to maternal mortality. Objective: The objective of this article was to explore gender inequality and its relationship with health expenditure and maternal mortality in sub-Saharan Africa (SSA. A unique analysis was used to correlate the Gender Inequality Index (GII, Health Expenditure and Maternal Mortality Ratio (MMR. The GII captured inequalities across three dimensions – Reproductive health, Women empowerment and Labour force participation between men and women. The GII is a composite index introduced by the UNDP in 2010 and corrects for the disadavanatges of the other gender indices. Although the GII incorporates MMR in its calculation, it should not be taken as a substitute for, but rather as complementary to, the MMR. Method: An exploratory and descriptive design to a secondary documentary review using quantitative data and qualitative information was used. The article referred to sub-Saharan Africa, but seven countries were purposively selected for an in-depth analysis based on the availability of data. The countries selected were Angola, Botswana, Malawi, Mozambique,South Africa, Zambia and Zimbabwe. Results: Countries with high gender inequality captured by the gender inequality index were associated with high maternal mortality ratios as compared with countries with lower gender inequality, whilst countries that spend less on health were associated with higher maternal deaths than countries that spend more. Conclusion: A potential relationship exists between gender inequality, health expenditure, and maternal mortality. Gender inequalities are systematic and occur at the macro, societal and household levels.
Markus Brückner; Antonio Ciccone
To learn more about the effect of economic conditions on civil war, we examine whether Sub-Saharan civil wars are more likely to start following downturns in the international price of countries main export commodities. The data show a robust effect of commodity price downturns on the outbreak of civil wars. We also find that Sub-Saharan countries are more likely to see civil wars following economic downturns in their main OECD export destinations.
Mwanri, Akwilina W; Kinabo, Joyce; Ramaiya, Kaushik; Feskens, Edith J M
We systematically reviewed publications on prevalence and risk factors for gestational diabetes mellitus (GDM) in the 47 countries of sub-Saharan Africa. We conducted a systematic search in PUBMED and reviewed articles published until June 2014 and searched the references of retrieved articles. We explored sources of heterogeneity among prevalence proportions with metaregression analysis. Of 1069 articles retrieved 22 studies were included. Half were from West Africa, specifically Nigeria, five from South Africa and six from East and Central Africa. There were differences in screening methods and diagnosis criteria used, even between studies carried out in the same country and same time period. Metaregression analysis indicated high heterogeneity among the studies (I(2) = 100, P 30 years. There are few studies on prevalence and risk factors for GDM in Sub-Saharan Africa and heterogeneity is high. Prevalence was up to about 14% when high-risk women were studied. Preventive actions should be taken to reduce the short- and long-term complications related to GDM in Sub-Saharan Africa. © 2015 John Wiley & Sons Ltd.
Using a panel dataset on 45 sub-Saharan Africa countries (SSA), this study analyzes empirically the socioeconomic determinants of life expectancy gain (considered as an indicator of global health improvement at country level). In order to treat heterogeneity and endogeneity concerns, we use multiple estimation methods including pooling, fixed-effect, long difference and system GMM. Our analyses show that income is critical for health enhancement. Particularly, we find that GDP per capita is s...
Blessing J Akombi
Full Text Available Sub-Saharan Africa has one of the highest levels of child malnutrition globally. Therefore, a critical look at the distribution of malnutrition within its sub-regions is required to identify the worst affected areas. This study provides a meta-analysis of the prevalence of malnutrition indicators (stunting, wasting and underweight within four sub-regions of sub-Saharan Africa.Cross-sectional data from the most recent Demographic and Health Surveys (2006-2016 of 32 countries in sub-Saharan Africa were used. The countries were grouped into four sub-regions (East Africa, West Africa, Southern Africa and Central Africa, and a meta-analysis was conducted to estimate the prevalence of each malnutrition indicator within each of the sub-regions. Significant heterogeneity was detected among the various surveys (I2 >50%, hence a random effect model was used, and sensitivity analysis was performed, to examine the effects of outliers. Stunting was defined as HAZ<-2; wasting as WHZ<-2 and underweight as WAZ<-2.Stunting was highest in Burundi (57.7% and Malawi (47.1% in East Africa; Niger (43.9%, Mali (38.3%, Sierra Leone (37.9% and Nigeria (36.8% in West Africa; Democratic Republic of Congo (42.7% and Chad (39.9% in Central Africa. Wasting was highest in Niger (18.0%, Burkina Faso (15.50% and Mali (12.7% in West Africa; Comoros (11.1% and Ethiopia (8.70% in East Africa; Namibia (6.2% in Southern Africa; Chad (13.0% and Sao Tome & Principle (10.5% in Central Africa. Underweight was highest in Burundi (28.8% and Ethiopia (25.2% in East Africa; Niger (36.4%, Nigeria (28.7%, Burkina Faso (25.7%, Mali (25.0% in West Africa; and Chad (28.8% in Central Africa.The prevalence of malnutrition was highest within countries in East Africa and West Africa compared to the WHO Millennium development goals target for 2015. Appropriate nutrition interventions need to be prioritised in East Africa and West Africa if sub-Saharan Africa is to meet the WHO global nutrition target
Even though the implications of foreign direct investment (FDI) have been studied greatly, only a small part have focused on Sub-Saharan Africa (SSA). With young and relatively talented workforce, SSA will provide enormous opportunities for multinationals entering the region. The purpose of this research is to examine whether FDI from China has a significant impact on economic development in Sub-Saharan African countries. In addition, it identifies the difference between the motivations o...
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
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 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
Tambo, Ernest; Ugwu, Chidiebere E; Guan, Yayi; Wei, Ding; Xiao-Ning; Xiao-Nong, Zhou
This review paper examines the growing implications of China's engagement in shaping innovative national initiatives against infectious diseases and poverty control and elimination in African countries. It seeks to understand the factors and enhancers that can promote mutual and innovative health development initiatives, and those that are necessary in generating reliable and quality data for evidence-based contextual policy, priorities and programs. We examined the China-Africa health cooperation in supporting global health agenda on infectious diseases such as malaria, schistosomiasis, Ebola, TB, HIV/AIDS, neglected tropical diseases (NTDs) prevention, control and elimination spanning a period of 10 years. We reviewed referenced publications, global support data, and extensive sources related to and other emerging epidemics and infectious diseases of poverty, programs and interventions, health systems development issues, challenges, opportunities and investments. Published literature in PubMed, Scopus, Google Scholar, Books and web-based peer-reviewed journal articles, government annual reports were assessed from the first Forum on China-Africa Cooperation (FOCAC) in November 2006 to December 2015 Third Ministerial conferences. Our findings highlight current shared public health challenges and emphasize the need to nurture, develop and establish effective, functional and sustainable health systems capacity to detect and respond to all public health threats and epidemic burdens, evidence-based programs and quality care outcomes. China's significant health diplomacy emphasizes the importance of health financing in establishing health development commitment and investment in improving the gains and opportunities, importantly efficiency and value health priorities and planning. Strengthening China-Africa health development agenda towards collective commitment and investment in quality care delivery, effective programs coverage and efficiency, preparedness and
Akombi, Blessing J; Agho, Kingsley E; Merom, Dafna; Renzaho, Andre M; Hall, John J
Sub-Saharan Africa has one of the highest levels of child malnutrition globally. Therefore, a critical look at the distribution of malnutrition within its sub-regions is required to identify the worst affected areas. This study provides a meta-analysis of the prevalence of malnutrition indicators (stunting, wasting and underweight) within four sub-regions of sub-Saharan Africa. Cross-sectional data from the most recent Demographic and Health Surveys (2006-2016) of 32 countries in sub-Saharan Africa were used. The countries were grouped into four sub-regions (East Africa, West Africa, Southern Africa and Central Africa), and a meta-analysis was conducted to estimate the prevalence of each malnutrition indicator within each of the sub-regions. Significant heterogeneity was detected among the various surveys (I2 >50%), hence a random effect model was used, and sensitivity analysis was performed, to examine the effects of outliers. Stunting was defined as HAZAfrica; Niger (43.9%), Mali (38.3%), Sierra Leone (37.9%) and Nigeria (36.8%) in West Africa; Democratic Republic of Congo (42.7%) and Chad (39.9%) in Central Africa. Wasting was highest in Niger (18.0%), Burkina Faso (15.50%) and Mali (12.7%) in West Africa; Comoros (11.1%) and Ethiopia (8.70%) in East Africa; Namibia (6.2%) in Southern Africa; Chad (13.0%) and Sao Tome & Principle (10.5%) in Central Africa. Underweight was highest in Burundi (28.8%) and Ethiopia (25.2%) in East Africa; Niger (36.4%), Nigeria (28.7%), Burkina Faso (25.7%), Mali (25.0%) in West Africa; and Chad (28.8%) in Central Africa. The prevalence of malnutrition was highest within countries in East Africa and West Africa compared to the WHO Millennium development goals target for 2015. Appropriate nutrition interventions need to be prioritised in East Africa and West Africa if sub-Saharan Africa is to meet the WHO global nutrition target of improving maternal, infant and young child nutrition by 2025.
Benie-Bi, J; Cambon, L; Grimaud, O; Kivits, J; Alla, F
To describe the reporting of public health research in Francophone sub-Saharan Africa (FSA). A bibliometric research study of scientific public health publications in FSA, which includes 24 countries and approximately 260 million people. Two researchers analysed original articles published in 2007 in the medical or social sciences fields and indexed in Scopus. At least one co-author of articles had to be based in FSA. The analysis focused on research field, public health function (WHO classification), FSA country author's affiliation, language, journal type and global burden of disease (WHO classification). Of 1047 articles retrieved by the search, 212 were from the public health field. The number of articles per country varied from 0 to 36. Public health functions examined were health service research (24.5%), health monitoring (27.4%), prevention (15%) and legislation (0.5%). The distribution of health needs described in the articles was close to that of the WHO data for Africa for 2004: infectious and parasitic diseases (70% vs 54%), maternal and perinatal conditions (15% vs 17%), non-communicable diseases (15.6% vs 21%), and injuries (0.5% vs 8%). The areas reported in published articles from sub-Saharan Africa reflect the health needs distribution in Africa; however, the number of publications is low, particularly for prevention. In light of the current focus on evidence-based public health, this study questions whether the international scientific community adequately considers the expertise and perspectives of African researchers and professionals. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
3 juin 2014 ... A key part of Canada's foreign policy efforts, IDRC supports research in developing countries to promote growth and development. Here are a few examples that show how IDRC-supported research in Africa has improved lives.
Deaton, Angus S; Tortora, Robert
The health of people in sub-Saharan Africa is a major global concern. However, data are weak, and little is known about how people in the region perceive their health or their health care. We used data from the Gallup World Poll in 2012 to document sub-Saharan Africans' perceived health status, their satisfaction with health care, their contact with medical professionals, and the priority they attach to health care. In comparison to other regions of the world, sub-Saharan Africa has the lowest ratings for well-being and the lowest satisfaction with health care. It also has the second-lowest perception of personal health, after only the former Soviet Union and its Eastern European satellites. HIV prevalence is positively correlated with perceived improvements in health care in countries with high prevalence. This is consistent with an improvement in at least some health care services as a result of the largely aid-funded rollout of antiretroviral treatment. Even so, sub-Saharan Africans do not prioritize health care as a matter of policy, although donors are increasingly shifting their aid efforts in the region toward health. Project HOPE—The People-to-People Health Foundation, Inc.
How did nutritional status develop in sub-Saharan Africa during the second half of the 20th century, and what role did economic development play in nutrition and health? Aggregating data from more than 200,000 women in 28 sub-Saharan African countries, we use mean height as an indicator of net nutritional status and find that the nutritional status of 1960 birth cohorts was relatively high. This situation, however, was not sustained. In almost all countries examined, mean heights were stagnating or decreasing after the 1970 cohorts. Using regression analysis we model human growth from birth to maturity, and find that economic growth had a significant and robust influence on final adult height at two distinct periods of the life cycle: (1) in the first years of life and (2) at puberty. We conclude that the economic difficulties of the late 1970s and 1980s contributed to the decline or stagnation in heights. Copyright 2009 Elsevier B.V. All rights reserved.
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]: 91,577–154,736) under-five malaria deaths were associated with consumption of poor-quality antimalarials, representing 3.75% (IQR: 2.81–4.75%) 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
Asher, Alice K; Hahn, Judith A; Couture, Marie-Claude; Maher, Kelsey; Page, Kimberly
Dramatic rises in injection drug use (IDU) in sub-Saharan Africa account for increasingly more infections in a region already overwhelmed by the HIV epidemic. There is no known estimate of the number of people who inject drugs (PWID) in the region, or the associated HIV prevalence in PWID. We reviewed literature with the goal of describing high-risk practices and exposures in PWID in sub-Saharan Africa, as well as current HIV prevention activities aimed at drug use. The literature search looked for articles related to HIV risk, injection drug users, stigma, and HIV testing in sub-Saharan Africa. This review found evidence demonstrating high rates of HIV in IDU populations in sub-Saharan Africa, high-risk behaviors of the populations, lack of knowledge regarding HIV, and low HIV testing uptake. There is an urgent need for action to address IDU in order to maintain recent decreases in the spread of HIV in sub-Saharan Africa. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
van Hulst, Marinus; Smit Sibinga, Cees Th; Postma, Maarten J
Health economics provides a standardised methodology for valid comparisons of interventions in different fields of health care. This review discusses the health economic evaluations of strategies to enhance blood product safety in sub-Saharan Africa. We reviewed health economic methodology with special reference to cost-effectiveness analysis. We searched the literature for cost-effectiveness in blood product safety in sub-Saharan Africa. HIV-antibody screening in different settings in sub-Saharan Africa showed health gains and saved costs. Except for adding HIV-p24 screening, adding other tests such as nucleic acid amplification testing (NAT) to HIV-antibody screening displayed incremental cost-effectiveness ratios greater than the WHO/World Bank specified threshold for cost-effectiveness. The addition of HIV-p24 in combination with HCV antibody/antigen screening and multiplex (HBV, HCV and HIV) NAT in pools of 24 may also be cost-effective options for Ghana. From a health economic viewpoint, HIV-antibody screening should always be implemented in sub-Saharan Africa. The addition of HIV-p24 antigen screening, in combination with HCV antibody/antigen screening and multiplex (HBV, HCV and HIV) NAT in pools of 24 may be feasible options for Ghana. Suggestions for future health economic evaluations of blood transfusion safety interventions in sub-Saharan Africa are: mis-transfusion, laboratory quality and donor management. Copyright 2009 The International Association for Biologicals. Published by Elsevier Ltd. All rights reserved.
Hsia, Renee Y; Mbembati, Naboth A; Macfarlane, Sarah; Kruk, Margaret E
The effort to increase access to emergency and surgical care in low-income countries has received global attention. While most of the literature on this issue focuses on workforce challenges, it is critical to recognize infrastructure gaps that hinder the ability of health systems to make emergency and surgical care a reality. This study reviews key barriers to the provision of emergency and surgical care in sub-Saharan Africa using aggregate data from the Service Provision Assessments and Demographic and Health Surveys of five countries: Ghana, Kenya, Rwanda, Tanzania and Uganda. For hospitals and health centres, competency was assessed in six areas: basic infrastructure, equipment, medicine storage, infection control, education and quality control. Percentage of compliant facilities in each country was calculated for each of the six areas to facilitate comparison of hospitals and health centres across the five countries. The percentage of hospitals with dependable running water and electricity ranged from 22% to 46%. In countries analysed, only 19-50% of hospitals had the ability to provide 24-hour emergency care. For storage of medication, only 18% to 41% of facilities had unexpired drugs and current inventories. Availability of supplies to control infection and safely dispose of hazardous waste was generally poor (less than 50%) across all facilities. As few as 14% of hospitals (and as high as 76%) among those surveyed had training and supervision in place. No surveyed hospital had enough infrastructure to follow minimum standards and practices that the World Health Organization has deemed essential for the provision of emergency and surgical care. The countries where these hospitals are located may be representative of other low-income countries in sub-Saharan Africa. Thus, the results suggest that increased attention to building up the infrastructure within struggling health systems is necessary for improvements in global access to medical care.
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.)
Marta M. Maffia
Full Text Available Even though in Argentina we have immigrants from Sub Saharan Africa arriving at the end of the Nineteenth Century and beginning of the Twentieth Century such as those from South Africa and Cape Verde, this new immigration from Senegal, Nigeria, Cameroon, Ghana, among other countries, during the last decade of the Twentieth Century and first decade of the Twenty-first Century appears in a different historical and political context. This new migration is facing legal regimes and increasingly restrictive administrative by-laws, framed in the growing economic globalization.This work is part of the first results of a research on this migration from an anthropological perspective. This study, which began in 2009, takes into account contributions made by history, political sciences, demography, among other disciplines, making use of articles written by African and Non-African social scientists. We are convinced that in this exchange of views our limitations may be overcome.
Brian G Williams
Full Text Available A randomized controlled trial (RCT has shown that male circumcision (MC reduces sexual transmission of HIV from women to men by 60% (32%-76%; 95% CI offering an intervention of proven efficacy for reducing the sexual spread of HIV. We explore the implications of this finding for the promotion of MC as a public health intervention to control HIV in sub-Saharan Africa.Using dynamical simulation models we consider the impact of MC on the relative prevalence of HIV in men and women and in circumcised and uncircumcised men. Using country level data on HIV prevalence and MC, we estimate the impact of increasing MC coverage on HIV incidence, HIV prevalence, and HIV-related deaths over the next ten, twenty, and thirty years in sub-Saharan Africa. Assuming that full coverage of MC is achieved over the next ten years, we consider three scenarios in which the reduction in transmission is given by the best estimate and the upper and lower 95% confidence limits of the reduction in transmission observed in the RCT. MC could avert 2.0 (1.1-3.8 million new HIV infections and 0.3 (0.1-0.5 million deaths over the next ten years in sub-Saharan Africa. In the ten years after that, it could avert a further 3.7 (1.9-7.5 million new HIV infections and 2.7 (1.5-5.3 million deaths, with about one quarter of all the incident cases prevented and the deaths averted occurring in South Africa. We show that a MC will increase the proportion of infected people who are women from about 52% to 58%; b where there is homogenous mixing but not all men are circumcised, the prevalence of infection in circumcised men is likely to be about 80% of that in uncircumcised men; c MC is equivalent to an intervention, such as a vaccine or increased condom use, that reduces transmission in both directions by 37%.This analysis is based on the result of just one RCT, but if the results of that trial are confirmed we suggest that MC could substantially reduce the burden of HIV in Africa
Full Text Available The changing demands on the health sectors in low- and middle-income countries especially sub-Saharan African countries continue to challenge efforts to address critical shortages of the health workforce. Addressing these challenges have led to the evolution of “non-physician clinicians” (NPCs, that assume some physician roles and thus mitigate the continuing shortage of doctors in these countries. While it is agreed that changes are needed in physicians’ roles and their training as part of the new continuum of care that includes NPCs, we disagree that such training should be geared solely at ensuring physicians dominated health systems. Discussions on the workforce models to suit low-income countries must avoid an endorsement of a culture of physician focused health systems as the only model for sub-Saharan Africa (SSA. It is also essential that training for NPCs be harmonized with that of physicians to clarify the technical roles of both.
Muwanika, Vincent B.; Nyakaana, Silvester; Siegismund, Hans Redlef
data that are relevant to understanding of the genetic effects of war and social strife on Africa's wildlife. Uganda was probably one of the worst affected countries. Before 1972, Uganda had large herds and a variety of mammals. However, following the breakdown of law and order, some large mammals were......The spectacular diversity of sub-Saharan Africa's large mammals was hit by constant social strife and civil war over three decades (1970s-1990s) leading to localized extinctions and drastic reductions in population sizes for many species. These localized extinctions and reduction in population...... sizes undermine the ability of species to evolve and adapt to changing environments as a result of genetic erosion. The genetic consequences of the widespread reduction of population sizes as a result of social strife in sub-Saharan Africa are not well documented. Here we review past molecular genetic...
Gray, I P; Carter, J Y
Pathology services represent the rational, scientific basis of the practice of clinical care. It does not represent deus ex machina, an implausible solution to a complex plot, but rather the way in which clinical care can be audited, controlled, guided and kept appropriate to the funds and the skills available. Arguments are presented to support this statement as well as to analyse what is wrong with health care, from the point of view of laboratory medicine, in sub-Saharan Africa. In most African countries 'first world' technology has to be imported by economies barely able to sustain the basic requirements of human life. Badly needed foreign exchange is obtained by growing export crops at the cost of traditional lifestyle, disenfranchising communities, urbanisation, and even at the cost not being able to grow food. War, corruption, lack of accountability even in the Western sense of being able to go to the polls every so often, lack of empowerment, low literacy rate etc all debase the communities, with minimal exceptions, of Africa. Health care is under the same capricious rule as all other public services: investment in laboratories is poor and most have no access to a professional laboratory at all. More investment, not less; expansion of pathology services not restricting them, is needed throughout the continent.
Tambo, Ernest; Ugwu, Chidiebere E.; Guan, Yayi; Wei, Ding; Xiao-Ning; Xiao-Nong, Zhou
Background and Introduction: This review paper examines the growing implications of China’s engagement in shaping innovative national initiatives against infectious diseases and poverty control and elimination in African countries. It seeks to understand the factors and enhancers that can promote mutual and innovative health development initiatives, and those that are necessary in generating reliable and quality data for evidence-based contextual policy, priorities and programs. Methods: We examined the China-Africa health cooperation in supporting global health agenda on infectious diseases such as malaria, schistosomiasis, Ebola, TB, HIV/AIDS, neglected tropical diseases (NTDs) prevention, control and elimination spanning a period of 10 years. We reviewed referenced publications, global support data, and extensive sources related to and other emerging epidemics and infectious diseases of poverty, programs and interventions, health systems development issues, challenges, opportunities and investments. Published literature in PubMed, Scopus, Google Scholar, Books and web-based peer-reviewed journal articles, government annual reports were assessed from the first Forum on China-Africa Cooperation (FOCAC) in November 2006 to December 2015 Third Ministerial conferences. Results: Our findings highlight current shared public health challenges and emphasize the need to nurture, develop and establish effective, functional and sustainable health systems capacity to detect and respond to all public health threats and epidemic burdens, evidence-based programs and quality care outcomes. China’s significant health diplomacy emphasizes the importance of health financing in establishing health development commitment and investment in improving the gains and opportunities, importantly efficiency and value health priorities and planning. Conclusions and Global Health Implications: Strengthening China-Africa health development agenda towards collective commitment and investment
Markus Brückner; Antonio Ciccone
To learn more about the effect of economic conditions on civil war, we examine whether Sub-Saharan civil wars are more likely to start following downturns in the international price of countries’ main export commodities. The data show a robust effect of commodity price downturns on the outbreak of civil wars. We also find that Sub-Saharan countries are more likely to see civil wars following economic downturns in their main OECD export destinations.
Full Text Available This article examines the nature of the paralysis of public governance, leadership, conflict and economic development in selected countries in sub-Saharan Africa. It argues that ineffective political leadership and conflict will serve as a lever to poor economic growth and social development. Servant leadership and democratic representation are the continuous process of development that could be accomplished through the participation of the citizens in their own development. The dynamics of development and participation at both national and grassroots levels must involve the exposure of government change agents to peace, participatory learning and action models. The article uses data derived from primary and secondary sources to analyse the problem of political conflict, peace, leadership and economic growth. The conceptual framework is based on the structural conflict theory, negative and positive peace theories, frustration-aggression theory, physiological theories, human needs theory and economic theories. The findings show that there is a negative correlation between authoritarian political leadership and economic growth in Africa. In addition, there is a positive relationship between authoritarian political leadership and conflict in several countries in Africa. The article recommends internal and external mediation and peace education mechanisms to prevent conflict from escalating or degenerating into avoidable crises. Thus, government, private sector and nongovernmental organisations should collaborate to restore justice and equality by liberating citizens from cultural, and ethnic elements that subjugate them. The nations in sub-Saharan Africa need to establish capacity-building initiatives that could help to nurture changes in behaviour, attitudes, peace and humanist paradigm, as well as offer not only the basis for self-reliance, participatory sustainable development, but also a means to peaceful shared governance and inclusive
Ahinkorah, Bright Opoku; Dickson, Kwamena Sekyi; Seidu, Abdul-Aziz
Violence against women is a common form of human rights violation, and intimate partner violence (IPV) appears to be the most significant component of violence. The aim of this study was to examine the association between women decision-making capacity and IPV among Women in Sub-Saharan Africa. The study also looked at how socio-demographic factors also influence IPV among Women in Sub-Saharan Africa. The study made use of pooled data from most recent Demographic and Health Survey (DHS) conducted from January 1, 2010, and December 3, 2016, in 18 countries in Sub-Saharan Africa. For the purpose of the study, only women aged 15-49 were used ( N = 84,486). Univariate and multivariate logistic regression models were used to investigate the relationship between the explanatory variables and the outcome variable. The odds of reporting ever experienced IPV was higher among women with decision-making capacity [AOR = 1.35; CI = 1.35-1.48]. The likelihood of experiencing IPV was low among young women. Women who belong to other religious groups and Christians were more likely to experience IPV compared to those who were Muslims [AOR = 1.73; CI = 1.65-1.82] and [AOR = 1.87; CI = 1.72-2.02] respectively. Women who have partners with no education [AOR = 1.11; CI = 1.03-1.20], those whose partners had primary education [AOR = 1.34; CI = 1.25-1.44] and those whose partners had secondary education [AOR = 1.22; CI = 1.15-1.30] were more likely to IPV compared to those whose partners had higher education. The odds of experiencing IPV were high among women who were employed compared to those who were unemployed [AOR = 1.33; CI = 1.28-1.37]. The likelihood of the occurrence of IPV was also high among women who were cohabiting compared to those who were married [AOR = 1.16; CI = 1.10-1.21]. Women with no education [AOR = 1.37; CI = 1.24-1.51], those with primary education [AOR = 1.65; CI = 1
Cheraghi, Maryam; Schøtt, Thomas; Kew, Jaqueline
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...
Mohiddin, Abdu; Johnston, Deborah
The HIV/AIDS pandemic in sub-Saharan Africa is widely recognised as a development disaster threatening poverty reduction, economic growth and not merely a health issue. Its mitigation includes the societal-wide adoption and implementation of specific health technologies, many of which depend on functional institutions and State. Donor and International Institutions' strategies to mitigate HIV/AIDS in sub-Saharan Africa are premised on a single optimal model of the State, one which focuses on the decentralised delivery of public goods alone (such as healthcare) - the service delivery state. The empirical evidence, though sparse, of "successful" and "unsuccessful" sub-Saharan Africa states' performance in mitigating HIV/AIDS does not support this model. Rather, the evidence suggests an alternative model that takes a country context specific approach - encompassing political power, institutional structures and the level of health technology needed. This model draws on the historical experience of East Asian countries' rapid development. For international public health policies to be effective, they must consider a country tailored approach, one that advocates a coordinated strategy designed and led by the State with involvement of wider society specific to each country's particular history, culture, and level of development.
Kabra, Rita; Ali, Moazzam; Kiarie, James
Strengthening contraceptive services in sub Saharan Africa is critical to achieve the FP 2020 goal of enabling 120 million more women and girls to access and use contraceptives by 2020 and the Sustainable Development Goals (SDG) targets of universal access to sexual and reproductive health (SRH) services including family planning by 2030. The World Health Organization (WHO) and partners have designed a multifaceted project to strengthen health systems to reduce the unmet need of contraceptive and family planning services in sub Saharan Africa. The plan leverages global, regional and national partnerships to facilitate and increase the use of evidence based WHO guidelines with a specific focus on postpartum family planning. The four key approaches undertaken are i) making WHO Guidelines adaptable & appropriate for country use ii) building capacity of WHO regional/country staff iii) providing technical support to countries and iv) strengthening partnerships for introduction and implementation of WHO guidelines. This paper describes the project design and elaborates the multifaceted approaches required in initial implementation to strengthen contraceptive services. The initial results from this project reflect that simultaneous application these approaches may strengthen contraceptive services in Sub Saharan Africa and ensure sustainability of the efforts. The lessons learned may be used to scale up and expand services in other countries.
Full Text Available Abstract Background The HIV/AIDS pandemic in sub-Saharan Africa is widely recognised as a development disaster threatening poverty reduction, economic growth and not merely a health issue. Its mitigation includes the societal-wide adoption and implementation of specific health technologies, many of which depend on functional institutions and State. Discussion Donor and International Institutions' strategies to mitigate HIV/AIDS in sub-Saharan Africa are premised on a single optimal model of the State, one which focuses on the decentralised delivery of public goods alone (such as healthcare – the service delivery state. The empirical evidence, though sparse, of "successful" and "unsuccessful" sub-Saharan Africa states' performance in mitigating HIV/AIDS does not support this model. Rather, the evidence suggests an alternative model that takes a country context specific approach – encompassing political power, institutional structures and the level of health technology needed. This model draws on the historical experience of East Asian countries' rapid development. Summary For international public health policies to be effective, they must consider a country tailored approach, one that advocates a coordinated strategy designed and led by the State with involvement of wider society specific to each country's particular history, culture, and level of development.
Georgios K. Bountagkidis
Full Text Available The EU and most aid donors invoke a strong normative power face by explicitly connecting foreign aid with human and social development. However, how well the EU’s rhetoric is consistent with its practices as a multilateral development actor has not been explored extensively. In this study, we challenge the normative dimension of the EU’s development policy and explore whether the EU’s Official Development Assistance to Sub-Saharan Africa is based on objective deprivation on the part of recipient countries or whether it is “interest driven”. We use a least squares dummy variable model regression to examine aid flows from the EU to all 48 Sub-Saharan African states for the period 2000 to 2010. The evidence found indicates that in certain instances, aid allocation contradicts the normative rhetoric that the EU uses to describe its development policy, as the donor’s own interests in the region seem to supersede priority given to the needs of the aid recipient states. A limitation to the findings is the fact that normative values and strategic interests are not mutually exclusive. Nevertheless, the present study suggests that the EU’s portrayal as a force for good in international relations requires cautious critique.
Mac-Seing, Muriel; Zarowsky, Christina
Reproductive health remains a major global health issue. People with disabilities face additional discrimination and barriers to access which need to be better understood. To contribute to future interventions, we examined the intersections between gender and disability related to reproductive health in sub-Saharan Africa in the qualitative literature. We conducted a meta-synthesis, using a taxonomic analysis. An inductive and iterative approach was adopted to allow exploration of new and emergent semantic variations in themes. NVivo 11 Plus was used to code themes. Ten qualitative studies from six sub-Saharan African countries were analysed. Two main thematic areas emerged from the analysis: 1) gendered roles of people with disabilities are programmed by sociocultural normativity, including perceptions about sexuality. They are exacerbated by the hegemony of ableism and influenced by the type of reproductive health issues experienced by people with disabilities; and 2) experiences of disability in interaction with a reproductive health issue are exacerbated by the type of disability, influenced by the type of barriers to access, and perceived differently depending upon the actors involved. The intersections between gender and disability embodied by people with disabilities are multiple and complex. Not only do imposed gendered roles influence the lives of people with disabilities, but their experiences of disability are also intricately linked to gender. An intersectional analysis is proposed as a useful support to developing future perspectives.
Olaniran, Abimbola A
Female genital mutilation (FGM) is an age-old practice that has since been linked with many health problems. This review aims to highlight some of the controversies trailing the relationship between FGM and HIV transmission in sub-Saharan Africa. A literature search was conducted on the subject matter. This was done using articles published in English while limiting the geographical coverage to sub-Saharan Africa. Three themes were noted. These themes include: Direct causal link between FGM and HIV transmission; indirect causal link between FGM and HIV transmission and a negative or no association between FGM and HIV transmission. While many of the arguments are within scientific reasoning, the researches supporting the views seem to lack the necessary objectivity. This study underscored the need for a more objective lens in viewing and conducting research on the relationship between FGM and HIV transmission in sub-Saharan Africa.
Sasipriya M Karumanchi
Full Text Available To begin to meet the need for cataract surgery in sub-Saharan Africa, the cataract surgical rate (CSR should be at least 2,000 to 3,000; i.e. there should be 2,000-3,000 cataract operations per million population, per year. The current levels are below 1,000 (and often much lower. Sub-Saharan Africa poses a unique set of challenges: low population density; inadequate transportation systems that inhibit access; big differences in wealth; and a shortage of eye care resources (which are usually concentrated in larger cities. Additional issues relate to productivity, the supply chain and the quality of outcomes, all of which contribute to the low cataract surgical rates. It is in this context that the Hilton Foundation sought to enhance cataract surgical services in sub-Saharan Africa, through the Hilton Cataract Initiative.
Burke, Marshall; Heft-Neal, Sam; Bendavid, Eran
Detailed spatial understanding of levels and trends in under-5 mortality is needed to improve the targeting of interventions to the areas of highest need, and to understand the sources of variation in mortality. To improve this understanding, we analysed local-level information on child mortality across sub-Saharan Africa between 1980-2010. We used data from 82 Demographic and Health Surveys in 28 sub-Saharan African countries, including the location and timing of 3·24 million childbirths and 393 685 deaths, to develop high-resolution spatial maps of under-5 mortality in the 1980s, 1990s, and 2000s. These estimates were at a resolution of 0·1 degree latitude by 0·1 degree longitude (roughly 10 km × 10 km). We then analysed this spatial information to distinguish within-country versus between-country sources of variation in mortality, to examine the extent to which declines in mortality have been accompanied by convergence in the distribution of mortality, and to study localised drivers of mortality differences, including temperature, malaria burden, and conflict. In our sample of sub-Saharan African countries from the 1980s to the 2000s, within-country differences in under-5 mortality accounted for 74-78% of overall variation in under-5 mortality across space and over time. Mortality differed significantly across only 8-15% of country borders, supporting the role of local, rather than national, factors in driving mortality patterns. We found that by the end of the study period, 23% of the eligible children in the study countries continue to live in mortality hotspots-areas where, if current trends continue, the Sustainable Developent Goals mortality targets will not be met. In multivariate analysis, within-country mortality levels at each pixel were significantly related to local temperature, malaria burden, and recent history of conflict. Our findings suggest that sub-national determinants explain a greater portion of under-5 mortality than do country
Full Text Available Holly Taggart,1 Sheila Greatrex-White,2 1Mental Health Commission, CentreForum, Westminster, UK; 2School of Health Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK Aim: To identify relevant and pertinent themes and interventions within the literature relating to childhood traumatic grief, in order to provide a sound background of evidence for further research and service development. Background: Childhood traumatic grief is caused when a significant person in a child's life dies under circumstances that they perceive to be traumatic. This can leave a child unable to return to the same level of physical and emotional functioning that he or she had prior to the death occurring. In Sub-Saharan Africa, there is an increased risk for childhood traumatic grief due to a high prevalence of orphanhood, environmental stressors, stigma, and abuse. This can have detrimental effects upon mental health. Methods: The review followed the York methodology: identifying the purpose and agreeing on the strategy beforehand; identifying relevant sources/studies; selecting the studies; charting the data; and collating, summarizing, and reporting results. Results and discussion: Interventions identified to prevent and/or manage traumatic grief included narrative exposure therapy, psychotherapy, mentoring, peer-group support, psychosocial support, a grief and loss therapy session, and memory boxes. Mental health remains neglected within service and policy development as well as in global health spending. The average amount expended on mental health services per person per year in low-income countries is less than $0.25. Only 36% of people in low income countries are covered by a mental health policy, compared with 92% in high income countries. Limitations: The sixth stage of the York methodology was omitted. Only papers written in English were included in the review. Conclusion: Childhood traumatic grief in young people is an important issue
Okoye, Mekam T; Nguyen, Evelyn T; Kushner, Adam L; Ameh, Emmanuel A; Nwomeh, Benedict C
The relationship between economic status and pediatric surgical capacity in low- and middle-income countries (LMICs) is poorly understood. In sub-Saharan Africa (SSA), Nigeria accounts for 20 % of the population and has the highest Gross Domestic Product (GDP), but whether this economic advantage translates to increased pediatric surgical capacity is unknown. This study compares the pediatric surgical capacity between Nigeria and other countries within the region. The Pediatric Personnel, Infrastructure, Procedures, Equipment and Supplies (PediPIPES) survey, a recent tool that is useful in assessing and comparing the capacity of health facilities to deliver essential and emergency surgical care (EESC) to children in LMICs, was used for this evaluation. Data from hospitals in Nigeria (n = 24) and hospitals in 17 other sub-Saharan African countries (n = 25) were compared. The GDP of Nigeria was approximately twenty-five times the average GDP of the 17 other countries represented in our survey. Running water was unavailable in 58 % of the hospitals in Nigeria compared to 20 % of the hospitals in the other countries. Most hospitals in Nigeria and in the other countries did not have a CT scan (67 and 60 %, respectively). Endoscopes were unavailable in 58 % of the hospitals in Nigeria and 44 % of the hospitals in the other countries. Despite better economic indicators in Nigeria, there were no distinct advantages over the other countries in the ability to deliver EESC to children. Our findings highlighted the urgent need for specific allocation of more resources to pediatric surgical capacity building efforts across the entire region.
Frankema, Ewout; Bolt, Jutta
Cross-country research on educational inequality presents contrasting views on the extent of educational inequality in Latin America and Sub-Saharan Africa. The differences in opinion also concern the relation between educational inequality and income inequality. This paper argues that part of the reported results are influenced by the type of inequality indicator applied. Moreover, there may be a separate effect of educational attainment and educational distribution on income inequality, whi...
At a time when global relations are characterised by great complexity, uncertainty and inequality, the role of higher education is crucial for a balanced and coherent development strategy, and achievement of the Sustainable Development Goals (SDGs). This is especially true for countries of sub-Saharan Africa, where there is a critical need to generate knowledge that can be used in the service of social and economic development, human rights and climate change adaptation. The study concern...
Abdalla, Fayrouz Mohammed; Omar, Mayeh Abu
Around 1.2 million children living in Sub-Saharan Africa have a hearing impairment (HI) or hearing loss (HL). Limited attention and scarce resources dedicated to this condition means that such children often receive no management for their problem. This has substantial negative effects on their development, and ultimately results in poverty. Half of the number of cases of HI in such countries results from preventable causes. Formulation of effective prevention strategies to address the causes...
Harries, A D; Jensen, P M; Zachariah, R; Rusen, I D; Enarson, D A
Weak and dysfunctional health systems in low-income countries, particularly in sub-Saharan Africa, are recognised as major obstacles to attaining the health-related Millennium Development Goals by 2015. Some progress is being made towards achieving the targets of Millennium Development Goal 6 for tuberculosis (TB), HIV/AIDS and malaria, with the achievements largely resulting from clearly defined strategies and intervention delivery systems combined with large amounts of external funding. Thi...
Rachel Peletz; Emily Kumpel; Mateyo Bonham; Zarah Rahman; Ranjiv Khush
Water quality information is important for guiding water safety management and preventing water-related diseases. To assess the current status of regulated water quality monitoring in sub-Saharan Africa, we evaluated testing programs for fecal contamination in 72 institutions (water suppliers and public health agencies) across 10 countries. Data were collected through written surveys, in-person interviews, and analysis of microbial water quality testing levels. Though most institutions did no...
Teplitz Sembitzky, W.
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
Head, Michael G; Goss, Sian; Gelister, Yann; Alegana, Victor; Brown, Rebecca J; Clarke, Stuart C; Fitchett, Joseph R A; Atun, Rifat; Scott, J Anthony G; Newell, Marie-Louise; Padmadas, Sabu S; Tatem, Andrew J
Total domestic and international funding for malaria is inadequate to achieve WHO global targets in burden reduction by 2030. We describe the trends of investments in malaria-related research in sub-Saharan Africa and compare investment with national disease burden to identify areas of funding strength and potentially neglected populations. We also considered funding for malaria control. Research funding data related to malaria for 1997-2013 were sourced from existing datasets, from 13 major public and philanthropic global health funders, and from funding databases. Investments (reported in US$) were considered by geographical area and compared with data on parasite prevalence and populations at risk in sub-Saharan Africa. 45 sub-Saharan African countries were ranked by amount of research funding received. We found 333 research awards totalling US$814·4 million. Public health research covered $308·1 million (37·8%) and clinical trials covered $275·2 million (33·8%). Tanzania ($107·8 million [13·2%]), Uganda ($97·9 million [12·0%]), and Kenya ($92·9 million [11·4%]) received the highest sum of research investment and the most research awards. Malawi, Tanzania, and Uganda remained highly ranked after adjusting for national gross domestic product. Countries with a reasonably high malaria burden that received little research investment or funding for malaria control included Central African Republic (ranked 40th) and Sierra Leone (ranked 35th). Congo (Brazzaville) and Guinea had reasonably high malaria mortality, yet Congo (Brazzaville) ranked 38th and Guinea ranked 25th, thus receiving little investment. Some countries receive reasonably large investments in malaria-related research (Tanzania, Kenya, Uganda), whereas others receive little or no investments (Sierra Leone, Central African Republic). Research investments are typically highest in countries where funding for malaria control is also high. Investment strategies should consider more equitable
Kuada, John Ernest
Private Enterprise-Led Development in Sub-Saharan Africa provides a novel theoretical and conceptual model to guide research into Africa's economic development. It endorses the view that private enterprise-led growth will help reduce poverty since it strengthens individuals' capacity to care...
Austin, G.; Frankema, E.H.P.; Jerven, M.
This paper reviews the 'long twentieth-century' development of 'modern' manufacturing in Sub-Saharan Africa from colonization to the present. We argue that classifying Africa generically as a 'late industrializer' is inaccurate. To understand the distinctively African pattern of manufacturing
Austin, G.; Frankema, E.H.P.; Jerven, M.
This paper reviews the ‘long twentieth-century’ development of ‘modern’manufacturing in Sub-Saharan Africa from colonization to the present. We argue thatclassifying Africa generically as a ‘late industrializer’ is inaccurate. To understand thedistinctively African pattern of manufacturing growth,
Nielsen, Ulrik B.
In the past decade, Africa has developed from being an extremely impoverished continent with discouraging prospects to a more promising destination and home to some of the fastest growing Frontier Market economies. Approximately 75% of Africans rely on agriculture for their livelihoods, making...... to create growth opportunities in Frontier Markets of Sub-Saharan Africa....
Moock, Joyce Lewinger
Focuses on the impact of overseas training on national development objectives in Sub-Saharan Africa. Reviews the current economic crisis in Africa and the need for high-level, skilled workers. Examines the advantages and disadvantages of foreign study as a means of developing competent indigenous professionals. Notes pertinent research issues. (SB)
Ngimwa, Pauline; Wilson, Tina
In the past few years, Africa has joined the rest of the world as an active participant in the Open Educational Resource (OER) movement with a number of home-grown and externally driven initiatives. These have the potential to make an immense contribution to teaching and learning in Sub-Saharan Africa (SSA). However, certain barriers prevent full…
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¢Â€Â™s population. The health workforce is the backbone of each health system, the lubricant that facilitates the smooth implementation of health action for sustainable socio-economic development. It has been proved beyond reasonable doubt that the density of the health workforce is directly correlated with positive health outcomes. In other words, health workers save lives and improve health. About 59 million people make up the health workforce of paid full-time health workers world-wide. However, enormous gaps remain between the potential of health systems and their actual performance, and there are far too many inequities in the distribution of health workers between countries and within countries. The Americas (mainly USA and Canada are home to 14% of the worldÃ¢Â€Â™s population, bear only 10% of the worldÃ¢Â€Â™s disease burden, have 37% of the global health workforce and spend about 50% of the worldÃ¢Â€Â™s financial resources for health. Conversely, sub-Saharan Africa, with about 11% of the worldÃ¢Â€Â™s population bears over 24% of the global disease burden, is home to only 3% of the global health workforce, and spends less than 1% of the worldÃ¢Â€Â™s financial resources on health. In most developing countries, the health workforce is concentrated in the major towns and cities, while rural areas can only boast of about 23% and 38% of the countryÃ¢Â€Â™s doctors and nurses respectively. The imbalances exist not only in the total numbers and geographical distribution of health workers, but also in the skills mix of available health workers. WHO estimates that 57 countries world wide have a critical shortage of health workers, equivalent to a global deficit of about 2
Yakubu, Ibrahim; Salisu, Waliu Jawula
Adolescent pregnancy has been persistently high in sub-Saharan Africa. The objective of this review is to identify factors influencing adolescent pregnancies in sub-Saharan Africa in order to design appropriate intervention program. A search in MEDLINE, Scopus, Web of science, and Google Scholar databases with the following keywords: determinants, factors, reasons, sociocultural factors, adolescent pregnancy, unintended pregnancies, and sub- Saharan Africa. Qualitative and cross-sectional studies intended to assess factors influencing adolescent pregnancies as the primary outcome variable in sub- Saharan Africa were included. Our search was limited to, articles published from the year 2000 to 2017 in English. Twenty-four (24) original articles met the inclusion criteria. The study identified Sociocultural, environmental and Economic factors (Peer influence, unwanted sexual advances from adult males, coercive sexual relations, unequal gender power relations, poverty, religion, early marriage, lack of parental counseling and guidance, parental neglect, absence of affordable or free education, lack of comprehensive sexuality education, non-use of contraceptives, male's responsibility to buy condoms, early sexual debut and inappropriate forms of recreation). Individual factors (excessive use of alcohol, substance abuse, educational status, low self-esteem, and inability to resist sexual temptation, curiosity, and cell phone usage). Health service-related factors (cost of contraceptives, Inadequate and unskilled health workers, long waiting time and lack of privacy at clinics, lack of comprehensive sexuality education, misconceptions about contraceptives, and non-friendly adolescent reproductive services,) as influencing adolescent pregnancies in Sub-Saharan Africa CONCLUSION: High levels of adolescent pregnancies in Sub-Saharan Africa is attributable to multiple factors. Our study, however, categorized these factors into three major themes; sociocultural and economic
Verna D.N.K. Vanderpuye
Full Text Available Purpose: To understand the current state of breast cancer management in sub-Saharan Africa. Methods: We conducted an anonymous online survey of breast cancer management among African Organization for Research and Treatment in Cancer (AORTIC members by using a 42-question structured questionnaire in both English and French in 2013. Results: Twenty members from 19 facilities in 14 countries responded to the survey. Twelve members (60% belonged to a multidisciplinary breast cancer team. Radiotherapy equipment was available in seven facilities (36%, but equipment had down time at least once a week in four facilities. Available chemotherapy drugs included methotrexate, cyclophosphamide, fluorouracil, anthracyclines, and vincristine, whereas trastuzumab, taxanes, vinorelbine, and gemcitabine were available in few facilities. Core-needle biopsy was available in 16 facilities (84%; mammogram, in 17 facilities (89%; computed tomography scan, in 15 facilities (79%; magnetic resonance imaging, in 11 facilities (58%; and bone scans, in nine facilities (47%. It took an average of 1 to 3 weeks to report histopathology. Immunohistochemistry was available locally in eight facilities (42%, outside hospitals but within the country in seven facilities (37%, and outside the country in four facilities (21%. Thirteen facilities (68% performed axillary node dissections as part of a breast protocol. Neoadjuvant chemotherapy was the most common therapy for locally advanced breast cancer in 13 facilities (68%. In three facilities (16%, receptor status did not influence the prescription of hormone treatment. Conclusion: This pilot survey suggests that AORTIC members in sub-Saharan Africa continue to make gains in the provision of access to multidisciplinary breast cancer care, but the lack of adequate pathology and radiotherapy services is a barrier. Focused attention on in-country and regional training needs and improvement of health systems deliverables is urgently
McGann, Patrick T; Tshilolo, Léon; Santos, Brigida; Tomlinson, George A; Stuber, Susan; Latham, Teresa; Aygun, Banu; Obaro, Stephen K; Olupot-Olupot, Peter; Williams, Thomas N; Odame, Isaac; Ware, Russell E
Sickle cell anemia (SCA) is an inherited hematological disorder that causes a large but neglected global health burden, particularly in Africa. Hydroxyurea represents the only available disease-modifying therapy for SCA, and has proven safety and efficacy in high-resource countries. In sub-Saharan Africa, there is minimal use of hydroxyurea, due to lack of data, absence of evidence-based guidelines, and inexperience among healthcare providers. A partnership was established between investigators in North America and sub-Saharan Africa, to develop a prospective multicenter research protocol designed to provide data on the safety, feasibility, and benefits of hydroxyurea for children with SCA. The Realizing Effectiveness Across Continents with Hydroxyurea (REACH, ClinicalTrials.gov NCT01966731) trial is a prospective, phase I/II open-label dose escalation study of hydroxyurea that will treat a total of 600 children age 1-10 years with SCA: 150 at each of four different clinical sites within sub-Saharan Africa (Angola, Democratic Republic of Congo, Kenya, and Uganda). The primary study endpoint will be severe hematological toxicities that occur during the fixed-dose treatment phase. REACH has an adaptive statistical design that allows for careful assessment of toxicities to accurately identify a safe hydroxyurea dose. REACH will provide data that address critical gaps in knowledge for the treatment of SCA in sub-Saharan Africa. By developing local expertise with the use of hydroxyurea and helping to establish treatment guidelines, the REACH trial results will have the potential to transform care for children with SCA in Africa. © 2015 The Authors. Pediatric Blood & Cancer Published by Wiley Periodicals, Inc.
The skill set of a plastic surgeon, which addresses a broad range of soft tissue conditions that are prevalent in sub-Saharan Africa, remains relevant in the unmet need for surgical care. Recently, there has being a major paradigm shift from discipline-based to disease-based care, resulting in an emerging component of patient-centered care; adequate access to subspecialty care in plastic and reconstructive surgery. Given the need for an evolution in sub-specialization, this article focuses on the benefits and future role of differentiation of plastic surgeons into sub-specialty training pathways in sub-Saharan Africa. PMID:25584125
In 1950, 28% of the world¿s population lived in cities. At that point, localities larger than 10,000 inhabitants were home to 0.7 billion people, of whom 36% were in developing countries. However, according to UN projections, the rate of urbanization will reach 47.4% in 2000, with cities housing 2.9 billion people, of whom 68.7% will be in developing countries. Africa, like other continents, is urbanizing. Although Africa is among the world¿s least urbanized regions, it is nonetheless the continent with the highest rate of urbanization. Urban population growth reached its height during the 1950s, then the urban population in the region multiplied by a factor of 10 during 1950-90, far outpacing the rate of overall population growth on the continent. However, during the 1980s and 1990s, urban growth in Africa declined sharply. The author discusses urbanization in Africa devoid of industrialization, declining rates of urban population growth in the region, the uncertain future of urbanization in Africa, and how future urbanization in Africa depends upon the role the continent will play in the global economy.
Gupta, Somya; Granich, Reuben
The World Health Organization (WHO) HIV treatment guidelines have been used by various countries to revise their national guidelines. Our study discusses the national policy response to the HIV epidemic in sub-Saharan Africa and quantifies delays in adopting the WHO guidelines published in 2009, 2013 and 2015. From the Internet, health authorities and experts, and community members, we collected 59 published HIV guidelines from 33 countries in the sub-Saharan African region, and abstracted dates of publication and antiretroviral therapy (ART) eligibility criteria. For these 33 countries, representing 97% regional HIV burden in 2015, the number of months taken to adopt the WHO 2009, 2013 and/or 2015 guidelines were calculated to determine the average delay in months needed to publish revised national guidelines. Of the 33 countries, 3 (6% regional burden) are recommending ART according to the WHO 2015 guidelines (irrespective of CD4 count); 19 (65% regional burden) are recommending ART according to the WHO 2013 guidelines (CD4 count ≤ 500 cells/mm 3 ); and 11 (26% regional burden) according to the WHO 2009 guidelines (CD4 count ≤ 350 cells/mm 3 ). The average time lag to WHO 2009 guidelines adoption in 33 countries was 24 (range 3-56) months. The 22 that have adopted the WHO 2013 guidelines took an average of 10 (range 0-36) months, whilst the three countries that adopted the WHO 2015 guidelines took an average of 8 (range 7-9) months. There is an urgent need to shorten the time lag in adopting and implementing the new WHO guidelines recommending 'treatment for all' to achieve the 90-90-90 targets.
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
Phillips, Sharon J; Mbizvo, Michael T
The need to prevent early pregnancy and HIV among adolescent girls in Sub-Saharan Africa has been recognized increasingly over recent years. Although extensive work has been done to determine appropriate interventions for girls in high-income countries, very little evidence is available to guide programmatic interventions in Sub-Saharan Africa. The available evidence has been equivocal regarding improved outcomes. While knowledge and self-reported behaviors frequently change with interventions, including those performed at the community level, educational programs, and direct contraceptive provision, downstream outcomes rarely reflect a significant effect of the interventions; however, provision of financial or other interventions to incentivize continued school enrollment are a promising development. We suggest directions for future research to fill this critical gap in the literature. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Jun 3, 2014 ... Here are a few examples that show how IDRC-supported research in Africa has improved lives. ... Lasting Impacts. A key part of Canada's foreign policy efforts, IDRC supports research in developing countries to promote growth and development. Here are a ... Cellphones are improving agriculture in Kenya.
Africa has many electricity supply problems with major causes being natural causes (drought), oil price shock, system disruption by conflict, and low investment in electricity generation. To solve the problem, many countries adopted several reforms. However, the reforms failed to bring solutions. Electricity sector privatisation ...
However, unlike other developing countries in Asia, the level of agricultural mechanization in Sub-‐Sahara Africa is still very low and is faced with a number of constraints. It is important for the attention of governments and other institutions to be drawn to these for immediate intervention to be taken. The objective of this ...
The author examines the history of Lebanese migration to western Africa. Aspects considered include changes in countries of origin and destination, Africanization policies, wars in Lebanon, independence movements, economic status of migrants, temporary and return migration, and the brain drain. (SUMMARY IN ENG AND SPA)