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.
(Meade and l'iot, 1993). Such ﬁndings which were carried out at different settings of develop' ing countries including Sub-Saharan Africa, appear conflicting and need to be reconciled through a sub-regional survey. Touching on the preventive mechanisms, especially the use of condoms, the educated are more likely to ...
DEVELOPING COUNTRIES: CASE STUDY OF CHINA AND. SUB-SAHARAN AFRICA (SSA). Andzio-Bika Herve Lezin Wilfrid and Kamitewoko Edwige. Abstract. This paper analyzed the inﬂuence of agriculture in GDP of China and three SSA countries. Data used for the study was drawn from the Food and Agriculture ...
Sub-Saharan Africa. Inbound tourism movement has emerged as an important factor in the preva- lence of the disease, after education. Defects of quality of data would not be far fetched, given the lack of logistics and financial resources of most governments for the exercise, possible political manipulations and ideological ...
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 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...
.... 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...
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...
Full Text Available Introduction: Antiretrovirals are available at low prices in sub-Saharan Africa, but these prices may not be consistently available for middle-income countries in other regions with large HIV epidemics. Over 30% of HIV infected people live in countries outside sub-Saharan Africa. Several key antiretrovirals are still on patent, with generic production restricted. We assessed price variations for key antiretroviral drugs inside versus outside sub-Saharan Africa. Methods: HIV drug prices used in national programmes (2010–2014 were extracted from the WHO Global Price Reporting Mechanism database for all reporting middle-income countries as classified by the World Bank. Treatment costs (branded and generic were compared for countries inside sub-Saharan Africa versus those outside. Five key second-line antiretrovirals were analysed: abacavir, atazanavir, darunavir, lopinavir/ritonavir, raltegravir. Results: Prices of branded antiretrovirals were significantly higher outside sub-Saharan Africa (p<0.001, adjusted for year of purchase (see Table 1. For example, the median (interquartile range price of darunavir from Janssen was $732 (IQR $732-806 per person-year in sub-Saharan Africa versus $4689 (IQR $4075-5717 in non-African middle-income countries, an increase of 541%. However, when supplied by generic companies, most antiretrovirals were similarly priced between countries in sub-Saharan Africa and other regions. Conclusions: Pharmaceutical companies are selling antiretrovirals to non-African middle-income countries at prices 74–541% higher than African countries with similar gross national incomes. However, generic companies are selling most of these drugs at similar prices across regions. Mechanisms to ensure fair pricing for patented antiretrovirals across both African and non-African middle-income countries need to be improved, to ensure sustainable treatment access.
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.
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...
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?.
Full Text Available This paper argues that Sub-Saharan Africa needs to produce more journals indexed by ISI Web of Science (WoS. Researchers from the region should also publish in other ISI indexed, reputable and high impact journals such as Nature and Science. Inevitably, this will make Sub-Saharan African researchers visible and globally competitive. The Sub- Saharan African region has only about 40 journals out of over 12 000 journals that have been indexed by the ISI Web of Science (WoS. Arguably, ranking of universities across the globe and qualification for Nobel Prizes are determined by metrics-based evaluation of research performance. Sub-Saharan Africa is poorly represented on the world university rankings. The region has also produced only six Nobel Prize award winners from 1901 to 2010. In the same period, USA, UK and Germany produced 326, 116 and 102 recipients respectively. While there are some limitations on the use of citation indicators to evaluate research output, this researcher argues that citation impact indicators of research performance provide policymakers, researchers and funding agencies with an objective measure for assessing research performance and therefore are of great significance in the developing countries of Sub-Saharan Africa.
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.
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 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.
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.
Full Text Available Background: More than 60 years ago the international community declared literacy a basic human right. Recognition of its intrinsic value and evidence of its social and economic benefits have motivated an expansive international effort to estimate the percentage of adults that can read, especially in low-income countries where educational opportunities are limited. Population data on adults' educational attainment is commonly used to approximate adult literacy rates. Though increasing evidence from school-based studies of pupils confirm literacy achievement is not universal - even at advanced grades - it remains unclear whether adults' educational attainment is reflective of their literacy. Objective: This study leverages population-based data that include direct assessments of adults' literacy skills to provide a descriptive account of the proportion of adults that can read at each level of educational attainment. The study focuses on the Sub-Saharan African context, a world region where school participation has expanded rapidly in the last three decades. Because many African adults have discontinued their education at the primary level, the study focuses on basic reading skills at each level of primary school. The study focuses specifically on women, whose literacy has garnered extensive international interest. Results: Demographic and Health Survey data from 31 African countries confirm that there are many instances in which women have several years of primary school but cannot read. In fact, in some countries, large proportions of African women who never went to school can read, even as some of their peers who have completed primary school cannot. The weak correlation between educational attainment and literacy is not specific to older cohorts of women, but is also observed among younger women. Conclusions: The findings demonstrate that educational attainment is generally a poor proxy for literacy, highlighting the need to measure, theorize
More than 60 years ago the international community declared literacy a basic human right. Recognition of its intrinsic value and evidence of its social and economic benefits have motivated an expansive international effort to estimate the percentage of adults that can read, especially in low-income countries where educational opportunities are limited. Population data on adults' educational attainment is commonly used to approximate adult literacy rates. Though increasing evidence from school-based studies of pupils confirm literacy achievement is not universal - even at advanced grades - it remains unclear whether adults' educational attainment is reflective of their literacy. This study leverages population-based data that include direct assessments of adults' literacy skills to provide a descriptive account of the proportion of adults that can read at each level of educational attainment. The study focuses on the Sub-Saharan African context, a world region where school participation has expanded rapidly in the last three decades. Because many African adults have discontinued their education at the primary level, the study focuses on basic reading skills at each level of primary school. The study focuses specifically on women, whose literacy has garnered extensive international interest. Demographic and Health Survey data from 31 African countries confirm that there are many instances in which women have several years of primary school but cannot read. In fact, in some countries, large proportions of African women who never went to school can read, even as some of their peers who have completed primary school cannot. The weak correlation between educational attainment and literacy is not specific to older cohorts of women, but is also observed among younger women. The findings demonstrate that educational attainment is generally a poor proxy for literacy, highlighting the need to measure, theorize, and study literacy as empirically distinct from education.
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.
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.
Victor Ombati; Ombati Mokua
This paper examines the issue of gender inequality in education in sub-Saharan Africa. It argues that in sub-Saharan African countries, the provision of education for boys and girls is uneven, and biased through gender, location, class and region- resulting to high illiteracy rates for girls and women. The paper concludes that political instability and violence, poverty and economical challenges, negative cultural values, female genital mutilation, early marriage, and sexual harassment are so...
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
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
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
Briefly describe your organization, its vision and mission, its interest in STI issues, and its interest in forging long-term relationships with Science Granting Councils in Sub-Saharan Africa (SSA).1 Which regions (Eastern, Southern, Central or West Africa) and countries has your organization worked in? 1 The Initiative is keen ...
Sep 4, 2007 ... In this review article, the issues related to provision of psychotropic drugs in services in sub-Saharan Africa are explored. Problems encountered in procurement of drugs, their safe prescription and practical supply systems are discussed, with possible solutions suggested. The evidence-base for the ...
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.
Full Text Available With the proposal to search for universal cooperation in the field of Medicinal Chemistry, the IUPAC group has elaborated a line of work divided into two phases: a- An Awareness of the true situation of Medicinal Chemistry in the different geographic areas of the world; b- A proposal of actions as to achieve more effective cooperation. This first report presents and discusses the actual situation in South and Central America as well as in sub-Saharan Africa.
Henderson, J. Vernon; Roberts, Mark; Storeygard, Adam
In the past dozen years, a literature has developed arguing that urbanization has unfolded differently in post-independence Sub-Saharan Africa than in the rest of the developing world, with implications for African economic growth overall. While African countries are more urbanized than other countries at comparable levels of income, it is well-recognized that total and sector gross domest...
.... 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...
Abiola Fatimah Adenowo
Full Text Available Schistosomiasis, a neglected tropical disease of poverty ranks second among the most widespread parasitic disease in various nations in sub-Saharan Africa. Neglected tropical diseases are causes of about 534,000 deaths annually in sub-Saharan Africa and an estimated 57 million disability-adjusted life-years are lost annually due to the neglected tropical diseases. The neglected tropical diseases exert great health, social and ﬁnancial burden on economies of households and governments. Schistosomiasis has profound negative effects on child development, outcome of pregnancy, and agricultural productivity, thus a key reason why the "bottom 500 million" inhabitants of sub-Saharan Africa continue to live in poverty. In 2008, 17.5 million people were treated globally for schistosomiasis, 11.7 million of those treated were from sub-Saharan Africa. This enervating disease has been successfully eradicated in Japan, as well as in Tunisia. Morocco and some Caribbean Island countries have made signiﬁcant progress on control and management of this disease. Brazil, China and Egypt are taking steps towards elimination of the disease, while most sub-Saharan countries are still groaning under the burden of the disease. Various factors are responsible for the continuous and persistent transmission of schistosomiasis in sub-Saharan Africa. These include climatic changes and global warming, proximity to water bodies, irrigation and dam construction as well as socio-economic factors such as occupational activities and poverty. The morbidity and mortality caused by this disease cannot be overemphasized. This review is an exposition of human schistosomiasis as it affects the inhabitants of various communities in sub-Sahara African countries. It is hoped this will bring a re-awakening towards efforts to combat this impoverishing disease in terms of vaccines development, alternative drug design, as well as new point-of-care diagnostics.
Adenowo, Abiola Fatimah; Oyinloye, Babatunji Emmanuel; Ogunyinka, Bolajoko Idiat; Kappo, Abidemi Paul
Schistosomiasis, a neglected tropical disease of poverty ranks second among the most widespread parasitic disease in various nations in sub-Saharan Africa. Neglected tropical diseases are causes of about 534,000 deaths annually in sub-Saharan Africa and an estimated 57 million disability-adjusted life-years are lost annually due to the neglected tropical diseases. The neglected tropical diseases exert great health, social and financial burden on economies of households and governments. Schistosomiasis has profound negative effects on child development, outcome of pregnancy, and agricultural productivity, thus a key reason why the "bottom 500 million" inhabitants of sub-Saharan Africa continue to live in poverty. In 2008, 17.5 million people were treated globally for schistosomiasis, 11.7 million of those treated were from sub-Saharan Africa. This enervating disease has been successfully eradicated in Japan, as well as in Tunisia. Morocco and some Caribbean Island countries have made significant progress on control and management of this disease. Brazil, China and Egypt are taking steps towards elimination of the disease, while most sub-Saharan countries are still groaning under the burden of the disease. Various factors are responsible for the continuous and persistent transmission of schistosomiasis in sub-Saharan Africa. These include climatic changes and global warming, proximity to water bodies, irrigation and dam construction as well as socio-economic factors such as occupational activities and poverty. The morbidity and mortality caused by this disease cannot be overemphasized. This review is an exposition of human schistosomiasis as it affects the inhabitants of various communities in sub-Sahara African countries. It is hoped this will bring a re-awakening towards efforts to combat this impoverishing disease in terms of vaccines development, alternative drug design, as well as new point-of-care diagnostics. 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.
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.
economic development in sub-Saharan Africa. However, there is an implicit determination of the people to protect the human health of the sub-Saharan population and the environment from the adverse effects of pollution and degraded ...
Pertinent books and monographs were accessed. Data in formats inaccessible to the reviewer were excluded. 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.
Objectives: To identify possible existence of therapeutic misconception and its effects on clinical trials in sub-Saharan Africa. Data source: Original research findings and reviews published in the English literature and author's professional experience with clinical trials in some East, Central and West African countries.
AJRH Managing Editor
Endometriosis is a gynaecological disorder that is characterized by the growth of endometrial tissue outside the uterine cavity1. In developed countries, it occurs in up to 20% of women of reproductive age and is a common cause of pelvic pain and infertility1,2. In sub-Saharan Africa, epidemiological data on the prevalence ...
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
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 ...
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.
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 trends globally. The relatively low CDM penetration in sub-Saharan Africa and the East African Community (SSA/EAC) countries is a result of endogenous barriers, particularly the inadequate general i...
Partial Contents: Subsaharan Africa, Resolution, Settlement, Leaderships, Election Fraud, Political, Propaganda War, Guerilla War, Commonwealth President, Warns Officers, National Youth Corps, Diversity, Unemployment...
on the wildlife habitats, reduces the animal population through poaching, and reduces another source of income, tourism . 3 Hearing before the...their livestock, and defecate. The roads between Mombassa, Kenya and Goma, Zaire are often litde more than trails of rubble, remnants of what once was...authority of four different unified commands. In sub-Saharan Africa the U.S. Central Command (CENTCOM) is responsible for Djibouti, Kenya , Ethiopia and
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.
advantage if he is identified at this point. Meanwhile, it has emerged that while Lt Gen Ian Gleeson , acting chief of the SADF, referred in a statement...American Secretary of State Mr George Shultz had praised the unpre- cedented reforms taking place in South Africa, Earlier this month he spoke of the
society" in Africa has been effectively des- troyed —the activity of labor unions and other independent groups, for example. The West African Ghana...of South African industry," Dr Chris Garn - ers, president and chief executive officer of the CSIR, said in a statement released at a Press confer
According to World Health Organization (WHO), the prevalence of epilepsy is highest in low- and lower middle-income countries, which include over eighty percent of the countries of sub-Saharan Africa, where the majority of people with epilepsy are not receiving appropriate care. In sub-Saharan Africa, shortages of trained ...
Suaves, and Tipo -Raro: 135.00 MT; Havana, Cometa, Tam-Tam, Kwekwero, Orrera, and Ceumar: 120.00 MT; and Almirante (pipe tobacco): 660.00 MT per pouch...in television ownership among blacks since it was introduced had levelled off during 1986 and stabilized at 53 percent black adults having access to...television in their homes or hostels. Market Research Africa results were based on 1,000 black adults in main metropolitan areas, excluding Cape
Health sector reform is a 'sustained process of fundamental changes in national health policy, institutional arrangements, etc. guided by government and designed to improve the functioning and performance of the health sector and, ultimately, the health status of the population'. All the forty six countries in the African ...
van Ittersum, Martin K; van Bussel, Lenny G J; Wolf, Joost; Grassini, Patricio; van Wart, Justin; Guilpart, Nicolas; Claessens, Lieven; de Groot, Hugo; Wiebe, Keith; Mason-D'Croz, Daniel; Yang, Haishun; Boogaard, Hendrik; van Oort, Pepijn A J; van Loon, Marloes P; Saito, Kazuki; Adimo, Ochieng; Adjei-Nsiah, Samuel; Agali, Alhassane; Bala, Abdullahi; Chikowo, Regis; Kaizzi, Kayuki; Kouressy, Mamoutou; Makoi, Joachim H J R; Ouattara, Korodjouma; Tesfaye, Kindie; Cassman, Kenneth G
Although global food demand is expected to increase 60% by 2050 compared with 2005/2007, the rise will be much greater in sub-Saharan Africa (SSA). Indeed, SSA is the region at greatest food security risk because by 2050 its population will increase 2.5-fold and demand for cereals approximately triple, whereas current levels of cereal consumption already depend on substantial imports. At issue is whether SSA can meet this vast increase in cereal demand without greater reliance on cereal imports or major expansion of agricultural area and associated biodiversity loss and greenhouse gas emissions. Recent studies indicate that the global increase in food demand by 2050 can be met through closing the gap between current farm yield and yield potential on existing cropland. Here, however, we estimate it will not be feasible to meet future SSA cereal demand on existing production area by yield gap closure alone. Our agronomically robust yield gap analysis for 10 countries in SSA using location-specific data and a spatial upscaling approach reveals that, in addition to yield gap closure, other more complex and uncertain components of intensification are also needed, i.e., increasing cropping intensity (the number of crops grown per 12 mo on the same field) and sustainable expansion of irrigated production area. If intensification is not successful and massive cropland land expansion is to be avoided, SSA will depend much more on imports of cereals than it does today.
redeemed the country from being reduced to an anomaly in economic science ) a country in which no money can be found." Reading the statement, the party’s...LOAN-.France’s Caisse Centrale de Cooperation Economique .Till f appfved/ ?R 49-7 miHl°* ($3.9 million) loan to Air Mauritius to ™ " vu a^rcraf fc...veterinary science is to benefit from an inter-university co-operation agreement with Solland’s University of Utrecht. Specialist teachers will be
nature or favouritism resulting into incompetents assuming senior leadership positions in the Government. The participants attributed this to...established in the initial 10 countries — Brazil, China, Egypt, India, Kenya, Mexico, Peru, Pakistan , Phll- liplnes an«! Zimbabwe. With the help
Zimbabwe Tourist Development Corporation and its Mozambican counterpart, Empresa Nacional de Turismo , will co-operate in training programmes for...for us to deliberately broaden our cultural contacts. "Through such contact we must address the world and all other cultures within our country...David Curry, Min- ister of Local Govern- ment, Housing and Agri- culture in the House of Delegates, said that R67,9-m allocated for Coloured
Jorge Jardim was embarked on a " Programa de Lusaka," which was supposed to declare Mozambican independence without the intervention of FRELIMO and...mayJ^J^T^ Samora Machel, benefiting not only from that fact that, for the last 10 £*». he has been evaluating the evolution of the country’s foreign...ambit, however, the regulations are extremely far-reaching and clearly disturb fundamental legal values. "Our common law is a resilient instrument as
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
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.
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
Full Text Available Among 35 million people living with the human immunodeficiency virus (HIV in 2013, only 37% had access to antiretroviral therapy (ART. Despite global concerted efforts to provide the universal access to the ART treatment, the ART coverage varies among countries and regions. At present, there is a lack of systematic empirical analyses on factors that determine the ART coverage. Therefore, the current study aimed to identify the determinants of the ART coverage in 41 countries in Sub-Saharan Africa. It employed statistical analyses for this purpose. Four elements, namely, the HIV prevalence, the level of national income, the level of medical expenditure and the number of nurses, were hypothesised to determine the ART coverage. The findings revealed that among the four proposed determinants only the HIV prevalence had a statistically significant impact on the ART coverage. In other words, the HIV prevalence was the sole determinant of the ART coverage in Sub-Saharan Africa.
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.
Ángel Pérez González
Full Text Available The contributions made by theory on democratic consolidation in Eastern Europe are also pertinent to analysis of processes of democratization and democratic consolidation in other areas, such as sub-Saharan Africa. The parameters of analysis highlight the importance of a strong state (organized, with legitimated institutions and a structured society (whether multiethnic or not as necessary conditions for democratization. On the assumption that the colonizing powers basically used two models –the French assimilationist model and the British indirect government model– the study of how these conditions were fulfilled in various sub-Saharan states leads to two conclusions: the first, the possibility of a process of democratization in those states where European (French colonization produced a total assimilation of the colonized society, including above all the colonizer’s political values; and the second, the possibility of processes of democratization in states produced by British colonization where the indigenous structures and those of the metropolis were superimposed, a phenomenon which allowed the application of democratic values by legitimated local institutions.
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…
Collin, S M; Marshall, T; Filippi, V
To determine the impact of caesarean section on fertility among women in sub-Saharan Africa. Analysis of standardised cross-sectional surveys (Demographic and Health Surveys). Twenty-two countries in sub-Saharan Africa, 1993-2003. A total of 35 398 women of childbearing age (15-49 years). Time to subsequent pregnancy was compared by mode of delivery using Cox proportional hazards regression models. Natural fertility rates subsequent to delivery by caesarean section compared with natural fertility rates subsequent to vaginal delivery. The natural fertility rate subsequent to delivery by caesarean section was 17% lower than the natural fertility rate subsequent to vaginal delivery (hazard ratio = 0.83, 95% CI 0.73-0.96, P Caesarean section was also associated with prior fertility and desire for further children: among multiparous women, an interval > or =3 versus caesarean section at the index birth (OR = 1.4, 95% CI 1.1-1.7, P= 0.005); among all women, the odds of desiring further children were lower among women who had previously delivered by caesarean section (OR = 0.67, 95% CI 0.54-0.84, P Caesarean section did not appear to increase the risk of a subsequent pregnancy ending in miscarriage, abortion or stillbirth. Among women in sub-Saharan Africa, caesarean section is associated with lower subsequent natural fertility. Although this reflects findings from developed countries, the roles of pathological and psychological factors may be quite different because a much higher proportion of caesarean sections in sub-Saharan Africa are emergency procedures for maternal indication.
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.
Sub-Saharan Africa has a history of land dispossession and contestation which have resulted in various types of inequalities and a skewed distribution of land resources. Land in Sub-Saharan Africa has been subject to conflict, conquest, expropriation and exploitation thus resulting in the many discrepancies that exist today ...
At this critical time of development in sub-Saharan Africa where the continent's growth actually makes it a region of great potential, it would be vital to integrate the youth in the development of the youngest continent in the world. Long-time considered as the continent of all worries and social threats, sub-Saharan Africa has ...
Diabetes mellitus is becoming more common in African cities, where it may affect up to 7% of the hospital population. It particularly affects poor male patients and 73 to 80% of those affected have non insulin-dependent diabetes. The frequency of non-obese, poorly cetogenic patients is high in Sub-Saharan Africa. This may be due to malnutrition, with a deficit either in protein or in calories. Such malnutrition is a major public health problem affecting children in Sudanese and Sahelian areas and may interact with environmental and genetic factors. In equatorial environments, the toxic effects of alcohol abuse on the pancreas are simply another environmental factor, reducing the endocrine function of the pancreas. These observations are important because: 1) diabetes mellitus has a severe social impact in this area and 2) nutrition has a general effect on the pathogenesis of diabetes mellitus.
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.
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..
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.
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
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.
.... Such errors are exacerbated by a lack of reasonable estimates of the size and growth of towns in Nigeria, sub-Saharan Africa's most populous country with the region's most complex urban system...
Henson, Spencer; Masakure, Oliver; Cranfield, John
Summary This paper presents analysis of a survey of fresh produce export firms in 10 countries of sub-Saharan Africa, focusing on the determinants of GlobalGAP certification and the returns in terms...
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 ...
Akachi, Yoko; Canning, David
We investigate trends in cohort infant mortality rates and adult heights in 39 developing countries since 1961. In most regions of the world improved nutrition, and reduced childhood exposure to disease, have lead to improvements in both infant mortality and adult stature. In Sub-Saharan Africa, however, despite declining infant mortality rates, adult heights have not increased. We argue that in Sub-Saharan Africa the decline in infant mortality may have been due to interventions that prevent infant deaths rather than improved nutrition and childhood morbidity. Despite declining infant mortality, Sub-Saharan Africa may not be experiencing increases in health human capital. 2010 Elsevier B.V. All rights reserved.
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.
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
This study analyzes the association of protein energy malnutrition and mortality in preschool (non-emergency) children in Sub-Saharan Africa. 2 functional consequences of malnutrition are discussed: retarded physical growth (anthropometry) and mortality. The anthropometric measures used to assess malnutrition are weight-for-age, weight for height, and mid-upper arm circumference. The major factors associated with malnutrition and mortality include dietary intake, severity and frequency of infections, social, demographic, economic and cultural factors (area of residence, seasonality, socioeconomic status, mother's age and educational level, family support and cohesiveness, birth order of index child and birth interval between children and number of children under 5 in the family, maternal nutritional status and health and adequacy of breast milk volume and composition for young infants. Understanding these factors will identify children-at-risk for malnutrition and target them for intervention programs. The article focuses on the association of malnutrition with mortality in relation to: 1) breastfeeding and weaning practice; 2) vitamin A and 3) infection. Reviews of African and Asian studies on the subject demonstrated that higher mortality rates were associated with malnutrition, however, the causal associations remain unclear. Since malnourished children are at higher risk for illness, short-term interventions should include growth monitoring, nutrition education, prevention and treatment of infections, food supplementation, hospital rehabilitation, home gardens and improved agricultural practices; while long-term interventions should include improvement in the economic and environmental conditions. (author's modified).
Akachi, Yoko; CANNING, David
In most developing countries, rising levels of nutrition and improvements in public health have led to declines in infant mortality and rising adult height. In Sub-Saharan Africa, however, we see a different pattern. Sub-Saharan Africa has seen large reductions in infant mortality over the last fifty years, but without any increase in protein or energy intake, and against a background of stagnant, or even declining, adult height. Adult height is a sensitive indicator of the nutrition and morb...
climate causes undue harm to the human body. Such tropical diseases as malaria only compound the problem. Infant mortality is high due in part to...is unlimited 12b. DISTRIBUTION CODE 2 13. ABSTRACT (maximum 200 words) This thesis examines the causes of slow economic growth in Sub-Saharan...LEFT BLANK v ABSTRACT This thesis examines the causes of slow economic growth in Sub-Saharan Africa. In particular, it attempts to identify the
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 (phistory 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.
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
Sidibé, El Hassane
Thyroid gland diseases vary according to the environment. In sub-Saharan Africa, they are also influenced by population isolation and the absence of food self-sufficiency, both factors affecting the onset and persistence of iodine-deficiency goiters. More cosmopolitan diseases are now added to these thyroid disorders. Women are mainly affected (94.2%), most often with euthyroid goiters (54.7%), followed by Graves disease (13.1%), hypothyroidism (8.8%), thyroiditis (6.6%), toxic multinodular goiters (6.6 %) and unclassified goiters (10%) [Gabon]. The paucity of laboratories specializing in endocrinology and of nuclear medicine facilities, the delay in diagnosis that results in compressive or recurrent goiters, and endemic goiters are all typical in Africa. In children and adolescents, death rates increase with congenital or acquired thyroiditis as with delayed physical or mental development. In this environment, thyroiditis can also be pregnancy-related. Very recent surveys show a prevalence of endemic goiters of 28.6% in the community of Sekota, Ethiopia, 64-70% in Sahel-Sudan (population aged 10-20 years), 20-29% in KwaZulu-Natal (school children), 14.3-30.2% in Namibia (school children), 0.21% (congenital hypothyroidism or cretinism) in Plateau State, Nigeria, 55.2% at Zitenga, Burkina Faso (210 persons 0-45 years), and 10% in Hararé and Wedza, Zimbabwe (newborn TSH >10.1 microIU/mL). The prevalence of goiters is 43.6% in children emigrating from Ethiopia to Israel. Millet from semi-arid zones contains apigenin at a concentration of 150 mg/kg and luteolin at 350 mg/kg, both of which can interfere with thyroid function. The harmful effects of cassava (also known as manioc) are better known: milling cassava reduces its goitrogenic potential. In addition to iodine deficiency, selenium deficiency, and the effect of the thiocyanates in cassava, ion concentrations in soil and drinking water appear to play a role. The proportion of thyroid surgery indicated for
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.
Full Text Available Tuberculosis (TB today remains a global emergency affecting 9.0 million people globally. The African Region bears the highest global TB/HIV burden and over 50% of TB cases in SSA are co-infected with HIV. An estimated 1.5 million died from the TB globally in 2013. A large majority of the 360,000 HIV-positive TB cases who died were from sub-Saharan Africa. Research and development is an important pillar of the WHO post-2015 global TB strategy. Advances in development of diagnostics, drugs, host-directed therapies, and vaccines will require evaluation under field conditions through multi-centre clinical trials at different geographical locations. Thus it is critically important that these evaluations are fully supported by all African governments and the capacity, trained staff and infrastructure required to perform the research and evaluations is built and made available. This viewpoint article reviews the opportunities provided by recently launched second programme (2015-2024 of the European & Developing Countries Clinical Trials Partnership (EDCTP2 for tackling the TB epidemic in Africa through its magnanimous portfolio. The unique opportunities provided by EDCTP2 for leadership of scientific research in TB and other diseases fully devolving to Africa are also covered.
Background 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. Methods 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. Results 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
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.
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
Bietsch, Kristin E
This paper examines male attitudes towards family planning in Sub-Saharan Africa. Studying attitudes is ideal as they can be calculated for all men, at any point in their lives, regardless of marital status, sexual activity, or fertility desires. We find that positive attitudes towards family planning have increased across Sub-Saharan Africa in the last two decades. We analyze both the association of positive attitudes with a variety of demographic characteristics (age, marital status, education, and religion) and the relationships with multiple forms of discussion about family planning (radio, television, friends, and partners). We find higher approval at older ages and higher levels of education, and lower levels of approval among Muslims compared to Christians. Interactions between characteristics and discussion of family planning. demonstrate that hearing or talking about contraception has different associations for different groups. This paper offers a new way to explore fertility and reproductive health in Sub-Saharan Africa.
Van Der Borght, Stefaan; Schim Van Der Loeff, Maarten Franciscus; Clevenbergh, Philippe; Kabarega, Jean Pierre; Kamo, Emmanuel; Van Cranenburgh, Katinka; Rijckborst, Henk; Lange, Joep M; Rinke De Wit, Tobias Floris
International audience; High uptake of HIV voluntary counselling and testing (VCT) services is important for the success of HIV workplace programs in sub-Saharan Africa. From 2001 onwards Heineken, a multinational brewing company, implemented a comprehensive HIV prevention and treatment program for employees and their dependents of its African subsidiaries. Confidential in-house VCT is part of this program. VCT uptake dynamics over time, and factors associated with early uptake were studied. ...
Abstract High uptake of HIV voluntary counselling and testing (VCT) services is important for the success of HIV workplace programs in sub-Saharan Africa. From 2001 onwards Heineken, a multinational brewing company, implemented a comprehensive HIV prevention and treatment program for employees and their dependents of its African subsidiaries. Confidential in-house VCT is part of this program. VCT uptake dynamics over time, and factors associated with early uptake were studied. Be...
National Research Council Staff
...-SAHARAN AFRICA Working Group on Factors Affecting Contraceptive Use Panel on the Population Dynamics of Sub-Saharan Africa Committee on Population Commission on Behavioral and Social Sciences and Education National Research Council NATIONAL ACADEMY PRESS Washington, D.C. 1993 Copyrightoriginal retained, the be not from cannot book, paper original howeve...
Stefan, Cristina; Bray, Freddie; Ferlay, Jacques; Liu, Biying; Maxwell Parkin, D
Measurement of incidence rates of childhood cancer in Africa is difficult. The study ‘Cancer of Childhood in sub Saharan Africa’ 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. PMID:28900468
Full Text Available The state of research into media and information flows in sub-Saharan Africa describes a situation marked by rapid growth of a wide range of media and distinctive geo-linguistic mediaspheres. This article focuses on two revolutions in information flow in the region: first, an expansion since the 1990s of traditional media, facilitated by satellite broadcasting and related technologies; secondly, since about 2000, the ongoing embrace of mobile telephony. It describes these developments in Lusophone, Francophone and Anglophone mediaspheres. Building on the author’s own previous research, and that of others, the article highlights the shift from asymmetrical, elite dominated communications concerning the major public affairs of the day toward increasingly symmetrical and participatory electronic communications. L’état de la recherche portant sur les flux d’information en Afrique sub-saharienne implique un contexte marqué par la croissance rapide d’un vaste panel de médias et d’espaces médiatiques géolinguistiques spécifiques. Le présent article porte sur deux révolutions liées au flux de l’information dans la région : en premier lieu l’expansion des médias traditionnels depuis les années 90, facilitée par la diffusion satellitaire et les technologies qu’elle implique ; en second lieu, l’intérêt actuel pour la téléphonie mobile qui se développe depuis les années 2000. L’article analyse ces évolutions au sein des espaces médiatiques lusophones, francophones et anglophones. Dans la continuité de notre précédente recherche, et celle développée par d’autres à ce sujet, cet article souligne le déplacement de communications asymétriques et dominées par l’élite, sur les affaires publiques majeures, vers des communications électroniques de plus en plus symétriques et participatives. O estado da pesquisa sobre o fluxo da informação na África subsaariana remete a um contexto marcado pelo r
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
Shah, Jui A; Emina, Jacques B O; Eckert, Erin; Ye, Yazoume
Scaling up diagnostic testing and treatment is a key strategy to reduce the burden of malaria. Delays in accessing treatment can have fatal consequences; however, few studies have systematically assessed these delays among children under five years of age in malaria-endemic countries of sub-Saharan Africa. This study identifies predictors of prompt treatment with first-line artemisinin combination therapy (ACT) and describes profiles of children who received this recommended treatment. This study uses data from the most recent Demographic and Health Survey, Malaria Indicator Survey, or Anaemia and Parasite Prevalence Survey conducted in 13 countries. A Chi square automatic interaction detector (CHAID) model was used to identify factors associated with prompt and effective treatment among children under five years of age. The percentage of children with fever who received any anti-malarial treatment varies from 3.6 % (95 % CI 2.8-4.4 %) in Ethiopia to 64.5 % (95 % CI 62.7-66.2 %) in Uganda. Among those who received prompt treatment with any anti-malarial medicine, the percentage who received ACT ranged from 32.2 % (95 % CI 26.1-38.4 %) in Zambia to nearly 100 % in Tanzania mainland and Zanzibar. The CHAID analysis revealed that country of residence is the best predictor of prompt and effective treatment (p country, the second best predictor was maternal education (p = 0.004), place of residence (p = 0.008), or household wealth index (p country of residence, maternal education, place of residence, and socio-economic status are key predictors of prompt access to malaria treatment. Achieving universal coverage and the elimination agenda will require effective monitoring to detect disparities early and sustained investments in routine data collection and policy formulation.
Kuznik, Andreas; Habib, Abdulrazaq G.; Manabe, Yukari C.; Lamorde, Mohammed
Background 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 (SSA). Methods Estimated country-specific incidence of syphilis was generated from annual number of live births, the proportion of women with ≥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 antenatal care coverage to ≥95% and syphilis screening to ≥95% (WHO targets). Results For all 43 SSA countries, the estimated incidence of adverse pregnancy outcomes was 205,901(95% 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 WHO targets could reduce the burden by 8.5 million DALYs. Conclusions Substantial infant mortality and morbidity results from maternal syphilis infection concentrated in countries with low access to ANC or low rates of syphilis screening. PMID:26222749
Reed, Cecile C
Scattered records of parasitic species infecting commercially important marine fishes in sub-Saharan Africa are known from just a few countries where concerted efforts have been made by local parasitologists (e.g. Senegal, Nigeria, South Africa). Most of these consist of taxonomic records or general surveys of parasite faunas associated with marine hosts, which may or may not have been of commercial value. Little to no multi-disciplinary research is conducted in most parts of sub-Saharan Africa and hence parasitological data are not commonly used to advise fisheries management procedures. This review summarizes current knowledge on all parasitological research associated with commercially important marine fish species in sub-Saharan Africa.
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.
Twenty years into sub-Saharan Africa's democratic renewal, an understanding of democratic governance has become established among political actors in the region. Democratic governance is characterised by: legitimation of governmental power through elections, legitimation of governmental politics through ...
It is further argues that this can only be achievable if certain factors that can help to strengthen the expansion of cassava production as a food security crop in Nigeria in particular and Sub-Saharan Africa in general are put into adequate consideration. Some of these are proper implementation of cassava initiative ...
AJRH Managing Editor
Methods. Data for this paper are from the Demographic and. Health Surveys conducted in Sub-Saharan Africa. DHS has conducted surveys of men, independent of marital status, in the region since 1991. Inclusions of questions regarding attitudes towards and communication about family planning vary across surveys.
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 ...
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
Heerwaarden, van Joost; Baijukya, Frederick; Kyei-Boahen, Stephen; Adjei-nsiah, Samuel; Ebanyat, Peter; Kamai, Nkeki; Wolde-Meskel, Endalkachew; Kanampiu, Fred; Vanlauwe, Bernard; Giller, Ken
Improving bacterial nitrogen fixation in grain legumes is central to sustainable intensification of agriculture in sub-Saharan Africa. In the case of soyabean, two main approaches have been pursued: first, promiscuous varieties were developed to form effective symbiosis with locally abundant
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
Over the years, sub-Saharan Africa has experienced a prolonged development crisis, fuelled by complex ethnic, social, and political realities. The region suffers from weak governments, corruption, and mismanagement of resources. Its overburdened water systems are under increasing stress from fast-growing urban areas, ...
This thesis presents data from two multi-site programmes of research that have examined the social responses to malaria interventions in sub -Saharan Africa. The first dealt specifically with the attitudes and behaviours linked to a single intervention aimed at reducing malaria morbidity and
states, the conception of kinship needs to be broadened to transcend simple familial or ancestral relations. Key Words. Sub-Saharan Africa, kinship relations, ancestors, social justice, .... fundamentally rooted in kinship” (Finch 2008, 721). ... the ancestors laid the foundation for the order in the community is so important that it.
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, ...
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 ...
Olesen, Tina Bech; Munk, Christian; Christensen, Jane
BACKGROUND: We performed a systematic review and meta-analysis to summarise the available data on the prevalence of human papillomavirus (HPV) among men in sub-Saharan Africa. METHODS: PubMed and Embase were searched up to 10 March 2014. Random effects meta-analyses were used to calculate a poole...
On the other hand, they pose a significant threat to governance, macroeconomic management, industrial development, the environment and the sociopolitical fabric. Sub-Saharan Africa needs to develop a strategic response to the boom in commodities prices, which has already been more long-lived and less volatile than ...
Infectious diseases are especially problematic in sub-Saharan Africa, where livestock production accounts for up to 25% of national income. ... La pleuropneumonie contagieuse des bovins est une maladie d'origine bactérienne qui a de graves conséquences sur l'économie et le commerce en Afrique subsaharienne.
AJRH Managing Editor
Studying attitudes is ideal as they can be calculated for all men, at any point in their lives, regardless of marital status, sexual activity, or fertility desires. ... When studying men's sexual lives in Sub-. Saharan Africa (and elsewhere), benefit ...... we see in most cases a reversal of the main effect. For those who hear about family ...
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 ...
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
MEMBERS OF THE SUB-SAHARAN AFRICA CERVICAL CANCER WORKING GROUP. (Manucript N° ... of genital wart cases.. Decreasing the incidence of. HPV-related cancers, in particular cervical cancer morbidity and mortality, by means such as vaccination ... lesions which are amenable to treatment and hence.
Mkwananzi, Sibusiso; Odimegwu, Clifford
.... 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...
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
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…
Connell, John; Zurn, Pascal; Stilwell, Barbara; Awases, Magda; Braichet, Jean-Marc
Migration of skilled health workers from sub-Saharan African countries has significantly increased in this century, with most countries becoming sources of migrants. Despite the growing problem of health worker migration for the effective functioning of health care systems there is a remarkable paucity and incompleteness of data. Hence, it is difficult to determine the real extent of migration from, and within, Africa, and thus develop effective forecasting or remedial policies. This global overview and the most comprehensive data indicate that the key destinations remain the USA and the UK, and that major sources are South Africa and Nigeria, but in both contexts there is now greater diversity. Migrants move primarily for economic reasons, and increasingly choose health careers because they offer migration prospects. Migration has been at considerable economic cost, it has depleted workforces, diminished the effectiveness of health care delivery and reduced the morale of the remaining workforce. Countries have sought to implement national policies to manage migration, mitigate its harmful impacts and strengthen African health care systems. Recipient countries have been reluctant to establish effective ethical codes of recruitment practice, or other forms of compensation or technology transfer, hence migration is likely to increase further in the future, diminishing the possibility of achieving the United Nations millennium development goals and exacerbating existing inequalities in access to adequate health care.
One of the major barriers to access to healthcare in most sub-Saharan African countries is financial constraints. The need therefore arises for African states to put in place workable social health insurance schemes, as is the practice in most developed countries. This article assesses the peculiar characteristics of ...
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...
Full Text Available This article reviews the extensive evidence on agricultural market reforms in Sub-Saharan Africa and summarises the impact reforms have had on market performance, agricultural production, use of modern inputs, and poverty. It offers eight recommendations for completing the reform process and developing a new agenda for agricultural markets in Sub-Saharan Africa. The reform experience in Sub-Saharan Africa has varied widely across countries and crop subsectors. The available evidence shows clear progress in some areas and mixed results in others. Most reforms were only partially implemented and policy reversal was common. Once implemented, however, reforms have increased competition and reduced marketing margins, benefiting both producers and consumers. Reforms have also boosted export crop production. On the other hand, food crop production has stagnated and yields have not improved. Further expansion of private trade is constrained by lack of access to credit, uncertainty about the government’s commitment to reform, and high transaction costs.
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.
Livelihoods, food security, and development processes in Sub-Saharan Africa are highly dependent on land management practices to generate natural ecosystem goods and services. Out of a total population of about 717 million people, almost 60 percent depend for their livelihood on agriculture, hunting, fishing, or forestry. However, unsustainable land management already is leading to large-s...
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
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,
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.
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…
Evans, Ruth; Skovdal, Morten
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...... of the rights discourse in the context of sub-Saharan Africa, and policymakers, practitioners, children, and community members have emphasized children’s responsibilities to their families and communities, as well as their rights. The limitations of ILO definitions of child labor and child domestic work...... by policymakers and practitioners in East Africa, ranging from a child labor/child protection/abolitionist approach to a “young carer”/child-centered rights perspective. These differing perspectives influence the level and nature of support and resources that children involved in care work may be able to access...
Blackstone, Sarah R; Nwaozuru, Ucheoma; Iwelunmor, Juliet
The purpose of this study was to systematically review the literature regarding factors influencing contraceptive use in sub-Saharan Africa between 2005 and 2015. A total of 58 studies from twelve Sub-Saharan African countries were reviewed. Keywords were grouped using the PEN-3 cultural model. Negative factors prohibiting or reducing contraceptive use were women's misconceptions of contraceptive side-effects, male partner disapproval, and social/cultural norms surrounding fertility. Positive factors included education, employment, and communication with male partner. Increasing modern contraceptive use in Sub-Saharan Africa is a multi-faceted problem that will require community and systems wide interventions that aim to counteract negative perceptions and misinformation.
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
Hendriks, M.E.; Wit, F.W.N.M.; Roos, M.T.L.; Brewster, L.M.; Akande, T.M.; de Beer, I.H.; Mfinanga, S.G.; Kahwa, A.M.; Gatongi, P.; van Rooy, G.; Janssens, W.; Lammers, J.; Kramer, B.N.; Bonfrer, I.; Gaeb, E.; van der Gaag, J; Rinke de Wit, T.; Lange, J.M.A.; Schultz, C.
Background: Cardiovascular disease (CVD) is the leading cause of adult mortality in low-income countries but data on the prevalence of cardiovascular risk factors such as hypertension are scarce, especially in sub-Saharan Africa (SSA). This study aims to assess the prevalence of hypertension and
M.E. Hendriks (Marleen); F.W.N.M. Wit (Ferdinand); M.T.L. Roos; L.M. Brewster (Lizzy); T.M. Akande (Tanimola); I.H. de Beer (Ingrid); S.G. Mfinanga (Sayoki); A.M. Kahwa (Amos); P. Gatongi (Peter); G. van Rooy (Gert); W. Janssens (Wendy); J. Lammers (Judith); B. Kramer (Berber); I.E.J. Bonfrer (Igna); E. Gaeb (Esegiel); J. van der Gaag (Jacques); T.F. Rinke de Wit (Tobias); J.M.A. Lange (Joep); C. Schultsz (Constance)
textabstractBackground: Cardiovascular disease (CVD) is the leading cause of adult mortality in low-income countries but data on the prevalence of cardiovascular risk factors such as hypertension are scarce, especially in sub-Saharan Africa (SSA). This study aims to assess the prevalence of
A significant amount of research has been performed in high-income countries but less is known about HIV and mental health in sub-Saharan Africa. ... The reported prevalence levels of mental illness among people living with HIV or AIDS (PLHIV) was high, with all but one study noting a prevalence of 19% or higher.
H.A.C.M. Voeten (Hélène); D.C.J. Vissers (Debby); S. Gregson (Simon); B. Zaba (Basia); R.G. White (Richard); S.J. de Vlas (Sake); J.D.F. Habbema (Dik)
textabstractBackground: 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
Early in the study of HIV/AIDS, culture was invoked to explain differences in the disease patterns between sub-Saharan Africa and Western countries. Unfortunately, in an attempt to explain the statistics, many of the presumed risk factors were impugned in the absence of evidence. Many cultural practices were stripped of ...
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.…
Introduction. While there are differences in the way nations define literacy and the degree of accuracy in measuring it, it is generally agreed worldwide that the large number of illiterate people is worrisome. The problem is more acute in developing countries, especially in Sub-Saharan Africa, Asia, Latin America and the.
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.
There were deep contradictions at the heart of Soviet policy towards southern Africa. Despite its uncompro- mising denunciation of apartheid , Moscow...with apartheid .15 Out of Africa. The years immediately following the collapse of the Soviet Union in 1991 saw a dramatic reduction in Russia’s
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....
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
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 infor......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...
Pace, Lydia E; Shulman, Lawrence N
: The objective of this review is to describe existing data on breast cancer incidence and mortality in low- and middle-income countries (LMICs), in particular in sub-Saharan Africa; identify the limitations of these data; and review what is known about breast cancer control strategies in sub-Saharan African countries and other LMICs. Available estimates demonstrate that breast cancer incidence and mortality are rising in LMICs, including in Africa, although high-quality data from LMICs (and particularly from sub-Saharan Africa) are largely lacking. Case fatality rates from breast cancer appear to be substantially higher in LMICs than in high-income countries. Significant challenges exist to developing breast cancer control programs in LMICs, perhaps particularly in sub-Saharan Africa, and the most effective strategies for treatment and early detection in the context of limited resources are uncertain. High-quality research on breast cancer incidence and mortality and implementation research to guide effective breast cancer control strategies in LMICs are urgently needed. Enhanced investment in breast cancer research and treatment in LMICs should be a global public health priority. The numbers of new cases of breast cancer, and breast cancer deaths per year, in low- and middle-income countries are rising. Engagement by the international breast cancer community is critical to reduce global disparities in breast cancer outcomes. Cancer specialists and institutions in high-income countries can serve as key partners in training initiatives, clinical care, protocol and program development, and research. This article provides an overview of what is known about breast cancer incidence, mortality, and effective strategies for breast cancer control in sub-Saharan Africa and identifies key gaps in the literature. This information can help guide priorities for engagement by the global cancer community. ©AlphaMed Press.
Sauls, Phillip R.; Heaton, Neal D.
Approved for public release; distribution is unlimited China's position of non-interference in foreign governments' affairs, while currently good for Chinese business, may threaten to increase international terrorism, deepen regime corruption, and erode U.S. political relevance in sub-Saharan Africa. China has empowered private enterprises, which can monopolize African market sectors, marginalize African businesses, and exacerbate local social conditions. Using non-violent uprising and vio...
Kariuki, Samuel; Dougan, Gordon
Antibacterial resistance-associated infections are known to increase morbidity, mortality, and cost of treatment, and to potentially put others in the community at higher risk of infections. In high-income countries, where the burden of infectious diseases is relatively modest, resistance to first-line antibacterial agents is usually overcome by use of second- and third-line agents. However, in developing countries where the burden of infectious diseases is high, patients with antibacterial-resistant infections may be unable to obtain or afford effective second-line treatments. In sub-Saharan Africa (SSA), the situation is aggravated by poor hygiene, unreliable water supplies, civil conflicts, and increasing numbers of immunocompromised people, such as those with HIV, which facilitate both the evolution of resistant pathogens and their rapid spread in the community. Because of limited capacity for disease detection and surveillance, the burden of illnesses due to treatable bacterial infections, their specific etiologies, and the awareness of antibacterial resistance are less well established in most of SSA, and therefore the ability to mitigate their consequences is significantly limited. © 2014 New York Academy of Sciences.
Akachi, Yoko; Canning, David
We investigate trends in cohort infant mortality rates and adult heights in 39 developing countries since 1960. In most regions of the world improved nutrition, and reduced childhood exposure to disease, have lead to improvements in both infant mortality and adult stature. In Sub-Saharan Africa, however, despite declining infant mortality rates, adult heights have not increased. We argue that in Sub-Saharan Africa the decline in infant mortality may have been due to interventions that prevent...
There is a more and more emerging consensus claiming universal access to health care in order to achieve the desired Millennium Development Goals related to health in Africa. Unfortunately, the debate of the universal coverage has focussed so far mainly on financial affordability, while it is also a human resource matter. Many countries in sub-Saharan Africa are experiencing severe shortages of skilled health care workers. There are several causes, the importance of which varies by country, b...
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.
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.
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
Arens, Christof; Wang-Helmreich, Hanna; Hodes, Glenn Stuart
into the Global Carbon Market”, commissioned by the German Environment Ministry (BMU), it represents an interim step: it paints the picture of an overall donor activities map of the region, while an in-depth evaluation of the specific situation as regards local capacities and concrete capacity building needs...... for a broad overview of support activities funded by developed countries in the study region. This comprises both country-specific programmes as well as activities addressing regional aspects. This is followed by a short glance at the overall capacity building needs of sub-Saharan LDCs, complemented...... by an analysis of the capacity situation and the support needs in selected countries based on expert judgment. Conclusions on lessons learnt for future support activities of Annex I donors complete this report. In an annex, a summary of all donor activities is presented, which is complemented by an even more...
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.
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.
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.
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.
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.
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......,looking at the issue of distributed generation as opposed to grid extension and the role of renewable energy in this process. The purpose of this paper is to inform this discussion by two means. First, after examining the concept of distributed - or decentralised - generation in a region where urban population is...... 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...
Samuel Munalula Munjita
Full Text Available Noroviruses are a leading cause of acute sporadic gastroenteritis worldwide. In Sub-Saharan Africa, information regarding norovirus infections in children is scarce. A systematic review of studies performed between 1993 and June 2015 was conducted to establish the genotypic distribution and prevalence of norovirus infections in children (≤17 in Sub-Saharan Africa. Analysis of data from 19 studies involving 8,399 samples from children with symptomatic and nonsymptomatic gastroenteritis revealed prevalence of 12.6% (range 4.6% to 32.4%. The prevalence of norovirus infections was higher in symptomatic children (14.2% than asymptomatic children (9.2%. Genogroup II (GII was the most prevalent genogroup accounting for 76.4% of all the reported norovirus infections. The rest of the infections were GI (21.7% and GI/GII (1.9%. The most common genotypes were GII.4 (65.2%, GI.7 (33.3%, and GI.3 (21.3%. These statistics were calculated from studies carried out in 12 out of 48 Sub-Saharan African countries. Therefore, more studies involving several countries are required to determine fully the epidemiology of noroviruses and their contribution to childhood diarrhoea in Sub-Saharan Africa.
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.
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.
Julian T Hertz
Full Text Available BACKGROUND: Trends in the prevalence of acute myocardial infarction in sub-Saharan Africa have not been well described, despite growing recognition of the increasing burden of cardiovascular disease in low- and middle-income countries. The aim of this systematic review was to describe the prevalence of acute myocardial infarction in sub-Saharan Africa. METHODS: We searched PubMed, EMBASE, Global Health Archive, CINAHL, and Web of Science, and conducted reference and citation analyses. Inclusion criteria were: observational studies, studies that reported incidence or prevalence of acute myocardial infarction, studies conducted in sub-Saharan Africa, and studies that defined acute myocardial infarction by EKG changes or elevation of cardiac biomarkers. Studies conducted prior to 1992 were excluded. Two independent reviewers analyzed titles and abstracts, full-texts, and references and citations. These reviewers also performed quality assessment and data extraction. Quality assessment was conducted with a validated scale for observational studies. FINDINGS: Of 2292 records retrieved, seven studies met all inclusion criteria. These studies included a total of 92,378 participants from highly heterogeneous study populations in five different countries. Methodological quality assessment demonstrated scores ranging from 3 to 7 points (on an 8-point scale. Prevalence of acute myocardial infarction ranged from 0.1 to 10.4% among the included studies. INTERPRETATION: There is insufficient population-based data describing the prevalence of acute myocardial infarction in sub-Saharan Africa. Well-designed registries and surveillance studies that capture the broad and diverse population with acute myocardial infarction in sub-Saharan Africa using common diagnostic criteria are critical in order to guide prevention and treatment strategies. REGISTRATION: Registered in International Prospective Register of Systematic Reviews (PROSPERO Database #CRD42012003161.
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.
into account. Most African countries with data available from more than one survey appear to have experienced a trend toward decline in the number of very early marriages and pregnancies. Such declines as have occurred are probably the result of urbanization and school attendance rather than any specific policy measure. Programs targeted to adolescents should distinguish between the risks of early pregnancy and of premarital fertility. Increased attention should be directed to rural women who marry and have children at very young ages.
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.
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.
Okoro, Chinyere K; Kingsley, Robert A; Connor, Thomas R; Harris, Simon R; Parry, Christopher M; Al-Mashhadani, Manar N; Kariuki, Samuel; Msefula, Chisomo L; Gordon, Melita A; de Pinna, Elizabeth; Wain, John; Heyderman, Robert S; Obaro, Stephen; Alonso, Pedro L; Mandomando, Inacio; MacLennan, Calman A; Tapia, Milagritos D; Levine, Myron M; Tennant, Sharon M; Parkhill, Julian; Dougan, Gordon
A highly invasive form of non-typhoidal Salmonella (iNTS) disease has recently been documented in many countries in sub-Saharan Africa. The most common Salmonella enterica serovar causing this disease is Typhimurium (Salmonella Typhimurium). We applied whole-genome sequence-based phylogenetic methods to define the population structure of sub-Saharan African invasive Salmonella Typhimurium isolates and compared these to global Salmonella Typhimurium populations. Notably, the vast majority of sub-Saharan invasive Salmonella Typhimurium isolates fell within two closely related, highly clustered phylogenetic lineages that we estimate emerged independently ∼52 and ∼35 years ago in close temporal association with the current HIV pandemic. Clonal replacement of isolates from lineage I by those from lineage II was potentially influenced by the use of chloramphenicol for the treatment of iNTS disease. Our analysis suggests that iNTS disease is in part an epidemic in sub-Saharan Africa caused by highly related Salmonella Typhimurium lineages that may have occupied new niches associated with a compromised human population and antibiotic treatment.
Okoro, Chinyere K.; Kingsley, Robert A.; Connor, Thomas R.; Harris, Simon R.; Parry, Christopher M.; Al-Mashhadani, Manar N; Kariuki, Samuel; Msefula, Chisomo L.; Gordon, Melita A.; de Pinna, Elizabeth; Wain, John; Heyderman, Robert S.; Obaro, Stephen; Alonso, Pedro L.; Mandomando, Inacio; MacLennan, Calman A.; Tapia, Milagritos D.; Levine, Myron M.; Tennant, Sharon M; Parkhill, Julian; Dougan, Gordon
A highly invasive form of non-typhoidal Salmonella (iNTS) disease has been recently documented in many countries in sub-Saharan Africa. The most common Salmonella enterica serovar causing this disease is Typhimurium. We applied whole-genome sequence-based phylogenetic methods to define the population structure of sub-Saharan African invasive Salmonella Typhimurium and compared these to global Salmonella Typhimurium isolates. Notably, the vast majority of sub-Saharan invasive Salmonella Typhimurium fell within two closely-related, highly-clustered phylogenetic lineages that we estimate emerged independently ~52 and ~35 years ago, in close temporal association with the current HIV pandemic. Clonal replacement of isolates of lineage I by lineage II was potentially influenced by the use of chloramphenicol for the treatment of iNTS disease. Our analysis suggests that iNTS disease is in part an epidemic in sub-Saharan Africa caused by highly related Salmonella Typhimurium lineages that may have occupied new niches associated with a compromised human population and antibiotic treatment. PMID:23023330
Albertyn, R; Bickler, S W; Rode, H
Paediatric burn injuries in Sub Saharan Africa are common and often lead to devastating consequences. Unfortunately relevant and accurate data regarding these injuries is sketchy and incomplete. This paper reviews the available information on the epidemiology of paediatric burns in Africa, associated health problems and contributing environmental factors responsible for these burns. The current status of burn care, the lack of infrastructure, and traditional methods of treatment, further contribute to the unsatisfactory status of overall burn management, prevention, and rehabilitation of burn survivors. A strategy for improving burn care in Africa has been formulated. The management of childhood burns will only be successful if educational, social, fiscal and infrastructure standards are improved. Traditional beliefs and methods cannot be discarded as they play an important role in the management of these children. It is furthermore essential that local and central government organisations support these initiatives. Clearly, the children of Africa deserve better burn care.
Full Text Available The discourse on indigenous knowledge has incited a debate of epic proportions across the world over the years. In Africa, especially in the sub-Saharan region, while the so-called indigenous communities have always found value in their own local forms of knowledge, the colonial administration and its associates viewed indigenous knowledge as unscientific, illogical, anti-development, and/or ungodly. The status and importance of indigenous knowledge has changed in the wake of the landmark 1997 Global Knowledge Conference in Toronto, which emphasised the urgent need to learn, preserve, and exchange indigenous knowledge. Yet, even with this burgeoning interest and surging call, little has been done, especially in sub-Saharan Africa, to guarantee the maximum exploitation of indigenous knowledge for the common good. In view of this realisation, this paper discusses how indigenous knowledge can and should both act as a tool for promoting the teaching/learning process in Africaâ€™s public education and address the inexorably enigmatic amalgam of complex problems and cataclysms haunting the world.
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.
Kumwenda, Ben; Dowell, Jon; Daniels, Katy; Merrylees, Neil
Electives are part of most Western medical school curricula. It is estimated that each year 3000-4000 undergraduate medical students from the UK alone undertake an elective in a developing country. The impact of these electives has given some cause for concern, but the views of elective hosts are largely missing from the debate. The purpose of this study was to evaluate the organisation, outcomes and impacts of medical electives in sub-Saharan Africa from a host perspective. A qualitative analysis of 14 semi-structured interviews with elective hosts at seven elective sites in Malawi, Zambia and Tanzania was carried out. A framework analysis approach was used to analyse 483 minutes of audio-recorded data. Hosts were committed to providing elective experiences but their reasons for doing so varied considerably, in particular between urban or teaching hospitals and rural or mission hospitals. Nurturing a group of professionals who will understand the provision of health care from a global perspective was the main reason reported for hosting an elective, along with generating potential future staff. Hosts argued that the quality of supervision should be judged according to local context. Typical concerns cited in the literature with reference to clinical activities, safety and ethics did not emerge as issues for these hosts. However, in under-resourced clinical contexts, the training of local students sometimes had to take priority. Electives could be improved with greater student preparation and some contribution from sending institutions to support teaching, supervision or patient care. The challenge to both students and their sending institutions is to progress towards giving something proportionate back in return for the learning experiences received. There is clearly room to improve electives from the hosts' perspective, but individually host institutions lack the opportunity or ability to achieve change. © 2015 John Wiley & Sons Ltd.
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
This paper provides a test of the generalizability of the barriers’ approach (Rahat and Hazan, 2011) to the study of electoral system reform attempts. It does so by examining a set of recent attempts of electoral system change in four Sub-Saharan countries (South Africa, Lesotho, Kenya......, and Zimbabwe), some of which were successful, while other were abortive. The conclusion reached is that the barriers’ approach is useful as a helpful framework for evaluating such reform attempts, even though it is also less convincing in some cases. Two of the barriers (actors’ vested interest...
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.
Bryan, Elizabeth; Akpalu, Wisdom; Yesuf, Mahmud; Ringler, Claudia
"Global climate change poses great risks to poor people whose livelihoods depend directly on the use of natural resources. Mitigation of the adverse effects of climate change is a high priority on the international agenda. Carbon trading, under the Kyoto Protocol as well as outside the protocol, is growing rapidly from a small base and is expected to increase dramatically under present trends. However, developing countries, in particular Sub-Saharan Africa, remain marginalized in global carbo...
Zhang, Yu Yvette; Boadu, Frederick O.
Several countries in Sub-Saharan Africa (SSA) embraced the structural adjustment programs (SAPs) suggested by the World Bank and the International Monetary Fund (IMF) in the 1980s. SAPs entail three main transitions: (1) from state control to market-led development; (2) from authoritarianism to rule of law, and (3) from central control to constitutionalism (Cass, 1991). The transitions are interrelated and form the main pillars of a market economy to promote growth in SSA. As a part of SAPs, ...
Sam-Agudu, Nadia A; Folayan, Morenike O; Ezeanolue, Echezona E
More than 80% of the HIV-infected adolescents live in sub-Saharan Africa. Acquired immune deficiency syndrome (AIDS)-related mortality has increased among adolescents 10-19 y old. The impact is highest in sub-Saharan Africa, where >80% of HIV-infected adolescents live. The World Health Organization has cited inadequate access to HIV testing and counseling (HTC) as a contributing factor to AIDS-related adolescent deaths, most of which occur in sub-Saharan Africa. This review focuses on studies conducted in high adolescent HIV-burden countries targeted by the "All In to End Adolescent AIDS" initiative, and describes barriers to adolescent HTC uptake and coverage. Fear of stigma and family reaction, fear of the impact of a positive diagnosis, perceived risk with respect to sexual exposure, poor attitudes of healthcare providers, and parental consent requirements are identified as major impediments. Most-at-risk adolescents for HIV infection and missed opportunities for testing include, those perinatally infected, those with early sexual debut, high mobility and multiple/older partners, and pregnant and nonpregnant females. Regional analyses show relatively low adolescent testing rates and more restrictive consent requirements for HTC in West and Central Africa as compared to East and southern Africa. Actionable recommendations for widening adolescent access to HTC and therefore timely care include minimizing legal consent barriers, healthcare provider training, parental education and involvement, and expanding testing beyond healthcare facilities.
Mukaratirwa, Samson; La Grange, Louis; Pfukenyi, Davies M
The aim of this review is to provide information on Trichinella infection in humans, livestock and wildlife in sub-Saharan Africa mainly focusing on geographical distribution of species/genotypes, biology, host range, life cycles and to identify research gaps. Trichinella britovi, Trichinella nelsoni and Trichinella zimbabwensis and one genotype (Trichinella T8) are known to occur in sub-Saharan Africa. Distinct geographic ranges with overlapping of some taxa in some areas have been observed. Genetic variants of T. nelsoni has been reported to occur among parasites originating from Eastern and Southern Africa and sequence heterogeneity also occurs among T. zimbabwensis isolates originating from different regions of Zimbabwe and South Africa. Field observations so far indicate that sylvatic Trichinella infections in the region are common in carnivores (mammals and reptiles) and to a lesser extent in omnivores. Cannibalism, scavenging and predation appear to be the most important routes of transmission and maintenance of the sylvatic cycles of the Trichinella taxa. To date, human trichinellosis has been documented in only four sub-Saharan countries (8.7%, 4/46). Bushpigs and warthogs have been the source of human infection with T. britovi and T. nelsoni being the aetiological agents. An increase in bushmeat trade and the creation of Transfrontier Conservation Areas (TFCAs) may have increased the risk of human trichinellosis in the region. With the creation of TFCAs in the region, sampling of wildlife hosts from protected areas of most sub-Sahara African countries is required to fully map the distribution of Trichinella species/genotypes in this region. More structured field surveys are still needed to determine the sylvatic host distribution of the different Trichinella taxa. Biological data of the Trichinella taxa in both wild and domestic animals of sub-Saharan Africa is very limited and further research is required. Copyright © 2012 Elsevier B.V. All rights
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
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.
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
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
Background: The Electronic Health Record (EHR) is a key component of medical informatics that is increasingly being utilized in industrialized nations to improve healthcare. There is limited information on the use of EHR in sub-Saharan Africa. This paper reviews availability of EHRs in sub-Saharan Africa. Methods: ...
This thesis describes the virological and clinical outcomes of children with HIV in sub-Saharan Africa who start antiretroviral treatment (ART). We show that pretreatment HIV drug resistance among children is a serious problem in sub-Saharan Africa and that its prevalence is increasing. Children who
Verzandvoort, S.J.E.; Beek, C.L.; Conijn, J.G.; Froebrich, J.; Jansen, H.C.; Noij, I.G.A.M.; Roest, C.W.J.; Vreke, J.; Mansfeld, van M.J.M.
The demand for agricultural products (food, feed, fibre, and biomass for other purposes) produced in Sub-Saharan Africa (SSA) will increase for the coming decades. In addition, the global climate change will largely impact on the agricultural sector in Sub-Saharan Africa. Major challenges for the
Sub-Saharan Africa has a history of land dispossession and contestation which have resulted in various types of inequalities and a skewed distribution of land resources. Land in Sub-Saharan Africa has been subject to conflict, conquest, expropriation and exploitation thus resulting in the many discrepancies that exist today ...
Bingenheimer, Jeffrey B
Men's multiple sexual partnerships contribute to the spread of HIV in sub-Saharan Africa, but the social determinants of these relationships remain poorly understood. Prevailing wisdom suggests that men's institutionalized authority over women and their control of economic resources are key facilitators of multiple partnerships in this region. Men's exposure to or freedom from social control mechanisms embedded in family and village life may also play a role. This article provides insight into these issues by examining sociodemographic correlates of men's multiple sexual partnerships using data from recent Demographic and Health Surveys in 15 sub-Saharan African countries. The prevalence of self-reported multiple partnerships varies widely among countries. Sociodemographic patterns of such partnerships confirm the importance of men's control of economic resources and suggest that men's freedom from social control mechanisms may be more important than their authority over their wives.
Affinnih, Yahya H
This article takes an international perspective on the drug problem in sub-Saharan Africa. This analysis borrows ideas from physical and economic geography as a heuristic device to conceptualize the global narcoscapes in which drug trafficking occurs. Both the legitimate and the illegal drug trade operate within the same global capitalist system and draw on the same technological innovations and business processes. Central to the paper's argument is evidence that sub-Saharan African countries are now integrated into the political economy of drug consumption due to the spill-over effect. These countries are now minor markets for "hard drugs" as the result of the activities of organizations and individual traffickers that use Africa as a staging point in their trade with Europe and the United States. As a result, sub-Saharan African countries have drug consumption problems that were essentially absent prior to 1980, along with associated health, social, and economic costs. The emerging drug problem has forced African countries to develop their own drug control policy. The sub-Saharan African countries mentioned below vary to some extent in the level of drug use and misuse problems: Burundi, Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Reunion, Rwanda, Seychelles, Somalia, Tanzania, Uganda, Zambia, Angola, Cameroon, Central African Republic, Chad, Congo, Congo (Zaire), Equatorial Guinea, Gabon, Sao Tome and Principe, Botswana, Lesotho, Namibia, South Africa, Swaziland, Benin, Burkina Faso, Cape Verde, Cote d'Ivoire, Gambia, Ghana, Guinea, Guinea Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, and Togo. As part of this effort, African countries are assessing the health, social, and economic costs of drug-use-related problems to pinpoint methods which are both effective and inexpensive, since their budgets for social programs are severely constrained. Many have progressed to the point of adopting anti
Mahon, Barbara E; Fields, Patricia I
Invasive nontyphoidal Salmonella (NTS) infections in Africa cause an enormous burden of illness. These infections are often devastating, with mortality estimated at 20%, even with appropriate antimicrobial therapy. Two major groups-young children and HIV-infected adults-suffer the great majority of these infections. In children, younger age itself, as well as malaria, malnutrition, and HIV infection, are prominent risk factors. In adults, HIV infection is by far the most important risk factor. The most common serotypes in invasive infections are Salmonella enterica serotypes Typhimurium and Enteritidis. In recent years, a specific strain of Salmonella Typhimurium, multilocus sequence type 313, has caused epidemics of invasive disease. Little is known about risk factors for exposure to NTS, making the design of rational interventions to decrease exposure difficult. Antimicrobial therapy is critically important for treatment of invasive NTS infections. Thus, the emergence and spread of resistance to agents commonly used for treatment of invasive NTS infection, now including third-generation cephalosporins, is an ominous development. Already, many invasive NTS infections are essentially untreatable in many health care facilities in sub-Saharan Africa. Several candidate vaccines are in early development and, if safe and effective, could be promising. Interventions to prevent exposure to NTS (e.g., improved sanitation), to prevent the occurrence of disease if exposure does occur (e.g., vaccination, malaria control), and to prevent severe disease and death in those who become ill (e.g., preserving antimicrobial effectiveness) are all important in reducing the toll of invasive NTS disease in sub-Saharan Africa.
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.
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.
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.
Mlangwa, J E; Kisauzi, D N
The theory of privatisation is first reviewed with respect to animal health care in sub-Saharan Africa. Then, using the systems approach advocated in an accompanying paper, the authors argue that the nature of animal production systems obtaining in any economy is of central importance in determining the type and mixture of animal health services delivery systems present. These are influenced, in turn, by the demand placed on the production system by consumers, the levels of consumer income and the policies enacted by governments. The authors compare the situation in sub-Saharan Africa with that in developed countries, especially the United States of America. Theory would predict that privatisation of veterinary services in sub-Saharan Africa will be evolutionary rather than revolutionary, even with deliberate policies to encourage privatisation. In regard to personnel, private services would be much easier to develop on the basis of auxiliaries and technicians, rather than self-employed veterinarians and their associates. Hasty or wholesale privatisation, involving the creation of a cadre of self-employed veterinarians will, in the face of market failure, result in a reduction in the services available to low input/low output production systems. The general level of animal health care provided to certain types of producers will thus be lower than currently available. These theoretical predictions are borne out in practice.
Full Text Available Abstract Background In this paper, we aim to quantify the contribution of international health volunteers to the health workforce in sub-Saharan Africa and to explore the perceptions of health service managers regarding these volunteers. Methods Rapid survey among organizations sending international health volunteers and group discussions with experienced medical officers from sub-Saharan African countries. Results We contacted 13 volunteer organizations having more than 10 full-time equivalent international health volunteers in sub-Saharan Africa and estimated that they employed together 2072 full-time equivalent international health volunteers in 2005. The numbers sent by secular non-governmental organizations (NGOs is growing, while the number sent by development NGOs, including faith-based organizations, is mostly decreasing. The cost is estimated at between US$36 000 and US$50 000 per expatriate volunteer per year. There are trends towards more employment of international health volunteers from low-income countries and of national medical staff. Country experts express more negative views about international health volunteers than positive ones. They see them as increasingly paradoxical in view of the existence of urban unemployed doctors and nurses in most countries. Creating conditions for employment and training of national staff is strongly favoured as an alternative. Only in exceptional circumstances is sending international health volunteers viewed as a defendable temporary measure. Conclusion We estimate that not more than 5000 full-time equivalent international health volunteers were working in sub-Saharan Africa in 2005, of which not more than 1500 were doctors. A distinction should be made between (1 secular medical humanitarian NGOs, (2development NGOs, and (3 volunteer organizations, as Voluntary Service Overseas (VSO and United Nations volunteers (UNV. They have different views, undergo different trends and are differently
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.
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.
... From the Federal Register Online via the Government Publishing Office EXPORT-IMPORT BANK Postponement Notice of Open Special Meeting of the Sub-Saharan Africa Advisory Committee of the Export-Import... for trade with Sub-Saharan Africa. Postponement: The Sub-Saharan Africa Advisory Committee of the...
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.
Molyneux, Sassy; Sariola, Salla; Allman, Dan; Dijkstra, Maartje; Gichuru, Evans; Graham, Susan; Kamuya, Dorcas; Gakii, Gloria; Kayemba, Brian; Kombo, Bernadette; Maleche, Allan; Mbwambo, Jessie; Marsh, Vicki; Micheni, Murugi; Mumba, Noni; Parker, Michael; Shio, Jasmine; Yah, Clarence; van der Elst, Elise; Sanders, Eduard
Community engagement, incorporating elements of the broader concepts of public and stakeholder engagement, is increasingly promoted globally, including for health research conducted in developing countries. In sub-Saharan Africa, community engagement needs and challenges are arguably intensified for
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...
Dzik, Walter Sunny; Kyeyune, Dorothy; Otekat, Grace; Natukunda, Bernard; Hume, Heather; Kasirye, Phillip G; Ddungu, Henry; Kajja, Isaac; Dhabangi, Aggrey; Mugyenyi, Godfrey R; Seguin, Claire; Barnes, Linda; Delaney, Meghan
In November 2014, a 3-day conference devoted to transfusion medicine in sub-Saharan Africa was held in Kampala, Uganda. Faculty from academic institutions in Uganda provided a broad overview of issues pertinent to transfusion medicine in Africa. The conference consisted of lectures, demonstrations, and discussions followed by 5 small group workshops held at the Uganda Blood Transfusion Service Laboratories, the Ugandan Cancer Institute, and the Mulago National Referral Hospital. Highlighted topics included the challenges posed by increasing clinical demands for blood, the need for better patient identification at the time of transfusion, inadequate application of the antiglobulin reagent during pretransfusion testing, concern regarding proper recognition and evaluation of transfusion reactions, the expanded role for nurse leadership as a means to improve patient outcomes, and the need for an epidemiologic map of blood usage in Africa. Specialty areas of focus included the potential for broader application of transcranial Doppler and hydroxyurea therapy in sickle cell disease, African-specific guidelines for transfusion support of cancer patients, the challenges of transfusion support in trauma, and the importance of African-centered clinical research in pediatric and obstetric transfusion medicine. The course concluded by summarizing the benefits derived from an organized quality program that extended from the donor to the recipient. As an educational tool, the slide-audio presentation of the lectures will be made freely available at the International Society of Blood Transfusion Academy Web site: http://www.isbtweb.org/academy/. Copyright © 2015 Elsevier Inc. All rights reserved.
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)
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.
Asongu, Simplice; Boateng, Agyenim; Akamavi, Raphael
A recent World Bank report reveals that poverty has been decreasing in all regions of the world with the exception of sub-Saharan Africa (SSA) as more than 45% of countries in the sub-region are off-track from achieving the Millennium Development Goal (MDG) extreme poverty target. This paper investigates the effects of mobile phone technology, knowledge creation and diffusion on inclusive human development in 49 SSA countries for the period 2000-2012 using Tobit model. The study finds that mo...
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
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
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
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.…
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…
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
The rising prevalence of cardiovascular disease in sub-Saharan Africa (SSA) constitutes a significant health and socio-economic challenge for the countries in the region. This study examines the patterns and scientific impact of international collaboration in cardiovascular research (CVR) in SSA. Bibliographic data from 2005 to 2014 were obtained from the Web of Science for cardiovascular-related publications with at least one author affiliated to an SSA country. The number of publications involving multiple SSA countries over this period accounted for less than 10% of the total number of multi-country publications that included at least one SSA country. Collaboration patterns reflected dominance by countries in Europe and North America, with South Africa accounting for the bulk of scientific collaboration in CVR within SSA. The findings indicate that pro-active strategies are needed to strengthen collaboration in CVR across SSA for the region to derive health and socio-economic benefits from locally conducted research.
McMorrow, M.L.; Wemakoy, E.O.; Tshilobo, J.K.; Emukule, G.O.; Mott, J.A.; Njuguna, H.; Waiboci, L.; Heraud, J.M.; Rajatonirina, S.; Razanajatovo, N.H.; Chilombe, M.; Everett, D.; Heyderman, R.S.; Barakat, A.; Nyatanyi, T.; Rukelibuga, J.; Cohen, A.L.; Cohen, C.; Tempia, S.; Thomas, J.; Venter, M.; Mwakapeje, E.; Mponela, M.; Lutwama, J.; Duque, J.; Lafond, K.; Nzussouo, N.T.; Williams, T.; Widdowson, M.A.
BACKGROUND: Data on causes of death due to respiratory illness in Africa are limited. METHODS: From January to April 2013, 28 African countries were invited to participate in a review of severe acute respiratory illness (SARI)-associated deaths identified from influenza surveillance during
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.
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.
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
.... This calls for serious introspection. The present study examines the interaction between child labour, education participation and per capita economic growth for Sub-Saharan Africa in a holistic framework using two-stage least squares (2SLS...
Basedau, Matthias; Strüver, Georg; Vüllers, Johannes
Despite the religious diversity in sub-Saharan Africa and the religious overtones in a number of African conflicts, social science research has inadequately addressed the question of how and to what extent religion matters for conflict in Africa. This paper presents an innovative data inventory on religion and violent conflict in all sub-Saharan countries for the period 1990-2008 that seeks to contribute to filling the gap. The data underscore that religion has to be accounted for in conflict...
Matthias Basedau; Georg Strüver; Johannes Vüllers
Despite the religious diversity in sub-Saharan Africa and the religious overtones in a number of African conflicts, social science research has inadequately addressed the question of how and to what extent religion matters for conflict in Africa. This paper presents an innovative data inventory on religion and violent conflict in all sub-Saharan countries for the period 1990–2008 that seeks to contribute to filling the gap. The data underscore that religion has to be accounted for in conflict...
Full Text Available Introduction: The extent of neuromeningeal cryptococcosis (NMC has increased since the advent of HIV/AIDS. It has non-specific clinical signs but marked by high mortality. Objective: To analyze the characteristics of the NMC in sub-Saharan Africa. Materials and Methods: We have conducted a literature reviewed on the NMC in sub-Saharan Africa from the publications available on the basis of national and international data with keywords such as "Cryptococcus, Epidemiology, Symptoms, Outcomes and Mortality" and their equivalent in French in July 2011. All publications from 1990 to 2010 with 202 references were analyzed. The following results are the means of different studied variables. Results: We selected in final 43 publications dealing with the NMC which 24 involved 17 countries in Africa. The average age was 36 years old. The average prevalence was 3.41% and the average incidence was 10.48% (range 6.90% to 12%. The most common signs were fever (75%, headaches (62.50% and impaired consciousness. Meningeal signs were present in 49% of cases. The mean CD4 count was 44.8cells/mm 3 . The India ink and latex agglutination tests were the most sensitive. The average time before the consultation and the hospital stay was almost identical to 27.71 days. The average death rate was 45.90%. Fluconazole has been the most commonly used molecule. Conclusion: The epidemiological indicators of NMC varied more depending on the region of sub-Saharan Africa. Early and effective taking care of patients to reduce diagnostic delay and heavy mortality remains the challenges.
Cortina, Melissa A; Sodha, Anisha; Fazel, Mina; Ramchandani, Paul G
To assess the prevalence of child mental health problems in community settings in sub-Saharan Africa. A systematic search of MEDLINE, EMBASE, and PsychInfo, supplemented by tracking of references from identified articles and personal communications with local researchers. Only community-based studies in sub-Saharan Africa that assessed the general psychopathology of children aged 0 to 16 years were included. For each eligible study, the following information was extracted: year of publication, country, population sampled, area type (rural or urban), sampling method and sample size (percentage boys), age range, assessment instrument, informant, diagnostic criteria, and prevalence rates of general psychopathology. Pooled prevalence rate of psychopathology in children, identified by questionnaire and, specifically, by clinical diagnostic instruments. Eleven studies met the inclusion criteria, 10 of which were included in the meta-analysis. The 10 studies provided data for 9713 children from 6 countries, with substantial variation in assessment methods. Overall, 14.3% (95% CI, 13.6%-15.0%) of children were identified as having psychopathology. Studies using screening questionnaires reported higher prevalence rates (19.8%; 95% CI, 18.8%-20.7%) than did studies using clinical diagnostic instruments (9.5%; 8.4%-10.5%). Evidence suggests that considerable levels of mental health problems exist among children and adolescents in sub-Saharan Africa. One in 7 children and adolescents have significant difficulties, with 1 in 10 (9.5%) having a specific psychiatric disorder. There are clear sociodemographic correlates of psychopathology that may place children in areas of greatest deprivation at greatest risk.
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
Dillon, David G; Gurdasani, Deepti; Riha, Johanna
Sub-Saharan Africa (SSA) has the highest burden of HIV in the world and a rising prevalence of cardiometabolic disease; however, the interrelationship between HIV, antiretroviral therapy (ART) and cardiometabolic traits is not well described in SSA populations.......Sub-Saharan Africa (SSA) has the highest burden of HIV in the world and a rising prevalence of cardiometabolic disease; however, the interrelationship between HIV, antiretroviral therapy (ART) and cardiometabolic traits is not well described in SSA populations....
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....
Caldwell, J C; Orubuloye, I O; Caldwell, P
In those parts of Sub-Saharan Africa most affected by the HIV/AIDS epidemic both public and private reaction to the seriousness of the epidemic have been less than might have been anticipated. This limited reaction weakens national, community and family responses to the epidemic and also reduces the pressure on international donors to provide adequate support. The paper first examines the reasons for underreaction by governments. These reasons include an assessment that successes will not be easily achieved, a reluctance to give leadership in areas of private sensitivity, an awareness of the fragility of the data base, a persistent feeling that it is a disease of foreign origin with a foreign overreaction to the situation in Africa, and the nature of the disease itself with a long latency period, obscure symptoms and an urban bias. Nevertheless, the paper argues that the more fundamental underreaction, shaping the reactions of governments, is that from the community itself. This arises partly from the demonstration that it is a sexually transmitted disease in societies where the discussion of sexual relations between the generations and the sexes has always been difficult and where new religions have in some societies reinforced older attitudes towards the shame of being discovered to have had illicit relationships. However, the main reasons lie in continuing aspects of the cultures which emphasize the multiple antecedents of misfortune and plural explanations of death, an element of predestination in when death takes place, a concept of good fortune--sometimes arising from or demonstrated by sexual activity--which renders misadventure unlikely, and a courage when facing death which is partly attributable to belief about survival beyond this event.
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.
Fayose, Folasayo; Huan, Zhongjie
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.
Full Text Available This study gives an outlook on the carbon balance of Sub-Saharan Africa (SSA by presenting a summary of currently available results from the project CarboAfrica (namely net ecosystem productivity and emissions from fires, deforestation and forest degradation, by field and model estimates supplemented by bibliographic data and compared with a new synthesis of the data from national communications to UNFCCC. According to these preliminary estimates the biogenic carbon balance of SSA varies from 0.16 Pg C y−1 to a much higher sink of 1.00 Pg C y−1 (depending on the source data. Models estimates would give an unrealistic sink of 3.23 Pg C y−1, confirming their current inadequacy when applied to Africa. The carbon uptake by forests and savannas (0.34 and 1.89 Pg C y−1, respectively, are the main contributors to the resulting sink. Fires (0.72 Pg C y−1 and deforestation (0.25 Pg C y−1 are the main contributors to the SSA carbon emissions, while the agricultural sector and forest degradation contributes only with 0.12 and 0.08 Pg C y−1, respectively. Savannas play a major role in shaping the SSA carbon balance, due to their large extension, their fire regime, and their strong interannual NEP variability, but they are also a major uncertainty in the overall budget. Even if fossil fuel emissions from SSA are relative low, they can be crucial in defining the sign of the overall SSA carbon balance by reducing the natural sink potential, especially in the future. This paper shows that Africa plays a key role in the global carbon cycle system and probably could have a potential for carbon sequestration higher than expected, even if still highly uncertain. Further investigations are needed, particularly to better address the role of savannas and tropical forests and to improve biogeochemical models. The CarboAfrica network of carbon measurements could provide future
Sheahan, Megan; Barrett, Christopher B
Conventional wisdom holds that Sub-Saharan African farmers use few modern inputs despite the fact that most poverty-reducing agricultural growth in the region is expected to come largely from expanded use of inputs that embody improved technologies, particularly improved seed, fertilizers and other agro-chemicals, machinery, and irrigation. Yet following several years of high food prices, concerted policy efforts to intensify fertilizer and hybrid seed use, and increased public and private investment in agriculture, how low is modern input use in Africa really? This article revisits Africa's agricultural input landscape, exploiting the unique, recently collected, nationally representative, agriculturally intensive, and cross-country comparable Living Standard Measurement Study-Integrated Surveys on Agriculture (LSMS-ISA) covering six countries in the region (Ethiopia, Malawi, Niger, Nigeria, Tanzania, and Uganda). Using data from over 22,000 households and 62,000 agricultural plots, we offer ten potentially surprising facts about modern input use in Africa today.
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.
Pablo Viguera Ester
Full Text Available Half of the 10 million children who die annually in the world are from Sub-Saharan Africa (SSA. The reasons are known, but lack of will and resources avoid the development of sustainable policies. Associated factors to the high infant mortality rate (IMR in SSA have been investigated in this research. An ecological multi-group study was designed comparing rates within SSA. The dependent variable is the IMR and health services, economic and development indicators are the independent variables. Information and data sources were WHO, World Bank, UNICEF and UNDP (1997-2007. IMR mean value is 92.2 (per 1000 live births and a relationship with several of the factors could be observed. In the bi-variate analysis direct relationship was observed with maternal mortality rate and an inverse relationship was observed with prenatal care coverage, births assisted by skilled health personnel, gross national income per capita, per capita government expenditure on health, social security expenditure, adult literacy rate, net primary school enrolment rate, population with access to safe drinking water (in urban and rural areas and with population with access to basic sanitation in rural areas. In the multi-variate analysis IMR had an inverse relationship with children under 5 years with diarrhoea who receive oral re-hydration, with social security expenditure as percentage of general government expenditure on health and with per capita government expenditure on health. The situation in SSA would change if their inhabitants received education and information to demand more equitable polices and better investments from their governments.
Ruenes, Albert; Gueye, Serigne M
In the United States alone, approximately 220,000 new cases of prostate cancer will be detected in 2007, and 27000 men will die of that disease. African American men will suffer disproportionately, having a prostate cancer incidence that is nearly 60% higher than their Caucasian counterparts. In fact, it is widely accepted that African American men have the highest incidence of prostate cancer in the world. This observation has led investigators to study the prostate cancer risk among African men in an effort to identify factors responsible for the high incidence of prostate cancer that plagues the African American population. Findings suggest that the public health burden of prostate cancer to native African men is substantial. Effective management of prostate cancer depends on early detection of the disease and its definitive treatment. Cost-effective management can be elusive. Radical prostatectomy can cure clinically localized disease and may offer long-term cancer control in patients with stage T3 disease. Of the various forms of radical prostatectomy, radical perineal prostatectomy is ideally suited to accomplish these goals in sub-Saharan Africa. A program to teach radical perineal prostatectomy has begun in Dakar, Senegal. It is a system based on graded surgical responsibility. High-quality audiovisual guides familiarize surgeons with the procedure's unique anatomic concerns. They then observe live procedures, assist in live procedures and eventually begin performing the live procedures under direct supervision. Repeated performance of the operation with simultaneous critique is the hallmark of this program, the goal of which is to establish a center of excellence where surgeons throughout the continent can come to learn this technique.
Background Leadership is widely regarded as central to effective health-care systems, and resources are increasingly devoted to the cultivation of strong health-care leadership. Nevertheless, the literature regarding leadership capacity building has been developed primarily in the context of high-income settings. Less research has been done on leadership in low-income settings, including sub-Saharan Africa, particularly in health care, with attention to historical, political and sociocultural context. We sought to characterize the experiences of individuals in key health-care leadership roles in sub-Saharan Africa. Methods We conducted a qualitative study using in-person interviews with individuals (n = 17) in health-care leadership roles in four countries in sub-Saharan Africa: the Federal Democratic Republic of Ethiopia, the Republic of Ghana, the Republic of Liberia and the Republic of Rwanda. Individuals were identified by their 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. Results Five key themes emerged as important to participants in their leadership roles: having an aspirational, value-based vision for improving the future health of the country, being self-aware and having the ability to identify and use complementary skills of others, tending to relationships, using data in decision making, and sustaining a commitment to learning. Conclusions Current models of leadership capacity building address the need for core technical and management competencies. While these competencies are important, skills relevant to managing relationships are also critical in the sub-Saharan African context
Full Text Available Abstract Background Leadership is widely regarded as central to effective health-care systems, and resources are increasingly devoted to the cultivation of strong health-care leadership. Nevertheless, the literature regarding leadership capacity building has been developed primarily in the context of high-income settings. Less research has been done on leadership in low-income settings, including sub-Saharan Africa, particularly in health care, with attention to historical, political and sociocultural context. We sought to characterize the experiences of individuals in key health-care leadership roles in sub-Saharan Africa. Methods We conducted a qualitative study using in-person interviews with individuals (n = 17 in health-care leadership roles in four countries in sub-Saharan Africa: the Federal Democratic Republic of Ethiopia, the Republic of Ghana, the Republic of Liberia and the Republic of Rwanda. Individuals were identified by their 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. Results Five key themes emerged as important to participants in their leadership roles: having an aspirational, value-based vision for improving the future health of the country, being self-aware and having the ability to identify and use complementary skills of others, tending to relationships, using data in decision making, and sustaining a commitment to learning. Conclusions Current models of leadership capacity building address the need for core technical and management competencies. While these competencies are important, skills relevant to managing relationships are also critical in the sub-Saharan
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).
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
Jung, Minsoo; Lin, Leesa; Viswanath, Kasisomayajula
While several studies have examined the crucial role that parents' vaccination behaviors play in reducing disease spread and severity among children, few have evaluated the connection between parents' media use and their decision on whether or not to vaccinate their child, specifically in relation to the BCG (Bacillus Calmetter Guerin), DPT (Diptheria, Pertussis, Tetanus) polio, and measles vaccines. Media channels are a critical source of health information for parents, which is especially true in Sub-Saharan Africa, as there is often a dearth of local healthcare providers. The aim of this paper is to investigate the role that media use plays in a mothers' choice to vaccinate their infant children in sub-Saharan Africa, specifically focusing on whether media use is associated with socioeconomic status (SES) and a mothers' vaccination of their children. Cross-sectional data from the Demographic Health Surveys of 13 sub-Saharan countries (2004-2010) were pooled. A multivariate Poisson regression of 151,209 women was used to calculate adjusted relative ratios and 95% confidence intervals for the associations among SES, media use, and immunization. Education and wealth were found to be strongly and positively associated with vaccine-uptake behaviors. The effects of media use (radio and television) were found to be associated with the relationships between SES and vaccine uptake. However, it did not reduce the impact of SES on vaccination. These findings indicate that mass media may be an important tool for future efforts to reduce the health discrepancies between children from high- and low-socioeconomic backgrounds. Going forward, immunization strategies should include communication plans that will address and mitigate potential immunization disparities among parents of different SES backgrounds. Copyright © 2015 Elsevier Ltd. All rights reserved.
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.
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...
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 ...
Adisa, Femi; Isabalija, Stephen R.
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...
AJRH Managing Editor
endometriosis and improve service delivery that will ultimately result in an improved quality of life for women with endometriosis. The first ever Sub Saharan African scientific conference on endometriosis in. Kampala Uganda in 2006 highlighted the need to develop integrative and multidisciplinary endometriosis programs in ...
Hagopian, Amy; Thompson, Matthew J; Fordyce, Meredith; Johnson, Karin E; Hart, L Gary
BACKGROUND: The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa. METHODS: We used the American Medical Association 2002 Masterfile to identify and describe physicians who received their medical training in sub-Saharan Africa and are currently practicing in the USA. RESULTS: More than 23% of America's 771 491 physicians received their medical training outside the USA, the majority (64%) in low-income or lower middle-income countries. A total of 5334 physicians from sub-Saharan Africa are in that group, a number that represents more than 6% of the physicians practicing in sub-Saharan Africa now. Nearly 86% of these Africans practicing in the USA originate from only three countries: Nigeria, South Africa and Ghana. Furthermore, 79% were trained at only 10 medical schools. CONCLUSIONS: Physician migration from poor countries to rich ones contributes to worldwide health workforce imbalances that may be detrimental to the health systems of source countries. The migration of over 5000 doctors from sub-Saharan Africa to the USA has had a significantly negative effect on the doctor-to-population ratio of Africa. The finding that the bulk of migration occurs from only a few countries and medical schools suggests policy interventions in only a few locations could be effective in stemming the brain drain.
Johnson Karin E
Full Text Available Abstract Background The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa. Methods We used the American Medical Association 2002 Masterfile to identify and describe physicians who received their medical training in sub-Saharan Africa and are currently practicing in the USA. Results More than 23% of America's 771 491 physicians received their medical training outside the USA, the majority (64% in low-income or lower middle-income countries. A total of 5334 physicians from sub-Saharan Africa are in that group, a number that represents more than 6% of the physicians practicing in sub-Saharan Africa now. Nearly 86% of these Africans practicing in the USA originate from only three countries: Nigeria, South Africa and Ghana. Furthermore, 79% were trained at only 10 medical schools. Conclusions Physician migration from poor countries to rich ones contributes to worldwide health workforce imbalances that may be detrimental to the health systems of source countries. The migration of over 5000 doctors from sub-Saharan Africa to the USA has had a significantly negative effect on the doctor-to-population ratio of Africa. The finding that the bulk of migration occurs from only a few countries and medical schools suggests policy interventions in only a few locations could be effective in stemming the brain drain.
Bendavid, Eran; Avila, Patrick; Miller, Grant
To determine whether the Mexico City Policy, a United States government policy that prohibits funding to nongovernmental organizations performing or promoting abortion, was associated with the induced abortion rate in sub-Saharan Africa. Women in 20 African countries who had induced abortions between 1994 and 2008 were identified in Demographic and Health Surveys. A country's exposure to the Mexico City Policy was considered high (or low) if its per capita assistance from the United States for family planning and reproductive health was above (or below) the median among study countries before the policy's reinstatement in 2001. Using logistic regression and a difference-in-difference design, the authors estimated the differential change in the odds of having an induced abortion among women in high exposure countries relative to low exposure countries when the policy was reinstated. The study included 261,116 women aged 15 to 44 years. A comparison of 1994-2000 with 2001-2008 revealed an adjusted odds ratio for induced abortion of 2.55 for high-exposure countries versus low-exposure countries under the policy (95% confidence interval, CI: 1.76-3.71). There was a relative decline in the use of modern contraceptives in the high-exposure countries over the same time period. The induced abortion rate in sub-Saharan Africa rose in high-exposure countries relative to low-exposure countries when the Mexico City Policy was reintroduced. Reduced financial support for family planning may have led women to substitute abortion for contraception. Regardless of one's views about abortion, the findings may have important implications for public policies governing abortion.
Sacktor, Ned; Nakasujja, Noeline; Robertson, Kevin; Clifford, David B
In the US, HIV dementia occurs in 10-15% of HIV-positive individuals with advanced infection. The prevalence of HIV dementia in sub-Saharan countries, where the vast majority of individuals with HIV reside, is largely unknown. This Review will summarize our current understanding of HIV-associated cognitive impairment in resource-limited settings, focusing specifically on the countries of sub-Saharan Africa. We will describe the frequency of HIV dementia and HIV-associated cognitive impairment from several case series in the sub-Saharan region. We will then summarize recent studies from Uganda and Ethiopia that included detailed neuropsychological assessments. The potential influence of clade diversity on HIV-associated cognitive impairment will be discussed. Differences between the results of the studies in Uganda and in Ethiopia raise the possibility that HIV subtypes might have different biological properties with respect to their capacity to cause HIV-associated cognitive impairment. Further studies are needed to determine the true prevalence of HIV dementia in sub-Saharan Africa and to establish whether specific clade subtypes might influence the presentation of neurological complications.
Daniel J. Corsi; S. V. Subramanian
Background: Infant and child mortality rates are among the most important indicators of child health, nutrition, implementation of key survival interventions, and the overall social and economic development of a population. In this paper, we investigate the role of coverage of maternal and child health (MNCH) interventions in contributing to declines in child mortality in sub-Saharan Africa.Design: Data are from 81 Demographic and Health Surveys from 35 sub-Saharan African countries. Using ec...
Oryema, John Bosco; Gyimah-Brempong, Kwabena; Picone, Gabriel
This paper examines the impact of the Highly Indebted Poor Countries (HIPC) Initiative on under five mortality rate (U5MR) in Sub-Saharan Africa. The HIPC Initiative involves debt forgiveness and the redirection of funds that were meant to service external debt towards the provision of social services and poverty reduction in eligible countries. The Initiative is akin to a natural experiment since some countries benefited while some did not, and the timing of debt forgiveness varied across countries. We exploit these variations to identify the impact of HIPC Initiative on child mortality using a dynamic panel data estimator. We find that participation in HIPC Initiative is associated with statistically significant decreases in U5MR. On the other hand, the impact of actual debt cancelled is statistically insignificant.
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.
Atwood, Stephen; Van der Putten, Marc
Abstract 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.
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.
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.
Korkovelos, Alexandros; Mentis, Dimitrios; Hussain Siyal, Shahid; Arderne, Christopher; Beck, Hylke; de Roo, Ad; Howells, Mark
Sub-Saharan Africa has been the epicenter of ongoing global dialogues around energy poverty and justifiably so. More than half of the world's unserved population lives there. At the same time, a big part of the continent is privileged with plentiful renewable energy resources. Hydropower is one of them and to a large extent it remains untapped. This study focuses on the technical assessment of small-scale hydropower (0.01-10 MW) in Sub-Saharan Africa. The underlying methodology was based on open source geospatial datasets, whose combination allowed a consistent evaluation of 712,615 km of river network spanning over 44 countries. Environmental, topological and social constraints were included in the form of geospatial restrictions to help preserve the natural wealth and promote sustainable development. The results revealed that small-scale hydropower could cover 8.5-12.5% of the estimated electricity demand in 2030, thus making it a viable option to support electrification efforts in the region.
Pamela Y. Collins
Full Text Available The 2010 Global Burden of Disease Study points to a changing landscape in which non-communicable diseases, such as mental, neurological, and substance use (MNS disorders, account for an increasing proportion of premature mortality and disability globally. Despite evidence of the need for care, a remarkable deficit of providers for MNS disorder service delivery persists in sub-Saharan Africa. This critical workforce can be developed from a range of non-specialist and specialist health workers who have access to evidence-based interventions, whose roles, and the associated tasks, are articulated and clearly delineated, and who are equipped to master and maintain the competencies associated with providing MNS disorder care. In 2012, the Neuroscience Forum of the Institute of Medicine convened a meeting of key stakeholders in Kampala, Uganda, to discuss a set of candidate core competencies for the delivery of mental health and neurological care, focusing specifically on depression, psychosis, epilepsy, and alcohol use disorders. This article discusses the candidate core competencies for non-specialist health workers and the complexities of implementing core competencies in low- and middle-income country settings. Sub-Saharan Africa, however, has the potential to implement novel training initiatives through university networks and through structured processes that engage ministries of health. Finally, we outline challenges associated with implementing competencies in order to sustain a workforce capable of delivering quality services for people with MNS disorders.
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.
Zachariah, R; Ford, N; Philips, M; Lynch, S; Massaquoi, M; Janssens, V; Harries, A D
Sub-Saharan Africa is facing a crisis in human health resources due to a critical shortage of health workers. The shortage is compounded by a high burden of infectious diseases; emigration of trained professionals; difficult working conditions and low motivation. In particular, the burden of HIV/AIDS has led to the concept of task shifting being increasingly promoted as a way of rapidly expanding human resource capacity. This refers to the delegation of medical and health service responsibilities from higher to lower cadres of health staff, in some cases non-professionals. This paper, drawing on Médecins Sans Frontières' experience of scaling-up antiretroviral treatment in three sub-Saharan African countries (Malawi, South Africa and Lesotho) and supplemented by a review of the literature, highlights the main opportunities and challenges posed by task shifting and proposes specific actions to tackle the challenges. The opportunities include: increasing access to life-saving treatment; improving the workforce skills mix and health-system efficiency; enhancing the role of the community; cost advantages and reducing attrition and international 'brain drain'. The challenges include: maintaining quality and safety; addressing professional and institutional resistance; sustaining motivation and performance and preventing deaths of health workers from HIV/AIDS. Task shifting should not undermine the primary objective of improving patient benefits and public health outcomes.
Dembélé, Martial; Lefoka, Pulane
This article assumes that pedagogical renewal and teacher development are two sides of the same coin, and that the achievement of a universal primary education that is equitable and of acceptable quality in Sub-Saharan Africa will depend to a large extent on both. The need for pedagogical renewal stems from the evidence that (i) teaching is arguably the strongest school-level determinant of student achievement; (ii) teaching effect on student learning is reportedly higher in Sub-Saharan Africa than it is in high-income countries; (iii) learning achievement is considerably lower in the sub-continent's schools; and (iv) the kind of teaching that takes place in these schools confines students to a passive role and only fosters lower order skills. An overview of experiences with pedagogical renewal highlights the challenges involved in adopting open-ended instructional practices on the sub-continent. It further points to bilingual education as one of the most promising strategies. Regardless of the route taken for renewing pedagogy, the professional development of teacher educators/trainers must be considered a critical enabling condition.
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 diabetes, previous stillbirth, previous macrosomic child and age >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.
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
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
, boards, commissions, and foundations are central to funding and catalyzing research and innovation across Africa. A recent scoping study supported by IDRC in 17 SSA countries underscored the increasingly important role ...
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
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.
Van Lith, Lynn M; Yahner, Melanie; Bakamjian, Lynn
Demographic and Health Survey data from 18 countries were analyzed to better understand the characteristics of women wishing to limit childbearing. Demand for limiting (14% of all women) is less than that that for spacing (25%) but is still substantial. The mean "demand crossover age" (the average age at which demand to limit births begins to exceed demand to space) is generally around age 33, but in some countries it is as low as 23 or 24. Young women often intend to limit their births, contrary to the assumption that only older women do. Large numbers of women have exceeded their desired fertility but do not use family planning, citing fear of side effects and health concerns as barriers. When analysis is restricted to married women, demand for limiting nearly equals that for spacing. Many women who want no more children and who use contraception, especially poor women and those with less education, use less effective temporary contraceptive methods. A sizable number of women in sub-Saharan Africa-nearly 8 million-have demand for limiting future births. Limiting births has a greater impact on fertility rates than spacing births and is a major factor driving the fertility transition. Family planning programs must prepare to meet this demand by addressing supply- and demand-side barriers to use. Meeting the growing needs of sub-Saharan African women who want to limit births is essential, as they are a unique audience that has long been overlooked and underserved.
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.
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.
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
Full Text Available Background: The 2008 Maputo Declaration calls for the development of dedicated national laboratory policies and strategic plans supporting the enhancement of laboratory services in response to the long-lasting relegation of medical laboratory systems in sub-Saharan Africa.Objectives: This study describes the extent to which laboratories are addressed in the national health policies and plans created directly following the 2008 momentum for laboratory strengthening.Method: National health policies and plans from 39 sub-Saharan African countries, valid throughout and beyond 31 December 2010 were collected in March 2012 and analysed during 2013.Results: Laboratories were addressed by all countries. Human resources were the most addressed topic (38/39 and finances and budget were the least addressed (< 5/39. Countries lagging behind in national laboratory strategic planning at the end of 2013 (17/39 were more likely to be francophone countries located in West-Central Africa (13/17 and have historically low HIV prevalence. The most common gaps anticipated to compromise the implementation of the policies and plans were the disconnect between policies and plans, under-developed finance sections and monitoring and evaluating frameworks, absence of points of reference to define gaps and shortages, and inappropriate governance structure.Conclusion: The availability of laboratory policy and plan implementation can be improved by strictly applying a more standardised methodology for policy development, using harmonised norms to set targets for improvement and intensifying the establishment of directorates of laboratory services directly under the authority of Ministries of Health. Horizontal programmes such as the Global Health Security Agenda could provide the necessary impulse to take the least advanced countries on board.
Full Text Available Background: The 2008 Maputo Declaration calls for the development of dedicated national laboratory policies and strategic plans supporting the enhancement of laboratory services in response to the long-lasting relegation of medical laboratory systems in sub-Saharan Africa. Objectives: This study describes the extent to which laboratories are addressed in the national health policies and plans created directly following the 2008 momentum for laboratory strengthening. Method: National health policies and plans from 39 sub-Saharan African countries, valid throughout and beyond 31 December 2010 were collected in March 2012 and analysed during 2013. Results: Laboratories were addressed by all countries. Human resources were the most addressed topic (38/39 and finances and budget were the least addressed (< 5/39. Countries lagging behind in national laboratory strategic planning at the end of 2013 (17/39 were more likely to be francophone countries located in West-Central Africa (13/17 and have historically low HIV prevalence. The most common gaps anticipated to compromise the implementation of the policies and plans were the disconnect between policies and plans, under-developed finance sections and monitoring and evaluating frameworks, absence of points of reference to define gaps and shortages, and inappropriate governance structure. Conclusion: The availability of laboratory policy and plan implementation can be improved by strictly applying a more standardised methodology for policy development, using harmonised norms to set targets for improvement and intensifying the establishment of directorates of laboratory services directly under the authority of Ministries of Health. Horizontal programmes such as the Global Health Security Agenda could provide the necessary impulse to take the least advanced countries on board.
Grimes, Caris E; Law, Rebekah; Dare, Anna; Day, Nigel; Reshamwalla, Sophie; Murowa, Michael; George, Peter M; Kamara, Thaim B; Mkandawire, Nyengo C; Leather, Andrew J M; Lavy, Christopher B D
District hospitals in sub-Saharan Africa are in need of investment if countries are going to progress towards universal health coverage, and meet the sustainable development goals and the Lancet Commission on Global Surgery time-bound targets for 2030. Previous studies have suggested that government hospitals are likely to be highly cost-effective and therefore worthy of investment. A retrospective analysis of the inpatient logbooks for two government district hospitals in two sub-Saharan African hospitals was performed. Data were extracted and DALYs were calculated based on the diagnosis and procedures undertaken. Estimated costs were obtained based on the patient receiving ideal treatment for their condition rather than actual treatment received. Total cost per DALY averted was 26 (range 17-66) for Thyolo District Hospital in Malawi and 363 (range 187-881) for Bo District Hospital in Sierra Leone. This is the first published paper to support the hypothesis that government district hospitals are very cost-effective. The results are within the same range of the US$32.78-223 per DALY averted published for non-governmental hospitals.
Tenkorang, Eric Y
Studies on associations between marriage and HIV infection among women in sub-Saharan Africa are generally inconclusive. Not enough is known about HIV risks among divorced and widowed women. This study examined the relationship between marital status and HIV infection among women in seven sub-Saharan African countries. Retrospective data from the Demographic and Health Surveys were combined with HIV biomarker data from the AIDS Indicator Survey (AIS) for analysis. Random-effects complementary log-log models were applied to examine the relationship between marital status and HIV risks controlling for theoretically relevant covariates. Compared to never-married women, widowed women were significantly more likely to be HIV positive. Similarly, married women were more likely to be infected with HIV, compared to never-married women in Lesotho and Zimbabwe. In Tanzania and Zimbabwe, divorced women had higher risks of HIV infection, compared to never-married women. Findings suggest that specific HIV programs be directed at vulnerable women, in particular those widowed. Similar programs are needed for both poorer and wealthier women.
Ondoa, Pascale; van der Broek, Ankie; Jansen, Christel; de Bruijn, Hilde; Schultsz, Constance
The 2008 Maputo Declaration calls for the development of dedicated national laboratory policies and strategic plans supporting the enhancement of laboratory services in response to the long-lasting relegation of medical laboratory systems in sub-Saharan Africa. This study describes the extent to which laboratories are addressed in the national health policies and plans created directly following the 2008 momentum for laboratory strengthening. National health policies and plans from 39 sub-Saharan African countries, valid throughout and beyond 31 December 2010 were collected in March 2012 and analysed during 2013. Laboratories were addressed by all countries. Human resources were the most addressed topic (38/39) and finances and budget were the least addressed (strategic planning at the end of 2013 (17/39) were more likely to be francophone countries located in West-Central Africa (13/17) and have historically low HIV prevalence. The most common gaps anticipated to compromise the implementation of the policies and plans were the disconnect between policies and plans, under-developed finance sections and monitoring and evaluating frameworks, absence of points of reference to define gaps and shortages, and inappropriate governance structure. The availability of laboratory policy and plan implementation can be improved by strictly applying a more standardised methodology for policy development, using harmonised norms to set targets for improvement and intensifying the establishment of directorates of laboratory services directly under the authority of Ministries of Health. Horizontal programmes such as the Global Health Security Agenda could provide the necessary impulse to take the least advanced countries on board.
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
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
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.
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
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...
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)
Neerinckx, Simon B; Peterson, Andrew T; Gulinck, Hubert
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...
Apata, Ibironke W; Averhoff, Francisco; Pitman, John; Bjork, Adam; Yu, Junping; Amin, Noryati Abu; Dhingra, Neelam; Kolwaite, Amy; Marfin, Anthony
Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are major causes of morbidity and mortality globally, primarily because of sequelae of chronic liver disease including cirrhosis and hepatocellular carcinoma. The risks for HBV and HCV transmission via blood transfusions have been described previously and are believed to be higher in countries in sub-Saharan Africa. Reducing the risk for transfusion-transmitted human immunodeficiency virus (HIV), HBV, and HCV infection is a priority for international aid organizations, such as the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Combat HIV/AIDS, Malaria, and Tuberculosis, and the World Health Organization (WHO). Over the last decade, PEPFAR and the Global Fund have supported blood safety programs in many sub-Saharan African countries with heavy burdens of HIV and acquired immunodeficiency syndrome (AIDS), hepatitis, malaria, and maternal mortality. This report summarizes HBV- and HCV-related surveillance data reported by the blood transfusion services of WHO member states to WHO's Global Database on Blood Safety (GDBS) (4). It also evaluates the performance of blood safety programs in screening for HBV and HCV in 38 sub-Saharan Africa countries. Selected GDBS indicators were compared for the years 2000 and 2004 (referred to as the 2000/2004 period) and 2010 and 2011 (referred to as the 2010/2011 period). From 2000/2004 to 2010/2011, the median of the annual number of units donated per country increased, the number of countries screening at least 95% of blood donations for HBV and HCV increased, and the median of the national prevalence of HBV and HCV marker-reactive blood donations decreased. These findings suggest that during the past decade, more blood has been donated and screened for HBV and HCV, resulting in a safer blood supply. Investments in blood safety should be continued to further increase the availability and safety of blood products in sub-Saharan Africa.
Kluth, Michael Friederich
of the main EU powers. While Europe's initial African focus was on stabilising a continent marred by state failure, civil wars and genocides, changes in the global security context, especially the shift towards multipolarity manifest in China's growing engagement, has prompted a complementary focus...... on deterring other powers from making military inroads into the subcontinent. Hence Europe's sub-Saharan security focus is shifting from stabilisation towards deterrence. This helps explain recent military procurements which, in spite of the extremely challenging fiscal position of most EU member states...
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.
Winkler, Andrea Sylvia
Neurocysticercosis has been recognized as a major cause of secondary epilepsy worldwide. So far, most of the knowledge about the disease comes from Latin America and the Indian subcontinent. Unfortunately, in sub-Saharan Africa the condition was neglected for a long time, mainly owing to the lack of appropriate diagnostic tools. This review therefore focuses on the prevalence of neurocysticercosis in sub-Saharan Africa, the clinical picture with emphasis on epilepsy, as well as the diagnosis and treatment of neurocysticercosis and its related epilepsy/epileptic seizures in African resource-poor settings.
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 ...
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. Download the PDF (1.1MB). Battling malaria with treated bednets. Among the best news of this ...
Full Text Available Scale-up of malaria preventive and control interventions over the last decade resulted in substantial declines in mortality and morbidity from the disease in sub-Saharan Africa and many other parts of the world. Sustaining these gains will depend on the health system performance. Treatment provides individual benefits by curing infection and preventing progression to severe disease as well as community-level benefits by reducing the infectious reservoir and averting emergence and spread of drug resistance. However many patients with malaria do not access care, providers do not comply with treatment guidelines, and hence, patients do not necessarily receive the correct regimen. Even when the correct regimen is administered some patients will not adhere and others will be treated with counterfeit or substandard medication leading to treatment failures and spread of drug resistance. We apply systems effectiveness concepts that explicitly consider implications of health system factors such as treatment seeking, provider compliance, adherence, and quality of medication to estimate treatment outcomes for malaria case management. We compile data for these indicators to derive estimates of effective coverage for 43 high-burden Sub-Saharan African countries. Parameters are populated from the Demographic and Health Surveys and other published sources. We assess the relative importance of these factors on the level of effective coverage and consider variation in these health systems indicators across countries. Our findings suggest that effective coverage for malaria case management ranges from 8% to 72% in the region. Different factors account for health system inefficiencies in different countries. Significant losses in effectiveness of treatment are estimated in all countries. The patterns of inter-country variation suggest that these are system failures that are amenable to change. Identifying the reasons for the poor health system performance and
Galactionova, Katya; Tediosi, Fabrizio; de Savigny, Don; Smith, Thomas; Tanner, Marcel
Scale-up of malaria preventive and control interventions over the last decade resulted in substantial declines in mortality and morbidity from the disease in sub-Saharan Africa and many other parts of the world. Sustaining these gains will depend on the health system performance. Treatment provides individual benefits by curing infection and preventing progression to severe disease as well as community-level benefits by reducing the infectious reservoir and averting emergence and spread of drug resistance. However many patients with malaria do not access care, providers do not comply with treatment guidelines, and hence, patients do not necessarily receive the correct regimen. Even when the correct regimen is administered some patients will not adhere and others will be treated with counterfeit or substandard medication leading to treatment failures and spread of drug resistance. We apply systems effectiveness concepts that explicitly consider implications of health system factors such as treatment seeking, provider compliance, adherence, and quality of medication to estimate treatment outcomes for malaria case management. We compile data for these indicators to derive estimates of effective coverage for 43 high-burden Sub-Saharan African countries. Parameters are populated from the Demographic and Health Surveys and other published sources. We assess the relative importance of these factors on the level of effective coverage and consider variation in these health systems indicators across countries. Our findings suggest that effective coverage for malaria case management ranges from 8% to 72% in the region. Different factors account for health system inefficiencies in different countries. Significant losses in effectiveness of treatment are estimated in all countries. The patterns of inter-country variation suggest that these are system failures that are amenable to change. Identifying the reasons for the poor health system performance and intervening to tackle
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 sub-Saharan cities, particularly where contraceptive use is low and access to clinical abortion is high (though largely illegal), abortion appears to be the method of choice for limiting or spacing births. Even in rural areas, women may regularly resort to abortion, often using extremely unsafe procedures, instead of contraception. Available data seem to indicate that relatively high levels of abortion correlate with low access to modern contraception, low status of women, strong sanctions against out-of-wedlock pregnancy, traditional tolerance of abortion, and availability of modern abortion practices. Abortion has been and will likely continue to be used to plan families within much of sub-Saharan Africa.
Nygaard, Ivan; Bindner, Henrik W.; Katic, Ivan
Solar PV is one among other low carbon technologies for rural electrification in Sub Saharan Africa (SSA). Solar PV systems have for almost 30 years been disseminated in SSA, resulting in more than half a million installations concentrated in a few countries. While PV systems have technically...... matured and markets have gradually developed, PV for rural electrification has often been perceived with scepticism from potential users, donors, government officials and researchers, and solar PV has in many camps been labelled as donor driven, expensive and fragile technology mainly serving the richest...... electrification schemes governed and financed by electric utilities and rural electrification agencies. Based on a literature review and the experience with a full scale hybrid wind/PV diesel system at RISØ DTU, this paper provides cost estimates for hybrid PV-diesel systems and policy recommendations to change...
Abekah-Nkrumah, Gordon; Abor, Patience Aseweh; Abor, Joshua; Adjasi, Charles K D
This paper aims to examine links between women's access to micro-finance and how they use maternal healthcare services in sub-Saharan Africa (SSA). The authors use theoretical and empirical literature to propose a framework to sustain and improve women's access to maternal healthcare services through micro-financing. It is found that improved access to micro-finance by women, combined with education may enhance maternal health service uptake. The paper does not consider empirical data in the analysis. The authors advocate empirically testing the framework proposed in other SSA countries. It is important to empower women by facilitating their access to education and micro-finance. This has implications for improving maternal healthcare utilization in SSA. The paper moves beyond poor access to maternal health services in SSA and proposes a framework for providing sustainable solutions.
Aloni, Michel Ntetani; Kambere, Renault Sitwaminya; Molua, Antoine; Dilu, Joseph Nzinga; Tshibassu, Pierre Manianga; Kazadi-Lukusa, Aimé; Ngiyulu, René Makuala; Kalengayi, Raphael Mbona; Ehungu, Jean Lambert Gini
Cherubism is rare disease and has been rarely reported in African pediatric population. We report here the case of a 10-year-old child who was referred to our hospital for bilateral jaws swelling. Physical examination revealed bilateral swelling symmetry of the face. Histopathological examination of the biopsy specimen showed loose fibrous stroma, proliferating fibrous connective with tissue interspersed with multinucleated giant cells, small thin walled blood vessels and scattered sparse mononuclear inflammatory infiltrate. Our patient presented cherubism. Cherubism is rarely described in children living in sub-Saharan Africa. Genetic and molecular investigations plays an important role in diagnosis but were not available in poor resources settings in developing countries such as the Democratic Republic of Congo. PMID:25918610
Michel Ntetani Aloni
Full Text Available Cherubism is rare disease and has been rarely reported in African pediatric population. We report here the case of a 10-year-old child who was referred to our hospital for bilateral jaws swelling. Physical examination revealed bilateral swelling symmetry of the face. Histopathological examination of the biopsy specimen showed loose fibrous stroma, proliferating fibrous connective with tissue interspersed with multinucleated giant cells, small thin walled blood vessels and scattered sparse mononuclear inflammatory infiltrate. Our patient presented cherubism. Cherubism is rarely described in children living in sub-Saharan Africa. Genetic and molecular investigations plays an important role in diagnosis but were not available in poor resources settings in developing countries such as the Democratic Republic of Congo.
Asamoah-Akuoko, Lucy; Hassall, Oliver W; Bates, Imelda
save lives. The main deterrent to blood donation was fear due to lack of knowledge and discouraging spiritual, religious and cultural perceptions of blood donation. The main motivators for blood donation were altruism, donating blood for family and incentives. The findings support the need for targeted......Achieving an adequate blood supply in Sub-Saharan Africa (SSA) through donor mobilization and retention is crucial. Factors that motivate or deter blood donors vary according to beliefs and social norms. Understanding the factors that influence blood donation behaviour in SSA is vital to developing...... effective strategies to address blood donor motivation and retention. This review of 35 studies from 16 SSA countries collates available evidence concerning the perceptions, motivators and deterrents that influence blood donors in SSA. The review revealed a common understanding that blood and blood donation...
Adepoju, Ibukun-Oluwa Omolade; Albersen, Bregje Joanna Antonia; De Brouwere, Vincent; van Roosmalen, Jos; Zweekhorst, Marjolein
In a bid to deliver quality health services in resource-poor settings, mobile health (mHealth) is increasingly being adopted. The role of mHealth in facilitating evidence-based clinical decision-making through data collection, decision algorithms, and evidence-based guidelines, for example, is established in resource-rich settings. However, the extent to which mobile clinical decision support systems (mCDSS) have been adopted specifically in resource-poor settings such as Africa and the lessons learned about their use in such settings are yet to be established. The aim of this study was to synthesize evidence on the use of mHealth for point-of-care decision support and improved quality of care by health care workers in Africa. A scoping review of 4 peer-reviewed and 1 grey literature databases was conducted. No date limits were applied, but only articles in English language were selected. Using pre-established criteria, 2 reviewers screened articles and extracted data. Articles were analyzed using Microsoft Excel and MAXQDA. We retained 22 articles representing 11 different studies in 7 sub-Saharan African countries. Interventions were mainly in the domain of maternal health and ranged from simple text messaging (short message service, SMS) to complex multicomponent interventions. Although health workers are generally supportive of mCDSS and perceive them as useful, concerns about increased workload and altered workflow hinder sustainability. Facilitators and barriers to use of mCDSS include technical and infrastructural support, ownership, health system challenges, and training. The use of mCDSS in sub-Saharan Africa is an indication of progress in mHealth, although their effect on quality of service delivery is yet to be fully explored. Lessons learned are useful for informing future research, policy, and practice for technologically supported health care delivery, especially in resource-poor settings.
Namara, R.E.; Gebregziabher, G.; Giordano, M.; Fraiture, de C.M.S.
The expansion of irrigation in Sub-Saharan Africa has been slow. In Asia, the rapid expansion of smallholder irrigation systems was attributed in part to the availability and affordability of motorized pumps. This paper appraises the current extent of pump-based irrigation in Sub-Saharan Africa;
Breuer, Erica; Myer, Landon; Struthers, Helen; Joska, John A
The relationship between mental illness and HIV/AIDS is complex and bidirectional. A significant amount of research has been performed in high-income countries but less is known about HIV and mental health in sub-Saharan Africa. The objectives of the review were to search the literature for quantitative studies conducted in sub-Saharan Africa on mental health and HIV and to critically evaluate and collate the studies in order to identify research needs and priorities. The databases Ovid, MEDLINE, PsycINFO and the Social Sciences Citation Index (SSCI) were searched for variations of search terms related to HIV/AIDS and mental health and studies limited to the populations of African countries. In addition, we hand-searched indexes of key journals and the databases of academic theses. We included 104 papers or research publications. The majority of these were published after 2005. The major topics covered were: mental-health-related HIV-risk behaviour, HIV in psychiatric populations, and mental illness in HIV-positive populations. The reported prevalence levels of mental illness among people living with HIV or AIDS (PLHIV) was high, with all but one study noting a prevalence of 19% or higher. Neurocognitive changes in adults with HIV were also prevalent, with reported deficits of up to 99% in symptomatic PLHIV and 33% in non-symptomatic PLHIV. Research on HIV in relation to mental health is increasing; however, there is a need for good-quality prospective studies to investigate the bidirectional effects of mental illness and HIV on each other.
Omwami, Edith Mukudi; Keller, Edmond J.
Budgetary capacity that would allow for the public funding of the provision of universal access to primary education is lacking in many sub-Saharan economies. National revenues significantly lag behind the overall economic productivity measure of GDP. Analysis of data derived from UNESCO and UNDP for 2004 shows that governments in the region spend far less in US dollars per unit cost on primary education than do developed countries. Increasing the unit cost of education in order to enable a government to guarantee universal primary education would take away resources from other tiers of the education system in many countries in the region. The alternative is to universalise access, despite existing budget allocation constraints, and thereby further compound the problems of poor infrastructure and limited human resource capacity that continue to compromise education quality in sub-Saharan Africa.
Hiatt, Robert A; Engmann, Natalie J; Ahmed, Mushtaq; Amarsi, Yasmin; Macharia, William M; Macfarlane, Sarah B; Ngugi, Anthony K; Rabbani, Fauziah; Walraven, Gijs; Armstrong, Robert W
Sub-Saharan Africa suffers an inordinate burden of disease and does not have the numbers of suitably trained health care workers to address this challenge. New concepts in health sciences education are needed to offer alternatives to current training approaches.A perspective of integrated training in population health for undergraduate medical and nursing education is advanced, rather than continuing to take separate approaches for clinical and public health education. Population health science educates students in the social and environmental origins of disease, thus complementing disease-specific training and providing opportunities for learners to take the perspective of the community as a critical part of their education.Many of the recent initiatives in health science education in sub-Saharan Africa are reviewed, and two case studies of innovative change in undergraduate medical education are presented that begin to incorporate such population health thinking. The focus is on East Africa, one of the most rapidly growing economies in sub-Saharan Africa where opportunities for change in health science education are opening. The authors conclude that a focus on population health is a timely and effective way for enhancing training of health care professionals to reduce the burden of disease in sub-Saharan Africa.
General David M. Rodriguez, USA , U.S. Africa Commander). 6 Strange et al., “Tracking Underreported Financial Flows China’s Development Finance and the...agricultural prices. This is even more important in countries whose national currency is extraordinarily inflated , such as Zimbabwe and Zambia, and would...from foreign markets, as well as inflated pricing for natural resources and reduced foreign currency leverage. Deborah Brautigam notes that China
Kaplinsky, Raphael; Morris, Adam; Kaplan, David
In a complementary Discussion Paper (MMCP DP 12 2011) we set out the reasons why we believe that there is extensive scope for linkage development into and out of SSA’s commodities sectors. In this Discussion Paper, we present the findings of our detailed empirical enquiry into the determinants of the breadth and depth of linkages in eight SSA countries (Angola, Botswana, Gabon, Ghana, Nigeria, South Africa Tanzania, and Zambia) and six sectors (copper, diamonds, gold, oil and gas, mining serv...
Muideen O. Bakare; Kerim M. Munir; Mashudat A. Bello-Mojeed
Sub-Saharan African (SSA) population consists of about 45% children, while in Europe and North America children population is 10- 15%. Lately, attention has been directed at mitigating childhood infectious and communicable diseases to reduce under-five mortality. As the under-five mortality index in Sub-Saharan Africa has relatively improved over the last two decades, more Sub-Saharan African children are surviving beyond the age of five and, apparently, a sizeable percentage of this populati...
Wada, Y.; Luan, Y.; Fischer, G.; Sun, L.; Shi, P.
Forcing with the population growth and consequently increasing food requirement, food security in sub-Saharan Africa is one of the most emergent and challenging issues. The purposes of this work are 1) what's the future food requirement and their food security status in each sub-Saharan African countries? What is the distance from current and future food security status, corresponding to the food requirement, to the targeted food security status? 2) To what extent Sub-Saharan countries could meet their present and future food requirement, and whether they have potential to improve their food insecurity status on currently cultivated land? 3) Whether or, if there have, how the pressures on land resources from meeting the food requirements? To figure those questions out, we firstly use socio-economic pathways datasets, and historical food diet pattern classification to forecast the 2010-2050 food commodity and feed calories demand per country. A new food security indicator, which considered the influences of both the food energy and quality intake, was used to evaluate the food insecurity status and the distances to different targeted statuses of the specific country. The latest Global Agro-Ecological Zones (GAEZ) databases were used to estimate the current and future crop yield gap and crop potential production. For current to future scenario analysis, we considered population growth, dietary change, climate change, agricultural input level, and target food security status. Then the balance of food requirement with the current and potential crop production was analyzed for different scenarios. Land requirements were calculated for meeting those food requirements, and the pressures on land resources are evaluated. Our works are hoping to provide scientific-based evidences for policy recommendations for local government to tackle food insecurity problems in Sub-Saharan Africa.
Ondoa, Pascale; van der Broek, Ankie; Jansen, Christel; de Bruijn, Hilde; Schultsz, Constance
The 2008 Maputo Declaration calls for the development of dedicated national laboratory policies and strategic plans supporting the enhancement of laboratory services in response to the long-lasting relegation of medical laboratory systems in sub-Saharan Africa. This study describes the extent to
Chidebell Emordi, Chukwunonso
Energy poverty is pervasive in sub-Saharan Africa. Nigeria, located in sub-Saharan West Africa, is the world's seventh largest oil exporting country and is a resource-rich nation. It however experiences the same levels of energy poverty as most of its neighboring countries. Attributing this paradox only to corruption or the "Dutch Disease", where one sector booms at the expense of other sectors of the economy, is simplistic and enervates attempts at reform. In addition, data on energy consumption is aggregated at the national level via estimates, disaggregated data is virtually non-existent. Finally, the wave of decentralization of vertically integrated national utilities sweeping the developing world has caught on in sub-Saharan Africa. However, little is known of the economic and social implications of these transitions within the unique socio-technical system of the region's electricity sector, especially as it applies to energy poverty. This dissertation proposes a complex systems approach to measuring and mitigating energy poverty in Nigeria due to its multi-dimensional nature. This is done via a three-fold approach: the first section of the study delves into causation by examining the governance institutions that create and perpetuate energy poverty; the next section proposes a context-specific minimum energy poverty line based on field data collected on energy consumption; and the paper concludes with an indicator-based transition management framework encompassing institutional, economic, social, and environmental themes of sustainable transition within the electricity sector. This work contributes to intellectual discourse on systems-based mitigation strategies for energy poverty that are widely applicable within the sub-Saharan region, as well as adds to the knowledge-base of decision-support tools for addressing energy poverty in its complexity.
Oramasionwu, Christine U; Daniels, Kelly R; Labreche, Matthew J; Frei, Christopher R
The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) pandemic has caused far-reaching effects in sub-Saharan Africa. The pandemic has effectively diminished the workforce, increased poverty rates, reduced agricultural productivity, and transformed the structure of many rural households. HIV/AIDS further strains the already fragile relationship between livelihood and the natural and social environments of these regions. Therefore, the objective of this review is to characterize the impact of HIV/AIDS on the environment and the social infrastructure of rural sub-Saharan Africa. There are many aspects of rural life that contribute to disease transmission of HIV/AIDS and that pose unique challenges to the population dynamics in sub-Saharan Africa. Widespread AIDS-related mortality has caused a decrease in population growth for many African countries. In turn, these alterations in population dynamics have resulted in a decrease in the percentage of prime-age working adults, as well as a gender disparity, whereby, females carry a growing burden of household responsibilities. There is a rising proportion of older adults, often females, who assume the role of provider and caretaker for other dependent family members. These changing dynamics have caused many to exploit their natural surroundings, adopting less sustainable land use practices and utilizing protected resources as a primary means of generating revenue.
Iroh Tam, Pui-Ying; Sadoh, Ayebo E; Obaro, Stephen K
Pneumonia causes an enormous burden of childhood disease globally, particularly in low- and middle-income countries. Pneumococcus is the most common bacterial aetiology of pneumonia; however, antimicrobials are limited and may not adequately address the local epidemiology of the region. To undertake a review and meta-analysis of pneumonia studies in sub-Saharan Africa to evaluate antimicrobial susceptibility patterns in childhood pneumonia. Articles published in PubMed and Google between 2006 and 2016 which evaluated antimicrobial susceptibility profiles of pneumococcal pneumonia in children in sub-Saharan Africa were identified. The source of specimens, pathogens and antimicrobial susceptibility data were extracted. Pooled analysis of susceptible isolates was conducted using random effects models. Children from 15 studies and 1634 isolates were included in the meta-analysis. In cases of childhood pneumonia, the mean overall proportion of penicillin susceptibility from invasive specimens of Streptococcus pneumoniae was 85.7% (95% CI 80.1-91.3), and of trimethoprim-sulfamethoxazole was 21.0% (95% CI 5.1-36.9). Compared with all S. pneumoniae specimens, penicillin susceptibility was 68.6% (95% CI 59.6-77.5) and that of trimethoprim-sulfamethoxazole was 26.3% (95% CI 14.1-38.6). A high level of heterogeneity was detected, reflecting the paucity of data available. The establishment of national and regional diagnostic platforms to monitor antimicrobial susceptibility profiles for pneumonia as well as other invasive diseases will provide data with which to assess the relevance and adaptation of antimicrobial prescribing recommendations.
Zongo, Dramane; Kabre, B Gustave; Dayeri, Dianou; Savadogo, Boubacar; Poda, Jean-Noël
In spite of great progress in schistosomiasis control during the last decade in Burkina Faso, this disease remains a public health concern in the country. Indeed, our study consisted of the analysis of parasitological data related to Schistosoma haematobium and Schistosoma mansoni and in malacological investigations. The prevalence rate of Schistosoma haematobium varies from 3.3% to 50.4% and from 3.3% to 39.1% for Schistosoma mansoni, but only in the western part of Burkina Faso. Schoolboys are more infested than girls, but the phenomenon is reversed in adults. Biomphalaria pfeifferi, Bulinus truncatus, Bulinus senegalensis and Bulinus globosus were collected during this study. Thus, the behavioral factors as well as the dynamics and the distribution of the intermediate mollusks play a major role in the persistence of the disease. Copyright © 2013. Published by Elsevier SAS.
Schroeder, Lee F; Amukele, Timothy
A recent survey of laboratories in Kampala, Uganda, demonstrated that only 0.3% of laboratories (3/954) met international quality standards. To benchmark laboratory quality throughout the rest of sub-Saharan Africa (SSA), we compiled a list of SSA laboratories meeting international quality standards. Accrediting bodies were queried via online registries or direct communication in May 2013. There were 380 laboratories accredited to international standards in SSA. Ninety-one percent were in South Africa. Thirty-seven of 49 countries had no laboratories accredited to international quality standards. Accredited laboratory density (per million people) in South Africa, Namibia, and Botswana were similar to those in many European countries. Single variable linear regression showed a correlation between accredited laboratory density and health expenditures per person (adjusted R(2) = 0.81, P laboratory. For those that do, there is a strong correlation between country-specific accredited laboratory density and per-capita health expenditures. Copyright© by the American Society for Clinical Pathology.
economic , political, and social impacts of entrepreneurship , and the development of entrepreneurship in Sub-Saharan Africa was studied through the lens of...9 II. ENTREPRENEURSHIP AND ECONOMIC GROWTH IN THE DEVELOPING WORLD... Entrepreneurship ..............................................................16 B. ENTREPRENEURSHIP , ECONOMIC GROWTH, AND DEVELOPMENT STAGES
Bryceson, D.F.; MacCall, M.
This paper questions the assumptions of the rural technology debate, reassessing if and how technological interventions and initiatives are potentially valuable to rural women in sub-Saharan Africa. This entails examining what kinds of technologies are being promoted, and for whom they are being
Soil fertility management in sub-Saharan Africa is complex, diverse and dynamic. Farmers' investments are determined by a wide variety of factors, including bio-physical characteristics of the environment, access to resources and the institutional, and socio-economic context of farming and
The Information and Networks in Asia and Sub-Saharan Africa (INASSA) program focuses on producing and sharing credible, high-quality evidence on the influence of digital initiatives in governance, science, learning, and entrepreneurship. The program disseminates and shares knowledge to enhance policy dialogues ...
Ellis, S.D.K.; MacGaffey, Janet
This paper describes some of the methodological and conceptual problems in researching aspects of sub-Saharan Africa's international 'underground' trade, meaning commercial transactions which are conducted across international frontiers but which are unrecorded in official data. The authors focus in
Little investigation has been made to explain why women are less likely than are men to support democracy in Sub-Saharan Africa. This gender difference in politics has been found in numerous studies and may hinder the much needed legitimation of democracy in this region. This paper addresses the
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
Jan 13, 2016 ... This scoping paper is one of a series jointly commissioned by Canada's International Development Research Centre and the MasterCard Foundation. Read the full paper, Youth employment in sub-Saharan Africa: Taking stock of the evidence and knowledge gaps (PDF, 825 KB); For a visual representation ...
This paper examines the impact of in ation on economic growth in Sub-Saharan Africa in order to provide an empirical evidence whether in ation hinders or boost economic activities in the region. The paper found that in ation exhibits a reducing-growth effect in both short-term and long-term periods using Panel ...
This paper examines the female face of migration in sub-Saharan Africa.In the last two decades, there has been an increasing amount of research onfeminization of migration, which has begun to fill the gap created by the earlierfocus on male labour migration. Women in earlier migration research were seen ascompanions ...
Sola, Phosiso; Cerutti, Paolo Omar; Zhou, Wen; Gautier, Denis; Iiyama, Miyuki; Schure, Jolien; Chenevoy, Audrey; Yila, Jummai; Dufe, Vanessa; Nasi, Robert; Petrokofsky, Gillian; Shepherd, Gill
Background: In Sub-Saharan Africa (SSA), the production and use of woodfuel remains an important socio-economic activity with more than 70% of the population relying on woodfuel as their primary household energy source. Despite their socio-economic significance, woodfuel value chains are often
Buijtenhuijs, Rob; Rijnierse, Elly
This report gives an overview of the literature on recent democratization processes in sub-Saharan Africa (1989-1992). The authors first deal with the basic features of African politics that can serve as a framework within which present-day democratization developments can be comprehended. Then they
AJRH Managing Editor
Sub-Saharan Africa (SSA) has the highest maternal and under-5 mortality rates as well as low facility births, with a high percentage of births occurring in the absence of skilled personnel. We examine trends in health facility births in SSA by geographic areas (urban-rural) and regions; and also the correlation between health ...
Kolding, Jeppe; Zwieten, van P.A.M.; Marttin, Felix; Poulain, Florence
Dryland areas cover more than half of sub-Saharan Africa and are home to nearly 50 percent of
its populations, who depend on agriculture (including livestock, crops and fisheries) as their main
livelihood strategy. Sporadic and irregular rainfall patterns are the most important
The Integrated Program on Malaria in sub-Saharan Africa (IPMA) will offer a shared and synergistic approach to existing malaria control programs. It will do so by supporting research aimed at understanding the complex societal and environmental dynamics affecting malaria in the region, and testing interventions that ...
In the global landscape of tourism scholarship, the region of sub-Saharan Africa is an undeveloped research focus. This article offers an overview of recent research trends, and argues that cues for an African tourism agenda should be taken from the developmental imperatives that confront the continent. The nexus of ...
... African HIV exposed infants. It is hoped that when Highly Active Antiretroviral Therapy (HAART) becomes universally accessible and available to HIV infected women in sub-Saharan Africa, breast milk HIV transmission will be a rare event and the health benefits of breastfeeding for the infant and mother will be maximized.
Ungauged catchments can be found in many parts of the world, but particularly in sub-Saharan Africa. Information collected in a gauged catchment and its regionalisation to ungauged areas is crucial for water resources assessment. Especially farmers in semi-arid are in need of such information. Inter
Bryceson, Deborah Fahy
Drawing on research findings emanating from the De-Agrarianisation and Rural Employment (DARE) Research Programme, coordinated by the African Studies Centre, Leiden, this paper compares changing economic and social patterns in a wide variety of rural settlements in sub-Saharan Africa. Recently
Kluth, Michael Friederich; Pilegaard, Jess
Sub-Saharan Africa constitutes a distinct security region and hosts a high proportion of fragile and failed states presiding over territories with abundant resources – but no indigenous great powers! Following offensive neorealist logic, the absence of local great powers explains the continued...
Frambach, J.M.; Manuel, B.A.; Fumo, A.M.; Vleuten, C.P.M. van der; Driessen, E.W.
BACKGROUND: Evidence tailored to sub-Saharan Africa on outcomes of innovations in medical education is needed to encourage and advance their implementation in this region. AIM: To investigate preparedness for practice of students and graduates from an innovative and a conventional medical curriculum
Veltman, Jennifer A; Bristow, Claire C; Klausner, Jeffrey D
Meningitis is one of the leading causes of death among patients living with HIV in sub-Saharan Africa. There is no widespread tracking of the incidence rates of causative agents among patients living with HIV, yet the aetiologies of meningitis are different than those of the general population. We reviewed the scientific literature published in PubMed to determine the incidence rates of meningitis among hospitalized people living with HIV in sub-Saharan Africa and report our findings from seven studies across sub-Saharan Africa. We found high rates of cryptococcal meningitis (19-68%). Tuberculous meningitis was lower (1-36%), although some centres included possible cases as "other" meningitis; therefore, this may not be a true representation of the total cases. Pyogenic meningitis ranged from 6 to 30% and "other" meningitis ranged from 7 to 28% of all reported cases of meningitis. Mortality rates ranged from 25 to 68%. This review describes the most common aetiologies and provides practical diagnostic, treatment and prevention considerations as they apply to the individual living with HIV in sub-Saharan Africa. Diagnosis is often limited, and wider availability of accurate and low-cost laboratory diagnostics is desperately needed for prompt diagnosis and initiation of appropriate treatment. Wider acceptance and adoption of available preventative modalities can decrease the incidence of potentially fatal central nervous system infections in African patients living with HIV.
Guven, Melis U.; Abels, Miglena
The paper summarizes key design characteristics and performance indicators of national and civil service pension schemes in Sub-Saharan Africa (SSA). It is intended to serve as a resource in pension reform efforts in the region. The note delivers an up-to date assessment of the main design parameters, key performance metrics, and main challenges facing pension systems in SSA. The informati...
Leopold, Stije J.; van Leth, Frank; Tarekegn, Hayalnesh; Schultsz, Constance
Little is known about the prevalence of antimicrobial resistance (AMR) amongst bacterial pathogens in sub-Saharan Africa (sSA), despite calls for continent-wide surveillance to inform empirical treatment guidelines. We searched PubMed and additional databases for susceptibility data of key pathogens
Gysels, M.H.; Pell, C.; Straus, L.; Pool, R.
Background End of life (EoL) care in sub-Saharan Africa still lacks the sound evidence-base needed for the development of effective, appropriate service provision. It is essential to make evidence from all types of research available alongside clinical and health service data, to ensure that EoL
Conn, Katharine M.
In this article, I identify educational interventions with an impact on student learning in Sub-Saharan Africa. After a systematic literature search, I conducted a meta-analysis synthesizing 56 articles containing 66 separate experiments and quasi-experiments and 83 treatment arms. I evaluated 12 types of education interventions such as the…
There have been many attempts to control malaria in sub-Saharan Africa through health sector interventions (case diagnosis, management and prevention), vector control (larvicide, insecticide and environmentally based mosquito control), reduction of human-vector contact (bednets) and public education. These initiatives ...
Mutula, Stephen Mudogo
Purpose: This article aims to present experiences and the lessons learned from the University of Botswana (UB) library automation project. The implications of the project for similar libraries planning automation in sub Saharan Africa and beyond are adduced. Design/methodology/approach: The article is a case study of library automation at the…
Background: Sub-Saharan Africa has the largest burden of pediatric HIV in the world. Global target has been set for eradication of pediatric HIV by 2015 but there are still so many complex issues facing HIV infected and affected children in the sub-continent. Objective: To review the current and emerging challenges facing ...
The main objective of the paper is to test hypotheses on social class variables as determinants of the prevalence of HIV/AIDS in Sub-Saharan Africa, and to structure a schematic model for the relationship on the impact of social class on HIV/AIDS prevalence. World Bank data, 2002 World Development Indicators, are used ...
Biazin, B.; Sterk, G.; Temesgen, M.; Abdulkedir, A.; Stroosnijder, L.
Agricultural water scarcity in the predominantly rainfed agricultural system of sub-Saharan Africa (SSA) is more related to the variability of rainfall and excessive non-productive losses, than the total annual precipitation in the growing season. Less than 15% of the terrestrial precipitation
Ungauged catchments can be found in many parts of the world, but particularly in sub-Saharan Africa. Information collected in a gauged catchment and its regionalisation to ungauged areas is crucial for water resources assessment. Especially farmers in semi-arid areas are in need of such information.
Vanlauwe, B.; Descheemaeker, K.K.E.; Giller, K.E.; Huising, J.; Merckx, R.; Nziguheba, G.; Wendt, J.; Zingore, S.
Intensification of smallholder agriculture in sub-Saharan Africa is necessary to address rural poverty and natural resource degradation. Integrated Soil Fertility Management (ISFM) is a means to enhance crop productivity while maximizing the agronomic efficiency (AE) of applied inputs, and can thus
Analysis of Chinese FDI in Sub-Saharan Africa. EJBE Vol. 4 No. 2/2014. Page 192. Table 3. 5: Textile & Garment Manufacturers. The field work was conducted with textile & garment manufacturers specially producing shoe and textiles. No. Company. Name. Title. Company Name Address. 1. Awassa Textile. Share Company.
including two sites in Tanzania. There is a hope that malaria vaccines could be developed and deployed in malaria endemic communities. This article highlights the challenges of developing and deploying malaria vaccines. Key words: malaria, control, vaccine, development, challenges, Sub-Saharan Africa. Introduction .
Abubakar, Amina; Ssewanyana, Derrick; Newton, Charles R.
The burden of autism spectrum disorders (ASDs) in sub-Saharan Africa (SSA) is not well known. We carried out a systematic review of the literature to identify published work from SSA. We have systematically searched four databases, namely, Medline, PsycINFO, CINAHL, and Child Development &
Milagrosa, A.; Frickenstein, J.
Despite acknowledgment of the significant role of women in economic growth, gender-biased development policies still persist worldwide. In this context, the paper reviews recent policy reforms in Sub-Saharan Africa that perpetuate gender inequality and female poverty for the already impoverished
In sub-Saharan Africa, shortages of trained health workers, limited diagnostic equipment, inadequate anti-epileptic drug supplies, cultural beliefs, and social stigma contribute to the large treatment gap for epilepsy. The number of people with epilepsy, particularly children, will continue to rise as a result of projected ...
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…
Mortlock, Marinda; Kuzmin, Ivan V.; Weyer, Jacqueline; Gilbert, Amy T.; Agwanda, Bernard; Rupprecht, Charles E.; Nel, Louis H.; Kearney, Teresa; Malekani, Jean M.
As part of a larger survey for detection of pathogens among wildlife in sub-Saharan Africa conducted during 2007–2012, multiple diverse paramyxovirus sequences were detected in renal tissues of bats. Phylogenetic analysis supports the presence of at least 2 major viral lineages and suggests that paramyxoviruses are strongly associated with several bat genera. PMID:26402433
The choice of the language of instruction in Sub-Saharan Africa (SSA) is a fundamental educational issue with ramifications for educational access and effectiveness and ultimately national development. Indigenous SSA languages have suffered devaluation in colonial and post-colonial SSA education, and this devaluation alienates the majority of SSA…
Sub-Saharan Africa is steadily becoming less rural in character. For decades development thinking has prescribed industrialization as the virtuous path leading away from economic dependence on agriculture. The present paper rejects the view that rural or even national industrialization has taken
This review assesses the impact of climate change on lake water resources in Sub-Saharan Africa(SSA). Two significant global water features with immense contribution to agriculture and socio-economic development of the region were analysed. Lake Victoria is the world second largest freshwater lake and Lake Chad the ...
Komla Sena Amouzou
Full Text Available Fifty years after Chen has performed the first forearm replantation, we report our first case of hand replantation in a sub-Saharan African country. The etiology of the amputation was machete due to interpersonal violence. The amputation was trans-carpal, guillotine-type, subtotal non-viable maintained with a small skin bridge. The replantation procedure was successful. At one year follow-up, the functional result according to Chen's criteria was excellent. Through this first experience, we can state that hand replantation can be performed successfully both in survival and function in a non-specialized hospital of a sub-Saharan African country.
Moosa, Shabir; Wojczewski, Silvia; Hoffmann, Kathryn; Poppe, Annelien; Nkomazana, Oathokwa; Peersman, Wim; Willcox, Merlin; Derese, Anselme; Mant, David
Many low-income and middle-income countries globally are now pursuing ambitious plans for universal primary care, but are failing to deliver adequate care quality because of intractable human resource problems. To understand why migrant nurses and doctors from sub-Saharan Africa did not wish to take up available posts in primary and first-contact care in their home countries. Qualitative study of migrant health workers to Europe (UK, Belgium, and Austria) or southern Africa (Botswana and South Africa) from sub-Saharan Africa. Semi-structured interviews with 66 health workers (24 nurses and 42 doctors) from 18 countries between July 2011 and April 2012. Transcripts were analysed thematically using a framework approach. The reasons given for choosing not to work in primary care were grouped into three main analytic streams: poor working environment, difficult living experiences, and poor career path. Responders described a lack of basic medicines and equipment, an unmanageable workload, and lack of professional support. Many had concerns about personal security, living conditions (such as education for children), and poor income. Primary care was seen as lower status than hospital medicine, with lack of specialist training opportunities and more exposure to corruption. Clinicians are reluctant to work in the conditions they currently experience in primary care in sub-Saharan Africa and these conditions tend to get worse as poverty and need for primary care increases. This inverse primary care law undermines achievement of universal health coverage. Policy experience from countries outside Africa shows that it is not immutable. © British Journal of General Practice 2014.
Nsubuga, Peter; Johnson, Kenneth; Tetteh, Christopher; Oundo, Joseph; Weathers, Andrew; Vaughan, James; Elbon, Suzanne; Tshimanga, Mufuta; Ndugulile, Faustine; Ohuabunwo, Chima; Evering-Watley, Michele; Mosha, Fausta; Oleribe, Obinna; Nguku, Patrick; Davis, Lora; Preacely, Nykiconia; Luce, Richard; Antara, Simon; Imara, Hiari; Ndjakani, Yassa; Doyle, Timothy; Espinosa, Yescenia; Kazambu, Ditu; Delissaint, Dieula; Ngulefac, John; Njenga, Kariuki
As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competency-based training for field epidemiologists and public health laboratory scientists providing a master's degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a
Kyei-Nimakoh, Minerva; Carolan-Olah, Mary; McCann, Terence V
Since 2000, the United Nations' Millennium Development Goals, which included a goal to improve maternal health by the end of 2015, has facilitated significant reductions in maternal morbidity and mortality worldwide. However, despite more focused efforts made especially by low- and middle-income countries, targets were largely unmet in sub-Saharan Africa, where women are plagued by many challenges in seeking obstetric care. The aim of this review was to synthesise literature on barriers to obstetric care at health institutions in sub-Saharan Africa. This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus databases were electronically searched to identify studies on barriers to health facility-based obstetric care in sub-Saharan Africa, in English, and dated between 2000 and 2015. Combinations of search terms 'obstetric care', 'access', 'barriers', 'developing countries' and 'sub-Saharan Africa' were used to locate articles. Quantitative, qualitative and mixed-methods studies were considered. A narrative synthesis approach was employed to synthesise the evidence and explore relationships between included studies. One hundred and sixty articles met the inclusion criteria. Currently, obstetric care access is hindered by several demand- and supply-side barriers. The principal demand-side barriers identified were limited household resources/income, non-availability of means of transportation, indirect transport costs, a lack of information on health care services/providers, issues related to stigma and women's self-esteem/assertiveness, a lack of birth preparation, cultural beliefs/practices and ignorance about required obstetric health services. On the supply-side, the most significant barriers were cost of services, physical distance between health facilities and service users' residence, long waiting times at health
Nsubuga, Peter; Johnson, Kenneth; Tetteh, Christopher; Oundo, Joseph; Weathers, Andrew; Vaughan, James; Elbon, Suzanne; Tshimanga, Mufuta; Ndugulile, Faustine; Ohuabunwo, Chima; Evering-Watley, Michele; Mosha, Fausta; Oleribe, Obinna; Nguku, Patrick; Davis, Lora; Preacely, Nykiconia; Luce, Richard; Antara, Simon; Imara, Hiari; Ndjakani, Yassa; Doyle, Timothy; Espinosa, Yescenia; Kazambu, Ditu; Delissaint, Dieula; Ngulefac, John; Njenga, Kariuki
As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competency-based training for field epidemiologists and public health laboratory scientists providing a master's degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a
Jaja, Jones Michael
In conclusion, let us restate that globalization is an aspiration, a race which has only just started. As we Africans line up at the starting blocks we must insist on and ensure a multicultural world which sustains our identity. We in Africa, should not think that globalization is a train heading towards a set destination that may â€“ or may not â€“ stop at the station to pick us up. Rather letâ€™s think of globalization as a delicious cocktail into which every country and continent can add a...
Ginsberg, G.M.; Lauer, J.A.; Zelle, S.; Baeten, S.; Baltussen, R.M.
OBJECTIVE: To determine the costs and health effects of interventions to combat breast, cervical, and colorectal cancers in order to guide resource allocation decisions in developing countries. SETTING: Two World Health Organization sub-regions of the world: countries in sub-Saharan Africa with very
G.M. Ginsberg (Gary); J.A. Lauer (Jeremy); S.G. Zelle (Sten); S.A. Baeten (Stefan); R.M.P.M. Baltussen (Rob)
textabstractTo determine the costs and health effects of interventions to combat breast, cervical, and colorectal cancers in order to guide resource allocation decisions in developing countries. Two World Health Organization sub-regions of the world: countries in sub-Saharan Africa with very high
Full Text Available The burden of autism spectrum disorders (ASDs in sub-Saharan Africa (SSA is not well known. We carried out a systematic review of the literature to identify published work from SSA. We have systematically searched four databases, namely, Medline, PsycINFO, CINAHL, and Child Development & Adolescent Studies, through EBSCO and identified studies from across SSA. Based on predefined inclusion criteria, 47 studies were included in this review. Most of the identified studies (74% were conducted in only 2 African countries, that is, South Africa and Nigeria. Additionally, most of these studies (83% were carried out in the last decade. These studies had four major themes: development of measurement tools of ASD in Africa, examining the prevalence of ASD, identifying risk factors and risk markers, and examining psychosocial issues. We identified only a single population level study aimed at documenting the prevalence of ASD and could not identify a single case-control study aimed at examining a comprehensive set of potential risk factors. All intervention studies were based on very small sample sizes. Put together, our findings suggest that current evidence base is too scanty to provide the required information to plan adequately for effective intervention strategies for children with ASD in Africa.
Kamali, Bahareh; Abbaspour, Karim C.; Wehrli, Bernhard; Yang, Hong
Drought as a slow-onset phenomenon inflicts important losses to agriculture where the degree of vulnerability depends not only on physical variables such as precipitation and temperature, but also on societal preparedness. While the scopes of physical and social vulnerability are very different in nature, studies distinguishing these two aspects have been lacking. In this study we address the physical and social aspects of drought vulnerability of maize (CDVIphy and CDVIsoc) in Sub-Saharan Africa (SSA). To quantify vulnerability, we applied a probabilistic framework combining a Drought Exposure Index (DEI) with a physical or social Crop Failure Index, CFIphy or CFIsoc, respectively. DEI was derived from the exceedance probability of precipitation. Maize yields, simulated using the Environmental Policy Integrated Climate (EPIC) model, were used to build CFIphy, whereas the residual of simulated and FAO recorded yields were used to construct CFIsoc. The results showed that southern and partially central Africa are more vulnerable to physical drought as compared to other regions. Central and western Africa, however, are socially highly vulnerable. Comparison of CDVIphy and CDVIsoc revealed that societal factors cause more vulnerability than physical variables in almost all SSA countries except Nigeria and South Africa. We conclude that quantification of both drought vulnerabilities help a better characterization of droughts and identify regions where more investments in drought preparedness are required.
Daar Abdallah S
Full Text Available Abstract In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation. This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive on-the-ground research in the form of four country case studies of health and biotechnology innovation, six studies of institutions within Africa involved in health product development, and one study of health venture funds in Africa. To the best of our knowledge it is the first extensive collection of empirical work on African science-based health innovation. The four country cases are Ghana, Rwanda, Tanzania and Uganda. The six case studies of institutions are A to Z Textiles (Tanzania, Acorn Technologies (South Africa, Bioventures venture capital fund (South Africa, the Malagasy Institute of Applied Research (IMRA; Madagascar, the Kenyan Medical Research Institute (KEMRI; Kenya, and Niprisan’s development by Nigeria’s National Institute for Pharmaceutical Research and Development and Xechem (Nigeria. All of the examples highlight pioneering attempts to build technological capacity, create economic opportunities, and retain talent on a continent significantly affected by brain drain. They point to the practical challenges for innovators on the ground, and suggest potentially helpful policies, funding streams, and other support systems. For African nations, health innovation represents an opportunity to increase domestic capacity to solve health challenges; for international funders, it is an opportunity to move beyond foreign aid and dependency. The shared goal is creating self-sustaining innovation that has both health and development impacts. While
Al-Bader, Sara; Masum, Hassan; Simiyu, Ken; Daar, Abdallah S; Singer, Peter A
In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation.This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive on-the-ground research in the form of four country case studies of health and biotechnology innovation, six studies of institutions within Africa involved in health product development, and one study of health venture funds in Africa. To the best of our knowledge it is the first extensive collection of empirical work on African science-based health innovation.The four country cases are Ghana, Rwanda, Tanzania and Uganda. The six case studies of institutions are A to Z Textiles (Tanzania), Acorn Technologies (South Africa), Bioventures venture capital fund (South Africa), the Malagasy Institute of Applied Research (IMRA; Madagascar), the Kenyan Medical Research Institute (KEMRI; Kenya), and Niprisan's development by Nigeria's National Institute for Pharmaceutical Research and Development and Xechem (Nigeria).All of the examples highlight pioneering attempts to build technological capacity, create economic opportunities, and retain talent on a continent significantly affected by brain drain. They point to the practical challenges for innovators on the ground, and suggest potentially helpful policies, funding streams, and other support systems.For African nations, health innovation represents an opportunity to increase domestic capacity to solve health challenges; for international funders, it is an opportunity to move beyond foreign aid and dependency. The shared goal is creating self-sustaining innovation that has both health and development impacts. While this is a long-term strategy
Miller, Kim S; Winskell, Kate; Pruitt, Kaitlyn L; Saul, Janet
Despite widespread recognition of child sexual abuse as a serious problem in sub-Saharan Africa, few far-reaching programmatic interventions addressing child sexual abuse in this setting are currently available, and those interventions that do exist tend to focus on response rather than prevention. The Families Matter! Program is an evidence-based intervention for parents and caregivers of 9- to 12-year-olds in sub-Saharan African countries which promotes positive parenting practices and effective parent-child communication about sex-related issues. This article describes the enhancement of a new Families Matter! Program session on child sexual abuse, drawing on authentic narratives contributed by young people to the Global Dialogues from Africa youth scriptwriting competitions. Experiences are shared with a view to informing the development of interventions addressing child sexual abuse in sub-Saharan Africa.
Velayati, Ali-Akbar; Bakayev, Valerii; Bahadori, Moslem; Tabatabaei, Seyed-Javad; Alaei, Arash; Farahbood, Amir; Masjedi, Mohammad-Reza
The pandemic of HIV/AIDS in sub-Saharan Africa and the rise of epidemics in Asia to the previously unforeseen level are likely to have global social, economic, and political impacts. In this emergency, it is vital to reappraise the weight of powerful religious and cultural factors in spreading the disease. The role of Islam in shaping values, norms, and public policies in North African states is to be appreciated for the lowest HIV prevalence in their populations. Yet, the place of religion in prevention of the disease diffusion is not fully understood nor worldwide acknowledged by the primary decision makers. Another topic, which has received little attention to date, despite the abundance of literature concerning the unfortunate Africa's anti-AIDS campaign, is an issue of colonial past. To better comprehend the share of both traits in diverse spread of HIV in sub-Saharan Africa, we studied the correlation between Muslim and Christian proportions in the state's population and HIV rate. By this method, Muslim percentage came out as a potential predictor of HIV prevalence in a given state. In another approach, most subcontinental countries were clustered by colocalization and similarity in their leading religion, colonial past, and HIV seroprevalence starting from barely noticeable (0.6 - 1.2%, for Mauritania, Senegal, Somalia, and Niger) and low levels (1.9 - 4.8%, for Mali, Eritrea, Djibouti, Guinea, Guinea-Bissau, Burkina-Faso, and Chad) for Muslim populated past possessions of France and Italy, in the northern part of the subcontinent. Former territories of France, Belgium, Portugal, and the UK formed two other groups of the countries nearing the equator with Catholic prevailing (Democratic Republic of Congo, Republic of Congo, Rwanda, Gabon, and Burundi) or mixed populations comprising Christian, Muslim, and indigenous believers (Benin, Ghana, Uganda, Togo, Angola, Nigeria, Liberia, Kenya, Cameroon, Côte d'Ivoire, and Sierra-Leone), which covered the HIV
Lewallen, Susan; Etya'ale, Daniel; Kello, Amir Bedri; Courtright, Paul
Non-physician cataract surgeons (NPCS) provide cataract surgical services in some Sub-Saharan African (SSA) countries. However, their training, placement, legal framework and supervision have not been documented. We sought to do so to inform decision-making regarding future training. Standard questionnaires were sent to national eye coordinators and other ophthalmologic leaders in Africa to collect information. Face-to-face interviews were conducted at training programmes in Ethiopia, Tanzania and Kenya, and email interviews were conducted with directors at training programmes in the Gambia and Malawi. Responses were provided for 31/39 (79%) countries to which questionnaires were sent. These countries represent about 90% of the population of SSA. Overall, 17 countries have one or more NPCS; two-thirds of the total 245 NPCS are found in only three countries. Thirty-six percent of NPCS work alone, but a formal functioning supervision system was reported to be present in only one country. The training centres are similar and face similar challenges. There is considerable variation across SSA in the use and acceptance of NPCS. The placement and support of NPCS after training generally does not follow expectations, and training centres have little role in this. Overall, there was no consensus on whether the cadre, as it is currently viewed, is necessary, desirable or will contribute to addressing cataract surgical needs in SSA. © 2012 Blackwell Publishing Ltd.
Villholth, Karen G.; Ganeshamoorthy, Jegan; Rundblad, Christian M.
A simple but comprehensive framework for analysing the potential for and constraints to groundwater development for irrigated agriculture in sub-Saharan Africa is proposed. The framework, based on food value chain principles, is applied to the sub-Saharan context and a specific catchment in Tanza...
There is a more and more emerging consensus claiming universal access to health care in order to achieve the desired Millennium Development Goals related to health in Africa. Unfortunately, the debate of the universal coverage has focussed so far mainly on financial affordability, while it is also a human resource matter. Many countries in sub-Saharan Africa are experiencing severe shortages of skilled health care workers. There are several causes, the importance of which varies by country, but one of the most significant factors is brain drain. In those countries, scarcity of doctors increases the distance between a doctor and patients, and bridging that increased distance implies costs, both time and money. Adequate number of qualified health personnel is then vital to increase coverage and improve the quality of care. In as much as access to health services is also determined by access to qualified health workers, any reflection on the universal health coverage has to also consider the inequities in qualified health personnel distribution throughout the world.
Osafo, Charlotte; Raji, Yemi Raheem; Burke, David; Tayo, Bamidele O; Tiffin, Nicki; Moxey-Mims, Marva M; Rasooly, Rebekah S; Kimmel, Paul L; Ojo, Akinlolu; Adu, Dwomoa; Parekh, Rulan S
CKD affects an estimated 14% of adults in sub-Saharan Africa, but very little research has been done on the cause, progression, and prevention of CKD there. As part of the Human Heredity and Health in Africa (H3Africa) Consortium, the H3Africa Kidney Disease Research Network was established to study prevalent forms of kidney disease in sub-Saharan Africa and increase the capacity for genetics and genomics research. The study is performing comprehensive phenotypic characterization and analyzing environmental and genetic factors from nine clinical centers in four African countries (Ghana, Nigeria, Ethiopia, and Kenya) over a 5-year period. Approximately 4000 participants with specified kidney disease diagnoses and 4000 control participants will be enrolled in the four African countries. In addition, approximately 50 families with hereditary glomerular disease will be enrolled. The study includes both pediatric and adult participants age research infrastructure can be successfully established in Africa. This study will provide clinical, biochemical, and genotypic data that will greatly increase the understanding of CKD in sub-Saharan Africa. Copyright © 2015 by the American Society of Nephrology.
Full Text Available This contribution aims to analyze Sub-Saharan women’s migration with a special focus on highly skilled women in order to create a framework to better understand the different factors shaping migration patterns, such as the push and pull factors, the increase of flows and the complexity associated with them. In recent years the number of female Sub-Saharan migrants has grown at a rate much higher than the global average. In fact, in 2010 alone the number of female African migrants was 47.2% (World Bank, 2012, showing an increase of 5.2% since the 1960’s when women constituted 42% of the total migration from Sub-Saharan Africa. The feminization of migration flows from Sub-Saharan Africa (SSA in recent years has also witnessed a diversification of the flows. One specific segment on the rise is labor migration, specifically, highly skilled migration, especially for tertiary students and physicians and nurses. The study explores social geography and the geography of migration. The author considers two dimensions of analysis: women’s migration patterns from SSA (with a special focus on the impacts of the flows and highly skilled migration from SSA.
Iwelunmor, Juliet; Blackstone, Sarah; Veira, Dorice; Nwaozuru, Ucheoma; Airhihenbuwa, Collins; Munodawafa, Davison; Kalipeni, Ezekiel; Jutal, Antar; Shelley, Donna; Ogedegebe, Gbenga
Sub-Saharan Africa (SSA) is facing a double burden of disease with a rising prevalence of non-communicable diseases (NCDs) while the burden of communicable diseases (CDs) remains high. Despite these challenges, there remains a significant need to understand how or under what conditions health interventions implemented in sub-Saharan Africa are sustained. The purpose of this study was to conduct a systematic review of empirical literature to explore how health interventions implemented in SSA are sustained. We searched MEDLINE, Biological Abstracts, CINAHL, Embase, PsycInfo, SCIELO, Web of Science, and Google Scholar for available research investigating the sustainability of health interventions implemented in sub-Saharan Africa. We also used narrative synthesis to examine factors whether positive or negative that may influence the sustainability of health interventions in the region. The search identified 1819 citations, and following removal of duplicates and our inclusion/exclusion criteria, only 41 papers were eligible for inclusion in the review. Twenty-six countries were represented in this review, with Kenya and Nigeria having the most representation of available studies examining sustainability. Study dates ranged from 1996 to 2015. Of note, majority of these studies (30 %) were published in 2014. The most common framework utilized was the sustainability framework, which was discussed in four of the studies. Nineteen out of 41 studies (46 %) reported sustainability outcomes focused on communicable diseases, with HIV and AIDS represented in majority of the studies, followed by malaria. Only 21 out of 41 studies had clear definitions of sustainability. Community ownership and mobilization were recognized by many of the reviewed studies as crucial facilitators for intervention sustainability, both early on and after intervention implementation, while social and ecological conditions as well as societal upheavals were barriers that influenced the sustainment
Annie J Sasco
Full Text Available BACKGROUND: With the lengthening of life expectancy among HIV-positive subjects related to the use of highly active antiretroviral treatments, an increased risk of cancer has been described in industrialized countries. The question is to determine what occurs now and will happen in the future in the low income countries and particularly in sub-Saharan Africa where more than two-thirds of all HIV-positive people live in the world. The objective of our paper is to review the link between HIV and cancer in sub-Saharan Africa, putting it in perspective with what is already known in Western countries. METHODS AND FINDINGS: Studies for this review were identified from several bibliographical databases including Pubmed, Scopus, Cochrane, Pascal, Web of Science and using keywords "HIV, neoplasia, epidemiology and Africa" and related MesH terms. A clear association was found between HIV infection and AIDS-classifying cancers. In case-referent studies, odds ratios (OR were ranging from 21.9 (95% Confidence Interval (CI 12.5-38.6 to 47.1 (31.9-69.8 for Kaposi sarcoma and from 5.0 (2.7-9.5 to 12.6 (2.2-54.4 for non Hodgkin lymphoma. The association was less strong for invasive cervical cancer with ORs ranging from 1.1 (0.7-1.2 to 1.6 (1.1-2.3, whereas ORs for squamous intraepithelial lesions were higher, from 4.4 (2.3-8.4 to 17.0 (2.2-134.1. For non AIDS-classifying cancers, squamous cell conjunctival carcinoma of the eye was associated with HIV in many case-referent studies with ORs from 2.6 (1.4-4.9 to 13.0 (4.5-39.4. A record-linkage study conducted in Uganda showed an association between Hodgkin lymphoma and HIV infection with a standardized incidence ratio of 5.7 (1.2-17 although OR in case-referent studies ranged from 1.4 (0.7-2.8 to 1.6 (1.0-2.7. Other cancer sites found positively associated with HIV include lung, liver, anus, penis, vulva, kidney, thyroid and uterus and a decreased risk of female breast cancer. These results so far based on a
Debats, S. R.; Fuchs, T. J.; Thompson, D. R.; Estes, L. D.; Evans, T. P.; Caylor, K. K.
Food production in sub-Saharan Africa is dominated by smallholder agriculture. Rainfed farming practices and the prevailing dryland conditions render crop yields vulnerable to increasing climatic variability. As a result, smallholder farmers are among the poorest and most food insecure groups among the region's population. Quantifying the distribution of smallholder agriculture across sub-Saharan Africa would greatly assist efforts to boost food security. Existing agricultural land cover data sets are limited to estimating the percentage of cropland within a coarse grid cell. The goal of this research is to develop a statistical machine learning algorithm to map individual agricultural fields, mirroring the accuracy of hand-digitization. For the algorithm, a random forest pixel-wise classifier learns by example from training data to distinguish between fields and non-fields. The algorithm then applies this training to classify previously unseen data. These classifications can then be smoothed into coherent regions corresponding to agricultural fields. Our training data set consists of hand-digitized boundaries of agricultural fields in South Africa, commissioned by its government in 2008. Working with 1 km x 1 km scenes across South Africa, the hand-digitized field boundaries are matched with satellite images extracted from Google Maps. To highlight different information contained within the images, several image processing filters are applied. The inclusion of Landsat images for additional training information is also explored. After training and testing the algorithm in South Africa, we aim to expand our mapping efforts across sub-Saharan Africa. Through Princeton's Mapping Africa project, crowdsourcing will produce additional training data sets of hand-digitized field boundaries in new areas of interest. This algorithm and the resulting data sets will provide previously unavailable information at an unprecedented level of detail on the largest and most
Kim, Jane J; Campos, Nicole G; O'Shea, Meredith; Diaz, Mireia; Mutyaba, Innocent
Using population and epidemiologic data for 48 countries in sub-Saharan Africa, we used a model-based approach to estimate cervical cancer cases and deaths averted, disability-adjusted life years (DALYs) averted and incremental cost-effectiveness ratios (I$ (international dollar) per DALY averted) for human papillomavirus (HPV) vaccination of pre-adolescent girls. Additional epidemiologic data from Uganda and South Africa informed estimates of cancer risk reduction and cost-effectiveness ratios associated with pre-adolescent female vaccination followed by screening of women over age 30. Assuming 70% vaccination coverage, over 670,000 cervical cancer cases would be prevented among women in five consecutive birth cohorts vaccinated as young adolescents; over 90% of cases averted were projected to occur in countries eligible for GAVI Alliance support. There were large variations in health benefits across countries attributable to differential cancer rates, population size, and population age structure. More than half of DALYs averted in sub-Saharan Africa were in Nigeria, Tanzania, Uganda, the Democratic Republic of the Congo, Ethiopia, and Mozambique. When the cost per vaccinated girl was I$5 ($0.55 per dose), HPV vaccination was cost-saving in 38 sub-Saharan African countries, and cost I$300 per DALY averted or less in the remaining countries. At this vaccine price, pre-adolescent HPV vaccination followed by screening three times per lifetime in adulthood cost I$300 per year of life saved (YLS) in Uganda (per capita GDP I$1,140) and I$1,000 per YLS in South Africa (per capita GDP I$9,480). In nearly all countries assessed, HPV vaccination of pre-adolescent girls could be very cost-effective if the cost per vaccinated girl is less than I$25-I$50, reflecting a vaccine price being offered to the GAVI Alliance. In-country decision makers will need to consider many other factors, such as affordability, acceptability, feasibility, and competing health priorities, when
Higher education in Sub-Saharan African countries is examined. Attention is directed to the development of higher education in sub-Saharan African countries since the early 1960s, as well as criticisms currently directed at the sector, and the economic and budgetary environment for resource allocation. The labor market for African college…
Batana, Yele Maweki
Since the seminal work of Sen, poverty has been recognized as a multidimensional phenomenon. The recent availability of relevant databases renewed the interest in this approach. This paper estimates multidimensional poverty among women in fourteen Sub-Saharan African countries using the Alkire and Foster multidimensional poverty measures, whose…
This study sought to understand the relationship between child health outcomes and health spending while investigating lagged effects. The study employed panel data from 45 Sub-Saharan African countries between 1995 and 2011 obtained from the World Bank's World Development Indicators. Fixed and Random effect ...
This paper provides a comprehensive descriptive profile of non-farm household enterprises in ten Sub-Saharan African countries, disaggregated by the households' consumption quintiles. Various enterprise-related aspects are covered, such as the share of households that operate an enterprise, the
Naidoo, Jordan P.
Education decentralization efforts are examined in six primarily rural, sub-Saharan African countries--Ghana, Mali, Nigeria, Tanzania, Uganda, and Zimbabwe. Stated reasons do not always reflect the real underlying rationales for decentralization. Education decentralization that is publicly advocated to improve service delivery and local…
Walker, A R; Adam, F I
The World Health Organization (WHO) has stressed that 1.5 million infants die annually, unnecessarily, from deprival or from insufficiency of breast milk. Hence, the need for its maximal use, very particularly in impoverished populations, such as those in sub-Saharan Africa. In many developed populations, a generation ago the practice was very low, but now it has risen considerably. In contrast, in Africa and in most developing populations, despite the far greater need for breast-feeding, the practice is tending to decrease, especially among urban mothers. While the most common reasons given concern insufficiency of breast milk and employment of mothers, the latter, especially urban mothers, are under strong and increasing pressure to use proprietary replacement foods. These are often made up unsatisfactorily and are contaminated. Also influential are the often less than enthusiastic, and confusing, attitudes of staff at clinics and hospitals, albeit, due in part to their very heavy workloads. Additionally, there is society's relatively indifferent attitude to breast-feeding. Currently, a hugely adverse factor is the danger of human immunodeficiency virus (HIV) transference from seropositive mothers to their infants - in some African countries almost half of antenatal mothers are infected. Chances of early control of the infection are remote. However, apart from this danger, and from the pressure from replacement food companies, the outlook for breast-feeding practice in many African countries is unlikely to improve significantly until greater encouragement is given from State, local and other health authorities.
Emmett, Susan D; Tucci, Debara L; Smith, Magteld; Macharia, Isaac M; Ndegwa, Serah N; Nakku, Doreen; Mukara, Kaitesi B; Kaitesi, Mukara B; Ibekwe, Titus S; Mulwafu, Wakisa; Gong, Wenfeng; Francis, Howard W; Saunders, James E
Cochlear implantation and deaf education are cost effective in Sub-Saharan Africa. Cost effectiveness of pediatric cochlear implantation has been well established in developed countries but is unknown in low resource settings, where access to the technology has traditionally been limited. With incidence of severe-to-profound congenital sensorineural hearing loss 5 to 6 times higher in low/middle-income countries than the United States and Europe, developing cost-effective management strategies in these settings is critical. Costs were obtained from experts in Nigeria, South Africa, Kenya, Rwanda, Uganda, and Malawi using known costs and published data, with estimation when necessary. A disability adjusted life years (DALY) model was applied using 3% discounting and 10-year length of analysis. Sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost effectiveness was determined using the WHO standard of cost-effectiveness ratio/gross domestic product per capita (CER/GDP) less than 3. Cochlear implantation was cost effective in South Africa and Nigeria, with CER/GDP of 1.03 and 2.05, respectively. Deaf education was cost effective in all countries investigated, with CER/GDP ranging from 0.55 to 1.56. The most influential factor in the sensitivity analysis was device cost, with the cost-effective threshold reached in all countries using discounted device costs that varied directly with GDP. Cochlear implantation and deaf education are equally cost effective in lower-middle and upper-middle income economies of Nigeria and South Africa. Device cost may have greater impact in the emerging economies of Kenya, Uganda, Rwanda, and Malawi.
Atti, Emma; Gulis, Gabriel
Sub-Saharan Africa (SSA) lagged furthest behind in achieving targets for the millennium development goals (MDG). We investigate the hypothesis that its slow progress is influenced by political factors. Longitudinal data on three health MDG indicators: under-five mortality, maternal mortality and HIV prevalence rates were collated from 1990 to 2012 in 48 countries. Countries were grouped into geo-political and eco-political groups. Groupings were based on conflict trends in geographical regions and the International Monetary Fund's classification of SSA countries based on gross national income and development assistance respectively. Cumulative progress in each group was derived and main effects tested using ANOVA. Correlation analysis was conducted between political variables - POLITY 2, fragile state index (FSI), voter turnout rates, civil liberty scores (CLS) and the health variables. Our results suggest a significant main effect of eco-political and geo-political groups on some of the health variables. Political conflict as measured by FSI and political participation as measured by CLS were stronger predictors of slow progress in reducing under-five mortality rates and maternal mortality ratios. Our findings highlight the need for further research on political determinants of mortality in SSA. Cohesive effort should focus on strengthening countries' political, economic and social capacities in order to achieve sustainable goals beyond 2015.
Dempsey, Kara E; Qureshi, Mahmood M; Ondoma, Solomon M; Dempsey, Robert J
The population of Sub-Saharan Africa suffers from a critical shortage and maldistribution of health care professionals, especially highlighted in surgical subspecialties, such as neurosurgery. In light of The Lancet report and the World Health Organization's directive to provide essential surgical care through the developing world, solutions need to be found to close this training and distribution gap. Methods correcting the situation will only succeed if one understands the geopolitical forces which have shaped the distribution of health care in the region and continue to this day. Solutions have evolved from service to service with education. The partnering organizations, the Foundation of International Education in Neurological Surgery and the World Federation of Neurosurgical Societies, have supported neurosurgical training in the developing world, including curriculum, equipment, facilities, certification, and local acceptance, with a goal of developing a self-sustaining program within the developing country. These ideas heavily rely on partnerships to address classic geopolitical forces, including geography, drought, warfare, ethnic tensions, poverty, and lack of training facilities. Each can be addressed through partnerships, such as development of dyads with programs in developed countries and ongoing programs owned by the countries in question, but partnered with multiple international societies, institutions, and universities. This paper provides both a historic and topical overview of the forces at work which need to be addressed for success in delivering specialized care. This must always result in a self-sustaining program operated by the people of the home country with worldwide support through philanthropy and partnerships. Published by Elsevier Inc.
Watila, Musa M; Keezer, Mark R; Angwafor, Samuel A; Winkler, Andrea S; Sander, Josemir W
Epilepsy is a public health issue in sub-Saharan Africa (SSA) where many people with the condition receive no treatment. Health-care services for epilepsy in this region have not been comprehensively assessed. We examined key features of epilepsy health services provided in SSA. This was a scoping review conducted using pre-specified protocols. We implemented an electronic search strategy to identify relevant citations using PUBMED, EMBASE, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), African Index Medicus (AIM), Open Grey, Cochrane database, and Google Scholar. Articles eligible for full-text review were screened and data of interest were reported. The search identified 81 eligible articles, forty-nine from East Africa, 19 from West Africa, 8 from South Africa, and 5 from Central Africa. A variety of care services were identified, with reporting of rural epilepsy care in 75% of retrieved articles mainly from East and South African countries. The majority of the rural epilepsy clinics were health worker- or nurse-led, reporting good seizure control in about two-thirds of patients using phenobarbital as the most commonly prescribed antiepileptic drug. Funding for rural epilepsy care came mainly from external donor agencies. We attempted to provide a 'snapshot' of epilepsy care services in SSA. The successes achieved in some of the centers are due to the use of existing primary health-care systems and employing non-physician health-care personnel. The true picture of epilepsy care coverage is not apparent due to the lack of data and proper health system structure in most parts of SSA. As more individuals begin to receive care, the long-term funding for epilepsy care in African countries will depend on the commitment of their respective governments. Copyright © 2017 Elsevier Inc. All rights reserved.
Yaya Camara Seydou
Full Text Available This article addresses macroeconomic instabilities according to exchange rate regimes in Sub-Saharan Africa (SSA. Based on International Monetary Fund's exchange rate regimes de facto classification, the global sample, SSA, is first divided into two subsamples, which are countries within CFA franc zone (ZCFA and those outside CFA franc zone (HZCFA, and then into four categories, which are the Western Economic and Monetary Union (WAEMU, the Central African Economic and Monetary Community, the countries CFA franc zone with fix exchange rate regimes(HZCFA-FIX, and the countries outside CFA franc zone with flexible exchange rate regimes(HZCFA-FLEX. By applying advanced statistical and econometric methods upon internal and external macroeconomic equilibrium conditions, we show that the inflation, the GDP (or the output and the real exchange rate (RER are very volatile in SSA. However, we found out that they are more volatile in the group HZCFA comparatively to the group ZCFA. We also found out that they are higher in the group HZCFA-FIX than the group HZCFA-FLEX. Moreover, we found out that a high instability of the inflation is combined with those of the output and the RER.
Sessa, Emily B; Juslén, Aino; Väre, Henry; Chambers, Sally M
Our goal was to infer the phylogenetic relationships and historical biogeography of the genus Dryopteris with a focus on taxa in sub-Saharan Africa and neighboring islands. In general, little is known about the relationships between African fern species and their congeners in other geographic regions, and our aim was to determine whether the sub-Saharan African species of Dryopteris are monophyletic and evolved within Africa or arrived there via repeated dispersals into Africa from other regions. We obtained sequence data for five chloroplast markers from 214 species of Dryopteris and 18 outgroups. We performed phylogenetic and molecular dating analyses using a Bayesian relaxed clock method in BEAST with fossil and secondary calibration points and estimated ancestral ranges for the genus globally by comparing multiple models in BioGeoBEARS. We found that 22 of 27 accessions of sub-Saharan African Dryopteris belong to a large clade of 31 accessions that also includes taxa from Indian and Atlantic Ocean islands. Additional accessions of taxa from our regions of interest have Asian, Hawaiian, European, or North American species as their closest relatives. The majority of sub-Saharan African Dryopteris species are descended from a shared common ancestor that dispersed to Africa from Asia approximately 10 Ma. There have been subsequent dispersal events from the African mainland to islands in the Atlantic and Indian Oceans, including Madagascar. Several additional species are estimated to have descended from ancestors that reached Africa via separate events over the last roughly 20 million years. © 2017 Sessa et al. Published by the Botanical Society of America.This work is licensed under a Creative Commons Attribution License (CC-BY-NC).
Olaniyi O. Olayinka
Full Text Available Objectives. To review epidemiologic studies on the prevalence, incidence, and risk factors of dementia in sub-Saharan Africa (SSA. Methods. A MEDLINE search (from January 1992 to December 31, 2013 of epidemiologic studies, with no language restriction, was conducted using the keywords “dementia” or “Alzheimer’s” and “Africa.” We selected for review population and hospital-based studies that reported the prevalence, incidence, or risk factors of dementia in SSA in people aged 60 years and above. References of selected articles were reviewed to identify additional relevant articles that met our selection criteria. Results. Of a total of 522 articles, 41 were selected and reviewed. The reported prevalence of dementia in SSA varied widely (range: 2.29%–21.60%; Alzheimer’s disease was the most prevalent type of dementia. Only two studies conducted in Nigeria reported incidence data. Major risk factors identified include older age, female gender, cardiovascular disease, and illiteracy. Conclusion. Data on the epidemiology of dementia in SSA is limited. While earlier studies reported a lower prevalence of dementia in older persons, recent studies have put these findings into question suggesting that dementia prevalence rates in SSA in fact parallel data from Western countries.
Funk, C. C.; Artan, G. A.
This talk reports on an integrated set of satellite-based rainfall estimates (RFE) and statistical-hydrologic model for large-basin streamflow modeling. This work addresses the need to monitor hydrologic conditions in data sparse tropical and sub-tropical regions. In many countries with limited real-time stream flow data, estimates of flows based on RFE can assist in identifying extreme hydrologic conditions. Orographically enhanced precipitation mean fields and in situ gauge observations are used to reduce the bias and uncertainty in the RFE. The Global Precipitation Climatology Project time series is used to produce twenty-seven years of enhanced RFE. These fields are combined with reanalysis potential evapotranspiration to model the monthly abstraction ratios of seven large basins in sub- Saharan Africa. The abstraction ratio, defined as (rainfall-runoff)/rainfall, allows for the accurate assessment mean hydrologic flows. This provides twenty-seven years of stream flow estimates. We conclude by assessing recent variations in hydrologic conditions, with a focus on emergent droughts in eastern and southern Africa.
Full Text Available Over the last few decades, many states in sub-Saharan Africa have adopted draconian anti-migrant policies, leaving refugees and migrants vulnerable to violence, harassment, and economic exploitation. These policies represent a shift from the relatively hospitable attitude shown by many African nations in the immediate post-colonial period. Explanations at the local level do not adequately explain the pervasiveness of these changes or why many developing states are now replicating the migration discourse and practices of the global north. Drawing on scholarship and data from a number of states in the region, including Tanzania, Kenya, Ghana, and South Africa, this paper argues that owing to the widespread implementation of neoliberal economic policies, these states are now subject to many of the same incentives and constraints that operate in the developed north. As a result, political parties and business elites have used national migration policy as an instrument for enhancing their political and economic positions. Insofar as neoliberal globalization continues to exacerbate inequality within the developing world, the harsh measures taken by governments of developing countries against their refugee and migrant populations are likely to increase. It is therefore important that scholars of migration and human rights begin to reassess the prevailing, nearly exclusive emphasis in many globalization studies on the dehumanizing policies and exploitation of southern migrants by states in the global north, as such an emphasis risks obscuring the emergence of more complex patterns of migration and anti-migrant practices in the developing world.
Bates, Imelda; Hassall, Oliver; Mapako, Tonderai
Evidence to support many blood transfusion policies and practices in sub-Saharan Africa (SSA) is weak or lacking. SSA cannot extrapolate from wealthy countries' research findings because its environment, users and structures are very different and SSA has critical blood shortages. SSA needs to generate its own evidence but research funds are very scarce and need to be carefully targeted to match need. This study aimed to define this need by determining research priorities for blood services in SSA. Thirty-five stakeholders representing diverse blood services' interests and expertise participated in a workshop. An adapted 'consensus development method' was used to identify, agree and justify research priorities under five themes through small group and plenary discussion, and cumulative voting. Research priorities covered traditional research areas, such as clinical use of blood and infection screening, but also highlighted many new, under-researched topics, mostly concerning blood service 'systems', such as economics, blood components and regulation. Lack of electronic information management systems was an important hindrance to the blood services' ability to generate robust research data. This study has identified and prioritised novel research that will help blood services in SSA to address their own needs including their most urgent problem: the lack of access to adequate blood supplies. To catalyse this research blood services in SSA need to enhance their capacity to conduct, commission and manage research and to strengthen their collaborations within and beyond Africa. © 2017 John Wiley & Sons Ltd.
Prado, Elizabeth L; Abubakar, Amina A; Abbeddou, Souheila; Jimenez, Elizabeth Y; Somé, Jérôme W; Ouédraogo, Jean-Bosco
Sub-Saharan Africa bears a disproportionate amount of global diseases related to neurodevelopmental delays in infancy, including malnutrition, malaria and HIV. Evaluating interventions to prevent such delays requires developmental assessment tools appropriate for Sub-Saharan Africa. This study aimed to develop and evaluate such a tool. The Developmental Milestones Checklist (DMC) was developed in Kenya to provide motor, language and personal-social scores for children aged from 3 to 24 months. We developed an extended version (DMC-II) in Burkina Faso, West Africa, and then evaluated the reliability and sensitivity of the scores to age and nutritional and environmental measures. The internal, interinterviewer and test-retest reliability of the DMC-II scores were >0.7. In 214 children aged 11.6-25.4 months, each score correlated with age (rs > 0.7). In 1123 children aged 16.8-19.9 months, the scores were sensitive to stunting, wasting and underweight (effect sizes 0.31-0.87 SD). The scores also showed expected correlations with measures of play materials in the home and activities with caregivers (rs = 0.13-0.41). The DMC-II is easily used by trained fieldworkers with no previous experience in developmental assessment. It is a practical, reliable and sensitive tool for evaluating motor, language and personal-social development in different contexts in Sub-Saharan Africa. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Email : firstname.lastname@example.org ... factors responsible for the present abysmally low level of agricultural mechanization in the Sub-‐Saharan Africa .... Apart from Egypt,. Tunisia, Morocco and South Africa, the level of mechanization is very low in all other parts of the continent which puts the future food security in much danger ...
Kuzvinetsa Peter Dzvimbo
Full Text Available In a shrinking world, in which a neo-liberal discourse has permeated sub-Saharan African higher education, critical reflection is required to assess the merits and demerits of globalisation. Research, intensive discussion and hearings conducted over a two-year period by the Task Force on Higher Education and Society, convened by the World Bank and United Nations Educational, Scientific, and Cultural Organization (UNESCO for the purpose of exploring the future of higher education in the developing world, led to the conclusion that without more and better higher education, developing countries would find it increasingly difficult to benefit from the global knowledge economy. A decade later, we argue for a radical change in the traditional discourse on globalisation because of the emergence of countries such as China, South Africa, India, and Brazil as global players in the world economy. These emerging global powers, reframe the political and imperial philosophy at the epicentre of globalisation discourse - an economic creed, through their mutual consultation and coordination on significant political issues. Their economic and military capabilities enable them to influence the trade regime and thereby strengthen the voice of the developing world as a whole. In relation to this paper's inquiry, the cooperation of these emerging powers gives the free enfranchised people of the world an opportunity to choose a different path of international relations (internationalisation formed on more liberal lines, as opposed to the neo-liberal economic rationality of globalisation. This paper therefore examines globalisation and internationalisation of higher education in sub-Saharan Africa, a field in which increased knowledge production and distribution open up opportunities for users, institutions and societies. Against a background of chronic economic uncertainty we examine the influence of major international institutions on the direction of higher
Donald P. King
Full Text Available Using foot-and-mouth disease (FMD as an example, this review describes new tools that can be used to detect and characterise livestock diseases. In recent years, molecular tests that can detect and characterise pathogens in a diverse range of sample types have revolutionised laboratory diagnostics. In addition to use in centralised laboratories, there are opportunities to locate diagnostic technologies close to the animals with suspected clinical signs. Work in this area has developed simple-to-use lateral-flow devices for the detection of FMD virus (FMDV, as well as new hardware platforms to allow molecular testing to be deployed into the field for use by non-specialists. Once FMDV has been detected, nucleotide sequencing is used to compare field strains with reference viruses. Transboundary movements of FMDV are routinely monitored using VP1 sequence data, while higher resolution transmission trees (at the farm-to-farm level can be reconstructed using full-genome sequencing approaches. New technologies such as next-generation sequencing technologies are now being applied to dissect the viral sequence populations that exist within single samples. The driving force for the use of these technologies has largely been influenced by the priorities of developed countries with FMD-free (without vaccination status. However, it is important to recognise that these approaches also show considerable promise for use in countries where FMD is endemic, although further modifications (such as sample archiving and strain and serotype characterisation may be required to tailor these tests for use in these regions. Access to these new diagnostic and sequencing technologies in sub-Saharan Africa have the potential to provide novel insights into FMD epidemiology and will impact upon improved strategies for disease control.Effective control of infectious diseases is reliant upon accurate diagnosis of clinical cases using laboratory tests, together with an
Full Text Available Rice is one of the most important food crops in sub-Saharan Africa. Climate change, variability, and economic globalization threatens to disrupt rice value chains across the subcontinent, undermining their important role in economic development, food security, and poverty reduction. This paper maps existing research on the vulnerability of rice value chains, synthesizes the evidence and the risks posed by climate change and economic globalization, and discusses agriculture and rural development policies and their relevance for the vulnerability of rice value chains in sub-Saharan Africa. Important avenues for future research are identified. These include the impacts of multiple, simultaneous pressures on rice value chains, the effects of climate change and variability on parts of the value chain other than production, and the forms and extent to which different development policies hinder or enhance the resilience of rice value chains in the face of climatic and other pressures.
Lund, Henrik Hautop
This concept paper explores a technological building block approach to the development of a flexible rehabilitation tool that may address some of the needs in sub-Saharan Africa. We briefly outline some of the health challenges that lead us to suggest a concept for physical rehabilitation solutions...... to address many diverse patient groups (e.g. disabled children, cardiac, and stroke patients), to be used in both urban and rural areas, to be easily used in community based rehabilitation (e.g. by community rehabilitation workers), to motivate the users, and to be robust to failure (e.g. power failure......) in remote areas. The concept leads to the implementation of modular interactive tiles for rehabilitation, and suggestions for future use in sub-Saharan Africa....
Recent progress in malaria control in sub-Saharan Africa has been achieved primarily through provision of insecticide-treated nets, indoor residual spraying, and antimalarial drugs. Although these interventions are important, proper case identification and accurate measurement of their impact depend on quality diagnostic testing. Current availability of diagnostic testing for malaria in sub-Saharan Africa is inadequate to support disease management, prevention programs, and surveillance needs. Challenges faced include a dearth of skilled workforce, inadequate health systems infrastructure, and lack of political will. A coordinated approach to providing pre-service clinical and laboratory training together with systems that support a scale-up of laboratory services could provide means not only for effective malaria case management but also, management of non-malaria febrile illnesses, disease surveillance, and accurate control program evaluation. A synthesis of the challenges faced in ensuring quality malaria testing and how to include this information in the malaria control and elimination agenda are presented.
Kyari, Fatima; Abdull, Mohammed M.; Bastawrous, Andrew; Gilbert, Clare E.; Faal, Hannah
Purpose: The purpose of this study is to review the epidemiology of different types of glaucoma relevant to Sub-Saharan Africa (SSA) and to discuss the evidence regarding the risk factors for onset and progression of glaucoma, including risk factors for glaucoma blindness. Methods: Electronic databases (PubMed, MedLine, African Journals Online- AJOL) were searched using the full text, Medical Subject Headings (MeSH) terms, author(s) and title to identify publications since 1982 in the foll...
Njau Ntuli, Anthony
This paper reviews the effects globalisation has on the economic prosperity of sub-Saharan Africa, on a global information economy context, and in particular, the threats that globalisation has brought about as well as, the opportunities that are likely to emerge because of it. The fundamental shift in the nature of the global economy backed up by viable strategies, acting within the realities of globalisation and information economy open-up new windows for latecomers, and enables them conver...
Little investigation has been made to explain why women are less likely than are men to support democracy in Sub-Saharan Africa. This gender difference in politics has been found in numerous studies and may hinder the much needed legitimation of democracy in this region. This paper addresses the question of whether this observed gender gap is due to the omission of social institutions related to gender inequality, something that affects women's daily life and deprives them of autonomy at home...
resources used to promote security and strengthen security reforms in Sub-Saharan Africa, there is little evidence to suggest that sustainable successes...the President highlights is that the U.S. will shift away from fighting terrorism through costly, large scale wars and pursue a more sustainable ...2013, and an attack against a restaurant frequented by Westerners in Djibouti in 2014, they are not as deadly as the two groups listed in the previous
resources used to promote security and strengthen security reforms in Sub-Saharan Africa, there is little evidence to suggest that sustainable successes...the President highlights is that the U.S. will shift away from fighting terrorism through costly, large scale wars and pursue a more sustainable ...2013, and an attack against a restaurant frequented by Westerners in Djibouti in 2014, they are not as deadly as the two groups listed in the previous
Konstantin A. Pantserev
Full Text Available The paper devotes to the problem of overcoming of the digital divide in the Sub Saharan African States. On the example of Kenya the author speaks about the comparative success of the development of the information technologies in Africa and in turn underlines the most significant obstacles on the way of African states to the global information society and suggests the means how to overcome them.
Soil fertility management in sub-Saharan Africa is complex, diverse and dynamic. Farmers' investments are determined by a wide variety of factors, including bio-physical characteristics of the environment, access to resources and the institutional, and socio-economic context of farming and livelihood making. Within this context, defining soil fertility problems in general terms is not meaningful and proposing a limited number of standard interventions, aimed at the 'average' farmer i...
Sarnquist, Clea C; Rahangdale, Lisa; Maldonado, Yvonne
Review key topics and recent literature regarding reproductive health and family planning needs for HIV-infected women in Sub-Saharan Africa. Electronic searches performed in PubMed, JSTOR, and Web of Science; identified articles reviewed for inclusion. Most HIV-infected women in Sub-Saharan Africa bear children, and access to antiretroviral therapy may increase childbearing desires and/or fertility, resulting in greater need for contraception. Most contraceptive options can be safely and effectively used by HIV-infected women. Unmet need for contraception is high in this population, with 66- 92% of women reporting not wanting another child (now or ever), but only 20-43% using contraception. During pregnancy and delivery, HIV-infected women need access to prevention of mother-to-child transmission (PMTCT) services, a skilled birth attendant, and quality post-partum care to prevent HIV infection in the infant and maximize maternal health. Providers may lack resources as well as appropriate training and support to provide such services to women with HIV. Innovations in biomedical and behavioral interventions may improve reproductive healthcare for HIV-infected women, but in Sub-Saharan Africa, models of integrating HIV and PMTCT services with family planning and reproductive health services will be important to improve reproductive outcomes. HIV-infected women in Sub-Saharan Africa have myriad needs related to reproductive health, including access to high-quality family planning information and options, high-quality pregnancy care, and trained providers. Integrated services that help prevent unintended pregnancy and optimize maternal and infant health before, during and after pregnancy will both maximize limited resources as well as provide improved reproductive outcomes.
Corruption in Sub-Saharan Africa: Towards a more holistic approach. Munyae M. Mulinge, Gwen N. Lesetedi. Abstract. (Af. J. Political Science: 2001 7(1): 51-78). Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/ajps.v7i1.27324 · AJOL African ...
Ungauged catchments can be found in many parts of the world, but particularly in sub-Saharan Africa. Information collected in a gauged catchment and its regionalisation to ungauged areas is crucial for water resources assessment. Especially farmers in semi-arid areas are in need of such information. Inter and intra-seasonal rainfall variability is large in these areas, and farmers depend more and more on additional surface and groundwater resources for their crop production. As a result, unde...
Collins, PY; Musisi, S; Frehywot, S; Patel, V
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...
Frank Chirowa; Stephen Atwood; Marc Van Der Putten
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 – Reproducti...
Agriculture is one of the most important human activities providing food and more agricultural goods for seven billion people around the world and is of special importance in sub-Saharan Africa. The majority of people depends on the agricultural sector for their livelihoods and will suffer from negative climate change impacts on agriculture until the middle and end of the 21st century, even more if weak governments, economic crises or violent conflicts endanger the countries’ food security. T...
Yeatman, S.; Eaton, JW; Beckles, Z.; Benton, L.; Gregson, S.; Zaba, B
Objective Understanding the fertility of HIV-positive women is critical to estimating HIV epidemic trends from surveillance data and planning resource needs and coverage of prevention-of-mother-to-child transmission services in sub-Saharan Africa. In light of the considerable scale-up in antiretroviral therapy (ART) coverage over the last decade, we conducted a systematic review of the impact of ART on the fertility outcomes of HIV-positive women. Methods We searched Medline, Embase, Popline,...
Subhayu Bandyopadhyay; Jonathan Munemo
Sub-Saharan Africa (SSA) is highly dependent on imported capital goods that are used in the import competing industrialized sector. The exporting sector focuses on primary products where land and labor are predominantly used. We build a two-good general equilibrium model, where the import competing sector uses imported capital input. Transfers induce changes in commodity terms of trade, which in turn affects capital inflows and the price of imported capital. The welfare effect of transfers is...
Maxwell, Daniel G.
Sub-Saharan African cities in the late 1990s face a daunting set of problems including rapid growth, increasing poverty, deteriorating infrastructure, and inadequate capacity for service provision. However, even as a renewed debate is shaping up around issues of urban development, there is little attention given to the question of urban food security and nutrition. Whereas in the 1970s and 1980s, urban food problems in Africa commanded political attention, the nature of urban food insecurity ...
Lazarus, Jeffrey V; Safreed-Harmon, Kelly; Nicholson, Joey
OBJECTIVES: In response to the lack of evidence-based guidance for how to continue scaling up antiretroviral therapy (ART) in ways that make optimal use of limited resources, to assess comparative studies of ART service delivery models implemented in sub-Saharan Africa. METHODS: A systematic...... of service delivery models, making it difficult to draw conclusions about some models. The strongest evidence was related to the feasibility of decentralisation and task-shifting, both of which appear to be effective strategies....
local African people. The discovery of resources such as gold, diamonds and rubber encouraged the influx of Europeans to Sub-Saharan Africa...different system of colonial rule to govern its colonies. The British colonies included British Somaliland, Botswana , Cameroon, Gambia, Ghana, Kenya, Lesotho...firms, agro-industries, mines , and factories were nationalized with the owners who were mostly foreign being compensated.53 In reality the
Objective. This article reviews the English-language literature on child sexual abuse in sub-Saharan Africa (SSA). The focus is on the sexual abuse of children in the home/community, as opposed to the commercial sexual exploitation of children. Method. English language, peer-reviewed papers cited in the Social Sciences Citation Index (SSCI) are examined. Reports from international and local NGOs and UN agencies are also examined. Results. Few published studies on the sexual abuse of children ...
Bates, Imelda; Hassall, Oliver; Mapako, Tonderai
Evidence to support many blood transfusion policies and practices in sub-Saharan Africa (SSA) is weak or lacking. SSA cannot extrapolate from wealthy countries’ research findings because its environment, users and structures are very different and SSA has critical blood shortages. SSA needs to generate its own evidence but research funds are very scarce and need to be carefully targeted to match need. This study aimed to define this need by determining research priorities for blood services i...
Eastern Africa Social Science Research Review. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 29, No 2 (2013) >. Log in or Register to get access to full text downloads.
Cort, David A; Tu, Hsin Fei
How are people's expression of HIV stigma beliefs connected to their own personal decisions concerning safe sexual practices? Does this relationship vary across countries and by the national context in which people reside? To answer these questions, we develop and test individual, contextual, and cross-level interactional hypotheses of the impact of instrumental HIV stigma attitudes on several measures of protective sexual behavior. Using Demographic and Health Survey data from 467,656 unpartnered individuals across 34 sub-Saharan African countries, we first find that counterintuitively, conservative HIV stigma attitudes are associated with lower likelihoods of participating in all types of protective sexual behaviors. Second, this negative relationship is most pronounced in the Southern and Eastern regions of Africa, where HIV prevalence is highest. Together, these findings suggest that stigma beliefs can shape private behaviors in counterintuitive yet important ways that have profound implications for current epidemiological and public health approaches to slowing the spread of HIV. Copyright © 2017 Elsevier Ltd. All rights reserved.
Nayyar, Gaurvika M L; Breman, Joel G; Newton, Paul N; Herrington, James
Poor-quality antimalarial drugs lead to drug resistance and inadequate treatment, which pose an urgent threat to vulnerable populations and jeopardise progress and investments in combating malaria. Emergence of artemisinin resistance or tolerance in Plasmodium falciparum on the Thailand-Cambodia border makes protection of the effectiveness of the drug supply imperative. We reviewed published and unpublished studies reporting chemical analyses and assessments of packaging of antimalarial drugs. Of 1437 samples of drugs in five classes from seven countries in southeast Asia, 497 (35%) failed chemical analysis, 423 (46%) of 919 failed packaging analysis, and 450 (36%) of 1260 were classified as falsified. In 21 surveys of drugs from six classes from 21 countries in sub-Saharan Africa, 796 (35%) of 2297 failed chemical analysis, 28 (36%) of 77 failed packaging analysis, and 79 (20%) of 389 were classified as falsified. Data were insufficient to identify the frequency of substandard (products resulting from poor manufacturing) antimalarial drugs, and packaging analysis data were scarce. Concurrent interventions and a multifaceted approach are needed to define and eliminate criminal production, distribution, and poor manufacturing of antimalarial drugs. Empowering of national medicine regulatory authorities to protect the global drug supply is more important than ever. Copyright © 2012 Elsevier Ltd. All rights reserved.
Full Text Available In developing countries, the drinking water supply is still an open issue. In sub-Saharan Africa, only 68% of the population has access to improved sources of drinking water. Moreover, some regions are affected by geogenic contaminants (e.g., fluoride and arsenic and the lack of access to sanitation facilities and hygiene practices causes high microbiological contamination of drinking water in the supply chain. The Water Safety Plan (WSP approach introduced by the World Health Organisation (WHO in 2004 is now under development in several developing countries in order to face up to these issues. The WSP approach was elaborated within two cooperation projects implemented in rural areas of Burkina Faso and Senegal by two Italian NGOs (Non-Governmental Organisations. In order to evaluate its sustainability, a questionnaire based on five different sustainability elements and a cost and time consumption evaluation were carried out and applied in both the case studies. Results demonstrated that the questionnaire can provide a useful and interesting overview regarding the sustainability of the WSP; however, further surveys in the field are recommended for gathering more information. Time and costs related to the WSP elaboration, implementation, and management were demonstrated not to be negligible and above all strongly dependent on water quality and the water supply system complexity.
Davidson, Ogunlade [Energy and Development Research Centre (EDRC), University of Cape Town (South Africa); Halsnaes, Kirsten [UNEP Collaborating Centre on Energy and Environment, Risoe, Roskilde (Denmark); Huq, Saleemul [International Institute for Environment and Development (IIED), London (United Kingdom); Kok, Marcel; Metz, Bert [National Institute of Public Health and Environment, (RIVM), Bilthoven (Netherlands); Sokona, Youba [Environnement et Developpement du Tiers Monde, (ENDA), Dakar (Senegal); Verhagen, Jan [Plant Research International, Wageningen UR, Wageningen (Netherlands)
This paper explores an alternative approach to future climate policies in developing countries. Although climate change seems marginal compared to the pressing issues of poverty alleviation and economic development, it is becoming clear that the realisation of development goals may be hampered by climate change. However, development can be shaped in such a way as to achieve its goals and at the same time reduce vulnerability to climate change, thereby facilitating sustainable development that realises economic, social, local and global environmental goals. This approach has been coined the 'development first approach', in which a future climate regime should focus on development strategies with ancillary climate benefits and increase the capability of developing countries to implement these. This is anticipated to offer a possible positive way out of the current deadlock between North and South in the climate negotiations. First, elements are presented for an integrated approach to development and climate; second, the approach is elaborated for food and energy security in sub-Saharan Africa; and third, possibilities are outlined for international mechanisms to support such integrated development and climate strategies.
Jacob K. Kariuki
Full Text Available Background. Although 80% of the burden of cardiovascular disease (CVD is in developing countries, the 2010 global burden of disease (GBD estimates have been cited to support a premise that sub-Saharan Africa (SSA is exempt from the CVD epidemic sweeping across developing countries. The widely publicized perspective influences research priorities and resource allocation at a time when secular trends indicate a rapid increase in prevalence of CVD in SSA by 2030. Purpose. To explore methodological challenges in estimating trends and burden of CVD in SSA via appraisal of the current CVD statistics and literature. Methods. This review was guided by the Critical review methodology described by Grant and Booth. The review traces the origins and evolution of GBD metrics and then explores the methodological limitations inherent in the current GBD statistics. Articles were included based on their conceptual contribution to the existing body of knowledge on the burden of CVD in SSA. Results/Conclusion. Cognizant of the methodological challenges discussed, we caution against extrapolation of the global burden of CVD statistics in a way that underrates the actual but uncertain impact of CVD in SSA. We conclude by making a case for optimal but cost-effective surveillance and prevention of CVD in SSA.
Avery, B.; Boadu, F.O. [Hewitt Associates, The Woodlands, TX (United States)
The technologies for solving existing environmental problems are collectively called environmental goods and services (EGS). The question is, how can sub-Saharan Africa (SSA) nations take advantage of the existing environmental technologies and avoid reinventing the wheel? In this paper, the authors present a broader political economy perspective to argue that countries must take adjustments in both the domestic institutional structure (democratization, governance, administrative transparency, protection of intellectual property rights, etc.) in addition to the ongoing macro-economic adjustments if they are to benefit from existing technologies. The next, empirical section of the article investigates the relationship between imports of EGS in SSA countries, and selected institutional, economic and structural variables. The following section presents background of the EGS industry, focusing particularly on the industry in the United States. Selected factors influencing the import of EGS products into SSA are examined within a political economy framework and against a background of ongoing structural reform programs. A statistical relationship between the factors and imports of EGS is formulated and used to provide quantitative impacts of the factors critical to a sustainable use of existing technologies. Finally, policy implications of the conclusions are discussed. 30 refs., 3 tabs., 1 app.
Full Text Available by the researcher community. We surveyed stakeholders within sub-Saharan Africa, determining their ES data requirements using a targeted sampling strategy. Of those respondents utilising ES information (>90%; n=60), 27% report having sufficient data...
... on Strategy Recommendations for Increasing Export-Import Bank Transactions in Sub-Saharan Africa... set aside for oral questions or comments. Members of the public may also file written statement(s...
Habib, Abdulrazaq G; Yakasai, Ahmad M; Owolabi, Lukman F; Ibrahim, Aliyu; Habib, Zaharaddeen G; Gudaji, Mustafa; Karaye, Kamilu M; Ibrahim, Daiyabu A; Nashabaru, Ibrahim
...) in Sub-Saharan Africa. Estimates were derived from a random effects meta-analysis of prospective studies reporting HIV status, utilization of ART, and the presence of NCI determined using the International HIV Dementia Scale...
Osunla, Charles A; Okoh, Anthony I
Members of the Vibrio genus are autochthonous inhabitants of aquatic environments and play vital roles in sustaining the aquatic milieu. The genus comprises about 100 species, which are mostly of marine or freshwater origin, and their classification is frequently updated due to the continuous discovery of novel species. The main route of transmission of Vibrio pathogens to man is through drinking of contaminated water and consumption inadequately cooked aquatic food products. In sub-Saharan Africa and much of the developing world, some rural dwellers use freshwater resources such as rivers for domestic activities, bathing, and cultural and religious purposes. This review describes the impact of inadequately treated sewage effluents on the receiving freshwater resources and the associated risk to the rural dwellers that depends on the water. Vibrio infections remain a threat to public health. In the last decade, Vibrio disease outbreaks have created alertness on the personal, economic, and public health uncertainties associated with the impact of contaminated water in the aquatic environment of sub-Saharan Africa. In this review, we carried out an overview of Vibrio pathogens in rural water resources in Sub-Saharan Africa and the implication of Vibrio pathogens on public health. Continuous monitoring of Vibrio pathogens among environmental freshwater and treated effluents is expected to help reduce the risk associated with the early detection of sources of infection, and also aid our understanding of the natural ecology and evolution of Vibrio pathogens.
Charles A. Osunla
Full Text Available Members of the Vibrio genus are autochthonous inhabitants of aquatic environments and play vital roles in sustaining the aquatic milieu. The genus comprises about 100 species, which are mostly of marine or freshwater origin, and their classification is frequently updated due to the continuous discovery of novel species. The main route of transmission of Vibrio pathogens to man is through drinking of contaminated water and consumption inadequately cooked aquatic food products. In sub-Saharan Africa and much of the developing world, some rural dwellers use freshwater resources such as rivers for domestic activities, bathing, and cultural and religious purposes. This review describes the impact of inadequately treated sewage effluents on the receiving freshwater resources and the associated risk to the rural dwellers that depends on the water. Vibrio infections remain a threat to public health. In the last decade, Vibrio disease outbreaks have created alertness on the personal, economic, and public health uncertainties associated with the impact of contaminated water in the aquatic environment of sub-Saharan Africa. In this review, we carried out an overview of Vibrio pathogens in rural water resources in Sub-Saharan Africa and the implication of Vibrio pathogens on public health. Continuous monitoring of Vibrio pathogens among environmental freshwater and treated effluents is expected to help reduce the risk associated with the early detection of sources of infection, and also aid our understanding of the natural ecology and evolution of Vibrio pathogens.
AgMIP conducted the first set of comprehensive regional integrated assessments of climate change impacts on smallholder farmers in Sub-Saharan Africa and South Asia led by researchers from the regions themselves. The project developed new methods integrating climate, crop, livestock and economic models to conduct climate change impact assessments that characterize impacts on smallholder groups. AgMIP projections of climate change impacts on agriculture are more realistic than previous assessments because they take agricultural development into account. Using the best available data and models, the assessments directly evaluated yield, income, and poverty outcomes including the effects of adaptation packages and development pathways. Results show that even with agricultural development, climate change generally will exert negative pressure on yields of smallholder farmers in Sub-Saharan Africa and South Asia. Without adaptation, climate change leads to increased poverty in some locations in Sub-Saharan Africa and South Asia compared to a future in which climate change does not occur. Adaptation can significantly improve smallholder farmer responses to climate change. AgMIP expert teams identified improved varieties, sowing practices, fertilizer application, and irrigation applications as prioritized adaptation strategies. These targeted adaptation packages were able to overcome a portion of detrimental impacts but could not compensate completely in many locations. Even in cases where average impact is near zero, vulnerability (i.e., those at risk of loss) can be substantial even when mean impacts are positive.
Sacktor, N; Nakasujja, N; Skolasky, R; Robertson, K; Wong, M; Musisi, S; Ronald, A; Katabira, E
Highly active antiretroviral therapy (HAART) can improve cognitive performance in some patients with HIV-associated cognitive impairment in the United States. The effect of HAART on HIV dementia in sub-Saharan Africa is largely unknown. To evaluate neuropsychological test and functional performance in HIV+ individuals after 3 and 6 months of HAART in Uganda. Twenty-three HIV+ individuals receiving HAART also received a detailed clinical history, neuropsychological testing, and a functional assessment. Follow-up evaluations were performed at 3 and 6 months after baseline. Longitudinal changes in the HIV dementia stage, the mean Z score for each neuropsychological test, and the Karnofsky Functional Performance Scale were evaluated at 3 and 6 months. The mean (SD) CD4 cell count improved from 71 (15) at baseline to 161 (30) at 3 months (p = 0.005) and 222 (46) at 6 months (p dementia stage and in tests of verbal memory, psychomotor speed, and executive functioning after 3 and 6 months of HAART (p < 0.001 at 6 months for each neuropsychological test). There was also improvement in the Karnofsky Functional Performance Scale at both 3 and 6 months after the initiation of HAART (p < 0.001). Highly active antiretroviral therapy (HAART) can be associated with improvement in neurocognitive and functional performance in HIV+ individuals in sub-Saharan Africa. These results suggest that HAART, if available in areas with limited resources in sub-Saharan Africa, should be provided for patients with HIV-associated cognitive impairment.
Saharan African (SSA) countries between 2000 and 2006. We examine both the impact of introducing competition and the role of intensity of competition on mobile penetration in these countries. Different specifications with different measures of ...
The multi-sectoral team of participants from each country was ..... (ii) In order to facilitate a better organisation and (iii) In order to enhance the provision of quality ..... projects. The Development and Implementation of Health SWAps in the Region '. From the country reports presented at the three inter- country meetings on the ...
Alexander J Stockdale, MRes; Mas Chaponda, PhD; Apostolos Beloukas, PhD; Richard Odame Phillips, PhD; Philippa C Matthews, PhD; Athanasios Papadimitropoulos, MSc; Simon King, PhD; Laura Bonnett, PhD; Prof Anna Maria Geretti, PhD
Summary Background Hepatitis D virus (also known as hepatitis delta virus) can establish a persistent infection in people with chronic hepatitis B, leading to accelerated progression of liver disease. In sub-Saharan Africa, where HBsAg prevalence is higher than 8%, hepatitis D virus might represent an important additive cause of chronic liver disease. We aimed to establish the prevalence of hepatitis D virus among HBsAg-positive populations in sub-Saharan Africa. Methods We systematically rev...
Andre M. N. Renzaho
Full Text Available Background: Diabetes is one of the non-communicable diseases (NCDs which is rising significantly across sub-Saharan African (SSA countries and posing a threat to the social, economic, and cultural fabric of the SSA population. The inclusion of NCDs into the post-2015 development agenda along with the global monitoring framework provides an opportunity to monitor progress of development programmes in developing countries. This paper examines challenges associated with dealing with diabetes within the development agenda in SSA and explores some policy options. Design: This conceptual review draws from a range of works published in Medline and the grey literature to advance the understanding of the post-2015 development agenda and how it relates to NCDs. The paper begins with the burden of diabetes in sub-Sahara Africa and then moves on to examine challenges associated with diabetes prevention, treatment, and management in Africa. It finishes by exploring policy implications. Results: With regards to development programmes on NCDs in the SSA sub-continent, several challenges exist: 1 poor documentation of risk factors, 2 demographic transitions (rapid urbanisation and ageing, 3 the complementary role of traditional healers, 4 tuberculosis and the treatment of the acquired immunodeficiency syndrome as risk factors for diabetes, 5 diabetes in complex emergencies, 6 diabetes as an international development priority and not a policy agenda for many SSA countries, and 7 poorly regulated food and beverage industry. Conclusion: For the post-2015 development agenda for NCDs to have an impact, sufficient investments will be needed to address legislative, technical, human, and fiscal resource constraints through advocacy, accountability, political leadership, and effective public–private partnership. Striking the right balance between competing demands and priorities, policies, and implementation strategies hold the key to an effective response to diabetes
Appau, Adriana; Drope, Jeffrey; Labonté, Ronald; Stoklosa, Michal; Lencucha, Raphael
In principle, trade and investment agreements are meant to boost economic growth. However, the removal of trade barriers and the provision of investment incentives to attract foreign direct investments may facilitate increased trade in and/or more efficient production of commodities considered harmful to health such as tobacco. We analyze existing evidence on trade and investment liberalization and its relationship to tobacco trade in Sub-Saharan African countries. We compare tobacco trading patterns to foreign direct investments made by tobacco companies. We estimate and compare changes in the Konjunkturforschungsstelle (KOF) Economic Globalization measure, relative price measure and cigarette prices. Preferential regional trade agreements appear to have encouraged the consolidation of cigarette production, which has shaped trading patterns of tobacco leaf. Since 2002, British American Tobacco has invested in tobacco manufacturing facilities in Nigeria, Kenya and South Africa strategically located to serve different regions in Africa. Following this, British America Tobacco closed factories in Ghana, Rwanda, Uganda, Mauritius and Angola. At the same time, Malawi and Tanzania exported a large percentage of tobacco leaf to European countries. After 2010, there was an increase in tobacco exports from Malawi and Zambia to China, which may be a result of preferential trade agreements the EU and China have with these countries. Economic liberalization has been accompanied by greater cigarette affordability for the countries included in our analysis. However, only excise taxes and income have an effect on cigarette prices within the region. These results suggest that the changing economic structures of international trade and investment are likely heightening the efficiency and effectiveness of the tobacco industry. As tobacco control advocates consider supply-side tobacco control interventions, they must consider carefully the effects of these economic agreements and
Alberto Begué Aguado
Full Text Available As showed in another article in this same issue, the gap between countries in relation to education is still significant. The financing of education is one of the aspects that will require more attention in order to close this gap. MDG 2 and 3 were not be reached by about 50 countries (among them several middle income countries, and quality is low in at least hundred countries, so it’s urgent to demand to the governments of these countries and to donor and development agencies to make an extra effort beyond the one already made since the nineties.
Esu, Godwin; Atan, Johnson
In this study, we attempted the assessment of the validity of the Philip’s curve hypothesis in the Sub-Saharan African region. We employed a panel data technique of analysis, drawing data from twenty-nine countries in the region. The data spanned 24 years (1991 to 2015). The annual data for unemployment rate and inflation rate for these countries were obtained from World Development Indicators (WDI) (2016). The inflation rate was captured using the consumer price index (CPI), while unemployme...
Even the Spanish government's Action Plans for Africa (2001-2012), efforts at the diplomatic level to foster bilateral relationships through cultural exchange, and introduction of Spanish as a foreign and international language into the African continent did not have any resonancein Nigeria. Investigations however, confirm a ...
Slaughtering infected animals is not feasible in Africa due to a lack of veterinary services, including disease testing and little or no compensation for destroyed animals. This has put the global spotlight on vaccines, which have proven to be the single, most cost-effective method of disease control. But while vaccines are ...
An easy-to-use vaccine that is inexpensive, safe, and easily stored and transported would reduce losses by small-scale livestock keepers in rural Africa, particularly women whose livelihoods rely heavily on small animals. This project is applying modern biotechnology to engineer a thermostable, single dose vaccine that ...
... with ethnicity before tackling problems of political misrule, poverty and human misery. Development efforts in the region must be preceded by the political will on the part of national governments to bring forth tangible solutions to the question of ethnicity. Journal of Social Development in Africa Vol 15 No 2 2000, pp. 55-68.
Konings, P.J.J.; Meilink, H.A.
The issue of regional integration has acquired a new relevance and urgency in Africa due to wide-reaching national and global changes. African leaders' commitment to regional economic integration was clearly expressed during the June 1991 OAU summit meeting in Abuja, Nigeria. On that occasion, they
As use of the Internet and mobile technologies in the developing world continues to grow at a high rate, there is potential to provide real income opportunities to ... More specifically, the research team will: -examine how virtual production networks in Africa and Asia are structured; -assess their positive and negative effects ...
Huis, van Arnold
Background: 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.
Africa remains the region most affected by the AIDS epidemic and HIV/AIDS prevention remains a global health priority. This project supports the emergence of African HIV scientists to lead high-quality, multidisciplinary HIV prevention and vaccine research to fight the biomedical, social, and behavioral factors that underpin ...
relatively low HIV prevalence (Liberia, Madagascar, Gabon, Congo), or high levels of HIV prevalence despite low .... as in Madagascar. In modern Africa, one can therefore expect a statistical relationship between prevalence of premarital fertility and prevalence of STD's, and in ..... Islands) or because of poor economic.
Tabi, James; Wayne H. Howard; Phillips, Truman
The Granger statistical test of causality was used to examine the relationship between total food imports and urbanization and between food aid and urbanization. Urbanization appears to have caused total food imports to increase in 13 of the 24 countries. Food imports appear to be a cause of urbanization in three countries. Food aid, however, apparently was a cause of urbanization in 16 of the 24 countries used in the analysis.
Thomas N O Achia
Full Text Available Media utilization has been identified as an important determinant of tobacco use. We examined the association between self-reported tobacco use and frequency of mass media utilization by women and men in nine low-to middle-income sub-Saharan African countries.Data for the study came from Demographic and Health Surveys conducted in Burkina Faso, Ethiopia, Liberia, Lesotho, Malawi, Swaziland, Uganda, Zambia and Zimbabwe over the period 2006-2011. Each survey population was a cross-sectional sample of women aged 15-49 years and men aged 15-59 years, with information on tobacco use and media access being obtained by face-to-face interviews. An index of media utilization was constructed based on responses to questions on the frequency of reading newspapers, frequency of watching television and frequency of listening to the radio. Demographic and socioeconomic variables were considered as potentially confounding covariates. Logistic regression models with country and cluster specific random effects were estimated for the pooled data.The risk of cigarette smoking increased with greater utilization to mass media. The use of smokeless tobacco and tobacco use in general declined with greater utilization to mass media. The risk of tobacco use was 5% lower in women with high media utilization compared to those with low media utilization [Adjusted Odds Ratio (AOR = 0.95, 95% confidence interval (CI:0.82-1.00]. Men with a high media utilization were 21% less likely to use tobacco compared to those with low media utilization [AOR = 0.79, 95%CI = 0.73-0.85]. In the male sample, tobacco use also declined with the increased frequency of reading newspapers (or magazines, listening to radio and watching television.Mass media campaigns, conducted in the context of comprehensive tobacco control programmes, can reduce the prevalence of tobacco smoking in sub-Saharan Africa. The reach, intensity, duration and type of messages are important aspects of the campaigns but
Achia, Thomas N O
Media utilization has been identified as an important determinant of tobacco use. We examined the association between self-reported tobacco use and frequency of mass media utilization by women and men in nine low-to middle-income sub-Saharan African countries. Data for the study came from Demographic and Health Surveys conducted in Burkina Faso, Ethiopia, Liberia, Lesotho, Malawi, Swaziland, Uganda, Zambia and Zimbabwe over the period 2006-2011. Each survey population was a cross-sectional sample of women aged 15-49 years and men aged 15-59 years, with information on tobacco use and media access being obtained by face-to-face interviews. An index of media utilization was constructed based on responses to questions on the frequency of reading newspapers, frequency of watching television and frequency of listening to the radio. Demographic and socioeconomic variables were considered as potentially confounding covariates. Logistic regression models with country and cluster specific random effects were estimated for the pooled data. The risk of cigarette smoking increased with greater utilization to mass media. The use of smokeless tobacco and tobacco use in general declined with greater utilization to mass media. The risk of tobacco use was 5% lower in women with high media utilization compared to those with low media utilization [Adjusted Odds Ratio (AOR) = 0.95, 95% confidence interval (CI):0.82-1.00]. Men with a high media utilization were 21% less likely to use tobacco compared to those with low media utilization [AOR = 0.79, 95%CI = 0.73-0.85]. In the male sample, tobacco use also declined with the increased frequency of reading newspapers (or magazines), listening to radio and watching television. Mass media campaigns, conducted in the context of comprehensive tobacco control programmes, can reduce the prevalence of tobacco smoking in sub-Saharan Africa. The reach, intensity, duration and type of messages are important aspects of the campaigns but need to also
Full Text Available Abstract There are already 40 cities in Africa with over 1 million inhabitants and the United Nations Environmental Programme estimates that by 2025 over 800 million people will live in urban areas. Recognizing that malaria control can improve the health of the vulnerable and remove a major obstacle to their economic development, the Malaria Knowledge Programme of the Liverpool School of Tropical Medicine and the Systemwide Initiative on Malaria and Agriculture convened a multi-sectoral technical consultation on urban malaria in Pretoria, South Africa from 2nd to 4th December, 2004. The aim of the meeting was to identify strategies for the assessment and control of urban malaria. This commentary reflects the discussions held during the meeting and aims to inform researchers and policy makers of the potential for containing and reversing the emerging problem of urban malaria.
Donnelly, Martin J; McCall, P J; Lengeler, Christian
There are already 40 cities in Africa with over 1 million inhabitants and the United Nations Environmental Programme estimates that by 2025 over 800 million people will live in urban areas. Recognizing that malaria control can improve the health of the vulnerable and remove a major obstacle...... to their economic development, the Malaria Knowledge Programme of the Liverpool School of Tropical Medicine and the Systemwide Initiative on Malaria and Agriculture convened a multi-sectoral technical consultation on urban malaria in Pretoria, South Africa from 2nd to 4th December, 2004. The aim of the meeting...... was to identify strategies for the assessment and control of urban malaria. This commentary reflects the discussions held during the meeting and aims to inform researchers and policy makers of the potential for containing and reversing the emerging problem of urban malaria....
Berkum, van Siemen; Achterbosch, Thom; Linderhof, Vincent; Godeschalk, Frans; Vroege, Willemijn
This paper looks into the dynamics in the food system in SSA countries, describing developments in drivers of the food system, analysing food consumption patterns in selected SSA countries, investigating the pace of change of the regional food retail formats and the impacts it has on how local
Lynch, B M; Robbins, L H
Namoratunga, a megalithic site in northwestern Kenya, has an alignment of 19 basalt pillars that are nonrandomly oriented toward certain stars and constellations. The same stars and constellations are used by modern eastern Cushitic peoples to calculate an accurate calendar. The fact that Namoratunga dates to about 300 B.C. suggests that a prehistoric calendar based on detailed astronomical knowledge was in use in eastern Africa.
van Huis, Arnold
Background: 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 termit...
Full Text Available Abstract Background Diabetes prevalence is increasing globally, and Sub-Saharan Africa is no exception. With diverse health challenges, health authorities in Sub-Saharan Africa and international donors need robust data on the epidemiology and impact of diabetes in order to plan and prioritise their health programmes. This paper aims to provide a comprehensive and up-to-date review of the epidemiological trends and public health implications of diabetes in Sub-Saharan Africa. Methods We conducted a systematic literature review of papers published on diabetes in Sub-Saharan Africa 1999-March 2011, providing data on diabetes prevalence, outcomes (chronic complications, infections, and mortality, access to diagnosis and care and economic impact. Results Type 2 diabetes accounts for well over 90% of diabetes in Sub-Saharan Africa, and population prevalence proportions ranged from 1% in rural Uganda to 12% in urban Kenya. Reported type 1 diabetes prevalence was low and ranged from 4 per 100,000 in Mozambique to 12 per 100,000 in Zambia. Gestational diabetes prevalence varied from 0% in Tanzania to 9% in Ethiopia. Proportions of patients with diabetic complications ranged from 7-63% for retinopathy, 27-66% for neuropathy, and 10-83% for microalbuminuria. Diabetes is likely to increase the risk of several important infections in the region, including tuberculosis, pneumonia and sepsis. Meanwhile, antiviral treatment for HIV increases the risk of obesity and insulin resistance. Five-year mortality proportions of patients with diabetes varied from 4-57%. Screening studies identified high proportions (> 40% with previously undiagnosed diabetes, and low levels of adequate glucose control among previously diagnosed diabetics. Barriers to accessing diagnosis and treatment included a lack of diagnostic tools and glucose monitoring equipment and high cost of diabetes treatment. The total annual cost of diabetes in the region was estimated at US$67.03 billion
Mugabo, Lambert; Rouleau, Dominique; Odhiambo, Jackline; Nisingizwe, Marie Paul; Amoroso, Cheryl; Barebwanuwe, Peter; Warugaba, Christine; Habumugisha, Lameck; Hedt-Gauthier, Bethany L
Research is essential to identify and prioritize health needs and to develop appropriate strategies to improve health outcomes. In the last decade, non-academic research capacity strengthening trainings in sub-Saharan Africa, coupled with developing research infrastructure and the provision of individual mentorship support, has been used to build health worker skills. The objectives of this review are to describe different training approaches to research capacity strengthening in sub-Saharan Africa outside academic programs, assess methods used to evaluate research capacity strengthening activities, and learn about the challenges facing research capacity strengthening and the strategies/innovations required to overcome them. The PubMed database was searched using nine search terms and articles were included if 1) they explicitly described research capacity strengthening training activities, including information on program duration, target audience, immediate program outputs and outcomes; 2) all or part of the training program took place in sub-Saharan African countries; 3) the training activities were not a formal academic program; 4) papers were published between 2000 and 2013; and 5) both abstract and full paper were available in English. The search resulted in 495 articles, of which 450 were retained; 14 papers met all inclusion criteria and were included and analysed. In total, 4136 people were trained, of which 2939 were from Africa. Of the 14 included papers, six fell in the category of short-term evaluation period and eight in the long-term evaluation period. Conduct of evaluations and use of evaluation frameworks varied between short and long term models and some trainings were not evaluated. Evaluation methods included tests, surveys, interviews, and systems approach matrix. Research capacity strengthening activities in sub-Saharan Africa outside of academic settings provide important contributions to developing in-country capacity to participate in and
Full Text Available Background: Many studies have investigated the migration intentions of sub-Saharan African medical students and health professionals within the context of a legacy of active international recruitment by receiving countries. However, many health workers migrate outside of this recruitment paradigm. This paper aims to explore the reasons for migration of health workers from sub-Saharan Africa to Belgium and Austria; European countries without a history of active recruitment in sub-Saharan Africa. Methods: Data were collected using semistructured interviews. Twenty-seven health workers were interviewed about their migration experiences. Included participants were born in sub-Saharan Africa, had trained as health workers in sub-Saharan Africa, and were currently living in Belgium or Austria, though not necessarily currently working as a health professional. Results: Both Austria and Belgium were shown not to be target countries for the health workers, who instead moved there by circumstance, rather than choice. Three principal reasons for migration were reported: 1 educational purposes; 2 political instability or insecurity in their country of origin; and 3 family reunification. In addition, two respondents mentioned medical reasons and, although less explicit, economic factors were also involved in several of the respondents’ decision to migrate. Conclusion: These results highlight the importance of the broader economic, social, and political context within which migration decisions are made. Training opportunities proved to be an important factor for migration. A further development and upgrade of primary care might help to counter the common desire to specialize and improve domestic training opportunities.
Racovita, Monica; Obonyo, Dennis Ndolo; Abdallah, Roshan; Anguzu, Robert; Bamwenda, Gratian; Kiggundu, Andrew; Maganga, Harrison; Muchiri, Nancy; Nzeduru, Chinyere; Otadoh, Jane; Rumjaun, Anwar; Suleiman, Iro; Sunil, Manjusha; Tepfer, Mark; Timpo, Samuel; van der Walt, Wynand; Kaboré-Zoungrana, Chantal; Nfor, Lilian; Craig, Wendy
In tackling agricultural challenges, policy-makers in sub-Saharan Africa (SSA) have increasingly considered genetically modified (GM) crops as a potential tool to increase productivity and to improve product quality. Yet, as elsewhere in the world, the adoption of GM crops in SSA has been marked by controversy, encompassing not only the potential risks to animal and human health, and to the environment, but also other concerns such as ethical issues, public participation in decision-making, socio-economic factors and intellectual property rights. With these non-scientific factors complicating an already controversial situation, disseminating credible information to the public as well as facilitating stakeholder input into decision-making is essential. In SSA, there are various and innovative risk communication approaches and strategies being developed, yet a comprehensive analysis of such data is missing. This gap is addressed by giving an overview of current strategies, identifying similarities and differences between various country and institutional approaches and promoting a way forward, building on a recent workshop with risk communicators working in SSA.
Cardoso, Luis Alfaro
Livestock production in sub-Saharan Africa (SSA) is not matching the annual 2.5 % growth of its population. Regional per capita meat and milk production corresponds, respectively, to about 13 and 8 % of developed countries indicators. Livestock performances in this region have decreased within the last 30 years. In fact, SSA, with a 12 % bovine extraction rate against a world average of 21 %, includes about 16 % of world cattle, only producing 6 and 2.6 % of global meat and milk, respectively. These low performances have economic and environmental consequences reflecting the necessity for upgrading livestock managing skills in the region. This effort includes various components such as sanitary prophylaxis, reproduction, nutrition, and in particular, substantial increase in livestock yield for human consumption. This will allow for an improved animal and pasture management and soil preservation, enhancing meat production and decreasing methane and nitrogen emissions from enteric fermentation and manure processing. These environmental gains due to increased livestock off-take rates can represent relevant credits in the global Environmental Carbon Market under the United Nations Framework Convention on Climate Change Kyoto protocol. These credits can be used for investments in livestock essential services and marketing facilities leading to improved productivity.
Early in the study of HIV/AIDS, culture was invoked to explain differences in the disease patterns between sub-Saharan Africa and Western countries. Unfortunately, in an attempt to explain the statistics, many of the presumed risk factors were impugned in the absence of evidence. Many cultural practices were stripped of their meanings, societal context and historical positioning and transformed into cofactors of disease. Other supposedly beneficial cultural traits were used to explain the absence of disease in certain populations, implicitly blaming victims in other groups. Despite years of study, assumptions about culture as a cofactor in the spread of HIV/AIDS have persisted, despite a lack of empirical evidence. In recent years, more and more ideas about cultural causality have been called into question, and often disproved by studies. Thus, in light of new evidence, a review of purported cultural causes of disease, enhanced by an understanding of the differences between individual and population risks, is both warranted and long overdue. The preponderance of evidence suggests that culture as a singular determinant in the African epidemic of HIV/AIDS falls flat when disabused of its biased and ethnocentric assumptions. PMID:23895330
Calvello, Emilie J B; Tenner, Andrea G; Broccoli, Morgan C; Skog, Alexander P; Muck, Andrew E; Tupesis, Janis P; Brysiewicz, Petra; Teklu, Sisay; Wallis, Lee; Reynolds, Teri
A major barrier to successful integration of acute care into health systems is the lack of consensus on the essential components of emergency care within resource-limited environments. The 2013 African Federation of Emergency Medicine Consensus Conference was convened to address the growing need for practical solutions to further implementation of emergency care in sub-Saharan Africa. Over 40 participants from 15 countries participated in the working group that focused on emergency care delivery at health facilities. Using the well-established approach developed in the WHO's Monitoring Emergency Obstetric Care, the workgroup identified the essential services delivered-signal functions-associated with each emergency care sentinel condition. Levels of emergency care were assigned based on the expected capacity of the facility to perform signal functions, and the necessary human, equipment and infrastructure resources identified. These consensus-based recommendations provide the foundation for objective facility capacity assessment in developing emergency health systems that can bolster strategic planning as well as facilitate monitoring and evaluation of service delivery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Hoffman, Alexis L; Kemanian, Armen R; Forest, Chris E
Food security and agriculture productivity assessments in sub-Saharan Africa (SSA) require a better understanding of how climate and other drivers influence regional crop yields. In this paper, our objective was to identify the climate signal in the realized yields of maize, sorghum, and groundnut in SSA. We explored the relation between crop yields and scale-compatible climate data for the 1962-2014 period using Random Forest, a diagnostic machine learning technique. We found that improved agricultural technology and country fixed effects are three times more important than climate variables for explaining changes in crop yields in SSA. We also found that increasing temperatures reduced yields for all three crops in the temperature range observed in SSA, while precipitation increased yields up to a level roughly matching crop evapotranspiration. Crop yields exhibited both linear and nonlinear responses to temperature and precipitation, respectively. For maize, technology steadily increased yields by about 1% (13 kg/ha) per year while increasing temperatures decreased yields by 0.8% (10 kg/ha) per °C. This study demonstrates that although we should expect increases in future crop yields due to improving technology, the potential yields could be progressively reduced due to warmer and drier climates. © 2017 John Wiley & Sons Ltd.
Kakou-Guikahue, Maurice; N'Guetta, Roland; Anzouan-Kacou, Jean-Baptiste; Kramoh, Euloge; N'Dori, Raymond; Ba, Serigne Abdou; Diao, Maboury; Sarr, Moustapha; Kane, Abdoul; Kane, Adama; Damorou, Findide; Balde, Dadhi; Diarra, Mamadou Bocary; Djiddou, Mohamed; Kimbally-Kaki, Gisèle; Zabsonre, Patrice; Toure, Ibrahim Ali; Houénassi, Martin; Gamra, Habib; Chajai, Bachir; Gerardin, Benoit; Pillière, Rémy; Aubry, Pierre; Iliou, Marie-Christine; Isnard, Richard; Leprince, Pascal; Cottin, Yves; Bertrand, Edmond; Juillière, Yves; Monsuez, Jean-Jacques
Whereas the coronary artery disease death rate has declined in high-income countries, the incidence of acute coronary syndromes (ACS) is increasing in sub-Saharan Africa, where their management remains a challenge. To propose a consensus statement to optimize management of ACS in sub-Saharan Africa on the basis of realistic considerations. The AFRICARDIO-2 conference (Yamoussoukro, May 2015) reviewed the ongoing features of ACS in 10 sub-Saharan countries (Benin, Burkina-Faso, Congo-Brazzaville, Guinea, Ivory Coast, Mali, Mauritania, Niger, Senegal, Togo), and analysed whether improvements in strategies and policies may be expected using readily available healthcare facilities. The outcome of patients with ACS is affected by clearly identified factors, including: delay to reaching first medical contact, achieving effective hospital transportation, increased time from symptom onset to reperfusion therapy, limited primary emergency facilities (especially in rural areas) and emergency medical service (EMS) prehospital management, and hence limited numbers of patients eligible for myocardial reperfusion (thrombolytic therapy and/or percutaneous coronary intervention [PCI]). With only five catheterization laboratories in the 10 participating countries, PCI rates are very low. However, in recent years, catheterization laboratories have been built in referral cardiology departments in large African towns (Abidjan and Dakar). Improvements in patient care and outcomes should target limited but selected objectives: increasing awareness and recognition of ACS symptoms; education of rural-based healthcare professionals; and developing and managing a network between first-line healthcare facilities in rural areas or small cities, emergency rooms in larger towns, the EMS, hospital-based cardiology departments and catheterization laboratories. Faced with the increasing prevalence of ACS in sub-Saharan Africa, healthcare policies should be developed to overcome the multiple
Many constraints to intensive food-crop production in tropical Africa are related to tropical soils. Improved technologies are available for different ecological regions. Important technological innovations include manual land clearing, mulch farming, conservation tillage and tiedridges, agroforestry, cover crops, mixed- and relay-cropping, and early sowing for improved and sustained productivity. Irrigation, animal traction or draft animals, and the use of chemical fertilizers are also important. Much of the agrarian stagnation in Africa is caused by neglect and misuse of the most basic of all resources, the soil. In fact, the root cause of the perpetual famine can be traced to the misuse of soil and water resources and issues related to their misuse. Substantial increases in food production are possible if the proven technologies can be effectively transferred and implemented. Priorities lie in both short-term development projects and in initiating long-term research to understand soil and water resources and how to manage them. The agrarian research must address the issue of improving the welfare of resource-poor farmers.
Kaulich, Florian; Luken, Ralph; Mhlanga, Alois; Polzerova, Ingrid
We draw on a unique dataset for energy use by manufacturing firms in 18 Sub-Saharan African countries to estimate the relationship between energy intensity of production and firms' characteristics. Our results show that lower levels of energy intensity are associated with export activity, foreign ownership, size and capital-labor ratio, while higher levels of energy intensity are associated with a higher share of fuels in total energy consumption. We do not find a statistically significant re...
Robert C York; Misa Takebe
In the extensive empirical work carried out across the IMF on oil-producing sub-Saharan African (SSA) countries, the notion of "sustainability" is often directed toward fiscal policies, and, in particular, views on the "optimal" non-oil primary fiscal deficit. The bulk of this work does not, however, address external sustainability, which is a concern especially for those SSA oil producers operating under a fixed exchange rate regime. A couple of recent papers have extended the existing metho...
Abukari I Issaka
Full Text Available The literature on the impact of internal migration on under-five mortality in sub-Saharan Africa has been limited. This study examined the impact of internal migration on under-five mortality rate in 27 sub-Saharan African countries.The analysis used cross-sectional data from the most recent Demographic and Health Surveys of 27 sub-Saharan African countries. Information on the number of live births and the number of under-five deaths in the five years preceding the surveys in these countries was examined. Using variables from which migration data were generated, four migration statuses were computed, and the impact of each migration status on under-five mortality was analysed by using multivariate Cox proportional hazards regression models.Of the 96333 live births, 7036 deaths were reported. In the unadjusted model, we found that, compared to urban non-migrant mothers, hazard of under-five mortality was 20% [HR: 1.20; 95% confidence interval (CI: (1.06–1.35], 40% [HR: 1.40; 95% CI: (1.29–1.53], and 43% [HR: 1.43; 95% CI: (1.30–1.58] higher among urban-rural migrant, rural non-migrant, and rural-urban migrant mothers respectively. The likelihood of children dying did not change considerably when country and demographic variables were adjusted for. However, after controlling for health care service utilization factors, the results remained consistently significant for rurality. That is, mortality rates remained significantly higher among children of rural non-migrant [(HR: 1.20; 95% CI: (1.08–1.33, P-value (p < 0.001] and rural-urban migrant [HR: 1.29; 95% CI: (1.15–1.45, p < 0.001] mothers than those of urban non-migrant mothers.Although under-five child mortality rate declined by 52% between 1990 and 2015 (from 179 to 86 per1000 live births in sub-Saharan Africa, the continent still has the highest rate in the world. This finding highlights the need to consider providing education and health care services in rural areas, when
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. Using routine programme data, four approaches to simplify ART delivery for stable patients on ART were assessed from a patient and health system perspective: appointment spacing for clinical and drug refill visits in Malawi, peer educator-led ART refill groups in South Africa, community ART distribution points in DRC and patient-led community ART groups in Mozambique. All four approaches lightened the burden for both patients (reduced travel and lost income) and health system (reduced clinic attendance). Retention in care is high: 94% at 36 months in Malawi, 89% at 12 months in DRC, 97% at 40 months in South Africa and 92% at 48 months in Mozambique. Where evaluable, service provider costs are reported to be lower. Separating ART delivery from clinical assessments was found to benefit patients and programmes in a range of settings. The success of community ART models depends on sufficient and reliable support and resources, including a flexible and reliable drug supply, access to quality clinical management, a reliable monitoring system and a supported lay workers cadre. Such models require ongoing evaluation and further adaptation to be able to reach out to more patients, including specific groups who may be challenged to meet the demands of frequent clinic visits and the integrated delivery of other essential chronic disease interventions. © 2014 John Wiley & Sons Ltd.
Miquel Reynés Ramón
Full Text Available Studies and analysis of African educational systems’ performance do not pay much attention to the role of families; to the value they give to school and to how this may affect their decisions. By contrast, there are numerous researches focused on the most subjective elements of the relation between families and school: the attitudes, meanings and representations families, separately or as members of a social class or ethnic group, have of school. In this paper we will give five examples, drawn on sociological and anthropological studies, of different schooling practices and family representations of school. These are examples situated in different contexts and geographical areas that will allow us to appreciate the level of heterogeneity of family-school relationships in Africa and that may contribute to make us think otherwise the evolution of these educational systems.
Kiguli-Malwadde, Elsie; Talib, Zohray M; Wohltjen, Hannah; Connors, Susan C; Gandari, Jonathan; Banda, Sekelani S; Maggio, Lauren A; van Schalkwyk, Susan C
Many African countries are investing in medical education to address significant health care workforce shortages and ultimately improve health care. Increasingly, training institutions are establishing medical education departments as part of this investment. This article describes the status of four such departments at sub-Saharan African medical schools supported by the Medical Education Partnership Initiative (MEPI). This article will provide information about the role of these institutional structures in fostering the development of medical education within the African context and highlight factors that enable or constrain their establishment and sustainability. In-depth interviews were conducted with the heads or directors of the four medical education departments using a structured interview protocol developed by the study group. An inductive approach to analysis of the interview transcripts was adopted as the texts were subjected to thematic content analysis. Medical education departments, also known as units or centers, were established for a range of reasons including: to support curriculum review, to provide faculty development in Health Professions Education, and to improve scholarship in learning and teaching. The reporting structures of these departments differ in terms of composition and staff numbers. Though the functions of departments do vary, all focus on improving the quality of health professions education. External and internal funding, where available, as well as educational innovations were key enablers for these departments. Challenges included establishing and maintaining the legitimacy of the department, staffing the departments with qualified individuals, and navigating dependence on external funding. All departments seek to expand the scope of their services by offering higher degrees in HPE, providing assistance to other universities in this domain, and developing and maintaining a medical education research agenda. The establishment of
van Rijn, F.; Bulte, E.H.; Adekunle, A.
In this paper we use a novel and extensive dataset to explore the association between different forms of social capital and innovation in agriculture, for a sample of African countries. We find mixed evidence. While structural social capital, especially in the form of connections beyond the village,
and lessons from the case studies to guide the planning and management of .... A review of recent literature reveals that more countries globally are embracing .... Primary data were from key informant interviews with stakeholders in Nigeria's National. Health Insurance Scheme (NHIS). These included Mr. Ajodi, M. Nuhu,.
identities when asked to identify one, but in Botswana, 32.9 percent or 1 out of 3 respondents chose not to differentiate by sub national group. By comparison, in each of the other countries less than two percent of respondents chose not to differentiate by ethnicity/tribe, religion, gender or occupation. identification' group is ...
Lavallée, Emmanuelle; Razafindrakoto, Mireille; Roubaud, François
(english) This paper analyzes the impact of corruption on the extent of trust in political institutions using a rich collection of comparable data provided by the Afrobarometer surveys conducted in 18 sub-Saharan African countries. More specifically, we set out to test the “efficient grease” hypothesis that corruption can strengthen citizens’ trust since bribe paying and clientelism open the door to otherwise scarce and inaccessible services and subsidies, and that this increases institutiona...
Habib, Abdulrazaq G; Yakasai, Ahmad M; Owolabi, Lukman F; Ibrahim, Aliyu; Habib, Zaharaddeen G; Gudaji, Mustafa; Karaye, Kamilu M; Ibrahim, Daiyabu A; Nashabaru, Ibrahim
To estimate the burden of HIV neurocognitive impairment (NCI) among adult patients on and off antiretroviral therapy (ART) in Sub-Saharan Africa. Estimates were derived from a random effects meta-analysis of prospective studies reporting HIV status, utilization of ART, and the presence of NCI determined using the International HIV Dementia Scale. Sixteen studies with quality data from seven countries in Sub-Saharan Africa up to June 2012 were included. Among HIV patients, the frequency of NCI pre-ART was 42.37% (95% confidence interval (CI) 32.18-52.56%), and among those on ART for ≥6 months was 30.39% (95% CI 13.17-47.61%). Respective NCI estimates in studies from Uganda were 46.49% (95% CI 30.62-62.37%) and 28.50% (95% CI -1.31-58.30%). NCI was more common among patients with a concomitant psychiatric ailment. HIV-positive patients compared to HIV-negative controls were predisposed to NCI (odds ratio (OR) 6.49, 95% CI 1.68-25.08); the estimated unadjusted attributable risk of HIV infection leading to NCI was 85%. Meta-regression showed no associations between age, gender, CD4 cell counts, or years of education with NCI. Patients on ART were less likely to have NCI compared to HIV-infected pre-ART patients, with OR 0.36 (95% CI 0.19-0.69). In longitudinal studies with the same patients followed before and at ≥6 months after ART, the OR of NCI after ART compared to pre-ART was 0.23 (95% CI 0.14-0.37). The combined burden of NCI among pre-ART and on-ART patients in Sub-Saharan Africa was estimated at 8,121,910 (95% CI 5,772,140-10,471,680). No publication bias was observed, although residual confounding from differing environmental factors, stages of HIV infection, and viral clades might be a limitation. HIV strongly predisposes to NCI leading to a huge burden in Sub-Saharan Africa, and scale-up of ART can substantially reduce it. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Macias at Bata, a continental coast city in the northwest part of the country, the foreign minister ordered an uprising from Santa Isabel (now... constitutionally elected president proclaimed himself "president for life." Attempted coups d’etat, one after another; an endless series of reports...English 2 Nov 78 p 10 [Editorial] [Text] CSO: 4420 roviso II IS the intention that in tthodesia life should go on as usual as far as possible
Steyn Nelia P
Full Text Available Abstract Background During the last century we have seen wide-reaching changes in diet, nutritional status and life expectancy. The change in diet and physical activity patterns has become known as the nutrition transition. At any given time, a country or region within a country may be at different stages within this transition. This paper examines a range of nutrition-related indicators for countries in Sub-Saharan Africa (SSA and attempts to develop a typical model of a country in transition. Methods Based on the availability of data, 40 countries in SSA were selected for analysis. Data were obtained from the World Health Organisation, Demographic and Health Surveys and the Food and Agriculture Organisation of the United Nations. Multiple linear regression analysis (MLRA was used to explore the determinants of infant mortality. A six point score was developed to identify each country's stage in the nutrition transition. Results MLRA showed that underweight-for-age, protein and the percentage of exclusively breastfed infants were associated with the infant mortality rate (IMR. The majority of countries (n = 26 used in the analysis had nutrition transition scores of zero and one. Most of them had a high prevalence of infant mortality, children that were stunted or underweight-for-age, small percentages of women that were overweight and obese, and low intakes of energy, protein, and fat. Countries with the highest scores include South Africa, Ghana, Gabon, Cape Verde and Senegal which had relatively low IMRs, high levels of obesity/overweight, and low levels of underweight in women, as well as high intakes of energy and fat. These countries display classic signs of a population well established in the nutrition-related non-communicable disease phase of the nutrition transition. Conclusions Countries in SSA are clearly undergoing a nutrition transition. More than half of them are still in the early stage, while a few have reached a point where
Ordway, Elsa M.; Asner, Gregory P.; Lambin, Eric F.
Rapid integration of global agricultural markets and subsequent cropland displacement in recent decades increased large-scale tropical deforestation in South America and Southeast Asia. Growing land scarcity and more stringent land use regulations in these regions could incentivize the offshoring of export-oriented commodity crops to sub-Saharan Africa (SSA). We assess the effects of domestic- and export-oriented agricultural expansion on deforestation in SSA in recent decades. Analyses were conducted at the global, regional and local scales. We found that commodity crops are expanding in SSA, increasing pressure on tropical forests. Four Congo Basin countries, Sierra Leone, Liberia, and Côte d’Ivoire were most at risk in terms of exposure, vulnerability and pressures from agricultural expansion. These countries averaged the highest percent forest cover (58% ± 17.93) and lowest proportions of potentially available cropland outside forest areas (1% ± 0.89). Foreign investment in these countries was concentrated in oil palm production (81%), with a median investment area of 41 582 thousand ha. Cocoa, the fastest expanding export-oriented crop across SSA, accounted for 57% of global expansion in 2000-2013 at a rate of 132 thousand ha yr-1. However, cocoa only amounted to 0.89% of foreign land investment. Commodity crop expansion in SSA appears largely driven by small- and medium-scale farmers rather than industrial plantations. Land-use changes associated with large-scale investments remain to be observed in many countries. Although domestic demand for commodity crops was associated with most agricultural expansion, we provide evidence of a growing influence of distant markets on land-use change in SSA.
Full Text Available The article covers the peculiarities of economic development of the two countries of Sub-Saharan Africa – Ghana and Senegal from 1970 to 2013. The trends of their GDP and GDP per capita were analysed. The question of how these indices are affected by changes in population, structure of production, flows of foreign direct investment (FDI and official development assistance (ODA, as well as the number of employees by economic sectors and indicators distribution of income was investigated. Comparing with other investigations much attention was paid to the trends of remittances from citizens abroad to Ghana and Senegal in addition to these factors. It is revealed that ODA was more important for two countries during a period of slow growth, and during the period of rapid growth of FDI and the growth of GDP, the flows of FDI and ODA were more significant in Ghana, and remittances and SDT – in Senegal. Services are significantly superior in the structure of production of two countries. Among the different types, financial and insurance services are predominant in Ghana and Senegal. The share of agriculture in the structure of production of two countries decreased somewhat during the specified period, while the share of industry increased, which occurred at the expense of the mining sector and construction. It has been determined that there are cycles of ups and downs associated with restructuring of production in the economic processes of Ghana and Senegal. It has been established that not only the human factor, as determined in the conclusions of Kuznets S., but also capital, are important for the growth of their production. The action of “the Kuznets law” was confirmed in Ghana: At the initial stage of growth, the distribution of income deteriorated, then its equalization took place. “The Kuznets law" has not been confirmed in Senegal: At the initial stage of growth, the distribution of revenues improved, and later, during the period of
Sub-Saharan Africa (SSA) has the greatest population growth rates, the highest levels of infant and child mortality, and the poorest economies in the world. The physical quality of life index for developed countries is 80, yet for 33 SSA countries it ranges from 20.5-66. Routine monitoring of growth and nutritional status of children demonstrates their health status. The proportion of low birth weight infants is high in SSA with most countries having levels 10-20% . Further even though average birth weight consistently rose during the 1980s in SSA, the range of smallest to largest mean birth weights is lower than the medians for developed counties. Moreover 40% of 5 year olds are mild or moderately malnourished as evidenced by growth retardation and some biochemical changes, yet they exhibit or clinical signs and symptoms. Besides diarrhea often exacerbates malnutrition. Through childhood and adolescence, growth patterns (particularly among the rural Turkana pastoralists) steadily deviate from the 50th centile of US norms. Thus almost 50% of early adolescents in rural areas are below the 5th centile. Studies have found that pastoralist children tend to begin being slightly above the 5th centile of US norms and gradually fall below it. Further peak growth velocities among SSA children are low, but postpeak velocities are higher than equal velocities for children in developed countries. Thus adult heights are only between the 5th-50th centiles. Throughout childhood and adolescence, US Blacks have higher absolute levels of subcutaneous fat than children in SSA. Yet the main centralized patterning of fat in SSA children basically equals that of US Blacks, but invariably less marginal than in Whites. In conclusion, adverse socioeconomic conditions in SSA result in low levels of health at all growth phases thereby confounding their genetic potential.
Frambach, Janneke M; Manuel, Beatriz A F; Fumo, Afonso M T; Van Der Vleuten, Cees P M; Driessen, Erik W
Evidence tailored to sub-Saharan Africa on outcomes of innovations in medical education is needed to encourage and advance their implementation in this region. To investigate preparedness for practice of students and graduates from an innovative and a conventional medical curriculum in a sub-Saharan African context. Using mixed methods we compared junior doctors and fifth-year students from two Mozambican medical schools: one with an innovative problem- and community-based curriculum and one with a conventional lecture- and discipline-based curriculum. A questionnaire on professional competencies was administered, semi-structured interviews were conducted, and work diaries were collected. The findings were integrated in a conceptual model. Six areas of tension between global health care ideals and local health care practice emerged from the data that challenged doctors' motivation and preparedness for practice. Four elements of the innovative curriculum equipped students and graduates with skills, attitudes and competencies to better cope with these tensions. Students and graduates from the innovative curriculum rated significantly higher levels on various competencies and expressed more satisfaction with the curriculum and its usefulness for their work. An innovative problem- and community-based curriculum can improve sub-Saharan African doctors' motivation and preparedness to tackle the challenges of health care practice in this region.