Selected socioeconomic barriers of education in Sub-Saharan Africa Abstract The aim of bachelor thesis is to describe and understand the process of education in Sub-Saharan Africa and analyze components that cause limited access to education. The first part of the thesis describes the process of education in Sub-Saharan Africa using selected indicators. The second main part focuses on the description and possible relations between selected socioeconomic barriers and literacy. Selected barrier...
Emoungu, Paul-Albert N.
The 1988 World Bank report on education in sub-Saharan Africa overstates the regional "crisis" in educational quality and recommends unrealistic strategies, ignoring the fact that basic human needs such as education are unmet because political elites corruptly privatize much of the wealth generated by their nations' economies. (SV)
Griffin, Rosarii, Ed.
In the drive to achieve universal primary education as one of the Millennium Development Goals, there is an increasing recognition of the urgency of focusing on teacher education to both meet the demand for more than one million qualified teachers required to achieve this goal within sub-Saharan Africa, as well as to combat the sometimes poor…
Thakrar, Jayshree; Zinn, Denise; Wolfenden, Freda
The challenges to teacher educators in sub-Saharan Africa are acute. This paper describes how the Teacher Education in Sub-Saharan Africa (TESSA) consortium is working within institutional and national policy systems to support school-based teacher professional development. The TESSA consortium (13 African institutions and 5 international…
Over the past decade, the largest growth in Sub-Saharan Africa's private higher education has been among institutions with religious affiliations. This article examines the rise of private, religious higher education in Sub-Saharan Africa with international affiliations. Using an analysis of multiple stakeholders from the region and international…
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.
James R. Ochwa-Echel
Full Text Available This article reviews the history of university development in Sub-Saharan Africa (SSA and discusses the impact of neoliberal policies. This will be followed by an examination of the problems facing universities in the region. The following questions will be explored: (a Are the existing universities in SSA serving the development needs of the region? (b Are these universities up to the task of moving SSA out of the predicaments it faces such as famine, HIV/AIDS, poverty, diseases, debt, and human rights abuses? Finally, the article argues that for universities to play a role in the development of the region, a new paradigm that makes university education a public good should be established.
.... This report from Sub-Saharan Africa, Benin, Botswana, Burkina, Cameroon, Chad, Comoros, Ethiopia, Ghana, Guinea, Kenya, Liberia, Madagascar, Mauritius, Mozambique, Sierra Leone, Somalia, South Africa...
.... This report on Sub-Saharan Africa, Angola, Botswana, Burkina, Cameroon, Ghana, Ivory Coast, Liberia, Madagascar, Malawi, Mali, Mozambique, Namibia, Senegal, South Africa, and Swaziland, contains...
.... This report from Sub-Saharan Africa, Angola, Benin, Botswana, Burundi, Ghana, Lesoto, Liberia, Malawi, Namibia, Nigeria, Senegal, Seychelles, South Africa, Tanzania and Zimbabwe, contains articles...
.... This report contains articles from Sub-Saharan Africa, Angola, Ethiopia, Ghana, Mozambique, Namibia, Sierra Leone, Togo, Zambia, and South Africa, the articles deal mainly with Politics, Sociology...
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...
This is a preliminary survey of the laws and statutes that determine governance arrangements for higher education systems as well as individual institutions in 24 countries of Sub-Saharan Africa. Following an overview of recent higher education governance trends within Africa, it describes the current range of practice and most common approaches…
Minnis, John R.
Education policy in sub-Saharan Africa is predicated on human capital assumptions and therefore promotes the expansion of formal education as a way to promote economic growth. As a result, formal education is valued primarily as a private consumer good, a form of cultural capital that allows some to get ahead and stay ahead, rather than as a…
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…
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…
Fredriksen, Birger; Fossberg, Camilla Helgø
Over the next two decades, sub-Saharan Africa will face substantial pressure to expand its secondary education system. This is driven by the current low development of secondary education compared to other world regions, continued rapid population growth, the increase in the enrollment and completion rates at the primary education level, and the…
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.
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.
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…
Moon, Bob; Villet, Charmaine
The purpose of this report is to provide an overview of the present and future impact of digital learning on teacher education in Sub-Saharan Africa. The focus of the report is student-teachers and teachers, and its central argument is that existing institutional structures will be insufficient to meet the scale of demand for well-prepared,…
Tilak, Jandhyala B. G.
Worsening economic conditions, reflected in mounting external debt, debt service, and structural adjustment processes have forced governments to reveal their expenditure priorities, which are largely against human capital investment activities like education. This paper examines this phenomenon, using cross-country data for Sub-Saharan Africa.…
This commentary discusses the three articles in this (2017) issue. The articles expand the published research base on the effectiveness of early education in the sub-Saharan Africa countries of Zambia, Kenya, and the Democratic Republic of Congo (DRC). Each of the three articles employs rigorous methods to better understand the impact of…
Dembele, Martial; Lefoka, Pulane
This article assumes that pedagogical renewal and teacher development are two sides of the same coin, and that the achievement of a universal primary education that is equitable and of acceptable quality in Sub-Saharan Africa will depend to a large extent on both. The need for pedagogical renewal stems from the evidence that (i) teaching is…
The aim of this dissertation is to identify effective educational interventions in Sub-Saharan African with an impact on student learning. This is the first meta-analysis in the field of education conducted for Sub-Saharan Africa. This paper takes an in-depth look at twelve different types of education interventions or programs and attempts to not…
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.
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...
Bvumbwe, Thokozani; Mtshali, Ntombifikile
The Lancet Commission and the Global Health Workforce Alliance reported that professional education has generally not kept up the pace of health care challenges. Sub Saharan Africa needs an effective and efficient nursing education system to build an adequate, competent and relevant nursing workforce necessary for the achievement of Sustainable Development Goals. The Plan of Action for Scaling up Quality Nursing and Midwifery Education and Practice for the African Region 2012 - 2022 provided a framework for scale up of nurses and midwives. This integrative review examined literature on nursing education challenges and solutions in Sub Saharan Africa to inform development of a model for improving the quality, quantity and relevance of nursing education at local level. A search of PubMed, Medline on EBCSOhost and Google Scholar was conducted using key words: nursing education, challenges, solutions and/ or Africa. Published works from 2012 to 2016 were reviewed to explore reports about challenges and solution in nursing education in Sub Saharan Africa. Full texts of relevant studies were retrieved after reading the tittles and abstracts. Critical appraisal was undertaken and the findings of the relevant studies were analysed using thematic analysis. Twenty articles and five grey sources were included. Findings of the review generally supports World Health Organisation framework for transformative and scale up of health professions education. Six themes emerged; curriculum reforms, profession regulation, transformative teaching strategies, collaboration and partnership, capacity building and infrastructure and resources. Challenges and solutions in nursing education are common within countries. The review shows that massive investment by development partners is resulting in positive development of nursing education in Sub Saharan Africa. However, strategic leadership, networking and partnership to share expertise and best practices are critical. Sub Saharan Africa
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.
Zymelman, Manuel, Ed.
This guide to assessing engineering education in Sub-Saharan Africa consists of three sections, covering: (1) assessment of qualitative and quantitative needs; (2) assessment of the engineering education institution in developing countries; and (3) methods of forecasting demand for engineers; assessment of the efficiency of engineering training…
Materu, Peter; Righetti, Petra
This article assesses the status and practice of higher education quality assurance in sub-Saharan Africa, focusing on degree-granting tertiary institutions. A main finding is that structured national-level quality assurance processes in African higher education are a very recent phenomenon and that most countries face major capacity constraints.…
Social Education, 1997
Presents a wealth of statistical, geographic, and economic information on Sub-Saharan Africa arranged and displayed for easy and immediate access. Lists all of the countries of the region along with pertinent information including religious affiliation, capital, Gross National Product, main exports, population growth, education, and literacy. (MJP)
This paper draws together research on seasonality, child labour and education in the context of primary education in sub-Saharan Africa. It describes how income poverty and demand for labour can fluctuate within and between years, affecting participation and progression through school systems. It highlights how analysis of the private and public…
This paper employs postcolonial framework to discuss the contradictions of promoting western education in Islamic communities in sub-Saharan Africa (SSA). Prior to colonization, Islamic education was an important socializing process that instilled strong Islamic identity in Islamic communities in SSA. European encounters in SSA and the…
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.
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
World Bank, Washington, DC.
Only an educated people can command the skills necessary for sustainable economic growth and for a better quality of life. Recognizing this, African governments have placed heavy emphasis on expanding educational opportunities. Even so, education in Sub-Saharan Africa is in crisis. Rapid population growth has resulted in more children than ever…
Lewin, Keith M.; Sabates, Ricardo
This paper explores changing patterns of access to basic education in six Sub-Saharan Africa countries using data from Demographic and Health Surveys at two points in time. In general the analysis confirms that participation of children in schooling has increased over the last decade. However, access to education remains strongly associated with…
Malakpa, Sakui W. G.
Despite genuine efforts, countries in sub-Saharan Africa significantly lag behind sister nations of the world in providing basic education and more so in providing special education and rehabilitation services for students with disabilities. This work gives an overview of the magnitude of this problem and outlines some of its causes. In addition,…
This article focuses on available opportunities and challenges which institutions of higher education in sub-Saharan Africa face in producing and distributing knowledge. Institutions of higher education are also expected to produce knowledge workers for the knowledge economy. Knowledge production falls into Mode 1, in which problems are set and…
McKenney, Susan; Reeves, T.C.
Progress toward the UN Millennium Development Goal to “Achieve Universal Primary Education” by 2015 is severely limited, especially in Sub-Saharan Africa. This paper describes the application of educational design research (EDR) to this goal, specifically in the context of improving the capacity of
Mtebe, Joel S.
Learning Management Systems (LMS) have been widely adopted by higher education institutions globally for over a decade. Institutions in sub-Saharan Africa now spend a significant proportion of their limited resources on installing and maintaining these systems. This expenditure continues to increase, raising questions as to whether LMS in these…
Multilateral donors like the World Bank and bilateral agencies such as the United States Agency for International Development (USAID) and the British Department for International Development exert a great deal of influence in international educational development--particularly in sub-Saharan Africa--both in the programs they fund and the types of…
Davis, Kristin E.; Ekboir, Javier; Spielman, David J.
This paper examines how post-secondary agricultural education and training (AET) in sub-Saharan Africa can contribute to agricultural development by strengthening the capacity to innovate--to introduce new products and processes that are socially or economically relevant to smallholder farmers and other agents. Using the AET system in Mozambique…
Johnson, Ane Turner
The purpose of this phenomenological study was to explore the life and career paths of women higher education administrators in sub-Saharan Africa. Specifically, the study sought to interpret the women's experiences and identities, through the framework of intersectionality and gender performance, as ones that contributed to advancement within…
Moodley, V. R.; Loughman, James; Naidoo, K. S.
The dire need for eye care services and a dearth of human resources (HR) in sub-Saharan Africa motivated the setting up of new optometry programmes. However, to make a meaningful impact, geographical, gender, economic and educational disparities must additionally be addressed. A qualitative study utilizing purposive sampling to select academic…
Browne, Angela W.; Barrett, Hazel R.
In sub-Saharan Africa, aggregate data show that female literacy is associated with higher agricultural productivity and is more strongly correlated than GNP with mortality and immunization rates of young children. A case study of Gambia confirms these relationships, with high female illiteracy apparently impeding both human and economic…
Ngwana, Terfot Augustine
This paper argues that a framework for strategic planning in universities in Sub-Saharan Africa can be developed with the background of global, regional, and institutional realities. Using the specific case of the University of Buea in Cameroon, the paper attempts to expose the global trends of polarization in knowledge production capacity as an…
The phenomenon of low-cost private schools "mushrooming" in poor areas of sub-Saharan Africa and South Asia, and elsewhere, is now well-documented. Findings from research by the author's teams and others show that these schools are serving a majority (urban and peri-urban) or significant minority (rural) of the poor, including…
Uchudi, J M
Although the general objective of this study is to examine the extent to which spouses' socioeconomic characteristics determine whether modern contraception is used and whether family limitation (the demand for no more children) is desired, its central goal is to evaluate the degree to which the net effect of a woman's education on those fertility decisions is altered once a control is made for the level of schooling of the husband. Individual characteristics of spouses included as controls in this analysis are on the one hand women's attributes relating to employment, age, parity, ethnic identity, and urban residence and, on the other hand, the occupation of the husband. Data used in this research are provided by DHS surveys conducted in fourteen sub-Saharan countries: Mali. Burkina Faso, Niger, Nigeria, Cameroon, Benin, Senegal. Ghana, Central African Republic, Kenya, Zambia, Zimbabwe, Namibia and Rwanda. With two dichotomous outcome variables, logistic regression was used to estimate two nested models for each dependent variable and for each country covered by the study. DHS respondents used as units of analysis in this study are women who were married (any kind of union) and non-pregnant at the time when each national survey was conducted. The findings suggest that, while an educated wife needs the support of an educated husband to state a preference for family limitation in contemporary sub-Saharan Africa, controlling for husband's education and other relevant covariates does little to undermine the evidence that woman's advanced education and the adoption of modern family planning are positively related in the developing world.
Frankema, Ewout; Bolt, Jutta
Cross-country research on educational inequality presents contrasting views on the extent of educational inequality in Latin America and Sub-Saharan Africa. The differences in opinion also concern the relation between educational inequality and income inequality. This paper argues that part of the reported results are influenced by the type of inequality indicator applied. Moreover, there may be a separate effect of educational attainment and educational distribution on income inequality, whi...
.... In reassessing United States interests and security policy in Sub-Saharan Africa in the Post Cold War era, it is important to understand modern Africa's past and the peculiar relationship of politics...
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
Dzvimbo, Kuzvinetsa Peter; Moloi, Kholeka Constance
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…
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.
Full Text Available BACKGROUND Earlier investigations have shown that a woman's chance of having a child, or various proximate determinants of her fertility, are influenced by the socioeconomic resources in the community in which she lives, net of her own resources. METHODS This study, which is based on DHS surveys from 28 countries in sub-Saharan Africa, adds to the knowledge about this issue. With a focus on first and higher-order birth rates, four specific questions are addressed. RESULTS One result is that the effects of the average education in the census enumeration area in which a woman lives, net of her own education, have remained stable or become stronger over the last decade. Second, these effects are most pronounced among women who score high on indicators of socioeconomic development, which suggests that they may become further strengthened. Third, effects even appear when a fixed-effects approach - based on data from two DHS surveys with GPS coordinates in each country - is employed to control for unobserved constant characteristics of units at a slightly higher level than the census enumeration area. Fourth, local processes seem to be particularly important: the education among women in the province or nearest census enumeration areas does not have a similar fertility-depressing effect.
Dzvimbo, Kuzvinetsa Peter; Moloi, Kholeka Constance
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 devel...
EPA’s environmental program in Sub-Saharan Africa is focused on addressing Africa’s growing urban and industrial pollution issues, such as air quality, water quality, electronics waste and indoor air from cookstoves.
Hughes, D. A.
This paper represents a perspective on the education and training needs related to hydrology and water resources science within the sub-Saharan Africa region and discusses the requirements of the region, some of the relatively recent developments and initiatives and some of the constraints that exist and remain difficult to surmount. The requirements include the development of academic research capacity and technical skill for both the private and public sector at a variety of levels. Some of the constraints that exist include a lack of adequate funding, lack of follow-up after short training courses, lack of institutional support to continue training, and competition for major water resources development projects from organizations outside the region. One of the main conclusions is that to sustain both educational and practical expertise in hydrology and water resources science within the region there is a need to build a "critical mass" of local expertise. Part of this could be achieved by increasing networking within the region and promoting the sharing of information, tools and expertise. There is also a need to promote institutional support.
Emina, Jacques B O; Chirwa, Tobias; Kandala, Ngianga-Bakwin
Existing literature revealed positive association between women's education and modern contraceptive use in sub-Saharan Africa (SSA). Overall modern contraception prevalence (MCP) and proportion of women with formal education have increased in region. However, little is known about how much the change in the prevalence of modern contraceptive methods is relative to the compositional change in population and how much of the change is actually due to increases in the number of women adopting the new behavior. This study aims to (1) describe trends in modern contraception prevalence by female education; and (2) identify the source of changes in modern contraceptive use by educational attainment (changes in structure or in population behavior). This is a cross-sectional study using Demographic and Health Surveys from 27 SSA countries where at least two comparable surveys have been conducted. Overall modern contraception prevalence (MCP) has increased in SSA over the study period. The ongoing increase in the contraceptive use is due to changes in behavior consistent with the ongoing family planning promotion over the past 30 years. By contrast, an increase in the proportion of women with secondary education does not explain the change in MCP in most SSA countries. To achieve universal access to family planning, efforts in promoting female education should be complemented with economic, cultural and geographical access to MCP. Household-based sensitization, general hospitals, mobile family planning clinics, and community-based distributors of modern contraceptive methods are key strategies to improve access to modern contraceptive use. Findings from this study suggest that countries should combine social investments, including health services and education, with family planning programs using reproductive health services, mobile family planning clinics and community-based distributors of modern contraceptive methods. Therefore, governments' legislation measures that
At a time when global relations are characterised by great complexity, uncertainty and inequality, the role of higher education is crucial for a balanced and coherent development strategy, and achievement of the Sustainable Development Goals (SDGs). This is especially true for countries of sub-Saharan Africa, where there is a critical need to generate knowledge that can be used in the service of social and economic development, human rights and climate change adaptation. The study concern...
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.
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.
Ademola Samson Adewoyin
Full Text Available Sickle cell disease (SCD predominates in sub-Saharan Africa, East Mediterranean areas, Middle East, and India. Nigeria, being the most populous black nation in the world, bears its greatest burden in sub-Saharan Africa. The last few decades have witnessed remarkable scientific progress in the understanding of the complex pathophysiology of the disease. Improved clinical insights have heralded development and establishment of disease modifying interventions such as chronic blood transfusions, hydroxyurea therapy, and haemopoietic stem cell transplantation. Coupled with parallel improvements in general supportive, symptomatic, and preventive measures, current evidence reveals remarkable appreciation in quality of life among affected individuals in developed nations. Currently, in Nigeria and other West African states, treatment and control of SCD are largely suboptimal. Improved knowledge regarding SCD phenotypes and its comprehensive care among Nigerian physicians will enhance quality of care for affected persons. This paper therefore provides a review on the aetiopathogenesis, clinical manifestations, and management of SCD in Nigeria, with a focus on its local patterns and peculiarities. Established treatment guidelines as appropriate in the Nigerian setting are proffered, as well as recommendations for improving care of affected persons.
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..
Sarr, Bachir; Fernandes, Meena; Banham, Louise; Bundy, Donald; Gillespie, Amaya; McMahon, Brie; Peel, Francis; Tang, K C; Tembon, Andy; Drake, Lesley
To document the progression of school health and nutrition and its integration within the education sector in sub-Saharan Africa between 2000 and 2015. School health and nutrition programs have contributed to "Education for All" objectives by helping ensure that children benefit from quality education and reach their educational potential. Analysis of education sector plans (ESPs) in terms of the Focusing Resources on Effective School Health (FRESH) framework and the World Bank Systems Approach for Better Education Results (SABER) School Health survey from a set of countries in sub-Saharan Africa. Between 2000 and 2015, the presence and scope of school health and nutrition as reflected in the four FRESH pillars grew substantially in ESPs. Three of these pillars have large, upfront costs. The fourth pillar requires recurring annual budgetary allotments. Governments clearly recognize that evidence-based, contextually designed school health and nutrition programs can contribute to education sector goals. Moving into the post-2015 era, these programs can also help draw the last 10% of children into school and enhance their readiness to learn.
... the increasingly important role of these councils in national science systems. ... that will contribute to economic and social development in Sub-Saharan Africa. ... Initiative for Sub-Saharan Africa's website to learn more about the initiative.
Wahlers, Kerstin; Menezes, Colin N.; Wong, Michelle L.; Zeyhle, Eberhard; Ahmed, Mohammed E.; Ocaido, Michael; Stijnis, Cornelis; Romig, Thomas; Kern, Peter; Grobusch, Martin P.
Cystic echinococcosis is regarded as endemic in sub-Saharan Africa; however, for most countries only scarce data, if any, exist. For most of the continent, information about burden of disease is not available; neither are data for the animal hosts involved in the lifecycle of the parasite, thus
Rivera-Santos, M.; Holt, D.; Littlewood, D.; Kolk, A.
Responding to calls for a better understanding of the relationship between social enterprises and their environments, this article focuses on contextual influences on social entrepreneurship in sub-Saharan Africa. We identify four predominantly African contextual dimensions, i.e., acute poverty,
Domatob, J K
Given the heavy Western metropolitan bias of the media in sub-Saharan Africa, the ideology of neocolonialism continues to exert a dominant influence on economic, social, political, and cultural life. This neocolonial influence is further reinforced by advertising that champions a consumerist culture centered around Western goods. The capital of multinational firms plays a crucial role in the strategy of media imperialism. The dramatic growth of monopolies and the creation of military-industrial-information conglomerates in the 1970s and 1980s have been reflected in the international exchange of information and the interlinkage of mass communication systems in sub-Saharan Africa. Another media strategy that reinforces neocolonialism is the use of satellite communication. If cultural autonomy is defined as sub-Saharan Africa's capacity to decide on the allocation of its environmental resources, then cultural synchronization is a massive threat to that autonomy. Few African nations have the resources or expertise necessary to design, establish, or maintain communication systems that could accurately reflect their own culture. Nonetheless, there are some policy options. Personnel can be trained to respect African values and to recognize the dangers of neocolonial domination. The production of indigenous programs could reduce the media's foreign content. The incorporation of traditional drama and dance in the media could enhance this process. Above all, a high degree of planning is necessary if sub-Saharan African states intend to tackle the media and its domination by neocolonialist ideology.
.... 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...
Full Text Available Africa is a rising star - one of the most desirable investment destinations in the world. Nonetheless, economic growth is uneven among African countries, and many obstacles must be overcome in order to realize the full potential of opportunity. To achieve long-term sustainable investment results, and ultimately progress towards Sustainable Development goals, many risks must be isolated, analyzed, and mitigated. This paper introduces the concept of Sustainability Risk, identifying a set of major risk components for Sub-Saharan Africa and building an integral measure to quantify the degree of remoteness of the forty-six Sub-Saharan Africa countries from the total set of threats considered. The countries are separated into distinct groups with similar characteristics in terms of Sustainability Risk, and an analysis for potential decision-making, based on the visualization of the countries' position in relation to the major sustainability threats, is performed for each group. The research identifies risks with maximum impacts.
Frantz, José M; Bezuidenhout, Juanita; Burch, Vanessa C; Mthembu, Sindi; Rowe, Michael; Tan, Christina; Van Wyk, Jacqueline; Van Heerden, Ben
In 2008 the sub-Saharan FAIMER Regional Institute launched a faculty development programme aimed at enhancing the academic and research capacity of health professions educators working in sub-Saharan Africa. This two-year programme, a combination of residential and distance learning activities, focuses on developing the leadership, project management and programme evaluation skills of participants as well as teaching the key principles of health professions education-curriculum design, teaching and learning and assessment. Participants also gain first-hand research experience by designing and conducting an education innovation project in their home institutions. This study was conducted to determine the perceptions of participants regarding the personal and professional impact of the SAFRI programme. A retrospective document review, which included data about fellows who completed the programme between 2008 and 2011, was performed. Data included fellows' descriptions of their expectations, reflections on achievements and information shared on an online discussion forum. Data were analysed using Kirkpatrick's evaluation framework. Participants (n=61) came from 10 African countries and included a wide range of health professions educators. Five key themes about the impact of the SAFRI programme were identified: (1) belonging to a community of practice, (2) personal development, (3) professional development, (4) capacity development, and (5) tools/strategies for project management and/or advancement. The SAFRI programme has a positive developmental impact on both participants and their respective institutions.
McGill, P E; Oyoo, G O
To review prevalence of rheumatic disorders in Sub-saharan Africa and in the context of current medical practice in the region assess the need for service and educational provision. Medline, (English, French). Pre-Medline literature review from the 1950's (Current contents). Various conference reports including attendance at all three AFLAR (African League Against Rheumatism) congresses in the 1990's. Author's personal database. All cited references read in full. The evidence shows rheumatoid arthritis and systemic lupus erythematosus to be increasing in frequency in the indigenous populations of East, Central and South Africa but remaining rare in West Africans. Gout is now more prevalent than ever throughout the subcontinent. HIV has spawned a variety of previously rare spondyloarthropathies (reactive arthritis, psoriatic arthritis, enthesopathy) and changed the epidemiology of pyomyositis and osteomyelitis. Osteoarthritis is a universal problem. Juvenile chronic arthritis is not rare and rheumatic fever is common. Acute and chronic locomotor problems associated with diverse entities such as leprosy, brucellosis, meningococcus, alpha viruses, parasites, fluorosis, rickets and haemoglobinopathies enhance diagnostic diversity and therapeutic and educational requirements. Suggestions made to address the challenge posed by the burden of rheumatic disorders.
Partial Contents: Subsaharan Africa, Railway Development, Arrests, International Reports, Lends Funds, Refugees, Investment Tax, Territory, Evidence, Leadership, Journalists, Credit LIne, Soliderity, Foreign Trades...
Partial Contents: Subsaharan Africa, Resolution, Settlement, Leaderships, Election Fraud, Political, Propaganda War, Guerilla War, Commonwealth President, Warns Officers, National Youth Corps, Diversity, Unemployment...
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.
Ramón Aguadero Miguel
Full Text Available In a diverse context, remarkable progress has been made in basic education development in sub-Saharan Africa over the past years. Despite these significant improvements, many SSA countries are still a long way for achieving education of adequate quality, and progress has been accompanied by increasing inequality. Millions of children, young people and adults are emerging from school each year without having acquired basic literacy and numeracy skills. Furthermore, wealth, gender, ethnicity, language, disability and other markers of disadvantage are fuelling wider processes of social exclusion. Focusing the discussion on the root causes of marginalization, within education and beyond, we´ll try to show how proactive policies should make a difference, especially directed at making education more accessible, affordable and inclusive for disadvantaged groups.
Full Text Available Premarital childbearing is common in many parts of sub-Saharan Africa, and may become increasingly so with the rise in women’s age at first marriage. These trends are concerning given the severe childhood health consequences associated with being born premaritally. However, women’s could condition the experience of having a premarital birth in a way that lessens its consequences for children. Extending the large literature on the child health benefits of mothers’ education—including her educational attainment and acquisition of key educational skills – I analyze whether the consequences of being born premaritally are lessened among children whose mothers are more highly-educated. The study focuses on Malawi, a southeast African country where child mortality rates remain high. I use Demographic and Health Survey data to estimate discrete-time logistic regression models (N=30,411 children younger than age five of the relationships between premarital childbearing, mothers’ educational background, and child mortality. The findings confirm that though being born premaritally is associated with higher child mortality, this is only true for children whose mothers have never been to school or discontinued at the primary level and/or never learned how to read. There is no evidence that being born premaritally is associated with elevated mortality among children whose mothers have been to secondary school and/or know how to read. The results demonstrate that analyzing how premarital childbearing intersects with other sources of health inequality enhances our understanding of the circumstances under which it poses the greatest risk to child well-being in sub-Saharan Africa. Keywords: Child health, Child mortality, Premarital childbearing, Education, Literacy, Africa, Malawi
education opportunities for aspiring sub-Saharan Africa leaders, improve drinking water , and protect forests—all of which is an interesting foreign...ANALYSIS OF UNITED STATES AND CHINESE ECONOMIC ENGAGEMENT IN SUB-SAHARAN AFRICA by James Housley Furman, Jr. March 2016 Thesis Advisor...ENGAGEMENT IN SUB-SAHARAN AFRICA 5. FUNDING NUMBERS 6. AUTHOR(S) James Housley Furman, Jr. 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES
The United Nations Millennium Development Goals (MDGs) project is coming to an end in 2015 and is being replaced by ambitious and aspirational Sustainable Development Goals (SDGs). Although the MDGs have been nearly achieved, this is not true in Sub-Saharan Africa where there is still unnecessarily high infant and childhood mortality and where there are many challenges to providing modern child health care. To achieve the SDGs in the next fifteen years, in low-income countries, national minis...
Information and Networks in Asia and Sub-Saharan Africa: Strengthening Research Capacity ... credible, high-quality evidence on the influence of digital initiatives in the areas of ... use of digital information networks and economic growth, democratic reform, and increased educational opportunities in developing countries.
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.
..., Medical Services, Radical, Conservative Party, Boycott, Consumers, Surveys, Education Crisis, National Teacher, Education Systems, Endangered, International, Capital Formation, Computer Journalists...
Kelcey, Ben; Shen, Zuchao
A key consideration in planning studies of community-based HIV education programs is identifying a sample size large enough to ensure a reasonable probability of detecting program effects if they exist. Sufficient sample sizes for community- or group-based designs are proportional to the correlation or similarity of individuals within communities. As a result, efficient and effective design requires reasonable a priori estimates of the correlational structure among individuals within communities. In this study, we investigate the degree of correlation among individuals within communities and regions using samples of sixth-grade adolescents from 609 local area district communities and 122 regions in 15 sub-Saharan African nations. We develop nation-specific and international summaries of these correlations using variance partitioning coefficients from multilevel models and subsequently assess the extent to which different types of background variables delineate key sources of these correlations. The results suggest persistent differences among communities and regions and that the degree of correlation among individuals within communities varied considerably by nation. The findings underscore the importance of empirically derived values of design parameters that are anchored in evidence specific to the outcome, nation and context of the planned study. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email: email@example.com.
Baker, David P.; Collins, John M.; Leon, Juan
Numerous epidemiological studies from the early years of the tragic HIV and AIDS pandemic in sub-Saharan Africa identified formal education as a risk factor increasing the chance of infection. Instead of playing its usual role as a preventative factor, as has been noted in many other public health cases, until the mid-1990s educated African men…
about DM30 million to Mozambique. This money will be used toward the rehabilitation of the industrial and financial estate [ parque ], invest- ments in...26 Industrial Sector Prioritized Under SFEM (NEW NIGERIAN, 24 Oct 86) 28 Cocoa Inspection Controls To Tighten (AFRICA ECONOMIC DIGEST, 1-7...86) 101 Briefs White Urbanites Spending Cuts 103 Black/White Consumer Confidence IO3 Coastal Industry Expansion Urged 104 Corn to Lesotha 104
Africa "governed by the votes of some 900 000 White men and women admitted to the franchise (because) they had a white skin and an age of :21 years’V...what they are doing now." /9317 CSO: 3400/848 111 KX$ vS ;:; sxv£ .WfflE’iUÄiJ**»ÜÄ5Jau«ÄftBd!Effli iMMWWflnttfta&tt •ÖSE *V5äi&a?.W- -■-: SOUTH...deregula- tion". The SBDC is calling for a freer economy with more visible gains from entrepreneurship . Says Woolford: "You cannot expect
Partial Contents: Oil Installations, Defense Minister, Polices, Electricity Crisis, Agronomy, Popularity, Universal Suffrage, Radio Services, Internal Children Protested, Sociopolitical,Warning, Black Education...
Rates of primary enrollment, female primary enrollment, private school enrollment, and literacy during 1960-92 were analyzed for 39 sub-Saharan African countries. Throughout the period, strongly Christian countries had higher enrollment and literacy rates than strongly Islamic countries, regardless of economic level, type of state, or colonial…
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.
Jul 1, 2013 ... its trade and education ties with the three countries. In Accra, the Governor ... and malnutrition; a project that uses modern techniques to produce new .... The project targets traditional and local authorities, judicial institutions ...
This paper employs postcolonial framework to discuss the contradictions of promoting western education in Islamic communities in sub-Saharan Africa (SSA). Prior to colonization, Islamic education was an important socializing process that instilled strong Islamic identity in Islamic communities in SSA. European encounters in SSA and the introduction of western education shifted the socializing process and reconfigured SSA societies and dislocated Islamic communities in the region. I argue that...
Tumuheki, Peace; Zeelen, Jacobus; Openjuru, George L.
Building on the participation model of Schuetze and Slowey, this study contributes to the public discourse on theoretical considerations for guidance of empirical research on participation of non-traditional students (NTS) in higher education in Sub-Saharan Africa (SSA). Drawing from empirical work
Recent studies of the current state of rural education and training (RET) systems in sub-Saharan Africa have assessed their ability to provide for the learning needs essential for more knowledgeable and productive small-scale rural households. These are most necessary if the endemic causes of rural poverty (poor nutrition, lack of sustainable…
Sani, A. Sadiq; Abraham, Charles; Denford, Sarah; Mathews, Catherine
This study investigated facilitators and challenges to designing, implementing and evaluating school-based sexual health education in sub-Saharan Africa, using interviews with intervention designers and researchers. At the pre-planning and planning stages, participants reported that facilitating factors included addressing the reproductive health…
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
British colonial rule has often been praised for its comparatively benign features, such as its support of local educational development. This study argues that the impact of British educational policies and investments on the supply of schooling in British Africa should not be overstated. Until
Gray, Kenneth R.; Credle, Sid Howard
Examines Kenya's policy concerning growth and development of higher education over the last 20 years. Concludes that Kenya has problems of infrastructure quality and physical plant similar to those of other Sub-Saharan African countries, that resource allocation policies are inconsistent, and that expansion should be guided by popular demand for…
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…
Zuilkowski, Stephanie Simmons; Jukes, Matthew C H
Many studies have attempted to determine the relationship between education and HIV status. However, a complete and causal understanding of this relationship requires analysis of its mediating pathways, focusing on sexual behaviors. We developed a series of hypotheses based on the differential effect of educational attainment on three sexual behaviors. We tested our predictions in a systematic literature review including 65 articles reporting associations between three specific sexual behaviors -- sexual initiation, number of partners, and condom use -- and educational attainment or school enrollment in sub-Saharan Africa. The patterns of associations varied by behavior. The findings for condom use were particularly convergent; none of the 44 studies using educational attainment as a predictor reviewed found that more educated people were significantly less likely to use condoms. Findings for sexual initiation and number of partners were more complex. The contrast between findings for condom use on the one hand and sexual initiation and number of partners on the other supports predictions based on our theoretical framework.
Since the nineteenth century, moral education in Africa's traditional societies, generally presented in schools as Christian instruction, has been hampered by difficulties inherent in colonial situations and in attempts to integrate western and indigenous values. Success in these circumstances calls for cooperation between school, home, and the…
This article provides an overview of the current state of the liquefied petroleum gases (LPG) market in sub Saharan Africa (SSA) and analyses the supply and demand patterns, the constraints on supply imposed by the insufficient output from refineries unable to meet the increasing demand, and institutional and regulatory issues. Details are given of the pricing policies, the economic benefits that could be obtained by increasing the scale of operations, the use of subsidies, private sector participation, and LPG activities in Angola, Cameroon, the Congo, and the Ivory Coast. The role of the World Bank in the Africa Gas Initiative to promote the use of natural gas reserves in SSA, and requirements for developing the LPG market are discussed
Asgari, Mahdi; Nogueira, Lia
Countries successful in achieving growth and equity throughout their development process could provide continuing gross flow of resources to agriculture in the form of technical, educational, and financial elements combined with proper institutions and policies to increase agricultural productivity. The main purpose of this study is to analyze the impact of institutional differences in governance, health and markets on the overall agricultural performance of Sub-Saharan Africa countries. Gove...
Sintayehu Kassaye Alemu
Full Text Available Over the past decades, the development of the internationalisation of higher education has revised the conceptual framework of higher education, enhanced its scope, scale and importance, and transformed its world, as well as reshaping relationships between countries. More powerful universities play a central role and are suppliers of knowledge, whereas weaker institutions and systems with fewer resources and lower academic standards occupy a peripheral position and are consumers. The centre-periphery dichotomy in the internationalisation of higher education undoubtedly presents considerable challenges to the higher education institutions of the peripheries. For developing regions like Africa, higher education is an important instrument for socio-economic development, and one of the strategies to improve and qualify higher education is internationalisation. In spite of various attempts to enhance the benefits of internationalisation, African higher education has continued to be peripheral, with relationships remaining asymmetrical, unethical and unequal. Along with some positive benefits, internationalisation has brought complicated implications and new challenges, such as the brain drain, cultural values, the commodification of higher education, the persistence of inequality between global north-south universities, and so on. The purpose of the present paper is to highlight the challenges and unintended consequences of the internationalisation of higher education, with a particular focus on Africa.
Boosting food security in sub-Saharan Africa through cassava production: a case study of Nigeria. ... Nigerian Journal of Economic History ... The paper argues that cassava which is widely grown in Sub-Saharan Africa with a lot of variety of food derivatives from it can reduce to the barest minimum the present state of food ...
Price, Amy; Verma, Arpana; Welfare, William
An estimated 129 million people are infected with urogenital schistosomiasis in sub-Saharan Africa. Current control recommendations endorse mass administration of praziquantel. Health education is an important component of effective schistosomiasis prevention and control, but there has been limited research on its effectiveness. This paper reviews the effectiveness of health education as an intervention in the prevention and control of urogenital schistosomiasis in sub-Saharan Africa. The outcomes of interest were prevalence, incidence or transmission of schistosomiasis, behaviour change associated with infection, or changes in knowledge of the disease. The findings from this review suggest that health education has a beneficial impact on knowledge and understanding of schistosomiasis within the target groups. However, further research is needed due to the poor quality of the included studies. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Increasing levels of education has been especially important in the quest for reducing poverty and have accordingly been a high priority for both international organizations and local governments. However, some doubt have been cast on extent to which these increases in the level of education...... will lead to economic growth. One of the most concerning factors is that academic skills remain low despite increases in the access to education. In Africa, 15-20% do not have full competencies in reading or basic math when they leave primary school. Shedding light on how to improve learning is a central......-constrained context as northern Uganda variations in teacher quality do explain a significant part of the variation in learning. This suggests that shifting the worst performing teachers to the level of the best performing could have a large impact on learning. The last Chapter points to the complexity of public...
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.
Full Text Available This paper employs postcolonial framework to discuss the contradictions of promoting western education in Islamic communities in sub-Saharan Africa (SSA. Prior to colonization, Islamic education was an important socializing process that instilled strong Islamic identity in Islamic communities in SSA. European encounters in SSA and the introduction of western education shifted the socializing process and reconfigured SSA societies and dislocated Islamic communities in the region. I argue that Islamic communities’ marginalization educationally since the colonial era is partly the result of their resistance to western colonization and all its forms. In the first part of the paper I discuss postcolonial discourse and education. The second part discusses education and religion nexus in sub-Saharan Africa. It uses recent Pew Research for example as evidence to delineate the Muslim-Christian gaps in education by age categories and gender. The third part outlines ways western education became a tool for reconfiguring Islamic communities and the rationales behind Islamic communities’ resistance to this form of education. The concluding section discusses contemporary efforts to promote education in Islamic communities in SSA within the rubric of Education for All (EFA.
Sub-Saharan Africa (SSA) is the region with the world's highest rates of HIV and other sexually transmissible infections (STIs), yet numerous studies show that condom use is generally rare. This suggests a need for a better understanding of how condoms fit within sexual practices and relationships in SSA. This paper seeks to address this need by reviewing research published between the late 1980s and 2011 on use and factors influencing use of male condoms in SSA. What is evident from this research is that condom use involves complex social and interpersonal dynamics, with structural and cultural conditions exerting an influence through framing social cognitions and setting boundaries on autonomy that make the apparently irrational choice of eschewing condoms a rational decision. The influences of poverty; relationships with parents, peers and partners; limited, insufficient or absent information especially in rural areas and among men who have sex with men; gender and sexual norms, and the dynamics of gendered power; and beliefs and attitudes about HIV, condoms and sexuality all have been shown to work against condom use for a large proportion of Africa's people. However, promising results are shown in trends towards increased condom use among single women in numerous countries, increasing acceptance and use of condoms among some university students, successes in producing potentially sustainable condom use resulting from select interventions, and resistance to succumbing to the dominant gender-power dynamics and structural-cultural impediments that women in groups have mobilised.
The end of the Cold War and dissolution of the Soviet Union and Warsaw Pact caused the United States and its allies to reevaluate its national interests and strategy in and toward the countries of sub-Saharan Africa...
Key words: food, constraints, mechanization, Sub-Saharan Africa, food security. Introduction ... ensure all-year-round food production. Agricultural .... her citizens to travel to the United States to ... downsize in the intake of students into these.
In addition, sub-Saharan Africa suffers the most impact from the HIV ... Our work in Benin has resulted in agricultural improvements and stronger local leadership. ... has stimulated better agriculture, health care, and anti-poverty programs.
Microwork and Virtual Production Networks in Sub-Saharan Africa and Southeast Asia ... content posted to social media sites; -categorizing products in online shops; or, ... that have realized that entry-level workers can be efficient and effective.
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. ...
There is increasing interest in the intersection of education and training through societal development in the developing world, a concept linked to national human resource development (NHRD). In addition, education and training is known to correlate strongly with employment outcomes that are connected to economic success, health and family…
Asamoah, Moses Kumi; Mackin, Eva Esi
Higher education institutions (HEI) are established to address human resource needs by producing graduates with the relevant knowledge, skills and attitude for the labour market and improving the country's ability to maximize its long-term economic, social and political developments. The fetters of higher education are the challenges bedeviling…
Full Text Available This paper studies the education-employment nexus in the context of Senegal. Using the 2005 Senegal Household Survey, we find that households’ heads with higher education (lower secondary level and above are less likely to be self-employed but more likely to be working in the public sector. Disaggregation by gender and location (rural vs. urban does not affect the results. Besides, female headed households with secondary education and above are more likely to be employed in the private sector. The results suggest the importance of steps for extensive promotion of education (especially for an upward revision of the level of compulsory education in resolving the persistent unemployment problem and improving the job availability in the private sector.
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
Fjelde, Hanne; Höglund, Kristine
Political violence remains a pervasive feature of electoral dynamics in many countries in Sub-Saharan Africa, even where multiparty elections have become the dominant mode of regulating access to political power. With cross-national data on electoral violence in Sub-Saharan African elections between 1990 and 2010, this article develops and tests a theory that links the use of violent electoral tactics to the high stakes put in place by majoritarian electoral institutions. It is found that ele...
Arndt, Channing; McKay, Andrew; Tarp, Finn
While the economic growth renaissance in sub-Saharan Africa is widely recognized, much less is known about progress in living conditions. This book comprehensively evaluates trends in living conditions in 16 major sub-Saharan African countries, corresponding to nearly 75% of the total population. A striking diversity of experience emerges. While monetary indicators improved in many countries, others are yet to succeed in channeling the benefits of economic growth into the pockets of the poor....
Hisako KAI; Shigeyuki HAMORI
This paper examines the relationship between globalization, financial deepening, and inequality in sub-Saharan Africa between 1980 and 2002. We provide the first detailed econometric analysis in this regard covering the entire sub-Saharan African region; such an analysis has hardly been conducted owing to the lack of relevant data. We find that while globalization deteriorates inequality, its disequalizing effect depends on the level of development of the country. Further, this paper confirms...
Murphy, Patricia; Wolfenden, Freda
The TESSA (teacher education in sub Saharan Africa) programme aims to improve teacher education at scale by developing open educational resources (OER) that allow sustainable and locally managed pedagogical change in higher education institutions and schools. The article offers a sociocultural theoretical rationale for the pedagogy of mutuality…
Colletta, Nat J.; And Others
In Sub-Saharan Africa, severe adverse conditions have placed children at high risk: persistent and worsening poverty, rapid economic change and population growth, increasing urbanization, a changing family structure, growing numbers of orphaned refugees, and displaced women and children from internal civil strife. These conditions make a viable…
Austin, G.; Frankema, E.H.P.; Jerven, M.
This chapter reviews the ‘long twentieth-century’ development of ‘modern’ manufacturing in Sub-Saharan Africa from colonization to the present. It argues that classifying Africa generically as a ‘late industrializer’ is inaccurate. To understand the distinctively African pattern of manufacturing
Larson, Paul R; Chege, Patrick; Dahlman, Bruce; Gibson, Christine; Evensen, Ann; Colon-Gonzalez, Maria C; Onguka, Stephanie; Lamptey, Roberta; Cayley, William E; Nguyen, Bich-May; Johnson, Brian; Getnet, Sawra; Hasnain, Memoona
Reducing the shortage of primary care physicians in sub-Saharan Africa requires expansion of training programs in family medicine. Challenges remain in preparing, recruiting, and retaining faculty qualified to teach in these pioneering programs. Little is known about the unique faculty development needs of family medicine faculty within the sub-Saharan African context. The purpose of this study was to assess the current status and future needs for developing robust family medicine faculty in sub-Saharan Africa. The results are reported in two companion articles. A cross-sectional study design was used to conduct a qualitative needs assessment comprising 37 in-depth, semi-structured interviews of individual faculty trainers from postgraduate family medicine training programs in eight sub-Saharan African countries. Data were analyzed according to qualitative description. While faculty development opportunities in sub-Saharan Africa were identified, current faculty note many barriers to faculty development and limited participation in available programs. Faculty value teaching competency, but institutional structures do not provide adequate support. Sub-Saharan African family physicians and postgraduate trainee physicians value good teachers and recognize that clinical training alone does not provide all of the skills needed by educators. The current status of limited resources of institutions and individuals constrain faculty development efforts. Where faculty development opportunities do exist, they are too infrequent or otherwise inaccessible to provide trainers the necessary skills to help them succeed as educators.
Deforestation has been a complex phenomenon to study in sub-Saharan Africa. The average annual deforestation rate in the region is by far higher than the world average. What causes and drives deforestation in the region are debated to date. The present paper is motivated by this debate. It attempts to test whether the maintained hypotheses on the causes of deforestation can give answer to the problem in sub-Saharan Africa. It used average cross-national data of forty eight countries in the re...
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
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.
Adisa, Femi; Isabalija, Stephen R.
This paper discusses the need for IS research with a focus on SME adoption of enterprise systems in the context of Sub-Saharan Africa. Previous IS research into general adoption in several developing countries have shown that local context play a significant role in the successful implementation...... of any information system. SMEs constitute a majority of all organizations in most Sub Saharan economies, thus their importance to the socioeconomic development and empowerment of the region cannot be overemphasized. However, the absence of literature and focused research into factors that influence...
Jorge Fernández Ruiz
Full Text Available In recent years, the rate of growth of tourism in Sub-Saharan Africa has continued apace at almost twice the rate of the rest of the globe. In this paper we examine some economic consequences of this growth focusing our attention on two Sub-Saharan countries with important tourist sectors: Cape Verde and Gambia. We examine the factors driving the growth of tourism in these countries and those affecting whether or not this increase can help promote broader economic development and increase the overall welfare of the citizens of these two countries.
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 ...
Barasa, L.; Kinyanjui, B.; Knoben, Joris; Kimuyu, P.; Vermeulen, P.A.M.
Our study seeks to examine the bi-directional relationship between innovation and exporting in four countries in Sub-Saharan Africa. We hypothesize that there is a positive relationship between innovation and subsequent exporting, and that this relationship is mediated by market creation. We also
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
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 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 ...
Early Marriage and Motherhood in Sub-Saharan Africa. Thérèse Locoh. Abstract. (African Environment: 3-4 (39-40): 31-42). Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...
Venot, J.P.J.N.; Hirvonen, M.
This article draws from the fields of anthropology of development and sociology of science to bring new light on the discourses and dynamics of agricultural water management in Sub-Saharan Africa. Specifically, it investigates the persistence of a long-standing and apparently contradictory narrative
Serdeczny, Olivia; Adams, Sophie; Baarsch, Florent; Coumou, Dim; Robinson, Alexander; Hare, William; Schaeffer, Michiel; Perrette, Mahé; Reinhardt, Julia
The repercussions of climate change will be felt in various ways throughout both natural and human systems in Sub-Saharan Africa. Climate change projections for this region point to a warming trend, particularly in the inland subtropics; frequent occurrence of extreme heat events; increasing
Considers the relevance for sub-Saharan Africa of electronic information systems in terms of the segments of the population that would benefit from such services, as opposed to a broader library role of advancing literacy to the general population. (Author/CLB)
Brook, Diane L.
Articulates many reasons to teach about Sub-Saharan Africa in social studies classes. Although the region will become increasingly important because of global interdependence, it suffers widespread misunderstanding concerning its history and culture. Discusses the region's need for economic development and the quest for political democracy. (MJP)
Mutula, Stephen M.
Purpose: Seeks to argue that the peculiarities of sub-Saharan Africa, in terms of its socio-cultural diversity, low economic development, linguistic factors, HIV/AIDS pandemic, gender discrimination, low ICT awareness and so on, demand a new model of addressing the digital divide. Design/methodology/approach: Paper largely based on literature…
Kroesen, J.O.; Romijn, H.A.; Kroesen, J.O.
This paper takes a capability approach to analyze the role of entrepreneurship in the socio-economic development of present-day sub-Saharan Africa. The paper zooms in on the nature of the capabilities that are built through the development of entrepreneurship; the key challenges to the development
Kroesen, J.O.; Romijn, H
This paper takes a capability approach to analyze the role of entrepreneurship in the socio-economic development of present-day Sub Saharan Africa. The paper zooms in on the nature of the capabilities that are built through the development of entrepreneurship; the key challenges to the development
This report identifies the strategic factors that should propel the African youth to benefit from the opportunities that lie ahead, in particular, economic growth, ... In addition, better focus on information and communications technology could bridge the digital divide between sub-Saharan Africa and the West while making the ...
Meerman, J; Cochrane, S H
The authors argue that sub-Saharan Africa, given its present institutions and endowments of capital and technology, is already dangerously close to overpopulation. Specifically, they suggest that projected rapid population growth will have disastrous effects on the region's ability to increase exports and provide people with goods.
David E. Sahn; H. Alderman
Sub-Saharan Africa (SSA) has had an aggregate malnutrition rate of nearly 30 percent for the last decade. While malnutrition prevalence has decreased significantly in most other developing countries in the last decade, it has been nearly static for SSA. This static trend in the percentage of malnourished children, however, does not fully reflect the rapidly rising numbers of malnourished c...
GrOW is a five-year, multi-funder partnership of the United Kingdom's Department for International Development, The William and Flora Hewlett Foundation, and IDRC. With a focus on low-income countries in sub-Saharan Africa and South Asia, GrOW aims to support policies and interventions that improve women's ...
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 ...
Romig, T.; Omer, R. A.; Zeyhle, E.; Hüttner, M.; Dinkel, A.; Siefert, L.; Elmahdi, I. E.; Magambo, J.; Ocaido, M.; Menezes, C. N.; Ahmed, M. E.; Mbae, C.; Grobusch, M. P.; Kern, P.
Cystic echinococcosis occurs in most regions of sub-Saharan Africa, but the frequency of this zoonosis differs considerably among and within countries. Especially human cases seem to be focally distributed. A number of environmental and behavioural factors partially explain this pattern, i.e.
Oral Health Challenges for Sub-Saharan Africa. IS Danfillo. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...
Result and Conclusion: Neonatal hypothermia is a major condition of public health importance in countries of sub- Saharan Africa. Awareness of the burden of the disease is still low in some communities. Risk factors for neonatal hypothermia in the region include poverty, home delivery, low birthweight, early bathing of ...
This book has been nominated for the Conover-Porter Award 2008 - This bibliography on Islam in contemporary Sub-Saharan Africa has been prepared as part of the African Studies Centre/Centre d'Étude d'Afrique Noire project entitled "Islam, the Disengagement of the State, and Globalization in
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
sub-region one of the poorest in the world with 46.4 percent of its people living on ... variables on the level of poverty as observed in Sub-Saharan Africa, using a ... Studies by UNDP also advocate the use of Human Development Index (HDI) and .... Gdisi = gender discrimination proxy by low women status relative to men.
This book has been nominated for the Conover-Porter Award 2008 - This bibliography on Islam in contemporary Sub-Saharan Africa has been prepared as part of the African Studies Centre/Centre d'Etude d'Afrique Noire project entitled "Islam, the Disengagement of the State, and Globalization in
Calderón, César; Servén, Luis
An adequate supply of infrastructure services has long been viewed by both academics and policy makers as a key ingredient for economic development. Sub-Saharan Africa ranks consistently at the bottom of all developing regions in terms of infrastructure performance, and an increasing number of observers point to deficient infrastructure as a major obstacle for growth and poverty reduction ...
This project seeks to provide capacity-building support to develop and implement the Information and Networks in Asia and Sub-Saharan Africa (INASSA) research program. INASSA is focused on producing credible, high-quality evidence on the influence of digital initiatives in the areas of governance, science, learning, ...
Ellis, S.D.K.; Haar, Gerrie ter
In the considerable number of countries in sub-Saharan Africa in which political institutions have largely broken down, religious discourse can be seen as an attempted remedy by means of a reordering of power. The numerous popular texts on witchcraft and other perceived forms of evil reflect the
Ngimwa, Pauline; Wilson, Tina
In the past few years, Africa has joined the rest of the world as an active participant in the Open Educational Resource (OER) movement with a number of home-grown and externally driven initiatives. These have the potential to make an immense contribution to teaching and learning in Sub-Saharan Africa (SSA). However, certain barriers prevent full…
Bridging the Atlantic is a descriptive study of Brazil's involvement with counterparts in Sub-Saharan Africa through knowledge exchange, trade, and investments. The objective of the study is to understand these relations better with the intent to forge concrete and mutually beneficial partnerships between Brazil and Sub-Saharan Africa. Brazil and Sub-Saharan Africa are natural partners, wi...
Yakubu, Ibrahim; Salisu, Waliu Jawula
Adolescent pregnancy has been persistently high in sub-Saharan Africa. The objective of this review is to identify factors influencing adolescent pregnancies in sub-Saharan Africa in order to design appropriate intervention program. A search in MEDLINE, Scopus, Web of science, and Google Scholar databases with the following keywords: determinants, factors, reasons, sociocultural factors, adolescent pregnancy, unintended pregnancies, and sub- Saharan Africa. Qualitative and cross-sectional studies intended to assess factors influencing adolescent pregnancies as the primary outcome variable in sub- Saharan Africa were included. Our search was limited to, articles published from the year 2000 to 2017 in English. Twenty-four (24) original articles met the inclusion criteria. The study identified Sociocultural, environmental and Economic factors (Peer influence, unwanted sexual advances from adult males, coercive sexual relations, unequal gender power relations, poverty, religion, early marriage, lack of parental counseling and guidance, parental neglect, absence of affordable or free education, lack of comprehensive sexuality education, non-use of contraceptives, male's responsibility to buy condoms, early sexual debut and inappropriate forms of recreation). Individual factors (excessive use of alcohol, substance abuse, educational status, low self-esteem, and inability to resist sexual temptation, curiosity, and cell phone usage). Health service-related factors (cost of contraceptives, Inadequate and unskilled health workers, long waiting time and lack of privacy at clinics, lack of comprehensive sexuality education, misconceptions about contraceptives, and non-friendly adolescent reproductive services,) as influencing adolescent pregnancies in Sub-Saharan Africa CONCLUSION: High levels of adolescent pregnancies in Sub-Saharan Africa is attributable to multiple factors. Our study, however, categorized these factors into three major themes; sociocultural and economic
Sambala, Evanson Z; Uthman, Olalekan A; Adamu, Abdu; Ndwandwe, Duduzile; Wiyeh, Alison B; Olukade, Tawa; Bishwajit, Ghose; Yaya, Sanni; Okwo-Bele, Jean-Marie; Wiysonge, Charles S
Missed opportunities for vaccination (MOV) is an important barrier hindering full immunisation coverage among eligible children. Though factors responsible for MOV are well documented in literature, little attention has been paid to the role of inequalities. The aim of this study is to examine the association between structural or compositional factors and education inequalities in MOV. Blinder-Oaxaca decomposition technique was used to explain the factors contributing to the average gap in missed opportunities for vaccination between uneducated and educated mothers in sub-Saharan Africa using DHS survey data from 35 sub Saharan African countries collected between 2007 and 2016. The sample contained 69,657 children aged 12 to 23 months. We observed a wide variation and inter-country differences in the prevalence of missed opportunity for vaccination across populations and geographical locations. Our results show that the prevalence of MOV in Zimbabwe among uneducated and educated mothers was 9% and 21% respectively while in Gabon corresponding numbers were 85% and 89% respectively. In 15 countries, MOV was significantly prevalent among children born to uneducated mothers (pro-illiterate inequality) while in 5 countries MOV was significantly prevalent among educated mothers (pro-educated inequality). Our results suggest that education-related inequalities in missed opportunities for vaccination are explained by compositional and structural characteristics; and that neighbourhood socio-economic status was the most important contributor to education-related inequalities across countries followed by either the presence of under-five children, media access or household wealth index. The results showed that differential effects such as neighbourhood socio-economic status, presence of under-five children, media access and household wealth index, primarily explained education-related inequality in MOV. Interventions to reduce gaps in education-related inequality in MOV
Sani, A Sadiq; Abraham, Charles; Denford, Sarah; Ball, Susan
School-based sexual health education has the potential to provide an inclusive and comprehensive approach to promoting sexual health among young people. We reviewed evaluations of school-based sexual health education interventions in sub-Saharan Africa to assess effectiveness in reducing sexually transmitted infections and promoting condom use. We searched ten electronic databases, hand-searched key journals, and reference lists of included articles for potential studies. Data were extracted on outcomes, intervention characteristics, methods and study characteristics indicative of methodological quality. Where possible, data were synthesized using random effect meta-analysis. Intervention features found predominantly in effective interventions were noted. The initial search retrieved 21634 potentially relevant citations. Of these, 51 papers reporting on 31 interventions were included. No evaluation reported statistically significant effects on the incidence or prevalence of Human Immunodeficiency Virus and Herpes Simplex Virus 2 infections. However, intervention participants reported statistically significant greater condom use in both randomised controlled trials and non-randomised trials for short (less than 6 months) follow-up periods (OR = 1.62, 95 % CI = 1.03-2.55 and OR = 2.88, 95 % CI = 1.41-5.90 respectively). For intermediate (6-10 months) and long-term (more than 10 months) follow-up periods, the effect was statistically significant (OR = 1.40, 95 % CI = 1.16-1.68) and marginally significant (OR = 1.22, 95 % CI = 0.99-1.50) among the randomised trials respectively. Only 12 of the 31 interventions reported implementation details, out of which seven reported on fidelity. School-based sexual health education has the potential to promote condom use among young people in sub-Saharan Africa. However, further work is needed to develop and evaluate interventions that have measurable effects on sexually transmitted infections.
Obi, Dorothy S.
Based on a survey, the major characteristics of Sub-Saharan African library schools are summarized. An analysis of the current situation and suggestions for development are given in the areas of objectives, research and publication efforts, financial support, and physical facilities. Also considered are the staff, students, and programs of the…
Nthumba, Peter M
Burns are important preventable causes of morbidity and mortality, with a disproportionate incidence in sub-Saharan Africa. The management of these injuries in sub-Saharan Africa is a challenge because of multiple other competing problems such as infectious diseases (HIV/AIDS, tuberculosis and malaria), terrorist acts and political instability. There is little investment in preventive measures, pre-hospital, in-hospital and post-discharge care of burns, resulting in high numbers of burns, high morbidity and mortality. Lack of data that can be used in legislation and policy formulation is a major hindrance in highlighting the problem of burns in this sub-region. An online search of publications on burns from sub-Saharan countries was performed. A total of 54 publications with 32,862 patients from 14 countries qualified for inclusion in the study. The average age was 15.3 years. Children aged 10 years and below represented over 80% of the burn patient population. Males constituted 55% of those who suffered burns. Scalds were the commonest cause of thermal injuries, accounting for 59% of all burns, while flame burns accounted for 33%. The burn mortality averaged 17%, or the death of one of every five burn victims. These statistics indicate the need for an urgent review of burn policies and related legislation across the sub-Saharan region to help reduce burns, and provide a safe environment for children. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.
Chinsembu, Kazhila C
Although the burden of malaria is decreasing, parasite resistance to current antimalarial drugs and resistance to insecticides by vector mosquitoes threaten the prospects of malaria elimination in endemic areas. Corollary, there is a scientific departure to discover new antimalarial agents from nature. Because the two antimalarial drugs quinine and artemisinin were discovered through improved understanding of the indigenous knowledge of plants, bioprospecting Sub-Saharan Africa's enormous plant biodiversity may be a source of new and better drugs to treat malaria. This review analyses the medicinal plants used to manage malaria in Sub-Saharan Africa. Chemical compounds with antiplasmodial activity are described. In the Sub-Saharan African countries cited in this review, hundreds of plants are used as antimalarial remedies. While the number of plant species is not exhaustive, plants used in more than one country probably indicate better antimalarial efficacy and safety. The antiplasmodial data suggest an opportunity for inventing new antimalarial drugs from Sub-Saharan-African flora. Copyright © 2015 Elsevier B.V. All rights reserved.
such as Angola, Sudan, Chad, Equatorial Guinea, Nigeria , and South Africa.83 Until 2005, Sudan was the top recipient of Chinese non- financial overseas...compared to standard reporting by the IMF and World Bank. This study dissects the market sector competition generated by China’s investment...corruption, and erode U.S. political relevance in sub-Saharan Africa. China has empowered private enterprises, which can monopolize African market sectors
Sub-Saharan Africa is home to some of the most nutritionally insecure people in the world. Poor infrastructure and limited resources compounded with conflict, HIV, and poor access to health services are factors that contribute to the staggering levels of malnutrition and food insecurity on the continent. Despite these enormous challenges, some countries in Africa are making progress towards food and nutrition security and there has never been a better time to work towards improved human devel...
Clegg, John; Simpson, John
Most academic discussion on the role of language in education in sub-Saharan Africa (SSA) supports the extended use of African languages as media of instruction (MoI), while most practice preserves a monolingual role for European languages. Many ministries of education maintain the belief that African languages are not appropriate as MoIs beyond…
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.
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
Countries in sub-Saharan Africa are some of the poorest and least developed in the world, with deplorable health and education levels. One way intended to promote better living standards in this region has been through development aid. This study examines the determinants of multilateral aid inflows to sub-Saharan Africa to determine whether it is directed to the least developed countries. I use panel data about 22 countries in sub-Saharan Africa from the 1995-2004 period to estimate a regres...
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.
Butler, Ivan Harry
Study of food value chains in East Africa as a preliminary study. The paper wishes to underline a few under-researched assumptions about esepcially protein deficiencies, allergies etc. to establish what enablers and constraints exist when trying to supply food from e.g. Europe to e.g. East Africa....
there was general consensus that the “democratic experiment” had taken root in Africa ... African Charter on Democracy, Elections and Governance is of particular importance in this context. The .... of governmental work through results in the interests of citizens. ... declarations impact on the reality of political rule in Africa?
Olesen, Tina Bech; Munk, Christian; Christensen, Jane
among men in sub-Saharan Africa, which could contribute to the high rates of penile and cervical cancer in this part of the world. Implementation of the prophylactic HPV vaccines could potentially help prevent this large burden of HPV and HPV-associated disease in sub-Saharan Africa. CLINICALTRIALS...... was 78.2% (95% CI 54.2 to 91.6) among HIV-positive and 49.4% (95% CI 30.4 to 68.6) among HIV-negative men (p=0.0632). When restricting the analyses to PCR-based studies, the pooled prevalence of any HPV was 84.5% (95% CI 74.2 to 91.2) among HIV-positive and 56.4% (95% CI 49.7 to 62.9) among HIV...
Ana Paula F. Mendes
Full Text Available This article aims to contribute to the understanding of the process of import substitution in Sub-Saharan Africa. The process of industrialization in Sub-Saharan Africa occurred in two phases: a first step, even very early during the colonial regime began around the 1920s and ended in the late forties; a second phase of industrialization began in the late fifties and gained momentum in the sixties, when import substitution was implemented more widely. Although these countries were the last to embark on the strategy of import substitution, they followed the same steps of Latin American countries, and as the structural domestic and external constraints were too strong, the failure of the policy of import substitution arrived early and the negative impact on these economies had a greater magnitude.
Eberhard, Anton; Gratwick, Katharine Nawaal
This study analyses the outcomes of independent power projects (IPPs) across Sub-Saharan Africa. Approximately 20 such projects have taken root to date, concentrated mainly in 8 countries. A suite of country level and project level factors play a critical role in determining project success, chief among them: the manner in which planning, procurement and contracting are coherently linked, the role of development finance institutions along with the development origins of firms and credit enhancements. - Highlights: → We analyse the outcomes of independent power projects (IPPs) across Sub-Saharan Africa. → Approximately 20 IPPs have taken root to date, concentrated mainly in 8 countries. → A suite of country level and project level factors play a critical role in determining project success. → Key success factors are the coherence of planning, procurement and contracting. → Also important is the role of DFIs, the development origins of firms, and credit enhancements.
Derrick Ssewanyana; Derrick Ssewanyana; Byron Bitanihirwe
Gambling is a cross-cultural and global activity which typically involves the wagering of money or an item of monetary value on an outcome that is governed by chance. Although gambling is positioned as a legitimate recreational and leisure activity within sub-Saharan Africa (SSA), there is widespread recognition among healthcare professionals and policy-makers that gambling has the capacity to become dysfunctional in a minority. Emerging knowledge suggests that problem gambling is rapidly evo...
Rudel, Thomas K.
For decades, the dynamics of tropical deforestation in sub-Saharan Africa (SSA) have defied easy explanation. The rates of deforestation have been lower than elsewhere in the tropics, and the driving forces evident in other places, government new land settlement schemes and industrialized agriculture, have largely been absent in SSA. The context and causes for African deforestation become clearer through an analysis of new, national-level data on forest cover change for SSA countries for the ...
Motivated by sustainable development challenges in Sub-Saharan Africa, this study assesses the comparative persistence of environmental unsustainability in a sample of 44 countries in the sub-region for the period 2000 to 2012. The empirical evidence is based on Generalised Method of Moments. Of the six hypotheses tested, it is not feasible to assess the hypothesis on resource-wealth because of issues in degrees of freedom. As for the remaining hypotheses, the following findings are establis...
Joseph Ato Forson; Theresa Yaaba Baah-Ennumh; Ponlapat Buracom; Guojin Chen; Peng Zhen
This study explores the causes of corruption in 22 countries in sub-Saharan Africa from 1996 to 2013. The sources of corruption are grouped into three main thematic areas – historical roots, contemporary causes and institutional causes to make way for subjective and objective measures. The subjective measures allow for assessment of the effectiveness of anticorruption policies. Using pooled OLS, fixed-effect and instrumental-variable approaches, and focusing on the perceived level of corrupti...
Abdulai, Awudu; Barrett, Christopher B.; Hazell, Peter
"Food aid remains significant for food availability in many low-income countries in sub-Saharan Africa, helping to reduce the gap between food consumption needs and supply from domestic production and inventories and commercial imports. Food aid remains a contentious subject, however, and there have been many recent pleas for more effective use of the resource. This study explores how food aid might be used for domestic food market development to facilitate poverty alleviation and economic gr...
Mathieu Couttenier; Raphael Soubeyran
We show that civil war is strongly related to drought in sub-Saharan Africa. We consider the e ect of variations in the Palmer Drought Severity Index (Palmer 1965) - a cumulative index that combines precipitation, temperature and the local characteristics of the soil - on the risk of civil war. While the recent, contentious debate on the link between climate and civil war has mainly focused on precipitation and temperature, without obtaining converging results, the Palmer index describes soci...
Spearman, C Wendy; Sonderup, Mark W
Disparities in health reflect the differences in the incidence, prevalence, burden of disease and access to care determined by socio-economic and environmental factors. With liver disease, these disparities are exacerbated by a combination of limited awareness and preventable causes of morbidity and mortality in addition to the diagnostic and management costs. Sub-Saharan Africa, comprising 11% of the world's population, disproportionately has 24% of the global disease burden, yet allocates health. It has 3% of the global healthcare workforce with a mean of 0.8 healthcare workers per 1000 population. Barriers to healthcare access are many and compounded by limited civil registration data, socio-economic inequalities, discrepancies in private and public healthcare services and geopolitical strife. The UN 2014 report on the Millennium Development Goals suggest that sub-Saharan Africa will probably not meet several goals, however with HIV/AIDS and Malaria (goal 6), many successes have been achieved. A 2010 Global Burden of Disease study demonstrated that cirrhosis mortality in sub-Saharan Africa doubled between 1980 and 2010. Aetiologies included hepatitis B (34%), hepatitis C (17%), alcohol (18%) and unknown in 31%. Hepatitis B, C and alcohol accounted for 47, 23 and 20% of hepatocellular carcinoma respectively. In 10%, the underlying aetiology was not known. Liver disease reflects the broader disparities in healthcare in sub-Saharan Africa. However, many of these challenges are not insurmountable as vaccines and new therapies could comprehensively deal with the burden of viral hepatitis. Access to and affordability of therapeutics remains the major barrier. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Sub-Saharan Africa's long-term growth performance will need to improve significantly for the region to visibly reduce poverty and raise the standard of living to an acceptable level. Appropriate actions will also be needed to ensure that an adequate share of the growing income is devoted to reducing poverty. The key policy question for these countries and their development partners is how ...
Lilyan E. Fulginiti; Richard K. Perrin; Bingxin Yu
Agricultural productivity in 41 Sub-Saharan Africa (SSA) countries from 1960 to 1999 is examined by estimating a semi-nonparametric Fourier production frontier. Over the four decades the estimated rate of productivity change was 0.83% per year, although the average rate from 1985-99 was a strong 1.90% per year. Former UK colonies exhibited significantly higher productivity gains than others, while Liberia and countries that had been colonies of Portugal or Belgium exhibited net reductions in ...
Cools, Sara; Kotsadam, Andreas
Combining DHS data for 580,000 women from 30 different countries in Sub-Saharan Africa, we analyze how both the incidence and the acceptance of intimate partner violence vary across time and space, in a region with record high levels of violence against women. We review the existing literature regarding the impact of resources on intimate partner violence, extracting testable and often conflicting hypotheses at the micro and macro level, and on the interaction across levels. We propose to ext...
This article begins by emphasizing that the number and intensity of armed conflict has fallen substantially but that military expenditure levels in sub-Saharan Africa have nonetheless increased, largely as a result of South African expenditure. The article attempts to answer two questions. First, how can the budget of the security sector be allocated so as to result in effective and efficient security outcomes? Second, how can an appropriate level of military expenditure for a country be dete...
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
In most parts of sub-Saharan Africa, it is either the second or the third contributor to blindness. More data needs to be gathered in order to obtain a more complete understanding of its burden, and to allow better public health planning, public education, prevalence assessment and management strategies. The present ...
Marriage has traditionally been early and universal in sub-Saharan Africa and this has been blamed for high fertility and the failure to achieve most MDGs including the eradication of extreme poverty and hunger, achieving the goal of universal primary education, promotion of gender equality and empowerment of women, ...
Ernest Aryeetey; Christopher Udry
Gross domestic savings in Africa averaged only 8 percent of GDP in the 1980s, compared to 23 percent for Southeast Asia and 35 percent in the Newly Industrialized Economies. Aside from being generally low, saving rates in most of Africa have shown consistent decline over the last thirty years. These savings figures must be considered tentative, because they are derived as a residual in the national accounts from expenditure and production data that are themselves quite unreliable. Notwithstan...
Slayton, Rachel B; Date, Kashmira A; Mintz, Eric D
Emerging data on the epidemiologic, clinical and microbiologic aspects of typhoid fever in sub-Saharan Africa call for new strategies and new resources to bring the regional epidemic under control. Areas with endemic disease at rates approaching those in south Asia have been identified; large, prolonged and severe outbreaks are occurring more frequently; and resistance to antimicrobial agents, including fluoroquinolones is increasing. Surveillance for typhoid fever is hampered by the lack of laboratory resources for rapid diagnosis, culture confirmation and antimicrobial susceptibility testing. Nonetheless, in 2010, typhoid fever was estimated to cause 725 incident cases and 7 deaths per 100,000 person years in sub-Saharan Africa. Efforts for prevention and outbreak control are challenged by limited access to safe drinking water and sanitation and by a lack of resources to initiate typhoid immunization. A comprehensive approach to typhoid fever prevention including laboratory and epidemiologic capacity building, investments in water, sanitation and hygiene and reconsideration of the role of currently available vaccines could significantly reduce the disease burden. Targeted vaccination using currently available typhoid vaccines should be considered as a short- to intermediate-term risk reduction strategy for high-risk groups across sub-Saharan Africa.
Sawers, Larry; Isaac, Alan
A widely accepted explanation for the exceptionally high HIV prevalence in sub-Saharan Africa is the practice of long-term overlapping heterosexual partnering. This article shows that long-duration concurrent partnering can be protective against HIV transmission rather than promoting it. Monogamous partnering prevents sexual transmission to anyone outside the partnership and, in an initially concordant-seronegative partnership, prevents sexual acquisition of HIV by either partner. Those protections against transmission and acquisition last as long as the partnership persists without new outside partnerships. Correspondingly, these two protective effects characterise polygynous partnerships, whether or not the polygyny is formal or informal, until a partner initiates a new partnership. Stable and exclusive unions of any size protect against HIV transmission, and more durable unions provide a longer protective effect. Survey research provides little information on partnership duration in sub-Saharan Africa and sheds no light on the interaction of duration, concurrency, and HIV. This article shows how assumptions about partnership duration in individual-based sexual-network models affect the contours of simulated HIV epidemics. Longer mean partnership duration slows the pace at which simulated epidemics grow. With plausible assumptions about partnership duration and at levels of concurrency found in the region, simulated HIV epidemics grow slowly or not at all. Those results are consistent with the hypothesis that long-duration partnering is protective against HIV and inconsistent with the hypothesis that long-term concurrency drives the HIV epidemics in sub-Saharan Africa.
Cresswell, Jenny A; Campbell, Oona M R; De Silva, Mary J; Slaymaker, Emma; Filippi, Veronique
To quantify maternal obesity as a risk factor for Caesarean delivery in sub-Saharan Africa. Multivariable logistic regression analysis using 31 nationally representative cross-sectional data sets from the Demographic and Health Surveys (DHS). Maternal obesity was a risk factor for Caesarean delivery in sub-Saharan Africa; a clear dose-response relationship (where the magnitude of the association increased with increasing BMI) was observable. Compared to women of optimal weight, overweight women (BMI 25-29 kg/m(2) ) were significantly more likely to deliver by Caesarean (OR: 1.54; 95% CI: 1.33, 1.78), as were obese women (30-34.9 kg/m(2) (OR: 2.39; 95%CI: 1.96-2.90); 35-39.9 kg/m(2) (OR: 2.47 95%CI: 1.78-3.43)) and morbidly obese women (BMI ≥40 kg/m(2) OR: 3.85; 95% CI: 2.46-6.00). BMI is projected to rise substantially in sub-Saharan Africa over the next few decades and demand for Caesarean sections already exceeds available capacity. Overweight women should be advised to lose weight prior to pregnancy. Furthermore, culturally appropriate prevention strategies to discourage further population-level rises in BMI need to be designed and implemented. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
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
Multiple pathways to gender-sensitive budget support in the education sector: Analysing the effectiveness of sex-disaggregated indicators in performance assessment frameworks and gender working groups in (education) budget support to Sub-Saharan Africa countries
Holvoet, Nathalie; Inberg, Liesbeth
In order to correct for the initial gender blindness of the Paris Declaration and related aid modalities as general and sector budget support, it has been proposed to integrate a gender dimension into budget support entry points. This paper studies the effectiveness of (joint) gender working groups and the integration of sex-disaggregated indicators and targets in performance assessment frameworks in the context of education sector budget support delivered to a sample of 17 Sub-Saharan Africa...
The intricate interrelationships between population and development in sub-Saharan Africa are examined and the prospects are considered for converting the abundant human resources into an effective development asset. The demographic trends that characterize the sub-Saharan region at this time differ markedly from what is happening in other parts of the developing world. In Africa, death rates have come down slightly (17/1000 in 1980-85 in contrast to 20/1000 in 1970-75); there has been practically no change in the birthrate. Consequently, population growth rates are on the rise throughout Africa although there are differences within the regions. The various factors responsible for high fertility in African societies and the consequences of the continuing high fertility often are mutually reinforcing. For example, low health and educational standards are likely to lead women to have large numbers of children, but these conditions are themselves the result of the population growth, which requires an expansion of health care and educational facilities that hard-pressed national budgets cannot provide. In Africa, the growth rate of the youth population is increasing even faster than that of the population as a whole -- from 3.1% in 1980-85 to an estimated 3.4% in 1990-95. The most critical problem posed by such growth rates is an increased demand for food. Countries which cannot adequately feed their growing populations are unlikely to be significantly more successful in satisfying their other basic needs. Whether educated or healthy or not, Africa's growing numbers of children represent major economic problems for countries with a low level of economic growth. There is little hope of effectively absorbing all the new entrants who swell the labor market each year, and the indirect consequences for the economy of rapid demographic growth are no less serious. Presently, Africa is the scene of major and particularly distressing movements of population as the drought has
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.
The changed role of rail in Africa over the last thirty years has seen it move from a situation where many of the systems were carrying a high share of their country's traffic to one in which their market share has declined, their assets have steadily deteriorated, their quality of service has reduced, and they are in many instances only a minor contributor to solving the transport problem...
Begins Housing Sales to Blacks (Johannesburg Domestic Service, 1 Jul 83) 79 Roles of Black Farmers, U.S. Firms Discussed (SAPA, 7 Jul 83...advanced technology and superpowers. Yet how many in Africa will share his sentiment if only because it is a necessary subject about which to talk and...some of the shocks, and prevent a dangerous internationalisation . Col. Mengistu, the new OAU Chairman, who has entered the fray to criticise Zaire’s
anti-colonial movements across the continent. As one historical study notes: In 1955, the Soviet Union made its first major arms transfer to an...arrange- ments with Pretoria to keep mineral prices high did not prevent it attacking South Africa’s Western busi- ness partners for doing business...Sudan, South Africa, Namibia, etc.); • Construction of power facilities—hydroelec- tric power plants on the River Congo (Angola, Zambia
Vanhecke, C; Le-Gall, P; Le Breton, M; Malvy, D
Pentastomiasis is a rare zoonotic infection but it is frequently observed in Africa and Asia. Most human infections are caused by members of the Armillifer armillatus species. They are responsible for visceral pentastomiasis in Western and Central Africa. Humans may be infected by eating infected undercooked snake meat or by direct contact with an infected reptile. An increasing number of infections are being reported in Congo, Nigeria, and Cameroon. Despite an occasionally high number of nymphs observed in human viscera, most infections are asymptomatic and often diagnosed by accident during surgery or autopsy. The clinical presentation of pentastomiasis is quite varied and depends on infected tissues. The liver, lungs, and pleura are most frequently involved. Abdominal emergencies have been reported. Diagnostic delays always occur and diagnosis focuses on the patient's lifestyle and living environment. It is mainly based on the morphological description of the parasite's calcified cuticle, the site of the lesion, and the parasite's region of origin. Most patients do not require any treatment. Personal measures such as avoidance of contact with snake droppings are recommended to prevent transmission. Imported pentastomiasis has been observed in African migrants. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Parkin, Donald Maxwell; Stefan, Cristina
Measurement of incidence rates of childhood cancer in Africa is difficult. The study 'Cancer of Childhood in sub Saharan Africa' [Stefan C, Bray F, Ferlay J, Parkin DM and Liu B (2017) Cancer of Childhood in sub-Saharan Africa ecancer 11 (755)] brings together results from 16 population-based registries which, as members of the African Cancer Registry Network (AFCRN), have been evaluated as achieving adequate coverage of their target population. The cancers are classified according to the third revision of the International Classification of Childhood Cancer (ICCC-3) and recorded rates in Africa are compared with those in childhood populations in the UK, France, and the USA. It is clear that, in many centres, lack of adequate diagnostic and treatment facilities, leads to under-diagnosis (and enumeration) of leukaemias and brain cancers. However, for several childhood cancers, incidence rates in Africa are higher than those in high income countries. This applies to infection-related cancers such as Kaposi sarcoma, Burkitt lymphoma, Hodgkin lymphoma and hepatocellular carcinoma, and also to two common embryonal cancers-retinoblastoma and nephroblastoma. These (and other) observations are unlikely to be artefact, and are of considerable interest when considering possible aetiological factors, including ethnic differences in risk (and hence genetic/familial antecedents). The data reported are the most extensive so far available on the incidence of cancer in sub Saharan Africa, and clearly indicate the need for more resources to be devoted to cancer registration, especially in the childhood age range, as part of an overall programme to improve the availability of diagnosis and treatment of this group of cancers, many of which have-potentially-an excellent prognosis.
Abdi, Ali A.; Ellis, Lee; Shizha, Edward
In addressing issues related to problems of democratisation in Africa, this paper attempts to relate the issue to the need for citizenship education and the role that can play in social development. Citizenship should be central to the formation of viable civil societies that claim a tangible stake in national public spaces in post-Cold War…
Kraus, S; Ogunbanjo, G; Sliwa, K; Ntusi, N A B
Despite medical advances, heart failure (HF) remains a global health problem and sub-Saharan Africa (SSA) is no exception, with decompensated HF being the most common primary diagnosis for patients admitted to hospital with heart disease. In SSA the in-hospital mortality rate of decompensated HF is up to 8.3%. HF is a clinical syndrome that is caused by a diverse group of aetiologies, each requiring unique management strategies, highlighting the need for diagnostic certainty and a broad understanding of the complex pathophysiology of this condition. While there are a number of advanced medical, device and surgical interventions being tailored for HF internationally, the fundamental basic principles of HF management, such as patient education, effective management of congestion and initiation of disease-modifying medical therapies, remain a challenge on our continent. This review addresses both the epidemiology of HF in SSA and principles of management that focus specifically on symptom relief, prevention of hospitalisation and improving survival in this population.
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.
Baum, Donald R.; Cooper, Rachel; Lusk-Stover, Oni
This study provides a comparative assessment of policies governing private schools in twenty countries in Sub-Saharan Africa. Findings suggest that current regulatory systems are failing to adequately address the negative externalities and failures of private schooling markets. Insufficient capacity on the part of governments is a contributor to uneven policy implementation and creates opportunities for rent-seeking and corruption. Onerous market entry regulations offer constraints on the gro...
cadres in Soviet higher educational institutions, occupational training of members of the Congolese cooperative movement , granting of material assistance...final analysis, our country’s young cooperative movement has always enjoyed the active support of the Soviet cooperative members, and benefits greatly
which we have not considered up to now. Meanwhile, we have concentrated our efforts on retraining the franchised dealers and their employees, as a...four cardinal programmes of free education, free health cafe , integrated rural development and full employment. Awolowo’s recent triumphant reception
Larson, Paul R; Chege, Patrick; Dahlman, Bruce; Gibson, Christine; Evensen, Ann; Colon-Gonzalez, Maria C; Onguka, Stephanie; Lamptey, Roberta; Cayley, William E; Nguyen, Bich-May; Johnson, Brian; Getnet, Sawra; Hasnain, Memoona
High-quality family medicine education is needed in sub-Saharan Africa to facilitate the future growth of primary care health systems. Current faculty educators recognize the value of dedicated teacher training and ongoing faculty development. However, they are constrained by inadequate faculty development program availability and institutional support. A cross-sectional study design was used to conduct a qualitative needs assessment comprised of 37 in-depth, semi-structured interviews of individual faculty trainers from postgraduate family medicine training programs in eight sub-Saharan African countries. Data were analyzed according to qualitative description. Informants described desired qualities for a family medicine educator in sub-Saharan Africa: (1) pedagogical expertise in topics and perspectives unique to family medicine, (2) engagement in self-directed, lifelong learning, and (3) exemplary character and behavior that inspires others. Informant recommendations to guide the development of faculty development programs include: (1) sustainability, partnership, and responsiveness to the needs of the institution, (2) intentional faculty development must begin early and be supported with high-quality mentorship, (3) presumptions of teaching competence based on clinical training must be overcome, and (4) evaluation and feedback are critical components of faculty development. High-quality faculty development in family medicine is critically important to the primary care workforce in sub-Saharan Africa. Our study describes specific needs and recommendations for family medicine faculty development in sub-Saharan Africa. Next steps include piloting and evaluating innovative models of faculty development that respond to specific institutional or regional needs.
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.
Shandera, Wayne Xavier
To investigate why Southern sub-Saharan Africa is more severely impacted by HIV and AIDS than other parts of sub-Saharan Africa, I conducted a review of the literature that assessed viral, host and transmission (societal) factors. This narrative review evaluates: 1) viral factors, in particular the aggregation of subtype-C HIV infections in Southern sub-Saharan Africa; 2) host factors, including unique behaviour patterns, concomitant high prevalence of sexually transmitted diseases, circumcision patterns, average age at first marriage and immunogenetic determinants; and, 3) transmission and societal factors, including levels of poverty, degrees of literacy, migrations of people, extent of political corruption, and the usage of contaminated injecting needles in community settings. HIV prevalence data and published indices on wealth, fertility, and governmental corruption were correlated using statistical software. The high prevalence of HIV in Southern sub-Saharan Africa is not explained by the unusual prevalence of subtype-C HIV infection. Many host factors contribute to HIV prevalence, including frequency of genital ulcerating sexually transmitted infections, absence of circumcision (compiled odds ratios suggest a protective effect of between 40% and 60% from circumcision), and immunogenetic loci, but no factor alone explains the high prevalence of HIV in the region. Among transmission and societal factors, the wealthiest, most literate and most educated, but also the most income-disparate, nations of sub-Saharan Africa show the highest HIV prevalence. HIV prevalence is also highest within societies experiencing significant migration and conflict as well as in those with government systems experiencing a high degree of corruption. The interactions between poverty and HIV transmission are complex. Epidemiologic studies currently do not suggest a strong role for the community usage of contaminated injecting needles. Areas meriting additional study include clade type
Yakubu, Ibrahim; Salisu, Waliu Jawula
Background Adolescent pregnancy has been persistently high in sub-Saharan Africa. The objective of this review is to identify factors influencing adolescent pregnancies in sub-Saharan Africa in order to design appropriate intervention program. Methods A search in MEDLINE, Scopus, Web of science, and Google Scholar databases with the following keywords: determinants, factors, reasons, sociocultural factors, adolescent pregnancy, unintended pregnancies, and sub- Saharan Africa. Qualitative and ...
Delfin Go; Denis Nikitin; Xiongjian Wang; Heng-fu Zou
This paper surveys the literature and assesses the magnitude, persistence, and depth of poverty and inequality in Sub-Saharan Africa using empirical analysis. Our analysis explores linkages between three key facts about development in Sub-Saharan Africa: poor economic growth, poor performance in terms of public health indicators, and resilient high-income inequality. Most of the differential between growth rates in Sub-Saharan Africa and other developing countries can be explained by two meas...
Rothe, C; Schlaich, C; Thompson, S
Healthcare-associated infections (HCAIs) are the most frequent adverse consequences of healthcare worldwide, threatening the health of both patients and healthcare workers (HCWs). The impact of HCAI is particularly felt in resource-poor countries, with an already overstretched health workforce and a high burden of community-acquired infection. To provide an overview of the current situation in sub-Saharan Africa with regards to the spectrum of HCAI, antimicrobial resistance, occupational exposure and infection prevention. We reviewed the literature published between 1995 and 2013 and from other sources such as national and international agencies. Sparse data suggest that HCAIs are widespread in sub-Saharan Africa, with surgical site being the dominant focus of infection. Nosocomial transmission of multidrug-resistant tuberculosis is a considerable concern, as is the prevalence of meticillin-resistant S. aureus and resistant Enterobacteriaceae. In HCWs, vaccination rates against vaccine-preventable occupational hazards are low, as is reporting and subsequent human immunodeficiency virus-testing after occupational exposure. HCWs have an increased risk of tuberculosis relative to the general population. Compliance with hand hygiene is highly variable within the region. Injection safety in immunization programmes has improved over the past decade, mainly due to the introduction of autodestruct syringes. Despite the scarcity of data, the burden of HCAI in sub-Saharan Africa appears to be high. There is evidence of some improvement in infection prevention and control, though widespread surveillance data are lacking. Overall, measures of infection prevention and occupational safety are scarce. Copyright © 2013 The Healthcare Infection Society. All rights reserved.
Hypothermia is a major factor in neonatal morbidity and mortality in developing countries. High prevalence of hypothermia has been reported widely even from warmer tropical countries. In spite of the World Health Organization's recommendation of maintenance of warm chain in newborn care, hypothermia continues to be a common neonatal condition which has remained under-recognized, under-documented, and poorly-managed. This review aims at providing the incidence of and risk factors for neonatal hypothermia as well as provides a pathophysiological overview and management options for neonates with the condition in sub-Saharan Africa. All available published literature on neonatal hypothermia was searched electronically and manually. The principal electronic reference libraries and sites searched were PubMed, Embase, Ajol, Cochrane Reference Libraries and Google Scholar. The search terms used included 'neonatal hypothermia,' 'Cold stress in newborn' 'thermal care of the newborn,' 'neonatal thermogenesis,' 'neonatal cold injury,' among others. Pertinent books and monographs were accessed. Data in formats inaccessible to the reviewer were excluded. Neonatal hypothermia is a major condition of public health importance in countries of sub- Saharan Africa. Awareness of the burden of the disease is still low in some communities. Risk factors for neonatal hypothermia in the region include poverty, home delivery, low birthweight, early bathing of babies, delayed initiation of breastfeeding and inadequate knowledge among health workers. Low-tech facilities to prevent heat losses and provide warmth are available in sub-Saharan Africa and are thus recommended as well as continuous efforts at sensitizing caregivers on the thermal needs of newborns.
Lepère, P; Tchounga, B; Ekouevi, D-K
Digital health has the potential to strengthen health systems and empower patients to prevent ill health and manage their own care. To confirm this potential, however, it is urgent to shift from pilot studies to the implementation of programs at a sufficient scale, with interoperable solutions and integrated into the national health system, while respecting human rights. It is also important to plan for studies to demonstrate the impact and produce the necessary evidence. Francophone sub-Saharan Africa can catch up in this area.
Jones, Edward Samuel; Tarp, Finn
Should policy-makers, including foreign donors, focus employment strategies in sub-Saharan Africa on strengthening access to formal wage employment or on raising productivity in the informal sector? We examine the evidence in Mozambique and show that crude distinctions between formality...... and informality are not illuminating. The observed welfare advantage of formal sector workers essentially derives from differences in endowments and local conditions. Non-agricultural informal work can yield higher returns than formal work. The implication is that the informal sector must not be marginalized......; and raising productivity in agriculture must be accorded a central place in boosting employment....
Azam, Jean-Paul; Thelen, Véronique
The incidence of civil war in Sub-Saharan Africa since the turn of the century is less than half of what it was on average in the last quarter of the 20th century. This paper shows that the aid boom triggered by 9/11 played a key role in achieving purposefully this result using panel data for 46 African countries over four decades. It applies a nearidentification approach to test the aid-conflict tradeoff, taking due account of asymmetric information between the donors and the econometrician....
Akokpari, J K
Migration and refugee movements could significantly decline in sub-Saharan African countries. However, countries must redistribute meager resources equitably and engage in environmental protection. Refugee and migrant populations have increased in sub-Saharan Africa during 1969-95, from 700,000 to 6.8 million. This study examined the causes of migration and the implications for host countries. Doornbos (1990) identifies the root problem as the partisan nature of African politics and the incapacity to manage ecological degradation. The African state is wholly or partially responsible for the creation of conflicts. Examples abound in Zaire, South Africa, Sudan, Rwanda, Burundi, Somalia, Ethiopia, Liberia, Congo, and Chad. State partisanship is also evident in Angola, Mozambique, Uganda, and Sierra Leone. An estimated 10 million Africans, in 1985, left their homes due to wars, government repression, or the inability of land to support them. In 1994, USAID estimated that 11.6 million Africans in 10 countries were threatened by famine from drought. Environmental degradation has generated conflicts. Africa's marginalized economy results in recession, unemployment, inflation, and distributional conflicts. Democratization has brought conflicts between the state, civil society, and exiles. Refugees face homelessness, poverty, emotional distress, inadequate food, and disease. Host countries face security threats, pressure on limited resources, rebellions from refugees and their involvement with foreign mercenaries, local conflicts between native and refugee populations, and environmental degradation from refugees.
Conclusion: HIV infected children and their families in sub-Saharan Africa face myriad of complex medical and psychosocial issues. A holistic health promotional approach is being advocated as the required step for eradication of pediatric HIV in Africa. Keywords: Pediatric HIV, sub-Saharan Africa, Challenges.
Full Text Available Deforestation has been a complex phenomenon to study in sub-Saharan Africa. The average annual deforestation rate in the region is by far higher than the world average. What causes and drives deforestation in the region are debated to date. The present paper is motivated by this debate. It attempts to test whether the maintained hypotheses on the causes of deforestation can give answer to the problem in sub-Saharan Africa. It used average cross-national data of forty eight countries in the region. The data are retrieved from international sources. The Spearman’s rank correlation coefficients between two deforestation indicators and five often-cited causes of deforestation were computed. The role of public forest ownership, share of forest and agricultural products in total exports, and the year of forest laws enacted are also discussed. However, it finds no clear, strong, and systematic pattern to argue that population density, rural population, rural poverty, industrial logging for exports, economic growth, late enactment of forest laws, and public ownership of forests are underlying causes of deforestation in the region. The trends of forestland in Rwanda and Zimbabwe vividly present the finding. Therefore, future studies related to the topic in the region shall focus on sub-national panel data.
Kimokoti, Ruth W; Hamer, Davidson H
The proportion of the population that is > or = 60 years of age in sub-Saharan Africa (SSA) is increasing rapidly and is likely to constrain healthcare systems in the future. Nevertheless, the elderly are not a health policy priority for African countries. This paper reviews the nutritional and health status of older adults in SSA and their determinants. Literature was abstracted through the Medline, Google Scholar, and Dogpile databases using the following search terms: sub-Saharan Africa, older adults, nutrition, health. Findings showed that up to half (6-48%) of elderly Africans in SSA are underweight and almost a quarter (2.5-21%) are overweight, while 56% of older South Africans are obese. Low-quality diets contribute to poor nutritional status. Poverty, HIV/AIDS, and complex humanitarian emergencies are major determinants of undernutrition. Effective interventions need to consider socioeconomic, health, and demographic factors; social pensions may be the most cost-effective option for improving the health and nutritional status of the elderly in SSA.
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
Blackden, M.; Canagarajah, S.; Klasen, S.; Lawson, D.
The study suggests that gender inequality acts as a significant constraint to growth in sub-Saharan Africa, and that removing gender-based barriers to growth will make a substantial contribution to realizing Africa’s economic potential. In particular we highlight gender gaps in education, related high fertility levels, gender gaps in formal sector employment, and gender gaps in access to assets and inputs in agricultural production as particular barriers reducing the ability of women to contr...
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
Schneider, William H
The adequacy and safety of blood transfusion in sub-Saharan Africa is the subject of much concern, yet there have been very few studies of its history. An overview of that record finds that transfusions were first reported in Africa (sub-Saharan and excluding South Africa) in the early 1920s, and organized transfusion practices were established before the Second World War. Blood transfusion grew rapidly after 1945, along with the construction of new hospitals and expanded health services in Africa. Significant differences existed between colonial powers in the organization of transfusion services, but these converged after independence as their use continued to grow and decentralized and hospital-based practices were adopted. It was only after the oil crisis in the mid-1970s that health spending declined and the collection, testing, and transfusion of blood began to level off. Thus, when the AIDS crisis hit transfusion services, they were already struggling to meet the needs of patients. At this time, foreign assistance as well as the World Health Organization and the League of Red Cross Societies helped respond to both the immediate problem of testing blood, and for some countries, support existed for the broader reorganization of transfusion. Overall, the history shows that transfusion was adopted widely and quickly, limited mainly by the availability of knowledgeable doctors and hospital facilities. There was less resistance than expected by Africans to receive transfusions, and the record shows a remarkable flexibility in obtaining blood. The dangers of disease transmission were recognized from an early date but were balanced against the potential lifesaving benefits of transfusion. Copyright © 2013 Elsevier Inc. All rights reserved.
Chakravarty, Shubha; Das, Smita; Vaillant, Julia
Although the ratio of female to male labor force participation rates is higher in Sub-Saharan Africa than in any other region, these high rates of female labor force participation mask underlying challenges for women. A large majority of employed women work in vulnerable employment. In addition, youth unemployment rates in Sub-Saharan Africa are double those of adult unemployment, and unem...
Calzadilla, Alvaro; Zhu, Tingju; Rehdanz, Katrin; Tol, Richard S J; Ringler, Claudia
Two possible adaptation scenarios to climate change for Sub-Saharan Africa are analyzed under the SRES B2 scenario. The first scenario doubles the irrigated area in Sub-Saharan Africa by 2050, compared to the baseline, but keeps total crop area constant. The second scenario increases both rainfed
Background: The failure to stem HIV in sub-Saharan Africa and the unique epidemiological modes of infection within this region have demonstrated that unique strategies for combatting the virus are required. This review article discusses why international AIDS campaigns in sub- Saharan Africa have largely been ...
Rosen, Stacey L.; Shapouri, Shahla
African Governments and international donors are focused on improving the regionâ€™s ability to grow food to mitigate projected long-term deterioration in food security. An ERS study shows that improving grain yields is the key to reducing food insecurity in Sub-Saharan Africa. Investment and technology adoption in Sub-Saharan Africa will be a challenge.
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.
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
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.
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
.... Unlike the period from 1960 to 1973, when economic growth in sub-Saharan Africa was relatively strong, since 1973 the countries of sub-Saharan Africa have grown at rates well below other developing countries...
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.
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.
Lema, Valentino M
Unconsummated marriage is a condition where newly married couples are unable to achieve penile-vaginal intercourse for variable periods despite desire and several attempts to do so. Its exact cause(s) is/are unknown, but performance anxiety resulting from or leading to other conditions is reportedly the major etiological factor. It is thought to be more prevalent in traditional and conservative religious communities where premarital sexual exposure is strictly prohibited. Most publications on unconsummated marriage have originated from North America, European and Middle Eastern countries. There have not been any such reports from sub-Saharan Africa, which is home to diverse cultures and traditions regarding premarital sex and marriage. This paper presents a sample of four cases with unconsummated marriage managed by the author in his private clinic based in the city of Nairobi Kenya, over the past five years. Possible etiological factors and management approaches are discussed, with a review of relevant literature.
Ameh, Emmanuel A; Ameh, Nkeiruka
Advances in neonatal intensive care, total parenteral nutrition and improvements in technology have led to a greatly improved outcome of neonatal surgery in developed countries. In many parts of sub-Saharan Africa, however, neonatal surgery continues to pose wide-ranging challenges. Delivery outside hospital, delayed referral, poor transportation, and lack of appropriate personnel and facilities continue to contribute to increased morbidity and mortality in neonates, particularly under emergency situations. Antenatal supervision and hospital delivery needs to be encouraged in our communities. Adequate attention needs to be paid to providing appropriate facilities for neonatal transport and support and training of appropriate staff for neonatal surgery. Neonates with surgical problems should be adequately resuscitated before referral where necessary but surgery should not be unduly delayed. Major neonatal surgery should as much as possible be performed by those trained to operate on neonates. Appropriate research and international collaboration is necessary to improve neonatal surgical care in the environment.
Adebamowo, Sally N; Tekola-Ayele, Fasil; Adeyemo, Adebowale A; Rotimi, Charles N
Sub-Saharan Africa (SSA) is experiencing a growing burden of cardiometabolic disorders, including diabetes, dyslipidemia, hypertension, obesity, coronary heart disease, and stroke. The increasing trends are expected to accelerate as SSA continues to experience economic progress, population growth, and the shift from communicable to noncommunicable diseases. These complex disorders are caused by multiple, potentially interacting, environmental, and genetic factors. While considerable progress has been made in the identification of the sociocultural, demographic, and lifestyle risk factors for cardiometabolic disorders, many genetic factors that underlie individual susceptibility to these diseases remain largely unknown. Although progress in genomic technologies has allowed for systematic characterization of genome-wide genetic diversity in health and disease in European and Asian ancestry populations, conduct of genetic studies in SSA has been underwhelming until recently. Here, we summarize recent understanding of the body of knowledge and highlight research opportunities on the genomics of cardiometabolic disorders in SSA. Published by S. Karger AG, Basel.
Evans, Ruth; Skovdal, Morten
and UNCRC concerns about “hazardous” and “harmful” work are highlighted through examining the situation of children providing unpaid domestic and care support to family members in the private space of their own or a relative’s home. Differing perspectives toward young caregiving have been adopted to date....... A contextual, multi-sectorial approach to young caregiving is needed that seeks to understand children’s, family members’, and community members’ perceptions of what constitutes inappropriate caring responsibilities within particular cultural contexts and how these should best be alleviated.......This chapter explores the spatialities of children’s rights through a focus on how children’s paid and unpaid work in sub-Saharan Africa intersects with wider debates about child labor, child domestic work, and young caregiving. Several tensions surround the universalist and individualistic nature...
Nozyechi Ngulube Chidumayo
Full Text Available Abstract Background Dogs have a close association with humans providing companionship, security and a source of dietary protein. However, dogs are also potential carriers of zoonotic pathogens. Dogs, therefore, pose a public health risk and a good understanding of canine diseases is important for planning and implementing control measures. The aim of this study was to characterise canine helminthiasis in sub-Saharan Africa using a systematic approach. Methods Pubmed and Google Scholar were searched for relevant primary studies published from 2000. Forty-one eligible studies were included in the meta-analysis. Pooled prevalences were estimated using the quality effects model. Results and conclusions Twenty-six genera of enteric helminths were reported and the pooled estimate of canine helminthiasis was 71% (95% CI: 63–79%. Species of Ancylostoma and Toxocara, causative agents of larva migrans in humans, were the most frequently reported helminths with pooled estimated prevalences of 41% (95% CI: 32–50% and 22% (95% CI: 16–29%, respectively. Dipylidium caninum and Taenia spp. were the most frequently reported cestodes with pooled estimated prevalences of 20% (95% CI: 12–29% and 9% (95% CI: 5–15%, respectively. Trematodes were rarely reported. There was a high level of heterogeneity in most pooled estimates (I2 ˃ 80%. The results of this study show that canine helminthiasis is highly prevalent in sub-Saharan Africa and there is need for regular deworming programmes to improve the health status of the dogs and minimise the potential health risk to humans.
Ilie, Sonia; Rose, Pauline
Higher education is back in the spotlight, with post-2015 sustainable development goals emphasising equality of access. In this paper, we highlight the long distance still to travel to achieve the goal of equal access to higher education for all, with a focus on poorer countries which tend to have lower levels of enrolment in higher education.…
Sacolo, Hlengiwe; Chimbari, Moses; Kalinda, Chester
Schistosomiasis remains a global health problem with an estimated 250 million people in 78 countries infected, of whom 85% live in Sub-Saharan Africa. Preventive chemotherapy remains the key public health strategy to combat schistosomiasis worldwide. Recently the WHO emphasized on the use of integrative approaches in the control and elimination of schistosomiasis. However, a detailed understanding of sociocultural factors that may influence the uptake of the intended health activities and services is vital. Thus, our study sought to understand the knowledge, attitudes, perceptions, beliefs and practices about schistosomiasis in various communities in Sub-Saharan Africa. A systematic search of literature for the period 2006-2016 was done on Medline, PubMed, CINAHL, Psych info and Google Scholar using the following key words "Schistosomiasis, S. mansoni, S. haematobium, knowledge, attitudes, perceptions, beliefs and practices in Sub-Saharan Africa" in combination with Bolean operators (OR, AND). In this context, we reviewed studies conducted among school children, community members and caregivers of preschool children. Thematic analysis was utilised for the overall synthesis of the selected studies. This was done after reading the articles in depth. Themes were identified and examined for similarities, differences and contradictions. Gaps in schistosomiasis related knowledge and sociocultural barriers towards the uptake of preventive and treatment services among communities in Sub-Saharan Africa were identified. In addition to limited knowledge and negative attitudes, risky water related practices among community members, school children and caregivers of preschool children were identified as key factors promoting transmission of the disease. The study concluded that a comprehensive health education programme using contextual and standardised training tools may improve peoples' knowledge, attitudes and practices in relation to schistosomiasis prevention and control
In this article, the author documents the learning disadvantage of rural primary school students in sub-Saharan Africa and attempts to identify the factors underlying such disadvantages. Analyzing data from 14 school systems participating in the second study of the Southern and Western Africa Consortium for Monitoring Educational Quality (SACMEQ…
Ismaila Adamu Saidu
Full Text Available Ensuring an efficient and equitable delivery of quality assured diagnosis and treatment of tuberculosis (TB is the major drive of the TB control programme and the alternatives for incorporating preventative efforts have not yet been fully considered. The aim of the study was to examine the social determinants of TB transmission in sub-Saharan Africa. Four electronic databases (Medline, CINAHL, PubMed, and Web of Science were systematically searched to obtained relevant articles and critical appraisal skill programme tools were used to analyze data. Out 515 articles obtained from the electronic database search only 18 met the inclusion and exclusion criteria of the systematic review. The study shows that male sex, young age (25-34 years, low education, unemployment, low income, poverty, tobacco smoking, and alcohol abuse are the identified social determinants of tuberculosis in sub-Saharan Africa. Therefore, focus on social determinates of TB, adjunct to early diagnosis and successful treatment completion, can play a pivotal role in reducing the soaring levels to TB transmission in sub-Saharan Africa.
Ismaila Adamu Saidu
Full Text Available Ensuring an efficient and equitable delivery of quality assured diagnosis and treatment of tuberculosis (TB is the major drive of the TB control programme and the alternatives for incorporating preventative efforts have not yet been fully considered. The aim of the study was to examine the social determinants of TB transmission in sub-Saharan Africa. Four electronic databases (Medline, CINAHL, PubMed, and Web of Science were systematically searched to obtained relevant articles and critical appraisal skill programme tools were used to analyze data. Out 515 articles obtained from the electronic database search only 18 met the inclusion and exclusion criteria of the systematic review. The study shows that male sex, young age (25-34 years, low education, unemployment, low income, poverty, tobacco smoking, and alcohol abuse are the identified social determinants of tuberculosis in sub-Saharan Africa. Therefore, focus on social determinates of TB, adjunct to early diagnosis and successful treatment completion, can play a pivotal role in reducing the soaring levels to TB transmission in sub-Saharan Africa.
Ingubu, Moses Shiasha
This paper captures the impact of the Global Economic Crisis on educational programs serving minority groups in developing countries. It has been established that the most vulnerable groupings include nomadic and pastoralist communities, slum dwellers, children in war zones, and women. Various educational interventions such as mobile schooling,…
... EXPORT-IMPORT BANK Postponement Notice of Open Special Meeting of the Sub-Saharan Africa Advisory Committee of the Export-Import Bank of the United States (Ex-Im Bank) SUMMARY: The Sub-Saharan Africa... of the Bank's financial commitments in Sub- Saharan Africa under the loan, guarantee, and insurance...
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.
Dec 18, 2017 ... Science Diplomacy Awards recognize outstanding achievements in South Africa's ... SGCI was recognized for its work with 15 public funding agencies in sub-Saharan Africa, as well as several science and ... Knowledge.
Gunzinger, Mark A; Thomas, David L
Extending from the urban centers of South Africa to the lesser-developed regions of the arid Sahel, Sub-Saharan Africa spans the post-Cold War spectrum of political, economic, and military challenges...
The purpose of this thesis is to define the poaching problem in sub-Saharan Africa, to provide for the development of solutions, and to illustrate the significance of the problem to both Africa and the United States...
Remington, Jeff; Henderson, Ron
... a challenge to the United States that appears almost insurmountable. Huge problems in Africa, especially Sub-Saharan Africa, can lead to huge threats to the national security of the United States...
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
Abugre, James B.
This article examines the developments and challenges of higher education in developing countries. Using a thorough qualitative interview of deans, directors and heads of Department of the University of Ghana, this paper draws on their analysis to discover unexplored issues that affect the universities in developing countries. The study identifies…
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…
Full Text Available Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of nonphysician clinicians (NPCs, resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary – for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system.
Eyal, Nir; Cancedda, Corrado; Kyamanywa, Patrick; Hurst, Samia A
Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of non-physician clinicians (NPCs), resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary - for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system. © 2016 by Kerman University of Medical Sciences.
sub-Saharan cities, particularly where contraceptive use is low and access to ... other regions, sub-Saharan women nevertheless exercise ... kinship networks to share the costs and benefits of .... developing countries in contraceptive use among married .... The report includes case studies of ..... Tours, France, July 2005.
Industrial expansion remains essential for the development and structural transformation of most sub-Saharan African economies. The advantages of industrialization go beyond the provision of manufactured goods and the diversification of exports to the modernization of society. Growth rates in formal manufacturing tell little about the economic…
Neerinckx, Simon B; Peterson, Andrew T; Gulinck, Hubert
Background Plague is a rapidly progressing, serious illness in humans that is likely to be fatal if not treated. It remains a public health threat, especially in sub-Saharan Africa. In spite of plague's highly focal nature, a thorough ecological understanding of the general distribution pattern...... of plague across sub-Saharan Africa has not been established to date. In this study, we used human plague data from sub-Saharan Africa for 1970-2007 in an ecological niche modeling framework to explore the potential geographic distribution of plague and its ecological requirements across Africa. Results We...... predict a broad potential distributional area of plague occurrences across sub-Saharan Africa. General tests of model's transferability suggest that our model can anticipate the potential distribution of plague occurrences in Madagascar and northern Africa. However, generality and predictive ability tests...
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…
Ba-Diop, Awa; Marin, Beno?t; Druet-Cabanac, Michel; Ngoungou, Edgard B; Newton, Charles R; Preux, Pierre-Marie
Epilepsy is a common neurological disease in tropical countries, particularly in sub-Saharan Africa. Previous work on epilepsy in sub-Saharan Africa has shown that many cases are severe, partly a result of some specific causes, that it carries a stigma, and that it is not adequately treated in many cases. Many studies on the epidemiology, aetiology, and management of epilepsy in sub-Saharan Africa have been reported in the past 10 years. The prevalence estimated from door-to-door studies is a...
...-Import Bank Transactions in Sub-Saharan Africa. Public Participation: The meeting will be open to public... EXPORT-IMPORT BANK Notice of Open Special Meeting of the Sub-Saharan Africa Advisory Committee (SAAC) of the Export-Import Bank of the United States (Export-Import Bank). SUMMARY: The Sub-Saharan...
De Paolis, M R
An analysis of 46 posters from 27 countries of Sub-Saharan Africa allowed the values conveyed by this medium to be defined, the status of the announcer and the recipient to be clarified, and their relationship and the attendant social consequences to be brought out. One of the primary characteristics of this sample was that the vast majority of the posters contained drawings and only a limited number used photos. The family was the theme most commonly represented by the image and the text: information on family planning necessarily involved the family, the synonym of fertility. The majority of posters represented the traditional, nuclear family of the Western world, comprising the father, mother, and children. It was interesting to observe that this image did not necessarily reflect reality in Africa, where traditionally the extended family, including the grandparents, uncles and aunts, is more widespread. The message most commonly conveyed the image of the nuclear family. The number of children shown varied from 1 to 4, with an average of 2. The most widely used message strategies in this sample of posters involved three types of announcer: authoritarian, nonauthoritarian, and character announcer. The authoritarian type announcer was not visually depicted but consisted of messages that were written orders or threats. The nonauthoritarian announcer, also not depicted, gave messages that contained no orders or threats. The character announcer was one the characters portrayed in the picture.
David Shapiro; Andrew Hinde
Background: This descriptive finding examines the comparative pace of fertility decline in sub-Saharan Africa, relative to Asia, Latin America and the Caribbean, and Northern Africa.Objective: We seek to determine if fertility decline has been slower in sub-Saharan Africa than elsewhere in the developing world.Methods: United Nations 2017 estimates of national fertility are used in assessing the comparative pace of fertility decline, and the four regions are compared in terms of how far they ...
Atun, Rifat; Silva, Sachin; Ncube, Mthuli; Vassall, Anna
In 2015 around 15 million people living with HIV were receiving antiretroviral treatment (ART) in sub-Saharan Africa. Sustained provision of ART, though both prudent and necessary, creates substantial long-term fiscal obligations for countries affected by HIV/AIDS. As donor assistance for health remains constrained, novel financing mechanisms are needed to augment funding domestic sources. We explore how Innovative Financing has been used to co-finance domestic HIV/AIDS responses. Based on analysis of non-health sectors, we identify innovative financing instruments that could be used in the HIV response. We undertook a systematic review to identify innovative financing instruments used for (1) domestic HIV/AIDS financing in sub-Saharan Africa (2) international health financing and (3) financing in non-health sectors. We analyzed peer-reviewed and grey literature published between 2002 and 2014. We examined the nature and volume of funds mobilized with innovative financing, then in consultation with leading experts, identified instruments that held potential for financing the HIV response. Our analysis revealed three innovative financing instruments in use: Zimbabwe's AIDS Trust Fund (a tax/levy-based instrument), Botswana's National HIV/AIDS Prevention Support (BNAPS) International Bank for Reconstruction and Development (IBRD) Buy-Down (a debt conversion instrument), and Côte d'Ivoire's Debt2Health Debt Swap Agreement (a debt conversion instrument). Zimbabwe's AIDS Trust Fund generated US$ 52.7 million between 2008 and 2011, Botswana's IBRD Buy-Down generated US$ 20 million, and Côte d'Ivoire's Debt2Health Debt Swap Agreement generated US$ 27 million, at least half of which was to be invested in HIV/AIDS programs. Four additional categories of innovative financing instruments met our criteria for future use: (1) remittances and diaspora bonds (2) social and development impact bonds (3) sovereign wealth funds (4) risk and credit guarantees. A limited number of
Full Text Available Background: This descriptive finding examines the comparative pace of fertility decline in sub-Saharan Africa, relative to Asia, Latin America and the Caribbean, and Northern Africa. Objective: We seek to determine if fertility decline has been slower in sub-Saharan Africa than elsewhere in the developing world. Methods: United Nations 2017 estimates of national fertility are used in assessing the comparative pace of fertility decline, and the four regions are compared in terms of how far they are into their fertility transition. Results: The data shows clearly that fertility decline in sub-Saharan Africa, still at a comparatively early stage, has been considerably slower than the earlier declines in Asia, Latin America and the Caribbean, and Northern Africa at comparable stages of the transition, and displays less within-region heterogeneity than the transitions in these other regions. Conclusions: The slower pace of fertility decline in sub-Saharan Africa, in conjunction with the high current fertility levels in the region, means that in the absence of policies seeking to accelerate fertility decline, sub-Saharan Africa will continue to experience rapid population growth that in turn will constrain its development. Contribution: Presentation of data in a novel way (Figures 2‒4, and associated calculations unambiguously demonstrates the slow pace of fertility decline in sub-Saharan Africa compared with other regions of the world.
Ssewanyana, Derrick; Bitanihirwe, Byron
Gambling is a cross-cultural and global activity which typically involves the wagering of money or an item of monetary value on an outcome that is governed by chance. Although gambling is positioned as a legitimate recreational and leisure activity within sub-Saharan Africa (SSA), there is widespread recognition among healthcare professionals and policy-makers that gambling has the capacity to become dysfunctional in a minority. Emerging knowledge suggests that problem gambling is rapidly evolving in to a public health concern in SSA, especially among youth. This article focuses on problem gambling among young people in SSA with an emphasis on three key themes: (1) gambling behavior and patterns in SSA; (2) public health and socioeconomic implications of gambling in SSA; and (3) public health policies and interventions for addressing this issue. We believe that collaborative efforts between government, prevention specialists, legislators, researchers, treatment providers, and other stake holders can influence the uptake of research findings necessary to implement social policies and design effective public health intervention options to combat problem gambling and its associated implications among young people in SSA.
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.
Schrijner, Sandor; Smits, Jeroen
Globally an estimated 159 million children under 5 years of age are being too short for one's age (stunted). More than one third of these children is living in Africa. Given the substantial number of sub-Saharan African (SSA) children living in households with co-residing grandparents and the negative effects of stunting on productivity and economic growth, gaining insight into the role grandparents play for children's stunting, has become increasingly important. By applying multilevel logistic regression analysis on a database with information on 344,748 children aged 6-60 months living in 31 SSA countries, the strength of the relationship between grandparental co-residence and children's stunting is examined. Interaction analysis is used to explore how this relationship is moderated by characteristics of the household and of the context in which the household is situated. Children in households with a co-residing grandmother have significantly lower odds of being stunted than other children, provided that the grandmother is in the 50-75 age range. When the grandmother is very young or very old, the likelihood of being stunted is higher. For grandfathers, no significant overall relationship is found, but our findings show that co-residence of a grandfather is associated with less stunting of girls, in poor households and in polygamous households. Copyright © 2018 Elsevier Ltd. All rights reserved.
McCullough, Ellen B
Drawing on a new set of nationally representative, internationally comparable household surveys, this paper provides an overview of key features of structural transformation - labor allocation and labor productivity - in four African economies. New, micro-based measures of sector labor allocation and cross-sector productivity differentials describe the incentives households face when allocating their labor. These measures are similar to national accounts-based measures that are typically used to characterize structural change. However, because agricultural workers supply far fewer hours of labor per year than do workers in other sectors in all of the countries analyzed, productivity gaps shrink by half, on average, when expressed on a per-hour basis. Underlying the productivity gaps that are prominently reflected in national accounts data are large employment gaps, which call into question the productivity gains that laborers can achieve through structural transformation. Furthermore, agriculture's continued relevance to structural change in Sub-Saharan Africa is highlighted by the strong linkages observed between rural non-farm activities and primary agricultural production.
Bove, Riley; Valeggia, Claudia
In this paper we review the literature on the association between polygyny and women's health in sub-Saharan Africa. We argue that polygyny is an example of "co-operative conflict" within households, with likely implications for the vulnerability of polygynous women to illness, and for their access to treatment. We begin with a review of polygyny and then examine vulnerability to sexually transmitted infections (STIs, including HIV) and differential reproductive outcomes. Polygyny is associated with an accelerated transmission of STIs, both because it permits a multiplication of sexual partners and because it correlates with low rates of condom use, poor communication between spouses, and age and power imbalances among other factors. Female fertility is affected by the interplay between marital rank, household status, and cultural norms in polygynous marriages. Finally, we present areas which have received only cursory attention: mental health and a premature, "social" menopause. Although data are scarce, polygyny seems to be associated with higher levels of anxiety and depression, particularly around stressful life events. It is our hope that the examples reviewed here will help build a framework for mixed method quality research, which in turn can inform decision makers on more appropriate, context-dependent health policies.
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.
Brockerhoff, M; Yang, X
Much lower levels of fertility in urban than rural areas throughout sub-Saharan Africa imply that fertility decline in the region may be facilitated by rapid urbanization and rural-to-urban migration. The present study uses data from Demographic and Health Surveys in six countries--Ghana, Kenya, Mali, Senegal, Togo and Uganda--to assess the impact of long-term rural-urban female migration on fertility. Results of logit analyses indicate that in most countries women who leave the countryside represent the higher fertility segment of the rural population in the years before migration. Migrants' risk of conception declines dramatically in all countries around the time of migration and remains lower in the long run among most migrant groups than among rural and urban nonmigrants. Descriptive analyses suggest that the decline in migrant fertility is related to the rapid and pronounced improvement in standard of living experienced by migrants after settling in the urban area and may be due in part to temporary spousal separation.
Thomas J. Betjeman
Full Text Available Mobile phone penetration rates have reached 63% in sub-Saharan Africa (SSA and are projected to pass 70% by 2013. In SSA, millions of people who never used traditional landlines now use mobile phones on a regular basis. Mobile health, or mHealth, is the utilization of short messaging service (SMS, wireless data transmission, voice calling, and smartphone applications to transmit health-related information or direct care. This systematic review analyzes and summarizes key articles from the current body of peer-reviewed literature on PubMed on the topic of mHealth in SSA. Studies included in the review demonstrate that mHealth can improve and reduce the cost of patient monitoring, medication adherence, and healthcare worker communication, especially in rural areas. mHealth has also shown initial promise in emergency and disaster response, helping standardize, store, analyze, and share patient information. Challenges for mHealth implementation in SSA include operating costs, knowledge, infrastructure, and policy among many others. Further studies of the effectiveness of mHealth interventions are being hindered by similar factors as well as a lack of standardization in study design. Overall, the current evidence is not strong enough to warrant large-scale implementation of existing mHealth interventions in SSA, but rapid progress of both infrastructure and mHealth-related research in the region could justify scale-up of the most promising programs in the near future.
Full Text Available Gambling is a cross-cultural and global activity which typically involves the wagering of money or an item of monetary value on an outcome that is governed by chance. Although gambling is positioned as a legitimate recreational and leisure activity within sub-Saharan Africa (SSA, there is widespread recognition among healthcare professionals and policy-makers that gambling has the capacity to become dysfunctional in a minority. Emerging knowledge suggests that problem gambling is rapidly evolving in to a public health concern in SSA, especially among youth. This article focuses on problem gambling among young people in SSA with an emphasis on three key themes: (1 gambling behavior and patterns in SSA; (2 public health and socioeconomic implications of gambling in SSA; and (3 public health policies and interventions for addressing this issue. We believe that collaborative efforts between government, prevention specialists, legislators, researchers, treatment providers, and other stake holders can influence the uptake of research findings necessary to implement social policies and design effective public health intervention options to combat problem gambling and its associated implications among young people in SSA.
Dillon, David G; Gurdasani, Deepti; Riha, Johanna
Sub-Saharan Africa (SSA) has the highest burden of HIV in the world and a rising prevalence of cardiometabolic disease; however, the interrelationship between HIV, antiretroviral therapy (ART) and cardiometabolic traits is not well described in SSA populations....
Gunzinger, Mark A; Thomas, David L
... for the United States Generally viewed as lagging in the effort to develop stable governments and self-sustaining economies, Sub-Saharan Africa is, with the exception of a few bright spots, caught...
The Tourism–Development Nexus in sub-Saharan Africa: Progress and Prospects. ... discussed concerning the impacts of differentiated kinds of tourism: tourism and ... finally, questions around tourism, climate change and the green economy.
Ojji, Dike B; Ojji, Dike B Ojji; Lamont, Kim; Sliwa, Karen; Ojji, Olubunmi I; Egenti, Bibiana Nonye; Sliwa, Karen
Summary Cardiovascular disease (CVD) is the frontrunner in the disease spectrum of sub-Saharan Africa, with stroke and ischaemic heart disease ranked seventh and 14th as leading causes of death, respectively, on this sub-continent. Unfortunately, this region is also grappling with many communicable, maternal, neonatal and nutritional disorders. Limited resources and the high cost of CVD treatment necessitate that primary prevention should have a high priority for CVD control in sub- Saharan Africa. One major challenge of such an approach is how to equip primary care to respond promptly and effectively to this burden. We present a practical approach on how primary care in sub-Saharan Africa could effectively address the prevention, treatment and control of CVD on the subcontinent. For effective prevention, control and treatment of CVD in sub-Saharan Africa, there should be strategic plans to equip primary care clinics with well-trained allied healthcare workers who are supervised by physicians. PMID:28752890
Alexander C Tsai; David R Bangsberg; Sheri D Weiser
Alexander Tsai and colleagues highlight the complex relationship between poverty and HIV stigma in sub-Saharan Africa, and discuss possible ways to break the cycle. Please see later in the article for the Editors' Summary.
Smigelsky, Melissa A; Aten, Jamie D; Gerberich, Stacy; Sanders, Mark; Post, Rachael; Hook, Kimberly; Ku, Angie; Boan, David M; Monroe, Phil
Trauma is a widely acknowledged problem facing individuals and communities in developing countries. In sub-Saharan Africa-a region that is home to some of the world's worst human rights violations, ethnic and civil conflicts, disease epidemics, and conditions of poverty-trauma is an all-too-common experience in citizens' daily lives. In order to address these conditions effectively, the impact of trauma must be understood. The authors reviewed recent literature on the cost and consequences of psychological trauma in sub-Saharan Africa to provide a substantive perspective on how trauma affects individuals, communities, and organizations and to inform the effort to determine a method for measuring the impact of trauma in sub-Saharan Africa and the efficacy of trauma interventions in the region. Several recommendations are offered to help broaden and deepen the current approaches to conceptualizing trauma, evaluating its cost, and intervening on behalf of those impacted by trauma in sub-Saharan Africa.
Hoeve ten, Marieke
Poverty reduction is one of the main Millennium Development Goals (United Nations, 2000). Sub-Saharan Africa is the region with the highest prevalence of poverty. Almost half the population lives in extreme poverty (Chen & Ravillion, 2004; UN, 2005). Pove
Ala, Fereydoun; Allain, Jean-Pierre; Bates, Imelda; Boukef, Kamel; Boulton, Frank; Brandful, James; Dax, Elizabeth M.; El Ekiaby, Magdy; Farrugia, Albert; Gorlin, Jed; Hassall, Oliver; Lee, Helen; Loua, André; Maitland, Kathryn; Mbanya, Dora; Mukhtar, Zainab; Murphy, William; Opare-Sem, Ohene; Owusu-Ofori, Shirley; Reesink, Henk; Roberts, David; Torres, Oscar; Totoe, Grace; Ullum, Henrik; Wendel, Silvano
Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking
Full Text Available Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking.
Ala, Fereydoun; Allain, Jean-Pierre; Bates, Imelda; Boukef, Kamel; Boulton, Frank; Brandful, James; Dax, Elizabeth M.; El Ekiaby, Magdy; Farrugia, Albert; Gorlin, Jed; Hassall, Oliver; Lee, Helen; Loua, André; Maitland, Kathryn; Mbanya, Dora
Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking.
Gunzinger, Mark A; Thomas, David L
... in a vicious cycle of conflict, deteriorating infrastructures and humanitarian disasters Despite this apparent gloomy prognosis, Sub-Saharan Africa is one of the richest regions in the world in human...
Hassler, Bjoern; Hennessy, Sara; Hofmann, Riikka
Developing sustainable and scalable educational initiatives is a key challenge in low-income countries where donor-funded short-term projects are limited by both contextual factors and programme design. In this commentary we examine some of the issues related to in-service teacher development in the context of sub-Saharan Africa, grounded…
McKenney, Susan; Reeves, Thomas
McKenney, S., & Reeves, T. (2013, 27 April-1 May). The application of design-based research in the context of curriculum materials development in sub-Saharan Africa. Paper presented at the annual meeting of the American Educational Research Association, San Francisco, US.
Frambach, J.M.; Manuel, B.A.; Fumo, A.M.; Groosjohan, B.; Vleuten, C.P.M. van der; Driessen, E.W.
BACKGROUND: Medical education in Sub-Saharan Africa is in need of reform to promote the number and quality of physicians trained. Curriculum change and innovation in this region, however, face a challenging context that may affect curriculum outcomes. Research on outcomes of curriculum innovation in
Chopra, Mickey; Darnton-Hill, Ian
In the chapter dealing with education and health, the report of the influential Commission for Africa prioritises basic health systems, HIV/AIDS, malaria and tuberculosis. In contrast, nutrition is given less than half a page and is reduced to parasite control and micronutrient support. Such neglect of nutrition is hard to understand in the context of increasing hunger and malnutrition across the continent. Sub-Saharan Africa is the only region in the world where the proportion of underweight children has stagnated and the absolute numbers have actually increased in the last decade. It has been pointed out that if current trends continue sub-Saharan Africa will achieve the Millennium Development Goal for child mortality around 2115 - one century after the target date. Quite clearly those concerned with nutrition need to more powerfully advocate the role of nutrition in lifting Africa out of the spiral of poverty. The present paper argues that to achieve this requires an understanding not just of the critical role of nutrition for health and development (both individual and national), but also of how recent global changes are interacting with changes in food production and supply, other determinants of maternal and child health, and the role and capacity of the state to tackle malnutrition in Africa. It concludes by suggesting some responses that nutritionists could now be making.
Inoue, Takeshi; Hamori, Shigeyuki
This article empirically analyzes the role of finance in economic growth in Sub-Saharan Africa from the perspective of what is termed herein “financial permeation”. By estimating panel data on 37 countries in Sub-Saharan Africa between 2004 and 2010, we examine whether financial permeation through improved convenience and access to financial services has contributed to economic growth in this region. Empirical results clearly indicate that financial permeation has a statistically significant ...
Janda, Karel; Quarshie, Gregory
This paper takes a critical look at the natural resource curse in countries in sub-Saharan Africa and it highlights the role of institutionalised authority. The paper first provides a comprehensive literature review of natural resource curse, Dutch disease and the role of oil resources in resource curse. This is follow by the description of the relevant economic factors in sub-Saharan Africa, which is taken as prime example of the region with both important oil and other natural resources and...
This paper is a comparative study of the role of agriculture in economic development in sub-Saharan Africa and Asia. Popular notions of economic duality and agricultural squeeze in sub-Saharan Africa are re-examined, and new explanations in terms of agrarian structures and resource availabilities are put forward to account for the apparent economic duality in that continent. Comparison with surplus labour economies of Asia highlights the constraints posed by the prevailing agrarian structures...
Francis M. Kemegue; Reneé van Eyden; Emmanuel Owusu-Sekyere
This paper investigates the effect of remittance inflows on real exchange rates in sub-Saharan Africa (SSA) using annual data from 1980 to 2008 for 34 countries, the method of moments estimator developed by Arellano and Bover (1995) and the feasible generalized least squares estimator developed by Parks (1967) and Kmenta (1986). We find that when cross-sectional dependence and individual effects are controlled for, remittances to sub-Saharan Africa as a whole increase the underlying real exch...
Cherewick, Megan L; Cherewick, Steven D; Kushner, Adam L
In 2015, it was estimated that approximately 36.7 million people were living with HIV globally and approximately 25.5 million of those people were living in sub-Saharan Africa. Limitations in the availability and access to adequate operative care require policy and planning to enhance operative capacity. Data estimating the total number of persons living with HIV by country, sex, and age group were obtained from the Joint United Nations Programme on HIV/AIDS (UNAIDS) in 2015. Using minimum proposed surgical rates per 100,000 for 4, defined, sub-Saharan regions of Africa, country-specific and regional estimates were calculated. The total need and unmet need for operative procedures were estimated. A minimum of 1,539,138 operative procedures were needed in 2015 for the 25.5 million persons living with HIV in sub-Saharan Africa. In 2015, there was an unmet need of 908,513 operative cases in sub-Saharan Africa with the greatest unmet need in eastern sub-Saharan Africa (427,820) and western sub-Saharan Africa (325,026). Approximately 55.6% of the total need for operative cases is adult women, 38.4% are adult men, and 6.0% are among children under the age of 15. A minimum of 1.5 million operative procedures annually are required to meet the needs of persons living with HIV in sub-Saharan Africa. The unmet need for operative care is greatest in eastern and western sub-Saharan Africa and will require investments in personnel, infrastructure, facilities, supplies, and equipment. We highlight the need for global planning and investment in resources to meet targets of operative capacity. Copyright © 2016 Elsevier Inc. All rights reserved.
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....
Natural resources in sub-Saharan Africa suffer from a bad reputation. Oil and diamonds, particularly, have been blamed for a number of Africa’s illnesses such as poverty, corruption, dictatorship and war. This paper outlines the different areas and transmission channels of how this so-called “resource curse” is said to materialize. By assessing empirical evidence on sub-Saharan Africa it concludes that the resource curse theory fails to sufficiently explain why and how several countries have ...
A new dataset by Bazzi and Blattman (2014) allows examining the effects of international commodity prices on the risk of civil war outbreak with more comprehensive data. I find that international commodity price downturns sparked civil wars in Sub-Saharan Africa. Another finding with the new dataset is that commodity price downturns also sparked civil wars beyond Sub-Saharan Africa since 1980. Effects are sizable relative to the baseline risk of civil war outbreak. My conclusions contrast wit...
Liwa, Anthony C; Smart, Luke R; Frumkin, Amara; Epstein, Helen-Ann B; Fitzgerald, Daniel W; Peck, Robert N
Hypertension is increasingly common in sub-Saharan Africa, and rates of hypertension control are low. Use of traditional herbal medicines (THM) is common among adults in sub-Saharan Africa and may affect hypertension therapy. We searched Ovid MEDLINE, Ovid EMBASE, and Web of Knowledge in June 2013 to find studies about THM use among hypertensive patients living in sub-Saharan Africa. Two independent reviewers evaluated titles and abstracts. Qualifying references were reviewed in full text. Data were extracted using a standardized questionnaire. Four hundred and eighty-one references were retrieved, and four articles from two countries met criteria for inclusion. The prevalence of THM use was 25-65% (average 38.6%). THM was the most common type of complementary and alternative medicines used by patients (86.7-96.6%). Among THM users, 47.5% concomitantly used both allopathic medicine and THM. Increased age (psupernatural cause of hypertension (RR 2.11), and family history of hypertension (OR 1.78) were positively associated with THM use, while belief that hypertension is preventable was negatively associated with THM use (OR 0.57). More than one-third of adults with hypertension in sub-Saharan Africa use THM. Half of these patients use THM concurrently with allopathic medicine. Healthcare workers in sub-Saharan Africa must discuss THM use with their hypertensive patients. More research is urgently needed to define the impact of THM use on hypertension control and outcomes in sub-Saharan Africa.
Nearly all of the sex life satisfaction literature has dealt with developed-country settings, and nothing has been published on sex life satisfaction in sub-Saharan Africa. Not only is sub-Saharan African a substantively relevant area in its own right, but it also provides a useful point of comparison for patterns and relations found in developed-world contexts. A brief descriptive and exploratory study of sex life satisfaction in sub-Saharan Africa was conducted using the World Gallup Poll, a dataset with representative sex life satisfaction data for 31 countries and 25,483 cases. In general, there was little variation in weighted averages across countries, and most of the samples surveyed were satisfied with their sex lives, with the modal score being a perfect 10. Furthermore, what variation did exist could not be attributed to level of economic development or gender inequality. Within countries, sociodemographic associations generally comported with patterns found in other contexts: income, education, and being partnered were generally associated with sex life satisfaction, and for two of the four UN subregions (West Africa and East Africa), males were significantly more satisfied with their sex lives than women. The relationship with age demonstrated a curvilinear relationship, with the peak age of sexual satisfaction in the late 20s to early 30s depending on the geographic region. The age pattern was not due to health differences, but combining estimators after a seemingly unrelated regression suggests that 4-12% of the effect of income on sex life satisfaction was attributable to better health. In general, religiosity and perceived gravity of the HIV/AIDS problem in one's country were not significantly related to sexual satisfaction.
Otieno, C F; Kayima, J K; Omonge, E O; Oyoo, G O
Diabetic ketoacidosis is the most common hyperglycaemic emergency in patients with diabetes mellitus, especially type 1 diabetes. It carries very high mortality in sub-Saharan Africa, both in the treated patients and those who are presenting to hospital with diabetes for the first time. To review the risk factors, mechanisms and management approaches in diabetes ketoacidosis in published literature and to discuss them in the context of why a significant proportion of patients who develop diabetic ketoacidosis in sub-Saharan Africa still have high mortality. Literature review of relevant published literature from both Africa and the rest of the world. The main causes or precipitants of DKA in patients in SSA are newly diagnosed diabetes, missed insulin doses and infections. The major underlying mechanism is insulin deficiency. Treated patients miss insulin doses for various reasons, for example, inaccessibility occasioned by; unavailability and unaffordability of insulin, missed clinics, perceived ill-health and alternative therapies like herbs, prayers and rituals. Infections also occur quite often, but are not overt, like urinary tract, tuberculosis and pneumonia. Due to widespread poverty of individuals and nations alike, the healthcare systems are scarce and the few available centres are unable to adequately maintain a reliable system of insulin supply and exhaustively investigate their hospitalised patients. Consequently, there is little guarantee of successful outcomes. Poor people may also have sub-optimal nutrition, caused or worsened by diabetes, more so, at first presentation to hospital. Intensive insulin therapy in such individuals mimics 're-feeding syndrome', an acute anabolic state whose outcome may be unfavourable during the period of treatment of diabetic ketoacidosis. Although mortality and morbidity from diabetic ketoacidosis remains high in sub-Saharan Africa, improved healthcare systems and reliable insulin supply can reverse the trend, at least
Kabiru, Caroline W; Izugbara, Chimaraoke O; Beguy, Donatien
A third of sub-Saharan Africa's (SSA) population comprises persons aged 10-24 years. These youth are growing up in a context marked by pervasive poverty, limited educational opportunities, high HIV/AIDS prevalence, widespread conflict, and weak social controls. Published research on the broad issues that affect youth health and wellbeing in SSA is limited and centers heavily on sexual and reproductive health. In this commentary, we provide a broad overview of sub-Saharan African youth, highlight research gaps with respect to youth health and wellbeing, and describe potential avenues to develop the region's research capacity on youth health and wellbeing.
There is increasing agreement among the nutrition community about the use of length/height-for-age as the indicator to monitor the long-term impact of chronic nutritional deficiencies. Stunting, an indicator of linear growth failure, has both long- and short-term consequences affecting growth and development and adult work potential. The number of stunted children in sub-Saharan Africa is expected to increase by 2025 if the current trends remain. Stunting among African children peaks during the complementary feeding period, which coincides with the period when children are no longer on exclusive breastfeeding and infections are frequent. Addressing stunting has become the focus of global efforts. The World Health Assembly in 2012 set a 40 % reduction in the number of stunted children by 2025. To effectively address the issues of stunting in sub-Saharan Africa is it appropriate to examine the issue of what it takes. The WHO Multicentre Growth Reference Study (MGRS) conducted in several regions of the world, including Africa has lessons on what it would take to prevent in African children. The children in the MGRS had good socioeconomic background characteristics reflected by years of maternal education and availability of basic amenities, such as potable water and sanitary conditions. The prescription of exclusive breastfeeding, high-quality diversified diets and attention to care were critical factors contributing to healthy growth for the African children. Preventing stunting in sub-Saharan Africa is possible. It requires governments to put in place policies that would create the conducive environment needed. The complex and multiple causes of stunting offer the opportunity to address stunting in a multisectoral and within a food systems approach. The global resolve to make food systems deliver on healthy diet requires all stakeholders to work together to achieve the global goal of reducing stunting. This review highlights the key elements contributing to adequate
Ndebele, Paul; Wassenaar, Douglas; Benatar, Solomon; Fleischer, Theodore; Kruger, Mariana; Adebamowo, Clement; Kass, Nancy; Hyder, Adnan A.; Meslin, Eric M.
The last fifteen years have witnessed a significant increase in investment in research ethics capacity development throughout the world. We examine nine research ethics training programs that are focused on Sub-Saharan Africa and supported by the US National Institutes of Health. We collected data from grants awards’ documents and annual reports supplemented by questionnaires completed by the training program directors. Together, these programs provided long-term training in research ethics to 275 African professionals, strengthened research ethics committees in 19 countries in Sub-Saharan Africa, and created research ethics curricula at many institutions and bioethics centers within Africa. Trainees’ leadership resulted in new national systems and policies on research ethics, human tissue storage and export, and methods of monitoring compliance with research ethics guidelines. Training programs adapted to challenges that arose due to varied trainees’ background knowledge in ethics, duration of time available for training, spoken and written English language skills, administrative obstacles, and the need to sustain post-training research ethics activities. Our report showcases the development of awareness of research ethics and building/strengthening of basic research ethics infrastructure in Sub-Saharan Africa. Nevertheless, the increasing amount and complexity of health research being conducted in Sub-Saharan Africa suggests the need for continued investment in research ethics capacity development in this region. This paper is part of a collection of papers analyzing the Fogarty International Center’s International Research Ethics Education and Curriculum Development program. PMID:24782070
Ndebele, Paul; Wassenaar, Douglas; Benatar, Solomon; Fleischer, Theodore; Kruger, Mariana; Adebamowo, Clement; Kass, Nancy; Hyder, Adnan A; Meslin, Eric M
The last fifteen years have witnessed a significant increase in investment in research ethics capacity development throughout the world. We examine nine research ethics training programs that are focused on Sub-Saharan Africa and supported by the US National Institutes of Health. We collected data from grants awards' documents and annual reports supplemented by questionnaires completed by the training program directors. Together, these programs provided long-term training in research ethics to 275 African professionals, strengthened research ethics committees in 19 countries in Sub-Saharan Africa, and created research ethics curricula at many institutions and bioethics centers within Africa. Trainees' leadership resulted in new national systems and policies on research ethics, human tissue storage and export, and methods of monitoring compliance with research ethics guidelines. Training programs adapted to challenges that arose due to varied trainees' background knowledge in ethics, duration of time available for training, spoken and written English language skills, administrative obstacles, and the need to sustain post-training research ethics activities. Our report showcases the development of awareness of research ethics and building/strengthening of basic research ethics infrastructure in Sub-Saharan Africa. Nevertheless, the increasing amount and complexity of health research being conducted in Sub-Saharan Africa suggests the need for continued investment in research ethics capacity development in this region. This paper is part of a collection of papers analyzing the Fogarty International Center's International Research Ethics Education and Curriculum Development program.
This paper 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...
Mills, Edward J; Kanters, Steve; Hagopian, Amy; Bansback, Nick; Nachega, Jean; Alberton, Mark; Au-Yeung, Christopher G; Mtambo, Andy; Bourgeault, Ivy L; Luboga, Samuel; Hogg, Robert S; Ford, Nathan
To estimate the lost investment of domestically educated doctors migrating from sub-Saharan African countries to Australia, Canada, the United Kingdom, and the United States. Human capital cost analysis using publicly accessible data. Sub-Saharan African countries. Nine sub-Saharan African countries with an HIV prevalence of 5% or greater or with more than one million people with HIV/AIDS and with at least one medical school (Ethiopia, Kenya, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe), and data available on the number of doctors practising in destination countries. The financial cost of educating a doctor (through primary, secondary, and medical school), assuming that migration occurred after graduation, using current country specific interest rates for savings converted to US dollars; cost according to the number of source country doctors currently working in the destination countries; and savings to destination countries of receiving trained doctors. In the nine source countries the estimated government subsidised cost of a doctor's education ranged from $21,000 (£13,000; €15,000) in Uganda to $58,700 in South Africa. The overall estimated loss of returns from investment for all doctors currently working in the destination countries was $2.17bn (95% confidence interval 2.13bn to 2.21bn), with costs for each country ranging from $2.16m (1.55m to 2.78m) for Malawi to $1.41bn (1.38bn to 1.44bn) for South Africa. The ratio of the estimated compounded lost investment over gross domestic product showed that Zimbabwe and South Africa had the largest losses. The benefit to destination countries of recruiting trained doctors was largest for the United Kingdom ($2.7bn) and United States ($846m). Among sub-Saharan African countries most affected by HIV/AIDS, lost investment from the emigration of doctors is considerable. Destination countries should consider investing in measurable training for source countries and strengthening of their
Full Text Available This paper employs a generalized mixture model approach to empiricallydetermine if Sub-Saharan African countries henceforth (SSA follow ahomogenous growth pattern based on the conditional distribution of their growthrates. Latent effects are employed to determine the growth experience of SSAcountries and to examine the structural characteristics of the clusters if any exist.Affirmation of clusters might imply significant productivity divergence amongSub-Saharan economies, helping explaining the structural imbalances in theregion. Results strongly buttress the existence of clusters and little evidence of acommon growth path, implying divergence among Sub-Saharan economies andspecific economic reforms are required in the identified clusters to guaranteesustainability and equality of growth in the SSA region. We also observed apositive and significant effect of investment even though the estimated long runeffects of investment on economic growth are smaller than expected
Full Text Available Abstract Background The rapid urban malaria appraisal (RUMA methodology aims to provide a cost-effective tool to conduct rapid assessments of the malaria situation in urban sub-Saharan Africa and to improve the understanding of urban malaria epidemiology. Methods This work was done in Yopougon municipality (Abidjan, Cotonou, Dar es Salaam and Ouagadougou. The study design consists of six components: 1 a literature review, 2 the collection of available health statistics, 3 a risk mapping, 4 school parasitaemia surveys, 5 health facility-based surveys and 6 a brief description of the health care system. These formed the basis of a multi-country evaluation of RUMA's feasibility, consistency and usefulness. Results A substantial amount of literature (including unpublished theses and statistics was found at each site, providing a good overview of the malaria situation. School and health facility-based surveys provided an overview of local endemicity and the overall malaria burden in different city areas. This helped to identify important problems for in-depth assessment, especially the extent to which malaria is over-diagnosed in health facilities. Mapping health facilities and breeding sites allowed the visualization of the complex interplay between population characteristics, health services and malaria risk. However, the latter task was very time-consuming and required special expertise. RUMA is inexpensive, costing around 8,500–13,000 USD for a six to ten-week period. Conclusion RUMA was successfully implemented in four urban areas with different endemicity and proved to be a cost-effective first approach to study the features of urban malaria and provide an evidence basis for planning control measures.
Full Text Available This paper 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.
As a result of two years of constructive dialogue between the World Bank (WB), government agencies and grassroots' associations involved in the advancement of women, a workshop for the Promotion of the societal status of women in Francophone Sub-Saharan Africa was organized in March 1998 in Cotonou by the Association of Women Jurists (AFJB) with WB technical and financial assistance. From ...
HIV/AIDS is a real threat for Sub-Saharan Countries. It increased adult mortality substantially. HIV/AIDS pandemic causes the death of the most productive part of affected population. Human capital passing on to future generations is limited. Low economic performance and income inequality induce higher HIV vulnerability. Contra wise HIV/AIDS has significant negative effect on the welfare of affected population. The sources of pandemic in Sub-Saharan Africa are not only social and cultural. He...
Ojji, Dike B; Ojji, Dike B Ojji; Lamont, Kim; Sliwa, Karen; Ojji, Olubunmi I; Egenti, Bibiana Nonye; Sliwa, Karen
Summary Cardiovascular disease (CVD) is the frontrunner in the disease spectrum of sub-Saharan Africa, with stroke and ischaemic heart disease ranked seventh and 14th as leading causes of death, respectively, on this sub-continent. Unfortunately, this region is also grappling with many communicable, maternal, neonatal and nutritional disorders. Limited resources and the high cost of CVD treatment necessitate that primary prevention should have a high priority for CVD control in sub- Saharan A...
A major obstacle to the development of sustainable democratic systems of government in contemporary sub-Saharan African states is the difficulty in articulating an adequate conception of social justice to serve as a guiding principle in these polities. This difficulty is a consequence of the ethnically heterogeneous character ...
Kluth, Michael Friederich
This article argues that aspirations of maintaining a dominant influence over sub-Saharan security issues has spurred the French and British leadership of European Union (EU) foreign and security policy integration, just as it has informed military capability expansions by the armed forces...
This paper studies tax policies as currently pursued in a number of sub-Saharan African countries against the backdrop of increasing worldwide economic integration and the pressure this puts on revenues from trade taxes and taxes on mobile production factors. This contrasts with existing (growing)
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...
African Journal of Reproductive Health ... Data are analyzed here from 95 surveys conducted since 1980 in 38 sub-Saharan African countries, to determine past injectable trends in the context of alternative ... Most use is supplied through the public sector, which raises long term cost issues for health ministries and donors.
Ahinkorah, Bright Opoku; Dickson, Kwamena Sekyi; Seidu, Abdul-Aziz
Violence against women is a common form of human rights violation, and intimate partner violence (IPV) appears to be the most significant component of violence. The aim of this study was to examine the association between women decision-making capacity and IPV among Women in Sub-Saharan Africa. The study also looked at how socio-demographic factors also influence IPV among Women in Sub-Saharan Africa. The study made use of pooled data from most recent Demographic and Health Survey (DHS) conducted from January 1, 2010, and December 3, 2016, in 18 countries in Sub-Saharan Africa. For the purpose of the study, only women aged 15-49 were used ( N = 84,486). Univariate and multivariate logistic regression models were used to investigate the relationship between the explanatory variables and the outcome variable. The odds of reporting ever experienced IPV was higher among women with decision-making capacity [AOR = 1.35; CI = 1.35-1.48]. The likelihood of experiencing IPV was low among young women. Women who belong to other religious groups and Christians were more likely to experience IPV compared to those who were Muslims [AOR = 1.73; CI = 1.65-1.82] and [AOR = 1.87; CI = 1.72-2.02] respectively. Women who have partners with no education [AOR = 1.11; CI = 1.03-1.20], those whose partners had primary education [AOR = 1.34; CI = 1.25-1.44] and those whose partners had secondary education [AOR = 1.22; CI = 1.15-1.30] were more likely to IPV compared to those whose partners had higher education. The odds of experiencing IPV were high among women who were employed compared to those who were unemployed [AOR = 1.33; CI = 1.28-1.37]. The likelihood of the occurrence of IPV was also high among women who were cohabiting compared to those who were married [AOR = 1.16; CI = 1.10-1.21]. Women with no education [AOR = 1.37; CI = 1.24-1.51], those with primary education [AOR = 1.65; CI = 1
Hernandez-Villafuerte, Karla; Li, Ryan; Hofman, Karen J
Collaboration between Sub-Saharan African researchers is important for the generation and transfer of health technology assessment (HTA) evidence, in order to support priority-setting in health. The objective of this analysis was to evaluate collaboration patterns between countries. We conducted a rapid evidence assessment that included a random sample of health economic evaluations carried out in 20 countries (Angola, Botswana, Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe, Ghana, Kenya, Nigeria, Ethiopia, Uganda). We conducted bibliometric network analysis based on all first authors with a Sub-Saharan African academic affiliation and their co-authored publications ("network-articles"). Then we produced a connection map of collaboration patterns among Sub-Saharan African researchers, reflecting the number of network-articles and the country of affiliation of the main co-authors. The sample of 119 economic evaluations mostly related to treatments of communicable diseases, in particular HIV/AIDS (42/119, 35.29 %) and malaria (26/119, 21.85 %). The 39 first authors from Sub-Saharan African institutions together co-authored 729 network-articles. The network analysis showed weak collaboration between health economic researchers in Sub-Saharan Africa, with researchers being more likely to collaborate with Europe and North America than with other African countries. South Africa stood out as producing the highest number of health economic evaluations and collaborations. The development and evaluation of HTA research networks in Sub-Saharan Africa should be supported, with South Africa central to any such efforts. Organizations and institutions from high income countries interested in supporting priority setting in Sub-Saharan Africa should include promoting collaboration as part of their agendas, in order to take advantage of the potential transferability of results and methods of the
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.
Vesper H. Chisumpa
Full Text Available Place of death remains an issue of growing interest and debate among scholars as an indicator of quality of end-of-life care in developed countries. In sub-Saharan Africa, however, variations in place of death may suggest inequalities in access to and the utilization of health care services that should be addressed by public health interventions. Limited research exists on factors associated with place of death in sub-Saharan Africa. The study examines factors associated with the place of death among Zambian adults aged 15–59 years using the 2010–2012 sample vital registration with verbal autopsy survey (SAVVY data, descriptive statistics and multivariate logistic regression analysis. Results show that more than half of the adult deaths occurred in a health facility and two-fifths died at home. Higher educational attainment, urban versus rural residence, and being of female gender were significant predictors of the place of death. Improvement in educational attainment and investment in rural health facilities and the health care system as a whole may improve access and utilization of health services among adults.
Chisumpa, Vesper H; Odimegwu, Clifford O; De Wet, Nicole
Place of death remains an issue of growing interest and debate among scholars as an indicator of quality of end-of-life care in developed countries. In sub-Saharan Africa, however, variations in place of death may suggest inequalities in access to and the utilization of health care services that should be addressed by public health interventions. Limited research exists on factors associated with place of death in sub-Saharan Africa. The study examines factors associated with the place of death among Zambian adults aged 15-59 years using the 2010-2012 sample vital registration with verbal autopsy survey (SAVVY) data, descriptive statistics and multivariate logistic regression analysis. Results show that more than half of the adult deaths occurred in a health facility and two-fifths died at home. Higher educational attainment, urban versus rural residence, and being of female gender were significant predictors of the place of death. Improvement in educational attainment and investment in rural health facilities and the health care system as a whole may improve access and utilization of health services among adults.
Chen, Candice; Baird, Sarah; Ssentongo, Katumba; Mehtsun, Sinit; Olapade-Olaopa, Emiola Oluwabunmi; Scott, Jim; Sewankambo, Nelson; Talib, Zohray; Ward-Peterson, Melissa; Mariam, Damen Haile; Rugarabamu, Paschalis
Physician tracking systems are critical for health workforce planning as well as for activities to ensure quality health care - such as physician regulation, education, and emergency response. However, information on current systems for physician tracking in sub-Saharan Africa is limited. The objective of this study is to provide information on the current state of physician tracking systems in the region, highlighting emerging themes and innovative practices. This study included a review of the literature, an online search for physician licensing systems, and a document review of publicly available physician registration forms for sub-Saharan African countries. Primary data on physician tracking activities was collected as part of the Medical Education Partnership Initiative (MEPI) - through two rounds over two years of annual surveys to 13 medical schools in 12 sub-Saharan countries. Two innovations were identified during two MEPI school site visits in Uganda and Ghana. Out of twelve countries, nine had existing frameworks for physician tracking through licensing requirements. Most countries collected basic demographic information: name, address, date of birth, nationality/citizenship, and training institution. Practice information was less frequently collected. The most frequently collected practice fields were specialty/degree and current title/position. Location of employment and name and sector of current employer were less frequently collected. Many medical schools are taking steps to implement graduate tracking systems. We also highlight two innovative practices: mobile technology access to physician registries in Uganda and MDNet, a public-private partnership providing free mobile-to-mobile voice and text messages to all doctors registered with the Ghana Medical Association. While physician tracking systems vary widely between countries and a number of challenges remain, there appears to be increasing interest in developing these systems and many
Lowenthal, Elizabeth D; Bakeera-Kitaka, Sabrina; Marukutira, Tafireyi; Chapman, Jennifer; Goldrath, Kathryn; Ferrand, Rashida A
Worldwide, more than three million children are infected with HIV, 90% of whom live in sub-Saharan Africa. As the HIV epidemic matures and antiretroviral treatment is scaled up, children with HIV are reaching adolescence in large numbers. The growing population of adolescents with perinatally acquired HIV infection living within this region presents not only unprecedented challenges but also opportunities to learn about the pathogenesis of HIV infection. In this Review, we discuss the changing epidemiology of paediatric HIV and the particular features of HIV infection in adolescents in sub-Saharan Africa. Longstanding HIV infection acquired when the immune system is not developed results in distinctive chronic clinical complications that cause severe morbidity. As well as dealing with chronic illness, HIV-infected adolescents have to confront psychosocial issues, maintain adherence to drugs, and learn to negotiate sexual relationships, while undergoing rapid physical and psychological development. Context-specific strategies for early identification of HIV infection in children and prompt linkage to care need to be developed. Clinical HIV care should integrate age-appropriate sexual and reproductive health and psychological, educational, and social services. Health-care workers will need to be trained to recognise and manage the needs of these young people so that the increasing numbers of children surviving to adolescence can access quality care beyond specialist services at low-level health-care facilities. Copyright © 2014 Elsevier Ltd. All rights reserved.
Asher, Alice K; Hahn, Judith A; Couture, Marie-Claude; Maher, Kelsey; Page, Kimberly
Dramatic rises in injection drug use (IDU) in sub-Saharan Africa account for increasingly more infections in a region already overwhelmed by the HIV epidemic. There is no known estimate of the number of people who inject drugs (PWID) in the region, or the associated HIV prevalence in PWID. We reviewed literature with the goal of describing high-risk practices and exposures in PWID in sub-Saharan Africa, as well as current HIV prevention activities aimed at drug use. The literature search looked for articles related to HIV risk, injection drug users, stigma, and HIV testing in sub-Saharan Africa. This review found evidence demonstrating high rates of HIV in IDU populations in sub-Saharan Africa, high-risk behaviors of the populations, lack of knowledge regarding HIV, and low HIV testing uptake. There is an urgent need for action to address IDU in order to maintain recent decreases in the spread of HIV in sub-Saharan Africa. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
van Hulst, Marinus; Smit Sibinga, Cees Th; Postma, Maarten J
Health economics provides a standardised methodology for valid comparisons of interventions in different fields of health care. This review discusses the health economic evaluations of strategies to enhance blood product safety in sub-Saharan Africa. We reviewed health economic methodology with special reference to cost-effectiveness analysis. We searched the literature for cost-effectiveness in blood product safety in sub-Saharan Africa. HIV-antibody screening in different settings in sub-Saharan Africa showed health gains and saved costs. Except for adding HIV-p24 screening, adding other tests such as nucleic acid amplification testing (NAT) to HIV-antibody screening displayed incremental cost-effectiveness ratios greater than the WHO/World Bank specified threshold for cost-effectiveness. The addition of HIV-p24 in combination with HCV antibody/antigen screening and multiplex (HBV, HCV and HIV) NAT in pools of 24 may also be cost-effective options for Ghana. From a health economic viewpoint, HIV-antibody screening should always be implemented in sub-Saharan Africa. The addition of HIV-p24 antigen screening, in combination with HCV antibody/antigen screening and multiplex (HBV, HCV and HIV) NAT in pools of 24 may be feasible options for Ghana. Suggestions for future health economic evaluations of blood transfusion safety interventions in sub-Saharan Africa are: mis-transfusion, laboratory quality and donor management. Copyright 2009 The International Association for Biologicals. Published by Elsevier Ltd. All rights reserved.
Naoussi , Claude Francis; Tripier , Fabien
This article explores the role of trend shocks in explaining the specificities of business cycles in Sub-Saharan African (SSA) countries using the methodology introduced by Aguiar and Gopinath (2007) [Emerging Market Business Cycles: The Cycle Is the Trend Journal of Political Economy 115(1)]. We specify a small open economy model with transitory and trend shocks on productivity to replicate the differences in the business cycle behavior of output and consumption across countries, especially ...
Full Text Available Africa belongs to the poorest regions of the world. This statement may be applied especially to its sub-Saharan part. The paper analyses some basic structural characteristics related to the economic development of sub-Saharan region. The article reveals existing differences between countries and regions of sub-Saharan Africa and analyses key problems which influence economic development of individual states. An emphasis is placed on analysing an unsuitable GDP structure and on external economic relations which affect this structure. Results of an investigation show that the GDP of sub-Saharan countries is to a large extend generated by the primary sector of their economies, which is dominant in the total GDP value and its position is continuously strengthening due to a high dynamics of its growth. Having regard to the external environment, there can be stated that the foreign trade has contributed to the GDP growth of the whole region only to a limited degree (this does not apply to all countries seen as individuals. The integration process in sub-Saharan Africa may be characterized as questionable. Many integration groupings are operating in the region, but their influence on economic growth is limited due a low potential for mutual cooperation based on specialisation and use of comparative advantages. The economies of sub-Saharan countries are very sensitive to changes in their external economic environment. In this regard, there is important to highlight the very strong sensitivity of the GDP in the sub-Saharan region in relation to the World GDP (mainly to European and US GDP because both regions belong to the most important trading partners of Africa as a whole.
Ichoku, H E; Ifelunini, A I
This article reviews the changing political undercurrent in health service delivery in Sub-Saharan Africa, chronicling the ideological shift in orientation toward neoliberalism in the health sector, an ideology crafted and introduced into Sub-Saharan Africa by the International Monetary Fund and the World Bank. The article examines the implication of this neoliberal reform on the efficiency in health care provision and on the quality and accessibility of health services by the poor and vulnerable. Drawing inference from countries like Nigeria, the authors argue that the ascendency of neoliberalism in the health systems of Sub-Saharan Africa has engendered unethical practices and introduced elements of moral hazard in the health sector, reducing the incentive for governments to develop effective service delivery over the long term. The authors therefore advocate for a rejection of neoliberal ideology in favor of a universal coverage principle if an inclusive health system is to be developed.
Olaniran, Abimbola A
Female genital mutilation (FGM) is an age-old practice that has since been linked with many health problems. This review aims to highlight some of the controversies trailing the relationship between FGM and HIV transmission in sub-Saharan Africa. A literature search was conducted on the subject matter. This was done using articles published in English while limiting the geographical coverage to sub-Saharan Africa. Three themes were noted. These themes include: Direct causal link between FGM and HIV transmission; indirect causal link between FGM and HIV transmission and a negative or no association between FGM and HIV transmission. While many of the arguments are within scientific reasoning, the researches supporting the views seem to lack the necessary objectivity. This study underscored the need for a more objective lens in viewing and conducting research on the relationship between FGM and HIV transmission in sub-Saharan Africa.
Sasipriya M Karumanchi
Full Text Available To begin to meet the need for cataract surgery in sub-Saharan Africa, the cataract surgical rate (CSR should be at least 2,000 to 3,000; i.e. there should be 2,000-3,000 cataract operations per million population, per year. The current levels are below 1,000 (and often much lower. Sub-Saharan Africa poses a unique set of challenges: low population density; inadequate transportation systems that inhibit access; big differences in wealth; and a shortage of eye care resources (which are usually concentrated in larger cities. Additional issues relate to productivity, the supply chain and the quality of outcomes, all of which contribute to the low cataract surgical rates. It is in this context that the Hilton Foundation sought to enhance cataract surgical services in sub-Saharan Africa, through the Hilton Cataract Initiative.
Kuada, John Ernest
Private Enterprise-Led Development in Sub-Saharan Africa provides a novel theoretical and conceptual model to guide research into Africa's economic development. It endorses the view that private enterprise-led growth will help reduce poverty since it strengthens individuals' capacity to care...
Austin, G.; Frankema, E.H.P.; Jerven, M.
This paper reviews the 'long twentieth-century' development of 'modern' manufacturing in Sub-Saharan Africa from colonization to the present. We argue that classifying Africa generically as a 'late industrializer' is inaccurate. To understand the distinctively African pattern of manufacturing
Austin, G.; Frankema, E.H.P.; Jerven, M.
This paper reviews the ‘long twentieth-century’ development of ‘modern’manufacturing in Sub-Saharan Africa from colonization to the present. We argue thatclassifying Africa generically as a ‘late industrializer’ is inaccurate. To understand thedistinctively African pattern of manufacturing growth,
Nielsen, Ulrik B.
In the past decade, Africa has developed from being an extremely impoverished continent with discouraging prospects to a more promising destination and home to some of the fastest growing Frontier Market economies. Approximately 75% of Africans rely on agriculture for their livelihoods, making...... to create growth opportunities in Frontier Markets of Sub-Saharan Africa....
Moock, Joyce Lewinger
Focuses on the impact of overseas training on national development objectives in Sub-Saharan Africa. Reviews the current economic crisis in Africa and the need for high-level, skilled workers. Examines the advantages and disadvantages of foreign study as a means of developing competent indigenous professionals. Notes pertinent research issues. (SB)
Narenda P. Sharma; Simon Reitbergen; Claude R. Heimo; Joti Patel
The note summarizes the findings of the Africa Forest Strategy Paper, which responded to the problems confronting forest resources in the Sub-Saharan Africa (SSA), providing a comprehensive overview, and analysis of the forest sector, and mapping a set of actions for consideration by African countries. The diagnosis highlights the nexus between rapid population growth, environmental degrad...
Wang, Y T; Meheš, M M; Naseem, H-R; Ibrahim, M; Butt, M A; Ahmed, N; Wahab Bin Adam, M A; Issah, A-W; Mohammed, I; Goldstein, S D; Cartwright, K; Abdullah, F
Inguinal hernia repair is the most common general surgery operation performed globally. However, the adoption of tension-free hernia repair with mesh has been limited in low-income settings, largely due to a lack of technical training and resources. The present study evaluates the impact of a 2-day training course instructing use of polypropylene mesh for inguinal hernia repair on the practice patterns of sub-Saharan African physicians. A surgical training course on tension-free mesh repair of hernias was provided to 16 physicians working in rural Ghanaian and Liberian hospitals. Three physicians were requested to prospectively record all their inguinal hernia surgeries, performed with or without mesh, during the 14-month period following the training. Demographic variables, diagnoses, and complications were collected by an independent data collector for mesh and non-mesh procedures. Surgery with mesh increased significantly following intervention, from near negligible levels prior to the training to 8.1 % of all inguinal hernia repairs afterwards. Mesh repair accounted for 90.8 % of recurrent hernia repairs and 2.9 % of primary hernia repairs after training. Overall complication rates between mesh and non-mesh procedures were not significantly different (p = 0.20). Three physicians who participated in an intensive education course were routinely using mesh for inguinal hernia repair 14 months after the training. This represents a significant change in practice pattern. Complication rates between patients who underwent inguinal hernia repairs with and without mesh were comparable. The present study provides evidence that short-term surgical training initiatives can have a substantial impact on local healthcare practice in resource-limited settings.
The personal value of being part of a Tropical Health Education Trust (THET) links programme to develop a palliative care degree programme in Sub Saharan Africa: a descriptive study of the views of volunteer UK health care professionals.
Jack, B A; Kirton, J A; Downing, J; Frame, K
There is a global need to expand palliative care services to reach the increasing number requiring end of life care. In developing countries where the incidences of cancer are rising there is an urgent need to develop the palliative care workforce. This paper reports on a UK Department for international development (DFID) initiative funded through the Tropical Health Education Trust (THET) where palliative care staff, both clinical and academic, volunteered to help to develop, support and deliver a degree in palliative care in sub-Saharan Africa. The objective of the study was to explore the personal impact on the health care professionals of being part of this initiative. An evaluation approach using a confidential electronic survey containing quantitative and qualitative questions was distributed to all 17 volunteers on the programme, three months after completion of the first cohort. Data were analysed using descriptive statistics and content thematic analysis. Ethical review deemed the study to be service evaluation. 82 % (14) responded and several themes emerged from the data including the positive impact on teaching and educational skills; clinical practice and finally personal development. Using a score of 1-10 (1-no impact, 10 maximum impact) 'Lifestyle choices - life work balance' (rating 7.83) had the most impact. This approach to supporting the development of palliative care in Sub-Saharan Africa through skill sharing in supporting the delivery of a degree programme in palliative care was successful in terms of delivery of the degree programme, material development and mentorship of local staff. Additionally, this study shows it provided a range of positive impacts on the volunteer health care professionals from the UK. Professional impacts including increased management skills, and being better prepared to undertake a senior role. However it is the personal impact including lifestyle choices which the volunteers reported as the highest impact
Deaton, Angus S.; Tortora, Robert
The health of people in sub-Saharan Africa is a major global concern. However, data are weak, and little is known about how people in the region perceive their health or their health care. We used data from the Gallup World Poll in 2012 to document sub-Saharan Africans’ perceived health status, their satisfaction with health care, their contact with medical professionals, and the priority they attach to health care. In comparison to other regions of the world, sub-Saharan Africa has the lowest ratings for well-being and the lowest satisfaction with health care. It also has the second lowest perception of personal health, after only the former Soviet Union and its satellites. HIV prevalence is positively correlated with perceived improvements in health care in countries with high prevalence. This is consistent with an improvement in at least some health care services as a result of the largely aid-funded rollout of antiretroviral treatment. Even so, sub-Saharan Africans do not prioritize health care as a matter of policy, although donors are increasingly shifting their aid efforts in sub-Saharan Africa toward health. PMID:25715657
Brockerhoff, M; Hewett, P
Accounts by journalists of wars in several countries of sub-Saharan Africa in the 1990s have raised concern that ethnic cleavages and overlapping religious and racial affiliations may widen the inequalities in health and survival among ethnic groups throughout the region, particularly among children. Paradoxically, there has been no systematic examination of ethnic inequality in child survival chances across countries in the region. This paper uses survey data collected in the 1990s in 11 countries (Central African Republic, Côte d'Ivoire, Ghana, Kenya, Mali, Namibia, Niger, Rwanda, Senegal, Uganda, and Zambia) to examine whether ethnic inequality in child mortality has been present and spreading in sub-Saharan Africa since the 1980s. The focus was on one or two groups in each country which may have experienced distinct child health and survival chances, compared to the rest of the national population, as a result of their geographical location. The factors examined to explain potential child survival inequalities among ethnic groups included residence in the largest city, household economic conditions, educational attainment and nutritional status of the mothers, use of modern maternal and child health services including immunization, and patterns of fertility and migration. The results show remarkable consistency. In all 11 countries there were significant differentials between ethnic groups in the odds of dying during infancy or before the age of 5 years. Multivariate analysis shows that ethnic child mortality differences are closely linked with economic inequality in many countries, and perhaps with differential use of child health services in countries of the Sahel region. Strong and consistent results in this study support placing the notion of ethnicity at the forefront of theories and analyses of child mortality in Africa which incorporate social, and not purely epidemiological, considerations. Moreover, the typical advantage of relatively small, clearly
Sarfo, Fred S; Adamu, Sheila; Awuah, Dominic; Ovbiagele, Bruce
The rapid advancement in telecommunications on the African continent has opened up avenues for improving medical care to underserved populations. Although the greatest burden of neurological disorders is borne by Low-and-Middle Income Countries (LMICs) including sub-Saharan Africa (SSA), there is a profound paucity of neurologists to serve the population. Telemedicine presents a promising avenue for effective mobilization and utilization of the few neurologists in Africa. To systematically review the published literature on the use of telemedicine for improved care and outcomes for patients with neurological disorders in SSA. We searched PubMed and Cochrane library from January 1, 1980 to April 30, 2017 using the following keywords: "Telemedicine neurology Africa", "Teleneurology Africa", "Telestroke Africa", "Telerehabilitation Africa", "Telemedicine for epilepsy", "Telemedicine for Parkinson's disease Africa", "Telemedicine for dementia Africa", "Telehealth neurology Africa". Our inclusion criteria were randomized controlled trials, or case series that reported the utilization of telemedicine for care/education of individuals with neurological disorders in sub-Saharan Africa. This search yielded 6 abstracts. By consensus between two investigators, 1 publication met the criteria for inclusion and further review. The one study identified utilized telemedicine for the purpose of improving education/knowledge of 16 doctors and 17 allied health professionals in Parkinson's disease (PD) in Cameroon. The study noted feasibility and satisfaction of participants with telemedicine as well as improved knowledge base of participants after the educational course but noted access to healthcare by patients did not change. No studies have evaluated the use of telemedicine for care of patients with neurological disorders. The indication is that teleneurology may be feasible in SSA and studies are needed to assess feasibility, acceptability, efficacy, cost-effectiveness of this
The skill set of a plastic surgeon, which addresses a broad range of soft tissue conditions that are prevalent in sub-Saharan Africa, remains relevant in the unmet need for surgical care. Recently, there has being a major paradigm shift from discipline-based to disease-based care, resulting in an emerging component of patient-centered care; adequate access to subspecialty care in plastic and reconstructive surgery. Given the need for an evolution in sub-specialization, this article focuses on the benefits and future role of differentiation of plastic surgeons into sub-specialty training pathways in sub-Saharan Africa. PMID:25584125
Chisumpa, Vesper H.; Odimegwu, Clifford O.; De Wet, Nicole
Place of death remains an issue of growing interest and debate among scholars as an indicator of quality of end-of-life care in developed countries. In sub-Saharan Africa, however, variations in place of death may suggest inequalities in access to and the utilization of health care services that should be addressed by public health interventions. Limited research exists on factors associated with place of death in sub-Saharan Africa. The study examines factors associated with the place of dea...
Mboumba Bouassa, Ralph-Sydney; Prazuck, Thierry; Lethu, Thérèse; Jenabian, Mohammad-Ali; Meye, Jean-François; Bélec, Laurent
Infections caused by high-risk human papillomavirus (HPV) are responsible for 7.7% of cancers in developing countries, mainly cervical cancer. This disease is steadily increasing in sub-Saharan Africa, with more than 75,000 new cases and 50,000 deaths yearly, further increased by HIV infection. Areas covered: The current status of cervical cancer associated with HPV in sub-Saharan Africa has been systematically revised. The main issues discussed here are related to the public health burden of cervical cancer in sub-Saharan Africa and predictions for the coming decades, including molecular epidemiology and determinants of HPV infection in Africa, and promising prevention measures currently being evaluated in Africa. Expert commentary: By the year 2030, cervical cancer will kill more than 443,000 women yearly worldwide, most of them in sub-Saharan Africa. The increase in the incidence of cervical cancer in Africa could counteract the progress made by African women in reducing maternal mortality and longevity. Nevertheless, cervical cancer is a potentially preventable noncommunicable disease, and intervention strategies to eliminate cervical cancer as a public health concern should be urgently implemented.
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
Barofsky, Jeremy; Anekwe, Tobenna D; Chase, Claire
This study evaluates the economic consequences of a 1959-1960 malaria eradication campaign in southwestern Uganda. The effort constitutes a rare, large-scale, and well-documented attempt to eliminate malaria in sub-Saharan Africa and produced an immediate disease reduction. We use this quasi-experimental health shock to identify long-term changes in educational and economic outcomes. Comparing the treatment district to a similar synthetic control, we find malaria eradication raised educational attainment by about a half year for both males and females, increased primary school completion among females and generated an almost 40% rise in the likelihood of male wage employment. Copyright © 2015 Elsevier B.V. All rights reserved.
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.
Mavhungu Abel Mafukata
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 corrupt...
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.
Busby, George BJ; Band, Gavin; Si Le, Quang; Jallow, Muminatou; Bougama, Edith; Mangano, Valentina D; Amenga-Etego, Lucas N; Enimil, Anthony; Apinjoh, Tobias; Ndila, Carolyne M; Manjurano, Alphaxard; Nyirongo, Vysaul; Doumba, Ogobara; Rockett, Kirk A; Kwiatkowski, Dominic P; Spencer, Chris CA
Similarity between two individuals in the combination of genetic markers along their chromosomes indicates shared ancestry and can be used to identify historical connections between different population groups due to admixture. We use a genome-wide, haplotype-based, analysis to characterise the structure of genetic diversity and gene-flow in a collection of 48 sub-Saharan African groups. We show that coastal populations experienced an influx of Eurasian haplotypes over the last 7000 years, and that Eastern and Southern Niger-Congo speaking groups share ancestry with Central West Africans as a result of recent population expansions. In fact, most sub-Saharan populations share ancestry with groups from outside of their current geographic region as a result of gene-flow within the last 4000 years. Our in-depth analysis provides insight into haplotype sharing across different ethno-linguistic groups and the recent movement of alleles into new environments, both of which are relevant to studies of genetic epidemiology. DOI: http://dx.doi.org/10.7554/eLife.15266.001 PMID:27324836
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;
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.
Phillips, Sharon J; Mbizvo, Michael T
The need to prevent early pregnancy and HIV among adolescent girls in Sub-Saharan Africa has been recognized increasingly over recent years. Although extensive work has been done to determine appropriate interventions for girls in high-income countries, very little evidence is available to guide programmatic interventions in Sub-Saharan Africa. The available evidence has been equivocal regarding improved outcomes. While knowledge and self-reported behaviors frequently change with interventions, including those performed at the community level, educational programs, and direct contraceptive provision, downstream outcomes rarely reflect a significant effect of the interventions; however, provision of financial or other interventions to incentivize continued school enrollment are a promising development. We suggest directions for future research to fill this critical gap in the literature. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Ekouevi, K; Adepoju, A
This discussion concludes that the economic crises of the 1980s resulted in a halt to the social and economic development of sub-Saharan Africa. Employment, health, and education sectors all deteriorated under structural adjustment programs (SAPs) and poor economic performance. SAPs are considered inadequate solutions to long-term problems. Economic crises were found to affect countries differently in their demographic impact. Delayed demographic transition occurred both through economic development as a prerequisite and as a result of poor economic development. Case studies of each country are considered the appropriate geographic unit of analysis of demographic change rather than regional or comparative studies. The economic crises in sub-Saharan Africa occurred due to both external (commodity prices, high real interest rates, and decreasing net capital flows) and internal distortions (strategies of development such as import substitution, neglect of the agricultural sector, and government control of prices and trade). The unfavorable external context reduced export prices and earnings while increasing the costs of imports. Internal controls were detrimental to farmers. During the 1970s and 1980s African countries experienced declines in both the volume and value of exports, increases in import volume, and imbalances in the balance of payments. Large domestic borrowing and foreign borrowing was done by governments, which was at the expense of the private sector. Economic management and corruption were rampant. SAPs restrained demand, reduced public expenditures, adjusted exchange rates, contracted the size of the public sector, liberalized trade, deregulated the interest rate, stimulated domestic production, and used market forces for balancing optimum allocation of resources. SAPs were the fix for trade imbalances and government debt. Development was slowed or stopped. During 1980-87 spending on health care, education, and infrastructure was drastically reduced
Banda, H; Robinson, R; Thomson, R; Squire, S B; Mortimer, K
There is a high burden of respiratory disease in sub-Saharan Africa. To address this problem, the World Health Organization launched the 'Practical approach to Lung Health' (PAL), i.e., locally applicable integrated syndromic algorithms, to improve primary care management of these diseases. To examine the evidence for the impact of PAL on the diagnosis and management of tuberculosis (TB) and other common respiratory problems in sub-Saharan Africa. A systematic review of MEDLINE (1998-2015), EMBASE (1998-2015) and CINAHL (1998-2015) was conducted to find trials evaluating PAL implementation in sub-Saharan Africa. Five studies were found, evaluating three PAL variations: PAL in South Africa (PALSA), PALSA with integrated human immunodeficiency virus treatment (PALSA PLUS) and PAL in Malawi using lay health workers (PALM/LHW). PALSA increased TB diagnosis (OR 1.72, 95%CI 1.04-2.85), as did PALSA PLUS (OR 1.25, 95%CI 1.01-1.55). Cure or completion rates in retreatment cases in PALSA and PALSA PLUS were significantly improved (OR 1.78, 95%CI 1.13-2.76). PALM/LHW, which examined TB treatment success, found no significant improvement (P = 0.578). The limited research performed shows that PAL can be effective in TB diagnosis and partial treatment success; however, more evidence is needed to assess its effects on other respiratory diseases, especially in wider sub-Saharan Africa.
Schlag, Nicolai; Zuzarte, Fiona
In the developing nations of sub-Saharan Africa, providing households with modern energy services is a critical step towards development. A large majority of households in the region rely on traditional biomass fuels for cooking, which represent a significant proportion of energy used in the domestic setting. The disadvantages of these fuels are many: they are inefficient energy carriers and their heat is difficult to control; they produce dangerous emissions; and their current rate of extraction is not sustainable for forests. Transition to clean cooking fuels such as liquefied petroleum gas (LPG) or ethanol would resolve many of these issues as they do not produce dangerous particulate emissions, and are commercially viable, offering a number of socio-economic advantages over traditional options. Despite the benefits of fuel switching, clean cooking fuels are rarely used in households in sub-Saharan Africa. Their failure to attain widespread use can be attributed to a number of market barriers. One of the major issues is cost: clean cooking fuels are prohibitively expensive for many households, and the high price of compatible stoves further discourages their use. Besides the expense, many consumers are hesitant to adopt the new technology, reflecting the lack of public awareness of the relevant issues. At the same time, Africa's underdeveloped infrastructure prevents these fuels from being made available in many local marketplaces. To date, this combination of factors has largely stifled the transition to clean cooking fuels. National governments can adopt a number of strategies to address these issues. The creation of clean cooking-fuel initiatives at the national level would be an important first step, after which governments can begin to address the issues more effectively. The introduction of relevant financial instruments would help to tackle the economic barriers to clean cooking fuels, and public outreach and education could overcome socio
Bakare, Muideen O.; Munir, Kerim M.; Bello-Mojeed, Mashudat A.
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...
The author reviews trends in rural electrification over the past 30 years in Sub-Saharan Africa. In particular, it is shown that motivations for rural electrification programs have evolved significantly over the years, following changes in development paradigms. The author finds, however, that knowledge of the impact of this has only marginally improved: low connection rates and weak productive utilization identified in the 1980's remain true today, and impacts on such dimensions as health, education, or income, though often used to justify projects, are largely undocumented. Indeed impact evaluations are methodologically challenging in the field of infrastructures and have been limited thus far. Nevertheless examples of recent or ongoing impact evaluations of rural electrification programs offer promising avenues for identifying both the effect of electricity per se and the relative effectiveness of approaches to promoting it
Asamoah-Akuoko, Lucy; Hassall, Oliver W; Bates, Imelda; Ullum, Henrik
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 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, culturally sensitive education, recruitment and retention strategies to improve the blood supply in SSA. © 2017 John Wiley & Sons Ltd.
English, Mike; English, Rex; English, Atti
Sub-Saharan Africa is a highly diverse geo-political region. Any brief discussion of the progress made over the last 15 years towards the Millennium Development Goals (MDGs) will therefore not do justice to the true complexity of context and events. Our focus will be MDG4-to reduce child mortality by 66% from 1990 levels. We will touch briefly on MDG1, to eradicate extreme poverty and hunger, MDG2, to achieve universal primary education, and MDG5, to improve maternal health, which are inextricably linked with child well-being. We will also draw on an eclectic mix of additional global indicators. Acknowledging the limitations of this approach, we first offer a summary of expected progress and then point to debates on future goals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
English, Mike; English, Rex; English, Atti
Sub-Saharan Africa is a highly diverse geo-political region. Any brief discussion of the progress made over the last 15 years towards the Millennium Development Goals (MDGs) will therefore not do justice to the true complexity of context and events. Our focus will be MDG4—to reduce child mortality by 66% from 1990 levels. We will touch briefly on MDG1, to eradicate extreme poverty and hunger, MDG2, to achieve universal primary education, and MDG5, to improve maternal health, which are inextricably linked with child well-being. We will also draw on an eclectic mix of additional global indicators. Acknowledging the limitations of this approach, we first offer a summary of expected progress and then point to debates on future goals. PMID:25613971
Melito, Thomas; Thomas, Phillip J; Bray, Carol; Chen, Ming; Chung, Debbie; De Alteriis, Martin; DeWolf, Leah; Dowling, Mark; Finkler, Etana; Hudson Acknowledgments, Melinda
.... The gap between the average grain yield in sub- Saharan Africa compared with the rest of the world's developing countries has widened over the years, and, by 2006, the yield in sub-Saharan Africa...
HIV prevalence data and published indices on wealth, fertility, and governmental corruption were correlated using statistical software. The high prevalence of HIV in Southern sub-Saharan Africa is not explained by the unusual prevalence of subtype-C HIV infection. Many host factors contribute to HIV prevalence, including ...
Voeten, Hélène A C M; Vissers, Debby C J; Gregson, Simon; Zaba, Basia; White, Richard G; de Vlas, Sake J; Habbema, J Dik F
Enormous variation exists in HIV prevalence between countries in sub-Saharan Africa. The contribution of migration to the spread of HIV has long been recognized, but its effect at the population level has never been assessed. In this ecological analysis, we explore how much variation in HIV prevalence in urban sub-Saharan Africa is explained by in-migration. We performed a linear regression to analyze the association between the proportion of recent in-migrants and HIV prevalence for men and women in urban areas, using 60 data points from 28 sub-Saharan African countries between 1987 and 2005. We found a strong association between recent in-migration and HIV prevalence for women (Pearson R = 57%, P Africa (R = 50%, P = 0.003). For both genders, the association was strongest between 1985 and 1994, slightly weaker between 1995 and 1999, and nonexistent as from 2000. The overall association for both men and women was not confounded by the developmental indicators GNI per capita, income inequalities, or adult literacy. Migration explains much of the variation in HIV spread in urban areas of sub-Saharan Africa, especially before the year 2000, after which HIV prevalences started to level off in many countries. Our findings suggest that migration is an important factor in the spread of HIV, especially in rapidly increasing epidemics. This may be of relevance to the current HIV epidemics in China and India.
N. Awortwi (Nicholas); A.H.J. Helmsing (Bert)
textabstractDuring 1970 to mid 1980s, governments’ policies on basic services in sub-Saharan Africa (SSA) had an almost exclusive focus on directly provided, publicly-funded. This approach coupled with disintegration of the economic structures resulted in steep decline in people’s access to basic
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
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
There has been an unprecedented interest in reforming pedagogical practices in sub-Saharan Africa in the past two decades. The reform efforts are often characterised by a move away from teacher-centred instruction to child-centred pedagogy (CCP). Uganda has been no exception to this trend as the new
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 report presents findings, and the way forward in respect of the Knowledge and Research (KAR) Project on vehicle operations in Sub-Saharan Africa, basically undertaken in Uganda and Ghana. In the first phase, the study identified problems faced by transport operators in both countries, and analyzed their impact on vehicle operating costs, as well as examining transport regulations, and ...
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 lite...
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
Amoah, Abena S.; Boakye, Daniel A.; Yazdanbakhsh, Maria; van Ree, Ronald
Epidemiological studies from Sub-Saharan Africa indicate that allergies are on the rise in this region especially in urban compared to rural areas. This increase has been linked to improved hygiene, lifestyle changes, and lower exposure to pathogens in childhood. Reduced exposure to parasitic worm
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…
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
van Hulst, Marinus; Smit Sibinga, Cees Th. Smit; Postma, Maarten J.
Background and objectives. Health economics provides a standardised methodology for valid comparisons of interventions in different fields of health care. This review discusses the health economic evaluations of strategies to enhance blood product safety in sub-Saharan Africa Methods. We reviewed
The past decade has witnessed an unparalleled expansion of access to antiretroviral treatment for people living with HIV/AIDS in sub-Saharan Africa. This historic public health achievement has saved the lives and improved the well-being of millions of people. Concern has been raised about rising
Turkson, J.K.; Wohlgemuth, N.
As part of the current liberalisation process sweeping sub-Saharan Africa, power sectors across the region are being scrutinised and restructured. A critical aspect of the reform is improving access to electricity by large segments of the population. Many in the continent are, therefore,looking a......As part of the current liberalisation process sweeping sub-Saharan Africa, power sectors across the region are being scrutinised and restructured. A critical aspect of the reform is improving access to electricity by large segments of the population. Many in the continent are, therefore......, on average, 30-40 per cent of the region's population, the authors discuss the issues involved, drawing on the experiences of other countries whether there are any apparent 'preconditions' for success. Second, the role renewable energy can play in this process and the extent to which lessons from other parts...... of the world might be transferable to the countries of sub-Saharan Africa is assessed. The paper concludes by investigating the prospects for distributed generation in power sector reform in sub-Saharan Africa, arguing that though lessons from other parts of the world will be helpful, they cannot be all...
Aterido, R.; Beck, T.H.L.; Lacovone, L.
We show the existence of an unconditional gender gap in Sub-Saharan Africa. However, when key observable characteristics of the enterprises or individuals are taken into account the gender gap disappears. In the case of enterprises, we explain our finding with differences in key characteristics and
The International Maize and Wheat Improvement Center (CIMMYT), in collaboration with public and private partners, is working on developing and disseminating drought tolerant maize for sub Saharan Africa (SSA) using pedigree selection and molecular breeding. In this paper, we provide an overview of ...
Spearman, C Wendy; Afihene, Mary; Ally, Reidwaan; Apica, Betty; Awuku, Yaw; Cunha, Lina; Dusheiko, Geoffrey; Gogela, Neliswa; Kassianides, Chris; Kew, Michael; Lam, Philip; Lesi, Olufunmilayo; Lohouès-Kouacou, Marie-Jeanne; Mbaye, Papa Saliou; Musabeyezu, Emmanuel; Musau, Betty; Ojo, Olusegun; Rwegasha, John; Scholz, Barbara; Shewaye, Abate B; Tzeuton, Christian; Sonderup, Mark W
The WHO global health sector strategy on viral hepatitis, created in May, 2016, aims to achieve a 90% reduction in new cases of chronic hepatitis B and C and a 65% reduction in mortality due to hepatitis B and C by 2030. Hepatitis B virus (HBV) is endemic in sub-Saharan Africa, and despite the introduction of universal hepatitis B vaccination and effective antiviral therapy, the estimated overall seroprevalence of hepatitis B surface antigen remains high at 6·1% (95% uncertainty interval 4·6-8·5). In this Series paper, we have reviewed the literature to examine the epidemiology, burden of liver disease, and elimination strategies of hepatitis B in sub-Saharan Africa. This paper reflects a supranational perspective of sub-Saharan Africa, and recommends several priority elimination strategies that address the need both to prevent new infections and to diagnose and treat chronic infections. The key to achieving these elimination goals in sub-Saharan Africa is the effective prevention of new infections via universal implementation of the HBV birth-dose vaccine, full vaccine coverage, access to affordable diagnostics to identify HBV-infected individuals, and to enable linkage to care and antiviral therapy. Copyright © 2017 Elsevier Ltd. All rights reserved.
Moon, Bob; Villet, Charmaine
Sub-Saharan Africa, more than any other part of the world, is experiencing a crisis in finding sufficiently qualified teachers to meet the needs of expanding school systems. The professional development support provided to serving teachers is also inadequate in most countries. The most recent data on learner outcomes has revealed a worrying…
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.
Peptic ulcer disease is a significant cause of morbidity and mortality worldwide, with a significant burden in low- and middle-income countries. However, there is limited information regarding management of peptic ulcer disease in these countries. This study describes surgical interventions for peptic ulcer disease in sub-Saharan Africa. A systematic review was performed using PubMed, EMBASE, and African Index Medicus for studies describing surgical management of peptic ulcer disease in sub-Saharan Africa. From 55 published reports, 6594 patients underwent surgery for peptic ulcer disease. Most ulcers (86%) were duodenal with the remainder gastric (14%). Thirty-five percent of operations were performed for perforation, 7% for bleeding, 30% for obstruction, and 28% for chronic disease. Common operations included vagotomy (60%) and primary repair (31%). The overall case fatality rate for peptic ulcer disease was 5.7% and varied with indication for operation: 13.6% for perforation, 11.5% for bleeding, 0.5% for obstruction, and 0.3% for chronic disease. Peptic ulcer disease remains a significant indication for surgery in sub-Saharan Africa. Recognizing the continued role of surgery for peptic ulcer disease in sub-Saharan Africa is important for strengthening surgical training programs and optimizing allocation of resources.
Sub-Saharan Africa has one of the highest incidences of infection with HIV globally, but more people in this region are living longer owing to increased access to antiretroviral therapy. However, along with increased care and treatment, this population is expected to have an increase in HIV-associated cancers, as is being ...
Background: In Sub-Saharan Africa, the fight against tuberculosis (TB) has encountered a great challenge because of the emergence of drug resistant TB strains and the high prevalence of HIV infection. The aim of this meta-analysis was to determine the association of drug-resistant TB with anti-TB drug treatment history ...
Climate change is projected to adversely impact different parts of the world to varying extents. Preliminary studies show that Sub-Saharan Africa is particularly vulnerable to climate change impacts, including changes to precipitation levels and temperatures. This work will analyse the effect of changes in temperature on critical systems such as energy supply and demand. Factors that determine energy demand include income, population, temperature (represented by cooling and heating degree days), and household structures. With many countries in Sub-Saharan Africa projected to experience rapid growth in both income and population levels, this study aims to quantify the amplified effects of these factors - coupled with temperature changes - on energy demand. The temperature effects will be studied across a range of scenarios for each of the factors mentioned above, and identify which of the factors is likely to have the most significant impact on energy demand in Sub-Saharan Africa. Results of this study can help set priorities for decision-makers to enhance the climate resilience of critical infrastructure in Sub-Saharan Africa.
Cleaver, Kevin; Schreiber, Gotz
Over the past thirty years, most of Sub-Saharan Africa has seen rapid population growth, poor agricultural performance, and increasing environmental degradation. Why do these problems seem so intractable? Are they connected? Do they reinforce each other? If so, what are the critical links? This book tests the hypothesis that these phenomena are strongly interrelated. The finding - that thi...
Huth, M J
Population projections for nine Sub-Saharan African countries (excluding southern Africa) are reviewed for the period to the year 2020. Consideration is given to the determinants of fertility and to the consequences of rapid population growth. Suggestions for population policies that will resolve population-related development problems are discussed.
Improving Labour Market Outcomes for the Poor in Sub-Saharan Africa. African economies are finally experiencing a period of high economic growth, speeding up the slow transition from agriculture to manufacturing. Nonetheless, the share of agriculture in the region's economies continues to be higher than in any other ...
Hofwegen, van G.; Becx, G.A.; Broek, van den J.A.; Koning, N.B.J.
Sub-Saharan Africa is trapped in a complex unsustainability spiral with demographic, biophysical, technical and socio-political dimensions. Unravelling the spiral is vital to perceive which policy actions are needed to reverse it and initiate sustainable pro-poor growth. The article presents an
Haan, de L.J.; Ton, P.
This review of Dutch research on environmental issues in sub-Saharan Africa is based on an inventory of some 80 research programmes carried out in the Netherlands during the 1990s. An analysis of the research themes indicates that most of the research concentrates on the exploitation of natural
Beaudoin, Michael F.
Many countries identified with the developing world, such as those in sub-Saharan Africa, have been recipients of aid programs over the past five decades totaling billions of dollars and aimed at fostering social and economic development to achieve global parity with the industrialized world. Much of this activity has been focused on building…
Impact of China on sub-Saharan Africa : Country Case Studies. China is emerging as a major power in the global economy. The broad-based nature of its industrial development has generated a sustained and high demand for oil and raw materials, a significant reason for the current strength of oil and other commodity ...
Ward, P.S.; Florax, R.J.G.M.; Flores-Lagunes, A.
Using spatially explicit data, we estimate a cereal yield response function using a recently developed estimator for spatial error models when endogenous sample selection is of concern. Our results suggest that yields across Sub-Saharan Africa will decline with projected climatic changes, and that
Background: Sino - nasal surgery poses a great challenge to practicing ear, nose and throat surgeons in the sub- Saharan Africa where facilities are inadequate and most patients are distantly located from the few hospitals available in this region. Method: A retrospective study of 79 patients who had nasal and paranasal ...
Jamin, J.Y.; Andriesse, W.; Thiombiano, L.; Windmeijer, P.N.
These proceedings are an account of an international workshop in support of research strategy development for the Inland Valley Consortium in sub-Saharan Africa. This consortium aims at concerted research planning for rice-based cropping systems in the lower parts of inland valleys. The Consortium
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
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
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.
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 reviews the legal and policy context of HIV disclosure in sub-Saharan Africa, as well as what is known about rates, consequences and social context of disclosure, with special attention to gender issues and the role of health services. Persistent rates of nondisclosure by those diagnosed with HIV raise difficult ...
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…
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.…
Cross-sectional and repeated surveys from household components of Demographic and Health Surveys in sub-Saharan Africa were examined to determine whether household composition indicators for older adults (N = 52,573), involving offspring and grandchildren, correlated with national levels of AIDS mortality. One in 4 was living with a grandchild…
Hamers, Raph L.; Derdelinckx, Inge; van Vugt, Michèle; Stevens, Wendy; Rinke de Wit, Tobias F.; Schuurman, Rob
Access to highly active antiretroviral therapy (HAART) for persons infected with HIV in sub-Saharan Africa has greatly improved over the past few years. However, data on long-term clinical outcomes of Africans receiving HAART, patterns of HIV resistance to antiretroviral drugs and implications of
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
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
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
View Point: Economic growth and child health in Sub Saharan Africa. BA O'Hare, N Bar-Zeev, L Chiwaula. Abstract. After independence most African countries witnessed growth in their economies and decreases in child mortality. However both economic growth and the gains in under 5 mortality slowed dramatically in the ...
Onywera, Vincent O; Blanchard, Claire
Road traffic injuries (RTIs) continue to be a major cause of death and disability throughout low- and middle-income countries (LMICs). The aim of this commentary is highlight some of the major causes of RTIs in sub-Saharan Africa and suggests strategies for better road safety as well as suggestions on how to reduce road accidents in LMICs.
Franke, A.C.; Brand, van den G.J.; Vanlauwe, B.; Giller, K.E.
We conducted a systematic review of literature on the residual effects of grain legumes in cereal-based systems of sub-Saharan Africa (SSA) to quantify the magnitude and variability of rotational effects, to explore the importance of environmental and management factors in determining variability
Knowledge of HIV and AIDS in women in sub-Saharan Africa. Amy D. Burgoyne and Peter D. Drummond. ABSTRACT. Although most African people have heard of HIV and AIDS, there is still widespread misunderstanding about how HIV is spread, the consequences of infection, and how to protect against infection.
Major, Rebecca; Ege, Ergen
In Sub-Saharan Africa, the energy sector should theoretically enjoy the high economic growth rate that applies to the whole of the continent. But in reality prospects are affected by such obstacles as political and legal instability, as well as the drop in oil prices. (authors)
Altinyelken, Hulya K.
There has been an unprecedented interest in reforming pedagogical practices in sub-Saharan Africa in the past two decades. The reform efforts are often characterised by a move away from teacher-centred instruction to child-centred pedagogy (CCP). Uganda has been no exception to this trend as the new curriculum adopted the principles of CCP and…
Our findings emphasise the necessity of creating regional-specific interventions and prevention campaigns to address multilevel factors such as family disruption as well as the need for governments to address issues of unemployment, poverty and inequality. Keywords: Teenage pregnancy, sub-Saharan Africa, multilevel ...
Gerrits, G.J.E.; Slager, E.
Infertility treatments, including the use of advanced reproductive technologies (ARTs), are nowadays provided at several places in sub-Saharan Africa. This article, which is based on a review of (scarce) social science studies, gives insight into the way biomedical infertility care is provided,
Introduction The purpose of this database is to list all the taxonomic publications on this Superfamily in Sub-Saharan Africa until the year 2000. It is also intended to give an indication of the kind of information contained in each paper. No attempt has been made to change or criticise what
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.
Bildung in der Struktur Sozio-oekonomisher Entwicklung: Eine Analyse von Laengsschnittsdaten aus Afrika suedlich der Sahara (Education in the Structure of Socioeconomic Development: An Analysis of Longitudinal Data from Sub-Saharan Africa).
Examines development indicators from 1960 to 1984 for 38 sub-Saharan African countries to determine whether education is an independent factor in development. Concludes that development indicators are determined by factors including basic education; urbanization; pupil-teacher ratio; standard of living; economic growth; service sector; food…
Inequality in outcomes for adolescents living with perinatally acquired HIV in sub-Saharan Africa: a Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Cohort Collaboration analysis.
Eighty percent of adolescents living with perinatally and behaviourally acquired HIV live in sub-Saharan Africa (SSA), a continent with marked economic inequality. As part of our global project describing adolescents living with perinatally acquired HIV (APH), we aimed to assess whether inequality in outcomes exists by country income group (CIG) for APH within SSA. Through the CIPHER cohort collaboration, individual retrospective data from 7 networks and 25 countries in SSA were included. APH were included if they entered care at age 10 years. World Bank CIG classification for median year of first visit was used. Cumulative incidence of mortality, transfer-out and loss-to-follow-up was calculated by competing risks analysis. Mortality was compared across CIG by Cox proportional hazards models. A total of 30,296 APH were included; 50.9% were female and 75.7% were resident in low-income countries (LIC). Median [interquartile range (IQR)] age at antiretroviral therapy (ART) start was 8.1 [6.3; 9.5], 7.8 [6.2; 9.3] and 7.3 [5.2; 8.9] years in LIC, lower-middle income countries (LMIC) and upper-middle income countries (UMIC) respectively. Median age at last follow-up was 12.1 [10.9; 13.8] years, with no difference between CIG. Cumulative incidence (95% CI) for mortality between age 10 and 15 years was lowest in UMIC (1.1% (0.8; 1.4)) compared to LIC (3.5% (3.1; 3.8)) and LMIC (3.9% (2.7; 5.4)). Loss-to-follow-up was highest in UMIC (14.0% (12.9; 15.3)) compared to LIC (13.1% (12.4; 13.8)) and LMIC (8.3% (6.3; 10.6)). Adjusted mortality hazard ratios (95% CI) for APH in LIC and LMIC in reference to UMIC were 2.50 (1.85; 3.37) and 2.96 (1.90; 4.61) respectively, with little difference when restricted only to APH who ever received ART. In adjusted analyses mortality was similar for male and female APH. Results highlight probable inequality in mortality according to CIG in SSA even when ART was received. These findings highlight that without attention towards SDG 10 (to
Flinkenflögel, Maaike; Essuman, Akye; Chege, Patrick; Ayankogbe, Olayinka; De Maeseneer, Jan
Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. To explore the extent to which the Primafamed South-South cooperative project contributed to the development of family medicine in sub-Saharan Africa. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South-South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels. © The Author 2014. Published by Oxford University Press.
Flinkenflögel, Maaike; Essuman, Akye; Chege, Patrick; Ayankogbe, Olayinka; De Maeseneer, Jan
Background. Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. Objective. To explore the extent to which the Primafamed South–South cooperative project contributed to the development of family medicine in sub-Saharan Africa. Methods. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. Results. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. Conclusions. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South–South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels. PMID:24857843
Herman van der Elst
Full Text Available Despite isolated progress there seems to be no clear-cut guideline or solution to the collective eradication of extreme poverty in sub-Saharan Africa. In an attempt to overcome the above reality, the objective of the Millennium Development Goals (MDGs is short term poverty relief to the poorest of the poor by 2015. This is to be achieved through the realisation of eight pro-poor objectives. Since 2000 there has been notable progress. Developmental organisations such as the World Bank, the International Monetary Fund (IMF and the Freedom House Index project that global poverty will have been reduced to below fifteen per cent by 2015. The MDGs can, however, currently only be perceived as partially effective because poverty relief remains restricted to mainly Latin America and South and South East Asia. This partial success is substantiated by the reality that the majority of states in sub-Saharan Africa remains subjected to a cycle of extreme poverty, which seems impossible to overcome. There is consensus amongst many researchers that none of the MDGs will be achieved in this region by 2015. This article aims to critically analyse the nature, objectives and progress of the MDGs as a global developmental paradigm shift. In order to explore future trends and identify potential solutions, an emphasis is, however, placed on the possible reasons for the slow progress of the MDGs, specifically in sub-Saharan Africa. Keywords: Global paradigm shift, new conditionality, extreme poverty, poverty eradication, sub-Saharan Africa, foreign aid, deprivation hypothesis, weak governance, free-market approach and the poverty trap Disciplines: International relations, law, political economy, politics, environmental studies, water studies, communication studies, public management and governance, education, sociology, anthropology and history.
Mwai, Grace W; Mburu, Gitau; Torpey, Kwasi; Frost, Peter; Ford, Nathan; Seeley, Janet
Introduction The provision of HIV treatment and care in sub-Saharan Africa faces multiple challenges, including weak health systems and attrition of trained health workers. One potential response to overcome these challenges has been to engage community health workers (CHWs). Methodology A systematic literature search for quantitative and qualitative studies describing the role and outcomes of CHWs in HIV care between inception and December 2012 in sub-Saharan Africa was performed in the following databases: PubMed, PsychINFO, Embase, Web of Science, JSTOR, WHOLIS, Google Scholar and SAGE journals online. Bibliographies of included articles were also searched. A narrative synthesis approach was used to analyze common emerging themes on the role and outcomes of CHWs in HIV care in sub-Saharan Africa. Results In total, 21 studies met the inclusion criteria, documenting a range of tasks performed by CHWs. These included patient support (counselling, home-based care, education, adherence support and livelihood support) and health service support (screening, referral and health service organization and surveillance). CHWs were reported to enhance the reach, uptake and quality of HIV services, as well as the dignity, quality of life and retention in care of people living with HIV. The presence of CHWs in clinics was reported to reduce waiting times, streamline patient flow and reduce the workload of health workers. Clinical outcomes appeared not to be compromised, with no differences in virologic failure and mortality comparing patients under community-based and those under facility-based care. Despite these benefits, CHWs faced challenges related to lack of recognition, remuneration and involvement in decision making. Conclusions CHWs can clearly contribute to HIV services delivery and strengthen human resource capacity in sub-Saharan Africa. For their contribution to be sustained, CHWs need to be recognized, remunerated and integrated in wider health systems. Further
Mwai, Grace W; Mburu, Gitau; Torpey, Kwasi; Frost, Peter; Ford, Nathan; Seeley, Janet
The provision of HIV treatment and care in sub-Saharan Africa faces multiple challenges, including weak health systems and attrition of trained health workers. One potential response to overcome these challenges has been to engage community health workers (CHWs). A systematic literature search for quantitative and qualitative studies describing the role and outcomes of CHWs in HIV care between inception and December 2012 in sub-Saharan Africa was performed in the following databases: PubMed, PsychINFO, Embase, Web of Science, JSTOR, WHOLIS, Google Scholar and SAGE journals online. Bibliographies of included articles were also searched. A narrative synthesis approach was used to analyze common emerging themes on the role and outcomes of CHWs in HIV care in sub-Saharan Africa. In total, 21 studies met the inclusion criteria, documenting a range of tasks performed by CHWs. These included patient support (counselling, home-based care, education, adherence support and livelihood support) and health service support (screening, referral and health service organization and surveillance). CHWs were reported to enhance the reach, uptake and quality of HIV services, as well as the dignity, quality of life and retention in care of people living with HIV. The presence of CHWs in clinics was reported to reduce waiting times, streamline patient flow and reduce the workload of health workers. Clinical outcomes appeared not to be compromised, with no differences in virologic failure and mortality comparing patients under community-based and those under facility-based care. Despite these benefits, CHWs faced challenges related to lack of recognition, remuneration and involvement in decision making. CHWs can clearly contribute to HIV services delivery and strengthen human resource capacity in sub-Saharan Africa. For their contribution to be sustained, CHWs need to be recognized, remunerated and integrated in wider health systems. Further research focusing on comparative costs of CHW
Sampson, Uchechukwu K A; Engelgau, Michael M; Peprah, Emmanuel K; Mensah, George A
It is well established that the leading causes of death and disability worldwide are cardiovascular diseases (CVD), chief among which is ischaemic heart disease. However, it is also recognised that ischaemic heart disease frequently coexists with other vascular conditions, such as cerebrovascular, renovascular and peripheral vascular disease, thus raising the notion of a common underlying pathobiology, albeit with differing manifestations, dictated by the implicated vascular bed. The understanding that common metabolic and behavioural risk factors as well as social determinants and drivers are convergent in the development of CVD evokes the idea that the dysfunction of a common bio-molecular platform is central to the occurrence of these diseases. The state of endothelial activation, otherwise known as endothelial dysfunction, occurs when reactive oxygen signalling predominates due to an uncoupled state of endothelial nitric oxide synthase (eNOS). This can be a physiological response to stimulation of the innate immune system or a pathophysiological response triggered by cardiovascular disease risk factors. The conventional wisdom is that the endothelium plays an important role in the initiation, progression and development of CVD and other non-communicable diseases. Consequently, the endothelium has remarkable relevance in clinical and public health practice as well as in health education, health promotion, and disease- and risk-factor prevention strategies. It also presents a plausible unifying hypothesis for the burden of CVD seen globally and in sub-Saharan Africa. Importantly, the heterogeneity in individual responses to metabolic, behavioural, and social drivers of CVD may stem from a complex interplay of these drivers with genomic, epigenetic and environmental factors that underpin eNOS uncoupling. Therefore, further biomedical research into the underlying genetic and other mechanisms of eNOS uncoupling may enlighten and shape strategies for addressing the
Mishra, Vinod; Assche, Simona Bignami-Van; Greener, Robert; Vaessen, Martin; Hong, Rathavuth; Ghys, Peter D; Boerma, J Ties; Van Assche, Ari; Khan, Shane; Rutstein, Shea
Wealthier populations do better than poorer ones on most measures of health status, including nutrition, morbidity and mortality, and healthcare utilization. This study examines the association between household wealth status and HIV serostatus to identify what characteristics and behaviours are associated with HIV infection, and the role of confounding factors such as place of residence and other risk factors. Data are from eight national surveys in sub-Saharan Africa (Kenya, Ghana, Burkina Faso, Cameroon, Tanzania, Lesotho, Malawi, and Uganda) conducted during 2003-2005. Dried blood spot samples were collected and tested for HIV, following internationally accepted ethical standards and laboratory procedures. The association between household wealth (measured by an index based on household ownership of durable assets and other amenities) and HIV serostatus is examined using both descriptive and multivariate statistical methods. In all eight countries, adults in the wealthiest quintiles have a higher prevalence of HIV than those in the poorer quintiles. Prevalence increases monotonically with wealth in most cases. Similarly for cohabiting couples, the likelihood that one or both partners is HIV infected increases with wealth. The positive association between wealth and HIV prevalence is only partly explained by an association of wealth with other underlying factors, such as place of residence and education, and by differences in sexual behaviour, such as multiple sex partners, condom use, and male circumcision. In sub-Saharan Africa, HIV prevalence does not exhibit the same pattern of association with poverty as most other diseases. HIV programmes should also focus on the wealthier segments of the population.
Hsia, Renee Y; Mbembati, Naboth A; Macfarlane, Sarah; Kruk, Margaret E
The effort to increase access to emergency and surgical care in low-income countries has received global attention. While most of the literature on this issue focuses on workforce challenges, it is critical to recognize infrastructure gaps that hinder the ability of health systems to make emergency and surgical care a reality. This study reviews key barriers to the provision of emergency and surgical care in sub-Saharan Africa using aggregate data from the Service Provision Assessments and Demographic and Health Surveys of five countries: Ghana, Kenya, Rwanda, Tanzania and Uganda. For hospitals and health centres, competency was assessed in six areas: basic infrastructure, equipment, medicine storage, infection control, education and quality control. Percentage of compliant facilities in each country was calculated for each of the six areas to facilitate comparison of hospitals and health centres across the five countries. The percentage of hospitals with dependable running water and electricity ranged from 22% to 46%. In countries analysed, only 19-50% of hospitals had the ability to provide 24-hour emergency care. For storage of medication, only 18% to 41% of facilities had unexpired drugs and current inventories. Availability of supplies to control infection and safely dispose of hazardous waste was generally poor (less than 50%) across all facilities. As few as 14% of hospitals (and as high as 76%) among those surveyed had training and supervision in place. No surveyed hospital had enough infrastructure to follow minimum standards and practices that the World Health Organization has deemed essential for the provision of emergency and surgical care. The countries where these hospitals are located may be representative of other low-income countries in sub-Saharan Africa. Thus, the results suggest that increased attention to building up the infrastructure within struggling health systems is necessary for improvements in global access to medical care.
... financial commitments in Sub- Saharan Africa under the loan, guarantee, and insurance programs of the Bank... EXPORT-IMPORT BANK Notice of Open Special Meeting of the Sub-Saharan Africa Advisory Committee of the Export-Import Bank of the United States (Ex-Im Bank) SUMMARY: The Sub-Saharan Africa Advisory...
Kharsany, Ayesha B M; Karim, Quarraisha A
Global trends in HIV infection demonstrate an overall increase in HIV prevalence and substantial declines in AIDS related deaths largely attributable to the survival benefits of antiretroviral treatment. Sub-Saharan Africa carries a disproportionate burden of HIV, accounting for more than 70% of the global burden of infection. Success in HIV prevention in sub-Saharan Africa has the potential to impact on the global burden of HIV. Notwithstanding substantial progress in scaling up antiretroviral therapy (ART), sub-Saharan Africa accounted for 74% of the 1.5 million AIDS related deaths in 2013. Of the estimated 6000 new infections that occur globally each day, two out of three are in sub-Saharan Africa with young women continuing to bear a disproportionate burden. Adolescent girls and young women aged 15-24 years have up to eight fold higher rates of HIV infection compared to their male peers. There remains a gap in women initiated HIV prevention technologies especially for women who are unable to negotiate the current HIV prevention options of abstinence, behavior change, condoms and medical male circumcision or early treatment initiation in their relationships. The possibility of an AIDS free generation cannot be realized unless we are able to prevent HIV infection in young women. This review will focus on the epidemiology of HIV infection in sub-Saharan Africa, key drivers of the continued high incidence, mortality rates and priorities for altering current epidemic trajectory in the region. Strategies for optimizing the use of existing and increasingly limited resources are included.
Chidarikire, S; Cross, M; Skinner, I; Cleary, M
To identify the treatments and interventions available and their impact on people living with schizophrenia in Sub-Saharan Africa. Help-seeking behaviour and the choice of treatment are largely influenced by socio-cultural factors and beliefs about the causes of mental illness. This review addresses the gap in knowledge regarding the treatment options available to people living with schizophrenia in Sub-Saharan Africa. Adapted realist literature review. Electronic databases searched in June 2016 included PubMed, EMBASE, PsycINFO, ProQuest and CINAHL. The adapted realist review approach used to synthesize the published research involved identifying the review aim, searching and selecting relevant studies, extracting, iteratively analysing and synthesizing relevant data and reporting results. Forty studies from eight countries were reviewed. Most people were treated by both faith/traditional healers and modern psychiatry. Common treatments included antipsychotics, electroconvulsive therapy and psychosocial interventions. Few treatment options were available outside major centres, there was poor adherence to medication and families reported a high level of burden associated with caring for a relative. Major limitations of this review were the lack of studies, variable quality and low level of evidence available from most countries from Sub-Saharan Africa and lack of generalizability. People living with schizophrenia in Sub-Saharan Africa were treated by faith, traditional healers and modern psychiatry, if at all. Further research is needed to better understand the local situation and the implications for caring for people from this region. Mental health services in Sub-Saharan Africa are limited by fiscal shortages, lack of mental health services and qualified mental health professionals. This review provides evidence to inform nursing and healthcare policy, including recruiting and training mental health professionals and ensuring access to evidence-based, person
Kharsany, Ayesha B.M.; Karim, Quarraisha A.
Global trends in HIV infection demonstrate an overall increase in HIV prevalence and substantial declines in AIDS related deaths largely attributable to the survival benefits of antiretroviral treatment. Sub-Saharan Africa carries a disproportionate burden of HIV, accounting for more than 70% of the global burden of infection. Success in HIV prevention in sub-Saharan Africa has the potential to impact on the global burden of HIV. Notwithstanding substantial progress in scaling up antiretroviral therapy (ART), sub-Saharan Africa accounted for 74% of the 1.5 million AIDS related deaths in 2013. Of the estimated 6000 new infections that occur globally each day, two out of three are in sub-Saharan Africa with young women continuing to bear a disproportionate burden. Adolescent girls and young women aged 15-24 years have up to eight fold higher rates of HIV infection compared to their male peers. There remains a gap in women initiated HIV prevention technologies especially for women who are unable to negotiate the current HIV prevention options of abstinence, behavior change, condoms and medical male circumcision or early treatment initiation in their relationships. The possibility of an AIDS free generation cannot be realized unless we are able to prevent HIV infection in young women. This review will focus on the epidemiology of HIV infection in sub-Saharan Africa, key drivers of the continued high incidence, mortality rates and priorities for altering current epidemic trajectory in the region. Strategies for optimizing the use of existing and increasingly limited resources are included. PMID:27347270
Caradee Y. Wright
Full Text Available Photoprotection messages and ‘SunSmart’ programmes exist mainly to prevent skin cancers and, more recently, to encourage adequate personal sun exposure to elicit a vitamin D response for healthy bone and immune systems. Several developed countries maintain intensive research networks and monitor solar UV radiation to support awareness campaigns and intervention development. The situation is different in sub-Saharan Africa. Adequate empirical evidence of the impact of solar UV radiation on human health, even for melanomas and cataracts, is lacking, and is overshadowed by other factors such as communicable diseases, especially HIV, AIDS and tuberculosis. In addition, the established photoprotection messages used in developed countries have been adopted and implemented in a limited number of sub-Saharan countries but with minimal understanding of local conditions and behaviours. In this review, we consider the current evidence for sun-related effects on human health in sub-Saharan Africa, summarise published research and identify key issues. Data on the prevalence of human diseases affected by solar UV radiation in all subpopulations are not generally available, financial support is insufficient and the infrastructure to address these and other related topics is inadequate. Despite these limitations, considerable progress may be made regarding the management of solar UV radiation related health outcomes in sub-Saharan Africa, provided researchers collaborate and resources are allocated appropriately.
Asaolu, Ibitola O; Gunn, Jayleen K; Center, Katherine E; Koss, Mary P; Iwelunmor, Juliet I; Ehiri, John E
In spite of a high prevalence of HIV infection among adolescents and young adults in sub-Saharan Africa, uptake of HIV testing and counseling among youth in the region remains sub-optimal. The objective of this study was to assess factors that influence uptake of HIV testing and counseling among youth aged 15-24 years in sub-Saharan Africa. This study used the Demographic and Health Survey (DHS) data from countries that represent four geographic regions of sub-Saharan Africa: Congo (Brazzaville), representing central Africa (DHS 2011-2012); Mozambique, representing southern Africa (DHS 2011); Nigeria, representing western Africa (DHS 2013); and Uganda, representing eastern Africa (DHS 2011). Analyses were restricted to 23,367 male and female respondents aged 15-24 years with complete data on the variables of interest. Chi-square tests and logistic regression models were used to assess predictors of HIV testing. Statistical significance was set at psub-Saharan Africa for HIV testing continues to be a challenge. Public health programs that seek to increase HIV counseling and testing among youth should pay particular attention to efforts that target high-risk subpopulations of youth. The results further suggest that these initiatives would be strengthened by including strategies to increase HIV comprehensive knowledge.
Ruff, Ryan Richard
Education in Sub-Saharan Africa is increasingly viewed as a means of emancipation and a transformative project for social mobility. Developing nations have pursued policies such as universal or free primary education to increase access to education and improve student outcomes. In this study, direct and indirect precursors to primary school…
Adjei, Jones K; Saewyc, Elizabeth M
Research on youth sexual exploitation in Africa has largely neglected the experiences of exploited boys. To date, much of the research in sub-Saharan Africa continues to consider boys mainly as exploiters but not as exploited. Using the only publicly available population-based surveys from the National Survey of Adolescents, conducted in four sub-Saharan African countries - Burkina Faso, Ghana, Malawi, and Uganda-we assessed factors associated with transactional sexual behaviour among never-married adolescent boys and girls. We also examined whether boys' reported sexual exploitation was linked to similar risky sexual behaviours as has been noted among girls in sub-Saharan Africa. Results from our analyses indicated that even though adolescent girls have a somewhat higher likelihood of reporting sexual abuse and exploitation, the odds of trading sex were significantly elevated for previously traumatized boys (that is those with a history of sexual and physical abuse) but not for their female counterparts. Just like adolescent girls, transactional sexual behaviour was associated with the risk of having concurrent multiple sexual partners for boys. These findings support the reality of boys' sexual exploitation within the African context, and further highlight the importance of including males in general and boys in particular in population-based studies on sexual health, risk, and protective factors in the sub-Saharan African region. Understanding the factors linked to sexual exploitation for both boys and girls will help in developing policies and programs that could improve the overall sexual and reproductive health outcomes among adolescents and youth in sub-Saharan Africa. Copyright © 2017 Elsevier Ltd. All rights reserved.
Barr, Bill; Daoud, Beshir
The history of Africa is of a continent colonized and deeply exploited by European powers In the late 1940's, only four countries in Africa were independent Egypt, Liberia, Ethiopia and South Africa...
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.
Matthews, William G.
Petroleum products are the lifeblood of the economies of all Sub-Saharan African countries. They are key fuels used in road transport and power generation. Households use kerosene and liquefied petroleum gas (LPG) for lighting and cooking. In this era of high oil prices, if the product is state-subsidized, the government budget bears the brunt of price increases. If the price changes are passed through to consumers, the household budgets are impacted directly. The countries most vulnerable to oil price shocks are the low-income oil importers which are disproportionately concentrated in Sub-Saharan Africa. End user prices are affected by several factors: market size and economies of scale, mode of product transport, controlled pricing, protection of inefficient domestic suppliers, degree of competition, clear and stable legal framework, effective monitoring and disclosure of industry statistics. This paper is based on two recent studies of the oil sectors of several countries in Sub-Saharan Africa which posed the following questions: Is each stage in the supply chain, from import of crude oil or refined products to retail, efficiently run and are the efficiency gains passed on to end-users? If not, what are the potential causes and possible means of remedying the problems? - Highlights: • Examines comparative efficiencies of oil product supply chains in twelve sub-Saharan countries. • Identifies areas for improvement towards “best practice”. • Objective is to reduce differential between international reference prices and consumer prices
The original logic underlying the World Bank's structural adjustment policies in Africa was that the removal of state-created distortions would not only improve efficiency in the operation of markets but also enhance income equality and reduce poverty. The paper explores the linkage between adjustment and the deteriorating income distribution and rising poverty in sub-Saharan Africa with a focus on the rural sector where most of the population earns its livelihoods. The pattern observed is a ...
In the past decades, most of the countries in Sub-Saharan Africa have been affected by armed conflicts. By means of a time-series cross-sectional (TSCS) database, we attempt to measure the impact of war on a sample of 43 countries in Africa from 1950 to 2010. These conflicts, and especially civil wars, are shown to have a strong negative effect on…
Uchudi, Joseph; Magadi, Monica; Mostazir, Mohammod
A number of authors have identified multiple concurrent sexual partnerships by both men and women to lie at the root of the HIV/AIDS epidemic in sub-Saharan Africa. This study applies multilevel models to Demographic and Health Survey data collected during 2003-2008 in 20 sub-Saharan African countries to examine the influence of social and cultural context on involvement with multiple sexual partnerships in the region, above and beyond the effects of individual characteristics. The findings provide support for the ecological argument that health behaviours are shaped and determined by societal conditions, in addition to the effects of individual and household characteristics. Involvement with multiple sex partners is most prevalent in societies in which sexual norms are widely permissive and where polygyny is common. Individual autonomy is substantial and attitudes towards sexuality are more liberal among men and women who live in communities in which sexual norms are widely permissive. Men and women who are most likely to have multiple sex partners in the sub-Saharan region are those who initiated sexual activity earlier and those who have the individual attributes (e.g. young age, urban residence, education, media exposure and working for cash and away from home) that bring to them more rights and/or decision-making autonomy, but not necessarily more financial resources and economic security (mostly among women). On the other hand, involvement with multiple partners is determined by cultural norms (i.e. permissive sexual norms) and social change (i.e. mass education, expansion of cash employment). The findings suggest a number of opportunities for more effective policy and programmatic responses to curb the prevalence of multiple partnerships in sub-Saharan Africa.
Burgess, Philip I; Msukwa, Gerald; Beare, Nicholas A V
Sub-Saharan Africa faces an epidemic of diabetes. Diabetes causes significant morbidity including visual loss from diabetic retinopathy, which is largely preventable. In this resource-poor setting, health systems are poorly organized to deliver chronic care with multiple system involvement. The specific skills and resources needed to manage diabetic retinopathy are scarce. The costs of inaction for individuals, communities and countries are likely to be high. Screening for and treatment of diabetic retinopathy have been shown to be effective, and cost-effective, in resource-rich settings. In sub-Saharan Africa, clinical services for diabetes need to be expanded with the provision of effective, integrated care, including case-finding and management of diabetic retinopathy. This should be underpinned by a high quality evidence base accounting for differences in diabetes types, resources, patients and society in Africa. Research must address the epidemiology of diabetic retinopathy in Africa, strategies for disease detection and management with laser treatment, and include health economic analyses. Models of care tailored to the local geographic and social context are most likely to be cost effective, and should draw on experience and expertise from other continents. Research into diabetic retinopathy in Africa can drive the political agenda for service development and enable informed prioritization of available health funding at a national level. Effective interventions need to be implemented in the near future to avert a large burden of visual loss from diabetic retinopathy in the continent. An increase in visual loss from diabetic retinopathy is inevitable as the diabetes epidemic emerges in sub-Saharan Africa. This could be minimized by the provision of case-finding and laser treatment, but how to do this most effectively in the regional context is not known. Research into the epidemiology, case-finding and laser treatment of diabetic retinopathy in sub-Saharan
Alderuccio, Michela Chiara
This paper focuses on investigating the dialectic between global and local educational agendas in shaping curriculum transformations in sub-Saharan Africa (SSA). Curriculum transformations are seen as a way to respond to the challenges of promoting Education for All (EFA), but also reflect SSA traditions, social and economic changes. In this…
Casterline, John B; El-Zeini, Laila O
This study assesses how changes in unmet need for family planning have contributed to contemporary fertility declines, and the implications of this historical record for further fertility decline, especially in sub-Saharan Africa. We examine joint trends at the national level in fertility, unintended fertility, and unmet need. We bring unintended fertility into the analysis because the underlying rationale for reducing unmet need is to avert unintended pregnancies and births. The association over time between unmet need and fertility is investigated using survey data from 45 countries in Africa, Asia, and Latin America and the Caribbean from the mid-1970s to the present. The empirical analysis finds that reduction in unmet need, especially unmet need for limiting, is strongly associated with fertility decline in Latin America and the Caribbean and in Asia and North Africa. Fertility decline in sub-Saharan Africa is weakly associated with trends in unmet need (and satisfaction of demand). We propose that the stark regional difference is due to measurement problems and to the fundamentally different character of fertility decline in sub-Saharan Africa, itself reflective of basic differences in pretransition reproductive regimes. © 2013 The Population Council, Inc.
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.
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.
Gathering of wild edible plant resources by people in sub-Saharan Africa is discussed with reference to pteridophytes, which is an ancient plant group. Pteridophytes are crucial to food diversity and security in sub-Saharan Africa, although they are notably neglected as a result of inadequate research and agricultural development. Current research and agricultural development agenda still appear to focus on the popular and commonly used food crops, vegetables and fruits; ignoring minor and underutilized plant species such as pteridophytes which have shown significant potential as sources of macro and micro nutrients required to improve the diet of children and other vulnerable groups in sub-Saharan Africa. Documentation of edible pteridophytes is needed to reveal the importance of this plant group in the region and the associated indigenous knowledge about them; so that this knowledge can be preserved and utilized species used to combat dietary deficiencies as well as improve food security in the region. The aim of this study is to present an overview of food value of pteridophytes in sub-Saharan Africa using available literature and to highlight their potential in addressing dietary deficiencies in impoverished communities in the region. This study is based on review of the literature published in scientific journals, books, reports from national, regional and international organizations, theses, conference papers and other grey materials obtained from libraries and electronic search of Google Scholar, ISI Web of Science and Scopus. A total of 24 taxa belonging to 14 genera and 11 families are used in sub-Saharan Africa as fodder and human food. Pteridium aquilinum (L.) Kuhn is the most common edible pteridophyte in sub-Saharan Africa, used as human food in Angola, Cameroon, DRC, Gabon, Madagascar, Nigeria and South Africa, followed by Ophioglossum reticulatum L. (South Africa, Swaziland and Zanzibar), Ceratopteris thalictroides (L.) Brongn. (Madagascar and
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.
Commonwealth of Learning, 2004
Ideological arguments are made for open learning, economic ones for distance education. If it can produce similar results to those of conventional education at a lower cost, then distance education has a powerful appeal. With increasing demand for access to educational opportunities at all levels, and often decreasing budgets in real terms for…
Full Text Available This paper analyses the channels through which the economic and financial crisis of 2008–2009 was transmitted to Sub-Saharan Africa, with a focus on countries in situation of fragility. Trade stands out as the main direct channel, even though intra-Africa remittances play a relevant role, given that most migrants in Sub-Saharan Africa cannot afford the cost of migrating to Europe or to the United States and stay close, remaining in the continent. Whether reduced aid flows also act as a crisis transmission channel remains an open question, even though preliminary estimates suggest that, at least in the medium run, OECD countries are likely to lower aid, with potentially very damaging effects. The paper also shows that many African countries in a situation of fragility are characterised by very low resilience and capacity to cope with shocks. It concludes, by highlighting how Sub-Saharan Africa (fragile countries’ policymakers’ room for manoeuver is limited in periods of crisis because of low fiscal space and limited institutional capacity. It advocates that the right response to the crisis would be to mobilise domestic resources, although this will require functional institutions able to offset the potential trade-offs between adverse short-term shocks and a long-term perspective.
Ba-Diop, Awa; Marin, Benoît; Druet-Cabanac, Michel; Ngoungou, Edgard B; Newton, Charles R; Preux, Pierre-Marie
Epilepsy is a common neurological disease in tropical countries, particularly in sub-Saharan Africa. Previous work on epilepsy in sub-Saharan Africa has shown that many cases are severe, partly a result of some specific causes, that it carries a stigma, and that it is not adequately treated in many cases. Many studies on the epidemiology, aetiology, and management of epilepsy in sub-Saharan Africa have been reported in the past 10 years. The prevalence estimated from door-to-door studies is almost double that in Asia, Europe, and North America. The most commonly implicated risk factors are birth trauma, CNS infections, and traumatic brain injury. About 60% of patients with epilepsy receive no antiepileptic treatment, largely for economic and social reasons. Further epidemiological studies should be a priority to improve understanding of possible risk factors and thereby the prevention of epilepsy in Africa, and action should be taken to improve access to treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.
The successful efforts in the 1980s to redress nutrition problems in sub-Saharan Africa are being eroded. Countries in eastern and southern Africa are now facing serious food shortages because of recurrent droughts, floods, civil wars, and the concomitant growing poverty. The potential for biotechnology to alleviate hunger holds promise if the new technology can be adapted to the prevailing sociocultural context in Africa. Agronomists and biotechnologists need to work together to ensure that the biotechnology agenda for Africa is responsive to the food and nutrition needs of its people.
Galan, Deise I; Kim, Seung-Sup; Graham, Jay P
In sub-Saharan Africa, it is estimated that 215 million people continue to engage in open defecation. This practice facilitates the transmission of diarrheal diseases - one of the leading causes of mortality in children under 5 in sub-Saharan Africa. The main purpose of this study is to: estimate changes in open defecation prevalence between 2005 and 2010 across countries in sub-Saharan Africa; examine the association between national level indices and changes in open defecation prevalence; and assess how many countries can achieve 'open defecation free status' by 2015. After applying selection criteria, this study analyzed country-level data for 34 sub-Saharan African countries. Seven country-level indices were collected: 1) presence of a national sanitation policy; 2) budget line for sanitation; 3) budget allocated to sanitation; 4) annual per capita GDP; 5) GDP growth; 6) implementation of total sanitation approaches; and 7) per capita aid disbursement for water supply and sanitation. The relationships between these country-level indices and the change in open defecation from 2005 to 2010 were investigated using Wilcoxon Signed-Rank test and Spearman's rank correlation test. Only 3 countries (i.e. Ethiopia, Angola and Sao Tome and Principe) decreased open defecation by 10% or more between 2005 and 2010. No significant associations were observed between the change in open defecation prevalence and all of national level indices except per capita aid disbursement. Per capita aid disbursement for water and sanitation was positively associated with a reduction in open defecation (p-value = 0.02) for a subset of 29 low-income countries from 2005 to 2010. Only one country in our analysis, Angola, is on track to end open defecation by 2015 based on their performance between 2000 and 2010. Most of the national level indices, including a country's economic status, were not associated with the change in the open defecation prevalence. Based on current trends, the goal
Rwego, Innocent B; Babalobi, Olutayo Olajide; Musotsi, Protus; Nzietchueng, Serge; Tiambo, Christian Keambo; Kabasa, John David; Naigaga, Irene; Kalema-Zikusoka, Gladys; Pelican, Katherine
Africa of late has been faced with challenges that require a multidisciplinary and multisectoral approach to address them, and academic and non-academic institutions have played a key role in training and conducting research that would promote the One Health approach. The objective of this review was to document networks and organizations conducting One Health training, research, and outreach in Africa, as one of a series of articles around the world. Data for this review were collected from organizations through key contacts of the authors and their knowledge of networks they have worked with. Web searches were conducted using One Health, training, and research as key words for work done in Africa. Africa has major networks involved in One Health training, research, and outreach, with participation of both academic and non-academic institutions. This review highlights an effort in Africa to form networks to conduct multidisciplinary training and research. The main networks include Afrique One, Southern African Centre for Infectious Disease Surveillance (SACIDS), and One Health Central and Eastern Africa (OHCEA). Both academic and non-academic institutions and organizations have shown an interest to conduct multidisciplinary training and research in Africa for managing challenges that Africa is facing currently, especially the outbreak of infectious diseases.
the private sector in Africa is embracing joint health insurance schemes for their ... the unemployed, the under-employed and the unemployable (who ...... Agyepong, A.I. and Adjei, S., 2008, 'Public Social Policy Development and Implementation: .... Johannesburg, South Africa', WBI Learning Resource Series: World Bank.
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.
Full Text Available The continuous increase in the rate of poverty in Sub-Saharan Africa can be linked to the inadequate management and use of international financial assistance such as foreign aid. Using a cross-country data, this paper examines the relationship between foreign aid and poverty reduction in Sub-Saharan Africa (SSA. The result obtained indicates that foreign aid has no significant influence on poverty reduction in SSA, because of the countries’ weak economic management evidenced by high levels of corruption, bad governance, and political and economic instability. To improve the performance of foreign aid directed at poverty reduction, the paper suggests the implementation of measures directed at good governance, macroeconomic and political stability.Incentives in Nigeria’s food manufacturing industries and their impact on output and prices
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.
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.
A complex relationship exists between population growth and economic development. The historical quantitative evidence is also ambiguous. Many social scientists consider rapid population growth in developing countries to be a major obstacle to development. There are, however, many ways in which population growth can foster development. There are also several rational reasons why families in developing countries may decide to bear many children. Theories on population and development are discussed. Using sub-Saharan Africa as its reference region, the paper describes how rapid population growth can impede development. Current demographic and economic trends in sub-Saharan Africa and the consequences of rapid population growth in terms of economic, environmental, and sociopolitical change, capital widening, the labor force, and trade are presented.
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.
Cappuccio, Francesco Paolo; Miller, Michelle Avril
Cardiovascular disease, including stroke, heart failure and kidney disease, has been common in sub-Saharan Africa for many years, and rapid urbanization is causing an upsurge of ischaemic heart disease and metabolic disorders. At least two-thirds of cardiovascular deaths now occur in low- and middle-income countries, bringing a double burden of disease to poor and developing world economies. High blood pressure (or hypertension) is by far the commonest underlying risk factor for cardiovascular disease. Its prevention, detection, treatment and control in sub-Saharan Africa are haphazard and suboptimal. This is due to a combination of lack of resources and health-care systems, non-existent effective preventive strategies at a population level, lack of sustainable drug therapy, and barriers to complete compliance with prescribed medications. The economic impact for loss of productive years of life and the need to divert scarce resources to tertiary care are substantial.
Haider, Taj L; Sharma, Manoj
This review assessed barriers to uptake of family planning and contraceptive services among women in sub-Saharan Africa. Included were studies: (1) published in the English; (2) between the years January 2010 and July 2012; (3) that measure barriers to family planning/contraceptive methods; and (4) that use any quantitative or qualitative study design. Eleven studies fitting the inclusion criteria were reviewed. The major barriers found to prevent uptake of services included cultural and societal pressure on women, socioeconomic status, financial barriers, and regional barriers associated with lack of access to services. Due to the diversity of the populations in sub-Saharan Africa, it is clear that a one-size-fits-all approach will not be efficacious; rather, a strategy that takes into account cultural and societal norms for the population of interest is better.
Stulac, Sara; Binagwaho, Agnes; Tapela, Neo M; Wagner, Claire M; Muhimpundu, Marie Aimee; Ngabo, Fidele; Nsanzimana, Sabin; Kayonde, Leonard; Bigirimana, Jean Bosco; Lessard, Adam J; Lehmann, Leslie; Shulman, Lawrence N; Nutt, Cameron T; Drobac, Peter; Mpunga, Tharcisse; Farmer, Paul E
Despite an estimated 456,000 deaths caused by cancer in sub-Saharan Africa in 2012 and a cancer burden that is predicted to double by 2030, the region accounts for only 0·3% of worldwide medical expenditure for cancer. Challenges to cancer care in sub-Saharan Africa include a shortage of clinicians and training programmes, weak healthcare infrastructure, and inadequate supplies. Since 2011, Rwanda has developed a national cancer programme by designing comprehensive, integrated frameworks of care, building local human resource capacity through partnerships, and delivering equitable, rights-based care. In the 2 years since the inauguration of Rwanda's first cancer centre, more than 2500 patients have been enrolled, including patients from every district in Rwanda. Based on Rwanda's national cancer programme development, we suggest principles that could guide other nations in the development of similar cancer programmes. Copyright © 2015 Elsevier Ltd. All rights reserved.
Sebitosi, A.B.; Pillay, P.; Khan, M.A.
The bulk of rural populations in sub-Saharan Africa have no access to electricity and are under-served by any other form of modern infrastructure. The cost of infrastructure to mainly scattered communities has been perennially cited as largely to blame. Quite often rural networks are overdesigned, resulting in under utilization and, therefore, costly overheads. One reason often cited for the overspecification is anticipation of load growth. In most sub-Sahara African rural areas, however, economic growth rates are low, and a designer has no justification in specifying an infrastructure capacity exceeding more than a few percent of existing consumer requirements. This paper proposes methods that critically look at the geometry of small grid network designs to address the construction challenges in rural sub-Saharan Africa
Ibrahim, Abdulrasheed; Garba, Ekundayo Stephen; Asuku, Malachy Eneye
Surgery in sub-Saharan Africa is widely known to be done against a background of poverty and illiteracy, late presentation with complicated pathologies, and a desperate lack of infrastructure. In addition, patient autonomy and self determination are highly flavored by cultural practices and religious beliefs. Any of these factors can influence the pattern and disclosure of adverse events and errors. The impact of these in the relationships between surgeons and patients, and between health institutions and patients must be considered as it may affect disclosure and response to errors. This article identifies the peculiar socioeconomic and cultural challenges that may hinder disclosure and proposes strategies for instituting disclosure of errors and adverse events services in Sub-Saharan Africa.
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.
Robert Dibie; Josephine Dibie
This article examines the nature of the paralysis of public governance, leadership, conflict and economic development in selected countries in sub-Saharan Africa. It argues that ineffective political leadership and conflict will serve as a lever to poor economic growth and social development. Servant leadership and democratic representation are the continuous process of development that could be accomplished through the participation of the citizens in their own development. The dynamics of d...
Adeniyi Jimmy Adedokun
Full Text Available Foreign aid strategies have undergone restructuring as donors adopt aid selectivity practice to improve aid effectiveness. This study investigates the impact of aid selectivity practice on aid effectiveness (aid-growth relationship in Sub-Saharan Africa (SSA and several groups of countries within SSA from 1980 to 2012. Employing system generalized methods of moments (system GMM technique; the study produces strong evidence that there is significant improvement in aid effectiveness due to aid selectivity practice.
Adedokun, Adeniyi Jimmy; Abiodun O. Folawewo, Abiodun O.
Foreign aid strategies have undergone restructuring as donors adopt aid selectivity practice to improve aid effectiveness. This study investigates the impact of aid selectivity practice on aid effectiveness (aid-growth relationship) in Sub-Saharan Africa (SSA) and several groups of countries within SSA from 1980 to 2012. Employing system generalized methods of moments (system GMM) technique; the study produces strong evidence that there is significant improvement in aid effectiveness due to a...
Rjoub, Husam; Aga, Mehmet; Alrub, Ahmad Abu; Bein, Murad
The recognition of Foreign Direct Investment (FDI) as a source of funding to foster economic development in both developed and developing countries has been in ascendancy. The prime purpose of this study is to empirically investigate the determinants of FDI for the “landlocked countries” in Sub-Saharan Africa over the period 1995–2013. By employing panel data analysis, the result of the study revealed that domestic investment, trade (openness), human capital, political constraint, natural res...
Julius A. Agbor and Gregory N. Price
To the extent that in utero and childhood malnutrition negatively affects later stage mental and physical health, it can possibly constrain later stage human capital acquisition, which is an important driver of economic growth. This paper considers the impact of famine on aggregate adolescent human capital formation in Sub-Saharan Africa. We parameterize a joint adolescent human capital and food nutrition production function to estimate the effects of famine on primary school completion rates...
Birds are not normally viewed as pests but, in the case of cereals and soft fruit, both resident and migrant species can cause significant losses. In sub-Saharan Africa, the expansion of the area under cereal crops, especially in displacing the normal food plants of the grain-eating birds, has exacerbated the problem and rendered ineffective many traditional me.t_hods of crop protection. Environmental considerations mean that management strategies must now be tackled at the government and com...
This article deals with the problems and prospects of development of the digital economy of Sub-Saharan Africa. The work will examine the relationship between the development of new information and communication technologies (ICT) and the formation of civil society in the region. The stages of implementation of Internet technologies will be explored. The development in different countries according to national circumstances, understand the basic functions of the new ICT in the development of ...
Little is known about the relationship between self-identified difficulties conceiving, biomedical infertility, and union instability in sub-Saharan Africa. Previous research suggests that infertility increases the risk of psychological distress and marital conflict, encourages risky sexual behavior, and deprives infertile individuals and couples of an important source of economic and social capital. Qualitative research has suggested that there may be a link between infertility and divorce; ...
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.
Sub-Saharan Africa economies introduced extensive reforms of their tax systems in the last two decades. In most of these countries taxes are now remitted through the self-assessment system that relies on quasi voluntary compliance and audit selection by risk. However, the revenues from direct taxes remained fairly stable and tax/GDP ratios lack behind the industrialized world. Several scholars argue that corruption is one of the major obstacles to increase tax revenues but focus on perceived ...
Asongu, Simplice; Nwachukwu, Jacinta
This study investigates the role of mobile phones in governance for doing business in Sub-Saharan Africa with data from the period 2000-2012 by employing the Generalised Method of Moments. Three broad concepts of governance are explored, namely: (i) political (comprising voice & accountability and political stability/no violence), (ii) economic (involving government effectiveness and regulation quality) and (iii) institutional (including corruption-control and rule of law). Ten dimensions of...
Asongu, Simplice; Asongu, Ndemaze
This study assesses how the mobile phone influences governance to improve information and communication technology (ICT) exports in Sub-Saharan Africa with data from 2000-2012. The empirical evidence is based on Generalised Method of Moments and three main governance concepts are used, namely: (i) institutional (comprising the rule of law and corruption-control); (ii) political (involving political stability/no violence and voice & accountability) and (iii) economic (including regulation qua...
Ibrahim, Muazu; Kumi, Emmanuel; Yeboah, Thomas
Corruption is a pervasive challenge confronting the world more especially countries in sub-Saharan Africa. This paper investigates the effect of corruption on economic growth in the subregion using data spanning 1998 to 2011. By employing the pooled estimated generalized least squares (EGLS) and two stage least squares (2SLS), we find that corruption is inimical toeconomic growth through its indirect effect on gross fixed capital formation and labour force. The results are not only robust to ...
Asongu, Simplice A; Nwachukwu, Jacinta
This study assesses the synergy effects of governance in mobile phone penetration for inclusive human development in Sub-Saharan Africa with data for the period 2000-2012 by employing a battery of interactive estimation techniques, namely: Fixed effects (FE), Generalised Method of Moments (GMM) and Tobit regressions. Concepts of political (voice & accountability and political stability/no violence), economic (government effectiveness and regulation quality) and institutional (corruption-contr...
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
Lund, Henrik Hautop
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....
Draper, Peter; Freytag, Andreas; Doyaili, Sarah Al
In recent years sub-Saharan Africa, notwithstanding the global financial crisis, has increased its share in global trade and investment flows. This has led to an appreciable improvement in development levels, albeit off a small base. However, these patterns are still dominated by commodity flows and investment, and remain marginal on the global stage. Increased trade and investment flows, particularly related to network services, would be of great benefit to the sub-continent. Yet many domest...
Background: In sub-Saharan Africa (SSA), impact evaluation has been used to assess whether agricultural extension interventions have brought the intended result or to establish causal linkages between interventions and outcomes. However, there is some scepticism about the validity and reliability of the results of the impact evaluation reports due to some contradictory and exaggerated results. Objectives: This article analyses some impact evaluation studies conducted in SSA as to why cont...
Bertocchi, Graziella; Guerzoni, Andrea
We explore the determinants of state fragility in sub-Saharan Africa. Controlling for a wide range of economic, demographic, geographic and institutional regressors, we find that institutions, and in particular the civil liberties index and the number of revolutions, are the main determinants of fragility, even taking into account their potential endogeneity. Economic factors such as income growth and investment display a non robust impact after controlling for omitted variables and reverse c...