Sexual and Gender-Based Violence Attitudes and Experiences among Nine Sub-Saharan African Militaries.

Science.gov (United States)

Nightingale, Vienna R; Tran, Bonnie R; Harbertson, Judith; Langa, Antonio; Grillo, Michael; Kalombo, Olivier; Thomas, Anne G

2017-01-01

While sexual and gender-based violence (SGBV) is recognized as an important factor driving the HIV epidemic in sub-Saharan Africa, attitudes toward and prevalence of SGBV within sub-Saharan African military populations are unknown. Data on SGBV were collected from military service members of nine sub-Saharan African militaries. Attitudes related to SGBV and characteristics of those who commit and experience SGBV are reported. Data for 8815 service members (8165 men and 650 women) aged 18 years or older who voluntarily participated in the Seroprevalence and Behavioral Epidemiology Risk Surveys from 2009 to 2014 were included in this secondary data analysis. Data were collected on demographics, HIV prevalence, SGBV attitudes, and experiences. Descriptive and bivariate statistical analyses were performed. 5% of men and 9% of women reported experiencing SGBV, and 6% of men reported they had ever committed SGBV. Men and women who had experienced SGBV were significantly more likely to agree with negative gender attitudes toward SGBV, and the majority of those who reported experiencing SGBV reported that SGBV was committed by someone outside of the military. This is the first study to examine SGBV in sub-Saharan military populations during periods of limited conflict. It provides evidence that SGBV is experienced by both male and female service members at rates not typically found in previous research examining SGBV in other military populations. A better understanding of SGBV in sub-Saharan military service members is necessary to ensure appropriate services and interventions are part of the military infrastructure. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

[Incidence of surgical site infections in sub-Saharan Africa: systematic review and meta-analysis].

Science.gov (United States)

Ngaroua; Ngah, Joseph Eloundou; Bénet, Thomas; Djibrilla, Yaouba

2016-01-01

Surgical Site Infections (SSI) cause morbi-mortality and additional healthcare expenditures. Developing countries are the most affected. The objective was to estimate the pooled incidence of SSI in Sub-Saharan Africa and describe its major risk factors. Systematic review and meta-analysis were conducted using the databases of the World Health Organization Regional Office for Africa, PubMed and standard search to select electronic articles published between 2006 and 2015. Only articles investigating SSI impact and risk factors in Sub-Saharan African countries were retained. Out of 95 articles found, 11 met the inclusion criteria. Only 9 countries out of 45 have contributed, with a huge amount of information coming from Nigeria (5 articles out of 11). The impact of SSI ranged from 6.8% to 26% with predominance in general surgery. The pooled incidence of SSI was 14.8% (95% CI: 15,5-16,2%) with significant heterogeneity according to the specialty and the method of monitoring. Most cited risk factors were long procedure length and categories 3 and 4 of Altemeier contamination class. Other factors included hospital environment, inadequate care practices and underlying pathologies. SSI incidence is high in Sub-Saharan Africa. Studies in this area could improve knowledge, prevention and control of these multiple risk factors.

Sub-Saharan Africa Report

National Research Council Canada - National Science Library

1985-01-01

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...

Financial development and economic growth: literature survey and empirical evidence from sub-Saharan African countries

Directory of Open Access Journals (Sweden)

Songul Kakilli Acaravci

2011-08-01

Full Text Available In this paper we review the literature on the finance-growth nexus and investigate the causality between financial development and economic growth in Sub-Saharan Africa for the period 1975-2005. Using panel co-integration and panel GMM estimation for causality, the results of the panel co-integration analysis provide evidence of no long-run relationship between financial development and economic growth. The empirical findings in the paper show a bi-directional causal relationship between the growth of real GDP per capita and the domestic credit provided by the banking sector for the panels of 24 Sub-Saharan African countries. The findings imply that African countries can accelerate their economic growth by improving their financial systems and vice versa.

Corruption in Sub-Saharan Africa: A practical-theological response

Directory of Open Access Journals (Sweden)

Petria M. Theron

2013-11-01

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.

The Impact of the African Growth and Opportunity Act (AGOA): An Empirical Analysis of Sub-Saharan African Agricultural Exports

OpenAIRE

Zenebe, Addisalem; Peterson, Wesley; Wamisho, Kassu

2014-01-01

The African Growth and Opportunities Act (AGOA) which was signed into law in 2000 as part of U.S. trade legislation has the objectives of increasing trade and investment between the U.S. and eligible Sub-Saharan African (SSA) countries, by reducing or eliminating tariffs applied to African exports of different products. This Act represents a promising approach to economic growth and development in SSA through international trade. This research paper examines the impact of AGOA on African agri...

Tales to Transit : Sub-Saharan African Migrants’ Experiences in Istanbul

OpenAIRE

Suter, Brigitte

2012-01-01

This dissertation presents the transit experiences of migrants from Sub-Saharan African countries in the Turkish metropolis of Istanbul. Although the narratives of the individuals met in the course of fieldwork in Istanbul are the primary focus, the thesis also outlines the larger macro-structural conditions faced. The overarching goal of this thesis is thus, through the experiences of the migrants themselves, to critically approach and discuss the concept of transit with the aid of the theor...

Sub-Saharan African migrant youths' help-seeking barriers and facilitators for mental health and substance use problems: a qualitative study.

Science.gov (United States)

McCann, Terence V; Mugavin, Janette; Renzaho, Andre; Lubman, Dan I

2016-08-02

Many young migrants and their parents are reluctant to seek help for mental health and substance use problems. Help-seeking delays can result in longer duration of untreated problems and poorer outcomes. In this study, we aimed to identify the help-seeking barriers and facilitators for anxiety, depression and alcohol and drug use problems in young people from recently established sub-Saharan African migrant communities. A qualitative study, incorporating individual, in-depth interviews and focus group discussions, was undertaken in Melbourne, Australia. Twenty-eight young sub-Saharan African migrants participated in the individual interviews, and 41 sub-Saharan African-born parents and key community leaders participated in 4 focus groups. All participants were aged 16 years or over. A thematic analysis of the data was undertaken. Themes and related sub-themes were abstracted from the data, reflecting the young people's, parents' and key community leaders' beliefs about barriers and facilitators to help-seeking for mental health and substance use problems. Four help-seeking barriers were identified: stigma of mental illness, lack of mental health literacy in parents and young people, lack of cultural competency of formal help sources, and financial costs deterring access. Five help-seeking facilitators were abstracted: being open with friends and family, strong community support systems, trustworthiness and confidentiality of help-sources, perceived expertise of formal help-sources, increasing young people's and parents' mental health literacy. Programs that identify and build on help-seeking facilitators while addressing help-seeking barriers are needed to address mental health issues among young sub-Saharan African migrants. Strategies to address help-seeking barriers should consider counteracting stigma and increasing mental health literacy in sub-Saharan African communities, increasing health providers' cultural competency and perceived trustworthiness, and

Raven’s test performance of sub-Saharan Africans: average performance, psychometric properties, and the Flynn Effect

NARCIS (Netherlands)

Wicherts, J.M.; Dolan, C.V.; Carlson, J.S.; van der Maas, H.L.J.

2010-01-01

This paper presents a systematic review of published data on the performance of sub-Saharan Africans on Raven's Progressive Matrices. The specific goals were to estimate the average level of performance, to study the Flynn Effect in African samples, and to examine the psychometric meaning of Raven's

Raven's Test Performance of Sub-Saharan Africans: Average Performance, Psychometric Properties, and the Flynn Effect

Science.gov (United States)

Wicherts, Jelte M.; Dolan, Conor V.; Carlson, Jerry S.; van der Maas, Han L. J.

2010-01-01

This paper presents a systematic review of published data on the performance of sub-Saharan Africans on Raven's Progressive Matrices. The specific goals were to estimate the average level of performance, to study the Flynn Effect in African samples, and to examine the psychometric meaning of Raven's test scores as measures of general intelligence.…

Bibliometric trends of health economic evaluation in Sub-Saharan Africa.

Science.gov (United States)

Hernandez-Villafuerte, Karla; Li, Ryan; Hofman, Karen J

2016-08-24

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

Acceptability of the female condom by Sub-Saharan African women: A literature review 

NARCIS (Netherlands)

Peters, J.T.P.; Driel, F.T.M. van; Jansen, W.H.M.

2014-01-01

Sub-Saharan African women are affected disproportionately highly by AIDS, while experiencing lack of choice for devices which protect them against sexual transmitted diseases, including HIV. One should expect that global policy makers react positive to the female condom, a contraceptive device which

Sub-Saharan Africa's media and neocolonialism.

Science.gov (United States)

Domatob, J K

1988-01-01

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.

Learning-by-Exporting Versus Self-Selection: New Evidence for 19 Sub-Saharan African Countries

NARCIS (Netherlands)

Foster-McGregor, N.; Isaksson, A.; Kaulich, F.

2015-01-01

We examine learning-by-exporting effects of manufacturing and services firms in 19 sub-Saharan African countries. Comparing several outlier-robust estimators, our results provide evidence for positive effects in the manufacturing sector when using the MM estimator, but not in the services sector.

Plants as antimalarial agents in Sub-Saharan Africa.

Science.gov (United States)

Chinsembu, Kazhila C

2015-12-01

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.

Pleistocene North African genomes link Near Eastern and sub-Saharan African human populations.

Science.gov (United States)

van de Loosdrecht, Marieke; Bouzouggar, Abdeljalil; Humphrey, Louise; Posth, Cosimo; Barton, Nick; Aximu-Petri, Ayinuer; Nickel, Birgit; Nagel, Sarah; Talbi, El Hassan; El Hajraoui, Mohammed Abdeljalil; Amzazi, Saaïd; Hublin, Jean-Jacques; Pääbo, Svante; Schiffels, Stephan; Meyer, Matthias; Haak, Wolfgang; Jeong, Choongwon; Krause, Johannes

2018-05-04

North Africa is a key region for understanding human history, but the genetic history of its people is largely unknown. We present genomic data from seven 15,000-year-old modern humans, attributed to the Iberomaurusian culture, from Morocco. We find a genetic affinity with early Holocene Near Easterners, best represented by Levantine Natufians, suggesting a pre-agricultural connection between Africa and the Near East. We do not find evidence for gene flow from Paleolithic Europeans to Late Pleistocene North Africans. The Taforalt individuals derive one-third of their ancestry from sub-Saharan Africans, best approximated by a mixture of genetic components preserved in present-day West and East Africans. Thus, we provide direct evidence for genetic interactions between modern humans across Africa and Eurasia in the Pleistocene. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

HUMAN SIDE OF E-COMMERCE IN THE SUB-SAHARAN AFRICAN COUNTRIES

OpenAIRE

DURAK, Görkem

2017-01-01

E-commerce is a new way of shopping through using internet since 1990s. This latest from of shopping is based on progress in information technologies. In the 1990s, companies just as Amazon and eBay started to change the shopping behavior of people. In this research, e-commerce index of 44 Sub-Saharan African countries are calculated by using World Development Indicators which are issued by the World Bank Group. The E-commerce index is consisting of access to electricity, co...

Energy Security and Sub-Saharan Africa

Directory of Open Access Journals (Sweden)

Emily Meierding

2013-02-01

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.

Bibliometric Assessment of European and Sub-Saharan African Research Output on Poverty-Related and Neglected Infectious Diseases from 2003 to 2011.

Science.gov (United States)

Breugelmans, J Gabrielle; Makanga, Michael M; Cardoso, Ana Lúcia V; Mathewson, Sophie B; Sheridan-Jones, Bethan R; Gurney, Karen A; Mgone, Charles S

2015-08-01

The European & Developing Countries Clinical Trials Partnership (EDCTP) is a partnership of European and sub-Saharan African countries that aims to accelerate the development of medical interventions against poverty-related diseases (PRDs). A bibliometric analysis was conducted to 1) measure research output from European and African researchers on PRDs, 2) describe collaboration patterns, and 3) assess the citation impact of clinical research funded by EDCTP. Disease-specific research publications were identified in Thomson Reuters Web of Science using search terms in titles, abstracts and keywords. Publication data, including citation counts, were extracted for 2003-2011. Analyses including output, share of global papers, normalised citation impact (NCI), and geographical distribution are presented. Data are presented as five-year moving averages. European EDCTP member countries accounted for ~33% of global research output in PRDs and sub-Saharan African countries for ~10% (2007-2011). Both regions contributed more to the global research output in malaria (43.4% and 22.2%, respectively). The overall number of PRD papers from sub-Saharan Africa increased markedly (>47%) since 2003, particularly for HIV/AIDS (102%) and tuberculosis (TB) (81%), and principally involving Southern and East Africa. For 2007-2011, European and sub-Saharan African research collaboration on PRDs was highly cited compared with the world average (NCI in brackets): HIV/AIDS 1.62 (NCI: 1.16), TB 2.11 (NCI: 1.06), malaria 1.81 (NCI: 1.22), and neglected infectious diseases 1.34 (NCI: 0.97). The NCI of EDCTP-funded papers for 2003-2011 was exceptionally high for HIV/AIDS (3.24), TB (4.08) and HIV/TB co-infection (5.10) compared with global research benchmarks (1.14, 1.05 and 1.35, respectively). The volume and citation impact of papers from sub-Saharan Africa has increased since 2003, as has collaborative research between Europe and sub-Saharan Africa. >90% of publications from EDCTP

Bibliometric Assessment of European and Sub-Saharan African Research Output on Poverty-Related and Neglected Infectious Diseases from 2003 to 2011

Science.gov (United States)

Gurney, Karen A.; Mgone, Charles S.

2015-01-01

Background The European & Developing Countries Clinical Trials Partnership (EDCTP) is a partnership of European and sub-Saharan African countries that aims to accelerate the development of medical interventions against poverty-related diseases (PRDs). A bibliometric analysis was conducted to 1) measure research output from European and African researchers on PRDs, 2) describe collaboration patterns, and 3) assess the citation impact of clinical research funded by EDCTP. Methodology/Principal Findings Disease-specific research publications were identified in Thomson Reuters Web of Science using search terms in titles, abstracts and keywords. Publication data, including citation counts, were extracted for 2003–2011. Analyses including output, share of global papers, normalised citation impact (NCI), and geographical distribution are presented. Data are presented as five-year moving averages. European EDCTP member countries accounted for ~33% of global research output in PRDs and sub-Saharan African countries for ~10% (2007–2011). Both regions contributed more to the global research output in malaria (43.4% and 22.2%, respectively). The overall number of PRD papers from sub-Saharan Africa increased markedly (>47%) since 2003, particularly for HIV/AIDS (102%) and tuberculosis (TB) (81%), and principally involving Southern and East Africa. For 2007–2011, European and sub-Saharan African research collaboration on PRDs was highly cited compared with the world average (NCI in brackets): HIV/AIDS 1.62 (NCI: 1.16), TB 2.11 (NCI: 1.06), malaria 1.81 (NCI: 1.22), and neglected infectious diseases 1.34 (NCI: 0.97). The NCI of EDCTP-funded papers for 2003–2011 was exceptionally high for HIV/AIDS (3.24), TB (4.08) and HIV/TB co-infection (5.10) compared with global research benchmarks (1.14, 1.05 and 1.35, respectively). Conclusions The volume and citation impact of papers from sub-Saharan Africa has increased since 2003, as has collaborative research between Europe and

Bibliometric Assessment of European and Sub-Saharan African Research Output on Poverty-Related and Neglected Infectious Diseases from 2003 to 2011.

Directory of Open Access Journals (Sweden)

J Gabrielle Breugelmans

2015-08-01

Full Text Available The European & Developing Countries Clinical Trials Partnership (EDCTP is a partnership of European and sub-Saharan African countries that aims to accelerate the development of medical interventions against poverty-related diseases (PRDs. A bibliometric analysis was conducted to 1 measure research output from European and African researchers on PRDs, 2 describe collaboration patterns, and 3 assess the citation impact of clinical research funded by EDCTP.Disease-specific research publications were identified in Thomson Reuters Web of Science using search terms in titles, abstracts and keywords. Publication data, including citation counts, were extracted for 2003-2011. Analyses including output, share of global papers, normalised citation impact (NCI, and geographical distribution are presented. Data are presented as five-year moving averages. European EDCTP member countries accounted for ~33% of global research output in PRDs and sub-Saharan African countries for ~10% (2007-2011. Both regions contributed more to the global research output in malaria (43.4% and 22.2%, respectively. The overall number of PRD papers from sub-Saharan Africa increased markedly (>47% since 2003, particularly for HIV/AIDS (102% and tuberculosis (TB (81%, and principally involving Southern and East Africa. For 2007-2011, European and sub-Saharan African research collaboration on PRDs was highly cited compared with the world average (NCI in brackets: HIV/AIDS 1.62 (NCI: 1.16, TB 2.11 (NCI: 1.06, malaria 1.81 (NCI: 1.22, and neglected infectious diseases 1.34 (NCI: 0.97. The NCI of EDCTP-funded papers for 2003-2011 was exceptionally high for HIV/AIDS (3.24, TB (4.08 and HIV/TB co-infection (5.10 compared with global research benchmarks (1.14, 1.05 and 1.35, respectively.The volume and citation impact of papers from sub-Saharan Africa has increased since 2003, as has collaborative research between Europe and sub-Saharan Africa. >90% of publications from EDCTP

An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective

NARCIS (Netherlands)

Belue, Rhonda; Okoror, Titilayo A.; Iwelunmor, Juliet; Taylor, Kelly D.; Degboe, Arnold N.; Agyemang, Charles; Ogedegbe, Gbenga

2009-01-01

ABSTRACT: BACKGROUND: Sub-Saharan African (SSA) countries are currently experiencing one of the most rapid epidemiological transitions characterized by increasing urbanization and changing lifestyle factors. This has resulted in an increase in the incidence of non-communicable diseases, especially

Sub Saharan African Terrorist Groups’ use of the Internet

Directory of Open Access Journals (Sweden)

Stewart Bertram

2014-02-01

Full Text Available Recent actions by French military forces in Niger and the global prominence of terrorist groups such as Al Shabaab and Boko Haram, have highlighted the growing counter terrorist focus on the countries of Sub Saharan Africa. Additionally in a post Bin Laden world and with the immanent withdrawal of coalition combat troops from Afghanistan, there is the possibility of Africa as a continent becoming the new front in the Global War on Terror ('Mben' et al., 2013. However, it is a mistake to assume that Africa’s story is uniformly one of violence and death. Vibrant cultures and a rugged entrepreneurial spirit have combined with a robust Internet backbone, to create the embryonic emergence of high tech hotspots across Africa. With rising IT literacy levels, more and more Africans are becoming connected to the information super highway on a daily basis (Graham, 2010. A tiny minority of these Africans are terrorists.

Current Status of Family Medicine Faculty Development in Sub-Saharan Africa.

Science.gov (United States)

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

2017-03-01

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.

Blood donation barriers and facilitators of Sub-Saharan African migrants and minorities in Western high-income countries: a systematic review of the literature

NARCIS (Netherlands)

Klinkenberg, E. F.; Huis In 't Veld, E. M. J.; de Wit, P. D.; van Dongen, A.; Daams, J. G.; de Kort, W. L. A. M.; Fransen, M. P.

2018-01-01

The present study aimed to gain more insight into, and summarise, blood donation determinants among migrants or minorities of Sub-Saharan heritage by systematically reviewing the current literature. Sub-Saharan Africans are under-represented in the blood donor population in Western high-income

Growth and Poverty in Sub-Saharan Africa

OpenAIRE

Arndt, Channing; McKay, Andrew; Tarp, Finn

2016-01-01

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....

African marketing boards under structural adjustment : the experience of Sub-Saharan Africa during the 1980s

NARCIS (Netherlands)

Laan, van der H.L.; Haaren, van W.T.M.

1990-01-01

Sum.: The economic policy of structural adjustment, which was initiated in most African countries during the 1980s, posed a serious threat to agricultural marketing boards in sub-Saharan Africa. Two elements of structural adjustment were particularly ominous: 'privatization' threatened the continued

Sub-Saharan African maize-based foods

NARCIS (Netherlands)

Ekpa, Onu; Palacios-Rojas, Natalia; Kruseman, Gideon; Fogliano, Vincenzo; Linnemann, Anita R.

2018-01-01

The demand for maize in Sub-Saharan Africa will triple by 2050 due to rapid population growth, while challenges from climate change will threaten agricultural productivity. Most maize breeding programmes have focused on improving agronomic properties and have paid relatively little attention to

The Average IQ of Sub-Saharan Africans: Comments on Wicherts, Dolan, and van der Maas

Science.gov (United States)

Lynn, Richard; Meisenberg, Gerhard

2010-01-01

Wicherts, Dolan, and van der Maas (2009) contend that the average IQ of sub-Saharan Africans is about 80. A critical evaluation of the studies presented by WDM shows that many of these are based on unrepresentative elite samples. We show that studies of 29 acceptably representative samples on tests other than the Progressive Matrices give a…

Social entrepreneurship in sub-Saharan Africa

NARCIS (Netherlands)

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,

Public Debts and Private Assets: Explaining Capital Flight from Sub-Saharan African Countries

OpenAIRE

Léonce Ndikumana; James K. Boyce

2002-01-01

We investigate the determinants of capital flight from 30 sub-Saharan African countries, including 24 countries classified as severely indebted low-income countries, for the period 1970-1996. The econometric analysis reveals that external borrowing is positively and significantly related to capital flight, suggesting that to a large extent capital flight is debt-fueled. We estimate that for every dollar of external borrowing in the region, roughly 80 cents flowed back as capital flight in the...

Review: Joseph Patrick Ganahl, Corruption, Good Governance, and the African State: A Critical Analysis of the Political-Economic Foundations of Corruption in Sub-Saharan Africa (2013)

OpenAIRE

Reinhart Kößler; Arnold-Bergstraesser-Institut

2015-01-01

Review of the monograph:Joseph Patrick Ganahl, Corruption, Good Governance, and the African State: A Critical Analysis of the Political-Economic Foundations of Corruption in Sub-Saharan Africa, Potsdam: Potsdam University Press, 2013, ISBN 9783869562483, 300 pp. Besprechung der Monographie:Joseph Patrick Ganahl, Corruption, Good Governance, and the African State: A Critical Analysis of the Political-Economic Foundations of Corruption in Sub-Saharan Africa, Potsdam: Potsdam University Press...

The African Capacity Building Initiative: Toward Improved Policy Analysis and Development Management in Sub-Saharan Africa.

Science.gov (United States)

World Bank, Washington, DC.

The objective of the African Capacity Building Initiative is to build and strengthen local capabilities for policy analysis and development management in Sub-Saharan Africa. This report examines the nature and magnitude of the problem, which basically consists of a shortage of development management skills combined with weakness in the area of…

Prices of second-line antiretroviral treatment for middle-income countries inside versus outside sub-Saharan Africa.

Science.gov (United States)

Simmons, Bryony; Hill, Andrew; Ford, Nathan; Ruxrungtham, Kiat; Ananworanich, Jintanat

2014-01-01

Antiretrovirals are available at low prices in sub-Saharan Africa, but these prices may not be consistently available for middle-income countries in other regions with large HIV epidemics. Over 30% of HIV infected people live in countries outside sub-Saharan Africa. Several key antiretrovirals are still on patent, with generic production restricted. We assessed price variations for key antiretroviral drugs inside versus outside sub-Saharan Africa. HIV drug prices used in national programmes (2010-2014) were extracted from the WHO Global Price Reporting Mechanism database for all reporting middle-income countries as classified by the World Bank. Treatment costs (branded and generic) were compared for countries inside sub-Saharan Africa versus those outside. Five key second-line antiretrovirals were analysed: abacavir, atazanavir, darunavir, lopinavir/ritonavir, raltegravir. Prices of branded antiretrovirals were significantly higher outside sub-Saharan Africa (psub-Saharan Africa versus $4689 (IQR $4075-5717) in non-African middle-income countries, an increase of 541%. However, when supplied by generic companies, most antiretrovirals were similarly priced between countries in sub-Saharan Africa and other regions. Pharmaceutical companies are selling antiretrovirals to non-African middle-income countries at prices 74-541% higher than African countries with similar gross national incomes. However, generic companies are selling most of these drugs at similar prices across regions. Mechanisms to ensure fair pricing for patented antiretrovirals across both African and non-African middle-income countries need to be improved, to ensure sustainable treatment access.

Effects of capital inflows on emerging market economies : How FDI from Chinese investors impacts on growth of Sub-Saharan African countries?

OpenAIRE

Mattila, Tuulia

2017-01-01

Even though the implications of foreign direct investment (FDI) have been studied greatly, only a small part have focused on Sub-Saharan Africa (SSA). With young and relatively talented workforce, SSA will provide enormous opportunities for multinationals entering the region. The purpose of this research is to examine whether FDI from China has a significant impact on economic development in Sub-Saharan African countries. In addition, it identifies the difference between the motivations o...

The Re-Birth of African Moral Traditions as Key to the Development of Sub-Saharan Africa: The Igbo Paradigm

Science.gov (United States)

Okpalikel, Chika J. B. Gabriel

2015-01-01

This work is set against the backdrop of the Sub-Saharan African environment observed to be morally degenerative. It judges that the level of decadence in the continent that could even amount to depravity could be blamed upon the disconnect between the present-day African and a moral tradition that has been swept under the carpet through history;…

Expenditures on health research in sub-Saharan African countries: results of a questionnaire-based survey.

Science.gov (United States)

Kebede, Derege; Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

2014-05-01

To estimate the sources of funds for health research (revenue) and the uses of these funds (expenditure). A structured questionnaire was used to solicit financial information from health research institutions. Forty-two sub-Saharan African countries. Key informants in 847 health research institutions in the 42 sub-Saharan African countries. Expenditure on health research by institutions, funders and subject areas. An estimated total of US$ 302 million was spent on health research by institutions that responded to the survey in the World Health Organization (WHO) African Region for the biennium 2005-2006. The most notable funders for health research activities were external funding, ministries of health, other government ministries, own funds and non-profit institutions. Most types of health research performers spent significant portions of their resources on in-house research, with medical schools spending 82% and government agencies 62%. Hospitals spent 38% of their resources on management, and other institutions (universities, firms, etc.) spent 87% of their resources on capital investment. Research on human immunodeficiency virus/tuberculosis and malaria accounted for 30% of funds, followed by research on other communicable diseases and maternal, perinatal and nutritional conditions (23%). Research on major health problems of the Region, such as communicable diseases, accounts for most of the research expenditures. However, the total expenditure is very low compared with other WHO regions. © The Royal Society of Medicine.

Population Genomics of sub-saharan Drosophila melanogaster: African diversity and non-African admixture.

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John E Pool

Full Text Available Drosophila melanogaster has played a pivotal role in the development of modern population genetics. However, many basic questions regarding the demographic and adaptive history of this species remain unresolved. We report the genome sequencing of 139 wild-derived strains of D. melanogaster, representing 22 population samples from the sub-Saharan ancestral range of this species, along with one European population. Most genomes were sequenced above 25X depth from haploid embryos. Results indicated a pervasive influence of non-African admixture in many African populations, motivating the development and application of a novel admixture detection method. Admixture proportions varied among populations, with greater admixture in urban locations. Admixture levels also varied across the genome, with localized peaks and valleys suggestive of a non-neutral introgression process. Genomes from the same location differed starkly in ancestry, suggesting that isolation mechanisms may exist within African populations. After removing putatively admixed genomic segments, the greatest genetic diversity was observed in southern Africa (e.g. Zambia, while diversity in other populations was largely consistent with a geographic expansion from this potentially ancestral region. The European population showed different levels of diversity reduction on each chromosome arm, and some African populations displayed chromosome arm-specific diversity reductions. Inversions in the European sample were associated with strong elevations in diversity across chromosome arms. Genomic scans were conducted to identify loci that may represent targets of positive selection within an African population, between African populations, and between European and African populations. A disproportionate number of candidate selective sweep regions were located near genes with varied roles in gene regulation. Outliers for Europe-Africa F(ST were found to be enriched in genomic regions of locally

Population Genomics of Sub-Saharan Drosophila melanogaster: African Diversity and Non-African Admixture

Science.gov (United States)

Pool, John E.; Corbett-Detig, Russell B.; Sugino, Ryuichi P.; Stevens, Kristian A.; Cardeno, Charis M.; Crepeau, Marc W.; Duchen, Pablo; Emerson, J. J.; Saelao, Perot; Begun, David J.; Langley, Charles H.

2012-01-01

Drosophila melanogaster has played a pivotal role in the development of modern population genetics. However, many basic questions regarding the demographic and adaptive history of this species remain unresolved. We report the genome sequencing of 139 wild-derived strains of D. melanogaster, representing 22 population samples from the sub-Saharan ancestral range of this species, along with one European population. Most genomes were sequenced above 25X depth from haploid embryos. Results indicated a pervasive influence of non-African admixture in many African populations, motivating the development and application of a novel admixture detection method. Admixture proportions varied among populations, with greater admixture in urban locations. Admixture levels also varied across the genome, with localized peaks and valleys suggestive of a non-neutral introgression process. Genomes from the same location differed starkly in ancestry, suggesting that isolation mechanisms may exist within African populations. After removing putatively admixed genomic segments, the greatest genetic diversity was observed in southern Africa (e.g. Zambia), while diversity in other populations was largely consistent with a geographic expansion from this potentially ancestral region. The European population showed different levels of diversity reduction on each chromosome arm, and some African populations displayed chromosome arm-specific diversity reductions. Inversions in the European sample were associated with strong elevations in diversity across chromosome arms. Genomic scans were conducted to identify loci that may represent targets of positive selection within an African population, between African populations, and between European and African populations. A disproportionate number of candidate selective sweep regions were located near genes with varied roles in gene regulation. Outliers for Europe-Africa FST were found to be enriched in genomic regions of locally elevated cosmopolitan

GDP Structure and Economic Performance in Sub-Saharan Countries

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Luboš Smutka

2014-01-01

Full Text Available Africa belongs to important regions of the world economy with specific problems distinguishing this part of the world from other regions. The region is suffering because of limited economy structure and high level of poverty. Low economic performance ranks most of African countries among the worldwide poorest ones (both from the point of view of total economy performance and also individuals living standards; the development is hindered by political instability and also by other accompanied problems as high level of corruption, deficit of democracy, low level of education, limited investments, criminality, local conflicts, civil wars etc. On the other hand, African natural, economy and social resources and unexploited opportunities in many areas offer a potential for a considerable economic development. Understanding the current economic position of African states thus may reveal causes of problematic development and outline ways to overcome existing shortcomings. The aim of the paper is to analyze main changes in area of GDP structure formation (agricultural, industrial and services sector share in GDP and value performance which have occurred in selected African (Sub-Saharan countries. Changes are analyzed both in relation to the total GDP and GDP per capita. The authors identify main trends of economic development in the Sub-Saharan region and to specify differences among Sub-Saharan countries with the intention to identify particular groups of African countries according to their economic structure and to identify differences in their GDP formation.

Globalization, Financial Depth, and Inequality in Sub-Saharan Africa

OpenAIRE

Hisako KAI; Shigeyuki HAMORI

2009-01-01

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...

Scarification in sub-Saharan Africa: social skin, remedy and medical import.

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Garve, Roland; Garve, Miriam; Türp, Jens C; Fobil, Julius N; Meyer, Christian G

2017-06-01

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.

Quality Assurance in Sub-Saharan Africa

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Materu, Peter; Righetti, Petra

2010-01-01

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.…

Electoral Institutions and Electoral Violence in Sub-Saharan Africa

OpenAIRE

Fjelde, Hanne; Höglund, Kristine

2016-01-01

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...

Productive Government Expenditure and Economic Performance in sub-Saharan Africa: An Empirical Investigation

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Adefeso Hammed Adetola

2016-11-01

Full Text Available This study examined the effect of government expenditure on its disaggregated level on economic growth in a sample of 20 sub-Saharan African Countries over the period of 1980-2010 in a dynamic panel data model. The result from Generalised Method of Moments (GMM revealed an inverse relationship between productive government expenditure and economic growth in sub-Sahara Africa. Also, productive government expenditures were not actually productive most especially when financed by non-distortonary government tax revenue in sub-Saharan African countries. The study concluded that the productive government expenditure and its corresponding source of the mode of financing were counterproductive for economic performance in the African countries.

Nutrition, health, and aging in sub-Saharan Africa.

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Kimokoti, Ruth W; Hamer, Davidson H

2008-11-01

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.

National health policies: sub-Saharan African case studies (1980-1990).

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Dugbatey, K

1999-07-01

changes in the sub-Saharan African region as a whole and in some of the case countries in particular. Political leadership has changed in Ghana and Cote d'Ivoire with some course corrections in Ghana's health plans. Health sector financing in the region has become more dependent on external donors. The World Bank leads the external donor community in promoting policy-based lending. The complexity of a number of health problems has changed while the problems themselves remain the same as before. Essentially, building viable public health infrastructures to address basic public health needs must still be high on the agenda of action for most governments in the region. Thus, notwithstanding some course corrections and reasonable shifts in priorities, all the PHC principles are still applicable, indeed, much needed in the sub-Saharan African region. This study's findings, underscoring the fact that significant improvements in health are possible even where financial resources are limited, still hold true.

CDM in sub-Saharan Africa and the prospects of the Nairobi Framework Initiative

NARCIS (Netherlands)

Byigero, Alfred D.; Clancy, Joy S.; Skutsch, Margaret

2010-01-01

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

Increased Use of Injectable Contraception in Sub-Saharan Africa ...

African Journals Online (AJOL)

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.

Boys are not exempt: Sexual exploitation of adolescents in sub-Saharan Africa.

Science.gov (United States)

Adjei, Jones K; Saewyc, Elizabeth M

2017-03-01

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.

A brief history of medical education in Sub-Saharan Africa.

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Monekosso, G L

2014-08-01

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.

Public health and research funding for childhood neurodevelopmental disorders in Sub-Saharan Africa: a time to balance priorities

OpenAIRE

Bakare, Muideen O.; Munir, Kerim M.; Bello-Mojeed, Mashudat A.

2014-01-01

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...

Biofuel Development Initiatives in Sub-Saharan Africa: Opportunities and Challenges

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Patrick T. Sekoai

2016-06-01

Full Text Available In recent years, biofuels have emerged as a suitable alternative to hydrocarbon fuel due to their foreseen potential of being a future energy resource. Biofuel development initiatives have been successfully implemented in countries like Brazil, United States of America, European Union, Canada, Australia, and Japan. However, such programmes have been stagnant in Africa due to various constraints, such as financial barriers, technical expertise, land availability, and government policies. Nonetheless, some countries within the continent have realized the potential of biofuels and have started to introduce similar programmes and initiatives for their development. These include the bioethanol production initiatives and the plantation of jatropha oil seeds in most Sub-Saharan African countries for biodiesel production. Therefore, this paper examines the biofuel development initiatives that have been implemented in several countries across Sub-Saharan Africa over the past few years. It also discusses the opportunities and challenges of having biofuel industries in the continent. Finally, it proposes some recommendations that could be applied to accelerate their development in these Sub-Saharan African countries.

Patterns of Manufacturing Growth in Sub-Saharan Africa

NARCIS (Netherlands)

Austin, G.; Frankema, E.H.P.; Jerven, M.

2017-01-01

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

Early Marriage and Motherhood in Sub-Saharan Africa | Locoh ...

African Journals Online (AJOL)

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 ...

Why sub-Saharan African health workers migrate to European countries that do not actively recruit: a qualitative study post-migration.

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Poppe, Annelien; Jirovsky, Elena; Blacklock, Claire; Laxmikanth, Pallavi; Moosa, Shabir; De Maeseneer, Jan; Kutalek, Ruth; Peersman, Wim

2014-01-01

Many studies have investigated the migration intentions of sub-Saharan African medical students and health professionals within the context of a legacy of active international recruitment by receiving countries. However, many health workers migrate outside of this recruitment paradigm. This paper aims to explore the reasons for migration of health workers from sub-Saharan Africa to Belgium and Austria; European countries without a history of active recruitment in sub-Saharan Africa. Data were collected using semistructured interviews. Twenty-seven health workers were interviewed about their migration experiences. Included participants were born in sub-Saharan Africa, had trained as health workers in sub-Saharan Africa, and were currently living in Belgium or Austria, though not necessarily currently working as a health professional. Both Austria and Belgium were shown not to be target countries for the health workers, who instead moved there by circumstance, rather than choice. Three principal reasons for migration were reported: 1) educational purposes; 2) political instability or insecurity in their country of origin; and 3) family reunification. In addition, two respondents mentioned medical reasons and, although less explicit, economic factors were also involved in several of the respondents' decision to migrate. These results highlight the importance of the broader economic, social, and political context within which migration decisions are made. Training opportunities proved to be an important factor for migration. A further development and upgrade of primary care might help to counter the common desire to specialize and improve domestic training opportunities.

Harnessing Open Educational Resources to the Challenges of Teacher Education in Sub-Saharan Africa

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Thakrar, Jayshree; Zinn, Denise; Wolfenden, Freda

2009-01-01

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…

A Positive Path for Food Security in Sub-Saharan Africa: Options and Challenges

OpenAIRE

Rosen, Stacey L.; Shapouri, Shahla

2010-01-01

African Governments and international donors are focused on improving the region’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.

GROWTH REGIMES IN SUB-SAHARAN AFRICA: A MIXTUREMODEL APPROACH

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Emmanuel Igbinoba

2016-07-01

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

Bibliography on Islam in contemporary Sub-Saharan Africa

NARCIS (Netherlands)

Schrijver, P.

2006-01-01

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

Admixture into and within sub-Saharan Africa

Science.gov (United States)

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

2016-01-01

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

Impact of human schistosomiasis in sub-Saharan Africa.

Science.gov (United States)

Adenowo, Abiola Fatimah; Oyinloye, Babatunji Emmanuel; Ogunyinka, Bolajoko Idiat; Kappo, Abidemi Paul

2015-01-01

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

Impact of human schistosomiasis in sub-Saharan Africa

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Abiola Fatimah Adenowo

2015-03-01

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.

X-linked MTMR8 diversity and evolutionary history of sub-Saharan populations.

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Damian Labuda

Full Text Available The genetic diversity within an 11 kb segment of the MTMR8 gene in a sample of 111 sub-Saharan and 49 non-African X chromosomes was investigated to assess the early evolutionary history of sub-Saharan Africans and the out-of-Africa expansion. The analyses revealed a complex genetic structure of the Africans that contributed to the emergence of modern humans. We observed partitioning of two thirds of old lineages among southern, west/central and east African populations indicating ancient population stratification predating the out of Africa migration. Age estimates of these lineages, older than coalescence times of uniparentally inherited markers, raise the question whether contemporary humans originated from a single population or as an amalgamation of different populations separated by years of independent evolution, thus suggesting a greater antiquity of our species than generally assumed. While the oldest sub-Saharan lineages, ~500 thousand years, are found among Khoe-San from southern-Africa, a distinct haplotype found among Biaka is likely due to admixture from an even older population. An East African population that gave rise to non-Africans underwent a selective sweep affecting the subcentromeric region where MTMR8 is located. This and similar sweeps in four other regions of the X chromosome, documented in the literature, effectively reduced genetic diversity of non-African chromosomes and therefore may have exacerbated the effect of the demographic bottleneck usually ascribed to the out of Africa migration. Our data is suggestive, however, that a bottleneck, occurred in Africa before range expansion.

X-linked MTMR8 diversity and evolutionary history of sub-Saharan populations.

Science.gov (United States)

Labuda, Damian; Yotova, Vania; Lefebvre, Jean-François; Moreau, Claudia; Utermann, Gerd; Williams, Scott M

2013-01-01

The genetic diversity within an 11 kb segment of the MTMR8 gene in a sample of 111 sub-Saharan and 49 non-African X chromosomes was investigated to assess the early evolutionary history of sub-Saharan Africans and the out-of-Africa expansion. The analyses revealed a complex genetic structure of the Africans that contributed to the emergence of modern humans. We observed partitioning of two thirds of old lineages among southern, west/central and east African populations indicating ancient population stratification predating the out of Africa migration. Age estimates of these lineages, older than coalescence times of uniparentally inherited markers, raise the question whether contemporary humans originated from a single population or as an amalgamation of different populations separated by years of independent evolution, thus suggesting a greater antiquity of our species than generally assumed. While the oldest sub-Saharan lineages, ~500 thousand years, are found among Khoe-San from southern-Africa, a distinct haplotype found among Biaka is likely due to admixture from an even older population. An East African population that gave rise to non-Africans underwent a selective sweep affecting the subcentromeric region where MTMR8 is located. This and similar sweeps in four other regions of the X chromosome, documented in the literature, effectively reduced genetic diversity of non-African chromosomes and therefore may have exacerbated the effect of the demographic bottleneck usually ascribed to the out of Africa migration. Our data is suggestive, however, that a bottleneck, occurred in Africa before range expansion.

Science Granting Councils Initiative in Sub-Saharan Africa ...

International Development Research Centre (IDRC) Digital Library (Canada)

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 ...

Empowering Youth for Sub-Saharan Africa's Development | Betchoo ...

African Journals Online (AJOL)

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 ...

Bibliography on Islam in contemporary Sub-Saharan Africa

NARCIS (Netherlands)

Schrijver, P.

2006-01-01

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

Challenges of doing research in sub-Saharan African universities ...

African Journals Online (AJOL)

The internationalisation of higher education, coupled with growing student ... efforts to rank universities in terms of their academic quality and productivity at national, ... scholarship, e-research, e-learning, sub-Saharan Africa, higher education ...

Explaining adherence success in sub-Saharan Africa: an ethnographic study.

Directory of Open Access Journals (Sweden)

Norma C Ware

2009-01-01

Full Text Available Individuals living with HIV/AIDS in sub-Saharan Africa generally take more than 90% of prescribed doses of antiretroviral therapy (ART. This number exceeds the levels of adherence observed in North America and dispels early scale-up concerns that adherence would be inadequate in settings of extreme poverty. This paper offers an explanation and theoretical model of ART adherence success based on the results of an ethnographic study in three sub-Saharan African countries.Determinants of ART adherence for HIV-infected persons in sub-Saharan Africa were examined with ethnographic research methods. 414 in-person interviews were carried out with 252 persons taking ART, their treatment partners, and health care professionals at HIV treatment sites in Jos, Nigeria; Dar es Salaam, Tanzania; and Mbarara, Uganda. 136 field observations of clinic activities were also conducted. Data were examined using category construction and interpretive approaches to analysis. Findings indicate that individuals taking ART routinely overcome economic obstacles to ART adherence through a number of deliberate strategies aimed at prioritizing adherence: borrowing and "begging" transport funds, making "impossible choices" to allocate resources in favor of treatment, and "doing without." Prioritization of adherence is accomplished through resources and help made available by treatment partners, other family members and friends, and health care providers. Helpers expect adherence and make their expectations known, creating a responsibility on the part of patients to adhere. Patients adhere to promote good will on the part of helpers, thereby ensuring help will be available when future needs arise.Adherence success in sub-Saharan Africa can be explained as a means of fulfilling social responsibilities and thus preserving social capital in essential relationships.

Population growth and food supply in sub-Saharan Africa.

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Meerman, J; Cochrane, S H

1982-09-01

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

Cervical cancer in sub-Saharan Africa: a preventable noncommunicable disease.

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Mboumba Bouassa, Ralph-Sydney; Prazuck, Thierry; Lethu, Thérèse; Jenabian, Mohammad-Ali; Meye, Jean-François; Bélec, Laurent

2017-06-01

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.

Shocks, civil war and economic development in Sub-Saharan Africa

OpenAIRE

Nillesen, E.E.M.

2010-01-01

Foreign aid, low institutional quality and civil wars are associated with slow economic development in many Sub-Sahara African countries. I aim to identify causal relations and mechanisms that explain significant correlations. I use both macro- and micro-economic data and show that results are not necessarily far apart. I assess the influence of foreign aid using macro-level data of 30 Sub-Saharan African countries. Opponents argue that foreign aid corrupts, and will end up in the hands of a...

Tax Policy in Sub-Saharan Africa : ECORYS Research Programme

NARCIS (Netherlands)

Volkerink, B.S.I.|info:eu-repo/dai/nl/181281864

2008-01-01

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)

Photovoltaic energy: an efficient development tool for Sub-Saharan economies

International Nuclear Information System (INIS)

Megherbi, Karim

2013-01-01

In this report, the author aims at highlighting the main success factors for a photovoltaic program in sub-Saharan Africa, and the benefits of this technology for African electricity operators. He first presents the electricity sector of Sub-Saharan Africa, its current situation, its scenarios of evolution, and the limitations of scenarios based on conventional energies. In a second part, he discusses the role photovoltaic solar energy could have within the energy mix of Sub-Saharan countries. He discusses how to calculate the cost of photovoltaic electricity production, and the value of photovoltaic electricity, discusses the main influencing parameters, and tries to identify when it becomes worth to choose photovoltaic electricity. He describes the implementation of an adapted legal and economic framework, the 'feed-in-tariff'. An appendix contains a proposition for Western Africa and analyses the case of Benin

Leptospirosis in Sub-Saharan Africa: a systematic review.

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de Vries, Sophia G; Visser, Benjamin J; Nagel, Ingeborg M; Goris, Marga G A; Hartskeerl, Rudy A; Grobusch, Martin P

2014-11-01

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.

The state, refugees and migration in sub-Saharan Africa.

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Akokpari, J K

1998-01-01

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.

Rapid population growth and fragile environments: the sub-Saharan African and south Asian experience.

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Caldwell, J C; Caldwell, P

1994-02-18

Case studies of the world's two poorest regions, sub-Saharan Africa and South Asia, were used to illustrate the compromised standard of living of the poor and environmental damage due to continued rapid population growth. The conclusion was that the livelihoods of the poor should not be endangered for preserving the living standards of richer people. Nations must not ignore the challenges of reducing population growth as fast as can be achieved. The transitional period over the next 50 years is the main concern, because population growth rates will be slowing. Rural population growth is expected to decline from 60% of total population growth in South Asia to 7% between 2000 and 2025; similarly the decline in sub-Saharan Africa would be from 50% to 15%. Over the past 30 years, food production in South Asia has kept pace with population growth. Sub-Saharan Africa has adopted food importation to meet demand. African problems are a low resource base, faster population growth, and the fact that governments and individuals are too poor to maintain soil fertility. Long-term studies of how much soil depletion will occur are not available for these regions, and local area studies are not as pessimistic. Transition policies are needed to put "people first in terms of engineered or directed population and ecological change." The six main issues are the following: 1) the Brundtland Commission appropriately identified poverty as the main cause and effect of environmental degradation because of the threat to survival; 2) the verdict is still out about whether food production will keep pace with population growth through economic growth and investment in agriculture; 3) empirical research is needed to examine local social and regulatory institutions and the possibility of reinforcing these mechanisms rather than instituting central controls; 4) central coercion or modernizing economic policies can destroy local level controls; 5) famine is a complex ecological phenomenon and the

Sub-Saharan Africa: Sustainability Risk Discussion

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Victoria Bakhtina

2011-11-01

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.

Identifying Effective Education Interventions in Sub-Saharan Africa: A Meta-Analysis of Rigorous Impact Evaluations

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Conn, Katharine

2014-01-01

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…

Review: Head and neck squamous cell carcinoma in sub-Saharan ...

African Journals Online (AJOL)

Aim Review the literature from 1990 to 2013 to determine known anatomic sites, risk factors, treatments, and outcomes of head and neck squamous cell carcinoma (HNSCC) in sub-Saharan Africa. Methods Using a systematic search strategy, literature pertaining to HNSCC in sub-Saharan Africa was reviewed and patient ...

Kinship Structures and Social Justice in Sub-Saharan Africa ...

African Journals Online (AJOL)

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 ...

Evaluating a LARC Expansion Program in 14 Sub-Saharan African Countries: A Service Delivery Model for Meeting FP2020 Goals.

Science.gov (United States)

Ngo, Thoai D; Nuccio, Olivia; Pereira, Shreya K; Footman, Katharine; Reiss, Kate

2017-09-01

Objectives In many sub-Saharan African countries, the use of long-acting reversible contraceptives (LARCs) is low while unmet need for family planning (FP) remains high. We evaluated the effectiveness of a LARC access expansion initiative in reaching young, less educated, poor, and rural women. Methods Starting in 2008, Marie Stopes International (MSI) has implemented a cross-country expansion intervention to increase access to LARCs through static clinics, mobile outreach units, and social franchising of private sector providers. We analyzed routine service statistics for 2008-2014 and 2014 client exit interview data. Indicators of effectiveness were the number of LARCs provided and the percentages of LARC clients who had not used a modern contraceptive in the last 3 months ("adopters"); switched from a short-term contraceptive to a LARC ("switchers"); were aged <25; lived in extreme poverty; had not completed primary school; lived in rural areas; and reported satisfaction with their overall experience at the facility/site. Results Our annual LARC service distribution increased 1037 % (from 149,881 to over 1.7 million) over 2008-2014. Of 3816 LARC clients interviewed, 46 % were adopters and 46 % switchers; 37 % were aged 15-24, 42 % had not completed primary education, and 56 % lived in a rural location. Satisfaction with services received was rated 4.46 out of 5. Conclusions The effectiveness of the LARC expansion in these 14 sub-Saharan African FP programs demonstrates vast untapped potential for wider use of LARC methods, and suggests that this service delivery model is a plausible way to support FP 2020 goals of reaching those with an unmet need for FP.

Corruption in Sub-Saharan Africa: A practical-theological response

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Petria M. Theron

2013-11-01

Full Text Available On the 2012 Corruption Perceptions Index of Transparency International, 89.6% of Sub-Saharan African countries received scores below 50, where a score of zero signifies that the country is highly corrupt and a score of 100 declares a country free of corruption. From these results, it seems as if Sub-Saharan African countries are quite vulnerable to corruption. In this article, the question whether certain traits in the Sub-Saharan African culture such as communalism, gift giving and a shame culture could in some situations influence people’s perception of, and their possible openness towards, certain forms of corruption was investigated. The research showed that cultural traits do influence people’s behaviour and that there are certain traits in the Sub-Saharan African culture that might sanction corruption. In response to these findings, some preliminary suggestions were proposed as to how Christians living in Africa could evaluate their cultural practices in the light of God’s Word and from a reformed theological paradigm. Instead of succumbing to the pressure posed by their culture to participate in immoral or corrupt activities, they could contribute to a moral regeneration on the African continent. Volgens Transparency International se 2012-CorruptionPerceptions Index het 89.6% van Afrikalande suid van die Sahara ’n telling van minder as 50 gekry, waar ’n telling van nul op hoë korrupsie dui en ’n telling van 100 aandui dat ’n land vry van korrupsie is. Hieruit blyk dat hierdie lande kwesbaar is vir korrupsie. In hierdie artikel word die moontlikheid ondersoek dat daar sekere eienskappe in die kultuur van hierdie lande is wat mense se persepsie van, en moontlike deelname aan, sekere vorme van korrupsie kan beïnvloed. Aandag word aan aspekte soos kommunalisme, die gee van geskenke en ’n ‘skandekultuur’ gegee. Die navorsing toon dat kultuur wel mense se gedrag beïnvloed en dat daar sekere eienskappe in die kultuur van

Corporate boards and ownership structure: Evidence from Sub-Saharan Africa

NARCIS (Netherlands)

Munisi, Gibson; Hermes, Niels; Randoy, Trond

2014-01-01

This study examines the relationship between board structure and ownership structure for firms listed on the stock exchanges of twelve Sub-Saharan African countries, using data for the period 2006–2009. We find that ownership concentration, foreign ownership and managerial ownership are negatively

HIV and tuberculosis in prisons in sub-Saharan Africa.

Science.gov (United States)

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

2016-09-17

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

Future of Family Medicine Faculty Development in Sub-Saharan Africa.

Science.gov (United States)

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

2017-03-01

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.

Health expenditure and child health outcomes in Sub-Saharan Africa

African Journals Online (AJOL)

This study sought to understand the relationship between child health outcomes and health spending while investigating lagged effects. The study employed panel data from 45 Sub-Saharan African countries between 1995 and 2011 obtained from the World Bank's World Development Indicators. Fixed and Random effect ...

Income-environment relationship in Sub-Saharan African countries: Further evidence with trade openness.

Science.gov (United States)

Zerbo, Eléazar

2017-07-01

This paper examines the dynamic relationship between energy consumption, income growth, carbon emissions and trade openness in fourteen Sub-Saharan African (SSA) countries. The autoregressive distributed lag (ARDL) approach to cointegration and the Toda-Yamamoto causality test were used to investigate the long-run and short-run properties, respectively. The long-run estimations give evidence against the environmental Kuznets curve (EKC) hypothesis in SSA countries. In contrast, the results highlight the significant and monotonically contribution of income growth and energy consumption in explaining carbon emissions in the long-run and short-run in several countries. Furthermore, the results show that trade openness enhances economic growth and is not linked to causing carbon emissions in these countries. Hence, a trade incentive policy may be implemented without harmful effect on the quality of the environment.

A Bayesian analysis of the impact of post-crash care on road mortality in Sub-Saharan African countries

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Wonmongo Lacina Soro

2017-10-01

Full Text Available Sub-Saharan Africa is undergoing a disproportionate road tragedy compared to its motorization rate and road network density. Most of the road traffic deaths occur in the pre-hospital phase. Yet, more than half of the African countries do not possess formal pre-hospital care system. This study assesses the potential impact of post-crash care on road mortality in 23 Sub-Saharan African countries. A panel Bayesian normal linear regression with normally distributed non-informative priors is used to fit the data set covering the time period 2001–2010. The post-crash care system is proxied by the estimated share of seriously injured transported by ambulance, and three binary variables indicating the existence of emergency access telephone services and emergency training for doctors and nurses. The findings suggest a negative correlation between the road mortality rate and the estimated share of seriously injured transported by ambulance, the emergency access telephone services and the emergency training for doctors. A positive relation is unexpectedly observed for the emergency training for nurses. Other regressors such as the Gross Domestic Product per capita and populations in the age range 15–64 years are related to higher fatality rates while the length of the road network and life expectancy are linked to decreasing fatality rates.

Barriers to early presentation and diagnosis of breast cancer among African women living in sub-Saharan Africa.

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Cynthia Pomaa Akuoko

Full Text Available Breast cancer (BC has been described as the leading cause of cancer deaths among women especially in the developing world including sub Saharan Africa (SSA. Delayed presentation and late diagnosis at health facilities are parts of the contributing factors of high BC mortality in Africa. This review aimed to appraise the contributing factors to delayed breast cancer presentation and diagnosis among SSA women.Five databases encompassing medical and social sciences were systematically searched using predefined search terms linked with breast cancer presentation and diagnosis and sub Saharan Africa. Reference lists of relevant papers were also hand searched. Quality of quantitative and qualitative articles were assessed using the National Institute of Health (NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Critical Appraisal Skills Programme (CASP quality appraisal checklist. Thematic analysis was used to synthesize the qualitative studies to integrate findings.Fourteen (14 quantitative studies, two (2 qualitative studies and one (1 mixed method study merited inclusion for analysis. This review identified low knowledge of breast cancer among SSA women. This review also found lack of awareness of early detection treatment, poor perception of BC, socio-cultural factors such as belief, traditions and fear as factors impacting African women's health seeking behavior in relation to breast cancer.Improving African women's knowledge and understanding will improve behaviors related to breast cancer and facilitate early presentation and detection and enhance proper management and treatment of breast cancer.

Barriers to early presentation and diagnosis of breast cancer among African women living in sub-Saharan Africa

Science.gov (United States)

Akuoko, Cynthia Pomaa; Armah, Ernestina; Sarpong, Theresa; Quansah, Dan Yedu; Amankwaa, Isaac

2017-01-01

Background Breast cancer (BC) has been described as the leading cause of cancer deaths among women especially in the developing world including sub Saharan Africa (SSA). Delayed presentation and late diagnosis at health facilities are parts of the contributing factors of high BC mortality in Africa. This review aimed to appraise the contributing factors to delayed breast cancer presentation and diagnosis among SSA women. Methods Five databases encompassing medical and social sciences were systematically searched using predefined search terms linked with breast cancer presentation and diagnosis and sub Saharan Africa. Reference lists of relevant papers were also hand searched. Quality of quantitative and qualitative articles were assessed using the National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Critical Appraisal Skills Programme (CASP) quality appraisal checklist. Thematic analysis was used to synthesize the qualitative studies to integrate findings. Results Fourteen (14) quantitative studies, two (2) qualitative studies and one (1) mixed method study merited inclusion for analysis. This review identified low knowledge of breast cancer among SSA women. This review also found lack of awareness of early detection treatment, poor perception of BC, socio-cultural factors such as belief, traditions and fear as factors impacting African women’s health seeking behavior in relation to breast cancer. Conclusion Improving African women’s knowledge and understanding will improve behaviors related to breast cancer and facilitate early presentation and detection and enhance proper management and treatment of breast cancer. PMID:28192444

A profile of non-farm household enterprises in Sub-Saharan Africa

NARCIS (Netherlands)

Nagler, Paula

2017-01-01

This paper provides a comprehensive descriptive profile of non-farm household enterprises in ten Sub-Saharan African countries, disaggregated by the households' consumption quintiles. Various enterprise-related aspects are covered, such as the share of households that operate an enterprise, the

Public health and research funding for childhood neurodevelopmental disorders in Sub-Saharan Africa: a time to balance priorities

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Muideen O. Bakare

2014-01-01

Full Text Available Sub-Saharan African (SSA population consists of about 45% children, while in Europe and North America children population is 10- 15%. Lately, attention has been directed at mitigating childhood infectious and communicable diseases to reduce under-five mortality. As the under-five mortality index in Sub-Saharan Africa has relatively improved over the last two decades, more Sub-Saharan African children are surviving beyond the age of five and, apparently, a sizeable percentage of this population would be living with one or more childhood neurodevelopmental disorders (NDD. The distribution of child mental health service resources across the world is unequal. This manifests in the treatment gap of major childhood onset mental health problems in SSA, with the gap being more pronounced for childhood NDD. It is important to balance the public health focus and research funding priorities in Sub-Saharan Africa. We urgently need to define the burden of childhood NDD in the region for healthcare planning and policy formulation.

Oral Health Challenges for Sub-Saharan Africa | Danfillo | Nigerian ...

African Journals Online (AJOL)

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 ...

Timing of maternal death: Levels, trends, and ecological correlates using sibling data from 34 sub-Saharan African countries.

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Leena Merdad

Full Text Available Millennium Development Goal 5 has not been universally achieved, particularly in sub-Saharan Africa. Understanding whether maternal deaths occur during pregnancy, childbirth, or puerperium is important to effectively plan maternal health programs and allocate resources. Our main research objectives are to (1 describe the proportions and rates of mortality for the antepartum, intrapartum, and postpartum periods; (2 document how these trends vary by sub-region; and (3 investigate ecological correlations between these rates and maternal care interventions. We used data from the Demographic and Health Survey program, which comprises 84 surveys from 34 sub-Saharan African countries conducted between 1990 and 2014. We calculated age-standardized maternal mortality rates and time-specific maternal mortality rates and proportions, and we assessed correlations with maternal care coverage. We found high levels of maternal mortality in all three periods. Time-specific maternal mortality rates varied by country and region, with some showing an orderly decline in all three periods and others exhibiting alarming increases in antepartum and postpartum mortality. Ecological analysis showed that antenatal care coverage was significantly associated with low antepartum mortality, whereas the presence of a skilled attendant at childbirth was significantly associated with low postpartum mortality. In sub-Saharan Africa, maternal deaths occur at high rates in all three risk periods, and vary substantially by country and region. The provision of maternal care is a predictor of time-specific maternal mortality. These results confirm the need for country-specific interventions during the continuum of care to achieve the global commitment to eliminating preventable maternal mortality.

Multidimensional Measurement of Poverty among Women in Sub-Saharan Africa

Science.gov (United States)

Batana, Yele Maweki

2013-01-01

Since the seminal work of Sen, poverty has been recognized as a multidimensional phenomenon. The recent availability of relevant databases renewed the interest in this approach. This paper estimates multidimensional poverty among women in fourteen Sub-Saharan African countries using the Alkire and Foster multidimensional poverty measures, whose…

Population prospects for Sub-Saharan Africa: determinants, consequences and policy.

Science.gov (United States)

Huth, M J

1986-01-01

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.

Who wants to adopt and who wants to be adopted: a sample of American families and sub-Saharan African orphans.

Science.gov (United States)

Balding, Christopher; Feng, Yan; Atashband, Armita

2015-12-01

The debate between pro- and anti-international adoption advocates relies heavily on rhetoric and little on data analysis. To better understand the state of orphans and potential adopters in this debate, we utilize the National Survey of Family Growth (NSFG) and the Demographic and Health Surveys (DHS) to study who adopts internationally and the status of orphaned children in sub-Saharan Africa. According to NSFG data adopters are church going, highly educated, stable families aware of the challenges faced by international adoption, with high rates of infertility and rates of child abuse half the population average. According to the DHS data, orphans in sub-Saharan Africa suffer from significantly higher deprivation, reduced schooling and increased levels of stunting and underweight reported than their cohort. Using this data, we estimate conservatively that that 1 50 000 orphans from our sample of sub-Saharan African countries died from their 5-year birth cohort. Given the large number of families seeking to adopt and the high number of orphan deaths, it seems counterproductive to restrict international adoptions given the significantly lower risks faced by children in adopted families compared with remaining orphaned. © The Author 2015; all rights reserved. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Review: Joseph Patrick Ganahl, Corruption, Good Governance, and the African State: A Critical Analysis of the Political-Economic Foundations of Corruption in Sub-Saharan Africa (2013)

OpenAIRE

Reinhart Kößler

2015-01-01

Review of the monograph:Joseph Patrick Ganahl, Corruption, Good Governance, and the African State: A Critical Analysis of the Political-Economic Foundations of Corruption in Sub-Saharan Africa, Potsdam: Potsdam University Press, 2013, ISBN 9783869562483, 300 pp.

Sub-Saharan Africa’s Lagging Development

Directory of Open Access Journals (Sweden)

Katja Vintar Mally

2009-12-01

Full Text Available Sub-Saharan Africa is a very diverse region with extensive natural wealth, great human potential, and a rich history. However, the majority of its countries are among the poorest in the world and about half of its 800 million inhabitants live in extreme poverty. Sub-Saharan Africa produces only 1.5% of the world’s GDP and its share in world trade has fallen from 6% in 1980 to 2% today. The region’s exports remain dominated by primary goods (fuels, ores, and agricultural products. The roots of the region’s economic weakness lie variously in the past colonial relationships with European countries and in unjust global trade patterns as well as in misuse of power by ruling political elites in the post-independence era. Numerous civil wars and other conflicts have fragmented the sub-Saharan countries into many factions and parties fighting for domination. The region is lagging behind developed countries because of corruption, lack of infrastructure, weakness of its institutions, heavy indebtedness, lack of education and health services, and unfavorable natural conditions, among other factors. Subsistence agriculture is the source of livelihood for most Africans. Nevertheless, average yields per hectare are low and heavily dependent on climatic conditions. Compared to urban areas (except for slums, people living in rural areas have worse infrastructure and are further from achieving the UN’s Millennium Development Goals. The recent increase in food prices is threatening the limited progress in reducing hunger and malnutrition (28% of children under age five are underweight and particularly vulnerable to infectious diseases. Little progress has been made in reducing child and maternal mortality; mortality rates remain the highest in the world. In the previous decade, life expectancy in sub-Saharan countries has fallen due to the spread of HIV/AIDS and it still remains below fifty. In addition, many negative socioeconomic effects are the result

Rail Transport : Framework for Improving Railway Sector Performance in Sub-Saharan Africa

OpenAIRE

Olievschi, Vasile Nicolae

2013-01-01

In most of the Sub-Saharan African (SSA) countries railways have played, throughout history, a key part in the economic development maintaining a dominant role in transporting freight and passengers at low costs. During the last 50 years, the road transport in the region as throughout the world has expanded rapidly due to the aggressive development of the automobile industry. African gover...

ON THE VALIDITY OF PURCHASING POWER PARITY: EVIDENCEFROM ENERGY EXPORTING SUB-SAHARAN AFRICA COUNTRIES

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Ntokozo Patrick Nzimande

2015-01-01

Full Text Available Substantial amount of studies have examined the validity of mean-reversion onthe real exchange rate. However very limited studies of this nature have beenconducted in Sub-Saharan Africa countries, particularly energy exportingcountries, hence this study endeavors to find evidence for or against the mean-reversion of the real exchange rate. There is, however inadequate data requiredfor the statistical significance for Sub-Saharan African currencies. Hence thisstudy uses a panel of 5 energy exporting countries, i.e. South Africa,Mozambique, Congo Republic, Nigeria and Angola, to examine the validity of thepurchasing power parity. Relying on the Im, Pesaran and Shin and the Fisher ADFproposed panel unit root tests the study fails to reject the null hypothesis of a unitroot when small sample size is employed however by extending sample size andemploying different price index, i.e. traded goods prices instead of GDP deflatorsthe study reject the null hypothesis of a unit root and hence concludes thepurchasing power parity holds in Sub-Saharan African energy exporting countriesconsidered in the study.

An approach to rural distribution network design for sub-Saharan Africa

International Nuclear Information System (INIS)

Sebitosi, A.B.; Pillay, P.; Khan, M.A.

2006-01-01

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

A Back Migration from Asia to Sub-Saharan Africa Is Supported by High-Resolution Analysis of Human Y-Chromosome Haplotypes

Science.gov (United States)

Cruciani, Fulvio; Santolamazza, Piero; Shen, Peidong; Macaulay, Vincent; Moral, Pedro; Olckers, Antonel; Modiano, David; Holmes, Susan; Destro-Bisol, Giovanni; Coia, Valentina; Wallace, Douglas C.; Oefner, Peter J.; Torroni, Antonio; Cavalli-Sforza, L. Luca; Scozzari, Rosaria; Underhill, Peter A.

2002-01-01

The variation of 77 biallelic sites located in the nonrecombining portion of the Y chromosome was examined in 608 male subjects from 22 African populations. This survey revealed a total of 37 binary haplotypes, which were combined with microsatellite polymorphism data to evaluate internal diversities and to estimate coalescence ages of the binary haplotypes. The majority of binary haplotypes showed a nonuniform distribution across the continent. Analysis of molecular variance detected a high level of interpopulation diversity (ΦST=0.342), which appears to be partially related to the geography (ΦCT=0.230). In sub-Saharan Africa, the recent spread of a set of haplotypes partially erased pre-existing diversity, but a high level of population (ΦST=0.332) and geographic (ΦCT=0.179) structuring persists. Correspondence analysis shows that three main clusters of populations can be identified: northern, eastern, and sub-Saharan Africans. Among the latter, the Khoisan, the Pygmies, and the northern Cameroonians are clearly distinct from a tight cluster formed by the Niger-Congo–speaking populations from western, central western, and southern Africa. Phylogeographic analyses suggest that a large component of the present Khoisan gene pool is eastern African in origin and that Asia was the source of a back migration to sub-Saharan Africa. Haplogroup IX Y chromosomes appear to have been involved in such a migration, the traces of which can now be observed mostly in northern Cameroon. PMID:11910562

The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis.

Science.gov (United States)

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

2011-11-23

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

Consequences of Chinese Aid in Sub-Saharan Africa

Science.gov (United States)

2016-12-01

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

Review: Joseph Patrick Ganahl, Corruption, Good Governance, and the African State: A Critical Analysis of the Political-Economic Foundations of Corruption in Sub-Saharan Africa (2013

Directory of Open Access Journals (Sweden)

Reinhart Kößler

2015-01-01

Full Text Available Review of the monograph:Joseph Patrick Ganahl, Corruption, Good Governance, and the African State: A Critical Analysis of the Political-Economic Foundations of Corruption in Sub-Saharan Africa, Potsdam: Potsdam University Press, 2013, ISBN 9783869562483, 300 pp.

A Systematic Review of Tobacco Smoking Prevalence and Description of Tobacco Control Strategies in Sub-Saharan African Countries; 2007 to 2014.

Science.gov (United States)

Brathwaite, Rachel; Addo, Juliet; Smeeth, Liam; Lock, Karen

2015-01-01

To systematically review current smoking prevalence among adults in sub-Saharan Africa from 2007 to May 2014 and to describe the context of tobacco control strategies in these countries. Five databases, Medline, Embase, Africa-wide Information, Cinahl Plus, and Global Health were searched using a systematic search strategy. There were no language restrictions. 26 included studies measured current smoking prevalence in nationally representative adult populations in sub-Saharan African countries. Study details were independently extracted using a standard datasheet. Data on tobacco control policies, taxation and trends in prices were obtained from the Implementation Database of the WHO FCTC website. Studies represented 13 countries. Current smoking prevalence varied widely ranging from 1.8% in Zambia to 25.8% in Sierra Leone. The prevalence of smoking was consistently lower in women compared to men with the widest gender difference observed in Malawi (men 25.9%, women 2.9%). Rwanda had the highest prevalence of women smokers (12.6%) and Ghana had the lowest (0.2%). Rural, urban patterns were inconsistent. Most countries have implemented demand-reduction measures including bans on advertising, and taxation rates but to different extents. Smoking prevalence varied widely across sub-Saharan Africa, even between similar country regions, but was always higher in men. High smoking rates were observed among countries in the eastern and southern regions of Africa, mainly among men in Ethiopia, Malawi, Rwanda, and Zambia and women in Rwanda and rural Zambia. Effective action to reduce smoking across sub-Saharan Africa, particularly targeting population groups at increased risk remains a pressing public health priority.

A Systematic Review of Tobacco Smoking Prevalence and Description of Tobacco Control Strategies in Sub-Saharan African Countries; 2007 to 2014.

Directory of Open Access Journals (Sweden)

Rachel Brathwaite

Full Text Available To systematically review current smoking prevalence among adults in sub-Saharan Africa from 2007 to May 2014 and to describe the context of tobacco control strategies in these countries.Five databases, Medline, Embase, Africa-wide Information, Cinahl Plus, and Global Health were searched using a systematic search strategy. There were no language restrictions.26 included studies measured current smoking prevalence in nationally representative adult populations in sub-Saharan African countries.Study details were independently extracted using a standard datasheet. Data on tobacco control policies, taxation and trends in prices were obtained from the Implementation Database of the WHO FCTC website.Studies represented 13 countries. Current smoking prevalence varied widely ranging from 1.8% in Zambia to 25.8% in Sierra Leone. The prevalence of smoking was consistently lower in women compared to men with the widest gender difference observed in Malawi (men 25.9%, women 2.9%. Rwanda had the highest prevalence of women smokers (12.6% and Ghana had the lowest (0.2%. Rural, urban patterns were inconsistent. Most countries have implemented demand-reduction measures including bans on advertising, and taxation rates but to different extents.Smoking prevalence varied widely across sub-Saharan Africa, even between similar country regions, but was always higher in men. High smoking rates were observed among countries in the eastern and southern regions of Africa, mainly among men in Ethiopia, Malawi, Rwanda, and Zambia and women in Rwanda and rural Zambia. Effective action to reduce smoking across sub-Saharan Africa, particularly targeting population groups at increased risk remains a pressing public health priority.

Appraising the quality of sub-Saharan African cancer registration systems that contributed to GLOBOCAN 2008: a review of the literature and critical appraisal.

Science.gov (United States)

Crocker-Buque, Tim; Pollock, Allyson M

2015-02-01

To critically appraise the quality of sub-Saharan African cancer registration systems that submitted data to GLOBOCAN 2008 with respect to population coverage using publicly available information and to show the use of GLOBOCAN statistics in determining global health priorities. Sources of cancer registration data for twenty-six sub-Saharan African cancer registries were identified from GLOBOCAN 2008 factsheets. Additional information was extracted from International Agency for Research on Cancer publications. A literature search was conducted to identify studies that reported additional information on data collection methods and provided 27 studies. The websites of the 10 largest funders of development assistance for health were searched for GLOBOCAN citations. Twenty-six sub-Saharan African cancer registration systems submitting data to GLOBOCAN 2008 in relation to 21 countries. Information on 15 quality variables were extracted and compared with the international gold standard for cancer registration systems. Population coverage of the cancer registries ranged from from 2.3% of the population in Kenya to 100% in The Gambia, with a heavy urban bias in all countries. However, 20 countries (300 million people) had no cancer registration systems. Nineteen of the 26 registries failed to meet more than five of the 15 quality criteria and only one country met more than 10. Seven of the 10 largest funders of development assistance for health cite GLOBOCAN statistics in support of policy priorities. GLOBOCAN 2008 estimates are based on data drawn from poor quality cancer registration systems, with limited or no population registry coverage. It is essential the GLOBOCAN 2012 estimates should provide information on the quality of the data collection and explain the limitations of the estimates. Development organisations and the World Health Organization need to take a more cautious approach when using these data to determine priorities and allocating resources. © The

An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective

Directory of Open Access Journals (Sweden)

Degboe Arnold N

2009-09-01

Full Text Available Abstract Background Sub-Saharan African (SSA countries are currently experiencing one of the most rapid epidemiological transitions characterized by increasing urbanization and changing lifestyle factors. This has resulted in an increase in the incidence of non-communicable diseases, especially cardiovascular disease (CVD. This double burden of communicable and chronic non-communicable diseases has long-term public health impact as it undermines healthcare systems. Purpose The purpose of this paper is to explore the socio-cultural context of CVD risk prevention and treatment in sub-Saharan Africa. We discuss risk factors specific to the SSA context, including poverty, urbanization, developing healthcare systems, traditional healing, lifestyle and socio-cultural factors. Methodology We conducted a search on African Journals On-Line, Medline, PubMed, and PsycINFO databases using combinations of the key country/geographic terms, disease and risk factor specific terms such as "diabetes and Congo" and "hypertension and Nigeria". Research articles on clinical trials were excluded from this overview. Contrarily, articles that reported prevalence and incidence data on CVD risk and/or articles that report on CVD risk-related beliefs and behaviors were included. Both qualitative and quantitative articles were included. Results The epidemic of CVD in SSA is driven by multiple factors working collectively. Lifestyle factors such as diet, exercise and smoking contribute to the increasing rates of CVD in SSA. Some lifestyle factors are considered gendered in that some are salient for women and others for men. For instance, obesity is a predominant risk factor for women compared to men, but smoking still remains mostly a risk factor for men. Additionally, structural and system level issues such as lack of infrastructure for healthcare, urbanization, poverty and lack of government programs also drive this epidemic and hampers proper prevention, surveillance and

An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective.

Science.gov (United States)

BeLue, Rhonda; Okoror, Titilayo A; Iwelunmor, Juliet; Taylor, Kelly D; Degboe, Arnold N; Agyemang, Charles; Ogedegbe, Gbenga

2009-09-22

Sub-Saharan African (SSA) countries are currently experiencing one of the most rapid epidemiological transitions characterized by increasing urbanization and changing lifestyle factors. This has resulted in an increase in the incidence of non-communicable diseases, especially cardiovascular disease (CVD). This double burden of communicable and chronic non-communicable diseases has long-term public health impact as it undermines healthcare systems. The purpose of this paper is to explore the socio-cultural context of CVD risk prevention and treatment in sub-Saharan Africa. We discuss risk factors specific to the SSA context, including poverty, urbanization, developing healthcare systems, traditional healing, lifestyle and socio-cultural factors. We conducted a search on African Journals On-Line, Medline, PubMed, and PsycINFO databases using combinations of the key country/geographic terms, disease and risk factor specific terms such as "diabetes and Congo" and "hypertension and Nigeria". Research articles on clinical trials were excluded from this overview. Contrarily, articles that reported prevalence and incidence data on CVD risk and/or articles that report on CVD risk-related beliefs and behaviors were included. Both qualitative and quantitative articles were included. The epidemic of CVD in SSA is driven by multiple factors working collectively. Lifestyle factors such as diet, exercise and smoking contribute to the increasing rates of CVD in SSA. Some lifestyle factors are considered gendered in that some are salient for women and others for men. For instance, obesity is a predominant risk factor for women compared to men, but smoking still remains mostly a risk factor for men. Additionally, structural and system level issues such as lack of infrastructure for healthcare, urbanization, poverty and lack of government programs also drive this epidemic and hampers proper prevention, surveillance and treatment efforts. Using an African-centered cultural framework

Structural transformation and its relevance for economic growth in sub-Saharan Africa

OpenAIRE

Busse, Matthias; Erdogan, Ceren; Mühlen, Henning

2017-01-01

In this paper, we analyse the role of structural transformation in view of the remarkable growth performance of sub-Saharan African countries since the mid-1990s. Our analysis covers 41 African countries over the period 1980 to 2014 and accounts for structural transformation by employing the analytical frameworks of (1) growth decomposition and (2) growth regression. Even though the low-productive agricultural sector continues to employ most of the African workforce, our results reveal that s...

The role of decentralized systems in providing universal electricity access in Sub-Saharan Africa – A model-based approach

NARCIS (Netherlands)

Dagnachew, Anteneh G.; Lucas, Paul L.|info:eu-repo/dai/nl/272607444; Hof, Andries F.|info:eu-repo/dai/nl/240412397; Gernaat, David E.H.J.|info:eu-repo/dai/nl/372664636; de Boer, Harmen Sytze; van Vuuren, Detlef P.|info:eu-repo/dai/nl/11522016X

2017-01-01

Poverty and lack of access to electricity are highly correlated. In Sub-Saharan Africa, one of the poorest regions in the world, two in every three people have no access to electricity. This paper describes a purpose designed model to explore and project the development in the Sub-Saharan African

Women's empowerment and ideal family size: an examination of DHS empowerment measures in Sub-Saharan Africa.

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Upadhyay, Ushma D; Karasek, Deborah

2012-06-01

The Demographic and Health Survey (DHS) program collects data on women's empowerment, but little is known about how these measures perform in Sub-Saharan African countries. It is important to understand whether women's empowerment is associated with their ideal number of children and ability to limit fertility to that ideal number in the Sub-Saharan African context. The analysis used couples data from DHS surveys in four Sub-Saharan African countries: Guinea, Mali, Namibia and Zambia. Women's empowerment was measured by participation in household decision making, attitudes toward wife beating and attitudes toward refusing sex with one's husband. Multivariable linear regression was used to model women's ideal number of children, and multivariable logistic regression was used to model women's odds of having more children than their ideal. In Guinea and Zambia, negative attitudes toward wife beating were associated with having a smaller ideal number of children (beta coefficients, -0.5 and -0.3, respectively). Greater household decision making was associated with a smaller ideal number of children only in Guinea (beta coefficient, -0.3). Additionally, household decision making and positive attitudes toward women's right to refuse sex were associated with elevated odds of having more children than desired in Namibia and Zambia, respectively (odds ratios, 2.3 and 1.4); negative attitudes toward wife beating were associated with reduced odds of the outcome in Mali (0.4). Women's empowerment--as assessed using currently available measures--is not consistently associated with a desire for smaller families or the ability to achieve desired fertility in these Sub-Saharan African countries. Further research is needed to determine what measures are most applicable for these contexts.

Sub-Saharan Africa at the global education market: role of South Africa

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Ramil Ravilevich Asmyatullin

2016-12-01

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.

Water reform in Sub-Saharan Africa: what is the difference?

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Van Koppen, Barbara

Since the early 1990s African governments took an active part in the global movement of water reform towards Integrated Water Resources Management (IWRM). The first step consisted primarily of assimilating the generic principles of IWRM. At this generic level, water reform in Sub-Saharan Africa seems quite similar to water reform elsewhere in the developed and developing world. However, in taking the second step of operationalizing generic principles into concrete actions on the ground, at least three salient differences between Sub-Saharan Africa and elsewhere emerged: (a) Africa’s relative abundance of water resources but its scarcity of economic means to harness available water resources; (b) the importance of agriculture and agricultural water development for economic growth and poverty eradication; and (c) the need for systems of water rights and financial resource mobilization that are separated and suit the African reality in which large water users are relatively few, while the bulk of water users are scattered smallholders. This paper discusses the early operationalization with regard to these three unique features and identifies lessons learnt.

Withholding breast milk for HIV exposed infants in sub-Saharan Africa

African Journals Online (AJOL)

At the moment, it seems sensible to recommend that health care workers and policy makers should explore the options of making breastfeeding safer rather than withholding it for sub-Saharan African HIV exposed infants. It is hoped that when Highly Active Antiretroviral Therapy (HAART) becomes universally accessible ...

Improving Labour Market Outcomes for the Poor in Sub-Saharan Africa

International Development Research Centre (IDRC) Digital Library (Canada)

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 ...

Knowledge of HIV and AIDS in women in sub-Saharan Africa

African Journals Online (AJOL)

Administrator

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.

People in sub-Saharan Africa rate their health and health care among the lowest in the world.

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Deaton, Angus S; Tortora, Robert

2015-03-01

The health of people in sub-Saharan Africa is a major global concern. However, data are weak, and little is known about how people in the region perceive their health or their health care. We used data from the Gallup World Poll in 2012 to document sub-Saharan Africans' perceived health status, their satisfaction with health care, their contact with medical professionals, and the priority they attach to health care. In comparison to other regions of the world, sub-Saharan Africa has the lowest ratings for well-being and the lowest satisfaction with health care. It also has the second-lowest perception of personal health, after only the former Soviet Union and its Eastern European satellites. HIV prevalence is positively correlated with perceived improvements in health care in countries with high prevalence. This is consistent with an improvement in at least some health care services as a result of the largely aid-funded rollout of antiretroviral treatment. Even so, sub-Saharan Africans do not prioritize health care as a matter of policy, although donors are increasingly shifting their aid efforts in the region toward health. Project HOPE—The People-to-People Health Foundation, Inc.

The health and wellbeing of young people in sub-Saharan Africa: an under-researched area?

OpenAIRE

Kabiru, Caroline W; Izugbara, Chimaraoke O; Beguy, Donatien

2013-01-01

Abstract 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 yout...

Why sub-Saharan Africa lags in electronic health record adoption and possible strategies to increase its adoption in this region

OpenAIRE

Odekunle, Florence Femi; Odekunle, Raphael Oluseun; Shankar, Srinivasan

2017-01-01

Poor health information system has been identified as a major challenge in the health-care system in many developing countries including sub-Saharan African countries. Electronic health record (EHR) has been shown as an important tool to improve access to patient information with attendance improved quality of care. However, EHR has not been widely implemented/adopted in sub-Saharan Africa. This study sought to identify factors that affect the adoption of an EHR in sub-Saharan Africa and stra...

Managing Forest Resources in Sub-Saharan Africa : Issues and Challenges

OpenAIRE

Narenda P. Sharma; Simon Reitbergen; Claude R. Heimo; Joti Patel

1994-01-01

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...

Angola - an Oil Dependant Country in Sub-Saharan Africa

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Baumgartner Boris

2016-12-01

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.

Shaping the Role of sub-Saharan African Nurses and Midwives ...

African Journals Online (AJOL)

To explore the role expectations of different stakeholders in the health care system on the roles and tasks that nurses and midwives perform, in order to clarify and strengthen these roles and shape the future of nursing education and practice in sub-Saharan Africa. Qualitative focus group discussions were held with different ...

View Point: Economic growth and child health in Sub Saharan Africa ...

African Journals Online (AJOL)

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 ...

Fatty acid compositions of preterm and term colostrum, transitional and mature milks in a sub-Saharan population with high fish intakes

NARCIS (Netherlands)

Kuipers, Remko S.; Luxwolda, Martine F.; Dijck-Brouwer, D. A. Janneke; Muskiet, Frits A. J.

2012-01-01

Background: There are no data on the fatty acid (FA) compositions of preterm and term milks for sub-Saharan African populations with advancing lactation. However, it is generally acknowledged that our ancestors evolved in sub-Saharan East-Africa, where they inhabited the land-water ecosystems.

Improving the Effectiveness of English as a Medium of Instruction in Sub-Saharan Africa

Science.gov (United States)

Clegg, John; Simpson, John

2016-01-01

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…

Mental health of sub-saharan african migrants: The gendered role of migration paths and transnational ties

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Julie Pannetier

2017-12-01

Full Text Available In Europe, migrants are at higher risk of common mental disorders or psychological distress than are natives. Little is known regarding the social determinants of migrant mental health, particularly the roles played by migration conditions and transnational practices, which may manifest themselves in different ways for men and for women. The goal of this paper was to understand the gendered roles of migration paths and transnational ties in mental health among sub-Saharan African migrants residing in the Paris, France, metropolitan area. This study used data from the Parcours study conducted in 2012–2013, which employed a life-event approach to collect data from a representative sample of migrants who visited healthcare facilities (n = 2468. We measured anxiety and depressive symptoms at the time of data collection with the Patient Health Questionnaire-4 (PHQ-4. Reasons for migration, the living conditions in the host country and transnational ties after migration were taken into account by sex and after adjustment. Our study demonstrates that among sub-Saharan African migrants, mental health is related to the migratory path and the migrant’s situation in the host country but differently for women and men. Among women, anxiety and depressive symptoms were strongly related to having left one’s home country because of threats to one’s life. Among men, residing illegally in the host country was related to impaired mental health. For both women and men, cross-border separation from a child less than 18 years old was not independently associated with anxiety and depressive symptoms. In addition, social and emotional support from relatives and friends—both from the society of origin and of destination—were associated with lower anxiety and depressive symptoms. Migrant mental health may be impaired in the current context of anti-migrant policies and an anti-immigrant social environment in Europe.

Social media reveal that charismatic species are not the main attractor of ecotourists to sub-Saharan protected areas.

Science.gov (United States)

Hausmann, Anna; Toivonen, Tuuli; Heikinheimo, Vuokko; Tenkanen, Henrikki; Slotow, Rob; Di Minin, Enrico

2017-04-10

Charismatic megafauna are arguably considered the primary attractor of ecotourists to sub-Saharan African protected areas. However, the lack of visitation data across the whole continent has thus far prevented the investigation of whether charismatic species are indeed a key attractor of ecotourists to protected areas. Social media data can now be used for this purpose. We mined data from Instagram, and used generalized linear models with site- and country-level deviations to explore which socio-economic, geographical and biological factors explain social media use in sub-Saharan African protected areas. We found that charismatic species richness did not explain social media usage. On the other hand, protected areas that were more accessible, had sparser vegetation, where human population density was higher, and that were located in wealthier countries, had higher social media use. Interestingly, protected areas with lower richness in non-charismatic species had more users. Overall, our results suggest that more factors than simply charismatic species might explain attractiveness of protected areas, and call for more in-depth content analysis of the posts. With African countries projected to develop further in the near-future, more social media data will become available, and could be used to inform protected area management and marketing.

Patterns of Manufacturing Growth in Sub-Saharan Africa: From Colonization to the Present

NARCIS (Netherlands)

Austin, G.; Frankema, E.H.P.; Jerven, M.

2016-01-01

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

Improving military expenditure decisionmaking in sub-Saharan Africa

OpenAIRE

Geoff Harris

2010-01-01

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...

Sub-Saharan Botanical Collections:Taxonomic research and impediments

OpenAIRE

Demissew, Sebsebe; Beentje, Henk; Cheek, Martin; Friis, Ib

2017-01-01

Many historical specimens from sub-Saharan Africa are only found in European herbaria, but a higher number of newer specimens than widely assumed are kept in African herbaria, with a concentration in eastern and southern parts of the continent. Many of these herbaria were initiated in connection with independence of former European colonies in Africa, fewer were built on well-established herbaria from the colonial period. There are many gaps in collecting coverage, not least with regard to ar...

People In Sub-Saharan Africa Rate Their Health And Health Care Among Lowest In World

Science.gov (United States)

Deaton, Angus S.; Tortora, Robert

2017-01-01

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

Meningitis in HIV-positive patients in sub-Saharan Africa: a review.

Science.gov (United States)

Veltman, Jennifer A; Bristow, Claire C; Klausner, Jeffrey D

2014-01-01

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.

Differences in primary health care use among sub-Saharan African immigrants in Norway: a register-based study.

Science.gov (United States)

Diaz, Esperanza; Mbanya, Vivian N; Gele, Abdi A; Kumar, Bernadette

2017-07-28

Immigrants' utilization of primary health care (PHC) services differs from that of the host populations. However, immigrants are often classified in broad groups by continent of origin, and the heterogeneity within the same continent may hide variation in use among immigrant groups at a national level. Differences in utilization of PHC between sub-Saharan African immigrants have not received much attention. Registry-based study using merged data from the National Population Register and the Norwegian Health Economics Administration. African immigrants and their descendants registered in Norway in 2008 (36,366 persons) where included in this study. Using χ 2 test and logistic regression models, we assessed the differences in the use of PHC, including general practitioner (GP) and emergency room (ER) services, and the distribution of morbidity burden for immigrants from Somalia, Ethiopia, Eritrea, and Gambia. For the analyses, we used the number of visits and medical diagnoses from each consultation registered by the physician. Among the total studied population, 66.1% visited PHC within 1 year. The diagnoses registered were similar for all four immigrants groups, regardless of country of origin. Compared to immigrants from Somalia, the age and sex adjusted odds ratios (OR) for use of GP were significantly lower for Ethiopians (OR 0.91; 0.86-0.97), Eritreans (OR 0.85; 0.79-0.91), and Gambians (OR 0.88; 0.80-0.97). Similarly, we also observed lower use of ER among Ethiopians (OR 0.88; 0.81-0.95), Eritreans (OR 0.56; 0.51-0.62) and Gambians (OR 0.81; 0.71-0.92). However, immigrants from Somalia reduced their use of PHC with longer duration of stay in Norway. Differences between groups persisted after further adjustment for employment status. Despite the similarities in diagnoses among the sub-Saharan African immigrant groups in Norway, their use of PHC services differs by country of origin and length of stay. It is important to assess the reasons for the differences

Globalisation and the Internationalisation of Higher Education in Sub-Saharan Africa

Science.gov (United States)

Dzvimbo, Kuzvinetsa Peter; Moloi, Kholeka Constance

2013-01-01

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…

Patterns of Manufacturing Growth in Sub-Saharan Africa: From Colonization to the Present

NARCIS (Netherlands)

Austin, G.; Frankema, E.H.P.; Jerven, M.

2015-01-01

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,

HIV misdiagnosis in sub-Saharan Africa: performance of diagnostic algorithms at six testing sites

Science.gov (United States)

Kosack, Cara S.; Shanks, Leslie; Beelaert, Greet; Benson, Tumwesigye; Savane, Aboubacar; Ng’ang’a, Anne; Andre, Bita; Zahinda, Jean-Paul BN; Fransen, Katrien; Page, Anne-Laure

2017-01-01

Abstract Introduction: We evaluated the diagnostic accuracy of HIV testing algorithms at six programmes in five sub-Saharan African countries. Methods: In this prospective multisite diagnostic evaluation study (Conakry, Guinea; Kitgum, Uganda; Arua, Uganda; Homa Bay, Kenya; Doula, Cameroun and Baraka, Democratic Republic of Congo), samples from clients (greater than equal to five years of age) testing for HIV were collected and compared to a state-of-the-art algorithm from the AIDS reference laboratory at the Institute of Tropical Medicine, Belgium. The reference algorithm consisted of an enzyme-linked immuno-sorbent assay, a line-immunoassay, a single antigen-enzyme immunoassay and a DNA polymerase chain reaction test. Results: Between August 2011 and January 2015, over 14,000 clients were tested for HIV at 6 HIV counselling and testing sites. Of those, 2786 (median age: 30; 38.1% males) were included in the study. Sensitivity of the testing algorithms ranged from 89.5% in Arua to 100% in Douala and Conakry, while specificity ranged from 98.3% in Doula to 100% in Conakry. Overall, 24 (0.9%) clients, and as many as 8 per site (1.7%), were misdiagnosed, with 16 false-positive and 8 false-negative results. Six false-negative specimens were retested with the on-site algorithm on the same sample and were found to be positive. Conversely, 13 false-positive specimens were retested: 8 remained false-positive with the on-site algorithm. Conclusions: The performance of algorithms at several sites failed to meet expectations and thresholds set by the World Health Organization, with unacceptably high rates of false results. Alongside the careful selection of rapid diagnostic tests and the validation of algorithms, strictly observing correct procedures can reduce the risk of false results. In the meantime, to identify false-positive diagnoses at initial testing, patients should be retested upon initiating antiretroviral therapy. PMID:28691437

Water quality monitoring in sub-Saharan African lakes: a review of ...

African Journals Online (AJOL)

This paper reviews the literature on various remote sensing platforms and techniques used for assessing and monitoring water quality in sub-Saharan Africa, and highlights their strengths and weaknesses. The use of remote sensing technology could enhance water quality monitoring, since remotely sensed data offer ...

Peripheral insulin resistance rather than beta cell dysfunction accounts for geographical differences in impaired fasting blood glucose among sub-Saharan African individuals : findings from the RODAM study

NARCIS (Netherlands)

Meeks, Karlijn A C; Stronks, Karien; Adeyemo, Adebowale; Addo, Juliet; Bahendeka, Silver; Beune, Erik; Owusu-Dabo, Ellis; Danquah, Ina; Galbete, Cecilia; Henneman, Peter; Klipstein-Grobusch, Kerstin; Mockenhaupt, Frank P; Osei, Kwame; Schulze, Matthias B; Spranger, Joachim; Smeeth, Liam; Agyemang, Charles

2017-01-01

AIMS/HYPOTHESIS: The aim of this study was to assess the extent to which insulin resistance and beta cell dysfunction account for differences in impaired fasting blood glucose (IFBG) levels in sub-Saharan African individuals living in different locations in Europe and Africa. We also aimed to

Peripheral insulin resistance rather than beta cell dysfunction accounts for geographical differences in impaired fasting blood glucose among sub-Saharan African individuals: findings from the RODAM study

NARCIS (Netherlands)

Meeks, Karlijn A. C.; Stronks, Karien; Adeyemo, Adebowale; Addo, Juliet; Bahendeka, Silver; Beune, Erik; Owusu-Dabo, Ellis; Danquah, Ina; Galbete, Cecilia; Henneman, Peter; Klipstein-Grobusch, Kerstin; Mockenhaupt, Frank P.; Osei, Kwame; Schulze, Matthias B.; Spranger, Joachim; Smeeth, Liam; Agyemang, Charles

2017-01-01

The aim of this study was to assess the extent to which insulin resistance and beta cell dysfunction account for differences in impaired fasting blood glucose (IFBG) levels in sub-Saharan African individuals living in different locations in Europe and Africa. We also aimed to identify determinants

The status of HIV-1 resistance to antiretroviral drugs in sub-Saharan Africa

NARCIS (Netherlands)

Hamers, Raph L.; Derdelinckx, Inge; van Vugt, Michèle; Stevens, Wendy; Rinke de Wit, Tobias F.; Schuurman, Rob

2008-01-01

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

Trend shocks and business cycles in Sub Saharan Africa

OpenAIRE

Naoussi , Claude Francis; Tripier , Fabien

2010-01-01

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 ...

Sexual violence legislation in sub-Saharan Africa: the need for strengthened medico-legal linkages.

Science.gov (United States)

Kilonzo, Nduku; Ndung'u, Njoki; Nthamburi, Nerida; Ajema, Caroline; Taegtmeyer, Miriam; Theobald, Sally; Tolhurst, Rachel

2009-11-01

Six sub-Saharan African countries currently have laws on sexual violence, including Kenya, and eight others have provisions on sexual violence in other legislation. Effective legislation requires functioning medico-legal linkages to enable both justice to be done in cases of sexual violence and the provision of health services for survivors of sexual violence. The health sector also needs to provide post-rape care services and collect and deliver evidence to the criminal justice system. This paper reviews existing data on sexual violence in sub-Saharan Africa, and summarises the content of sexual violence legislation in the region and the strengths and weaknesses of existing medico-legal linkages, using Kenya as a case study. Many sub-Saharan African countries do not yet have comprehensive post-rape care services, nor substantial co-ordination between HIV and sexual and reproductive health services, the legal and judicial systems, and sexual violence legislation. These need to be integrated by cross-referrals, using standardised referral guidelines and pathways, treatment protocols, and medico-legal procedures. Common training approaches and harmonised information across sectors, and common indicators, would facilitate government accountability. Joint and collaborative planning and working at country level, through sharing of information and data between the different systems remain key to achieving this.

Systematic review with meta-analysis: the risk of mother-to-child transmission of hepatitis B virus infection in sub-Saharan Africa.

Science.gov (United States)

Keane, E; Funk, A L; Shimakawa, Y

2016-11-01

The risk of mother-to-child transmission of hepatitis B virus (HBV) has been quoted as 70-90% among women positive for hepatitis B surface antigen (HBsAg) and e antigen (HBeAg), and 5-30% among HBsAg-positive HBeAg-negative women. These risks are derived from Asia; little is known about sub-Saharan Africa. To determine the risk of mother-to-child transmission in sub-Saharan Africa, according to maternal HBeAg and type of prophylaxis. We searched Medline, Global Health, Embase, African Journals Online and African Index Medicus. We included observational or interventional studies that enrolled infants of HBV-infected women, and that tested for HBsAg or HBV DNA between 3 and 12 months of age. Fifteen articles from 11 African countries were included. Among HBeAg-positive women, the pooled risk was 38.3% (95% CI: 7.0-74.4%) without prophylaxis, which was significantly lower than the lower bound of 70-90% risk in the literature (P = 0.007). Among HBeAg-negative women, the pooled risk was 4.8% (95% CI: 0.1-13.3%) without prophylaxis, which lays within the lower range of the 5-30% risk in Asia. By extrapolating the pooled transmission risks to the number of births to infectious mothers, an estimated 1% of newborns (n = 367 250) are annually infected with HBV at birth in sub-Saharan Africa. Compared to Asia, the risk of mother-to-child transmission is low in sub-Saharan Africa. However, the annual number of infants perinatally infected with HBV is twice the number of incident paediatric HIV infections in sub-Saharan Africa (n = 190 000). This highlights the importance of preventing mother-to-child transmission of HBV in sub-Saharan Africa, which has been long neglected. © 2016 John Wiley & Sons Ltd.

Did the Aid Boom Pacify Sub-Saharan Africa?

OpenAIRE

Azam, Jean-Paul; Thelen, Véronique

2017-01-01

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....

U.S. Trade and Investment Relationship with Sub-Saharan Africa: The African Growth and Opportunity Act and Beyond

National Research Council Canada - National Science Library

Langton, Danielle

2008-01-01

.... 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...

The effects of the financial crisis on Sub-Saharan Africa

Directory of Open Access Journals (Sweden)

Franklin Allen

2011-01-01

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.

Editorial: Childhood Cancer in sub-Saharan Africa.

Science.gov (United States)

Parkin, Donald Maxwell; Stefan, Cristina

2017-01-01

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.

The national determinants of deforestation in sub-Saharan Africa

OpenAIRE

Rudel, Thomas K.

2013-01-01

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 ...

Microwork and Virtual Production Networks in Sub-Saharan Africa ...

International Development Research Centre (IDRC) Digital Library (Canada)

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.

Why sub-Saharan Africa lags in electronic health record adoption and possible strategies to increase its adoption in this region.

Science.gov (United States)

Odekunle, Florence Femi; Odekunle, Raphael Oluseun; Shankar, Srinivasan

2017-01-01

Poor health information system has been identified as a major challenge in the health-care system in many developing countries including sub-Saharan African countries. Electronic health record (EHR) has been shown as an important tool to improve access to patient information with attendance improved quality of care. However, EHR has not been widely implemented/adopted in sub-Saharan Africa. This study sought to identify factors that affect the adoption of an EHR in sub-Saharan Africa and strategies to improve its adoption in this region. A comprehensive literature search was conducted on three electronic databases: PubMed, Medline, and Google Scholar. Articles of interest were those published in English that contained information on factors that limit the adoption of an EHR as well as strategies that improve its adoption in sub-Saharan African countries. The available evidence indicated that there were many factors that hindered the widespread adoption of an EHR in sub-Saharan Africa. These were high costs of procurement and maintenance of the EHR system, lack of financial incentives and priorities, poor electricity supply and internet connectivity, and primary user's limited computer skills. However, strategies such as implementation planning, financial supports, appropriate EHR system selection, training of primary users, and the adoption of the phased implementation process have been identified to facilitate the use of an EHR. Wide adoption of an EHR in sub-Saharan Africa region requires a lot more effort than what is assumed because of the current poor level of technological development, lack of required computer skills, and limited resources.

Government Quality Determinants of ICT Adoption in Sub-Saharan Africa

OpenAIRE

Asongu, Simplice; Biekpe, Nicholas

2017-01-01

This study investigates government quality determinants of ICT adoption using Generalised Method of Moments on a panel of 49 Sub-Saharan African (SSA) countries for the period 2000-2012. ICT is measured with mobile phone penetration, internet penetration and telephone penetration rates while all governance dimensions from the World Bank Governance Indicators are considered, namely: political governance (consisting of political stability and “voice & accountability”); economic governance (enta...

What would it take to prevent stunted growth in children in sub-Saharan Africa?

Science.gov (United States)

Lartey, Anna

2015-11-01

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

Effective coverage and systems effectiveness for malaria case management in sub-Saharan African countries.

Directory of Open Access Journals (Sweden)

Katya Galactionova

Full Text Available Scale-up of malaria preventive and control interventions over the last decade resulted in substantial declines in mortality and morbidity from the disease in sub-Saharan Africa and many other parts of the world. Sustaining these gains will depend on the health system performance. Treatment provides individual benefits by curing infection and preventing progression to severe disease as well as community-level benefits by reducing the infectious reservoir and averting emergence and spread of drug resistance. However many patients with malaria do not access care, providers do not comply with treatment guidelines, and hence, patients do not necessarily receive the correct regimen. Even when the correct regimen is administered some patients will not adhere and others will be treated with counterfeit or substandard medication leading to treatment failures and spread of drug resistance. We apply systems effectiveness concepts that explicitly consider implications of health system factors such as treatment seeking, provider compliance, adherence, and quality of medication to estimate treatment outcomes for malaria case management. We compile data for these indicators to derive estimates of effective coverage for 43 high-burden Sub-Saharan African countries. Parameters are populated from the Demographic and Health Surveys and other published sources. We assess the relative importance of these factors on the level of effective coverage and consider variation in these health systems indicators across countries. Our findings suggest that effective coverage for malaria case management ranges from 8% to 72% in the region. Different factors account for health system inefficiencies in different countries. Significant losses in effectiveness of treatment are estimated in all countries. The patterns of inter-country variation suggest that these are system failures that are amenable to change. Identifying the reasons for the poor health system performance and

Estimates of gender differences in firm’s access to credit in Sub-Saharan Africa

DEFF Research Database (Denmark)

Hansen, Henrik; Rand, John

2014-01-01

Based on firm level data from 16 Sub-Saharan African countries we show how three different measures of credit constraints lead to three different estimates of gender differences in manufacturing firms’ credit situation. Using a perception based credit constraint measure female owned firms appear...

The health and wellbeing of young people in sub-Saharan Africa: an under-researched area?

Science.gov (United States)

Kabiru, Caroline W; Izugbara, Chimaraoke O; Beguy, Donatien

2013-02-13

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.

The States of Sub Saharan Africa on the way to the Global Information Society

Directory of Open Access Journals (Sweden)

Konstantin A. Pantserev

2010-12-01

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.

Pharmacokinetics of Antibiotics in Sub-Saharan African Patient Populations: A Systematic Review

NARCIS (Netherlands)

Bos, Jeannet C.; van Hest, Reinier M.; Prins, Jan M.

2017-01-01

Background: In sub-Saharan Africa (SSA), severe febrile illness accounts for a large majority of medical admissions. SSA patients may also suffer from cachexia and organ dysfunction resulting from tuberculosis, hepatitis B, and hypertension. It is hard to tell how these conditions influence the

Exploring changes in open defecation prevalence in sub-Saharan Africa based on national level indices.

Science.gov (United States)

Galan, Deise I; Kim, Seung-Sup; Graham, Jay P

2013-05-30

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

The epidemiology of cardiovascular diseases in sub-Saharan Africa: the Global Burden of Diseases, Injuries and Risk Factors 2010 Study.

Science.gov (United States)

Moran, Andrew; Forouzanfar, Mohammad; Sampson, Uchechukwu; Chugh, Sumeet; Feigin, Valery; Mensah, George

2013-01-01

The epidemiology of cardiovascular diseases in sub-Saharan Africa is unique among world regions, with about half of cardiovascular diseases (CVDs) due to causes other than atherosclerosis. CVD epidemiology data are sparse and of uneven quality in sub-Saharan Africa. Using the available data, the Global Burden of Diseases, Risk Factors, and Injuries (GBD) 2010 Study estimated CVD mortality and burden of disease in sub-Saharan Africa in 1990 and 2010. The leading CVD cause of death and disability in 2010 in sub-Saharan Africa was stroke; the largest relative increases in CVD burden between 1990 and 2010 were in atrial fibrillation and peripheral arterial disease. CVD deaths constituted only 8.8% of all deaths and 3.5% of all disability-adjusted life years (DALYs) in sub-Sahara Africa, less than a quarter of the proportion of deaths and burden attributed to CVD in high income regions. However, CVD deaths in sub-Saharan Africa occur at younger ages on average than in the rest of the world. It remains uncertain if increased urbanization and life expectancy in some parts of sub-Saharan African nations will transition the region to higher CVD burden in future years. © 2013.

The Epidemiology of Cardiovascular Diseases in Sub-Saharan Africa: The Global Burden of Diseases, Injuries and Risk Factors 2010 Study

Science.gov (United States)

Moran, Andrew; Forouzanfar, Mohammad; Sampson, Uchechukwu; Chugh, Sumeet; Feigin, Valery; Mensah, George

2014-01-01

The epidemiology of cardiovascular diseases in sub-Saharan Africa is unique among world regions, with about half of cardiovascular diseases (CVDs) due to causes other than atherosclerosis. CVD epidemiology data are sparse and of uneven quality in sub-Saharan Africa. Using the available data, the Global Burden of Diseases, Risk Factors, and Injuries (GBD) 2010 Study estimated CVD mortality and burden of disease in sub-Saharan Africa in 1990 and 2010. The leading CVD cause of death and disability in 2010 in sub-Saharan Africa was stroke; the largest relative increases in CVD burden between 1990 and 2010 were in atrial fibrillation and peripheral arterial disease. CVD deaths constituted only 8.8% of all deaths and 3.5% of all disability-adjusted life years (DALYs) in sub-Sahara Africa, less than a quarter of the proportion of deaths and burden attributed to CVD in high income regions. However, CVD deaths in sub-Saharan Africa occur at younger ages on average than in the rest of the world. It remains uncertain if increased urbanization and life expectancy in some parts of sub-Saharan African nations will transition the region to higher CVD burden in future years. PMID:24267430

Nursing education challenges and solutions in Sub Saharan Africa: an integrative review.

Science.gov (United States)

Bvumbwe, Thokozani; Mtshali, Ntombifikile

2018-01-01

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

Sub-Saharan African university students' beliefs about condoms, condom-use intention, and subsequent condom use: a prospective study.

Science.gov (United States)

Heeren, G Anita; Jemmott, John B; Mandeya, Andrew; Tyler, Joanne C

2009-04-01

Whether certain behavioral beliefs, normative beliefs, and control beliefs predict the intention to use condoms and subsequent condom use was examined among 320 undergraduates at a university in South Africa who completed confidential questionnaires on two occasions separated by 3 months. Participants' mean age was 23.4 years, 47.8% were women, 48.9% were South Africans, and 51.1% were from other sub-Saharan African countries. Multiple regression revealed that condom-use intention was predicted by hedonistic behavioral beliefs, normative beliefs regarding sexual partners and peers, and control beliefs regarding condom-use technical skill and impulse control. Logistic regression revealed that baseline condom-use intention predicted consistent condom use and condom use during most recent intercourse at 3-month follow-up. HIV/STI risk-reduction interventions for undergraduates in South Africa should target their condom-use hedonistic beliefs, normative beliefs regarding partners and peers, and control beliefs regarding technical skill and impulse control.

Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance

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Sauvageot, Delphine; Njanpop-Lafourcade, Berthe-Marie; Akilimali, Laurent; Anne, Jean-Claude; Bidjada, Pawou; Bompangue, Didier; Bwire, Godfrey; Coulibaly, Daouda; Dengo-Baloi, Liliana; Dosso, Mireille; Orach, Christopher Garimoi; Inguane, Dorteia; Kagirita, Atek; Kacou-N’Douba, Adele; Keita, Sakoba; Kere Banla, Abiba; Kouame, Yao Jean-Pierre; Landoh, Dadja Essoya; Langa, Jose Paulo; Makumbi, Issa; Miwanda, Berthe; Malimbo, Muggaga; Mutombo, Guy; Mutombo, Annie; NGuetta, Emilienne Niamke; Saliou, Mamadou; Sarr, Veronique; Senga, Raphael Kakongo; Sory, Fode; Sema, Cynthia; Tante, Ouyi Valentin; Gessner, Bradford D.; Mengel, Martin A.

2016-01-01

Background Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org). Methods/ Principal findings During June 2011–December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC), Guinea, Uganda, Mozambique and Cote d’Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0–40% of suspected cases were aged under five years and from 0.3–86% had rice water stools. Within surveillance zones, 0–37% of suspected cases had confirmed cholera compared to 27–38% during outbreaks. Annual confirmed incidence per 10,000 population was Conakry had corrected incidences of 20.2 and 5.8 respectively, while the other zones a median of 0.3. During outbreaks, corrected incidence varied from 2.6 to 13.0. Case fatality ratios ranged from 0–10% (median, 1%) by country. Conclusions/Significance Across different African epidemiological contexts, substantial variation occurred in cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use. PMID:27186885

Physician tracking in sub-Saharan Africa: current initiatives and opportunities.

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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

2014-04-23

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

Opportunities and Challenges for Petroleum and LPG Markets in Sub-Saharan Africa

International Nuclear Information System (INIS)

Matthews, William G.

2014-01-01

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

Surgery for Peptic Ulcer Disease in sub-Saharan Africa: Systematic Review of Published Data.

Science.gov (United States)

Rickard, Jennifer

2016-04-01

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.

Association between coverage of maternal and child health interventions, and under-5 mortality: a repeated cross-sectional analysis of 35 sub-Saharan African countries.

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Corsi, Daniel J; Subramanian, S V

2014-01-01

Infant and child mortality rates are among the most important indicators of child health, nutrition, implementation of key survival interventions, and the overall social and economic development of a population. In this paper, we investigate the role of coverage of maternal and child health (MNCH) interventions in contributing to declines in child mortality in sub-Saharan Africa. Data are from 81 Demographic and Health Surveys from 35 sub-Saharan African countries. Using ecological time-series and child-level regression models, we estimated the effect of MNCH interventions (summarized by the percent composite coverage index, or CCI) on child mortality with in the first 5 years of life net of temporal trends and covariates at the household, maternal, and child levels. At the ecologic level, a unit increase in standardized CCI was associated with a reduction in under-5 child mortality rate (U5MR) of 29.0 per 1,000 (95% CI: -43.2, -14.7) after adjustment for survey period effects and country-level per capita gross domestic product (pcGDP). At the child level, a unit increase in standardized CCI was associated with an odds ratio of 0.86 for child mortality (95% CI: 0.82-0.90) after adjustment for survey period effect, country-level pcGDP, and a set of household-, maternal-, and child-level covariates. MNCH interventions are important in reducing U5MR, while the effects of economic growth in sub-Saharan Africa remain weak and inconsistent. Improved coverage of proven life-saving interventions will likely contribute to further reductions in U5MR in sub-Saharan Africa.

Association between coverage of maternal and child health interventions, and under-5 mortality: a repeated cross-sectional analysis of 35 sub-Saharan African countries

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Daniel J. Corsi

2014-09-01

Full Text Available Background: Infant and child mortality rates are among the most important indicators of child health, nutrition, implementation of key survival interventions, and the overall social and economic development of a population. In this paper, we investigate the role of coverage of maternal and child health (MNCH interventions in contributing to declines in child mortality in sub-Saharan Africa. Design: Data are from 81 Demographic and Health Surveys from 35 sub-Saharan African countries. Using ecological time-series and child-level regression models, we estimated the effect of MNCH interventions (summarized by the percent composite coverage index, or CCI on child mortality with in the first 5 years of life net of temporal trends and covariates at the household, maternal, and child levels. Results: At the ecologic level, a unit increase in standardized CCI was associated with a reduction in under-5 child mortality rate (U5MR of 29.0 per 1,000 (95% CI: −43.2, −14.7 after adjustment for survey period effects and country-level per capita gross domestic product (pcGDP. At the child level, a unit increase in standardized CCI was associated with an odds ratio of 0.86 for child mortality (95% CI: 0.82–0.90 after adjustment for survey period effect, country-level pcGDP, and a set of household-, maternal-, and child-level covariates. Conclusions: MNCH interventions are important in reducing U5MR, while the effects of economic growth in sub-Saharan Africa remain weak and inconsistent. Improved coverage of proven life-saving interventions will likely contribute to further reductions in U5MR in sub-Saharan Africa.

Comparative analysis of iron homeostasis in sub-Saharan African children with sickle cell disease and their unaffected siblings

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Selma eGomez

2016-02-01

Full Text Available Iron is an essential trace element subject to tight regulation to ensure adequate running of biological processes. In sub-Saharan Africa where hemoglobinopathies are common, iron homeostasis is likely to be impaired by these conditions. Here we assessed and compared key serum proteins associated with iron metabolism between sub-Saharan African children with sickle cell disease (SCD and their unaffected siblings. Complete blood counts and serum concentrations of four key proteins involved in iron regulation (ferritin, transferrin, sTfR and hepcidin were measured for 73 children with SCD and 68 healthy siblings in Benin, West Africa. We found significant differences in concentration of transferrin, sTfR and ferritin between the two groups. Hepcidin concentrations were found at unusually high concentrations but did not differ among the two groups. We found a significant negative correlation between hepcidin levels and both MCH and MCV in the SCD group and report that sTfR concentrations show a correlation with MCV and MHC in opposite directions in the two groups. These results highlight the unusually high levels of hepcidin in the Beninese population and the patterns of differential iron homeostasis taking place under sickle cell disease status. These results lay the foundation for a systematic evaluation of the underlying mechanisms deregulating iron homeostasis in populations with SCD or high prevalence of iron deficiency.

Primary Education in Sub-Saharan Africa--A Moral Issue, an Economic Matter, or Both?

Science.gov (United States)

Daun, Holger

2000-01-01

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…

Prevalence and circumstances of forced sex and post-migration HIV acquisition in sub-Saharan African migrant women in France: an analysis of the ANRS-PARCOURS retrospective population-based study.

Science.gov (United States)

Pannetier, Julie; Ravalihasy, Andrainolo; Lydié, Nathalie; Lert, France; Desgrées du Loû, Annabel

2018-01-01

Sub-Saharan African migrant women are a key population at risk of HIV infection in Europe. Using data from the ANRS-PARCOURS study, we aimed to assess the prevalence of forced sex after migration and its association with post-migration acquisition of HIV as well as the circumstances of forced sex after migration, including housing and administrative insecurity, among sub-Saharan African migrant women living in the Paris Region, France. The ANRS-PARCOURS study was a retrospective life-event survey done between February, 2012, and May, 2013, in health-care facilities in the Paris region of France. Women were eligible if they were born in sub-Saharan Africa, aged between 18 and 59 years, and had been diagnosed with HIV infection at least 3 months earlier for women receiving HIV care or not diagnosed with HIV. In this analysis, we used ANRS-PARCOURS study data to compare the incidence of forced sex after migration in three groups of sub-Saharan African migrant women: those who acquired HIV after migrating, those who acquired HIV before migrating, and those without HIV. We assessed the associations between forced sex, sexual partnerships, and living conditions after migration with mixed-effects logistic regression and generalised structural equation models. The study is registered with ClinicalTrials.gov, number NCT02566148. We obtained data from 980 eligible individuals who participated in the ANRS-PARCOURS study (407 without HIV and 573 HIV-positive) from 54 randomly selected health-care facilities. We excluded 20 women whose HIV infection could not be dated and eight women with missing data from the analyses, for a total of 405 women in the reference group (without HIV) and 547 women in the HIV group (156 with post-migration HIV acquisition, 391 with pre-migration HIV). Women who acquired HIV after migration experienced forced sex after migration more frequently than women without HIV (24 [15%] vs 18 [4%]; p=0·001). Forced sex after migration was associated with

Modern Biotechnology—Potential Contribution and Challenges for Sustainable Food Production in Sub-Saharan Africa

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E. Jane Morris

2011-06-01

Full Text Available Modern biotechnology, including the application of transgenic techniques to produce Genetically Modified Organisms (GMOs, can play a significant role in increasing agricultural production in a sustainable way, but its products need to be tailored for the developing world. In sub-Saharan Africa, the capacity to develop GMOs and ensure they meet stringent regulatory requirements is somewhat limited. Most African governments contribute little to science and technology either financially or through strong policies. This leaves the determination of research and development priorities in the hands of international funding agencies. Whereas funding from the United States is generally supportive of GM technology, the opposite is true of funding from European sources. African countries are thus pulled in two different directions. One alternative to this dilemma might be for countries in the sub-Saharan Africa region to develop stronger South-South collaborations, but these need to be supported with adequate funding. African governments as well as external funding agencies are urged to consider the important role that biotechnology, including GM technology, can play in contributing to sustainable development in Africa, and to provide adequate support to the development of capacity to research, develop and commercialize GMOs in the region.

Oculocutaneous albinism in sub-Saharan Africa: adverse sun-associated health effects and photoprotection.

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Wright, Caradee Y; Norval, Mary; Hertle, Richard W

2015-01-01

Oculocutaneous albinism (OCA) is a genetically inherited autosomal recessive condition. Individuals with OCA lack melanin and therefore are susceptible to the harmful effects of solar ultraviolet radiation, including extreme sun sensitivity, photophobia and skin cancer. OCA is a grave public health issue in sub-Saharan Africa with a prevalence as high as 1 in 1000 in some tribes. This article considers the characteristics and prevalence of OCA in sub-Saharan African countries. Sun-induced adverse health effects in the skin and eyes of OCA individuals are reviewed. Sun exposure behavior and the use of photoprotection for the skin and eyes are discussed to highlight the major challenges experienced by these at-risk individuals and how these might be best resolved. © 2014 The American Society of Photobiology.

Deployment of community health workers across rural sub-Saharan Africa: financial considerations and operational assumptions.

Science.gov (United States)

McCord, Gordon C; Liu, Anne; Singh, Prabhjot

2013-04-01

To provide cost guidance for developing a locally adaptable and nationally scalable community health worker (CHW) system within primary-health-care systems in sub-Saharan Africa. The yearly costs of training, equipping and deploying CHWs throughout rural sub-Saharan Africa were calculated using data from the literature and from the Millennium Villages Project. Model assumptions were such as to allow national governments to adapt the CHW subsystem to national needs and to deploy an average of 1 CHW per 650 rural inhabitants by 2015. The CHW subsystem described was costed by employing geographic information system (GIS) data on population, urban extents, national and subnational disease prevalence, and unit costs (from the field for wages and commodities). The model is easily replicable and configurable. Countries can adapt it to local prices, wages, population density and disease burdens in different geographic areas. The average annual cost of deploying CHWs to service the entire sub-Saharan African rural population by 2015 would be approximately 2.6 billion (i.e. 2600 million) United States dollars (US$). This sum, to be covered both by national governments and by donor partners, translates into US$ 6.86 per year per inhabitant covered by the CHW subsystem and into US$ 2.72 per year per inhabitant. Alternatively, it would take an annual average of US$ 3750 to train, equip and support each CHW. Comprehensive CHW subsystems can be deployed across sub-Saharan Africa at cost that is modest compared with the projected costs of the primary-health-care system. Given their documented successes, they offer a strong complement to facility-based care in rural African settings.

The foreign capital flows and economic growth in Sub-Saharan Africa : the role of financial markets and institutional quality

OpenAIRE

Ifo, Duba Jarso

2017-01-01

There are competing theories when comes to the effect of foreign capital inflows on the recipient country’s economic growth. The foreign capital inflows to the sub-saharan region has shown significant growth over last two decades which coincided with the relative economic progress in the region. This study investigated the impact of foreign capital flows on Economic growth of Sub- Saharan African countries. System Generalized Methodwas employed on 33 cross country panel in the period 19...

The current bioenergy production potential of semi-arid and arid regions in sub-Saharan Africa

NARCIS (Netherlands)

Wicke, B.; Smeets, E.M.W.; Watson, H.; Faaij, A.P.C.

2011-01-01

This article assesses the current technical and economic potential of three bioenergy production systems (cassava ethanol, jatropha oil and fuelwood) in semi-arid and arid regions of eight sub-Saharan African countries. The results indicate that the availability of land for energy production ranges

Tariff evasion in sub-Saharan Africa: the influence of corruption in importing and exporting countries

NARCIS (Netherlands)

Worku, T.; Mendoza Rodriguez, J.P.; Wielhouwer, J.L.

2016-01-01

Multilateral organizations recommend sub-Saharan African (SSA) countries to increase international trade in order to attain sustainable economic growth. The benefits of trade can be hampered, however, by tariff evasion. Using trade data from 2008–2014 of 31 SSA countries, we examine how the

The health and wellbeing of young people in sub-Saharan Africa: an under-researched area?

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Kabiru Caroline W

2013-02-01

Full Text Available Abstract 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.

Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance.

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Delphine Sauvageot

2016-05-01

Full Text Available Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org.During June 2011-December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC, Guinea, Uganda, Mozambique and Cote d'Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0-40% of suspected cases were aged under five years and from 0.3-86% had rice water stools. Within surveillance zones, 0-37% of suspected cases had confirmed cholera compared to 27-38% during outbreaks. Annual confirmed incidence per 10,000 population was <0.5 in surveillance zones, except Goma where it was 4.6. Goma and Conakry had corrected incidences of 20.2 and 5.8 respectively, while the other zones a median of 0.3. During outbreaks, corrected incidence varied from 2.6 to 13.0. Case fatality ratios ranged from 0-10% (median, 1% by country.Across different African epidemiological contexts, substantial variation occurred in cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use.

Effects of South Africa’s Economic Growth on Sub-Saharan Africa

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Kwon Sik Kim

2007-06-01

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.

Polygynous contexts, family structure, and infant mortality in sub-saharan Africa.

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Smith-Greenaway, Emily; Trinitapoli, Jenny

2014-04-01

Contextual characteristics influence infant mortality above and beyond family-level factors. The widespread practice of polygyny is one feature of many sub-Saharan African contexts that may be relevant to understanding patterns of infant mortality. Building on evidence that the prevalence of polygyny reflects broader economic, social, and cultural features and that it has implications for how families engage in the practice, we investigate whether and how the prevalence of polygyny (1) spills over to elevate infant mortality for all families, and (2) conditions the survival disadvantage for children living in polygynous families (i.e., compared with monogamous families). We use data from Demographic and Health Surveys to estimate multilevel hazard models that identify associations between infant mortality and region-level prevalence of polygyny for 236,336 children in 260 subnational regions across 29 sub-Saharan African countries. We find little evidence that the prevalence of polygyny influences mortality for infants in nonpolygynous households net of region-level socioeconomic factors and gender inequality. However, the prevalence of polygyny significantly amplifies the survival disadvantage for infants in polygynous families. Our findings demonstrate that considering the broader marital context reveals important insights into the relationship between family structure and child well-being.

Urban–rural and geographic differences in overweight and obesity in four sub-Saharan African adult populations: a multi-country cross-sectional study

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IkeOluwapo O. Ajayi

2016-10-01

Full Text Available Abstract Background Overweight and obesity are on the rise in developing countries including sub-Saharan Africa. We undertook a four-country survey to show the collective burden of these health conditions as they occur currently in sub-Saharan Africa and to determine the differences between urban and rural populations and other socio-economic factors. Methods Participants were nurses in two hospitals in Nigeria (200, school teachers in South Africa (489 and Tanzania (229, and village residents in one peri-urban (297 and one rural location in Uganda (200 who completed a standardised questionnaire. Their height and weight were measured and body mass index calculated. Factor analysis procedure (Principal component was used to generate a wealth index. Univariate and multivariate analyses with binary logistic regression models were conducted to examine the associations between potential correlates and the prevalence of overweight and obesity with 95 % confidence intervals. Results The prevalence of overweight and obese (combined was 46 %, 48 %, 68 %, 75 % and 85 % in rural Uganda, peri-urban Uganda, Nigeria, Tanzania and South Africa (SA, respectively. Rural Uganda, Peri- urban Uganda, Nigeria, Tanzania and SA had obesity prevalence of 10 %, 14 %, 31 %, 40 % and 54 %, respectively (p  =25 kg/m2 in Nigeria [Age > =45 - AOR = 9.11; 95 % CI: 1.72, 48.16] and SA [AOR = 6.22; 95 % CI: 2.75, 14.07], while marital status was predictor of BMI > =25 kg/m2 only in peri-urban Uganda. [Married - AOR = 4.49; 95 % CI: 1.74, 11.57]. Those in Nigeria [AOR = 2.56; 95 % CI: 1.45, 4.53], SA [AOR = 4.97; 95 % CI: 3.18, 7.78], and Tanzania [AOR = 2.68; 95 % CI: 1.60, 4.49] were more likely to have BMI > =25 kg/m2 compared with the rural and peri-urban sites. Conclusion The high prevalence of overweight and obesity in these sub-Saharan African countries and the differentials in prevalence and risk factors further

The views of migrant health workers living in Austria and Belgium on return migration to sub-Saharan Africa.

Science.gov (United States)

Poppe, Annelien; Wojczewski, Silvia; Taylor, Katherine; Kutalek, Ruth; Peersman, Wim

2016-06-30

The negative consequences of the brain drain of sub-Saharan African health workers for source countries are well documented and include understaffed facilities, decreased standards of care and higher workloads. However, studies suggest that, if migrated health workers eventually return to their home countries, this may lead to beneficial effects following the transfer of their acquired skills and knowledge (brain gain). The present study aims to explore the factors influencing the intentions for return migration of sub-Saharan African health workers who emigrated to Austria and Belgium, and gain further insight into the potential of circular migration. Semi-structured interviews with 27 sub-Saharan African health workers in Belgium and Austria were conducted. As mentioned by the respondents, the main barriers for returning were family, structural crises in the source country, and insecurity. These barriers overrule the perceived drivers, which were nearly all pull factors and emotion driven. Despite the fact that only a minority plans to return permanently, many wish to return regularly to work in the healthcare sector or to contribute to the development of their source country. As long as safety and structural stability cannot be guaranteed in source countries, the number of return migrants is likely to remain low. National governments and regional organizations could play a role in facilitating the engagement of migrant health workers in the development of the healthcare system in source countries.

Dissecting the African Digital Divide: Diffusing E-Learning in Sub-Saharan Africa

Science.gov (United States)

Beaudoin, Michael F.

2007-01-01

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…

Tax Mobilization in Sub-Saharan Africa: The Impact of Tax and Business Law Reforms

OpenAIRE

Bertinelli, Luisito; Bourgain, Arnaud

2016-01-01

This paper contributes to measuring the influence of business (and tax) law reforms on sub-Saharan African countries tax mobilization ability. Relying on a new business law reform indicator, our results validate the significant impact of corporate law modernization on governmental revenue, and unearth a complementary effect between business and tax law reforms.

A review of sustainable solar irrigation systems for Sub-Saharan Africa

OpenAIRE

Mohammed Wazed, S.; Hughes, B.R.; O’Connor, D.; Kaiser Calautit, J.

2018-01-01

This investigation focused on the research undertaken on solar photovoltaic (PV) and solar thermal technologies for pumping water generally for irrigation of remote rural farms specifically considering the Sub-Saharan African region. Solar PV systems have been researched extensively for irrigation purposes due to the rise in Oil prices and the upscaling in commercialisation of PV technology. Based on the literature the most effective PV system is presented for the irrigation of a small scare ...

Sub-Saharan Africa Report

National Research Council Canada - National Science Library

1985-01-01

.... 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...

Sub-Saharan Africa Report

National Research Council Canada - National Science Library

1985-01-01

.... 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...

Sub-Saharan Africa Report

National Research Council Canada - National Science Library

1985-01-01

.... 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...

Sub-Saharan Africa Report

National Research Council Canada - National Science Library

1987-01-01

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...

Strong association between in-migration and HIV prevalence in urban sub-Saharan Africa.

Science.gov (United States)

Voeten, Hélène A C M; Vissers, Debby C J; Gregson, Simon; Zaba, Basia; White, Richard G; de Vlas, Sake J; Habbema, J Dik F

2010-04-01

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.

Aetiologies of non-malaria febrile episodes in children under 5 years in sub-Saharan Africa

NARCIS (Netherlands)

Kiemde, Francois; Spijker, René; Mens, Petra F.; Tinto, Halidou; Boele, Michael; Schallig, Henk D. F. H.

2016-01-01

ObjectivesTo provide an overview of the most frequent aetiologies found in febrile episodes of children under 5 years from sub-Saharan Africa. MethodsMEDLINE and EMBASE were searched for publications in English and French on non-malaria fever episodes in African children under 5 years of age, which

Technology Transfer Strategies for Creating Growth Opportunities in Frontier Markets of Sub-Saharan Africa

DEFF Research Database (Denmark)

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....

Human Heredity and Health (H3) in Africa Kidney Disease Research Network: A Focus on Methods in Sub-Saharan Africa.

Science.gov (United States)

Osafo, Charlotte; Raji, Yemi Raheem; Burke, David; Tayo, Bamidele O; Tiffin, Nicki; Moxey-Mims, Marva M; Rasooly, Rebekah S; Kimmel, Paul L; Ojo, Akinlolu; Adu, Dwomoa; Parekh, Rulan S

2015-12-07

CKD affects an estimated 14% of adults in sub-Saharan Africa, but very little research has been done on the cause, progression, and prevention of CKD there. As part of the Human Heredity and Health in Africa (H3Africa) Consortium, the H3Africa Kidney Disease Research Network was established to study prevalent forms of kidney disease in sub-Saharan Africa and increase the capacity for genetics and genomics research. The study is performing comprehensive phenotypic characterization and analyzing environmental and genetic factors from nine clinical centers in four African countries (Ghana, Nigeria, Ethiopia, and Kenya) over a 5-year period. Approximately 4000 participants with specified kidney disease diagnoses and 4000 control participants will be enrolled in the four African countries. In addition, approximately 50 families with hereditary glomerular disease will be enrolled. The study includes both pediatric and adult participants age research infrastructure can be successfully established in Africa. This study will provide clinical, biochemical, and genotypic data that will greatly increase the understanding of CKD in sub-Saharan Africa. Copyright © 2015 by the American Society of Nephrology.

Nutritional status and economic development in sub-Saharan Africa, 1950-1980.

Science.gov (United States)

Moradi, Alexander

2010-03-01

How did nutritional status develop in sub-Saharan Africa during the second half of the 20th century, and what role did economic development play in nutrition and health? Aggregating data from more than 200,000 women in 28 sub-Saharan African countries, we use mean height as an indicator of net nutritional status and find that the nutritional status of 1960 birth cohorts was relatively high. This situation, however, was not sustained. In almost all countries examined, mean heights were stagnating or decreasing after the 1970 cohorts. Using regression analysis we model human growth from birth to maturity, and find that economic growth had a significant and robust influence on final adult height at two distinct periods of the life cycle: (1) in the first years of life and (2) at puberty. We conclude that the economic difficulties of the late 1970s and 1980s contributed to the decline or stagnation in heights. Copyright 2009 Elsevier B.V. All rights reserved.

Sub-Saharan Africa Report

National Research Council Canada - National Science Library

1986-01-01

.... 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...

Assessing sub-Saharan Erythrina for efficacy: traditional uses, biological activities and phytochemistry.

OpenAIRE

Kone , Witabouna Mamidou; Solange , Kakou-Ngazoa E; Dosso , Mireille

2011-01-01

International audience; The genus Erythrina comprises more than 100 species, widely distributed in tropical and subtropical areas. In Africa, 31 wild species and 14 cultivated species have been described. In sub-Saharan Africa, Erythrina species are used to treat frequent parasitic and microbial diseases, inflammation, cancer, wounds. The rationale of these traditional uses in African traditional medicine was established by screening several species for biological activities. Promising activi...

THE IMPACT OF MICROFINANCE BANKS IN RURAL AREAS OF SUB-SAHARAN AFRICA

OpenAIRE

Isabelle Musanganya; Chantal Nyinawumuntu; Pauline Nyirahagenimana

2017-01-01

Many researchers consider microfinance as a tool for poverty reduction. Even more, especially in post-conflict African countries, micro-financial institutions are seen as an opportunity of reconciliation. Lending from microfinance institutions to that from traditional banks and examine their respective effects upon economic growth has been practiced in some sub-Saharan countries. Considerable progress in research has been found that microfinance loans raise growth comparatively to that of tra...

Financing renewable energy in developing countries. Drivers and barriers for private finance in sub-Saharan Africa

Energy Technology Data Exchange (ETDEWEB)

NONE

2012-02-15

The focus of this report is to identify and portray current barriers to the scaling up of private investment and finance for electricity generation from renewable energy sources in the sub-Saharan region. Best practice in tackling these barriers is identified, partly from a literature review but especially from the results of a survey conducted among 36 financial institutions that are UNEP Finance Initiative members and two non-member banks (all survey respondents have experience in the field of energy infrastructure finance). Promising avenues in the areas of local policy reform, incentive mechanisms and international de-risking instruments are highlighted. In particular, this report addresses the following questions: (a) Why are sub-Saharan Africa and developing countries elsewhere failing to expand electricity generation from renewable sources? What are the barriers to such expansion? What is keeping the risk-return profile of renewable energy investments in sub-Saharan Africa unattractive and projects commercially unviable?; (b) What have been the experiences of private sector lenders and investors in the area of renewable energy projects in developing countries? What barriers and drivers have they encountered, and how can these experiences be of use in sub-Saharan Africa?; (c) What can be learned from the modest but encouraging successes of a few sub-Saharan African countries? Can these results be replicated? What was done in these countries to improve the risk-return profile of renewable energy and unlock private finance?.

Globalisation and the internationalisation of higher education in sub-Saharan Africa

OpenAIRE

Dzvimbo, Kuzvinetsa Peter; Moloi, Kholeka Constance

2013-01-01

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...

Novel GREM1 Variations in Sub-Saharan African Patients With Cleft Lip and/or Cleft Palate.

Science.gov (United States)

Gowans, Lord Jephthah Joojo; Oseni, Ganiyu; Mossey, Peter A; Adeyemo, Wasiu Lanre; Eshete, Mekonen A; Busch, Tamara D; Donkor, Peter; Obiri-Yeboah, Solomon; Plange-Rhule, Gyikua; Oti, Alexander A; Owais, Arwa; Olaitan, Peter B; Aregbesola, Babatunde S; Oginni, Fadekemi O; Bello, Seidu A; Audu, Rosemary; Onwuamah, Chika; Agbenorku, Pius; Ogunlewe, Mobolanle O; Abdur-Rahman, Lukman O; Marazita, Mary L; Adeyemo, A A; Murray, Jeffrey C; Butali, Azeez

2018-05-01

Cleft lip and/or cleft palate (CL/P) are congenital anomalies of the face and have multifactorial etiology, with both environmental and genetic risk factors playing crucial roles. Though at least 40 loci have attained genomewide significant association with nonsyndromic CL/P, these loci largely reside in noncoding regions of the human genome, and subsequent resequencing studies of neighboring candidate genes have revealed only a limited number of etiologic coding variants. The present study was conducted to identify etiologic coding variants in GREM1, a locus that has been shown to be largely associated with cleft of both lip and soft palate. We resequenced DNA from 397 sub-Saharan Africans with CL/P and 192 controls using Sanger sequencing. Following analyses of the sequence data, we observed 2 novel coding variants in GREM1. These variants were not found in the 192 African controls and have never been previously reported in any public genetic variant database that includes more than 5000 combined African and African American controls or from the CL/P literature. The novel variants include p.Pro164Ser in an individual with soft palate cleft only and p.Gly61Asp in an individual with bilateral cleft lip and palate. The proband with the p.Gly61Asp GREM1 variant is a van der Woude (VWS) case who also has an etiologic variant in IRF6 gene. Our study demonstrated that there is low number of etiologic coding variants in GREM1, confirming earlier suggestions that variants in regulatory elements may largely account for the association between this locus and CL/P.

Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance.

Science.gov (United States)

Sauvageot, Delphine; Njanpop-Lafourcade, Berthe-Marie; Akilimali, Laurent; Anne, Jean-Claude; Bidjada, Pawou; Bompangue, Didier; Bwire, Godfrey; Coulibaly, Daouda; Dengo-Baloi, Liliana; Dosso, Mireille; Orach, Christopher Garimoi; Inguane, Dorteia; Kagirita, Atek; Kacou-N'Douba, Adele; Keita, Sakoba; Kere Banla, Abiba; Kouame, Yao Jean-Pierre; Landoh, Dadja Essoya; Langa, Jose Paulo; Makumbi, Issa; Miwanda, Berthe; Malimbo, Muggaga; Mutombo, Guy; Mutombo, Annie; NGuetta, Emilienne Niamke; Saliou, Mamadou; Sarr, Veronique; Senga, Raphael Kakongo; Sory, Fode; Sema, Cynthia; Tante, Ouyi Valentin; Gessner, Bradford D; Mengel, Martin A

2016-05-01

Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org). During June 2011-December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC), Guinea, Uganda, Mozambique and Cote d'Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0-40% of suspected cases were aged under five years and from 0.3-86% had rice water stools. Within surveillance zones, 0-37% of suspected cases had confirmed cholera compared to 27-38% during outbreaks. Annual confirmed incidence per 10,000 population was cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use.

Prevention of Congenital Transmission of Malaria in Sub-Saharan African Countries: Challenges and Implications for Health System Strengthening

OpenAIRE

Osungbade, Kayode O.; Oladunjoye, Olubunmi O.

2012-01-01

Objectives. Review of burden of congenital transmission of malaria, challenges of preventive measures, and implications for health system strengthening in sub-Saharan Africa. Methods. Literature from Pubmed (MEDLINE), Biomed central, Google Scholar, and Cochrane Database were reviewed. Results. The prevalence of congenital malaria in sub-Saharan Africa ranges from 0 to 23%. Diagnosis and existing preventive measures are constantly hindered by weak health systems and sociocultural issues. WHO ...

Is the Role of Physicians Really Evolving Due to Non-physician Clinicians Predominance in Staff Makeup in Sub-Saharan African Health Systems?; Comment on “Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians”

OpenAIRE

Mohsin M. Sidat

2016-01-01

Health workforce shortages in Sub-Saharan Africa are widely recognized, particularly of physicians, leading the training and deployment of Non-physician clinicians (NPCs). The paper by Eyal et al provides interesting and legitimate viewpoints on evolving role of physicians in context of decisive increase of NPCss in Sub-Saharan Africa. Certainly, in short or mid-term, NPCs will continue to be a proxy solution and a valuable alternative to overcome physicians’ shortages in sub-Saharan Africa. ...

Healthcare-associated infections in sub-Saharan Africa.

Science.gov (United States)

Rothe, C; Schlaich, C; Thompson, S

2013-12-01

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.

Decomposition analysis of CO2 emission intensity between oil-producing and non-oil-producing sub-Saharan African countries

International Nuclear Information System (INIS)

Ebohon, Obas John; Ikeme, Anthony Jekwu

2006-01-01

The need to decompose CO 2 emission intensity is predicated upon the need for effective climate change mitigation and adaptation policies. Such analysis enables key variables that instigate CO 2 emission intensity to be identified while at the same time providing opportunities to verify the mitigation and adaptation capacities of countries. However, most CO 2 decomposition analysis has been conducted for the developed economies and little attention has been paid to sub-Saharan Africa. The need for such an analysis for SSA is overwhelming for several reasons. Firstly, the region is amongst the most vulnerable to climate change. Secondly, there are disparities in the amount and composition of energy consumption and the levels of economic growth and development in the region. Thus, a decomposition analysis of CO 2 emission intensity for SSA affords the opportunity to identify key influencing variables and to see how they compare among countries in the region. Also, attempts have been made to distinguish between oil and non-oil-producing SSA countries. To this effect a comparative static analysis of CO 2 emission intensity for oil-producing and non oil-producing SSA countries for the periods 1971-1998 has been undertaken, using the refined Laspeyres decomposition model. Our analysis confirms the findings for other regions that CO 2 emission intensity is attributable to energy consumption intensity, CO 2 emission coefficient of energy types and economic structure. Particularly, CO 2 emission coefficient of energy use was found to exercise the most influence on CO 2 emission intensity for both oil and non-oil-producing sub-Saharan African countries in the first sub-interval period of our investigation from 1971-1981. In the second subinterval of 1981-1991, energy intensity and structural effect were the two major influencing factors on emission intensity for the two groups of countries. However, energy intensity effect had the most pronounced impact on CO 2 emission

Energy, growth and sustainable development - An African equation. The Sub-Saharan Africa programme

International Nuclear Information System (INIS)

Heuraux, Christine; Guinebault, Alain; Auge, Benjamin; Ouedraogo, Lassane; Keita, Seydou; Gemenne, Francois

2010-01-01

A first contribution comments the situation of the African electricity sector by notably highlighting its paradoxes (huge available reserves but very low production capacities). The author proposes a brief overview and discussion of the present production capacities and supply, outlines production shortfalls and their main reasons, comments the situation of demand, consumption and markets by distinguishing three main geographical areas (Northern Africa, Southern Africa, and Central Africa) and indicating some data related to urban and rural electrification in different parts of Africa. He also addresses the issue of prices and costs. After having outlined these paradoxes and differences, he notices the weight of history, the fact that markets are too narrow and supported by too fragile economies, and the negative influence of political and economic failures. He proposes perspectives to introduce a sustainable growth of the African electricity sector. The second contribution proposes an analysis of the present situation in Sub-Saharan Africa and possibilities of action in the field of biomass. The author notably reports the case study of Bamako. The third contribution addresses the possibility of transformation of the African gas into electricity. He notably comments the leading and innovating projects in West-Africa: the West African Gas Pipeline (the first African gas project with a regional importance), the Mauritanian gas potential which could be a chance for the mining industry of this country and for neighbouring countries, the developments in Ivory Coast and Senegal. He gives an overview of projects in Central and Southern Africa: the Logbaba deposit in Cameroon, slow advances in the Republic of Congo, the challenge of methane development by the Kivu Lake, investments in Mozambique and Tanzania. The fourth contribution discusses challenges to be faced for energy projects (energy planning, hydrocarbons, renewable energies, electric energy) and for energy

Experiences of leadership in health care in sub-Saharan Africa.

Science.gov (United States)

Curry, Leslie; Taylor, Lauren; Chen, Peggy Guey-Chi; Bradley, Elizabeth

2012-09-13

Leadership is widely regarded as central to effective health-care systems, and resources are increasingly devoted to the cultivation of strong health-care leadership. Nevertheless, the literature regarding leadership capacity building has been developed primarily in the context of high-income settings. Less research has been done on leadership in low-income settings, including sub-Saharan Africa, particularly in health care, with attention to historical, political and sociocultural context. We sought to characterize the experiences of individuals in key health-care leadership roles in sub-Saharan Africa. We conducted a qualitative study using in-person interviews with individuals (n = 17) in health-care leadership roles in four countries in sub-Saharan Africa: the Federal Democratic Republic of Ethiopia, the Republic of Ghana, the Republic of Liberia and the Republic of Rwanda. Individuals were identified by their country's minister of health as key leaders in the health sector and were nominated to serve as delegates to a global health leadership conference in June 2010, at Yale University in the United States. Interviews were audio recorded and professionally transcribed. Data analysis was performed by a five-person multidisciplinary team using the constant comparative method, facilitated by ATLAS.ti 5.0 software. Five key themes emerged as important to participants in their leadership roles: having an aspirational, value-based vision for improving the future health of the country, being self-aware and having the ability to identify and use complementary skills of others, tending to relationships, using data in decision making, and sustaining a commitment to learning. Current models of leadership capacity building address the need for core technical and management competencies. While these competencies are important, skills relevant to managing relationships are also critical in the sub-Saharan African context. Developing such skills may require more time and

Determinants of Mobile Phone Penetration: Panel Threshold Evidence from Sub-Saharan Africa

OpenAIRE

Asongu, Simplice; Nwachukwu, Jacinta

2016-01-01

Despite the evolving literature on the development benefits of mobile phones, we still know very little about factors that influence their adoption. Using twenty five policy variables, we investigate determinants of mobile phone penetration in 49 Sub-Saharan African countries with data for the period 2000-2012. The empirical evidence is based on contemporary and non-contemporary OLS, Fixed effects, System GMM and Quantile regression techniques. The determinants are classified into six policy...

Knowledge and awareness of and perception towards cardiovascular disease risk in sub-Saharan Africa: A systematic review

NARCIS (Netherlands)

Boateng, Daniel; Wekesah, Frederick; Browne, Joyce L.; Agyemang, Charles; Agyei-Baffour, Peter; Aikins, Ama de-Graft; Smit, Henriette A.; Grobbee, Diederick E.; Klipstein-Grobusch, Kerstin

2017-01-01

Cardiovascular diseases (CVDs) are the most common cause of non-communicable disease mortality in sub-Saharan African (SSA) countries. Gaps in knowledge of CVD conditions and their risk factors are important barriers in effective prevention and treatment. Yet, evidence on the awareness and knowledge

Greenhouse gas emissions from forest and agroecosystems in Sub-Saharan Africa

Science.gov (United States)

Six, Johan

2017-04-01

The Sub-Saharan African (SSA) landscape is vulnerable to ongoing land use change and climatic variability, which significantly influences carbon and greenhouse gas (GHG) dynamics. However, empirical data on GHG emissions from SSA ecosystems is lacking; hence, limiting our understanding of the potential effects of rapid land use and climate change. Here, I will present information on GHG dynamics in agroecosystems, aquatic ecosystems and forest ecosystems across multiple spatial and temporal scales to elucidate key drivers of GHG emissions from plots to regions.

Publishing and the Book Trade in Sub-Saharan Africa: Trends and Issues and Their Implications for American Libraries.

Science.gov (United States)

Bischof, Phyllis B.

1991-01-01

Discusses developments in publishing in Sub-Saharan Africa and suggests implications for American libraries. Highlights include economic constraints; state-sponsored publishing; African authors; publishing in Nigeria and South Africa; publishing for children; religious publishing houses; multinational firms; cooperative efforts that offer…

Engaging black sub-Saharan African communities and their gatekeepers in HIV prevention programs: Challenges and strategies from England

Directory of Open Access Journals (Sweden)

Mathew Nyashanu

2016-12-01

Full Text Available Objective: HIV infection is a sensitive issue in black communities [Serrant-Green L. Black Caribbean men, sexual health decisions and silences. Doctoral thesis. Nottingham School of Nursing, University of Nottingham; 2004]. Statistics show black sub-Saharan African (BSSA communities disproportionately constitute two-thirds of people with HIV [Heath Protection Agency. Health protection report: latest infection reports-GOV.UK; 2013]. African communities constitute 30% of people accessing HIV treatment in the United Kingdom yet represent less than 1% of the population [Health Protection Agency. HIV in the United Kingdom: 2012 report; 2012], [Department of Health. DVD about FGM. 2012. Available from fgm@dh.gsi.gov.uk.]. This article explores the sociocultural challenges in engaging BSSA communities in HIV prevention programs in England and possible strategies to improve their involvement. Methods: Twelve focus group discussions and 24 semistructured interviews were conducted in a 2-year period with participants from the BSSA communities and sexual health services in the West Midlands, England. The research was supported by the Ubuntu scheme, a sexual health initiative working with African communities in Birmingham, England. Results: Ineffective engagement with African communities can hinder the effectiveness of HIV prevention programs. Skills and strategies sensitive to BSSA culture are important for successful implementation of prevention programs. HIV prevention programs face challenges including stigma, denial, and marginalized views within BSSA communities. Conclusion: Networking, coordination, and cultural sensitivity training for health professionals are key strategies for engaging BSSA communities in HIV prevention programs.

Rheumatic disorders in Sub-saharan Africa.

Science.gov (United States)

McGill, P E; Oyoo, G O

2002-04-01

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.

Selected socioeconomic barriers of education in Sub-Saharan Africa

OpenAIRE

Tillová, Petra

2015-01-01

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...

Energy consumption habits and human health nexus in Sub-Saharan Africa.

Science.gov (United States)

Hanif, Imran

2018-05-22

This study explores the impact of fossil fuels consumption, solid fuels consumption for cooking purposes, economic growth, and carbon emissions on human health, with a key emphasis on the occurrence of tuberculosis and the high mortality rate in Sub-Saharan Africa. For its practical insights, the study develops a system Generalized Method of Moment (GMM) for a panel of 34 middle- and lower-middle-income countries from 1995 to 2015. The study adopts a flexible methodology to tackle endogeneity in the variables. The robust results report that the use of solid fuels (charcoal, peat, wood, wood pellets, crop residues) for cooking purposes and the consumption of fossil fuels (oil, coal, gas) are significantly increasing the occurrence of tuberculosis. In addition, the results highlight that the consumption of both solid fuels and fossil fuels has adverse affects on life expectancy by increasing the mortality rate in Sub-Saharan African countries. Results report that renewable energy sources like sun, wind, and water (all with potential to prevent households from direct exposure to particulate matters and harmful gases) as well as a rise in economic growth serve as helping factors to control the occurrence of tuberculosis and to decrease the mortality rate. Moreover, the use of renewable energy sources is serving to lessen emissions of carbon dioxide, nitrogen dioxides, and particulate matters, which can ultimately decrease the mortality rate and extend the life expectancy in Sub-Saharan Africa.

How crude oil consumption impacts on economic growth of Sub-Saharan Africa?

International Nuclear Information System (INIS)

Bashiri Behmiri, Niaz; Pires Manso, José R.

2013-01-01

This study investigates the causality relationship between crude oil consumption and economic growth in twenty three Sub-Saharan African countries. We applied a multivariate panel Granger causality framework during 1985–2011 and we included crude oil price as the control variable of the model. The results indicate that in the short-run, there is a bi-directional causality relationship between crude oil consumption and economic growth in oil importing region and there is a uni-directional causality relationship from crude oil consumption to GDP in oil exporting region. However, in the long-run there is a bi-directional causality relationship between them in both regions. Therefore, reducing crude oil consumption without employing appropriate policies adversely impacts on economic growth of Sub-Saharan Africa. Hence, in order to reduce crude oil dependency of the region policymakers should pay more attention to the issue of energy efficiency programs. - Highlights: ► We examined Granger causality among oil consumption and GDP in Sub-Saharan Africa. ► Crude oil price is the control variable of the model. ► There is short run bi-directional causality among oil and GDP (oil importing). ► There is short run uni-directional causality from oil to GDP (oil exporting). ► There is a long run bi-directional causality among oil and GDP in both regions

Public Policy and the Management of Higher Education in Sub-Saharan Africa: The Case of Kenya.

Science.gov (United States)

Gray, Kenneth R.; Credle, Sid Howard

1996-01-01

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…

Education for Library, Archive, and Information Science in Sub-Saharan Africa: A Blueprint for Regional Planning.

Science.gov (United States)

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…

External quality assurance performance of clinical research laboratories in sub-saharan Africa.

Science.gov (United States)

Amukele, Timothy K; Michael, Kurt; Hanes, Mary; Miller, Robert E; Jackson, J Brooks

2012-11-01

Patient Safety Monitoring in International Laboratories (JHU-SMILE) is a resource at Johns Hopkins University that supports and monitors laboratories in National Institutes of Health-funded international clinical trials. To determine the impact of the JHU-SMILE quality assurance scheme in sub-Saharan African laboratories, we reviewed 40 to 60 months of external quality assurance (EQA) results of the College of American Pathologists (CAP) in these laboratories. We reviewed the performance of 8 analytes: albumin, alanine aminotransferase, creatinine, sodium, WBC, hemoglobin, hematocrit, and the human immunodeficiency virus antibody rapid test. Over the 40- to 60-month observation period, the sub-Saharan laboratories had a 1.63% failure rate, which was 40% lower than the 2011 CAP-wide rate of 2.8%. Seventy-six percent of the observed EQA failures occurred in 4 of the 21 laboratories. These results demonstrate that a system of remote monitoring, feedback, and audits can support quality in low-resource settings, even in places without strong regulatory support for laboratory quality.

A systematic review of essential obstetric and newborn care capacity building in rural sub-Saharan Africa.

Science.gov (United States)

Ni Bhuinneain, G M; McCarthy, F P

2015-01-01

Progress in maternal survival in sub-Saharan Africa has been poor since the Millennium Declaration. This systematic review aims to investigate the presence and rigour of evidence for effective capacity building for Essential Obstetric and Newborn Care (EONC) to reduce maternal mortality in rural, sub-Saharan Africa, where maternal mortality ratios are highest globally. MEDLINE (1990-January 2014), EMBASE (1990-January 2014), and the Cochrane Library were included in our search. Key developing world issues of The Lancet and the British Journal of Obstetrics and Gynaecology, African Ministry of Health websites, and the WHO reproductive health library were searched by hand. Studies investigating essential obstetric and newborn care packages in basic and comprehensive care facilities, at community and institutional level, in rural sub-Saharan Africa were included. Studies were included if they reported on healthcare worker performance, access to care, community behavioural change, and emergency obstetric and newborn care. Data were extracted and all relevant studies independently appraised using structured abstraction and appraisal tools. There is moderate evidence to support the training of healthcare workers of differing cadres in the provision of emergency obstetric and newborn services to reduce institutional maternal mortality and case-fatality rates in rural sub-Saharan Africa. Community schemes that sensitise and enable access to maternal health services result in a modest rise in facility birth and skilled birth attendance in this rural setting. Essential Obstetric and Newborn Care has merit as an intervention package to reduce maternal mortality in rural sub-Saharan Africa. © 2014 Royal College of Obstetricians and Gynaecologists.

Non-physician Clinicians – A Gain for Physicians’ Working in Sub-Saharan Africa; Comment on “Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians”

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Delanyo Dovlo

2017-02-01

Full Text Available The changing demands on the health sectors in low- and middle-income countries especially sub-Saharan African countries continue to challenge efforts to address critical shortages of the health workforce. Addressing these challenges have led to the evolution of “non-physician clinicians” (NPCs, that assume some physician roles and thus mitigate the continuing shortage of doctors in these countries. While it is agreed that changes are needed in physicians’ roles and their training as part of the new continuum of care that includes NPCs, we disagree that such training should be geared solely at ensuring physicians dominated health systems. Discussions on the workforce models to suit low-income countries must avoid an endorsement of a culture of physician focused health systems as the only model for sub-Saharan Africa (SSA. It is also essential that training for NPCs be harmonized with that of physicians to clarify the technical roles of both.

Performance of HIV Prevention of Mother-To-Child Transmission Programs in Sub-Saharan Africa: Longitudinal Assessment of 64 Nevirapine-Based Programs Implemented in 25 Countries, 2000-2011.

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Joël Ladner

Full Text Available To evaluate the performance and to identify predictive factors of performance in prevention of mother-to-child HIV transmission programs (PMTCT in sub-Saharan African countries.From 2000 to 2011, PMTCT programs included in the Viramune Donation Programme (VDP were prospectively followed. Each institution included in the VDP provided data on program implementation, type of management institution, number of PMTCT sites, key programs outputs (HIV counseling and testing, NVP regimens received by mothers and newborns. Nevirapine Coverage Ratio (NCR, defined as the number of women who should have received nevirapine (observed HIV prevalence x number of women in antenatal care, was used to measure performance. Included programs were followed every six months through progress reports.A total of 64 programs in 25 sub-Saharan African countries were included. The mean program follow-up was 48.0 months (SD = 24.5; 20,084,490 women attended in antenatal clinics were included. The overall mean NCR was 0.52 (SD = 0.25, with an increase from 0.37 to 0.57 between the first and last progress reports (p<.0001; NCR increased by 3.26% per year-program. Between the first and the last report, the number of women counseled and tested increased from 64.3% to 86.0% (p<.0001, the number of women post-counseled from 87.5% to 91.3% (p = 0.08. After mixed linear regression analysis, type of responsible institution, number of women attended in ANC, and program initiation in 2005-2006 were significant predictive factors associated with the NCR. The effect of the time period increased from earlier to later periods.A longitudinal assessment of large PMTCT programs shows that scaling-up of programs was increased in sub-Saharan African countries. The PMTCT coverage increased throughout the study period, especially after 2006. Performance may be better for programs with a small or medium number of women attended in ANC. Identification of factors that predict PMTCT program

From Theory to Practice: Exploring the Organised Crime-Terror Nexus in Sub-Saharan Africa

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Annette Hübschle

2011-09-01

Full Text Available  A growing body of scholarly literature suggests confluence or even convergence of organized crime and terrorism in various parts of the world. However, links remain somewhat nebulous at this stage and vary considerably, based on region and context. Africa has come under the spotlight due to perceived weaknesses in the criminal justice sector, limited law enforcement capacity, political and systemic corruption, poor border patrol and weak anti-terror and organized crime laws which are believed to provide an ideal environment for the terror-crime nexus to flourish. This article provides an African perspective on the links between organized crime and terror networks in Sub-Saharan Africa, with a particular focus on Southern Africa. The discussion begins with an overview of the theoretical discourse on the subject – relying on African definitions of the contested concepts of ‘terrorism’ and ‘organized crime’ – and will then narrow the analysis on the sub-Saharan case. It relies on an extensive literature review and concludes with empirical findings of a research project on organized crime in Southern Africa, which found no strong empirical links between criminal and terrorist organizations.

Population Policy Adoption in Sub-Saharan Africa: An Interplay of Global and Local Forces

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Robinson Rachel Sullivan

2016-08-01

Full Text Available Sub-Saharan African countries have the highest population growth rates in the world, and are also the poorest. In response to a variety of global and local forces, during the 1980s and 1990s two thirds of sub- Saharan African countries adopted national population policies to reduce population growth. Drawing from existing research and using the texts of population policies to illustrate key points, this article summarises the factors that drove population policy adoption in the region. Globally, powerful donors with significant leverage promoted population policies as a solution to lagging socioeconomic development while international organizations spread norms about women’s rights and reproductive health. Locally, technocrats working within relevant ministries backed efforts to increase contraceptive prevalence, and population policies furthered political projects unrelated to population. The interplay of global and local forces led to governments adopting population policies. Ultimately, continued high desired fertility and limited implementation capacity have prevented population policies from significantly lowering fertility, but these policies have likely increased the availability of contraception, created important discursive space related to gender and sexuality, and provided countries with an opportunity to test procedures and approaches for policy-making on sensitive issues.

Viral pneumonia in adults in sub-Saharan Africa – epidemiology, aetiology, diagnosis and management

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Antonia Ho

2014-06-01

Full Text Available Community-acquired pneumonia causes substantial morbidity and mortality in sub-Saharan Africa with an estimated 131 million new cases each year. Viruses – such as influenza virus, respiratory syncytial virus and parainfluenza virus – are now recognised as important causes of respiratory disease in older children and adults in the developed world following the emergence of sensitive molecular diagnostic tests, recent severe viral epidemics, and the discovery of novel viruses. Few studies have comprehensively evaluated the viral aetiology of adult pneumonia in Africa, but it is likely to differ from Western settings due to varying seasonality and the high proportion of patients with immunosuppression and co-morbidities. Emerging data suggest a high prevalence of viral pathogens, as well as multiple viral and viral/bacterial infections in African adults with pneumonia. However, the interpretation of positive results from highly sensitive polymerase chain reaction tests can be challenging. Therapeutic and preventative options against viral respiratory infections are currently limited in the African setting. This review summarises the current state of the epidemiology, aetiology, diagnosis and management of viral pneumonia in sub-Saharan Africa.

Tax Revenue in Sub-Saharan Africa; Effects of Economic Policies and Corruption

OpenAIRE

Dhaneshwar Ghura

1998-01-01

An analysis of data for 39 sub-Saharan African countries during 1985–96 indicates that the variations in tax revenue-GDP ratios within this group are influenced by economic policies and the level of corruption. Namely, these ratios rise with declining inflation, implementation of structural reforms, rising human capital (a proxy for the provision of public services by the government), and declining corruption. The paper confirms that the tax revenue ratio rises with income, and that elements ...

Education in Sub-Saharan Africa: Policies for Adjustment, Revitalization, and Expansion. A World Bank Policy Study.

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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…

Removing user fees in the health sector: a review of policy processes in six sub-Saharan African countries.

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Meessen, Bruno; Hercot, David; Noirhomme, Mathieu; Ridde, Valéry; Tibouti, Abdelmajid; Tashobya, Christine Kirunga; Gilson, Lucy

2011-11-01

In recent years, governments of several low-income countries have taken decisive action by removing fully or partially user fees in the health sector. In this study, we review recent reforms in six sub-Saharan African countries: Burkina Faso, Burundi, Ghana, Liberia, Senegal and Uganda. The review describes the processes and strategies through which user fee removal reforms have been implemented and tries to assess them by referring to a good practice hypotheses framework. The analysis shows that African leaders are willing to take strong action to remove financial barriers met by vulnerable groups, especially pregnant women and children. However, due to a lack of consultation and the often unexpected timing of the decision taken by the political authorities, there was insufficient preparation for user fee removal in several countries. This lack of preparation resulted in poor design of the reform and weaknesses in the processes of policy formulation and implementation. Our assessment is that there is now a window of opportunity in many African countries for policy action to address barriers to accessing health care. Mobilizing sufficient financial resources and obtaining long-term commitment are obviously crucial requirements, but design details, the formulation process and implementation plan also need careful thought. We contend that national policy-makers and international agencies could better collaborate in this respect.

Infertility in sub-Saharan women. New technologies in traditional African culture

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Auxiliadora Nieves Vázquez

2018-02-01

Full Text Available Africa is a multicultural continent with a large variety of sociopolitical situations. All along the continent there is a common characteristic based on traditional culture: women’s reproductive role is the basis of social and economic structure. Women’s infertility implies an important stigma which has a great personal, familiar and social impact. I study the incidence, causes and consequences of sub-Saharan women’s infertility. I also analyze the different therapeutic approaches, feasibility of new reproductive techniques for the general population in their real lives and the bioethics discussion this involves.

Interactions and Feedbacks Between Biomass Burning and Water Cycle Dynamics Across the Northern Sub-Saharan African Region

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Ichoku, Charles

2012-01-01

The northern sub-Saharan African (NSSA) region, bounded on the north and south by the Sahara and the Equator, respectively, and stretching from the West to the East African coastlines, has one of the highest biomass-burning rates per unit land area among all regions of the world. Because of the high concentration and frequency of fires in this region, with the associated abundance of heat release and gaseous and particulate smoke emissions, biomass-burning activity is believed to be one of the drivers of the regional carbon and energy cycles, with serious implications for the water cycle. A new interdisciplinary research effort sponsored by NASA is presently being focused on the NSSA region, to better understand the possible connection between the intense biomass burning observed from satellite year after year across the region and the rapid depletion of the regional water resources, as exemplified by the dramatic drying of Lake Chad. A combination of remote sensing and modeling approaches is being utilized in investigating multiple regional surface, atmospheric, and water-cycle processes, and inferring possible links between them. In this presentation, we will discuss preliminary results as well as the path toward improved understanding of the interrelationships and feedbacks between the biomass burning and the environmental change dynamics in the NSSA region.

Science Granting Councils Initiative in Sub-Saharan Africa | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

... 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.

Contemporary issues on the epidemiology and antiretroviral adherence of HIV-infected adolescents in sub-Saharan Africa: a narrative review

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Adejumo, Olurotimi A; Malee, Kathleen M; Ryscavage, Patrick; Hunter, Scott J; Taiwo, Babafemi O

2015-01-01

Introduction Adolescents are a unique and sometimes neglected group in the planning of healthcare services. This is the case in many parts of sub-Saharan Africa, where more than eight out of ten of the world's HIV-infected adolescents live. Although the last decade has seen a reduction in AIDS-related mortality worldwide, largely due to improved access to effective antiretroviral therapy (ART), AIDS remains a significant contributor to adolescent mortality in sub-Saharan Africa. Although inadequate access to ART in parts of the subcontinent may be implicated, research among youth with HIV elsewhere in the world suggests that suboptimal adherence to ART may play a significant role. In this article, we summarize the epidemiology of HIV among sub-Saharan African adolescents and review their adherence to ART, emphasizing the unique challenges and factors associated with adherence behaviour. Methods We conducted a comprehensive search of online databases for articles, relevant abstracts, and conference reports from meetings held between 2010 and 2014. Our search terms included “adherence,” “compliance,” “antiretroviral use” and “antiretroviral adherence,” in combination with “adolescents,” “youth,” “HIV,” “Africa,” “interventions” and the MeSH term “Africa South of the Sahara.” Of 19,537 articles and abstracts identified, 215 met inclusion criteria, and 148 were reviewed. Discussion Adolescents comprise a substantial portion of the population in many sub-Saharan African countries. They are at particular risk of HIV and may experience worse outcomes. Although demonstrated to have unique challenges, there is a dearth of comprehensive health services for adolescents, especially for those with HIV in sub-Saharan Africa. ART adherence is poorer among older adolescents than other age groups, and psychosocial, socio-economic, individual, and treatment-related factors influence adherence behaviour among adolescents in this region. With

Contemporary issues on the epidemiology and antiretroviral adherence of HIV-infected adolescents in sub-Saharan Africa: a narrative review.

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Adejumo, Olurotimi A; Malee, Kathleen M; Ryscavage, Patrick; Hunter, Scott J; Taiwo, Babafemi O

2015-01-01

Adolescents are a unique and sometimes neglected group in the planning of healthcare services. This is the case in many parts of sub-Saharan Africa, where more than eight out of ten of the world's HIV-infected adolescents live. Although the last decade has seen a reduction in AIDS-related mortality worldwide, largely due to improved access to effective antiretroviral therapy (ART), AIDS remains a significant contributor to adolescent mortality in sub-Saharan Africa. Although inadequate access to ART in parts of the subcontinent may be implicated, research among youth with HIV elsewhere in the world suggests that suboptimal adherence to ART may play a significant role. In this article, we summarize the epidemiology of HIV among sub-Saharan African adolescents and review their adherence to ART, emphasizing the unique challenges and factors associated with adherence behaviour. We conducted a comprehensive search of online databases for articles, relevant abstracts, and conference reports from meetings held between 2010 and 2014. Our search terms included "adherence," "compliance," "antiretroviral use" and "antiretroviral adherence," in combination with "adolescents," "youth," "HIV," "Africa," "interventions" and the MeSH term "Africa South of the Sahara." Of 19,537 articles and abstracts identified, 215 met inclusion criteria, and 148 were reviewed. Adolescents comprise a substantial portion of the population in many sub-Saharan African countries. They are at particular risk of HIV and may experience worse outcomes. Although demonstrated to have unique challenges, there is a dearth of comprehensive health services for adolescents, especially for those with HIV in sub-Saharan Africa. ART adherence is poorer among older adolescents than other age groups, and psychosocial, socio-economic, individual, and treatment-related factors influence adherence behaviour among adolescents in this region. With the exception of a few examples based on affective, cognitive, and

The Importance of Regional Economic Communities and Anchor States for Determining AFRICOM’s Receptivity in Sub Saharan Africa

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2014-02-13

international trade and investment. From 2001 through 2011, Sub-Saharan Africa possessed four out of the world’s ten quickest growing economies . By 2007...together to largely encompass the geography of the future East African Community ( EAC ) REC. While colonial administrators leveraged regionalism to ease...emerging African nations had a “sparse population, small internal market, limited infrastructure, new and fragile borders, economies vulnerable to

Analysis of strain distribution, migratory potential, and invasion history of fall armyworm populations in northern Sub-Saharan Africa

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Fall armyworm (Spodoptera frugiperda, J.E. Smith) is a noctuid moth pest endemic throughout the Western Hemisphere that has recently become widespread in Sub-Saharan Africa. There is a strong expectation of significant damage to African maize crop yield and a high likelihood of further dispersal, pu...

[Aging and health in Sub-Saharan Africa: an urgent agenda for international cooperation].

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Telles, José Luiz; Borges, Ana Paula Abreu

2013-12-01

The Sub-Saharan part of the African continent is the area that has the highest disease burden in the world and is the only region of the planet where it is expected that the number of poor people will increase in the coming decades. The countries of this region, to different degrees, experience slow process of population aging but at the same time, it is the are where the elderly population grows fastest in absolute numbers. Based on a review of the literature, an attempt was made to highlight the social and demographic situation in which the elderly live in the Sub-Saharan region and the main challenges faced by local governments to overcome the complex problems affecting society as a whole. It was found that public policies geared to this segment of the population in the region do not represent a priority and, consequently, are unlikely to be included in the current agenda of international cooperation.

Neonatal hypothermia in sub-Saharan Africa: a review.

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Onalo, R

2013-01-01

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.

Y-chromosomal variation in Sub-Saharan Africa: insights into the history of Niger-Congo groups

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de Filippo, Cesare; Barbieri, Chiara; Whitten, Mark; Mpoloka, Sununguko Wata; Gunnarsdóttir, Ellen Drofn; Bostoen, Koen; Nyambe, Terry; Beyer, Klaus; Schreiber, Henning; de Knijff, Peter; Luiselli, Donata; Stoneking, Mark; Pakendorf, Brigitte

2013-01-01

Technological and cultural innovations, as well as climate changes, are thought to have influenced the diffusion of major language phyla in sub-Saharan Africa. The most widespread and the richest in diversity is the Niger-Congo phylum, thought to have originated in West Africa ~10,000 years ago. The expansion of Bantu languages (a family within the Niger-Congo phylum) ~5,000 years ago represents a major event in the past demography of the continent. Many previous studies on Y chromosomal variation in Africa associated the Bantu expansion with haplogroup E1b1a (and sometimes its sub-lineage E1b1a7). However, the distribution of these two lineages extends far beyond the area occupied nowadays by Bantu speaking people, raising questions on the actual genetic structure behind this expansion. To address these issues, we directly genotyped 31 biallelic markers and 12 microsatellites on the Y chromosome in 1195 individuals of African ancestry focusing on areas that were previously poorly characterized (Botswana, Burkina Faso, D.R.C, and Zambia). With the inclusion of published data, we analyzed 2736 individuals from 26 groups representing all linguistic phyla and covering a large portion of Sub-Saharan Africa. Within the Niger-Congo phylum, we ascertain for the first time differences in haplogroup composition between Bantu and non-Bantu groups via two markers (U174 and U175) on the background of haplogroup E1b1a (and E1b1a7), which were directly genotyped in our samples and for which genotypes were inferred from published data using Linear Discriminant Analysis on STR haplotypes. No reduction in STR diversity levels was found across the Bantu groups, suggesting the absence of serial founder effects. In addition, the homogeneity of haplogroup composition and pattern of haplotype sharing between Western and Eastern Bantu groups suggest that their expansion throughout Sub-Saharan Africa reflects a rapid spread followed by backward and forward migrations. Overall, we found

Transitioning Towards Sustainable Development Goals: The Role of Household Environment in Influencing Child Health in Sub-Saharan Africa and South Asia using Recent Demographic Health Surveys.

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Ankit eAnand

2016-05-01

Full Text Available The millennium development goals are now replaced by seventeen sustainable development goals. The emphasis of old goals was on improving water, sanitation, and child mortality conditions in developing countries. The study explored the major question about the association between different household environment conditions with child survival and health in Sub-Saharan African and South Asian countries in the current scenario. This paper estimated the risk of death, morbidity and under-nutrition among children living in households with the improved sources of water, sanitation and non-solid cooking fuel. Two sources of information explored in this study. First, data from World Health Statistics (WHS -2014 for all of the Sub-Saharan African and South Asian countries were used. Second, available standard Demographic and Health Survey performed in the countries of Sub-Saharan Africa and South Asia after 2010, included in the study. It resulted in inclusion of 15 countries which were Bangladesh (2011, Congo Republic (2013-14, Cote d'Ivoire (2011-12, Ethiopia (2011, Gambia (2013, Mali (2012-13, Mozambique (2011, Namibia (2013, Nepal (2011, Niger (2012, Nigeria (2013, Pakistan (2012-13, Sierra Leone (2013, Uganda (2011 and Zambia (2013. The Scatter plot diagram was plotted, and the curve was fitted using the WHS-2014. Cox regression and logistic regression were used to estimate adjusted risks (odds ratio of child mortality and health outcomes using DHS surveys. The use of non-solid cooking fuel was very high in most of the Sub-Saharan African and South Asian Countries. There was a positive correlation between improving access to safe drinking water and sanitation. The exponential curve fitted well with child mortality and Household environmental indicators. The use of improved source of water and sanitation significantly related with the lower odds ratio of death, morbidity and under-nutrition among children aged 12-59 months. The risks were not

Burns in sub-Saharan Africa: A review.

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Nthumba, Peter M

2016-03-01

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.

Global funding trends for malaria research in sub-Saharan Africa: a systematic analysis.

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Head, Michael G; Goss, Sian; Gelister, Yann; Alegana, Victor; Brown, Rebecca J; Clarke, Stuart C; Fitchett, Joseph R A; Atun, Rifat; Scott, J Anthony G; Newell, Marie-Louise; Padmadas, Sabu S; Tatem, Andrew J

2017-08-01

Total domestic and international funding for malaria is inadequate to achieve WHO global targets in burden reduction by 2030. We describe the trends of investments in malaria-related research in sub-Saharan Africa and compare investment with national disease burden to identify areas of funding strength and potentially neglected populations. We also considered funding for malaria control. Research funding data related to malaria for 1997-2013 were sourced from existing datasets, from 13 major public and philanthropic global health funders, and from funding databases. Investments (reported in US$) were considered by geographical area and compared with data on parasite prevalence and populations at risk in sub-Saharan Africa. 45 sub-Saharan African countries were ranked by amount of research funding received. We found 333 research awards totalling US$814·4 million. Public health research covered $308·1 million (37·8%) and clinical trials covered $275·2 million (33·8%). Tanzania ($107·8 million [13·2%]), Uganda ($97·9 million [12·0%]), and Kenya ($92·9 million [11·4%]) received the highest sum of research investment and the most research awards. Malawi, Tanzania, and Uganda remained highly ranked after adjusting for national gross domestic product. Countries with a reasonably high malaria burden that received little research investment or funding for malaria control included Central African Republic (ranked 40th) and Sierra Leone (ranked 35th). Congo (Brazzaville) and Guinea had reasonably high malaria mortality, yet Congo (Brazzaville) ranked 38th and Guinea ranked 25th, thus receiving little investment. Some countries receive reasonably large investments in malaria-related research (Tanzania, Kenya, Uganda), whereas others receive little or no investments (Sierra Leone, Central African Republic). Research investments are typically highest in countries where funding for malaria control is also high. Investment strategies should consider more equitable

Not just minor wild edible forest products: consumption of pteridophytes in sub-Saharan Africa.

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Maroyi, Alfred

2014-12-22

Swaziland), Diplazium sammatii (Kuhn) C.Chr. (DRC and Nigeria), Nephrolepis biserrata Sw. (DRC and Nigeria) and Ophioglossum polyphyllum A. Braun (Namibia and South Africa). The majority of edible pteridophytes are eaten as vegetables or potherbs (66.7%), with some eaten raw or as salad or edible rhizomes (12.5% each). Literature search revealed that some of the documented pteridophytes have high macro and micro nutrient content comparable to recommended FAO/WHO daily nutrient intake from conventional food crops and vegetables. This study demonstrated the capability of literature research to reveal traditional knowledge on edible pteridophytes in sub-Saharan Africa from dispersed primary ethnobotanical data. Findings from this study suggest that edible pteridophytes could make an important contribution to provision of macro and micro nutrients to the sub-Saharan African population. This study also provided evidence of the importance of pteridophytes as food sources, and can therefore, used to enhance food security in the region by complementing the major food crops, vegetables and fruits.

Abortion and Contraceptive Use in Sub-Saharan Africa: How ...

African Journals Online (AJOL)

Erah

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.

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International.

Science.gov (United States)

Duvall, Susan; Thurston, Sarah; Weinberger, Michelle; Nuccio, Olivia; Fuchs-Montgomery, Nomi

2014-02-01

Contraceptive implants offer promising opportunities for addressing the high and growing unmet need for modern contraceptives in sub-Saharan Africa. Marie Stopes International (MSI) offers implants as one of many family planning options. Between 2008 and 2012, MSI scaled up voluntary access to implants in 15 sub-Saharan African countries, from 80,041 implants in 2008 to 754,329 implants in 2012. This 9-fold increase amounted to more than 1.7 million implants delivered cumulatively over the 5-year period. High levels of client satisfaction were attained alongside service provision scale up by using existing MSI service delivery channels-mobile outreach, social franchising, and clinics-to implement strategies that broadened access for underserved clients and maintained service quality. Use of adaptive and context-specific service delivery models and attention to key operational components, including sufficient numbers of trained providers, strong supply chains, diverse financing mechanisms, and implant removal services, underpinned our service delivery efforts. Accounting for 70% of the implants delivered by MSI in 2012, mobile outreach services through dedicated MSI provider teams played a central role in scale-up efforts, fueled in part by the provision of free or heavily subsidized services. Social franchising also demonstrated promise for future program growth, along with MSI clinics. Continued high growth in implant provision between 2011 and 2012 in all sub-Saharan African countries indicates the region's capacity for further service delivery expansion. Meeting the expected rising demand for implants and ensuring long-term sustainable access to the method, as part of a comprehensive method mix, will require continued use of appropriate service delivery models, effective operations, and ongoing collaboration between the private, public, and nongovernmental sectors. MSI's experience can be instructive for future efforts to ensure contraceptive access and choice

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International

Science.gov (United States)

Duvall, Susan; Thurston, Sarah; Weinberger, Michelle; Nuccio, Olivia; Fuchs-Montgomery, Nomi

2014-01-01

Contraceptive implants offer promising opportunities for addressing the high and growing unmet need for modern contraceptives in sub-Saharan Africa. Marie Stopes International (MSI) offers implants as one of many family planning options. Between 2008 and 2012, MSI scaled up voluntary access to implants in 15 sub-Saharan African countries, from 80,041 implants in 2008 to 754,329 implants in 2012. This 9-fold increase amounted to more than 1.7 million implants delivered cumulatively over the 5-year period. High levels of client satisfaction were attained alongside service provision scale up by using existing MSI service delivery channels—mobile outreach, social franchising, and clinics—to implement strategies that broadened access for underserved clients and maintained service quality. Use of adaptive and context-specific service delivery models and attention to key operational components, including sufficient numbers of trained providers, strong supply chains, diverse financing mechanisms, and implant removal services, underpinned our service delivery efforts. Accounting for 70% of the implants delivered by MSI in 2012, mobile outreach services through dedicated MSI provider teams played a central role in scale-up efforts, fueled in part by the provision of free or heavily subsidized services. Social franchising also demonstrated promise for future program growth, along with MSI clinics. Continued high growth in implant provision between 2011 and 2012 in all sub-Saharan African countries indicates the region's capacity for further service delivery expansion. Meeting the expected rising demand for implants and ensuring long-term sustainable access to the method, as part of a comprehensive method mix, will require continued use of appropriate service delivery models, effective operations, and ongoing collaboration between the private, public, and nongovernmental sectors. MSI's experience can be instructive for future efforts to ensure contraceptive access and

The Position of Sub-Saharan Countries in the World Economy

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Baumgartner Boris

2016-06-01

Full Text Available Most of the countries of sub-Saharan Africa belong to the most underdeveloped and poorest countries in the world economy. This region consists of forty-nine countries but at world GDP, world export, world import and inflow of foreign direct investment share only by small percent. There are some positive facts in the recent history of sub- Saharan Africa. Sub-Saharan Africa has grown faster than the world economy in the past ten years. The predictions are also positive. There is an expectation of another growth till the 2020. If the sub-Saharan countries want to keep the growth in the future they have to invest to infrastructure, in educational system, in research and science to make their economies more competitive.

Is the Role of Physicians Really Evolving Due to Non-physician Clinicians Predominance in Staff Makeup in Sub-Saharan African Health Systems?; Comment on “Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians”

Directory of Open Access Journals (Sweden)

Mohsin M. Sidat

2016-12-01

Full Text Available Health workforce shortages in Sub-Saharan Africa are widely recognized, particularly of physicians, leading the training and deployment of Non-physician clinicians (NPCs. The paper by Eyal et al provides interesting and legitimate viewpoints on evolving role of physicians in context of decisive increase of NPCss in Sub-Saharan Africa. Certainly, in short or mid-term, NPCs will continue to be a proxy solution and a valuable alternative to overcome physicians’ shortages in sub-Saharan Africa. Indeed, NPCs have an important role at primary healthcare (PHC level. Physicians at PHC level can certainly have all different roles that were suggested by Eyal et al, including those not directly related to healthcare provision. However, at secondary and higher levels of healthcare, physicians would assume other roles that are mainly related to patient clinical care. Thus, attempting to generalize the role of physicians without taking into account the context where they will work would be not entirely appropriate. It is true that often physicians start the professional carriers at PHC level and progress to other levels of healthcare particularly after clinical post-graduation training. Nevertheless, the training programs offered by medical institutions in sub-Saharan Africa need to be periodically reviewed and take into account professional and occupational roles physicians would take in context of evolving health systems in sub-Saharan Africa.

Assessing sub-Saharan Erythrina for efficacy: traditional uses, biological activities and phytochemistry.

Science.gov (United States)

Kone, Witabouna Mamidou; Solange, Kakou-Ngazoa E; Dosso, Mireille

2011-05-15

The genus Erythrina comprises more than 100 species, widely distributed in tropical and subtropical areas. In Africa, 31 wild species and 14 cultivated species have been described. In sub-Saharan Africa, Erythrina species are used to treat frequent parasitic and microbial diseases, inflammation, cancer, wounds. The rationale of these traditional uses in African traditional medicine was established by screening several species for biological activities. Promising activities were found against bacteria, parasites (Plasmodium), human and phytopathogenic fungi, some of which were multidrug resistant (MDR) micro organisms. Some species also exhibited antioxidant, anti-inflammatory activities and enzymes inhibitory properties. Most of the species chemically investigated were reported to contain flavanones, prenylated isoflavones, isoflavanones and pterocarpans. Some phytochemicals (vogelin B, vogelin C, isowightcone, abyssinin II, derrone) were the active principles as antibacterials, antifungals, antiplasmodials and inhibitors of enzyme borne diseases (PTP1B, HIV protease, DGAT). This review highlights the important role of Erythrina species as sources of lead compounds or new class of phytotherapeutic agents for fighting against major public health (MDR infections, cancer, diabetes, obesity) in sub-Saharan Africa.

Obesity and type 2 diabetes in sub-Saharan Africans - Is the burden in today's Africa similar to African migrants in Europe? The RODAM study.

Science.gov (United States)

Agyemang, Charles; Meeks, Karlijn; Beune, Erik; Owusu-Dabo, Ellis; Mockenhaupt, Frank P; Addo, Juliet; de Graft Aikins, Ama; Bahendeka, Silver; Danquah, Ina; Schulze, Matthias B; Spranger, Joachim; Burr, Tom; Agyei-Baffour, Peter; Amoah, Stephen K; Galbete, Cecilia; Henneman, Peter; Klipstein-Grobusch, Kerstin; Nicolaou, Mary; Adeyemo, Adebowale; van Straalen, Jan; Smeeth, Liam; Stronks, Karien

2016-10-21

Rising rates of obesity and type 2 diabetes (T2D) are impending major threats to the health of African populations, but the extent to which they differ between rural and urban settings in Africa and upon migration to Europe is unknown. We assessed the burden of obesity and T2D among Ghanaians living in rural and urban Ghana and Ghanaian migrants living in different European countries. A multi-centre cross-sectional study was conducted among Ghanaian adults (n = 5659) aged 25-70 years residing in rural and urban Ghana and three European cities (Amsterdam, London and Berlin). Comparisons between groups were made using prevalence ratios (PRs) with adjustments for age and education. In rural Ghana, the prevalence of obesity was 1.3 % in men and 8.3 % in women. The prevalence was considerably higher in urban Ghana (men, 6.9 %; PR: 5.26, 95 % CI, 2.04-13.57; women, 33.9 %; PR: 4.11, 3.13-5.40) and even more so in Europe, especially in London (men, 21.4 %; PR: 15.04, 5.98-37.84; women, 54.2 %; PR: 6.63, 5.04-8.72). The prevalence of T2D was low at 3.6 % and 5.5 % in rural Ghanaian men and women, and increased in urban Ghanaians (men, 10.3 %; PR: 3.06; 1.73-5.40; women, 9.2 %; PR: 1.81, 1.25-2.64) and highest in Berlin (men, 15.3 %; PR: 4.47; 2.50-7.98; women, 10.2 %; PR: 2.21, 1.30-3.75). Impaired fasting glycaemia prevalence was comparatively higher only in Amsterdam, and in London, men compared with rural Ghana. Our study shows high risks of obesity and T2D among sub-Saharan African populations living in Europe. In Ghana, similarly high prevalence rates were seen in an urban environment, whereas in rural areas, the prevalence of obesity among women is already remarkable. Similar processes underlying the high burden of obesity and T2D following migration may also be at play in sub-Saharan Africa as a consequence of urbanisation.

On the pace of fertility decline in sub-Saharan Africa

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David Shapiro

2017-10-01

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.

The role of corruption and unethical behaviour in precluding the placement of industry sponsored clinical trials in sub-Saharan Africa: Stakeholder views

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Efe Egharevba

2016-08-01

More discussion around corruption with all relevant stakeholders is required in order for progress to be made and to enable greater involvement of sub-Saharan African countries in the conduct of industry sponsored clinical trials.

Characterization and application of the Andean Diversity Panel for the improvement of common bean productivity in Sub-Saharan Africa

Science.gov (United States)

Common bean (Phaseolus vulgaris) productivity in Sub-Saharan Africa is far below yield potential, while climate change and access to inputs are persistent challenges. In addition, the market and human nutrition needs for common bean continue to expand in the African continent, which has the highest ...

Epidemiology, causes, and treatment of epilepsy in sub-Saharan Africa

OpenAIRE

Ba-Diop, Awa; Marin, Beno?t; Druet-Cabanac, Michel; Ngoungou, Edgard B; Newton, Charles R; Preux, Pierre-Marie

2014-01-01

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...

Mining and Risk of Tuberculosis in Sub-Saharan Africa

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Basu, Sanjay; McKee, Martin; Lurie, Mark

2011-01-01

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

Operative needs in HIV+ populations: An estimation for sub-Saharan Africa.

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Cherewick, Megan L; Cherewick, Steven D; Kushner, Adam L

2017-05-01

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.

Urban-rural and geographic differences in overweight and obesity in four sub-Saharan African adult populations: a multi-country cross-sectional study.

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Ajayi, IkeOluwapo O; Adebamowo, Clement; Adami, Hans-Olov; Dalal, Shona; Diamond, Megan B; Bajunirwe, Francis; Guwatudde, David; Njelekela, Marina; Nankya-Mutyoba, Joan; Chiwanga, Faraja S; Volmink, Jimmy; Kalyesubula, Robert; Laurence, Carien; Reid, Todd G; Dockery, Douglas; Hemenway, David; Spiegelman, Donna; Holmes, Michelle D

2016-10-28

.18, 7.78], and Tanzania [AOR = 2.68; 95 % CI: 1.60, 4.49] were more likely to have BMI > =25 kg/m 2 compared with the rural and peri-urban sites. The high prevalence of overweight and obesity in these sub-Saharan African countries and the differentials in prevalence and risk factors further highlights the need for urgent focused intervention to stem this trend, especially among women, professionals and urban dwellers.

Meeting the need: youth and family planning in sub-Saharan Africa.

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Prata, Ndola; Weidert, Karen; Sreenivas, Amita

2013-07-01

The need for a concerted effort to address the gaps in family planning services for youth in sub-Saharan Africa has been underreported and underexplored. Trends in fertility, childbearing, unmet need for family planning options and contraceptive prevalence (CP) among youth are described with data from six African countries with four consecutive Demographic and Health Surveys. Estimates of exposure to risk of pregnancy and number of new contraceptives users needed to maintain and double CP in 2015 are calculated using current CP and projected youth population size in six African countries. The youth population is expected to range from approximately 3 to 35 million in six African countries by 2015. Accounting for population growth and current estimates of sexual activity among youth, family planning services will need to absorb more than 800,000 and 11.3 million new contraceptive users total to maintain and double CP, respectively, in 2015 in those six African countries alone. Our findings support existing literature that calls for a reorientation of family planning policies and programs, especially improved access to modern contraceptive methods among African youth. Copyright © 2013 Elsevier Inc. All rights reserved.

Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review

OpenAIRE

Yakubu, Ibrahim; Salisu, Waliu Jawula

2018-01-01

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 ...

Validation of a French adaptation of the Harvard Trauma Questionnaire among torture survivors from sub-Saharan African countries

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de Fouchier, Capucine; Blanchet, Alain; Hopkins, William; Bui, Eric; Ait-Aoudia, Malik; Jehel, Louis

2012-01-01

Background To date no validated instrument in the French language exists to screen for posttraumatic stress disorder (PTSD) in survivors of torture and organized violence. Objective The aim of this study is to adapt and validate the Harvard Trauma Questionnaire (HTQ) to this population. Method The adapted version was administered to 52 French-speaking torture survivors, originally from sub-Saharan African countries, receiving psychological treatment in specialized treatment centers. A structured clinical interview for DSM was also conducted in order to assess if they met criteria for PTSD. Results Cronbach's alpha coefficient for the HTQ Part 4 was adequate (0.95). Criterion validity was evaluated using receiver operating characteristic curve analysis that generated good classification accuracy for PTSD (0.83). At the original cut-off score of 2.5, the HTQ demonstrated high sensitivity and specificity (0.87 and 0.73, respectively). Conclusion Results support the reliability and validity of the French version of the HTQ. PMID:23233870

"It's my secret": fear of disclosure among sub-Saharan African migrant women living with HIV/AIDS in Belgium.

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Agnes Ebotabe Arrey

Full Text Available Patients with HIV not only have to deal with the challenges of living with an incurable disease but also with the dilemma of whether or not to disclose their status to their partners, families and friends. This study explores the extent to which sub-Saharan African (SSA migrant women in Belgium disclose their HIV positive status, reasons for disclosure/non-disclosure and how they deal with HIV disclosure. A qualitative study consisting of interviews with twenty-eight SSA women with HIV/AIDS was conducted. Thematic content analysis was employed to identify themes as they emerged. Our study reveals that these women usually only disclose their status to healthcare professionals because of the treatment and care they need. This selective disclosure is mainly due to the taboo of HIV disease in SSA culture. Stigma, notably self-stigma, greatly impedes HIV disclosure. Techniques to systematically incorporate HIV disclosure into post-test counseling and primary care services are highly recommended.

Validation of a French adaptation of the Harvard Trauma Questionnaire among torture survivors from sub-Saharan African countries

Directory of Open Access Journals (Sweden)

Capucine de Fouchier

2012-12-01

Full Text Available Background: To date no validated instrument in the French language exists to screen for posttraumatic stress disorder (PTSD in survivors of torture and organized violence. Objective: The aim of this study is to adapt and validate the Harvard Trauma Questionnaire (HTQ to this population. Method: The adapted version was administered to 52 French-speaking torture survivors, originally from sub-Saharan African countries, receiving psychological treatment in specialized treatment centers. A structured clinical interview for DSM was also conducted in order to assess if they met criteria for PTSD. Results: Cronbach's alpha coefficient for the HTQ Part 4 was adequate (0.95. Criterion validity was evaluated using receiver operating characteristic curve analysis that generated good classification accuracy for PTSD (0.83. At the original cut-off score of 2.5, the HTQ demonstrated high sensitivity and specificity (0.87 and 0.73, respectively. Conclusion: Results support the reliability and validity of the French version of the HTQ.

Greenhouse gas emissions in Sub-Saharan Africa

Energy Technology Data Exchange (ETDEWEB)

Graham, R.L.; Perlack, R.D.; Prasad, A.M.G.; Ranney, J.W.; Waddle, D.B.

1990-11-01

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.

Y-chromosomal variation in sub-Saharan Africa: insights into the history of Niger-Congo groups.

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de Filippo, Cesare; Barbieri, Chiara; Whitten, Mark; Mpoloka, Sununguko Wata; Gunnarsdóttir, Ellen Drofn; Bostoen, Koen; Nyambe, Terry; Beyer, Klaus; Schreiber, Henning; de Knijff, Peter; Luiselli, Donata; Stoneking, Mark; Pakendorf, Brigitte

2011-03-01

Technological and cultural innovations as well as climate changes are thought to have influenced the diffusion of major language phyla in sub-Saharan Africa. The most widespread and the richest in diversity is the Niger-Congo phylum, thought to have originated in West Africa ∼ 10,000 years ago (ya). The expansion of Bantu languages (a family within the Niger-Congo phylum) ∼ 5,000 ya represents a major event in the past demography of the continent. Many previous studies on Y chromosomal variation in Africa associated the Bantu expansion with haplogroup E1b1a (and sometimes its sublineage E1b1a7). However, the distribution of these two lineages extends far beyond the area occupied nowadays by Bantu-speaking people, raising questions on the actual genetic structure behind this expansion. To address these issues, we directly genotyped 31 biallelic markers and 12 microsatellites on the Y chromosome in 1,195 individuals of African ancestry focusing on areas that were previously poorly characterized (Botswana, Burkina Faso, Democratic Republic of Congo, and Zambia). With the inclusion of published data, we analyzed 2,736 individuals from 26 groups representing all linguistic phyla and covering a large portion of sub-Saharan Africa. Within the Niger-Congo phylum, we ascertain for the first time differences in haplogroup composition between Bantu and non-Bantu groups via two markers (U174 and U175) on the background of haplogroup E1b1a (and E1b1a7), which were directly genotyped in our samples and for which genotypes were inferred from published data using linear discriminant analysis on short tandem repeat (STR) haplotypes. No reduction in STR diversity levels was found across the Bantu groups, suggesting the absence of serial founder effects. In addition, the homogeneity of haplogroup composition and pattern of haplotype sharing between Western and Eastern Bantu groups suggests that their expansion throughout sub-Saharan Africa reflects a rapid spread followed by

Genomic Ancestry of North Africans Supports Back-to-Africa Migrations

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Gravel, Simon; Wang, Wei; Brisbin, Abra; Byrnes, Jake K.; Fadhlaoui-Zid, Karima; Zalloua, Pierre A.; Moreno-Estrada, Andres; Bertranpetit, Jaume; Bustamante, Carlos D.; Comas, David

2012-01-01

North African populations are distinct from sub-Saharan Africans based on cultural, linguistic, and phenotypic attributes; however, the time and the extent of genetic divergence between populations north and south of the Sahara remain poorly understood. Here, we interrogate the multilayered history of North Africa by characterizing the effect of hypothesized migrations from the Near East, Europe, and sub-Saharan Africa on current genetic diversity. We present dense, genome-wide SNP genotyping array data (730,000 sites) from seven North African populations, spanning from Egypt to Morocco, and one Spanish population. We identify a gradient of likely autochthonous Maghrebi ancestry that increases from east to west across northern Africa; this ancestry is likely derived from “back-to-Africa” gene flow more than 12,000 years ago (ya), prior to the Holocene. The indigenous North African ancestry is more frequent in populations with historical Berber ethnicity. In most North African populations we also see substantial shared ancestry with the Near East, and to a lesser extent sub-Saharan Africa and Europe. To estimate the time of migration from sub-Saharan populations into North Africa, we implement a maximum likelihood dating method based on the distribution of migrant tracts. In order to first identify migrant tracts, we assign local ancestry to haplotypes using a novel, principal component-based analysis of three ancestral populations. We estimate that a migration of western African origin into Morocco began about 40 generations ago (approximately 1,200 ya); a migration of individuals with Nilotic ancestry into Egypt occurred about 25 generations ago (approximately 750 ya). Our genomic data reveal an extraordinarily complex history of migrations, involving at least five ancestral populations, into North Africa. PMID:22253600

Genomic ancestry of North Africans supports back-to-Africa migrations.

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Brenna M Henn

2012-01-01

Full Text Available North African populations are distinct from sub-Saharan Africans based on cultural, linguistic, and phenotypic attributes; however, the time and the extent of genetic divergence between populations north and south of the Sahara remain poorly understood. Here, we interrogate the multilayered history of North Africa by characterizing the effect of hypothesized migrations from the Near East, Europe, and sub-Saharan Africa on current genetic diversity. We present dense, genome-wide SNP genotyping array data (730,000 sites from seven North African populations, spanning from Egypt to Morocco, and one Spanish population. We identify a gradient of likely autochthonous Maghrebi ancestry that increases from east to west across northern Africa; this ancestry is likely derived from "back-to-Africa" gene flow more than 12,000 years ago (ya, prior to the Holocene. The indigenous North African ancestry is more frequent in populations with historical Berber ethnicity. In most North African populations we also see substantial shared ancestry with the Near East, and to a lesser extent sub-Saharan Africa and Europe. To estimate the time of migration from sub-Saharan populations into North Africa, we implement a maximum likelihood dating method based on the distribution of migrant tracts. In order to first identify migrant tracts, we assign local ancestry to haplotypes using a novel, principal component-based analysis of three ancestral populations. We estimate that a migration of western African origin into Morocco began about 40 generations ago (approximately 1,200 ya; a migration of individuals with Nilotic ancestry into Egypt occurred about 25 generations ago (approximately 750 ya. Our genomic data reveal an extraordinarily complex history of migrations, involving at least five ancestral populations, into North Africa.

Boosting food security in sub-Saharan Africa through cassava ...

African Journals Online (AJOL)

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 ...

The Burden of Cardiovascular Disease in Sub-Saharan Africa and the Black Diaspora.

Science.gov (United States)

Gillum, Richard F

2018-03-19

For over four decades the National Medical Association (NMA) and the Association of Black Cardiologists (ABC) have sought to bring to national attention the disparate burden of cardiovascular disease (CVD) among African Americans. However, systematic inquiry has been inadequate into the burden of CVD in the poor countries of Sub-Saharan Africa (SSA) and the African diaspora in the Americas outside the USA. However, recently, the Global Burden of Disease Study (GBD) has offered new tools for such inquiry. Several initial efforts in that direction using 2010 data have been published. This article highlights some new findings for SSA for 2016. It also suggests that NMA and ABC further this effort by direct advocacy and collaboration with the GBD to make estimates of CVD burden in African Americans and South American Blacks explicitly available in future iterations.

Estimating the hypothetical dual health impact and cost-effectiveness of the Woman’s Condom in selected sub-Saharan African countries

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Mvundura M

2015-03-01

Full Text Available Mercy Mvundura, Neeti Nundy, Maggie Kilbourne-Brook, Patricia S Coffey Technology Solutions Global Program, PATH, Seattle, WA, USA Background: Female condoms are the only currently available woman-initiated option that offers dual protection from pregnancy and sexually transmitted infections, including HIV. The Woman’s Condom is a new female condom designed to provide dual protection and to be highly pleasurable and acceptable. Objective: We sought to estimate the potential dual health impact and cost-effectiveness of a Woman’s Condom distribution program in 13 sub-Saharan African countries with HIV prevalence rates >4% among adults aged 15–49 years. We used two separate, publicly available models for this analysis, the Impact 2 model developed by Marie Stopes International and the Population Services International disability-adjusted life years (DALY calculator program. We estimated the potential numbers of pregnancies and DALYs averted when the Woman’s Condom is used as a family planning method and the HIV infections and DALYs averted when it is used as an HIV prevention method. Results: Programming 100,000 Woman’s Condoms in each of 13 countries in sub-Saharan Africa during a 1-year period could potentially prevent 194 pregnancies and an average of 21 HIV infections in each country. When using the World Health Organization CHOosing Interventions that are Cost-Effective (WHO-CHOICE criteria as a threshold to infer the potential cost-effectiveness of the Woman’s Condom, we found that the Woman’s Condom would be considered cost-effective. Conclusion: This was a first and successful attempt to estimate the impact of dual protection of female condoms. The health impact is greater for the use of the Woman’s Condom as an HIV prevention method than for contraception. Dual use of the Woman’s Condom increases the overall health impact. The Woman’s Condom was found to be very cost-effective in all 13 countries in our sample. Keywords

Mother-to-child transmission of HIV-1 in sub-Saharan Africa: past, present and future challenges.

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Taha, Taha E

2011-05-23

HIV prevalence continues to be high among women of reproductive age in sub-Saharan Africa. In 2007 the HIV prevalence among pregnant women attending antenatal clinics was >20% in the southern African counties of Botswana, Swaziland, South Africa and Lesotho. Mother-to-child transmission (MTCT) of HIV can occur in-utero, intrapartum or postnatally. Without any preventive measure the overall rate of the MTCT of HIV in breastfeeding women could be 25-45%. Prior to the discovery of successful antiretroviral interventions to prevent the MTCT of HIV in sub-Saharan Africa (before 1999), innovative research determined the magnitude of the problem, the impact of the HIV epidemic on mothers and children, and the main risk factors associated with MTCT. Non-antiretroviral interventions conducted before 1999 such as washing the birth canal with antiseptics and antenatal supplementation with vitamin A did not reduce the MTCT of HIV. However, during the period 1999 to present, major successes were made in the prevention of the MTCT of HIV. The use of single-dose nevirapine prophylaxis to the mother and infant reduced the MTCT of HIV to ~12%. Subsequently, longer prophylaxis and combined antiretroviral regimens were shown to be highly effective and very low HIV transmission rates comparable to those in developed countries were reported in some clinical trial settings in sub-Saharan Africa. The future is promising but challenges remain. The current successful intervention modalities are entirely dependent on antiretrovirals and breastfeeding continues to be vital for the survival of the child in the African setting. Reviewing past and present achievements assists in focusing future research and development of prevention programs. Copyright © 2010 Elsevier Inc. All rights reserved.

A Dragon and a Dove? A Comparative Overview of Chinese and European Trade Relations with Sub-Saharan Africa

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Bert Jacobs

2011-01-01

Full Text Available As China’s footprint in African trade grows larger by the day, the need to contextualize this rise through comparative analysis becomes ever more necessary. This paper contrasts the sub-Saharan trade relations of both China and Europe with their respective designated stereotypes: those of a dragon and a dove. The article compares the trade dynamics on four levels: the policies and institutional mechanisms that shape the relationship; the composition of the trade flows; the geographic distribution of trade dominance; and the influence of norms and values on the trade pattern. It concludes that although there are empirical grounds behind these stereotypes, Chinese and European trade relations with sub-Saharan Africa are becoming more similar, partly due to a more hawkish European stance.

Physical function, grip strength and frailty in people living with HIV in sub-Saharan Africa: systematic review.

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Bernard, Charlotte; Dabis, François; de Rekeneire, Nathalie

2017-05-01

To present the current knowledge on physical function, grip strength and frailty in HIV-infected patients living in sub-Saharan Africa, where the phenomenon is largely underestimated. A systematic search was conducted on MEDLINE, Scopus and African Index Medicus. We reviewed articles on sub-Saharan African people living with HIV (PLHIV) >18 years old, published until November 2016. Of 537 articles, 12 were conducted in six African countries and included in this review. Five articles reported information on functional limitation and one on disability. Two of these five articles reported functional limitation (low gait speed) in PLHIV. Disability was observed in 27% and 3% of PLHIV living in rural and urban places, respectively. Two of three studies reporting grip strength reported lower grip strength (nearly 4 kg) in PLHIV in comparison with uninfected patients. One study reported that PLHIV were more likely to be frail than HIV-uninfected individuals (19.4% vs. 13.3%), whereas another reported no statistical difference. Decline in physical function, grip strength and frailty are now part of the burden of PLHIV living in SSA countries, but current data are insufficient to characterise the real public health dimension of these impairments. Further studies are needed to depict this major public health challenge. As this is likely to contribute to a significant burden on the African healthcare systems and human resources in the near future, a holistic care approach should be developed to inform guidelines. © 2017 John Wiley & Sons Ltd.

Mental health and urban living in sub-Saharan Africa: major depressive episodes among the urban poor in Ouagadougou, Burkina Faso.

Science.gov (United States)

Duthé, Géraldine; Rossier, Clémentine; Bonnet, Doris; Soura, Abdramane Bassiahi; Corker, Jamaica

2016-01-01

In sub-Saharan African cities, the epidemiological transition has shifted a greater proportion of the burden of non-communicable diseases, including mental and behavioral disorder, to the adult population. The burden of major depressive disorder and its social risk factors in the urban sub-Saharan African population are not well understood and estimates vary widely. We conducted a study in Ouagadougou, Burkina Faso, in order to estimate the prevalence of major depressive episodes among adults in this urban setting. The Ouagadougou Health and Demographic System Site (HDSS) has followed the inhabitants of five outlying neighborhoods of the city since 2008. In 2010, a representative sample of 2,187 adults (aged 15 and over) from the Ouaga HDSS was interviewed in depth regarding their physical and mental health. Using criteria from the Mini International Neuropsychiatric Interview (MINI), we identified the prevalence of a major depressive episode at the time of the interview among respondents and analyzed its association with demographic, socioeconomic, and health characteristics through a multivariate analysis. Major depressive episode prevalence was 4.3 % (95 % CI: 3.1-5.5 %) among the survey respondents. We found a strong association between major depressive episode and reported chronic health problems, functional limitations, ethnicity and religion, household food shortages, having been recently a victim of physical violence and regularly drinking alcohol. Results show a U-shaped association of the relationship between major depressive episode and standard of living, with individuals in both the poorest and richest groups most likely to suffer from major depressive disorder than those in the middle. Though, the poorest group remains the most vulnerable one, even when controlling by health characteristics. Major depressive disorder is a reality for many urban residents in Burkina Faso and likely urbanites throughout sub-Saharan Africa. Countries in the region

Evaluation of waist-to-height ratio to predict 5 year cardiometabolic risk in sub-Saharan African adults.

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Ware, L J; Rennie, K L; Kruger, H S; Kruger, I M; Greeff, M; Fourie, C M T; Huisman, H W; Scheepers, J D W; Uys, A S; Kruger, R; Van Rooyen, J M; Schutte, R; Schutte, A E

2014-08-01

Simple, low-cost central obesity measures may help identify individuals with increased cardiometabolic disease risk, although it is unclear which measures perform best in African adults. We aimed to: 1) cross-sectionally compare the accuracy of existing waist-to-height ratio (WHtR) and waist circumference (WC) thresholds to identify individuals with hypertension, pre-diabetes, or dyslipidaemia; 2) identify optimal WC and WHtR thresholds to detect CVD risk in this African population; and 3) assess which measure best predicts 5-year CVD risk. Black South Africans (577 men, 942 women, aged >30years) were recruited by random household selection from four North West Province communities. Demographic and anthropometric measures were taken. Recommended diagnostic thresholds (WC > 80 cm for women, >94 cm for men; WHtR > 0.5) were evaluated to predict blood pressure, fasting blood glucose, lipids, and glycated haemoglobin measured at baseline and 5 year follow up. Women were significantly more overweight than men at baseline (mean body mass index (BMI) women 27.3 ± 7.4 kg/m(2), men 20.9 ± 4.3 kg/m(2)); median WC women 81.9 cm (interquartile range 61-103), men 74.7 cm (63-87 cm), all P women, both WC and WHtR significantly predicted all cardiometabolic risk factors after 5 years. In men, even after adjusting WC threshold based on ROC analysis, WHtR better predicted overall 5-year risk. Neither measure predicted hypertension in men. The WHtR threshold of >0.5 appears to be more consistently supported and may provide a better predictor of future cardiometabolic risk in sub-Saharan Africa. Copyright © 2014 Elsevier B.V. All rights reserved.

Impact of human schistosomiasis in sub-Saharan Africa

OpenAIRE

Adenowo, Abiola Fatimah; Oyinloye, Babatunji Emmanuel; Ogunyinka, Bolajoko Idiat; Kappo, Abidemi Paul

2015-01-01

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. ...

Red blood cell alloimmunization in transfused patients in sub-Saharan Africa: A systematic review and meta-analysis.

Science.gov (United States)

Ngoma, Alain M; Mutombo, Paulin B; Ikeda, Kazuhiko; Nollet, Kenneth E; Natukunda, Bernard; Ohto, Hitoshi

2016-04-01

Previous studies of Sub-Saharan Africans show significant alloimmunization to red blood cell (RBC) antigens, but country-specific data are limited. Thus, the aim of this study was to estimate, by meta-analysis, the overall proportion of red blood cell alloantibodies among transfused patients. We systematically searched Medline, Embase, and the Africa-Wide Information database to identify relevant studies in any language. Case reports, comments, letters, conference abstracts, editorials, and review articles were excluded. Of the 269 potentially relevant articles, 11 studies fulfilled our selection criteria. Overall proportions of alloimmunization were 6.7 (95% CI: 5.7, 7.8) per 100 transfused patients. With regard to antibody specificity, among clinically significant antibodies, anti-E ranked as the most common, followed by anti-K, anti-C and anti-D. Meta-analysis of available literature quantifies and qualifies the clinical challenge of RBC alloimmunization among transfused patients in Sub-Saharan Africa. These results should drive policy decisions in favour of routine testing of RBC antigens and irregular antibodies for transfused patients as a standard of care throughout Sub-Saharan Africa. Copyright © 2015 Elsevier Ltd. All rights reserved.

Neurology training in sub-Saharan Africa: A survey of people in training from 19 countries.

Science.gov (United States)

Mateen, Farrah J; Clark, Sarah J; Borzello, Mia; Kabore, Jean; Seidi, Osheik

2016-06-01

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.

A multi-dimensional assessment of urban vulnerability to climate change in Sub-Saharan Africa

DEFF Research Database (Denmark)

Herslund, Lise Byskov; Jalyer, Fatameh; Jean-Baptiste, Nathalie

2016-01-01

In this paper, we develop and apply a multi-dimensional vulnerability assessment framework for understanding the impacts of climate change-induced hazards in Sub- Saharan African cities. The research was carried out within the European/African FP7 project CLimate change and Urban Vulnerability...... in Africa, which investigated climate change-induced risks, assessed vulnerability and proposed policy initiatives in five African cities. Dar es Salaam (Tanzania) was used as a main case with a particular focus on urban flooding. The multi-dimensional assessment covered the physical, institutional...... encroachment on green and flood-prone land). Scenario modeling suggests that vulnerability will continue to increase strongly due to the expected loss of agricultural land at the urban fringes and loss of green space within the city. However, weak institutional commitment and capacity limit the potential...

Is the Role of Physicians Really Evolving Due to Non-physician Clinicians Predominance in Staff Makeup in Sub-Saharan African Health Systems? Comment on "Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians".

Science.gov (United States)

Sidat, Mohsin M

2016-07-02

Health workforce shortages in Sub-Saharan Africa are widely recognized, particularly of physicians, leading the training and deployment of Non-physician clinicians (NPCs). The paper by Eyal et al provides interesting and legitimate viewpoints on evolving role of physicians in context of decisive increase of NPCss in Sub-Saharan Africa. Certainly, in short or mid-term, NPCs will continue to be a proxy solution and a valuable alternative to overcome physicians' shortages in sub-Saharan Africa. Indeed, NPCs have an important role at primary healthcare (PHC) level. Physicians at PHC level can certainly have all different roles that were suggested by Eyal et al, including those not directly related to healthcare provision. However, at secondary and higher levels of healthcare, physicians would assume other roles that are mainly related to patient clinical care. Thus, attempting to generalize the role of physicians without taking into account the context where they will work would be not entirely appropriate. It is true that often physicians start the professional carriers at PHC level and progress to other levels of healthcare particularly after clinical post-graduation training. Nevertheless, the training programs offered by medical institutions in sub-Saharan Africa need to be periodically reviewed and take into account professional and occupational roles physicians would take in context of evolving health systems in sub-Saharan Africa. © 2016 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

A multilevel analysis of the determinants of high-risk sexual behaviour in sub-Saharan Africa.

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Uchudi, Joseph; Magadi, Monica; Mostazir, Mohammod

2012-05-01

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.

The movement ecology of the straw-colored fruit bat, Eidolon helvum, in sub-Saharan Africa assessed by stable isotope ratios.

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Gonzalo Ossa

Full Text Available Flying foxes (Pteropodidae are key seed dispersers on the African continent, yet their migratory behavior is largely unknown. Here, we studied the movement ecology of the straw-colored fruit bat, Eidolon helvum, and other fruit bats by analyzing stable isotope ratios in fur collected from museum specimens. In a triple-isotope approach based on samples of two ecologically similar non-migratory pteropodids, we first confirmed that a stable isotope approach is capable of delineating between geographically distinct locations in Sub-Saharan Africa. A discriminant function analysis assigned 84% of individuals correctly to their capture site. Further, we assessed how well hydrogen stable isotope ratios (δ(2H of fur keratin collected from non-migratory species (n = 191 individuals records variation in δ(2H of precipitation water in sub-Saharan Africa. Overall, we found positive, negative and no correlations within the six studied species. We then developed a reduced major axis regression equation based on individual data of non-migratory species to predict where potentially migratory E. helvum (n = 88 would come from based on their keratin δ(2H. Across non-migratory species, δ(2H of keratin and local water correlated positively. Based on the isoscape origin model, 22% of E. helvum were migratory, i.e. individuals had migrated over at least 250 km prior to their capture. Migratory individuals came from locations at a median distance of about 860 km from the collection site, four even from distances of at least 2,000 km. Ground-truthing of our isoscape origin model based on keratin δ(2H of extant E. helvum (n = 76 supported a high predictive power of assigning the provenance of African flying foxes. Our study highlights that stable isotope ratios can be used to explain the migratory behavior of flying foxes, even on the isotopically relatively homogenous African continent, and with material collected by museums many decades or more than a century ago.

The movement ecology of the straw-colored fruit bat, Eidolon helvum, in sub-Saharan Africa assessed by stable isotope ratios.

Science.gov (United States)

Ossa, Gonzalo; Kramer-Schadt, Stephanie; Peel, Alison J; Scharf, Anne K; Voigt, Christian C

2012-01-01

Flying foxes (Pteropodidae) are key seed dispersers on the African continent, yet their migratory behavior is largely unknown. Here, we studied the movement ecology of the straw-colored fruit bat, Eidolon helvum, and other fruit bats by analyzing stable isotope ratios in fur collected from museum specimens. In a triple-isotope approach based on samples of two ecologically similar non-migratory pteropodids, we first confirmed that a stable isotope approach is capable of delineating between geographically distinct locations in Sub-Saharan Africa. A discriminant function analysis assigned 84% of individuals correctly to their capture site. Further, we assessed how well hydrogen stable isotope ratios (δ(2)H) of fur keratin collected from non-migratory species (n = 191 individuals) records variation in δ(2)H of precipitation water in sub-Saharan Africa. Overall, we found positive, negative and no correlations within the six studied species. We then developed a reduced major axis regression equation based on individual data of non-migratory species to predict where potentially migratory E. helvum (n = 88) would come from based on their keratin δ(2)H. Across non-migratory species, δ(2)H of keratin and local water correlated positively. Based on the isoscape origin model, 22% of E. helvum were migratory, i.e. individuals had migrated over at least 250 km prior to their capture. Migratory individuals came from locations at a median distance of about 860 km from the collection site, four even from distances of at least 2,000 km. Ground-truthing of our isoscape origin model based on keratin δ(2)H of extant E. helvum (n = 76) supported a high predictive power of assigning the provenance of African flying foxes. Our study highlights that stable isotope ratios can be used to explain the migratory behavior of flying foxes, even on the isotopically relatively homogenous African continent, and with material collected by museums many decades or more than a century ago.

Currently important animal disease management issues in sub-Saharan Africa.

Science.gov (United States)

Thomson, G R

2009-03-01

The present international approach to management of transboundary animal diseases (TADs) is based on the assumption that most can be eradicated; consequently, that is the usual objective adopted by international organizations concerned with animal health. However, for sub-Saharan Africa and southern Africa more particularly, eradication of most TADs is impossible for the foreseeable future for a variety of technical, financial and logistical reasons. Compounding this, the present basis for access to international markets for products derived from animals requires that the area of origin (country or zone) is free from trade-influencing TADs. The ongoing development of transfrontier conservation areas (TFCAs), extending across huge areas of southern Africa, therefore presents a development conundrum because it makes creation of geographic areas free from TADs more difficult and brings development based on wildlife conservation on the one hand and that based on livestock production on the other into sharp conflict. Sub-Saharan Africa is consequently confronted by a complex problem that contributes significantly to retarded rural development which, in turn, impedes poverty alleviation. In southern Africa specifically, foot-and-mouth disease (FMD) presents the greatest problem in relation to access to international markets for animal products. However, it is argued that this problem could be overcome by a combination between (1) implementation of a commodity-based approach to trade in products derived from animals and (2) amendment of the international standards for FMD specifically (i.e. the FMD chapter in the Terrestrial Animal Health Code of the World Organisation for Animal Health [OIE]) so that occurrence of SAT serotype viruses in free-living African buffalo need not necessarily mean exclusion of areas where buffalo occur from international markets for animal products. This would overcome a presently intractable constraint to market access for southern African

Sub-specialization in plastic surgery in Sub-saharan Africa: capacities, gaps and opportunities

Science.gov (United States)

Ibrahim, Abdulrasheed

2014-01-01

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

Origin, extent and health impacts of air pollution in Sub-Saharan Africa

Science.gov (United States)

Bauer, S.; Im, U.; Mezuman, K.

2017-12-01

Southern Africa produces about a third of the Earth's biomass burning aerosol particles, yet the fate of these particles, their origin, chemical composition and their influence on regional and global climate is poorly understood. These research questions motivated the NASA field campaign ORACLES (ObseRvations of Aerosols above CLouds and their intEractionS). ORACLES is a five year investigation with three Intensive Observation Periods (IOP) designed to study key processes that determine the climate impacts of African biomass burning aerosols. The first IOP has been carried out in 2016. The main focus of the field campaign are aerosol-cloud interactions, however in our first study related to this area we will investigate the aerosol plume itself, its origin, extend and its resulting health impacts. Here we will discuss results using the global mesoscale model NASA GEOS-5 in conjunction with the NASA GISS-E2 climate model to investigate climate and health impacts that are directly related to the anthropogenic fire activities in Sub-Saharan Africa. Focus will be on the SH winter seasons biomass burning events, its contribution to Sub-Saharan air pollution in relationship to other air-pollution sources and its resulting premature mortality.

Origin, extend and health impacts of air pollution in Sub-Saharan Africa

Science.gov (United States)

Bauer, Susanne E.; Mezuman, Keren; Longo, Karla; da Silva, Arlindo

2017-04-01

Southern Africa produces about a third of the Earth's biomass burning aerosol particles, yet the fate of these particles, their origin, chemical composition and their influence on regional and global climate is poorly understood. These research questions motivated the NASA field campaign ORACLES (ObseRvations of Aerosols above CLouds and their intEractionS). ORACLES is a five year investigation with three Intensive Observation Periods (IOP) designed to study key processes that determine the climate impacts of African biomass burning aerosols. The first IOP has been carried out in 2016. The main focus of the field campaign are aerosol-cloud interactions, however in our first study related to this area we will investigate the aerosol plume itself, its origin, extend and its resulting health impacts. Here we will discuss results using the global mesoscale model NASA GEOS-5 in conjunction with the NASA GISS-E2 climate model to investigate climate and health impacts that are directly related to the anthropogenic fire activities in Sub-Saharan Africa. Focus will be on the SH winter seasons biomass burning events, its contribution to Sub-Saharan air pollution in relationship to other air-pollution sources and its resulting premature mortality.

The impact of asthma and COPD in sub-Saharan Africa

NARCIS (Netherlands)

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.

Sub-Saharan agriculture and migrations

Directory of Open Access Journals (Sweden)

Andrea Giordano

2018-06-01

Full Text Available In Sub-Saharan Africa, the rural population accounts for 70% of the total population and the family farming for 80% of all agricultural enterprises. It would seem logical to think that an unprofitable agriculture is responsible for the migration phenomenon. This is in part certainly true, but numerous other causes contribute to the phenomenon. However considering the current sub-Saharan situation, family farming structured in cooperatives still remains the most suitable land management model to achieve social, economic and ecological integration. On the contrary, we have to note that the commercial agriculture with the monocultures and in the recent past the Green Revolution and the GMOs have not achieved this integration which is fundamental for development. The migratory phenomenon (internal and external to Africa with its many causes is part of a complex framework where in the background the low profitability of family farming and the precarious availability of arable land impend with the inherent conflicting situations. The proposals presented in the paper concern the management and technical enhancement of the family farming, with the hope that they will be supported by local Governments, International Organizations and the NGO. We are conscious that what is indicated in the proposals will certainly not stop the migration phenomenon but could make it more aware and hence reduce it. In the conclusion is reaffirmed the role of cooperatives as main actors for implementing managerial and technological innovations and therefore for the development of agriculture and consequently for the geo-political stabilization of the sub-Saharan area.

Working outside of the box: how HIV counselors in Sub-Saharan Africa adapt Western HIV testing norms.

Science.gov (United States)

Angotti, Nicole

2010-09-01

The delivery of HIV counseling and testing programs throughout Sub-Saharan Africa relies on the work performed by trained HIV counselors. These individuals occupy a critical position: they are intermediaries between the rule-making of international and national policymakers, and the norms of the communities in which they live and work. This paper explains when, how and why HIV counselors adapt Western testing guidelines (the "3Cs"--consent, confidentiality and counseling) to local concerns, attempting to maintain the fidelity of testing principles, while reducing the harm they perceive may arise as a consequence of strict adherence to them. Data for this study come from Malawi: a poor, largely rural African country, where HIV prevalence is ranked 9th highest in the world. The analysis is based on 25 interviews with HIV counselors and a unique set of field journals, and captures local experiences and the moral quandaries that counselors in rural Sub-Saharan Africa face. The findings of this inquiry provide new insights into the implementation of HIV testing in rural African settings, insights that may guide HIV prevention policy. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

The challenge of AIDS-related malignancies in sub-Saharan Africa.

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Sasco, Annie J; Jaquet, Antoine; Boidin, Emilie; Ekouevi, Didier K; Thouillot, Fabian; Lemabec, Thomas; Forstin, Marie-Anna; Renaudier, Philippe; N'dom, Paul; Malvy, Denis; Dabis, François

2010-01-11

With the lengthening of life expectancy among HIV-positive subjects related to the use of highly active antiretroviral treatments, an increased risk of cancer has been described in industrialized countries. The question is to determine what occurs now and will happen in the future in the low income countries and particularly in sub-Saharan Africa where more than two-thirds of all HIV-positive people live in the world. The objective of our paper is to review the link between HIV and cancer in sub-Saharan Africa, putting it in perspective with what is already known in Western countries. Studies for this review were identified from several bibliographical databases including Pubmed, Scopus, Cochrane, Pascal, Web of Science and using keywords "HIV, neoplasia, epidemiology and Africa" and related MesH terms. A clear association was found between HIV infection and AIDS-classifying cancers. In case-referent studies, odds ratios (OR) were ranging from 21.9 (95% Confidence Interval (CI) 12.5-38.6) to 47.1 (31.9-69.8) for Kaposi sarcoma and from 5.0 (2.7-9.5) to 12.6 (2.2-54.4) for non Hodgkin lymphoma. The association was less strong for invasive cervical cancer with ORs ranging from 1.1 (0.7-1.2) to 1.6 (1.1-2.3), whereas ORs for squamous intraepithelial lesions were higher, from 4.4 (2.3-8.4) to 17.0 (2.2-134.1). For non AIDS-classifying cancers, squamous cell conjunctival carcinoma of the eye was associated with HIV in many case-referent studies with ORs from 2.6 (1.4-4.9) to 13.0 (4.5-39.4). A record-linkage study conducted in Uganda showed an association between Hodgkin lymphoma and HIV infection with a standardized incidence ratio of 5.7 (1.2-17) although OR in case-referent studies ranged from 1.4 (0.7-2.8) to 1.6 (1.0-2.7). Other cancer sites found positively associated with HIV include lung, liver, anus, penis, vulva, kidney, thyroid and uterus and a decreased risk of female breast cancer. These results so far based on a relatively small number of studies warrant

EU Development Aid towards Sub-Saharan Africa: Exploring the Normative Principle

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Georgios K. Bountagkidis

2015-01-01

Full Text Available The EU and most aid donors invoke a strong normative power face by explicitly connecting foreign aid with human and social development. However, how well the EU’s rhetoric is consistent with its practices as a multilateral development actor has not been explored extensively. In this study, we challenge the normative dimension of the EU’s development policy and explore whether the EU’s Official Development Assistance to Sub-Saharan Africa is based on objective deprivation on the part of recipient countries or whether it is “interest driven”. We use a least squares dummy variable model regression to examine aid flows from the EU to all 48 Sub-Saharan African states for the period 2000 to 2010. The evidence found indicates that in certain instances, aid allocation contradicts the normative rhetoric that the EU uses to describe its development policy, as the donor’s own interests in the region seem to supersede priority given to the needs of the aid recipient states. A limitation to the findings is the fact that normative values and strategic interests are not mutually exclusive. Nevertheless, the present study suggests that the EU’s portrayal as a force for good in international relations requires cautious critique.

Sex Life Satisfaction in Sub-Saharan Africa: A Descriptive and Exploratory Analysis.

Science.gov (United States)

Cranney, Stephen

2017-10-01

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.

Sex Differences in HIV Prevalence, Behavioral Risks and Prevention Needs Among Anglophone and Francophone Sub-Saharan African Migrants Living in Rabat, Morocco.

Science.gov (United States)

Johnston, Lisa; Oumzil, Hicham; El Rhilani, Houssine; Latifi, Amina; Bennani, Aziza; Alami, Kamal

2016-04-01

Morocco has experienced a dramatic increase of migration from sub-Sahara Africa during the past decade. Recently included among the most vulnerable populations cited in the Morocco National Strategic Plans on HIV/TB for 2012-2016, sub-Saharan Africa migrants living in an irregular administrative situation participated in a survey to provide baseline data about their socio-demographic, sexual and HIV testing behaviors and HIV and syphilis prevalence. Two surveys using respondent driven sampling were conducted in 2013 among males and females, ≥18 years, originating from sub-Saharan African countries and living and/or working in an irregular administrative situation in Rabat and residing at least 3 months in Morocco. Analysis was conducted to evaluate differences between the two samples and between females and males within each sample using the successive sampling estimator in RDS Analyst. Roughly 3 % of francophone and anglophone migrants were infected with HIV, whereas a statistically significantly higher percentage of francophone (2.8 %), compared to anglophone (0.3 %), migrants were infected with syphilis. Females were found to have HIV infection rates three times higher and past year sexually transmitted infection signs and symptoms more than two times higher than their male counterparts. Female migrants also had statistically significantly higher percentages of ever testing for HIV and HIV testing and receiving results in the past year compared to males. We found distinct and important differences between migrants depending on whether they come from francophone versus anglophone countries and whether they were male or female. Future research should continue to explore these differences, while policies and programs should note these differences to best allocate resources in providing social and health services to these populations.

Socioeconomic status and the prevalence of fever in children under age five: evidence from four sub-Saharan African countries

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Novignon Jacob

2012-07-01

Full Text Available Abstract Background The burden of fevers remains enormous in sub-Saharan Africa. While several efforts at reducing the burden of fevers have been made at the macro level, the relationship between socioeconomic status and fever prevalence has been inconclusive at the household and individual levels. The purpose of this study was to examine how individual and household socioeconomic status influences the prevalence of fever among children under age five in four sub-Saharan African countries. Methods The study used data from the 2008 Demographic and Health Survey (DHS from Ghana, Nigeria, Kenya and Sierra Leone with a total of 38,990 children below age five. A multi-level random effects logistic model was fitted to examine the socioeconomic factors that influence the prevalence of fever in the two weeks preceding the survey. Data from the four countries were also combined to estimate this relationship, after country-specific analysis. Results The results show that children from wealthier households reported lower prevalence of fever in Ghana, Nigeria and Kenya. Result from the combined dataset shows that children from wealthier households were less likely to report fever. In general, vaccination against fever-related diseases and the use of improved toilet facility reduces fever prevalence. The use of bed nets by children and mothers did not show consistent relationship across the countries. Conclusion Poverty does not only influence prevalence of fever at the macro level as shown in other studies but also the individual and household levels. Policies directed towards preventing childhood fevers should take a close account of issues of poverty alleviation. There is also the need to ensure that prevention and treatment mechanisms directed towards fever related diseases (such as malaria, pneumonia, measles, diarrhoea, polio, tuberculosis etc. are accessible and effectively used.

Sub-Saharan Africa: A Paradoxial Conundrum

National Research Council Canada - National Science Library

Dunn, Gracus

2002-01-01

.... 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...

Research Ethics Capacity Building in Sub-Saharan Africa: A Review of NIH Fogarty-Funded Programs 2000–2012

Science.gov (United States)

Ndebele, Paul; Wassenaar, Douglas; Benatar, Solomon; Fleischer, Theodore; Kruger, Mariana; Adebamowo, Clement; Kass, Nancy; Hyder, Adnan A.; Meslin, Eric M.

2014-01-01

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

Research ethics capacity building in Sub-Saharan Africa: a review of NIH Fogarty-funded programs 2000–2012.

Science.gov (United States)

Ndebele, Paul; Wassenaar, Douglas; Benatar, Solomon; Fleischer, Theodore; Kruger, Mariana; Adebamowo, Clement; Kass, Nancy; Hyder, Adnan A; Meslin, Eric M

2014-04-01

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.

Self-reported drunkenness among adolescents in four sub-Saharan African countries: associations with adverse childhood experiences

Directory of Open Access Journals (Sweden)

Crichton Joanna

2010-06-01

adverse events experienced and the proportion reporting drunkenness. Conclusions We find an association between experience of adverse childhood events and drunkenness among adolescents in four sub-Saharan African countries. The complex impacts of adverse childhood experiences on young people's development and behavior may have an important bearing on the effectiveness of interventions geared at reducing alcohol dependence among the youth.

Challenging the Concept of ''informal'' in Sub-Saharan African Cities

DEFF Research Database (Denmark)

Eskemose Andersen, Jørgen

2014-01-01

Current definitions of urbanity lead to claims that a large proportion (75% according to UN Habitat) of Sub-Saharan Africa’s (SSA) urban population is housed in ‘informal’ settlements with almost all new housing stock provided ‘informally’ in contradiction to the “formal” that is defined as planned......-modern (Folkers 2009, Hardoy 1990, Jenkins 2011, Nielsen 2008, Nguluma 2003, Mitlin, D. 2004, Koolhaas 2006). In 2003 the UN adopted a new terminology for what over decades used to be labelled as ‘informal’-, ‘squatter’-, ‘illegal’-, ‘unplanned’-, ‘spontaneous’ settlements, “shanty towns” with the term “slum” (UN...... habitat 2003). However, defining what slum implies is complex and this author consider the term as prejudiced and not covering the diversity most informal settlements represents Further the term stigmatises a remarkable share of any city population in SSA (Huchzermeyer 2011, Davis 2007, Harber 2011, Garau...

EPA Collaboration with Sub-Saharan Africa

Science.gov (United States)

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.

Geographic distribution and ecological niche of plague in sub-Saharan Africa

DEFF Research Database (Denmark)

Neerinckx, Simon B; Peterson, Andrew T; Gulinck, Hubert

2008-01-01

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...

The Perplex of Deforestation in sub-Saharan Africa

OpenAIRE

A.W Yalew

2015-01-01

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...

Health insurance systems in five Sub-Saharan African countries: medicine benefits and data for decision making.

Science.gov (United States)

Carapinha, João L; Ross-Degnan, Dennis; Desta, Abayneh Tamer; Wagner, Anita K

2011-03-01

Medicine benefits through health insurance programs have the potential to improve access to and promote more effective use of affordable, high quality medicines. Information is lacking about medicine benefits provided by health insurance programs in Sub-Saharan Africa. We describe the structure of medicine benefits and data routinely available for decision-making in 33 health insurance programs in Ghana, Kenya, Nigeria, Tanzania and Uganda. Most programs surveyed were private, for profit schemes covering voluntary enrollees, mostly in urban areas. Almost all provide both inpatient and outpatient medicine benefits, with members sharing the cost of medicines in all programs. Some programs use strategies that are common in high-income countries to manage the medicine benefits, such as formularies, generics policies, reimbursement limits, or price negotiation. Basic data to monitor performance in delivering medicine benefits are available in most programs, but key data elements and the resources needed to generate useful management information from the available data are typically missing. Many questions remain unanswered about the design, implementation, and effects of specific medicines policies in the emerging and expanding health insurance programs in Sub-Saharan Africa. These include questions about the most effective medicines policy choices, given different corporate and organizational structures and resources; impacts of specific benefit designs on quality and affordability of care and health outcomes; and ways to facilitate use of routine data for monitoring. Technical capacity building, strong government commitment, and international donor support will be needed to realize the benefits of medicines coverage in emerging and expanding health insurance programs in Sub-Saharan Africa. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Susceptibility of bacterial isolates from community-acquired infections in sub-Saharan Africa and Asia to macrolide antibiotics.

Science.gov (United States)

Lubell, Yoel; Turner, Paul; Ashley, Elizabeth A; White, Nicholas J

2011-10-01

To review the literature on the susceptibility of common community pathogens in sub-Saharan Africa and Asia to the macrolide antibiotics. Inclusion criteria required that isolates were collected since 2004 to ensure results were of contemporary relevance. The data were aggregated by region, age group and sterility of site of culture sample. A total of 51 studies were identified, which reported the macrolide antimicrobial susceptibilities of common bacterial pathogens isolated since 2004. In general, there was less macrolide resistance in African than in Asian isolates. Most African studies reported high levels of macrolide susceptibility in Streptococcus pneumoniae, whereas most Chinese studies reported high levels of resistance. There was very little information available for Gram-negative organisms. Susceptibility of the pneumococcus to macrolides in SSA remains high in many areas, and good activity of azithromycin has been shown against Salmonellae spp. in Asia. In urban areas where high antibiotic consumption is prevalent, there was evidence of increased resistance to macrolides. However, there is no information on susceptibility from large areas in both continents. © 2011 Blackwell Publishing Ltd.

International capital flows and investment volatility in selected sub-Saharan African countries

Directory of Open Access Journals (Sweden)

William Brafu-Insaidoo

2011-07-01

Full Text Available The study examines the impact of foreign capital flows on investment volatility in emerging and frontier market economies in sub-Saharan Africa. In particular, the study attempts to answer the question of whether different components of foreign capital inflows explain investment volatility. Theory suggests that increased cross-border capital mobility increases investment volatility due to the possibility of substituting foreign for domestic investments. Empirical literature does not, however, provide any clear evidence in support of this theory. By using the dynamic panel data analysis, this study tests the hypothesis that increased capital flows increases investment volatility and the study established that international capital flows reduce investment volatility.

Assessment of the Vulnerability of Water Resources to Seasonal Fires Across the Northern Sub-Saharan African Region

Science.gov (United States)

Ichoku, Charles M.

2010-01-01

The northern sub-Saharan African (NSSA) region, extending from the southern fringes of the Sahara to the Equator, and stretching west to east from the Atlantic to the Indian ocean coasts, plays a prominent role in the distribution of Saharan dust and other airborne matter around the region and to other parts of the world, the genesis of global atmospheric circulation, and the birth of such major (and often catastrophic) events as hurricanes. Therefore, this NSSA region represents a critical variable in the global climate change equation. Recent satellite-based studies have revealed that the NSSA region has one of the highest biomass-burning rates per unit land area among all regions of the world. Because of the high concentration and frequency of fires in this region, with the associated abundance of heat release and gaseous and particulate smoke emissions, biomass-burning activity is believed to be a major driver of the regional carbon, energy, and water cycles. We acknowledge that the rainy season in the NSSA region is from April to September while biomass burning occurs mainly during the dry season (October to March). Nevertheless, these two phenomena are indirectly coupled to each other through a chain of complex processes and conditions, including land-cover and surface-albedo changes, the carbon cycle, evapotranspiration, drought, desertification, surface water runoff, ground water recharge, and variability in atmospheric composition, heating rates, and circulation. In this presentation, we will examine the theoretical linkages between these processes, discuss the preliminary results based on satellite data analysis, and provide an overview of plans for more integrated research to be conducted over the next few years.

Heat Pump Drying of Fruits and Vegetables: Principles and Potentials for Sub-Saharan Africa

Directory of Open Access Journals (Sweden)

Folasayo Fayose

2016-01-01

Full Text Available Heat pump technology has been used for heating, ventilation, and air-conditioning in domestic and industrial sectors in most developed countries of the world including South Africa. However, heat pump drying (HPD of fruits and vegetables has been largely unexploited in South Africa and by extension to the sub-Saharan African region. Although studies on heat pump drying started in South Africa several years ago, not much progress has been recorded to date. Many potential users view heat pump drying technology as fragile, slow, and high capital intensive when compared with conventional dryer. This paper tried to divulge the principles and potentials of heat pump drying technology and the conditions for its optimum use. Also, various methods of quantifying performances during heat pump drying as well as the quality of the dried products are highlighted. Necessary factors for maximizing the capacity and efficiency of a heat pump dryer were identified. Finally, the erroneous view that heat pump drying is not feasible economically in sub-Saharan Africa was clarified.

Poverty and Inequality in Sub-Saharan Africa: Literature Survey and Empirical Assessment

OpenAIRE

Delfin Go; Denis Nikitin; Xiongjian Wang; Heng-fu Zou

2011-01-01

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...

Bridging the Atlantic : Brazil and Sub-Saharan Africa, South–South Partnering for Growth

OpenAIRE

World Bank

2012-01-01

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...

Temperature effects on future energy demand in Sub-Saharan Africa

Science.gov (United States)

Shivakumar, Abhishek

2016-04-01

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.

The environmental and social influences of HIV/AIDS in sub-Saharan Africa: a focus on rural communities.

Science.gov (United States)

Oramasionwu, Christine U; Daniels, Kelly R; Labreche, Matthew J; Frei, Christopher R

2011-07-01

The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) pandemic has caused far-reaching effects in sub-Saharan Africa. The pandemic has effectively diminished the workforce, increased poverty rates, reduced agricultural productivity, and transformed the structure of many rural households. HIV/AIDS further strains the already fragile relationship between livelihood and the natural and social environments of these regions. Therefore, the objective of this review is to characterize the impact of HIV/AIDS on the environment and the social infrastructure of rural sub-Saharan Africa. There are many aspects of rural life that contribute to disease transmission of HIV/AIDS and that pose unique challenges to the population dynamics in sub-Saharan Africa. Widespread AIDS-related mortality has caused a decrease in population growth for many African countries. In turn, these alterations in population dynamics have resulted in a decrease in the percentage of prime-age working adults, as well as a gender disparity, whereby, females carry a growing burden of household responsibilities. There is a rising proportion of older adults, often females, who assume the role of provider and caretaker for other dependent family members. These changing dynamics have caused many to exploit their natural surroundings, adopting less sustainable land use practices and utilizing protected resources as a primary means of generating revenue.

History of blood transfusion in sub-saharan Africa.

Science.gov (United States)

Schneider, William H

2013-01-01

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.

Fostering Growth through Tourism in Sub-Saharan Africa

Directory of Open Access Journals (Sweden)

Jorge Fernández Ruiz

2015-01-01

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.

Pharmacokinetics of Antibiotics in Sub-Saharan African Patient Populations: A Systematic Review.

Science.gov (United States)

Bos, Jeannet C; van Hest, Reinier M; Prins, Jan M

2017-08-01

In sub-Saharan Africa (SSA), severe febrile illness accounts for a large majority of medical admissions. SSA patients may also suffer from cachexia and organ dysfunction resulting from tuberculosis, hepatitis B, and hypertension. It is hard to tell how these conditions influence the pharmacokinetics (PK) of antibiotics in this population. The aim of this systematic review was to summarize antibiotic PK data of SSA adult patient populations to clarify whether inappropriate drug concentrations that may also lead to antimicrobial resistance are likely to occur. An electronic search was conducted in Ovid MEDLINE, Embase, and the African Index Medicus collecting studies from 1946 to May 2016. Reviewers independently selected studies reporting outcome data on volume of distribution (V), clearance, and half-life. Relevant information was abstracted and quality assessed. Twelve studies were selected, addressing 6 antibiotic classes. There were 6 studies on fluoroquinolones and 1 on β-lactam antibiotics. Nine out of 12 originated from South Africa and 6 of those dealt with intensive care unit (ICU) populations. The quality of most studies was low. Studies on amikacin, teicoplanin, and ertapenem (n = 4) displayed a pattern of a large V with low drug concentrations. Fluoroquinolone PK changes were less prominent and more diverse whereas the probability of pharmacodynamic target attainment was low for the treatment of tuberculosis in South Africa. Interindividual variability of V was high for 10/12 studies. Antibiotic PK data of SSA adult patient populations are scarce, but disease-induced inappropriate drug concentrations do occur. Data from non-ICU, severely ill patients, and β-lactam data are particularly lacking, whereas β-lactam antibiotics are commonly used, and typically vulnerable to disease-induced PK changes. Studies investigating the PK and pharmacodynamics of β-lactam antibiotics in severely ill, adult SSA patient populations are needed to improve local

Optimizing the management of acute coronary syndromes in sub-Saharan Africa: A statement from the AFRICARDIO 2015 Consensus Team.

Science.gov (United States)

Kakou-Guikahue, Maurice; N'Guetta, Roland; Anzouan-Kacou, Jean-Baptiste; Kramoh, Euloge; N'Dori, Raymond; Ba, Serigne Abdou; Diao, Maboury; Sarr, Moustapha; Kane, Abdoul; Kane, Adama; Damorou, Findide; Balde, Dadhi; Diarra, Mamadou Bocary; Djiddou, Mohamed; Kimbally-Kaki, Gisèle; Zabsonre, Patrice; Toure, Ibrahim Ali; Houénassi, Martin; Gamra, Habib; Chajai, Bachir; Gerardin, Benoit; Pillière, Rémy; Aubry, Pierre; Iliou, Marie-Christine; Isnard, Richard; Leprince, Pascal; Cottin, Yves; Bertrand, Edmond; Juillière, Yves; Monsuez, Jean-Jacques

2016-01-01

Whereas the coronary artery disease death rate has declined in high-income countries, the incidence of acute coronary syndromes (ACS) is increasing in sub-Saharan Africa, where their management remains a challenge. To propose a consensus statement to optimize management of ACS in sub-Saharan Africa on the basis of realistic considerations. The AFRICARDIO-2 conference (Yamoussoukro, May 2015) reviewed the ongoing features of ACS in 10 sub-Saharan countries (Benin, Burkina-Faso, Congo-Brazzaville, Guinea, Ivory Coast, Mali, Mauritania, Niger, Senegal, Togo), and analysed whether improvements in strategies and policies may be expected using readily available healthcare facilities. The outcome of patients with ACS is affected by clearly identified factors, including: delay to reaching first medical contact, achieving effective hospital transportation, increased time from symptom onset to reperfusion therapy, limited primary emergency facilities (especially in rural areas) and emergency medical service (EMS) prehospital management, and hence limited numbers of patients eligible for myocardial reperfusion (thrombolytic therapy and/or percutaneous coronary intervention [PCI]). With only five catheterization laboratories in the 10 participating countries, PCI rates are very low. However, in recent years, catheterization laboratories have been built in referral cardiology departments in large African towns (Abidjan and Dakar). Improvements in patient care and outcomes should target limited but selected objectives: increasing awareness and recognition of ACS symptoms; education of rural-based healthcare professionals; and developing and managing a network between first-line healthcare facilities in rural areas or small cities, emergency rooms in larger towns, the EMS, hospital-based cardiology departments and catheterization laboratories. Faced with the increasing prevalence of ACS in sub-Saharan Africa, healthcare policies should be developed to overcome the multiple

Becoming good in Africa: A critical appraisal of Stanley Hauerwas� ecclesial ethic in the sub-Saharan context

OpenAIRE

Charles K. Bafinamene

2017-01-01

The present article examines the appropriateness of Stanley Hauerwas� ecclesial ethic for the sub-Saharan African churches. Thus, it consists in a Christian ethical assessment of the metaethical foundational categories of his ecclesial ethic. In brief, his proposal is eclectic and pluri-disciplinarily applicable to the churches of various denominations. It reflects the marks of the Aristotelian ethical tradition endorsed by Thomas Aquinas and recovered by several communitarian philosophers. I...

Pediatric HIV/AIDS in sub-Saharan Africa: emerging issues and way ...

African Journals Online (AJOL)

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.

Intentional injury against children in Sub-Saharan Africa: A tertiary trauma centre experience.

Science.gov (United States)

Gallaher, Jared R; Wildfire, Benjamin; Mabedi, Charles; Cairns, Bruce A; Charles, Anthony G

2016-04-01

Intentional injuries are the result of violence. This is an important public health issue, particularly in children, and is an unaddressed problem in sub-Saharan Africa. This study sought to describe the characteristics of intentional injury, particularly physical abuse, in children presenting to our tertiary trauma centre in Lilongwe, Malawi and how they compare to children with unintentional injuries. A retrospective analysis of children (in Lilongwe, Malawi from 2009 to 2013 was performed. Children with intentional and unintentional injuries were compared with bivariate analysis and multivariate logistic regression modelling. 67,672 patients with traumatic injuries presented to KCH of which 24,365 were children. 1976 (8.1%) patients presented with intentional injury. Intentional injury patients had a higher mean age (11.1 ± 5.0 vs. 7.1 ± 4.6, pin intentional injury patients (80.5 vs. 45.4%, pin both groups (89.2 vs 80.9%, pin both groups. Sub-Saharan African tertiary hospitals are uniquely positioned to play a pivotal role in the identification, clinical management, and alleviation of intentional injuries to children by facilitating access to social services and through prevention efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

Selected aspects of GDP value and structure development in sub-Saharan Africa

Directory of Open Access Journals (Sweden)

Luboš Smutka

2011-01-01

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.

The African Genome Variation Project shapes medical genetics in Africa

Science.gov (United States)

Gurdasani, Deepti; Carstensen, Tommy; Tekola-Ayele, Fasil; Pagani, Luca; Tachmazidou, Ioanna; Hatzikotoulas, Konstantinos; Karthikeyan, Savita; Iles, Louise; Pollard, Martin O.; Choudhury, Ananyo; Ritchie, Graham R. S.; Xue, Yali; Asimit, Jennifer; Nsubuga, Rebecca N.; Young, Elizabeth H.; Pomilla, Cristina; Kivinen, Katja; Rockett, Kirk; Kamali, Anatoli; Doumatey, Ayo P.; Asiki, Gershim; Seeley, Janet; Sisay-Joof, Fatoumatta; Jallow, Muminatou; Tollman, Stephen; Mekonnen, Ephrem; Ekong, Rosemary; Oljira, Tamiru; Bradman, Neil; Bojang, Kalifa; Ramsay, Michele; Adeyemo, Adebowale; Bekele, Endashaw; Motala, Ayesha; Norris, Shane A.; Pirie, Fraser; Kaleebu, Pontiano; Kwiatkowski, Dominic; Tyler-Smith, Chris; Rotimi, Charles; Zeggini, Eleftheria; Sandhu, Manjinder S.

2015-01-01

Given the importance of Africa to studies of human origins and disease susceptibility, detailed characterization of African genetic diversity is needed. The African Genome Variation Project provides a resource with which to design, implement and interpret genomic studies in sub-Saharan Africa and worldwide. The African Genome Variation Project represents dense genotypes from 1,481 individuals and whole-genome sequences from 320 individuals across sub-Saharan Africa. Using this resource, we find novel evidence of complex, regionally distinct hunter-gatherer and Eurasian admixture across sub-Saharan Africa. We identify new loci under selection, including loci related to malaria susceptibility and hypertension. We show that modern imputation panels (sets of reference genotypes from which unobserved or missing genotypes in study sets can be inferred) can identify association signals at highly differentiated loci across populations in sub-Saharan Africa. Using whole-genome sequencing, we demonstrate further improvements in imputation accuracy, strengthening the case for large-scale sequencing efforts of diverse African haplotypes. Finally, we present an efficient genotype array design capturing common genetic variation in Africa.

The African Genome Variation Project shapes medical genetics in Africa.

Science.gov (United States)

Gurdasani, Deepti; Carstensen, Tommy; Tekola-Ayele, Fasil; Pagani, Luca; Tachmazidou, Ioanna; Hatzikotoulas, Konstantinos; Karthikeyan, Savita; Iles, Louise; Pollard, Martin O; Choudhury, Ananyo; Ritchie, Graham R S; Xue, Yali; Asimit, Jennifer; Nsubuga, Rebecca N; Young, Elizabeth H; Pomilla, Cristina; Kivinen, Katja; Rockett, Kirk; Kamali, Anatoli; Doumatey, Ayo P; Asiki, Gershim; Seeley, Janet; Sisay-Joof, Fatoumatta; Jallow, Muminatou; Tollman, Stephen; Mekonnen, Ephrem; Ekong, Rosemary; Oljira, Tamiru; Bradman, Neil; Bojang, Kalifa; Ramsay, Michele; Adeyemo, Adebowale; Bekele, Endashaw; Motala, Ayesha; Norris, Shane A; Pirie, Fraser; Kaleebu, Pontiano; Kwiatkowski, Dominic; Tyler-Smith, Chris; Rotimi, Charles; Zeggini, Eleftheria; Sandhu, Manjinder S

2015-01-15

Given the importance of Africa to studies of human origins and disease susceptibility, detailed characterization of African genetic diversity is needed. The African Genome Variation Project provides a resource with which to design, implement and interpret genomic studies in sub-Saharan Africa and worldwide. The African Genome Variation Project represents dense genotypes from 1,481 individuals and whole-genome sequences from 320 individuals across sub-Saharan Africa. Using this resource, we find novel evidence of complex, regionally distinct hunter-gatherer and Eurasian admixture across sub-Saharan Africa. We identify new loci under selection, including loci related to malaria susceptibility and hypertension. We show that modern imputation panels (sets of reference genotypes from which unobserved or missing genotypes in study sets can be inferred) can identify association signals at highly differentiated loci across populations in sub-Saharan Africa. Using whole-genome sequencing, we demonstrate further improvements in imputation accuracy, strengthening the case for large-scale sequencing efforts of diverse African haplotypes. Finally, we present an efficient genotype array design capturing common genetic variation in Africa.

Competition and mobile penetration in sub-Saharan Africa | Belayeh ...

African Journals Online (AJOL)

Saharan African (SSA) countries between 2000 and 2006. We examine both the impact of introducing competition and the role of intensity of competition on mobile penetration in these countries. Different specifications with different measures of ...

Aids prevention in sub-Saharan Africa: as easy as ABC? | Bertrand ...

African Journals Online (AJOL)

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 ...

Sources of variation in under-5 mortality across sub-Saharan Africa: a spatial analysis.

Science.gov (United States)

Burke, Marshall; Heft-Neal, Sam; Bendavid, Eran

2016-12-01

Detailed spatial understanding of levels and trends in under-5 mortality is needed to improve the targeting of interventions to the areas of highest need, and to understand the sources of variation in mortality. To improve this understanding, we analysed local-level information on child mortality across sub-Saharan Africa between 1980-2010. We used data from 82 Demographic and Health Surveys in 28 sub-Saharan African countries, including the location and timing of 3·24 million childbirths and 393 685 deaths, to develop high-resolution spatial maps of under-5 mortality in the 1980s, 1990s, and 2000s. These estimates were at a resolution of 0·1 degree latitude by 0·1 degree longitude (roughly 10 km × 10 km). We then analysed this spatial information to distinguish within-country versus between-country sources of variation in mortality, to examine the extent to which declines in mortality have been accompanied by convergence in the distribution of mortality, and to study localised drivers of mortality differences, including temperature, malaria burden, and conflict. In our sample of sub-Saharan African countries from the 1980s to the 2000s, within-country differences in under-5 mortality accounted for 74-78% of overall variation in under-5 mortality across space and over time. Mortality differed significantly across only 8-15% of country borders, supporting the role of local, rather than national, factors in driving mortality patterns. We found that by the end of the study period, 23% of the eligible children in the study countries continue to live in mortality hotspots-areas where, if current trends continue, the Sustainable Developent Goals mortality targets will not be met. In multivariate analysis, within-country mortality levels at each pixel were significantly related to local temperature, malaria burden, and recent history of conflict. Our findings suggest that sub-national determinants explain a greater portion of under-5 mortality than do country

Chromolaena odorata (L.) R.M. King & H. Rob. (Asteraceae) in sub-Saharan Africa: A synthesis and review of its medicinal potential.

Science.gov (United States)

Omokhua, Aitebiremen G; McGaw, Lyndy J; Finnie, Jeffrey F; Van Staden, Johannes

2016-05-13

Chromolaena odorata (L.) R.M. King & H. Rob. (Asteraceae) is a scrambling perennial shrub that originated in the Americas, but is now common in sub-Saharan Africa, Asia and Oceania, where it has become a serious weed. The species, particularly the biotype found in Asia and West Africa, has many ethnopharmacological uses, including treatment of malaria, wounds, diarrhoea, skin infection, toothache, dysentery, stomach ache, sore throat, convulsions, piles, coughs and colds. Furthermore, no attempt has been made to synthesise and review the available literature on the usefulness of the plant in the sub-Saharan African region, hence this paper examines the beneficial attributes of C. odorata in sub-Saharan Africa. Published information on the species was gathered by the use of different database platforms, including Google Scholar, ScienceDirect, SciFinder and Scopus. Records indicate that two biotypes of C. odorata are present in sub-Saharan Africa viz. the more widespread Asian/West African C. odorata biotype (AWAB) and the southern African biotype (SAB). While the usefulness of the former is well elucidated in the literature, such information on the latter is still scarce. Although the importance of AWAB C. odorata as a fallow species and as a soil fertility improvement plant in the slash and burn rotation system of agriculture in West Africa is increasingly being recognised, its usage in traditional medicinal practice is far more appreciated. The species has a wide range of ethnopharmacological uses, possibly because of the presence of flavonoids, essential oils, phenolics, tannins and saponins. The plant is reported to have antibacterial, anti-inflammatory, antioxidant, anthelminthic, antifungal, cytotoxic, anticonvulsant, antiprotozoal, antispasmodic, antipyretic and analgesic properties. While the results of this review suggest that the AWAB plant can be exploited as an alternative to other threatened plant species known to possess similar medicinal potential

HIV/AIDS drugs for Sub-Saharan Africa: how do brand and generic supply compare?

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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

The paediatric surgeon and his working conditions in Francophone sub-Saharan Africa

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K Gnassingbé

2011-01-01

Full Text Available Background: This study described the current conditions of work of paediatric surgeons in Francophone sub-Saharan Africa (FSSA and set the debate at the level of the humanist thinking in medicine. Patients and Methods: This was a multicentre study from 1 st May to 30 th October 2008. The African Society of paediatric surgeons′ directory was used to identify paediatric surgeons in the Francophone′s countries in Sub Saharan Africa. The parameters studied were number of surgeons per country, means of training, working conditions, remunerations, needs for continuous training and the research. Results: A total of 41 paediatric surgeons (68.33% responded. The average number of paediatric surgeons per country was 5. The means of training included government scholarships among 7 paediatric surgeons (17.07%, scholarship from a non-governmental organisations in 14 (34.15% and self-sponsorships in 20 (48.78%. The average salary was 450 Euros (€ (range: 120-1 400 Euros. Most of the paediatric surgeons (68.29% had internet services for continuous update courses and research. Thirty six paediatric surgeons (87.80% had no subscription to specialised scientific journals. Conclusion: The paediatric surgeon in FSSA faces many problems related to his working and living conditions that may have a negative impact on their competences.

Economywide impacts of climate change on agriculture in Sub-Saharan Africa

NARCIS (Netherlands)

Calzadilla, Alvaro; Zhu, Tingju; Rehdanz, Katrin; Tol, Richard S J; Ringler, Claudia

2013-01-01

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

Identifying key entry-points for strategic management of smallholder farming systems in sub-Saharan Africa using the dynamic farm-scale simulation model NUANCES-FARMSIM

NARCIS (Netherlands)

Wijk, van M.T.; Tittonell, P.A.; Rufino, M.C.; Herrero, M.; Pacini, C.; Ridder, de N.; Giller, K.E.

2009-01-01

African smallholder farming systems are complex, dynamic systems with many interacting biophysical subcomponents. In these systems the major inputs and outputs are managed by human agency ¿ the farmers. To analyse potential developmental pathways of smallholder farming systems in sub-Saharan Africa

Youth in sub-Saharan Africa.

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Blum, Robert W

2007-09-01

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.

Power sector reform and distributed generation in sub-Saharan Africa

DEFF Research Database (Denmark)

Turkson, J.K.; Wohlgemuth, N.

2001-01-01

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...

Resources, indicators, data management, dissemination and use in health information systems in sub-Saharan Africa: results of a questionnaire-based survey.

Science.gov (United States)

Mbondji, Peter Ebongue; Kebede, Derege; Soumbey-Alley, Edoh William; Zielinski, Chris; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

2014-05-01

To describe the status of health information systems in 14 sub-Saharan African countries of the World Health Organization African Region. A questionnaire-based survey. Fourteen sub-Saharan African countries of the African Region. Key informants in the ministries of health, national statistics offices, health programmes, donors and technical agencies. State of resources, indicators, data sources, data management, information products, dissemination and use of health information. The highest average score was in the identification and harmonisation of indicators (73%), reflecting successful efforts to identify priority indicators and reach international consensus on indicators for several diseases. This was followed by information products (63%), which indicated the availability of accurate and reliable data. The lowest score (41%) was in data management, the ability to collect, store, analyse and distribute data, followed by resources - policy and planning, human and financial resources, and infrastructure (53%). Data sources (e.g. censuses, surveys) were on average inadequate with a score of 56%. The average score for dissemination and use of health information was 57%, which indicated limited or inadequate use of data for advocacy, planning and decision-making. National health information systems are weak in the surveyed countries and much more needs to be done to improve the quality and relevance of data, and their management, sharing and use for policy-making and decision-making. © The Royal Society of Medicine.

The national determinants of deforestation in sub-Saharan Africa.

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Rudel, Thomas K

2013-01-01

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.

Antenatal syphilis screening using point-of-care testing in Sub-Saharan African countries: a cost-effectiveness analysis.

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Andreas Kuznik

2013-11-01

Full Text Available Untreated syphilis in pregnancy is associated with adverse clinical outcomes for the infant. Most syphilis infections occur in sub-Saharan Africa (SSA, where coverage of antenatal screening for syphilis is inadequate. Recently introduced point-of-care syphilis tests have high accuracy and demonstrate potential to increase coverage of antenatal screening. However, country-specific cost-effectiveness data for these tests are limited. The objective of this analysis was to evaluate the cost-effectiveness and budget impact of antenatal syphilis screening for 43 countries in SSA and estimate the impact of universal screening on stillbirths, neonatal deaths, congenital syphilis, and disability-adjusted life years (DALYs averted.The decision analytic model reflected the perspective of the national health care system and was based on the sensitivity (86% and specificity (99% reported for the immunochromatographic strip (ICS test. Clinical outcomes of infants born to syphilis-infected mothers on the end points of stillbirth, neonatal death, and congenital syphilis were obtained from published sources. Treatment was assumed to consist of three injections of benzathine penicillin. Country-specific inputs included the antenatal prevalence of syphilis, annual number of live births, proportion of women with at least one antenatal care visit, per capita gross national income, and estimated hourly nurse wages. In all 43 sub-Saharan African countries analyzed, syphilis screening is highly cost-effective, with an average cost/DALY averted of US$11 (range: US$2-US$48. Screening remains highly cost-effective even if the average prevalence falls from the current rate of 3.1% (range: 0.6%-14.0% to 0.038% (range: 0.002%-0.113%. Universal antenatal screening of pregnant women in clinics may reduce the annual number of stillbirths by up to 64,000, neonatal deaths by up to 25,000, and annual incidence of congenital syphilis by up to 32,000, and avert up to 2.6 million

The challenge of AIDS-related malignancies in sub-Saharan Africa.

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Annie J Sasco

Full Text Available BACKGROUND: With the lengthening of life expectancy among HIV-positive subjects related to the use of highly active antiretroviral treatments, an increased risk of cancer has been described in industrialized countries. The question is to determine what occurs now and will happen in the future in the low income countries and particularly in sub-Saharan Africa where more than two-thirds of all HIV-positive people live in the world. The objective of our paper is to review the link between HIV and cancer in sub-Saharan Africa, putting it in perspective with what is already known in Western countries. METHODS AND FINDINGS: Studies for this review were identified from several bibliographical databases including Pubmed, Scopus, Cochrane, Pascal, Web of Science and using keywords "HIV, neoplasia, epidemiology and Africa" and related MesH terms. A clear association was found between HIV infection and AIDS-classifying cancers. In case-referent studies, odds ratios (OR were ranging from 21.9 (95% Confidence Interval (CI 12.5-38.6 to 47.1 (31.9-69.8 for Kaposi sarcoma and from 5.0 (2.7-9.5 to 12.6 (2.2-54.4 for non Hodgkin lymphoma. The association was less strong for invasive cervical cancer with ORs ranging from 1.1 (0.7-1.2 to 1.6 (1.1-2.3, whereas ORs for squamous intraepithelial lesions were higher, from 4.4 (2.3-8.4 to 17.0 (2.2-134.1. For non AIDS-classifying cancers, squamous cell conjunctival carcinoma of the eye was associated with HIV in many case-referent studies with ORs from 2.6 (1.4-4.9 to 13.0 (4.5-39.4. A record-linkage study conducted in Uganda showed an association between Hodgkin lymphoma and HIV infection with a standardized incidence ratio of 5.7 (1.2-17 although OR in case-referent studies ranged from 1.4 (0.7-2.8 to 1.6 (1.0-2.7. Other cancer sites found positively associated with HIV include lung, liver, anus, penis, vulva, kidney, thyroid and uterus and a decreased risk of female breast cancer. These results so far based on a

Sub-Saharan centralized biorepository for genetic and genomic research.

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Gasmelseed, Nagla; Elsir, Afrah Awad; Deblasio, Pasquale; Biunno, Ida

2012-04-15

Quality-assessed biomedical samples are essential for academia- and industry driven research on human diseases. The etiologies and the molecular genetic factors relevant in African diseases, including both infections and complex degenerative diseases as well as cancer, need to be studied using well annotated and well-preserved biosamples acquired from native African ethnic groups and compare the results with non-African populations and/or with Afro-Americans. However, a number of difficulties negatively impact on the possibility to obtain clinically annotated biological samples in most Sub-Saharan African countries. This is mainly due to major organizational problems, lack of clinical centres that can dedicate resources to research, as well as lack of facilities in which biomaterials can be properly processed and safely stored. Harmonization of biosample acquisition, storage phenotyping schemes and biocomputer infrastructures are the principal objectives of biological resource centers (BRCs). BRCs comprise biobanks of different formats (collection of blood, DNA, tissues, etc., annotated with medical, environmental, life-style and follow up data) a fundamental tool for molecular epidemiological studies aiming to increase excellence and efficacy of biomedical results, drug development and public health. BRCs provide large and highly controlled biomolecular resources necessary to meet the "omics" scientific platforms. Sudan may be a candidate nation to host such infrastructure, in view of its strategic geographical position and the already existing simple biobanking experiences connected with research groups in Central Sudan. Here, we describe the potential role of biobanks in African genetic studies aiming to dissect the eziopathogenesis of complex diseases in relation to environmental and life-style factors. Copyright © 2010 Elsevier B.V. All rights reserved.

The Environmental and Social Influences of HIV/AIDS in Sub-Saharan Africa: A Focus on Rural Communities

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Oramasionwu, Christine U.; Daniels, Kelly R.; Labreche, Matthew J.; Frei, Christopher R.

2011-01-01

The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) pandemic has caused far-reaching effects in sub-Saharan Africa. The pandemic has effectively diminished the workforce, increased poverty rates, reduced agricultural productivity, and transformed the structure of many rural households. HIV/AIDS further strains the already fragile relationship between livelihood and the natural and social environments of these regions. Therefore, the objective of this review is to characterize the impact of HIV/AIDS on the environment and the social infrastructure of rural sub-Saharan Africa. There are many aspects of rural life that contribute to disease transmission of HIV/AIDS and that pose unique challenges to the population dynamics in sub-Saharan Africa. Widespread AIDS-related mortality has caused a decrease in population growth for many African countries. In turn, these alterations in population dynamics have resulted in a decrease in the percentage of prime-age working adults, as well as a gender disparity, whereby, females carry a growing burden of household responsibilities. There is a rising proportion of older adults, often females, who assume the role of provider and caretaker for other dependent family members. These changing dynamics have caused many to exploit their natural surroundings, adopting less sustainable land use practices and utilizing protected resources as a primary means of generating revenue. PMID:21845169

The Environmental and Social Influences of HIV/AIDS in Sub-Saharan Africa: A Focus on Rural Communities

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Christopher R. Frei

2011-07-01

Full Text Available The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS pandemic has caused far-reaching effects in sub-Saharan Africa. The pandemic has effectively diminished the workforce, increased poverty rates, reduced agricultural productivity, and transformed the structure of many rural households. HIV/AIDS further strains the already fragile relationship between livelihood and the natural and social environments of these regions. Therefore, the objective of this review is to characterize the impact of HIV/AIDS on the environment and the social infrastructure of rural sub-Saharan Africa. There are many aspects of rural life that contribute to disease transmission of HIV/AIDS and that pose unique challenges to the population dynamics in sub-Saharan Africa. Widespread AIDS-related mortality has caused a decrease in population growth for many African countries. In turn, these alterations in population dynamics have resulted in a decrease in the percentage of prime-age working adults, as well as a gender disparity, whereby, females carry a growing burden of household responsibilities. There is a rising proportion of older adults, often females, who assume the role of provider and caretaker for other dependent family members. These changing dynamics have caused many to exploit their natural surroundings, adopting less sustainable land use practices and utilizing protected resources as a primary means of generating revenue.

Determinants of Poverty in Sub-Saharan Africa

African Journals Online (AJOL)

Nekky Umera

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.

Physiotherapy for people with mental health problems in Sub-Saharan African countries: a systematic review

OpenAIRE

Vancampfort, Davy; Stubbs, Brendon; Probst, Michel; Mugisha, James

2018-01-01

Background There is a need for psychosocial interventions to address the escalating mental health burden in Sub-Saharan Africa (SSA). Physiotherapists could have a central role in reducing the burden and facilitating recovery within the multidisciplinary care of people with mental health problems. The aim of this systematic review was to explore the role of physiotherapists within the current mental health policies of SSA countries and to explore the current research evidence for physiotherap...

Mental and substance use disorders in Sub-Saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years.

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Charlson, Fiona J; Diminic, Sandra; Lund, Crick; Degenhardt, Louisa; Whiteford, Harvey A

2014-01-01

The world is undergoing a rapid health transition, with an ageing population and disease burden increasingly defined by disability. In Sub-Saharan Africa the next 40 years are predicted to see reduced mortality, signalling a surge in the impact of chronic diseases. We modelled these epidemiological changes and associated mental health workforce requirements. Years lived with a disability (YLD) predictions for mental and substance use disorders for each decade from 2010 to 2050 for four Sub-Saharan African regions were calculated using Global Burden of Disease 2010 study (GBD 2010) data and UN population forecasts. Predicted mental health workforce requirements for 2010 and 2050, by region and for selected countries, were modelled using GBD 2010 prevalence estimates and recommended packages of care and staffing ratios for low- and middle-income countries, and compared to current staffing from the WHO Mental Health Atlas. Significant population growth and ageing will result in an estimated 130% increase in the burden of mental and substance use disorders in Sub-Saharan Africa by 2050, to 45 million YLDs. As a result, the required mental health workforce will increase by 216,600 full time equivalent staff from 2010 to 2050, and far more compared to the existing workforce. The growth in mental and substance use disorders by 2050 is likely to significantly affect health and productivity in Sub-Saharan Africa. To reduce this burden, packages of care for key mental disorders should be provided through increasing the mental health workforce towards targets outlined in this paper. This requires a shift from current practice in most African countries, involving substantial investment in the training of primary care practitioners, supported by district based mental health specialist teams using a task sharing model that mobilises local community resources, with the expansion of inpatient psychiatric units based in district and regional general hospitals.

Mental and substance use disorders in Sub-Saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years.

Directory of Open Access Journals (Sweden)

Fiona J Charlson

Full Text Available The world is undergoing a rapid health transition, with an ageing population and disease burden increasingly defined by disability. In Sub-Saharan Africa the next 40 years are predicted to see reduced mortality, signalling a surge in the impact of chronic diseases. We modelled these epidemiological changes and associated mental health workforce requirements. Years lived with a disability (YLD predictions for mental and substance use disorders for each decade from 2010 to 2050 for four Sub-Saharan African regions were calculated using Global Burden of Disease 2010 study (GBD 2010 data and UN population forecasts. Predicted mental health workforce requirements for 2010 and 2050, by region and for selected countries, were modelled using GBD 2010 prevalence estimates and recommended packages of care and staffing ratios for low- and middle-income countries, and compared to current staffing from the WHO Mental Health Atlas. Significant population growth and ageing will result in an estimated 130% increase in the burden of mental and substance use disorders in Sub-Saharan Africa by 2050, to 45 million YLDs. As a result, the required mental health workforce will increase by 216,600 full time equivalent staff from 2010 to 2050, and far more compared to the existing workforce. The growth in mental and substance use disorders by 2050 is likely to significantly affect health and productivity in Sub-Saharan Africa. To reduce this burden, packages of care for key mental disorders should be provided through increasing the mental health workforce towards targets outlined in this paper. This requires a shift from current practice in most African countries, involving substantial investment in the training of primary care practitioners, supported by district based mental health specialist teams using a task sharing model that mobilises local community resources, with the expansion of inpatient psychiatric units based in district and regional general hospitals.

Mental and Substance Use Disorders in Sub-Saharan Africa: Predictions of Epidemiological Changes and Mental Health Workforce Requirements for the Next 40 Years

Science.gov (United States)

Charlson, Fiona J.; Diminic, Sandra; Lund, Crick; Degenhardt, Louisa; Whiteford, Harvey A.

2014-01-01

The world is undergoing a rapid health transition, with an ageing population and disease burden increasingly defined by disability. In Sub-Saharan Africa the next 40 years are predicted to see reduced mortality, signalling a surge in the impact of chronic diseases. We modelled these epidemiological changes and associated mental health workforce requirements. Years lived with a disability (YLD) predictions for mental and substance use disorders for each decade from 2010 to 2050 for four Sub-Saharan African regions were calculated using Global Burden of Disease 2010 study (GBD 2010) data and UN population forecasts. Predicted mental health workforce requirements for 2010 and 2050, by region and for selected countries, were modelled using GBD 2010 prevalence estimates and recommended packages of care and staffing ratios for low- and middle-income countries, and compared to current staffing from the WHO Mental Health Atlas. Significant population growth and ageing will result in an estimated 130% increase in the burden of mental and substance use disorders in Sub-Saharan Africa by 2050, to 45 million YLDs. As a result, the required mental health workforce will increase by 216,600 full time equivalent staff from 2010 to 2050, and far more compared to the existing workforce. The growth in mental and substance use disorders by 2050 is likely to significantly affect health and productivity in Sub-Saharan Africa. To reduce this burden, packages of care for key mental disorders should be provided through increasing the mental health workforce towards targets outlined in this paper. This requires a shift from current practice in most African countries, involving substantial investment in the training of primary care practitioners, supported by district based mental health specialist teams using a task sharing model that mobilises local community resources, with the expansion of inpatient psychiatric units based in district and regional general hospitals. PMID:25310010

Vaccination for typhoid fever in sub-Saharan Africa.

Science.gov (United States)

Slayton, Rachel B; Date, Kashmira A; Mintz, Eric D

2013-04-01

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.

m-Health Policy Readiness and Enabling Factors: Comparisons of Sub-Saharan Africa and Organization for Economic Cooperation and Development Countries.

Science.gov (United States)

Lee, Seohyun; Begley, Charles E; Morgan, Robert; Chan, Wenyaw; Kim, Sun-Young

2018-02-12

As an innovative solution to poor access to care in low- and middle-income countries (LMICs), m-health has gained wide attention in the past decade. Despite enthusiasm from the global health community, LMICs have not demonstrated high uptake of m-health promoting policies or public investment. To benchmark the current status, this study compared m-health policy readiness scores between sub-Saharan Africa and high-income Organization for Economic Cooperation and Development (OECD) countries using an independent two-sample t test. In addition, the enabling factors associated with m-health policy readiness were investigated using an ordinal logistic regression model. The study was based on the m-health policy readiness scores of 112 countries obtained from the World Health Organization Third Global Survey on e-Health. The mean m-health policy readiness score for sub-Saharan Africa was statistically significantly lower than that for OECD countries (p = 0.02). The enabling factors significantly associated with m-health policy readiness included information and communication technology development index (odds ratio [OR] 1.57; 95% confidence interval [CI] 1.12-2.2), e-health education for health professionals (OR 4.43; 95% CI 1.60-12.27), and the location in sub-Saharan Africa (OR 3.47; 95% CI 1.06-11.34). The findings of our study suggest dual policy goals for m-health in sub-Saharan Africa. First, enhance technological and educational support for m-health. Second, pursue global collaboration for building m-health capacity led by sub-Saharan African countries with hands-on experience and knowledge. Globally, countries should take a systematic and collaborative approach in pursuing m-health policy with the focus on technological and educational support.

Adaptation of the WHO maternal near miss tool for use in sub-Saharan Africa: an International Delphi study.

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Tura, Abera K; Stekelenburg, Jelle; Scherjon, Sicco A; Zwart, Joost; van den Akker, Thomas; van Roosmalen, Jos; Gordijn, Sanne J

2017-12-29

Assessments of maternal near miss (MNM) are increasingly used in addition to those of maternal mortality measures. The World Health Organization (WHO) has introduced an MNM tool in 2009, but this tool was previously found to be of limited applicability in several low-resource settings. The aim of this study was to identify adaptations to enhance applicability of the WHO MNM tool in sub-Saharan Africa. Using a Delphi consensus methodology, existing MNM tools were rated for applicability in sub-Saharan Africa over a series of three rounds. Maternal health experts from sub-Saharan Africa or with considerable knowledge of the context first rated importance of WHO MNM parameters using Likert scales, and were asked to suggest additional parameters. This was followed by two confirmation rounds. Parameters accepted by at least 70% of the panel members were accepted for use in the region. Of 58 experts who participated from study onset, 47 (81%) completed all three rounds. Out of the 25 WHO MNM parameters, all 11 clinical, four out of eight laboratory, and four out of six management-based parameters were accepted, while six parameters (PaO2/FiO2 100 μmol/l or >6.0 mg/dl, pH 5 μmol/l, dialysis for acute renal failure and use of continuous vasoactive drugs) were deemed to not be applicable. An additional eight parameters (uterine rupture, sepsis/severe systemic infection, eclampsia, laparotomy other than caesarean section, pulmonary edema, severe malaria, severe complications of abortions and severe pre-eclampsia with ICU admission) were suggested for inclusion into an adapted sub-Saharan African MNM tool. All WHO clinical criteria were accepted for use in the region. Only few of the laboratory- and management based were rated applicable. This study brought forward important suggestions for adaptations in the WHO MNM criteria to enhance its applicability in sub-Saharan Africa and possibly other low-resource settings.

Education, Skills and Industrial Development in the Structural Transformation of Africa. Innocenti Occasional Papers Number 3. Special Subseries: Structural Adjustment in Sub-Saharan Africa.

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Lall, Sanjaya

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…

Investigation of Economic Impacts of Economic Partnership Agreements between Sub-Saharan Africa and European Union

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Metin Pişkin

2016-06-01

Full Text Available This study tries to quantify the economic effects of Economic Partnership Agreements (EPAs which have been negotiating between sub-Saharan Africa (SSA and European Union (EU. The study addresses the following questions:  How are African countries likely to gain or lose from a bilateral trade liberalisation between Africa and the EU?, what are the welfare implications for the African countries from the EPAs?, how will the formation of EPAs affect trade expansion through trade creation and trade diversion effects?, what are the potential fiscal implications of the EPAs. Even though the full reciprocity principle appears to be trade expanding (singularly infavour of EU, this study indicates that it will pose serious implications for deepening of regional integration in Africa because of trade diversion effect between African countries.  Another key finding is welfare effect through the way of trade expantion between EU and SSA.

Selected aspects and specifics of the economic development in sub-Saharan Africa

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Karel Tomššík

2013-01-01

Full Text Available The paper examines the development of economies in the sub-Saharan region. It aims to identify particular development trends specific to the region. That means identifying changes which have occurred in the past five decades in following areas: development of the GDP value ​​and structure, growth in the value of foreign trade, demographic growth, and changes in the value of GDP per capita. The results of the analysis show very constrained economic power of sub-Saharan region. Not only weak economy of the region but also a significant population growth is a problem. Increasing production and trade does not contribute effectively to elimination of high level of poverty and malnutrition which remains a long-term problem of the sub-Saharan region. In real terms, the GDP per capita was growing by less than 1 % in the period 1961–2010. Sub-Saharan region is highly dependent on cooperation with other world regions in its effort to increase economic growth and to improve the economic situation of own population. The GDP growth is thus very sensitive to GDP development in Europe and North America. Concerning the foreign trade, development of sub-Saharan trade is dependent on regions of the Southern and Eastern Asia, and Europe.

Health economics of blood transfusion safety--focus on sub-Saharan Africa.

Science.gov (United States)

van Hulst, Marinus; Smit Sibinga, Cees Th; Postma, Maarten J

2010-01-01

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.

SME Adoption of Enterprise Systems in Sub-Saharan Africa

DEFF Research Database (Denmark)

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...

A contribution to study the immigration from Sub Saharan Africa to Argentina

Directory of Open Access Journals (Sweden)

Marta M. Maffia

2010-07-01

Full Text Available Even though in Argentina we have immigrants from Sub Saharan Africa arriving at the end of the Nineteenth Century and beginning of the Twentieth Century such as those from South Africa and Cape Verde, this new immigration from Senegal, Nigeria, Cameroon, Ghana, among other countries, during the last decade of the Twentieth Century and first decade of the Twenty-first Century appears in a different historical and political context. This new migration is facing legal regimes and increasingly restrictive administrative by-laws, framed in the growing economic globalization.This work is part of the first results of a research on this migration from an anthropological perspective. This study, which began in 2009, takes into account contributions made by history, political sciences, demography, among other disciplines, making use of articles written by African and Non-African social scientists. We are convinced that in this exchange of views our limitations may be overcome.

A Comparative Analysis of United States and Chinese Economic Engagement in Sub Saharan Africa

Science.gov (United States)

2016-03-01

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

Does Renewable Energy Consumption and Health Expenditure Decrease Carbon Dioxide Emissions? Evidence for sub-Saharan Africa Countries

OpenAIRE

Apergis, Nicholas; Ben Jebli, Mehdi

2015-01-01

This paper employs a number of panel methodological approaches to explore the link between per capita carbon dioxide emissions, per capita real income, renewable energy consumption and health expenditures for a panel of 42 sub-Saharan African countries, spanning the period 1995-2011. The empirical findings provide supportive of a long-run relationship among the variables. Granger causality reveals the presence of a short-run unidirectional causality running from real GDP to CO2 emissions, a b...

Financial Permeation and Economic Growth: Evidence from Sub-Saharan Africa

OpenAIRE

Inoue, Takeshi; Hamori, Shigeyuki

2013-01-01

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 ...

Agriculture and Economic Development in Sub-Saharan Africa and Asia

OpenAIRE

Massoud Karshenas

2000-01-01

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...

The food production and consumption balance in sub-Saharan Africa under different SSPs, from 2010 to 2050

Science.gov (United States)

Wada, Y.; Luan, Y.; Fischer, G.; Sun, L.; Shi, P.

2015-12-01

Forcing with the population growth and consequently increasing food requirement, food security in sub-Saharan Africa is one of the most emergent and challenging issues. The purposes of this work are 1) what's the future food requirement and their food security status in each sub-Saharan African countries? What is the distance from current and future food security status, corresponding to the food requirement, to the targeted food security status? 2) To what extent Sub-Saharan countries could meet their present and future food requirement, and whether they have potential to improve their food insecurity status on currently cultivated land? 3) Whether or, if there have, how the pressures on land resources from meeting the food requirements? To figure those questions out, we firstly use socio-economic pathways datasets, and historical food diet pattern classification to forecast the 2010-2050 food commodity and feed calories demand per country. A new food security indicator, which considered the influences of both the food energy and quality intake, was used to evaluate the food insecurity status and the distances to different targeted statuses of the specific country. The latest Global Agro-Ecological Zones (GAEZ) databases were used to estimate the current and future crop yield gap and crop potential production. For current to future scenario analysis, we considered population growth, dietary change, climate change, agricultural input level, and target food security status. Then the balance of food requirement with the current and potential crop production was analyzed for different scenarios. Land requirements were calculated for meeting those food requirements, and the pressures on land resources are evaluated. Our works are hoping to provide scientific-based evidences for policy recommendations for local government to tackle food insecurity problems in Sub-Saharan Africa.

Sub-Saharan Africa | IDRC - International Development Research ...

International Development Research Centre (IDRC) Digital Library (Canada)

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.

Sub-Saharan Africa at a Glance.

Science.gov (United States)

Social Education, 1997

1997-01-01

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)

Cystic echinococcosis in sub-Saharan Africa

NARCIS (Netherlands)

Wahlers, Kerstin; Menezes, Colin N.; Wong, Michelle L.; Zeyhle, Eberhard; Ahmed, Mohammed E.; Ocaido, Michael; Stijnis, Cornelis; Romig, Thomas; Kern, Peter; Grobusch, Martin P.

2012-01-01

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

Trauma in sub-Saharan Africa: review of cost, estimation methods, and interventions.

Science.gov (United States)

Smigelsky, Melissa A; Aten, Jamie D; Gerberich, Stacy; Sanders, Mark; Post, Rachael; Hook, Kimberly; Ku, Angie; Boan, David M; Monroe, Phil

2014-01-01

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.

The effect of pre-existing malnutrition on pediatric burn mortality in a sub-Saharan African burn unit.

Science.gov (United States)

Grudziak, Joanna; Snock, Carolyn; Mjuweni, Stephen; Gallaher, Jared; Cairns, Bruce; Charles, Anthony

2017-11-01

Nutritional status predicts burn outcomes in the developed world, but its effect on burn mortality in the developing world has not been widely studied. In sub Saharan Africa, burn is primarily a disease of children, and the majority of children in sub-Saharan Africa are malnourished. We therefore sought to determine the prevalence and effect of malnutrition on burn mortality at our institution. This is a retrospective review of children aged 0-5, with anthropomorphic measurements available, who were admitted to our burn unit from July 2011 to May 2016. Age-adjusted Z scores were calculated for height, weight, weight for height, and mid-upper arm circumference (MUAC). Following bivariate analysis, we used logistic regression to construct a fully adjusted model of predictors of mortality. Of the 1357 admitted patients, 839 (61.2%) were aged 0-5. Of those, 512 (62.9%) had one or more anthropomorphic measurements available, and were included in the analysis. 54% were male, and the median age was 28 months. The median TBSA was 15%, with a majority of burns caused by scalds (77%). Mortality was 16%. Average Z-score for any of the indicators of malnutrition was -1.45±1.66. TBSA (OR: 1.08, 95% CI: 1.06, 1.11), decreasing Z-score (OR: 1.19, 95% CI: 1.00, 1.41), and flame burn (OR: 2.51, 95% CI: 1.40, 4.49) were associated with an increase in mortality. Preexisting malnutrition in burn patients in sub-Saharan Africa increases odds of mortality after controlling for significant covariates. Survival of burn patients in this region will not reach that of the developed world until a strategy of aggressive nutritional support is implemented in this population. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Policy and regulatory framework conditions for small hydro power in Sub-Saharan Africa

Energy Technology Data Exchange (ETDEWEB)

Koelling, Fritz [Sustainable Energy and Environment, Karlsruhe (Germany); Gaul, Mirco; Schroeder, Miriam [SiNERGi Consultancy for Renewable Energies, Berlin (Germany)

2011-07-01

The vast potential of mini and micro hydro power (MHP) in Sub-Saharan African countries is one promising option to cover increasing energy demand and to enable electricity access for remote rural communities. Based on the analysis of 6 African countries (Ethiopia, Kenya, Mozambique, Nigeria, Rwanda, South Africa), this study sheds light on some of the main barriers on the level of political and regulatory framework conditions which include gap between the national-level policies and regulations and local MHP project implementation, lack of financing and limited capacities for project planning, building and operation. The paper also identifies some promising practices employed in several SSA countries of how to overcome these barriers and concludes with recommendations of how to create positive feed-backs between ambitious policies and regulations and MHP financing and capacity development needs in order to scale up MHP deployment and MHP sector development. (orig.)

Economic Analysis of HIV/AIDS Pandemic in Sub-Saharan Africa

OpenAIRE

Nýdrle, Tomáš

2009-01-01

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...

History and Structure of Sub-Saharan Populations of Drosophila melanogaster

OpenAIRE

Pool, John E.; Aquadro, Charles F.

2006-01-01

Drosophila melanogaster is an important model organism in evolutionary genetics, yet little is known about the population structure and the demographic history of this species within sub-Saharan Africa, which is thought to contain its ancestral range. We surveyed nucleotide variation at four 1-kb fragments in 240 individual lines representing 21 sub-Saharan and 4 Palearctic population samples of D. melanogaster. In agreement with recent studies, we find a small but significant level of geneti...

On the pace of fertility decline in sub-Saharan Africa

OpenAIRE

David Shapiro; Andrew Hinde

2017-01-01

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 ...

Key determinants of AIDS impact in Southern sub-Saharan Africa.

Science.gov (United States)

Shandera, Wayne Xavier

2007-11-01

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

Risk Factor or Social Vaccine? The Historical Progression of the Role of Education in HIV and AIDS Infection in Sub-Saharan Africa

Science.gov (United States)

Baker, David P.; Collins, John M.; Leon, Juan

2008-01-01

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…

Contraceptive Use and Uptake of HIV-Testing among Sub-Saharan African Women.

Directory of Open Access Journals (Sweden)

Katherine E Center

Full Text Available Despite improved availability of simple, relatively inexpensive, and highly effective antiretroviral treatment for HIV/AIDS, the disease remains a major public health challenge for women in sub-Saharan Africa (SSA. Given the numerous barriers in access to care for women in this region, every health issue that brings them into contact with the health system should be optimized as an opportunity to integrate HIV/AIDS prevention. Because most non-condom forms of modern contraception require a clinical appointment for use, contraception appointments could provide a confidential opportunity for access to HIV counseling, testing, and referral to care. This study sought to investigate the relationship between contraceptive methods and HIV testing among women in SSA. Data from the Demographic and Health Survey from four African countries-Congo, Mozambique, Nigeria, and Uganda-was used to examine whether modern (e.g., pills, condom or traditional (e.g., periodic abstinence, withdrawal forms of contraception were associated with uptake of HIV testing. Data for the current analyses were restricted to 35,748 women with complete information on the variables of interest. Chi-square tests and logistic regression models were used to assess the relationship between uptake of HIV testing and respondents' baseline characteristics and contraceptive methods. In the total sample and in Mozambique, women who used modern forms of contraception were more likely to be tested for HIV compared to those who did not use contraception. This positive association was not demonstrated in Congo, Nigeria, or Uganda. That many women who access modern contraception are not tested for HIV in high HIV burden areas highlights a missed opportunity to deliver an important intervention to promote maternal and child health. Given the increasing popularity of hormonal contraception methods in low-income countries, there is an urgent need to integrate HIV counseling, testing, and treatment

National Interests and Strategy: Sub-Saharan Africa

National Research Council Canada - National Science Library

Joel, Peter

1996-01-01

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...

HIV incidence in sub-Saharan Africa: a review of available data with implications for surveillance and prevention planning.

Science.gov (United States)

Braunstein, Sarah L; van de Wijgert, Janneke H H M; Nash, Denis

2009-01-01

HIV incidence estimation is increasingly being incorporated into HIV/AIDS surveillance activities in both resource-rich and developing countries. We conducted a systematic review to assess the availability of HIV incidence data from sub-Saharan Africa. We examined peer-reviewed articles, conference proceedings and technical reports published from 1987-2008. Incidence estimates were classified by country, year, population group, and estimation method (prospective study or the serologic testing algorithm for recent HIV seroconversion; STARHS). Our search yielded HIV incidence estimates for 15 of 44 sub-Saharan African countries, with 57 studies generating 264 unique estimates. Of these, 239 (91%) were obtained via prospective studies, and 25 (9%) via the STARHS method (24 using the BED-CEIA assay). Only five countries reported population-based estimates, and less than two-thirds of studies reported risk factor information. STARHS use increased over time, comprising 20% of estimates since 2006. However, studies that compared STARHS estimates with prospectively observed or modeled estimates often found substantial levels of disagreement, with STARHS often overestimating HIV incidence. Population-based HIV incidence estimates and risk factor information in sub-Saharan Africa remain scant but increasingly available. Regional STARHS data suggest a need for further validation prior to widespread use and incorporation into routine surveillance activities. In the meantime, prevalence and behavioral risk factor data remain important for HIV prevention planning.

Drivers of household food availability in sub-Saharan Africa based on big data from small farms

NARCIS (Netherlands)

Frelat, Romain; Lopez-Ridaura, Santiago; Giller, K.E.; Herrero, Mario; Douxchamps, Sabine; Djurfeldt, Agnes Andersson; Erenstein, Olaf; Henderson, Ben; Kassie, Menale; Paul, B.K.; Rigolot, Cyrille; Ritzema, Randall S.; Rodriguez, Daniel; Asten, Van P.J.A.; Wijk, Van M.T.

2016-01-01

We calculated a simple indicator of food availability using data from 93 sites in 17 countries across contrasted agroecologies in sub-Saharan Africa (>13,000 farm households) and analyzed the drivers of variations in food availability. Crop production was the major source of energy,

The HIV Epidemic in Sub-Saharan Africa is Aging: Evidence from the Demographic and Health Surveys in Sub-Saharan Africa.

Science.gov (United States)

Vollmer, Sebastian; Harttgen, Kenneth; Alfven, Tobias; Padayachy, Jude; Ghys, Peter; Bärnighausen, Till

2017-07-01

We use the individual-level data from all available Demographic and Health Surveys (DHS) from 27 sub-Saharan African countries conducted between 2003 and 2012 (40 population-based and nationally representative surveys in total) to calculate HIV testing consent rates and HIV prevalence for each country separately, as well as for the pooled sample. The pooled sample comprised of 427,130 individuals. In most countries HIV prevalence in adults aged 45 years and above is higher than in the total population. We further show that over the past decade HIV prevalence has increased in older age groups, while it has decreased in younger ones. While the age patterns of HIV consent rates vary across the 27 countries included in our sample, analysis of the pooled sample across all countries reveals a u-shaped relationship with lowest consent rates around age 35 years and higher consent rates among younger and older people. We argue that future DHS and other population-based HIV surveys should offer HIV testing to all adults without age limits.

External financial aid to blood transfusion services in sub-Saharan Africa

DEFF Research Database (Denmark)

Ala, Fereydoun; Allain, Jean-Pierre; Bates, Imelda

2012-01-01

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....

Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review.

Science.gov (United States)

Yakubu, Ibrahim; Salisu, Waliu Jawula

2018-01-27

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

Natural Resources, Oil and Economic Growth in Sub-Saharan Africa

OpenAIRE

Janda, Karel; Quarshie, Gregory

2017-01-01

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...

An analysis of the determinants of maternal mortality in sub-Saharan Africa.

Science.gov (United States)

Buor, Daniel; Bream, Kent

2004-10-01

To establish what population characteristics affect the high maternal mortality rate in the sub-Saharan Africa region and to propose possible solutions to reduce this rate. This study is a secondary analysis of existing data sources from the World Bank, the World Health Organization (WHO), as well as direct and indirect sources from UNAIDS, the United Nations, Demographic and Health Surveys (DHS), Macro International, and national statistical offices. Instead of looking at continentwide or individual nation models, it develops a regional model. Sociodemographic population variables are used as independent variables to predict the dependent variable, maternal mortality. Additionally, a new country-specific political stability independent variable is introduced into the model. Data from 28 sub-Saharan African countries are used. Bivariate correlations are used to establish associations among the variables, whereas cross-tabulations, using Kendall's tau-c values, and regression lines are used to establish impacts. In the sub-Saharan Africa region, births attended by skilled health personnel and life expectancy at birth strongly correlate with maternal mortality. Gross national product (GNP) per capita and health expenditure per capita also have strong association with maternal mortality. The availability of skilled delivery personnel, life expectancy, national economic wealth, and health expenditure per capita predict the maternal mortality rate of a country. Based on these findings, it is recommended that structural arrangements be made to train skilled health personnel to take care of maternal health problems. In view of the high cost of training physicians, middle-level health personnel may offer an affordable alternative to handle emergency obstetrical cases to address the shortage of physicians. In addition, the allocation of adequate resources to the health sector could improve maternal mortality. The economic wealth of a country and life expectancy at birth are

Sub-Saharan Africa and the Paperless Society.

Science.gov (United States)

Olden, Anthony

1987-01-01

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)

Plasmodium falciparum clearance in clinical studies of artesunate-amodiaquine and comparator treatments in sub-Saharan Africa, 1999–2009

Science.gov (United States)

2014-01-01

Background Artemisinin-based combination therapy (ACT) is the recommended first-line therapy for uncomplicated Plasmodium falciparum malaria worldwide but decreased artemisinin susceptibility, phenotypically characterized as slow parasite clearance time (PCT), has now been reported in Southeast Asia. This makes it all too important to measure the dynamics of parasite clearance in African patients treated with ACT over time, to understand trends and detect changes early enough to intervene Methods Individual patient data from 27 clinical trials of artesunate-amodiaquine (ASAQ) vs comparators conducted between 1999 and 2009 were analysed for parasite clearance on modified intent-to-treat (ITT) basis. Results Overall 15,017 patients treated for uncomplicated P. falciparum malaria at 44 sites in 20 sub-Saharan African countries were included in the analysis; 51% (n=7,660) vs 49% (n=7,357) were treated with ASAQ and comparator treatments, respectively. Seventy-seven per cent (77%) were children under six years of age. The proportion of the patients treated with ASAQ with persistent parasitaemia on Day 2 was 8.6%, and 1.5% on Day 3. Risk factor for not clearing parasites on Day 2 and Day 3 calculated by multivariate logistic regression with random effect on site and controlling for treatment were: high parasitaemia before treatment was (adjusted risk ratios (AOR) 2.12, 95% CI 1.91-2.35, AOR 2.43, 95% CI 1.98-3.00, respectively); non-ACT treatment (p=0.001, for all comparisons). Anaemia (p=0.001) was an additional factor for Day 2 and young age (p=0.005) for Day 3. In patients treated with ASAQ in studies who had complete parasitaemia data every 24 hours up to Day 3 and additionally Day 7, the parasite reduction ratio was 93.9% by Day 1 and 99.9% by Day 2. Using the median parasitaemia before treatment (p0=27,125 μL) and a fitted model, the predicted PCT (pPCT = 3.614*ln (p0) – 6.135, r² = 0.94) in ASAQ recipients was 31 hours. Conclusion Within the period covered by

Management of Sickle Cell Disease: A Review for Physician Education in Nigeria (Sub-Saharan Africa

Directory of Open Access Journals (Sweden)

Ademola Samson Adewoyin

2015-01-01

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.

A synthesis of the implementation ambivalence of REDD+ in Sub-Saharan Africa and Southeast Asia

Directory of Open Access Journals (Sweden)

Divine Odame Appiah

2018-04-01

Full Text Available Reducing emission from deforestation and forest degradation and associated benefits (REDD+, has received much attention as one of the most controversial climate change initiatives, especially by forest fringed community actors in sub-Saharan Africa (SSA and Southeast Asia, (SEA who are skeptical of the scheme.The object of this paper is to examine the seeming potential benefits and accompanying risks and challenges of REDD+ on the livelihoods among smallholder farmers in SSA and SEA. The paper espouses the sustainability context of REDD+ projects as pro-poor forest management mechanisms; through the provision of alternative livelihood. This is achieved through critical review and critique of scientific articles, project reports and relevant documents on REDD+ interventions from a worldwide, regional to local scale. The paper identifies projects that seem to solidify claims that REDD+ projects are simply a new form of colonialism; which the West is using to take advantage of vulnerable groups in the South. The paper concludes with the need to actively engage sub-Saharan African and Southeast Asian women in climate change mitigation benefit schemes on account of the expedient role women play in agricultural activities (which may involve deforestation and forest land degradation.

Epidemiology, causes, and treatment of epilepsy in sub-Saharan Africa.

Science.gov (United States)

Ba-Diop, Awa; Marin, Benoît; Druet-Cabanac, Michel; Ngoungou, Edgard B; Newton, Charles R; Preux, Pierre-Marie

2014-10-01

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.

Corporate Social Responsibility and Tax Avoidance in Sub-Saharan Africa - A Case Study of the Beverage Manufacturing Sector

OpenAIRE

Hansen, Rasmus Torpe

2015-01-01

To this date, the tax-CSR-nexus has mainly been analysed through regression studies examining the global-level data of major multinational corporations and is currently not well documented in specific developing countries and regions. Based on the CSR disclosure and annual reports for the Sub-Saharan African subsidiaries of three major beverage companies, I analyse the connection between the companies’ CSR initiatives on the one side and their tax avoidance behaviour on the other. Globally, I...

Association of Mass Media Communication with Contraceptive Use in Sub-Saharan Africa: A Meta-Analysis of Demographic and Health Surveys.

Science.gov (United States)

Babalola, Stella; Figueroa, Maria-Elena; Krenn, Susan

2017-11-01

Literature abounds with evidence on the effectiveness of individual mass media interventions on contraceptive use and other health behaviors. There have been, however, very few studies summarizing effect sizes of mass media health communication campaigns in sub-Saharan Africa. In this study, we used meta-analytic techniques to pool data from 47 demographic and health surveys conducted between 2005 and 2015 in 31 sub-Saharan African countries and estimate the prevalence of exposure to family planning-related mass media communication. We also estimated the average effect size of exposure to mass media communication after adjusting for endogeneity. We performed meta-regression to assess the moderating role of selected variables on effect size. On average, 44% of women in sub-Saharan Africa were exposed to family planning-related mass media interventions in the year preceding the survey. Overall, exposure was associated with an effect size equivalent to an odds ratio of 1.93. More recent surveys demonstrated smaller effect sizes than earlier ones, while the effects were larger in lower contraceptive prevalence settings than in higher prevalence ones. The findings have implications for designing communication programs, setting expectations about communication impact, and guiding decisions about sample size estimation for mass media evaluation studies.

people who inject drugs, HIV risk, and HIV testing uptake in sub-Saharan Africa.

Science.gov (United States)

Asher, Alice K; Hahn, Judith A; Couture, Marie-Claude; Maher, Kelsey; Page, Kimberly

2013-01-01

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.

Healthcare Programmes for Truck Drivers in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

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Lalla-Edward, Samanta Tresha; Fobosi, Siyabulela Christopher; Hankins, Catherine; Case, Kelsey; Venter, W D Francois; Gomez, Gabriela

2016-01-01

Truck drivers have unique health needs, and by virtue of their continuous travel, experience difficulty in accessing healthcare. Currently, planning for effective care is hindered by lack of knowledge about their health needs and about the impact of on-going programmes on this population's health outcomes. We reviewed healthcare programmes implemented for sub-Saharan African truck drivers, assessed the evaluation methods, and examined impact on health outcomes. We searched scientific and institutional databases, and online search engines to include all publications describing a healthcare programme in sub-Saharan Africa where the main clients were truck drivers. We consulted experts and organisations working with mobile populations to identify unpublished reports. Forest plots of impact and outcome indicators with unadjusted risk ratios and 95% confidence intervals were created to map the impact of these programmes. We performed a subgroup analysis by type of indicator using a random-effects model to assess between-study heterogeneity. We conducted a sensitivity analysis to examine both the summary effect estimate chosen (risk difference vs. risk ratio) and model to summarise results (fixed vs. random effects). Thirty-seven publications describing 22 healthcare programmes across 30 countries were included from 5,599 unique records. All programmes had an HIV-prevention focus with only three expanding their services to cover conditions other primary healthcare services. Twelve programmes were evaluated and most evaluations assessed changes in input, output, and outcome indicators. Absence of comparison groups, preventing attribution of the effect observed to the programme and lack of biologically confirmed outcomes were the main limitations. Four programmes estimated a quantitative change in HIV prevalence or reported STI incidence, with mixed results, and one provided anecdotal evidence of changes in AIDS-related mortality and social norms. Most programmes showed

An Examination of the Influence of Globalisation on Science Education in Anglophone Sub-Saharan Africa

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Koosimile, Anthony T.; Suping, Shanah M.

2015-09-01

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.

Family medicine training in sub-Saharan Africa: South-South cooperation in the Primafamed project as strategy for development.

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Flinkenflögel, Maaike; Essuman, Akye; Chege, Patrick; Ayankogbe, Olayinka; De Maeseneer, Jan

2014-08-01

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.

Family medicine training in sub-Saharan Africa: South–South cooperation in the Primafamed project as strategy for development

Science.gov (United States)

Flinkenflögel, Maaike; Essuman, Akye; Chege, Patrick; Ayankogbe, Olayinka; De Maeseneer, Jan

2014-01-01

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

Outcomes of acute kidney injury in children and adults in sub-Saharan Africa: a systematic review.

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Olowu, Wasiu A; Niang, Abdou; Osafo, Charlotte; Ashuntantang, Gloria; Arogundade, Fatiu A; Porter, John; Naicker, Saraladevi; Luyckx, Valerie A

2016-04-01

Access to diagnosis and dialysis for acute kidney injury can be life-saving, but can be prohibitively expensive in low-income settings. The burden of acute kidney injury in sub-Saharan Africa is presumably high but remains unknown. We did a systematic review to assess outcomes of acute kidney injury in sub-Saharan Africa and identify barriers to care. We searched PubMed, African Journals Online, WHO Global Health Library, and Web of Science for articles published between Jan 1, 1990, and Nov 30, 2014. We scored studies, and all were of medium-to-low quality. We made a pragmatic decision to include all studies to best reflect reality, and did a descriptive analysis of extracted data. This study is registered with PROSPERO, number CRD42015015690. We identified 3881 records, of which 41 met inclusion criteria, including 1403 adult patients and 1937 paediatric patients. Acute kidney injury in sub-Saharan Africa is severe, with 1042 (66%) of 1572 children and 178 (70%) 253 of adults needing dialysis in studies reporting dialysis need. Only 666 (64%) of 1042 children (across 11 studies) and 58 (33%) of 178 adults (across four studies) received dialysis when needed. Overall mortality was 34% in children and 32% in adults, but rose to 73% in children and 86% in adults when dialysis was needed but not received. Major barriers to access to care were out-of-pocket costs, erratic hospital resources, late presentation, and female sex. Patients in these studies are those with resources to access care. In view of overall study quality, data interpretation should be cautious, but high mortality and poor access to dialysis are concerning. The global scarcity of resources among patients and health centres highlights the need for a health-system-wide approach to prevention and management of acute kidney injury in sub-Saharan Africa. None. Copyright © 2016 Olowu et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

Challenges in malaria control in sub-Saharan Africa: the vaccine perspective

DEFF Research Database (Denmark)

Lusingu, John P A; Von Seidlein, Lorenz

2008-01-01

of these interventions. The emergence of resistance against drugs and insecticides requires in response a steady stream of new interventions. Up to the beginning of this millennium, most sub-Saharan African countries have been using chloroquine (CQ) as the first-line antimalarial drug, which had to be replaced...... malaria control measures have been applied such as environmental improvements, use of insecticide impregnated nets, residual indoor spraying, early case detection and treatment with effective antimalarial drugs. However, the adaptation of vector and parasite has so far limited the effect...... with sulphadoxine-pyrimethamine (SP) after resistant parasites had rendered CQ ineffective. Currently the first line treatment of malaria consists of combination therapy which includes an artemisinin derivative. The current approach appears robust but history has taught us to be alert and to expect resistance...

Improving social accountability processes in the health sector in sub-Saharan Africa: a systematic review.

Science.gov (United States)

Danhoundo, Georges; Nasiri, Khalidha; Wiktorowicz, Mary E

2018-04-13

Social accountability is a participatory process in which citizens are engaged to hold politicians, policy makers and public officials accountable for the services that they provide. In the Fifteenth Ordinary Session of the Assembly of the African Union, African leaders recognized the need for strong, decentralized health programs with linkages to civil society and private sector entities, full community participation in program design and implementation, and adaptive approaches to local political, socio-cultural and administrative environments. Despite the increasing use of social accountability, there is limited evidence on how it has been used in the health sector. The objective of this systematic review was to identify the conditions that facilitate effective social accountability in sub-Saharan Africa. Electronic databases (MEDLINE, PsycINFO, Sociological Abstracts, Social Sciences Abstracts) were searched for relevant articles published between 2000 and August 2017. Studies were eligible for inclusion if they were peer-reviewed English language publications describing a social accountability intervention in sub-Saharan Africa. Qualitative and quantitative study designs were eligible. Fourteen relevant studies were included in the review. The findings indicate that effective social accountability interventions involve leveraging partnerships and building coalitions; being context-appropriate; integrating data and information collection and analysis; clearly defined roles, standards, and responsibilities of leaders; and meaningful citizen engagement. Health system barriers, corruption, fear of reprisal, and limited funding appear to be major challenges to effective social accountability interventions. Although global accountability standards play an important guiding role, the successful implementation of global health initiatives depend on national contexts.

Applying stated-preference methods to improve health systems in sub-Saharan Africa: a systematic review.

Science.gov (United States)

Brown, Lauren; Lee, Ting-Hsuan; De Allegri, Manuela; Rao, Krishna; Bridges, John Fp

2017-10-01

Sub-Saharan African health systems must balance shifting disease burdens with desires for robust institutions. Stated-preference methods have been applied extensively to elicit health care workers' preferences and priorities for rural practice. This systematic review characterizes the range of their applications to African health systems problems. Areas covered: A PRISMA protocol was submitted to PROSPERO. Six databases were queried for peer-reviewed articles using quantitative stated-preference methods to evaluate a health systems-related trade-off. Quality was assessed using the PREFS checklist. Seventy-seven articles published between 1996 and 2017 met review criteria. Methods were primarily choice-based: discrete-choice experiments (n = 46), ranking/allocation techniques (n = 21), conjoint analyses (n = 7), and best-worst scaling (n = 3). Trade-offs fell into six 'building blocks': service features (n = 27), workforce incentives (n = 17), product features (n = 14), system priorities (n = 14), insurance features (n = 4), and research priorities (n = 1). Five countries dominated: South Africa (n = 11), Ghana (n = 9), Malawi (n = 9), Uganda (n = 9), and Tanzania (n = 8). Discrete-choice experiments were of highest quality (mean score: 3.36/5). Expert commentary: Stated-preference methods have been applied to many health systems contexts throughout sub-Saharan Africa. Studies examined established strategic areas, especially primary health care for women, prevention and treatment of infectious diseases, and workforce development. Studies have neglected the emerging areas of non-communicable diseases.

Labor productivity and employment gaps in Sub-Saharan Africa.

Science.gov (United States)

McCullough, Ellen B

2017-02-01

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.

HIV/AIDS National Strategic Plans of Sub-Saharan African countries: an analysis for gender equality and sex-disaggregated HIV targets.

Science.gov (United States)

Sherwood, Jennifer; Sharp, Alana; Cooper, Bergen; Roose-Snyder, Beirne; Blumenthal, Susan

2017-12-01

National Strategic Plans (NSPs) for HIV/AIDS are country planning documents that set priorities for programmes and services, including a set of targets to quantify progress toward national and international goals. The inclusion of sex-disaggregated targets and targets to combat gender inequality is important given the high disease burden among young women and adolescent girls in Sub-Saharan Africa, yet no comprehensive gender-focused analysis of NSP targets has been performed. This analysis quantitatively evaluates national HIV targets, included in NSPs from eighteen Sub-Saharan African countries, for sex-disaggregation. Additionally, NSP targets aimed at reducing gender-based inequality in health outcomes are compiled and inductively coded to report common themes. On average, in the eighteen countries included in this analysis, 31% of NSP targets include sex-disaggregation (range 0-92%). Three countries disaggregated a majority (>50%) of their targets by sex. Sex-disaggregation in data reporting was more common for targets related to the early phases of the HIV care continuum: 83% of countries included any sex-disaggregated targets for HIV prevention, 56% for testing and linkage to care, 22% for improving antiretroviral treatment coverage, and 11% for retention in treatment. The most common target to reduce gender inequality was to prevent gender-based violence (present in 50% of countries). Other commonly incorporated target areas related to improving women's access to family planning, human and legal rights, and decision-making power. The inclusion of sex-disaggregated targets in national planning is vital to ensure that programmes make progress for all population groups. Improving the availability and quality of indicators to measure gender inequality, as well as evaluating programme outcomes by sex, is critical to tracking this progress. This analysis reveals an urgent need to set specific and separate targets for men and women in order to achieve an equitable

HIV/AIDS National Strategic Plans of Sub-Saharan African countries: an analysis for gender equality and sex-disaggregated HIV targets

Science.gov (United States)

Sherwood, Jennifer; Sharp, Alana; Cooper, Bergen; Roose-Snyder, Beirne; Blumenthal, Susan

2017-01-01

Abstract National Strategic Plans (NSPs) for HIV/AIDS are country planning documents that set priorities for programmes and services, including a set of targets to quantify progress toward national and international goals. The inclusion of sex-disaggregated targets and targets to combat gender inequality is important given the high disease burden among young women and adolescent girls in Sub-Saharan Africa, yet no comprehensive gender-focused analysis of NSP targets has been performed. This analysis quantitatively evaluates national HIV targets, included in NSPs from eighteen Sub-Saharan African countries, for sex-disaggregation. Additionally, NSP targets aimed at reducing gender-based inequality in health outcomes are compiled and inductively coded to report common themes. On average, in the eighteen countries included in this analysis, 31% of NSP targets include sex-disaggregation (range 0–92%). Three countries disaggregated a majority (>50%) of their targets by sex. Sex-disaggregation in data reporting was more common for targets related to the early phases of the HIV care continuum: 83% of countries included any sex-disaggregated targets for HIV prevention, 56% for testing and linkage to care, 22% for improving antiretroviral treatment coverage, and 11% for retention in treatment. The most common target to reduce gender inequality was to prevent gender-based violence (present in 50% of countries). Other commonly incorporated target areas related to improving women’s access to family planning, human and legal rights, and decision-making power. The inclusion of sex-disaggregated targets in national planning is vital to ensure that programmes make progress for all population groups. Improving the availability and quality of indicators to measure gender inequality, as well as evaluating programme outcomes by sex, is critical to tracking this progress. This analysis reveals an urgent need to set specific and separate targets for men and women in order to achieve

The European Union and sub-Saharan Africa

DEFF Research Database (Denmark)

Kluth, Michael Friederich

2013-01-01

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...

Echinococcosis in sub-Saharan Africa: emerging complexity

NARCIS (Netherlands)

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.

2011-01-01

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.

The role of corruption and unethical behaviour in precluding the placement of industry sponsored clinical trials in sub-Saharan Africa: Stakeholder views.

Science.gov (United States)

Egharevba, Efe; Atkinson, Jacqueline

2016-08-15

Clinical trials still represent the gold standard in testing the safety and efficacy of new and existing treatments. However, developing regions including sub-Saharan Africa remain underrepresented in pharmaceutical industry sponsored trials for a number of reasons including fear of corruption and unethical behaviour. This fear exists both on the part of pharmaceutical companies, and investigators carrying out research in the region. The objective of this research was to understand the ethical considerations associated with the conduct of pharmaceutical industry sponsored clinical trials in sub-Saharan Africa. Corruption was identified as a significant issue by a number of stakeholders who participated in semi-structured interviews and completed questionnaires. Additionally, fear of being perceived as corrupt or unethical even when conducting ethically sound research was raised as a concern. Thus corruption, whether actual or perceived, is one of a number of issues which have precluded the placement of a greater number of pharmaceutical sponsored clinical trials in this region. More discussion around corruption with all relevant stakeholders is required in order for progress to be made and to enable greater involvement of sub-Saharan African countries in the conduct of industry sponsored clinical trials.

Returns to food and agricultural R&D investments in Sub-Saharan Africa, 1975-2014.

Science.gov (United States)

Pardey, Philip G; Andrade, Robert S; Hurley, Terrance M; Rao, Xudong; Liebenberg, Frikkie G

2016-12-01

Research-enabled growth in agricultural productivity is pivotal to sub-Saharan Africa's overall economic growth prospects. Yet, investments in research and development (R&D) targeted to many national food and agricultural economies throughout Africa are fragile and faltering. To gain insight into what could be driving this trend, this article updates, summarizes and reassesses the published evidence on the returns to African agricultural R&D. Based on a compilation of 113 studies published between 1975 and 2014 spanning 25 countries, the reported internal rates of return ( IRRs ) to food and agricultural research conducted in or of direct consequence for sub-Saharan Africa averaged 42.3%py. In addition to the 376 IRR estimates, the corresponding 129 benefit-cost ratios ( BCRs ) averaged 30.1. Most (96.5%) of the returns-to-research evaluations are of publicly performed R&D, and the majority (87.6%) of the studies were published in the period 1990-2009. The large dispersion in the reported IRRs and BCRs makes it difficult to discern meaningful patterns in the evidence. Moreover, the distribution of IRRs is heavily (positively) skewed, such that the median value (35.0%py) is well below the mean, like it is for research done elsewhere in the world (mean 62.4%py; median 38.0%py). Around 78.5% of the evaluations relate to the commodity-specific consequences of agricultural research, while 5.5% report on the returns to an "all agriculture" aggregate. The weight of commodity-specific evaluation evidence is not especially congruent with the composition of agricultural production throughout Africa, nor, to the best that can be determined, the commodity orientation of public African agricultural R&D.

Impact of ART on the fertility of HIV-positive women in sub-Saharan Africa.

Science.gov (United States)

Yeatman, Sara; Eaton, Jeffrey W; Beckles, Zosia; Benton, Lorna; Gregson, Simon; Zaba, Basia

2016-09-01

Understanding the fertility of HIV-positive women is critical to estimating HIV epidemic trends from surveillance data and to planning resource needs and coverage of prevention of mother-to-child transmission services in sub-Saharan Africa. In the light of the considerable scale-up in antiretroviral therapy (ART) coverage over the last decade, we conducted a systematic review of the impact of ART on the fertility outcomes of HIV-positive women. We searched Medline, Embase, Popline, PubMed and African Index Medicus. Studies were included if they were conducted in sub-Saharan Africa and provided estimates of fertility outcomes (live births or pregnancies) among women on ART relative to a comparison group. Of 2070 unique references, 18 published papers met all eligibility criteria. Comparisons fell into four categories: fertility of HIV-positive women relative to HIV-negative women; fertility of HIV-positive women on ART compared to those not yet on ART; fertility differences by duration on ART; and temporal trends in fertility among HIV-positive women. Evidence indicates that fertility increases after approximately the first year on ART and that while the fertility deficit of HIV-positive women is shrinking, their fertility remains below that of HIV-negative women. These findings, however, were based on limited data mostly during the period 2005-2010 when ART scaled up. Existing data are insufficient to characterise how ART has affected the fertility of HIV-positive women in sub-Saharan Africa. Improving evidence about fertility among women on ART is an urgent priority for planning HIV resource needs and understanding HIV epidemic trends. Alternative data sources such as antenatal clinic data, general population cohorts and population-based surveys can be harnessed to understand the issue. © 2016 John Wiley & Sons Ltd.

Epidemiology and treatment of relative anemia in children with sickle cell disease in sub-Saharan Africa.

Science.gov (United States)

Bello-Manga, Halima; DeBaun, Michael R; Kassim, Adetola A

2016-11-01

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.

Patterns of biomedical science production in a sub-Saharan research center

Directory of Open Access Journals (Sweden)

Agnandji Selidji T

2012-03-01

Full Text Available Abstract Background Research activities in sub-Saharan Africa may be limited to delegated tasks due to the strong control from Western collaborators, which could lead to scientific production of little value in terms of its impact on social and economic innovation in less developed areas. However, the current contexts of international biomedical research including the development of public-private partnerships and research institutions in Africa suggest that scientific activities are growing in sub-Saharan Africa. This study aims to describe the patterns of clinical research activities at a sub-Saharan biomedical research center. Methods In-depth interviews were conducted with a core group of researchers at the Medical Research Unit of the Albert Schweitzer Hospital from June 2009 to February 2010 in Lambaréné, Gabon. Scientific activities running at the MRU as well as the implementation of ethical and regulatory standards were covered by the interview sessions. Results The framework of clinical research includes transnational studies and research initiated locally. In transnational collaborations, a sub-Saharan research institution may be limited to producing confirmatory and late-stage data with little impact on economic and social innovation. However, ethical and regulatory guidelines are being implemented taking into consideration the local contexts. Similarly, the scientific content of studies designed by researchers at the MRU, if local needs are taken into account, may potentially contribute to a scientific production with long-term value on social and economic innovation in sub-Saharan Africa. Conclusion Further research questions and methods in social sciences should comprehensively address the construction of scientific content with the social, economic and cultural contexts surrounding research activities.

Health disparities in liver disease in sub-Saharan Africa.

Science.gov (United States)

Spearman, C Wendy; Sonderup, Mark W

2015-09-01

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.

Cherubism in sub-Saharan Africa: a first case-report in a child

Directory of Open Access Journals (Sweden)

Michel Ntetani Aloni

2015-02-01

Full Text Available Cherubism is rare disease and has been rarely reported in African pediatric population. We report here the case of a 10-year-old child who was referred to our hospital for bilateral jaws swelling. Physical examination revealed bilateral swelling symmetry of the face. Histopathological examination of the biopsy specimen showed loose fibrous stroma, proliferating fibrous connective with tissue interspersed with multinucleated giant cells, small thin walled blood vessels and scattered sparse mononuclear inflammatory infiltrate. Our patient presented cherubism. Cherubism is rarely described in children living in sub-Saharan Africa. Genetic and molecular investigations plays an important role in diagnosis but were not available in poor resources settings in developing countries such as the Democratic Republic of Congo.

Increasing sustainable cataract services in sub-Saharan Africa: an experimental initiative

Directory of Open Access Journals (Sweden)

Sasipriya M Karumanchi

2015-04-01

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.

Management of split skin graft donor site in the West African sub region: survey of plastic surgeons' practice.

Science.gov (United States)

Olawoye, O A; Ademola, S A; Iyun, A O; Michael, A I; Oluwatosin, O M

2017-06-30

Split skin graft (SSG) is one of the most commonly performed operations on any Plastic Surgery service. Rate of donor site healing is affected by various factors including the type of dressing applied. The aim of this study was to survey the practice of plastic surgeons in the sub region with respect to management of SSG donor site and see how it conforms to international standards. Structured questionnaires on various aspects of the harvest and management of SSG donor sites were administered to plastic surgeons during the 53rd annual conference of the West African College of Surgeons (WACS) at Lome, Togo in March 2013. The data were analyzed using descriptive statistics. There were 47 respondents out of 55 plastic surgeons from four West African countries, which represented 85.4% of registered participants at the plastic surgery section of the conference. All the respondents performed SSG regularly, and the thigh was the most commonly used donor site. Different types of paraffin gauze remained the most commonly used primary donor site dressing. Only 17% of the respondents apply a topical local anaesthetic agent on the donor site. The choice of SSG donor site dressing in the sub region was driven mainly by availability. Concerted efforts must be made to access newer wound care products for optimum management of this commonly performed operation.

Wind Resource Variations Over Selected Sites in the West African Sub-Region

International Nuclear Information System (INIS)

Iheonu, E. E.; Akingbade, F.O A.; Ocholi, M.

2002-01-01

The analysis of wind characteristics and wind resource potentials at 4 locations in the West African sub-region is presented, applying data obtained at the Ibadan central station of the International Institute of Tropical Agriculture (IITA-Ibadan, Nigeria). The study has shown that the annual variations of wind speed have coefficient of variability between 10 and 15% but the available wind power at the studied locations is generally poor with values ranging between 2 and 10 Wm2 at the standard meteorological height of 10 m. Cotonou (Lat. 6.4 0 N, Long. 2.3 0 E) Benin Republic has however been distinguished from the other three locations in Nigeria, as the most promising site for wind resource development and utilization in the sub-region. With appropriate choice of wind turbine characteristics and design efficiency, establishing wind farms at the Cotonou location for electrical energy production could be feasible

Inequality of child mortality among ethnic groups in sub-Saharan Africa.

Science.gov (United States)

Brockerhoff, M; Hewett, P

2000-01-01

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

The urgent need for health impact assessment: proposing a transdisciplinary approach to the e-waste crisis in sub-Saharan Africa.

Science.gov (United States)

Tetteh, Dinah; Lengel, Lara

2017-06-01

Electronic waste (e-waste) is a growing health and environmental concern in developing countries. In the sub-Saharan African region e-waste is considered a crisis with no end in sight yet; there is lack of structures and regulations to manage the problem. In this article, we discuss the potential of Health Impact Assessment (HIA) in addressing the health, environmental, and social impacts of e-waste in sub-Saharan Africa. We draw from environmental policy, environmental communication, global health policy, and health communication to argue that managing e-waste could be framed as ongoing HIA where all the steps of HIA are performed on a rolling basis with input from local communities. Further, we suggest that HIA should be infused into recycling legislation to help streamline the practice in order to make it safe for health and the environment and to maximize the economic benefits.

When will sub-Saharan Africa adopt HIV treatment for all?

Science.gov (United States)

Gupta, Somya; Granich, Reuben

2016-01-01

The World Health Organization (WHO) HIV treatment guidelines have been used by various countries to revise their national guidelines. Our study discusses the national policy response to the HIV epidemic in sub-Saharan Africa and quantifies delays in adopting the WHO guidelines published in 2009, 2013 and 2015. From the Internet, health authorities and experts, and community members, we collected 59 published HIV guidelines from 33 countries in the sub-Saharan African region, and abstracted dates of publication and antiretroviral therapy (ART) eligibility criteria. For these 33 countries, representing 97% regional HIV burden in 2015, the number of months taken to adopt the WHO 2009, 2013 and/or 2015 guidelines were calculated to determine the average delay in months needed to publish revised national guidelines. Of the 33 countries, 3 (6% regional burden) are recommending ART according to the WHO 2015 guidelines (irrespective of CD4 count); 19 (65% regional burden) are recommending ART according to the WHO 2013 guidelines (CD4 count ≤ 500 cells/mm 3 ); and 11 (26% regional burden) according to the WHO 2009 guidelines (CD4 count ≤ 350 cells/mm 3 ). The average time lag to WHO 2009 guidelines adoption in 33 countries was 24 (range 3-56) months. The 22 that have adopted the WHO 2013 guidelines took an average of 10 (range 0-36) months, whilst the three countries that adopted the WHO 2015 guidelines took an average of 8 (range 7-9) months. There is an urgent need to shorten the time lag in adopting and implementing the new WHO guidelines recommending 'treatment for all' to achieve the 90-90-90 targets.

Climate change impacts in Sub-Saharan Africa

NARCIS (Netherlands)

Serdeczny, Olivia; Adams, Sophie; Baarsch, Florent; Coumou, Dim; Robinson, Alexander; Hare, William; Schaeffer, Michiel; Perrette, Mahé; Reinhardt, Julia

2017-01-01

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

Export and Innovation in Sub-Saharan Africa

NARCIS (Netherlands)

Barasa, L.; Kinyanjui, B.; Knoben, Joris; Kimuyu, P.; Vermeulen, P.A.M.

2016-01-01

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

Assessing and forecasting groundwater development costs in Sub ...

African Journals Online (AJOL)

Greater use of groundwater in Sub-Saharan Africa is a pre-requisite for improved human welfare; however, the costs associated with groundwater development are prohibitively high and poorly defined. This study identifies and disaggregates the costs of groundwater development in 11 Sub-Saharan African countries, while ...

[A meta-synthesis on gender, disability and reproductive health in sub-Saharan Africa].

Science.gov (United States)

Mac-Seing, Muriel; Zarowsky, Christina

2017-01-01

Reproductive health remains a major global health issue. People with disabilities face additional discrimination and barriers to access which need to be better understood. To contribute to future interventions, we examined the intersections between gender and disability related to reproductive health in sub-Saharan Africa in the qualitative literature. We conducted a meta-synthesis, using a taxonomic analysis. An inductive and iterative approach was adopted to allow exploration of new and emergent semantic variations in themes. NVivo 11 Plus was used to code themes. Ten qualitative studies from six sub-Saharan African countries were analysed. Two main thematic areas emerged from the analysis: 1) gendered roles of people with disabilities are programmed by sociocultural normativity, including perceptions about sexuality. They are exacerbated by the hegemony of ableism and influenced by the type of reproductive health issues experienced by people with disabilities; and 2) experiences of disability in interaction with a reproductive health issue are exacerbated by the type of disability, influenced by the type of barriers to access, and perceived differently depending upon the actors involved. The intersections between gender and disability embodied by people with disabilities are multiple and complex. Not only do imposed gendered roles influence the lives of people with disabilities, but their experiences of disability are also intricately linked to gender. An intersectional analysis is proposed as a useful support to developing future perspectives.

Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries.

Science.gov (United States)

Monden, Christiaan W S; Smits, Jeroen

2017-07-01

Sub-Saharan Africa has the world's highest under-5 and neonatal mortality rates as well as the highest naturally occurring twin rates. Twin pregnancies carry high risk for children and mothers. Under-5 mortality has declined in sub-Saharan Africa over the last decades. It is unknown whether twins have shared in this reduction. We pooled data from 90 Demographic and Health Surveys for 30 sub-Saharan Africa countries on births reported between 1995 and 2014. We used information on 1 685 110 singleton and 56 597 twin livebirths to compute trends in mortality rates for singletons and twins. We examined whether the twin-singleton rate ratio can be attributed to biological, socioeconomic, care-related factors, or birth size, and estimated the mortality burden among sub-Saharan African twins. Under-5 mortality among twins has declined from 327·7 (95% CI 312·0-343·5) per 1000 livebirths in 1995-2001 to 213·0 (196·7-229·2) in 2009-14. This decline of 35·0% was much less steep than the 50·6% reduction among singletons (from 128·6 [95% CI 126·4-130·8] per 1000 livebirths in 1995-2001 to 63·5 [61·6-65·3] in 2009-14). Twins account for an increasing share of under-5 deaths in sub-Saharan Africa: currently 10·7% of under-5 mortality and 15·1% of neonatal mortality. We estimated that about 315 000 twins (uncertainty interval 289 000-343 000) die in sub-Saharan African each year. Excess twin mortality cannot be explained by common risk factors for under-5 mortality, including birthweight. The difference with singletons was especially stark for neonatal mortality (rate ratio 5·0, 95% CI 4·5-5·6). 51·7% of women pregnant with twins reported receiving medical assistance at birth. The fate of twins in sub-Saharan Africa is lagging behind that of singletons. An alarming one-fifth of twins in the region dies before age 5 years, three times the mortality rate among singletons. Twins account for a substantial and growing share of under-5 and neonatal

Traditional herbal medicine use among hypertensive patients in sub-Saharan Africa: a systematic review.

Science.gov (United States)

Liwa, Anthony C; Smart, Luke R; Frumkin, Amara; Epstein, Helen-Ann B; Fitzgerald, Daniel W; Peck, Robert N

2014-06-01

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.

The population crisis in sub-Saharan Africa.

Science.gov (United States)

Meerman, J; Cochrane, S H

1982-01-01

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.

An Overview of Sub-Saharan Africa Today.

Science.gov (United States)

Brook, Diane L.

1997-01-01

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)

End of life care in sub-Saharan Africa: a systematic review of the qualitative literature

Directory of Open Access Journals (Sweden)

Pool Robert

2011-03-01

Full Text Available Abstract Background End of life (EoL care in sub-Saharan Africa still lacks the sound evidence-base needed for the development of effective, appropriate service provision. It is essential to make evidence from all types of research available alongside clinical and health service data, to ensure that EoL care is ethical and culturally appropriate. This article aims to synthesize qualitative research on EoL care in sub-Saharan Africa to inform policy, practice and further research. It seeks to identify areas of existing research; describe findings specifically relevant to the African context; and, identify areas lacking evidence. Methods Relevant literature was identified through eight electronic databases: AMED, British Nursing Index & Archive, CINAHL, EMBASE, IBSS, MEDLINE, PsycINFO, and the Social Sciences Citation Index; and hand searches. Inclusion criteria were: published qualitative or mixed-method studies in sub-Saharan Africa, about EoL care. Study quality was assessed using a standard grading scale. Relevant data including findings and practice recommendations were extracted and compared in tabular format. Results Of the 407 articles initially identified, 51 were included in the qualitative synthesis. Nineteen came from South Africa and the majority (38 focused on HIV/AIDS. Nine dealt with multiple or unspecified conditions and four were about cancer. Study respondents included health professionals, informal carers, patients, community members and bereaved relatives. Informal carers were typically women, the elderly and children, providing total care in the home, and lacking support from professionals or the extended family. Twenty studies focused on home-based care, describing how programmes function in practice and what is needed to make them effective. Patients and carers were reported to prefer institutional care but this needs to be understood in context. Studies focusing on culture discussed good and bad death, culture

Context Matters – Rethinking the Resource Curse in Sub-Saharan Africa

OpenAIRE

Matthias Basedau

2005-01-01

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 ...

Constraints to Agricultural Mechanization in Sub-Saharan Africa

African Journals Online (AJOL)

Adeyinka Odunsi

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.

Comparative Sustainable Development in Sub-Saharan Africa

OpenAIRE

Asongu, Simplice

2017-01-01

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...

Hepatitis C in sub-Saharan Africa: the current status and recommendations for achieving elimination by 2030.

Science.gov (United States)

Sonderup, Mark W; Afihene, Mary; Ally, Reidwaan; Apica, Betty; Awuku, Yaw; Cunha, Lina; Dusheiko, Geoffrey; Gogela, Neliswa; Lohouès-Kouacou, Marie-Jeanne; Lam, Phillip; Lesi, Olufunmilayo; Mbaye, Papa Saliou; Musabeyezu, Emmanuel; Musau, Betty; Ojo, Olesegun; Rwegasha, John; Scholz, Barbara; Shewaye, Abate B; Tzeuton, Christian; Kassianides, Chris; Spearman, C Wendy

2017-12-01

In 2016, WHO adopted a strategy for the elimination of viral hepatitis by 2030. Africa, and more specifically, sub-Saharan Africa, carries a substantial portion of the global burden of viral hepatitis, especially chronic hepatitis B and hepatitis C virus infections. The task that lies ahead for sub-Saharan Africa to achieve elimination is substantial, but not insurmountable. Major developments in the management of hepatitis C have put elimination within reach, but several difficulties will need to be navigated on the path to elimination. Many of the challenges faced are unique to sub-Saharan Africa and the development of strategies is complicated by a scarcity of good data from countries and regions within sub-Saharan Africa. However, this hindrance should not act as a barrier to delay interventions in screening, detection, and linkage to care. Moreover, by sharing experiences from across sub-Saharan Africa, countries can create supranational synergies to develop their programmes and work together in a more cohesive manner to tackle the burden of hepatitis C in sub-Saharan Africa. In this Series paper, several issues related to hepatitis C in sub-Saharan Africa are addressed, including prevalence, risk factors, and fibrosis assessment, and recommendations are given by experts from across the region. Simplified diagnostic algorithms and treatment regimens for both HIV co-infected and hepatitis C mono-infected patients are suggested. The recommendations are consensus based and provided to guide the development of programmes in sub-Saharan Africa. Political will and appropriate funding will be required to provide impetus to implement these recommendations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Generating evidence to narrow the treatment gap for mental disorders in sub-Saharan Africa: rationale, overview and methods of AFFIRM.

Science.gov (United States)

Lund, C; Alem, A; Schneider, M; Hanlon, C; Ahrens, J; Bandawe, C; Bass, J; Bhana, A; Burns, J; Chibanda, D; Cowan, F; Davies, T; Dewey, M; Fekadu, A; Freeman, M; Honikman, S; Joska, J; Kagee, A; Mayston, R; Medhin, G; Musisi, S; Myer, L; Ntulo, T; Nyatsanza, M; Ofori-Atta, A; Petersen, I; Phakathi, S; Prince, M; Shibre, T; Stein, D J; Swartz, L; Thornicroft, G; Tomlinson, M; Wissow, L; Susser, E

2015-06-01

America, sub-Saharan Africa and south Asia, by designing and executing shared research projects related to task-sharing and narrowing the treatment gap. Finally, it is establishing a network of collaboration between researchers, non-governmental organisations and government agencies that facilitates the translation of research knowledge into policy and practice. This article describes the developmental process of this multi-site approach, and provides a narrative of challenges and opportunities that have arisen during the early phases. Crucial to the long-term sustainability of this work is the nurturing and sustaining of partnerships between African mental health researchers, policy makers, practitioners and international collaborators.

Development and poverty in sub-Saharan Africa

DEFF Research Database (Denmark)

Addison, Tony; Pikkarainen, Ville; Rönkkö, Risto

2017-01-01

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...

Religion and politics in sub-Saharan Africa

NARCIS (Netherlands)

Ellis, S.D.K.; Haar, Gerrie ter

1998-01-01

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

Human papillomavirus prevalence among men in sub-Saharan Africa

DEFF Research Database (Denmark)

Olesen, Tina Bech; Munk, Christian; Christensen, Jane

2014-01-01

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...

Hospital management practices and availability of surgery in sub-Saharan Africa: a pilot study of three hospitals.

Science.gov (United States)

Funk, Luke M; Conley, Dante M; Berry, William R; Gawande, Atul A

2013-11-01

Sub-Saharan Africa has a high surgical burden of disease but performs a disproportionately low volume of surgery. Closing this surgical gap will require increased surgical productivity of existing systems. We examined specific hospital management practices in three sub-Saharan African hospitals that are associated with surgical productivity and quality. We conducted 54 face-to-face, structured interviews with administrators, clinicians, and technicians at a teaching hospital, district hospital, and religious mission hospital across two countries in sub-Saharan Africa. Questions focused on recommended general management practices within five domains: goal setting, operations management, talent management, quality monitoring, and financial oversight. Records from each interview were analyzed in a qualitative fashion. Each hospital's management practices were scored according to the degree of implementation of the management practices (1 = none; 3 = some; 5 = systematic). The mission hospital had the highest number of employees per 100 beds (226), surgeons per operating room (3), and annual number of operations per operating room (1,800). None of the three hospitals had achieved systematic implementation of management practices in all 14 measures. The mission hospital had the highest total management score (44/70 points; average = 3.1 for each of the 14 measures). The teaching and district hospitals had statistically significantly lower management scores (average 1.3 and 1.1, respectively; p management practices in low resource settings. We observed substantial variation in implementation of basic management practices at the three hospitals. Future research should focus on whether enhancing management practices can improve surgical capacity and outcomes.

Effect of transmission intensity on hotspots and micro-epidemiology of malaria in sub-Saharan Africa.

Science.gov (United States)

Mogeni, Polycarp; Omedo, Irene; Nyundo, Christopher; Kamau, Alice; Noor, Abdisalan; Bejon, Philip

2017-06-30

Malaria transmission intensity is heterogeneous, complicating the implementation of malaria control interventions. We provide a description of the spatial micro-epidemiology of symptomatic malaria and asymptomatic parasitaemia in multiple sites. We assembled data from 19 studies conducted between 1996 and 2015 in seven countries of sub-Saharan Africa with homestead-level geospatial data. Data from each site were used to quantify spatial autocorrelation and examine the temporal stability of hotspots. Parameters from these analyses were examined to identify trends over varying transmission intensity. Significant hotspots of malaria transmission were observed in most years and sites. The risk ratios of malaria within hotspots were highest at low malaria positive fractions (MPFs) and decreased with increasing MPF (p hotspots was lowest at extremely low and extremely high MPFs, with a peak in statistical significance at an MPF of ~0.3. In four sites with longitudinal data we noted temporal instability and variable negative correlations between MPF and average age of symptomatic malaria across all sites, suggesting varying degrees of temporal stability. We observed geographical micro-variation in malaria transmission at sites with a variety of transmission intensities across sub-Saharan Africa. Hotspots are marked at lower transmission intensity, but it becomes difficult to show statistical significance when cases are sparse at very low transmission intensity. Given the predictability with which hotspots occur as transmission intensity falls, malaria control programmes should have a low threshold for responding to apparent clustering of cases.

Emergence and control of epidemic meningococcal meningitis in sub-Saharan Africa.

Science.gov (United States)

Mohammed, Idris; Iliyasu, Garba; Habib, Abdulrazaq Garba

2017-02-01

For more than a century, meningitis epidemics have regularly recurred across sub-Saharan Africa, involving 19 contiguous countries that constitute a 'meningitis belt' where historically the causative agent has been serogroup A meningococcus. Attempts to control epidemic meningococcal meningitis in Africa by vaccination with meningococcal polysaccharide (PS) vaccines have not been successful. This is largely because PS vaccines are poorly immunogenic in young children, do not induce immunological memory, and have little or no effect on the pharyngeal carriage. Meningococcal PS-protein conjugate vaccines overcome these deficiencies. Conjugate meningococcal vaccine against serotype A (MenAfriVac) was developed between 2001 and 2009 and deployed in 2010. So far, 262 million individuals have been immunized across the meningitis belt. The public health benefits of MenAfriVac have already been demonstrated by a sharp decline in reported cases of meningococcal disease in the countries where it has been introduced. However, serogroup replacement following mass meningitis vaccination has been noted, and in 2015 an epidemic with a novel strain of serogroup C was recorded in Niger and Nigeria for the first time since 1975. This has posed a serious challenge toward elimination of meningococcal meningitis epidemics in the African. For an effective control of meningococcal meningitis in the African meningitis belt, there is a need for an effective surveillance system, provision of rapid antigen detection kits as well as affordable vaccine that provides protection against the main serogroups causing meningitis in the sub-region.

Adult mortality in sub-saharan Africa, Zambia: Where do adults die?

OpenAIRE

Chisumpa, Vesper H.; Odimegwu, Clifford O.; De Wet, Nicole

2017-01-01

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...

78 FR 59917 - Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary Sub...

Science.gov (United States)

2013-09-30

... of Apparel Articles Assembled in Beneficiary Sub-Saharan African Countries From Regional and Third... 6002 of the Tax Relief and Health Care Act of 2006 (TRHCA 2006), Public Law 109-432, and section 1... apparel articles wholly assembled in one or more beneficiary sub-Saharan African countries from fabric...

Long-term effects of HIV treatment in sub-Saharan Africa: from access to quality

NARCIS (Netherlands)

Boender, T.S.

2016-01-01

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

Spirituality/Religiosity: A Cultural and Psychological Resource among Sub-Saharan African Migrant Women with HIV/AIDS in Belgium.

Directory of Open Access Journals (Sweden)

Agnes Ebotabe Arrey

Full Text Available Spirituality/religion serves important roles in coping, survival and maintaining overall wellbeing within African cultures and communities, especially when diagnosed with a chronic disease like HIV/AIDS that can have a profound effect on physical and mental health. However, spirituality/religion can be problematic to some patients and cause caregiving difficulties. The objective of this paper was to examine the role of spirituality/religion as a source of strength, resilience and wellbeing among sub-Saharan African (SSA migrant women with HIV/AIDS. A qualitative study of SSA migrant women was conducted between April 2013 and December 2014. Participants were recruited through purposive sampling and snowball techniques from AIDS Reference Centres and AIDS workshops in Belgium, if they were 18 years and older, French or English speaking, and diagnosed HIV positive more than 3 months beforehand. We conducted semi-structured interviews with patients and did observations during consultations and support groups attendances. Thematic analysis was used to analyse the data. 44 women were interviewed, of whom 42 were Christians and 2 Muslims. None reported religious/spiritual alienation, though at some point in time many had felt the need to question their relationship with God by asking "why me?" A majority reported being more spiritual/religious since being diagnosed HIV positive. Participants believed that prayer, meditation, regular church services and religious activities were the main spiritual/religious resources for achieving connectedness with God. They strongly believed in the power of God in their HIV/AIDS treatment and wellbeing. Spiritual/religious resources including prayer, meditation, church services, religious activities and believing in the power of God helped them cope with HIV/AIDS. These findings highlight the importance of spirituality in physical and mental health and wellbeing among SSA women with HIV/AIDS that should be taken into

Pilot Survey of Breast Cancer Management in Sub-Saharan Africa

Directory of Open Access Journals (Sweden)

Verna D.N.K. Vanderpuye

2017-06-01

Full Text Available Purpose: To understand the current state of breast cancer management in sub-Saharan Africa. Methods: We conducted an anonymous online survey of breast cancer management among African Organization for Research and Treatment in Cancer (AORTIC members by using a 42-question structured questionnaire in both English and French in 2013. Results: Twenty members from 19 facilities in 14 countries responded to the survey. Twelve members (60% belonged to a multidisciplinary breast cancer team. Radiotherapy equipment was available in seven facilities (36%, but equipment had down time at least once a week in four facilities. Available chemotherapy drugs included methotrexate, cyclophosphamide, fluorouracil, anthracyclines, and vincristine, whereas trastuzumab, taxanes, vinorelbine, and gemcitabine were available in few facilities. Core-needle biopsy was available in 16 facilities (84%; mammogram, in 17 facilities (89%; computed tomography scan, in 15 facilities (79%; magnetic resonance imaging, in 11 facilities (58%; and bone scans, in nine facilities (47%. It took an average of 1 to 3 weeks to report histopathology. Immunohistochemistry was available locally in eight facilities (42%, outside hospitals but within the country in seven facilities (37%, and outside the country in four facilities (21%. Thirteen facilities (68% performed axillary node dissections as part of a breast protocol. Neoadjuvant chemotherapy was the most common therapy for locally advanced breast cancer in 13 facilities (68%. In three facilities (16%, receptor status did not influence the prescription of hormone treatment. Conclusion: This pilot survey suggests that AORTIC members in sub-Saharan Africa continue to make gains in the provision of access to multidisciplinary breast cancer care, but the lack of adequate pathology and radiotherapy services is a barrier. Focused attention on in-country and regional training needs and improvement of health systems deliverables is urgently

Perspectives on key principles of generalist medical practice in public service in sub-saharan africa: a qualitative study

Directory of Open Access Journals (Sweden)

Downing Raymond V

2011-07-01

Full Text Available Abstract Background The principles and practice of Family Medicine that arose in developed Western countries have been imported and adopted in African countries without adequate consideration of their relevance and appropriateness to the African context. In this study we attempted to elicit a priori principles of generalist medical practice from the experience of long-serving medical officers in a variety of African counties, through which we explored emergent principles of Family Medicine in our own context. Methods A descriptive study design was utilized, using qualitative methods. 16 respondents who were clinically active medical practitioners, working as generalists in the public services or non-profit sector for at least 5 years, and who had had no previous formal training or involvement in academic Family Medicine, were purposively selected in 8 different countries in southern, western and east Africa, and interviewed. Results The respondents highlighted a number of key issues with respect to the external environment within which they work, their collective roles, activities and behaviours, as well as the personal values and beliefs that motivate their behaviour. The context is characterized by resource constraints, high workload, traditional health beliefs, and the difficulty of referring patients to the next level of care. Generalist clinicians in sub-Saharan Africa need to be competent across a wide range of clinical disciplines and procedural skills at the level of the district hospital and clinic, in both chronic and emergency care. They need to understand the patient's perspective and context, empowering the patient and building an effective doctor-patient relationship. They are also managers, focused on coordinating and improving the quality of clinical care through teamwork, training and mentoring other health workers in the generalist setting, while being life-long learners themselves. However, their role in the community, was

Gaps in the implementation of antenatal syphilis detection and treatment in health facilities across sub-Saharan Africa.

Science.gov (United States)

Kanyangarara, Mufaro; Walker, Neff; Boerma, Ties

2018-01-01

Syphilis in pregnancy is an under-recognized public health problem, especially in sub-Saharan Africa which accounts for over 60% of the global burden of syphilis. If left untreated, more than half of maternal syphilis cases will result in adverse pregnancy outcomes including stillbirth and fetal loss, neonatal death, prematurity or low birth weight, and neonatal infections. Achieving universal coverage of antenatal syphilis screening and treatment has been the focus of the global campaign for the elimination of mother-to-child transmission of syphilis. However, little is known about the availability of antenatal syphilis screening and treatment across sub-Saharan Africa. The objective of this study was to estimate the 'likelihood of appropriate care' for antenatal syphilis screening and treatment by analyzing health facility surveys and household surveys conducted from 2010 to 2015 in 12 sub-Saharan African countries. In this secondary data analysis, we linked indicators of health facility readiness to provide antenatal syphilis detection and treatment from Service Provision Assessments (SPAs) and Service Availability and Readiness Assessments (SARAs) to indicators of ANC use from the Demographic and Health Surveys (DHS) to compute estimates of the 'likelihood of appropriate care'. Based on data from 5,593 health facilities that reported offering antenatal care (ANC) services, the availability of syphilis detection and treatment in ANC facilities ranged from 2% to 83%. The availability of syphilis detection and treatment was substantially lower in ANC facilities in West Africa compared to the other sub-regions. Levels of ANC attendance were high (median 94.9%), but only 27% of ANC attendees initiated care at less than 4 months gestation. We estimated that about one in twelve pregnant women received ANC early (<4 months) at a facility ready to provide syphilis detection and treatment (median 8%, range 7-32%). The largest implementation bottleneck identified was low

Realizing effectiveness across continents with hydroxyurea: Enrollment and baseline characteristics of the multicenter REACH study in Sub-Saharan Africa.

Science.gov (United States)

McGann, Patrick T; Williams, Thomas N; Olupot-Olupot, Peter; Tomlinson, George A; Lane, Adam; Luís Reis da Fonseca, José; Kitenge, Robert; Mochamah, George; Wabwire, Ham; Stuber, Susan; Howard, Thad A; McElhinney, Kathryn; Aygun, Banu; Latham, Teresa; Santos, Brígida; Tshilolo, Léon; Ware, Russell E

2018-08-01

Despite its well-described safety and efficacy in the treatment of sickle cell anemia (SCA) in high-income settings, hydroxyurea remains largely unavailable in sub-Saharan Africa, where more than 75% of annual SCA births occur and many comorbidities exist. Realizing Effectiveness Across Continents with Hydroxyurea (REACH, ClinicalTrials.gov NCT01966731) is a prospective, Phase I/II open-label trial of hydroxyurea designed to evaluate the feasibility, safety, and benefits of hydroxyurea treatment for children with SCA in four sub-Saharan African countries. Following comprehensive training of local research teams, REACH was approved by local Ethics Committees and achieved full enrollment ahead of projections with 635 participants enrolled over a 30-month period, despite half of families living >12 km from their clinical site. At enrollment, study participants (age 5.4 ± 2.4 years) had substantial morbidity, including a history of vaso-occlusive pain (98%), transfusion (68%), malaria (85%), and stroke (6%). Significant differences in laboratory characteristics were noted across sites, with lower hemoglobin concentrations (P < .01) in Angola (7.2 ± 1.0 g/dL) and the DRC (7.0 ± 0.9 g/dL) compared to Kenya (7.4 ± 1.1 g/dL) and Uganda (7.5 ± 1.1 g/dL). Analysis of known genetic modifiers of SCA demonstrated a high frequency of α-thalassemia (58.4% with at least a single α-globin gene deletion) and G6PD deficiency (19.7% of males and 2.4% of females) across sites. The CAR β-globin haplotype was present in 99% of participants. The full enrollment to REACH confirms the feasibility of conducting high-quality SCA research in Africa; this study will provide vital information to guide safe and effective dosing of hydroxyurea for children with SCA living in Africa. © 2018 Wiley Periodicals, Inc.

Implementing focussed antenatal care in sub-Saharan Africa: an ...

African Journals Online (AJOL)

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 ...

The International Connections of Religious Higher Education in Sub-Saharan Africa: Rationales and Implications

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Karram, Grace

2011-01-01

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…

76 FR 59663 - Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary Sub...

Science.gov (United States)

2011-09-27

... of Apparel Articles Assembled in Beneficiary Sub-Saharan African Countries From Regional and Third... Acceleration Act of 2004, Pub. L. 108-274; Division D, Title VI, section 6002 of the Tax Relief and Health Care... beneficiary sub-Saharan African countries. Section 112(b)(3) of TDA 2000 provides duty- and quota-free...

78 FR 24744 - Postponement Notice of Open Special Meeting of the Sub-Saharan Africa Advisory Committee of the...

Science.gov (United States)

2013-04-26

... 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...

Can Economic Performance Predict Pediatric Surgical Capacity in Sub-Saharan Africa?

Science.gov (United States)

Okoye, Mekam T; Nguyen, Evelyn T; Kushner, Adam L; Ameh, Emmanuel A; Nwomeh, Benedict C

2016-06-01

The relationship between economic status and pediatric surgical capacity in low- and middle-income countries (LMICs) is poorly understood. In sub-Saharan Africa (SSA), Nigeria accounts for 20 % of the population and has the highest Gross Domestic Product (GDP), but whether this economic advantage translates to increased pediatric surgical capacity is unknown. This study compares the pediatric surgical capacity between Nigeria and other countries within the region. The Pediatric Personnel, Infrastructure, Procedures, Equipment and Supplies (PediPIPES) survey, a recent tool that is useful in assessing and comparing the capacity of health facilities to deliver essential and emergency surgical care (EESC) to children in LMICs, was used for this evaluation. Data from hospitals in Nigeria (n = 24) and hospitals in 17 other sub-Saharan African countries (n = 25) were compared. The GDP of Nigeria was approximately twenty-five times the average GDP of the 17 other countries represented in our survey. Running water was unavailable in 58 % of the hospitals in Nigeria compared to 20 % of the hospitals in the other countries. Most hospitals in Nigeria and in the other countries did not have a CT scan (67 and 60 %, respectively). Endoscopes were unavailable in 58 % of the hospitals in Nigeria and 44 % of the hospitals in the other countries. Despite better economic indicators in Nigeria, there were no distinct advantages over the other countries in the ability to deliver EESC to children. Our findings highlighted the urgent need for specific allocation of more resources to pediatric surgical capacity building efforts across the entire region.

Primary care in the prevention, treatment and control of cardiovascular disease in sub-Saharan Africa

Science.gov (United States)

Ojji, Dike B; Ojji, Dike B Ojji; Lamont, Kim; Sliwa, Karen; Ojji, Olubunmi I; Egenti, Bibiana Nonye; Sliwa, Karen

2017-01-01

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

Leptospirosis in Sub-Saharan Africa: a systematic review

NARCIS (Netherlands)

de Vries, Sophia G.; Visser, Benjamin J.; Nagel, Ingeborg M.; Goris, Marga G. A.; Hartskeerl, Rudy A.; Grobusch, Martin P.

2014-01-01

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

Assessing public and private sector contributions in reproductive health financing and utilization for six sub-Saharan African countries.

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Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg

2011-05-01

The present study provides evidence to support enhanced attention to reproductive health and comprehensive measures to increase access to quality reproductive health services. We compare and contrast the financing and utilization of reproductive health services in six sub-Saharan African countries using data from National Health Accounts and Demographic and Health Surveys. Spending on reproductive health in 2006 ranged from US$4 per woman of reproductive age in Ethiopia to US$17 in Uganda. These are below the necessary level for assuring adequate services given that an internationally recommended spending level for family planning alone was US$16 for 2006. Moreover, reproductive health spending shows signs of decline in tandem with insufficient improvement in service utilization. Public providers played a predominant role in antenatal and delivery care for institutional births, but home deliveries with unqualified attendants dominated. The private sector was a major supplier of condoms, oral pills and IUDs. Private clinics, pharmacies and drug vendors were important sources of STI treatment. The findings highlight the need to commit greatly increased funding for reproductive health services as well as more policy attention to the contribution of public, private and informal providers and the role of collaboration among them to expand access to services for under-served populations. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

IPPs in Sub-Saharan Africa: Determinants of success

International Nuclear Information System (INIS)

Eberhard, Anton; Gratwick, Katharine Nawaal

2011-01-01

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.

Approaches and impact of non-academic research capacity strengthening training models in sub-Saharan Africa: a systematic review.

Science.gov (United States)

Mugabo, Lambert; Rouleau, Dominique; Odhiambo, Jackline; Nisingizwe, Marie Paul; Amoroso, Cheryl; Barebwanuwe, Peter; Warugaba, Christine; Habumugisha, Lameck; Hedt-Gauthier, Bethany L

2015-06-09

Research is essential to identify and prioritize health needs and to develop appropriate strategies to improve health outcomes. In the last decade, non-academic research capacity strengthening trainings in sub-Saharan Africa, coupled with developing research infrastructure and the provision of individual mentorship support, has been used to build health worker skills. The objectives of this review are to describe different training approaches to research capacity strengthening in sub-Saharan Africa outside academic programs, assess methods used to evaluate research capacity strengthening activities, and learn about the challenges facing research capacity strengthening and the strategies/innovations required to overcome them. The PubMed database was searched using nine search terms and articles were included if 1) they explicitly described research capacity strengthening training activities, including information on program duration, target audience, immediate program outputs and outcomes; 2) all or part of the training program took place in sub-Saharan African countries; 3) the training activities were not a formal academic program; 4) papers were published between 2000 and 2013; and 5) both abstract and full paper were available in English. The search resulted in 495 articles, of which 450 were retained; 14 papers met all inclusion criteria and were included and analysed. In total, 4136 people were trained, of which 2939 were from Africa. Of the 14 included papers, six fell in the category of short-term evaluation period and eight in the long-term evaluation period. Conduct of evaluations and use of evaluation frameworks varied between short and long term models and some trainings were not evaluated. Evaluation methods included tests, surveys, interviews, and systems approach matrix. Research capacity strengthening activities in sub-Saharan Africa outside of academic settings provide important contributions to developing in-country capacity to participate in and

The Tourism–Development Nexus in sub-Saharan Africa: Progress ...

African Journals Online (AJOL)

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.

Agreement between clinicians' and care givers' assessment of intelligence in Nigerian children with intellectual disability: 'ratio IQ' as a viable option in the absence of standardized 'deviance IQ' tests in sub-Saharan Africa.

Science.gov (United States)

Bakare, Muideen O; Ubochi, Vincent N; Okoroikpa, Ifeoma N; Aguocha, Chinyere M; Ebigbo, Peter O

2009-09-15

There may be need to assess intelligent quotient (IQ) scores in sub-Saharan African children with intellectual disability, either for the purpose of educational needs assessment or research. However, modern intelligence scales developed in the western parts of the world suffer limitation of widespread use because of the influence of socio-cultural variations across the world. This study examined the agreement between IQ scores estimation among Nigerian children with intellectual disability using clinicians' judgment based on International Classification of Diseases, tenth Edition(ICD - 10) criteria for mental retardation and caregivers judgment based on 'ratio IQ' scores calculated from estimated mental age in the context of socio-cultural milieu of the children. It proposed a viable option of IQ score assessment among sub-Saharan African children with intellectual disability, using a ratio of culture-specific estimated mental age and chronological age of the child in the absence of standardized alternatives, borne out of great diversity in socio-cultural context of sub-Saharan Africa. Clinicians and care-givers independently assessed the children in relation to their socio-cultural background. Clinicians assessed the IQ scores of the children based on the ICD - 10 diagnostic criteria for mental retardation. 'Ratio IQ' scores were calculated from the ratio of estimated mental age and chronological age of each child. The IQ scores as assessed by the clinicians were then compared with the 'ratio IQ' scores using correlation statistics. A total of forty-four (44) children with intellectual disability were assessed. There was a significant correlation between clinicians' assessed IQ scores and the 'ratio IQ' scores employing zero order correlation without controlling for the chronological age of the children (r = 0.47, df = 42, p = 0.001). First order correlation controlling for the chronological age of the children showed higher correlation score between clinicians

The impact of energy consumption and CO2 emission on the economic growth and financial development in the Sub Saharan African countries

International Nuclear Information System (INIS)

Al-mulali, Usama; Binti Che Sab, Che Normee

2012-01-01

This study investigated the impact of energy consumption and CO 2 emission on GDP (gross domestic product) growth and the financial development in thirty Sub Saharan African Countries. The panel model was used in this study from the period 1980 to 2008. The results showed that energy consumption had played an important role to increase both economic growth and the financial development in the investigated economies but with the consequence of high po llution. This study recommended that these countries should increase energy productivity by increasing energy efficiency, implementation of energy savings projects, energy conservation, and energy infrastructure outsourcing to achieve its financial development and GDP growth and to increase their investment on energy projects to achieve the full energy potential. -- Highlights: ► The impact of energy consumption, CO 2 emission on GDP and the financial development in the SSA countries was investigated. ► The panel model was implied in this study from the period 1980 to 2008. ► The results show energy consumption increased economic growth and the financial development but with higher pollution.

Maternal obesity and Caesarean delivery in sub-Saharan Africa.

Science.gov (United States)

Cresswell, Jenny A; Campbell, Oona M R; De Silva, Mary J; Slaymaker, Emma; Filippi, Veronique

2016-07-01

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.

Non-farm entrepreneurship in rural sub-Saharan Africa: New empirical evidence.

Science.gov (United States)

Nagler, Paula; Naudé, Wim

2017-02-01

We report on the prevalence and patterns of non-farm enterprises in six sub-Saharan African countries, and study their performance in terms of labor productivity, survival and exit, using the World Bank's Living Standards Measurement Study - Integrated Surveys on Agriculture (LSMS-ISA). Rural households operate enterprises due to both push and pull factors and tend to do so predominantly in easy-to-enter activities, such as sales and trade, rather than in activities that require higher starting costs, such as transport services, or educational investment, such as professional services. Labor productivity differs widely: rural and female-headed enterprises, those located further away from population centers, and businesses that operate intermittently have lower levels of labor productivity compared to urban and male-owned enterprises, or enterprises that operate throughout the year. Finally, rural enterprises exit the market primarily due to a lack of profitability or finance, and due to idiosyncratic shocks.

EDITORIAL IMPACT OF HIV/AIDS ON EDUCATION IN THE SUB ...

African Journals Online (AJOL)

hi-tech

EAST AFRICAN MEDICAL JOURNAL. 609. EDITORIAL. IMPACT OF HIV/AIDS ON EDUCATION IN THE SUB-SAHARAN AFRICA. HIV /AIDS mark a severe development crisis in sub-Saharan Africa, which remains by far the worst affected region in the world. Approximately 3.5 million new infections occurred in 2001, ...

The Changing Political Undercurrents in Health Services Delivery in Sub-Saharan Africa.

Science.gov (United States)

Ichoku, H E; Ifelunini, A I

2017-07-01

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.

Rising global burden of breast cancer: the case of sub-Saharan Africa (with emphasis on Nigeria) and implications for regional development: a review.

Science.gov (United States)

Azubuike, Samuel O; Muirhead, Colin; Hayes, Louise; McNally, Richard

2018-03-22

Despite mortality from breast cancer in Africa being higher than in high income countries, breast cancer has not been extensively studied in the region. The aim of this paper was to highlight the rising burden of breast cancer with an emphasis on sub-Saharan Africa as well as trends, characteristics, controversies and their implications for regional development. A review of published studies and documents was conducted in Medline, Scopus, Pubmed and Google using combinations of key words-breast neoplasm, breast cancer, cancer, incidence, mortality, Africa, Nigeria. Graphical and frequency analyses were carried out on some of the incidence and mortality figures retrieved from published papers and the GLOBOCAN website. Globally, about 25% and 15% of all new cancer cases and cancer deaths respectively among females were due to breast cancer. Africa currently had the highest age-standardized breast cancer mortality rate globally, with the highest incidence rates being recorded within the sub-Saharan African sub-region. Incidence trends such as inherently aggressive tumour and younger age profile had been subject to controversies. Certain factors such as westernized diet, urbanization and possibly increasing awareness had been implicated, though their specific contributions were yet to be fully established. Unless urgent action is taken, breast cancer will compound sub-Saharan Africa's disease burden, increase poverty and gender inequality as well as reverse the current global gains against maternal and neonatal mortality.

Enduring Controversy: Small Reservoirs in Sub-Saharan Africa

NARCIS (Netherlands)

Venot, J.P.J.N.; Hirvonen, M.

2013-01-01

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

HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities.

Science.gov (United States)

Kharsany, Ayesha B M; Karim, Quarraisha A

2016-01-01

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.

HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities

Science.gov (United States)

Kharsany, Ayesha B.M.; Karim, Quarraisha A.

2016-01-01

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

Social determinants of tuberculosis in sub-Saharan Africa: A systematic review

Directory of Open Access Journals (Sweden)

Ismaila Adamu Saidu

2014-07-01

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.

Social determinants of tuberculosis in sub-Saharan Africa: A systematic review

Directory of Open Access Journals (Sweden)

Ismaila Adamu Saidu

2014-01-01

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.

Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa-a systematic review protocol.

Science.gov (United States)

Geleto, Ayele; Chojenta, Catherine; Mussa, Abdulbasit; Loxton, Deborah

2018-04-16

Nearly 15% of all pregnancies end in fatal perinatal obstetric complications including bleeding, infections, hypertension, obstructed labor, and complications of abortion. Between 1990 and 2015, an estimated 10.7 million women died due to obstetric complications. Almost all of these deaths (99%) happened in developing countries, and 66% of maternal deaths were attributed to sub-Saharan Africa. The majority of cases of maternal mortalities can be prevented through provision of evidence-based potentially life-saving signal functions of emergency obstetric care. However, different factors can hinder women's ability to access and use emergency obstetric services in sub-Saharan Africa. Therefore, the aim of this review is to synthesize current evidence on barriers to accessing and utilizing emergency obstetric care in sub-Saharan African. Decision-makers and policy formulators will use evidence generated from this review in improving maternal healthcare particularly the emergency obstetric care. Electronic databases including MEDLINE, CINAHL, Embase, and Maternity and Infant Care will be searched for studies using predefined search terms. Articles published in English language between 2010 and 2017 with quantitative and qualitative design will be included. The identified papers will be assessed for meeting eligibility criteria. First, the articles will be screened by examining their titles and abstracts. Then, two reviewers will review the full text of the selected articles independently. Two reviewers using a standard data extraction format will undertake data extraction from the retained studies. The quality of the included papers will be assessed using the mixed methods appraisal tool. Results from the eligible studies will be qualitatively synthesized using the narrative synthesis approach and reported using the three delays model. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be employed to present the findings. This

Industrialization in Sub-Saharan Africa and import substitution policy

Directory of Open Access Journals (Sweden)

Ana Paula F. Mendes

2014-03-01

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.

[Risk factors associated with leg erysipelas (cellulitis) in sub-Saharan Africa: A multicentre case-control study].

Science.gov (United States)

Pitché, P; Diatta, B; Faye, O; Diané, B-F; Sangaré, A; Niamba, P; Mandengue, C; Kobengue, L; Saka, B; Diop, A; Ly, F; Dieng, M-T; Dicko, A; Soumah, M-M; Cissé, M; Kourouma, S-H; Kouassi, Y-I; Boukari, T; Akakpo, S; Tchangaï-Walla, K

2015-11-01

Acute bacterial cellulitis of the leg (erysipelas) is a common problem involving considerable morbidity in dermatology practice in Africa. Previous studies conducted in Europe and North Africa have highlighted lymphoedema and toe-web intertrigo as independent factors associated with leg erysipelas. The aim of this case-control study was to identify risk factors associated with leg erysipelas in sub-Saharan Africa, within a different socio-economic and culture context. We conducted a prospective case-control study in hospital dermatology departments in 8 sub-Saharan African countries over a 12-month period (October 2013 to September 2014). Each case of acute leg cellulitis was matched with 2 controls for age (±5 years) and sex. We analysed the general and local factors. During the study period, 364 cases (223 female, 141 male) were matched with 728 controls. The mean age was 42.15±15.15 years for patients and 42.11±36 years for controls. Multivariate analysis showed the following to be independent risk factors associated with leg erysipelas in our study: obesity (odds ratio [OR]=2.82 ; 95% confidence interval: 2.11-3.76), lymphoedema (OR=3.87, 95%CI: 2.17-6.89), voluntary cosmetic depigmentation (OR=4.29, 95%CI: 2.35-7.83), neglected traumatic wound (OR=37.2, 95%CI: 24.9-57.72) and toe-web intertrigo (OR=37.86, 95%CI: 22.27-64.5). The results of this study confirms the major role of local risk factors (toe-web intertrigo, lymphoedema) previously identified in other geographical settings. However, the originality of our study consists of the identification of voluntary cosmetic depigmentation as a risk factor for leg erysipelas in sub-Saharan Africa. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Effect of health development assistance on health status in sub-Saharan Africa

Directory of Open Access Journals (Sweden)

Negeri KG

2016-04-01

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

Implications of Severe Economic Decline & Demographic Pressures on Youth Literacy in Sub-Saharan Africa

Science.gov (United States)

Okpala, Comfort O.

2009-01-01

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…

Capabilities, innovation and entrepreneurship in sub-Saharan Africa

NARCIS (Netherlands)

Kroesen, J.O.; Romijn, H.A.; Kroesen, J.O.

2015-01-01

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

Capabilities, innovation and entrepreneurship in sub-Saharan Africa

NARCIS (Netherlands)

Kroesen, J.O.; Romijn, H

2015-01-01

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

Endomyocardial involvement in asymptomatic sub-Saharan immigrants with helminth-related eosinophilia

Science.gov (United States)

Marrero-Santiago, Héctor; Hernández-Cabrera, Michele; Gil-Guillén, Carlos; Pisos-Álamo, Elena; Jaén-Sánchez, Nieves; Pérez-Arellano, José-Luis

2017-01-01

Background Among immigrants of sub-Saharan origin, parasitic infection is the leading cause of eosinophilia, which is generally interpreted as a defense mechanism. A side effect of the inflammatory mediators released by eosinophils is damage to host organs, especially the heart. The main objectives of this study were to i) assess cardiac involvement in asymptomatic sub-Saharan immigrants with eosinophilia, ii) relate the presence of lesions with the degree of eosinophilia, and iii) study the relationship between cardiac involvement and the type of causative parasite. Methodology/Principle findings In total, the study included 50 black immigrants (37 patients and 13 controls) from sub-Saharan Africa. In all subjects, heart structure and function were evaluated in a blinded manner using Sonos 5500 echocardiographic equipment. The findings were classified and described according to established criteria. The diagnostic criteria for helminthosis were those reported in the literature. Serum eosinophil-derived neurotoxin levels were measured using enzyme-linked immunosorbent assay. A significant association was found between the presence of eosinophilia and structural alterations (mitral valve thickening). However, the lack of an association between the degree of eosinophilia and heart valve disease and the absence of valve involvement in some patients with eosinophilia suggest the role of other factors in the appearance of endocardial lesions. There was also no association between the type of helminth and valve involvement. Conclusions We, therefore, suggest that transthoracic echocardiography be performed in every sub-Saharan individual with eosinophilia in order to rule out early heart valve lesions. PMID:28234952