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

PubMed

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 available health economic analyses in Africa and internationally.

Productivity losses associated with tuberculosis deaths in the World Health Organization African region.

PubMed

Kirigia, Joses Muthuri; Muthuri, Rosenabi Deborah Karimi

2016-06-01

In 2014, almost half of the global tuberculosis deaths occurred in the World Health Organization (WHO) African Region. Approximately 21.5 % of the 6 060 742 TB cases (new and relapse) reported to the WHO in 2014 were in the African Region. The specific objective of this study was to estimate future gross domestic product (GDP) losses associated with TB deaths in the African Region for use in advocating for better strategies to prevent and control tuberculosis. The cost-of-illness method was used to estimate non-health GDP losses associated with TB deaths. Future non-health GDP losses were discounted at 3 %. The analysis was conducted for three income groups of countries. One-way sensitivity analysis at 5 and 10 % discount rates was undertaken to assess the impact on the expected non-health GDP loss. The 0.753 million tuberculosis deaths that occurred in the African Region in 2014 would be expected to decrease the future non-health GDP by International Dollars (Int$) 50.4 billion. Nearly 40.8, 46.7 and 12.5 % of that loss would come from high and upper-middle- countries or lower-middle- and low-income countries, respectively. The average total non-health GDP loss would be Int$66 872 per tuberculosis death. The average non-health GDP loss per TB death was Int$167 592 for Group 1, Int$69 808 for Group 2 and Int$21 513 for Group 3. Tuberculosis exerts a sizeable economic burden on the economies of the WHO AFR countries. This implies the need to strongly advocate for better strategies to prevent and control tuberculosis and to help countries end the epidemic of tuberculosis by 2030, as envisioned in the United Nations General Assembly resolution on Sustainable Development Goals (SDGs).

IBFAN Africa training initiatives: code implementation and lactation management.

PubMed

Mbuli, A

1994-01-01

As part of an ongoing effort to halt the decline of breast feeding rates in Africa, 35 representatives of 12 different African countries met in Mangochi, Malawi, in February 1994. The Code of Marketing of Breastmilk Substitutes was scrutinized. National codes were drafted based on the "Model Law" of the IBFAN Code Documentation Centre (ICDC), Penang. Mechanisms of implementation, specific to each country, were developed. Strategies for the promotion, protection, and support of breast feeding, which is very important to child survival in Africa, were discussed. The training course was organized by ICDC, in conjunction with IBFAN Africa, and with the support of the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO). Countries in eastern, central, and southern Africa were invited to send participants, who included professors, pediatricians, nutritionists, MCH personnel, nurses, and lawyers. IBFAN Africa has also been conducting lactation management workshops for a number of years in African countries. 26 health personnel (pediatricians, nutritionists, senior nursing personnel, and MCH workers), representing 7 countries in the southern African region, attended a training of trainers lactation management workshop in Swaziland in August, 1993 with the support of their UNICEF country offices. The workshop included lectures, working sessions, discussions, and slide and video presentations. Topics covered included national nutrition statuses, the importance of breast feeding, the anatomy and physiology of breast feeding, breast feeding problems, the International Code of Marketing, counseling skills, and training methods. The field trip to a training course covering primary health care that was run by the Traditional Healers Organization (THO) in Swaziland was of particular interest because of the strong traditional medicine sector in many African countries. IBFAN Africa encourages use of community workers (traditional healers, Rural Health Motivators, Village Health Workers, Mother Support Groups) to promote breast feeding.

Plea to African heads-of-state: join the fight.

PubMed

Tyson, R

1997-10-01

Uganda's president, Yoweri Museveni, is the only African head-of-state who has led an all-out, extended campaign against AIDS, and Uganda is the only African country to realize a decline in HIV rates since the epidemic began spreading across central and southern Africa in the 1980s. While South Africa's President Nelson Mandela has spoken about AIDS in international forums, his country's programs against AIDS are in disarray. Rather than adopt a position of leadership against HIV/AIDS, African leaders have most often tried to cover up or ignore the AIDS threat. Zimbabwe and Nigeria are briefly discussed as examples. More than 100 delegates attended the HIV/AIDS workshop at the fourth African-African American Summit held in Harare, July 1997. After listening for 2 days to medical experts describe how the epidemic is destroying African economies and social structures, task force members called upon leaders of the 40 sub-Saharan African countries to acknowledge the threat of AIDS in their countries and to fight against the epidemic.

Suicidal behaviour across the African continent: a review of the literature

PubMed Central

2014-01-01

Background Suicide is a major cause of premature mortality worldwide, but data on its epidemiology in Africa, the world’s second most populous continent, are limited. Methods We systematically reviewed published literature on suicidal behaviour in African countries. We searched PubMed, Web of Knowledge, PsycINFO, African Index Medicus, Eastern Mediterranean Index Medicus and African Journals OnLine and carried out citation searches of key articles. We crudely estimated the incidence of suicide and suicide attempts in Africa based on country-specific data and compared these with published estimates. We also describe common features of suicide and suicide attempts across the studies, including information related to age, sex, methods used and risk factors. Results Regional or national suicide incidence data were available for less than one third (16/53) of African countries containing approximately 60% of Africa’s population; suicide attempt data were available for <20% of countries (7/53). Crude estimates suggest there are over 34,000 (inter-quartile range 13,141 to 63,757) suicides per year in Africa, with an overall incidence rate of 3.2 per 100,000 population. The recent Global Burden of Disease (GBD) estimate of 49,558 deaths is somewhat higher, but falls within the inter-quartile range of our estimate. Suicide rates in men are typically at least three times higher than in women. The most frequently used methods of suicide are hanging and pesticide poisoning. Reported risk factors are similar for suicide and suicide attempts and include interpersonal difficulties, mental and physical health problems, socioeconomic problems and drug and alcohol use/abuse. Qualitative studies are needed to identify additional culturally relevant risk factors and to understand how risk factors may be connected to suicidal behaviour in different socio-cultural contexts. Conclusions Our estimate is somewhat lower than GBD, but still clearly indicates suicidal behaviour is an important public health problem in Africa. More regional studies, in both urban and rural areas, are needed to more accurately estimate the burden of suicidal behaviour across the continent. Qualitative studies are required in addition to quantitative studies. PMID:24927746

19 CFR 208.2 - Definitions applicable to this part.

Code of Federal Regulations, 2010 CFR

2010-04-01

... INVESTIGATIONS WITH RESPECT TO COMMERCIAL AVAILABILITY OF TEXTILE FABRIC AND YARN IN SUB-SAHARAN AFRICAN COUNTRIES § 208.2 Definitions applicable to this part. (a) Beneficiary sub-Saharan African country. The term “beneficiary sub-Saharan African country” means those countries so designated by the President under 19 U.S.C...

Differences in HIV natural history among African and non-African seroconverters in Europe and seroconverters in sub-Saharan Africa.

PubMed

Pantazis, Nikos; Morrison, Charles; Amornkul, Pauli N; Lewden, Charlotte; Salata, Robert A; Minga, Albert; Chipato, Tsungai; Jaffe, Harold; Lakhi, Shabir; Karita, Etienne; Porter, Kholoud; Meyer, Laurence; Touloumi, Giota

2012-01-01

It is unknown whether HIV treatment guidelines, based on resource-rich country cohorts, are applicable to African populations. We estimated CD4 cell loss in ART-naïve, AIDS-free individuals using mixed models allowing for random intercept and slope, and time from seroconversion to clinical AIDS, death and antiretroviral therapy (ART) initiation by survival methods. Using CASCADE data from 20 European and 3 sub-Saharan African (SSA) cohorts of heterosexually-infected individuals, aged ≥15 years, infected ≥2000, we compared estimates between non-African Europeans, Africans in Europe, and Africans in SSA. Of 1,959 (913 non-Africans, 302 Europeans-African origin, 744 SSA), two-thirds were female; median age at seroconversion was 31 years. Individuals in SSA progressed faster to clinical AIDS but not to death or non-TB AIDS. They also initiated ART later than Europeans and at lower CD4 cell counts. In adjusted models, Africans (especially from Europe) had lower CD4 counts at seroconversion and slower CD4 decline than non-African Europeans. Median (95% CI) CD4 count at seroconversion for a 15-29 year old woman was 607 (588-627) (non-African European), 469 (442-497) (European-African origin) and 570 (551-589) (SSA) cells/µL with respective CD4 decline during the first 4 years of 259 (228-289), 155 (110-200), and 199 (174-224) cells/µL (p<0.01). Despite differences in CD4 cell count evolution, death and non-TB AIDS rates were similar across study groups. It is therefore prudent to apply current ART guidelines from resource-rich countries to African populations.

The ethics of improving African traditional medical practice: scientific or African traditional research methods?

PubMed

Nyika, Aceme

2009-11-01

The disease burden in Africa, which is relatively very large compared with developed countries, has been attributed to various factors that include poverty, food shortages, inadequate access to health care and unaffordability of Western medicines to the majority of African populations. Although for 'old diseases' knowledge about the right African traditional medicines to treat or cure the diseases has been passed from generation to generation, knowledge about traditional medicines to treat newly emerging diseases has to be generated in one way or another. In addition, the existing traditional medicines have to be continuously improved, which is also the case with Western scientific medicines. Whereas one school of thought supports the idea of improving medicines, be they traditional or Western, through scientific research, an opposing school of thought argues that subjecting African traditional medicines to scientific research would be tantamount to some form of colonization and imperialism. This paper argues that continuing to use African traditional medicines for old and new diseases without making concerted efforts to improve their efficacy and safety is unethical since the disease burden affecting Africa may continue to rise in spite of the availability and accessibility of the traditional medicines. Most importantly, the paper commends efforts being made in some African countries to improve African traditional medicine through a combination of different mechanisms that include the controversial approach of scientific research on traditional medicines.

Differentiated Quality Assurance for the African Virtual University's Teacher Education Qualification in Mathematics and Science

ERIC Educational Resources Information Center

Hattingh, A.

2008-01-01

For the African Virtual University and its consortium of African universities the implementation of quality promoting initiatives are not without challenges and scepticisms. To be discussed in this article is the case of a teacher education qualification in ten different African countries. Seven countries were sampled and visited in 2006 with the…

Cannabis and Amphetamine Use and Associated Factors among School-Going Adolescents in Nine African Countries

ERIC Educational Resources Information Center

Peltzer, Karl; Pengpid, Supa

2018-01-01

The aim of this study was to assess the prevalence of cannabis and amphetamine use and associated factors among adolescents in nine African countries. We analyzed cross-sectional data from 25,372 adolescents (mean age 14.3 years, SD = 1.6) from nine African countries that participated in the Global School-Based Student Health Survey (GSHS) in…

Evaluating the Effects of Vocational Training in Africa (based on the "African Economic Outlook 2008"), OECD Development Centre Policy Insights, No. 61

ERIC Educational Resources Information Center

Kingombe, Christian

2008-01-01

The impact of vocational training on economic growth and poverty reduction in African countries is unknown. Without such knowledge, however, countries and donors cannot formulate appropriate policies. Even the 35 countries surveyed in the 2008 "African Economic Outlook" can only supply approximate data. More and better data are needed to…

19 CFR 208.3 - Petitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... or likely time of the receipt by an apparel producer in all countries where the fabric or yarn has... sale, including lesser developed beneficiary sub-Saharan African countries, by country, for the most... yarn, by firm, that will be available in lesser developed beneficiary sub-Saharan African countries in...

Time from HIV seroconversion to death: a collaborative analysis of eight studies in six low and middle-income countries before highly active antiretroviral therapy

PubMed Central

Todd, Jim; Glynn, Judith R.; Marston, Milly; Lutalo, Tom; Biraro, Sam; Mwita, Wambura; Suriyanon, Vinai; Rangsin, Ram; Nelson, Kenrad E.; Sonnenberg, Pam; Fitzgerald, Dan; Karita, Etienne; Żaba, Basia

2018-01-01

Objectives To estimate survival patterns after HIV infection in adults in low and middle-income countries. Design An analysis of pooled data from eight different studies in six countries. Methods HIV seroconverters were included from eight studies (three population-based, two occupational, and three clinic cohorts) if they were at least 15 years of age, and had no more than 4 years between the last HIV-negative and subsequent HIV-positive test. Four strata were defined: East African cohorts; South African miners cohort; Thai cohorts; Haitian clinic cohort. Kaplan–Meier functions were used to estimate survival patterns, and Weibull distributions were used to model and extend survival estimates. Analyses examined the effect of site, age, and sex on survival. Results From 3823 eligible seroconverters, 1079 deaths were observed in 19 671 person-years of follow-up. Survival times varied by age and by study site. Adjusting to age 25–29 years at seroconversion, the median survival was longer in South African miners: 11.6 years [95% confidence interval (CI) 9.8–13.7] and East African cohorts: 11.1 years (95% CI 8.7–14.2) than in Haiti: 8.3 years (95% CI 3.2–21.4) and Thailand: 7.5 years (95% CI 5.4–10.4). Survival was similar for men and women, after adjustment for age at seroconversion and site. Conclusion Without antiretroviral therapy, overall survival after HIV infection in African cohorts was similar to survival in high-income countries, with a similar pattern of faster progression at older ages at seroconversion. Survival appears to be significantly worse in Thailand where other, unmeasured factors may affect progression. PMID:18032940

Epidemiology of diabetic retinopathy and maculopathy in Africa: a systematic review

PubMed Central

Burgess, P I; MacCormick, I J C; Harding, S P; Bastawrous, A; Beare, N A V; Garner, P

2013-01-01

Abstract Aim To summarize findings from studies reporting the prevalence and incidence of diabetic retinopathy and diabetic maculopathy in African countries in light of the rising prevalence of diabetes mellitus. Methods Using a predefined search strategy, we systematically searched MEDLINE, EMBASE, Science Citation index and Conference Proceedings Citation index, African Index Medicus and the grey literature database ‘OpenSIGLE’ for studies published between January 1990 and February 2011. Included studies reported prevalence or incidence of diabetic retinopathy or diabetic maculopathy of subjects with diabetes resident in African countries. Results Sixty-two studies from 21 countries were included: three population-based surveys; two cohort studies; five case–control studies; 32 diabetes clinic-based, nine eye clinic-based and 11 other hospital-based surveys. Included studies varied considerably in terms of patient selection, method of assessing the eye and retinopathy classification. In population-based studies, the reported prevalence range in patients with diabetes for diabetic retinopathy was 30.2 to 31.6%, proliferative diabetic retinopathy 0.9 to 1.3%, and any maculopathy 1.2 to 4.5%. In diabetes clinic-based surveys, the reported prevalence range for diabetic retinopathy was 7.0 to 62.4%, proliferative diabetic retinopathy 0 to 6.9%, and any maculopathy 1.2 to 31.1%. No obvious association between prevalence and income level of the country was detected. Conclusions Large, community-based cross-sectional and cohort studies are needed to investigate rates and determinants of prevalence of diabetic retinopathy, incidence and progression in Africa. Consensus is needed on the most appropriate methods of identification and classification of retinopathy for research and clinical practice. Estimates of prevalence of diabetic retinopathy, proliferative diabetic retinopathy and maculopathy are comparable with recent European and American studies. PMID:22817387

3 CFR 8618 - Proclamation 8618 of December 21, 2010. To Take Certain Actions Under the African Growth and...

Code of Federal Regulations, 2011 CFR

2011-01-01

... designated the Democratic Republic of Congo (DRC) as an eligible sub-Saharan African country pursuant to... “Democratic Republic of Congo” from the list of beneficiary sub-Saharan African countries. (3) In order to...

The metrics and correlates of physician migration from Africa.

PubMed

Arah, Onyebuchi A

2007-05-17

Physician migration from poor to rich countries is considered an important contributor to the growing health workforce crisis in the developing world. This is particularly true for Africa. The perceived magnitude of such migration for each source country might, however, depend on the choice of metrics used in the analysis. This study examined the influence of choice of migration metrics on the rankings of African countries that suffered the most physician migration, and investigated the correlates of physician migration. Ranking and correlational analyses were conducted on African physician migration data adjusted for bilateral net flows, and supplemented with developmental, economic and health system data. The setting was the 53 African birth countries of African-born physicians working in nine wealthier destination countries. Three metrics of physician migration were used: total number of physician émigrés; emigration fraction defined as the proportion of the potential physician pool working in destination countries; and physician migration density defined as the number of physician émigrés per 1000 population of the African source country. Rankings based on any of the migration metrics differed substantially from those based on the other two metrics. Although the emigration fraction and physician migration density metrics gave proportionality to the migration crisis, only the latter was consistently associated with source countries' workforce capacity, health, health spending, economic and development characteristics. As such, higher physician migration density was seen among African countries with relatively higher health workforce capacity (0.401 < or = r < or = 0.694, p < or = 0.011), health status, health spending, and development. The perceived magnitude of physician migration is sensitive to the choice of metrics. Complementing the emigration fraction, the physician migration density is a metric which gives a different but proportionate picture of which African countries stand to lose relatively more of its physicians with unchecked migration. The nature of health policies geared at health-worker migration can be expected to depend on the choice of migration metrics.

Africa's search for communication technologies for education: a reflection on problems and prospects.

PubMed

Ofori-ansa, K

1983-09-01

In postindependence Africa new and more efficient strategies were required to support educational expansion. Political independence was accompanied by an increased demand for education to meet the growing labor force needs of the emerging countries in Africa. It was considered that education, as a means for human resource development, was a viable capital investment necessary to support both social and economic development, yet in many African nations, the educational systems and the traditional teaching methods inherited from colonial rule were not adequate to satisfy the increased demand for trained personnel. In response to the need for educational reforms and expansion, governments of many African countries invested heavily in the development of their education systems. During the 1970s it is estimated that Africa spent between 15-20% of the national budget on education. That high level of expenditure was justified by the increased demand for education. The educational expansion efforts also increased shortages of qualified and competent teachers, shortages of adequate equipment, and physical facilities. New strategies and resources with required to solve these increasing problems. Many African countries began to experiment with the use of mass communication technologies to support their educational reform efforts. There was generally consensus that the mass media, particularly radio and television, had certain qualities that could be exploited either to replace or improve conventional methods of teaching. By the late 1960s at least 16 African countries were using educational broadcasting of 1 form or another. International aid agencies, govermental donor agencies, and private foundations in the industrially advanced countries provided the support base for many African countries in their efforts to use radio and television for educational improvement. Most of these efforts failed to make any significant impact on educational development in Africa. Educational analysts have generally concluded that post-independence educational reforms in Africa failed to achieve thier aims. Some recommendations are offered with the objective of contributing to the ongoing international effort to search for more effective approaches in using communication technologies to support educational development in Africa. Technical assistance programs supporting educational use of modern communication technologies should be perceived in the context of international cooperation, with a 2-way flow, rather than in the context of a donor recipient relationship. Greater emphasis should be placed on thorough country by country assessment of educational needs and problems in order to provide an adequate basis for designing project objectives and project contents to satisfy specific needs. Needs assessment should be tempered with pragmatism and flexibility in approach. Training and orientation for foreign and local exports and increased local participation are among the recommendations.

Clinical nursing and midwifery research in African countries: a scoping review.

PubMed

Sun, Carolyn; Larson, Elaine

2015-05-01

Globally, the nursing shortage has been deemed a crisis, but African countries have been hit hardest. Therefore, it is of utmost importance nurses use the best available evidence and that nursing research is targeted to address gaps in the evidence. To achieve this, an understanding of what is currently available and identification of gaps in clinical nursing research is critical. We performed a scoping review of existing literature to assess clinical nursing research conducted in all African countries over the past decade, identify gaps in clinical nursing and midwifery research, determine whether they match with health priorities for countries, and define priorities for regional clinical nursing research agendas to improve health outcomes. This is a scoping review of published clinical nursing research conducted in African countries. Systematic searches of literature published between January 01, 2004 and September 15, 2014 were performed in PubMed, Medline, CINHAL, and Embase. Research was included if it was conducted by nurses, included data obtained in African countries or regions within the African continent, published in a peer-reviewed journal with an abstract, and included patient outcomes. Abstracts were independently reviewed for inclusion by two authors. The following data were extracted: countries of publication and study, study type and design, journal, language, and topics of research. Gaps in the literature were identified. Initially, 1091 papers were identified with a final sample of 73 articles meeting inclusion criteria. Studies used 12 designs, were published in 35 journals published in five countries (including two African countries); 29% of the research was published in a single journal (Curatonis). Research was mostly qualitative (57%) and included twenty countries in Africa (38%). There were 12 major topics of study, most often midwifery/maternal/child health (43%), patient experiences (38%), and human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) (36%). Areas most often studied were associated with funding sources (e.g., a large influx of funds for HIV-related research). Major and common health care problems in African countries (e.g. infectious disease other than HIV, and noncommunicable diseases such as malnutrition, diarrheal disease, hypertension and diabetes) were not subjects of the published literature, indicating a clear gap between health care needs and problems and the focus of the majority of clinical nursing research. Additionally, the shortage of doctorally prepared nurses may contribute to the lack of clinical nursing and midwifery research in African countries. Copyright © 2015 Elsevier Ltd. All rights reserved.

Anti-homosexual legislation and HIV-related stigma in African nations: what has been the role of PEPFAR?

PubMed Central

Hagopian, Amy; Rao, Deepa; Katz, Aaron; Sanford, Sallie; Barnhart, Scott

2017-01-01

ABSTRACT Background: Gay men and other men who have sex with men are disproportionately burdened by HIV infection. Laws that penalize same-sex intercourse contribute to a cycle of stigma, homonegativity and discrimination. In many African nations, laws criminalizing homosexuality may be fueling the epidemic, as they dissuade key populations from seeking treatment and health care providers from offering it. Objectives: We analyzed the ways in which policies and practices of the US President’s Emergency Plan for AIDS Relief (PEPFAR) program addressed pervasively harsh anti-homosexuality laws across Africa. Given the aim of the US PEPFAR program to reduce stigma surrounding HIV, we explored how PEPFAR may have used its influence to reduce the criminalization of homosexuality in the countries where it operated. Methods: We assessed homosexuality laws in 21 African countries where PEPFAR funding sought to reduce the HIV epidemic. We examined PEPFAR Policy Framework agreements associated with those countries, and other PEPFAR documents, for evidence of attempts to reduce stigma by decriminalizing homosexuality. Results: We found 16 of Africa’s 21 PEPFAR-funded countries had laws characterized as harsh in relation to homosexuality. Among the top eight PEPFAR-funded countries in Africa, seven had harsh anti-homosexuality laws. Most (14) of the 16 African ‘Partnership Framework’ (PEPFAR) policy agreements between African governments and the US State Department call for stigma reduction; however, none call for reducing penalties on individuals who engage in homosexual behavior. Conclusions: We conclude that while PEPFAR has acknowledged the negative role of stigma in fueling the HIV epidemic, it has, so far, missed opportunities to explicitly address the role of the criminalization of homosexuality in feeding stigmatizing attitudes. Our analysis suggests mechanisms like PEPFAR Partnership Framework agreements could be ideal vehicles to call for removal of anti-homosexuality legislation. PMID:28580879

How students perceive medical competences: a cross-cultural study between the Medical Course in Portugal and African Portuguese Speaking Countries

PubMed Central

2011-01-01

Background A global effort has been made in the last years to establish a set of core competences that define the essential professional competence of a physician. Regardless of the environment, culture or medical education conditions, a set of core competences is required for medical practice worldwide. Evaluation of educational program is always needed to assure the best training for medical students and ultimately best care for patients. The aim of this study was to determine in what extent medical students in Portugal and Portuguese speaking African countries, felt they have acquired the core competences to start their clinical practice. For this reason, it was created a measurement tool to evaluate self-perceived competences, in different domains, across Portuguese and Portuguese-speaking African medical schools. Methods The information was collected through a questionnaire that defines the knowledge, attitudes and skills that future doctors should acquire. The Cronbach's Alpha and Principal Components Analysis (PCA) were used to evaluate the reliability of the questionnaire. In order to remove possible confounding effect, individual scores were standardized by country. Results The order of the domain's scores was similar between countries. After standardization, Personal Attitudes and Professional Behavior showed median scores above the country global median and Knowledge alone showed median score below the country global median. In Portugal, Clinical Skills showed score below the global median. In Angola, Clinical Skills and General Skills showed a similar result. There were only significant differences between countries in Personal Attitudes (p < 0.001) and Professional Behavior (p = 0.043). Conclusions The reliability of the instrument in Portuguese and Portuguese-speaking African medical schools was confirmed. Students have perceived their level of competence in personal attitudes in a high level and in opposite, knowledge and clinical skills with some weaknesses. PMID:21612609

Status of national health research systems in ten countries of the WHO African Region

PubMed Central

Kirigia, Joses M; Wambebe, Charles

2006-01-01

Background The World Health Organization (WHO) Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4) which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. Methods A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country) bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. Results The key findings were as follows: the response rate was 21.7% (10/46); three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS); two countries confirmed the existence of a functional national health research management forum (NHRMF); six countries had a functional ethical review committee (ERC); five countries had a scientific review committee (SRC); five countries reported the existence of health institutions with institutional review committees (IRC); two countries had a health research programme; and three countries had a national health research institute (NHRI) and a faculty of health sciences in the national university that conducted health research. Four out of the ten countries reported that they had a budget line for health research in the Ministry of Health budget document. Conclusion Governments of countries of the African Region, with the support of development partners, private sector and civil society, urgently need to improve the research policy environment by developing health research policies, strategic plans, legislations, programmes and rolling plans with the involvement of all stakeholders, e.g., relevant sectors, research organizations, communities, industry and donors. In a nutshell, development of high-performing national health research systems in the countries of the WHO African Region, though optional, is an imperative. It may be the only way of breaking free from the current vicious cycle of ill-health and poverty. PMID:17052326

Suicidal behaviour across the African continent: a review of the literature.

PubMed

Mars, Becky; Burrows, Stephanie; Hjelmeland, Heidi; Gunnell, David

2014-06-14

Suicide is a major cause of premature mortality worldwide, but data on its epidemiology in Africa, the world's second most populous continent, are limited. We systematically reviewed published literature on suicidal behaviour in African countries. We searched PubMed, Web of Knowledge, PsycINFO, African Index Medicus, Eastern Mediterranean Index Medicus and African Journals OnLine and carried out citation searches of key articles. We crudely estimated the incidence of suicide and suicide attempts in Africa based on country-specific data and compared these with published estimates. We also describe common features of suicide and suicide attempts across the studies, including information related to age, sex, methods used and risk factors. Regional or national suicide incidence data were available for less than one third (16/53) of African countries containing approximately 60% of Africa's population; suicide attempt data were available for <20% of countries (7/53). Crude estimates suggest there are over 34,000 (inter-quartile range 13,141 to 63,757) suicides per year in Africa, with an overall incidence rate of 3.2 per 100,000 population. The recent Global Burden of Disease (GBD) estimate of 49,558 deaths is somewhat higher, but falls within the inter-quartile range of our estimate. Suicide rates in men are typically at least three times higher than in women. The most frequently used methods of suicide are hanging and pesticide poisoning. Reported risk factors are similar for suicide and suicide attempts and include interpersonal difficulties, mental and physical health problems, socioeconomic problems and drug and alcohol use/abuse. Qualitative studies are needed to identify additional culturally relevant risk factors and to understand how risk factors may be connected to suicidal behaviour in different socio-cultural contexts. Our estimate is somewhat lower than GBD, but still clearly indicates suicidal behaviour is an important public health problem in Africa. More regional studies, in both urban and rural areas, are needed to more accurately estimate the burden of suicidal behaviour across the continent. Qualitative studies are required in addition to quantitative studies.

Women's empowerment and choice of contraceptive methods in selected African countries.

PubMed

Do, Mai; Kurimoto, Nami

2012-03-01

It is generally believed that women's lack of decision-making power may restrict their use of modern contraceptives. However, few studies have examined the different dimensions of women's empowerment and contraceptive use in African countries. Data came from the latest round of Demographic and Health Surveys conducted between 2006 and 2008 in Namibia, Zambia, Ghana and Uganda. Responses from married or cohabiting women aged 15-49 were analyzed for six dimensions of empowerment and the current use of female-only methods or couple methods. Bivariate and multivariate multinomial regressions were used to identify associations between the empowerment dimensions and method use. Positive associations were found between the overall empowerment score and method use in all countries (relative risk ratios, 1.1-1.3). In multivariate analysis, household economic decision making was associated with the use of either female-only or couple methods (1.1 for all), as was agreement on fertility preferences (1.3-1.6) and the ability to negotiate sexual activity (1.1-1.2). In Namibia, women's negative attitudes toward domestic violence were correlated with the use of couple methods (1.1). Intervention programs aimed at increasing contraceptive use may need to involve different approaches, including promoting couples' discussion of fertility preferences and family planning, improving women's self-efficacy in negotiating sexual activity and increasing their economic independence.

Urbanisation and the nutrition transition: a comparison of diet and weight status of South African and Kenyan women.

PubMed

Steyn, Nelia P; Nel, Johanna H; Parker, W; Ayah, Rosemary; Mbithe, Dorcus

2012-05-01

To determine and compare the extent of the nutrition transition between Kenyan and South African women. A nationally representative sample of women aged ≥15 years (n=1008) was assessed in Kenya. Weight, height, and waist and hip circumferences were measured. A 24-hour dietary recall was conducted with each participant. This data was compared with data of the Demographic and Health Survey (DHS) of women in South Africa (n=4481). Dietary intake of South African women was based on secondary data analysis of dietary studies using the 24-hour recall method (n=1726). In South Africa, 27.4% women had a BMI ≥30 kg/m(2) compared with 14.2% of Kenyan women. In both countries there were large urban-rural differences in BMI, with the highest prevalence in women in urban areas. BMI increased with age, as did abdominal obesity which was equally prolific in both countries with more than 45% of women in the older groups having a waist/hip ratio ≥0.85. The nutrient mean adequacy ratio (MAR) of the South African rural diet was lower than those of the Kenyans diet (55.9; 57.3%, respectively). Dietary diversity score (DDS) and food variety score (FVS) were significantly lower in South African rural women (3.3; 4.9) compared with Kenyans (4.5; 6.8). Urban-rural differences in diet and weight status indicates that the nutrition transition was similar in both countries despite large sociodemographic differences; however, rural Kenyan women had a better MAR, DDS, and FVS than South African women, most probably due to 60% having access to land.

Provision of inpatient rehabilitation and challenges experienced with participation post discharge: quantitative and qualitative inquiry of African stroke patients.

PubMed

Rhoda, Anthea; Cunningham, Natalie; Azaria, Simon; Urimubenshi, Gerard

2015-09-28

The provision of rehabilitation differs between developed and developing countries, this could impact on the outcomes of post stroke rehabilitation. The aim of this paper is to present provision of in-patient stroke rehabilitation. In addition the challenges experienced by the individuals with participation post discharge are also presented. Qualitative and quantitative research methods were used to collect data. The quantitative data was collected using a retrospective survey of stroke patients admitted to hospitals over a three- to five-year period. Quantitative data was captured on a validated data capture sheet and analysed descriptively. The qualitative data was collected using interviews from a purposively and conveniently selected sample, audio-taped and analysed thematically. The qualitative data was presented within the participation model. A total of 168 medical folders were reviewed for a South African sample, 139 for a Rwandan sample and 145 for a Tanzanian sample. The mean age ranged from 62.6 (13.78) years in the South African sample to 56.0 (17.4) in the Rwandan sample. While a total of 98 % of South African stroke patients received physiotherapy, only 39.4 % of Rwandan patients received physiotherapy. From the qualitative interviews, it became clear that the stroke patients had participation restrictions. When conceptualised within the Participation Model participation restrictions experienced by the stroke patients were a lack of accomplishment, inability to engage in previous roles and a perception of having health problems. With the exception of Rwanda, stroke patients in the countries studied are admitted to settings early post stroke allowing for implementation of effective acute interventions. The participants were experiencing challenges which included a lack of transport and the physical geographic surroundings in the rural settings not being conducive to wheelchair use. Stroke patients admitted to hospitals in certain African countries could receive limited in-patient therapeutic interventions. With the exception of barriers in the physical environment, stroke patients in developing countries where resources are limited experience the same participation restrictions as their counterparts in developed countries where resources are more freely available. Rehabilitation interventions in these developing countries should therefore be community-based focussing on intervening in the physical environment.

Optimising design and cost-effective implementation of future pan-African dietary studies: a review of existing economic integration and nutritional indicators for scenario-based profiling and clustering of countries.

PubMed

Aglago, Elom K; Landais, Edwige; Zotor, Francis; Nicolas, Genevieve; Gunter, Marc J; Amuna, Paul; Slimani, Nadia

2018-02-01

Most of the African countries are undergoing a complex nutrition and epidemiologic transition associated with a rapid increase in the prevalence of diverse non-communicable diseases. Despite this alarming situation, the still limited and fragmented resources available in Africa impede the implementation of effective action plans to tackle the current and projected diet-disease burden. In order to address these common needs and challenges, the African Union is increasingly supporting continental approaches and strategies as reflected in the launching of the Agenda 2063 and the African regional nutrition strategy 2015-2025, among others. To assure the successful implementation of pan-African nutritional and health initiatives, cost-effective approaches considering similarities/disparities in economy, regional integration, development and nutritional aspects between countries are needed. In the absence of pre-existing models, we reviewed regional economic integration and nutritional indicators (n 13) available in international organisations databases or governmental agencies websites, for fifty-two African countries. These indicators were used to map the countries according to common languages (e.g. Arabic, English, French, Portuguese), development status (e.g. human development index), malnutrition status (e.g. obesity) and diet (e.g. staples predominantly based on either cereals or tubers). The review of the indicators showed that there exist similarities between African countries that can be exploited to benefit the continent with cross-national experiences in order to avoid duplication of efforts in the implementation of future pan-African health studies. In addition, including present and future nutrition surveillance programmes in Africa into national statistical systems might be cost-effective and sustainable in the longer term.

State of equity: childhood immunization in the World Health Organization African Region.

PubMed

Casey, Rebecca Mary; Hampton, Lee McCalla; Anya, Blanche-Philomene Melanga; Gacic-Dobo, Marta; Diallo, Mamadou Saliou; Wallace, Aaron Stuart

2017-01-01

In 2010, the Global Vaccine Action Plan called on all countries to reach and sustain 90% national coverage and 80% coverage in all districts for the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) by 2015 and for all vaccines in national immunization schedules by 2020. The aims of this study are to analyze recent trends in national vaccination coverage in the World Health Organization African Region andto assess how these trends differ by country income category. We compared national vaccination coverage estimates for DTP3 and the first dose of measles-containing vaccine (MCV) obtained from the World Health Organization (WHO)/United Nations Children's Fund (UNICEF) joint estimates of national immunization coverage for all African Region countries. Using United Nations (UN) population estimates of surviving infants and country income category for the corresponding year, we calculated population-weighted average vaccination coverage by country income category (i.e., low, lower middle, and upper middle-income) for the years 2000, 2005, 2010 and 2015. DTP3 coverage in the African Region increased from 52% in 2000 to 76% in 2015,and MCV1 coverage increased from 53% to 74% during the same period, but with considerable differences among countries. Thirty-six African Region countries were low income in 2000 with an average DTP3 coverage of 50% while 26 were low income in 2015 with an average coverage of 80%. Five countries were lower middle-income in 2000 with an average DTP3 coverage of 84% while 12 were lower middle-income in 2015 with an average coverage of 69%. Five countries were upper middle-income in 2000 with an average DTP3 coverage of 73% and eight were upper middle-income in 2015 with an average coverage of 76%. Disparities in vaccination coverage by country persist in the African Region, with countries that were lower middle-income having the lowest coverage on average in 2015. Monitoring and addressing these disparities is essential for meeting global immunization targets.

Overview on health research ethics in Egypt and North Africa.

PubMed

Marzouk, Diaa; Abd El Aal, Wafaa; Saleh, Azza; Sleem, Hany; Khyatti, Meriem; Mazini, Loubna; Hemminki, Kari; Anwar, Wagida A

2014-08-01

Developing countries, including Egypt and North African countries, need to improve their quality of research by enhancing international cooperation and exchanges of scientific information, as well as competing for obtaining international funds to support research activities. Research must comply with laws and other requirements for research that involves human subjects. The purpose of this article is to overview the status of health research ethics in Egypt and North African countries, with reference to other Middle Eastern countries. The EU and North African Migrants: Health and Health Systems project (EUNAM) has supported the revision of the status of health research ethics in Egypt and North African countries, by holding meetings and discussions to collect information about research ethics committees in Egypt, and revising the structure and guidelines of the committees, as well as reviewing the literature concerning ethics activities in the concerned countries. This overview has revealed that noticeable efforts have been made to regulate research ethics in certain countries in the Middle East. This can be seen in the new regulations, which contain the majority of protections mentioned in the international guidelines related to research ethics. For most of the internationally registered research ethics committees in North African countries, the composition and functionality reflect the international guidelines. There is growing awareness of research ethics in these countries, which extends to teaching efforts to undergraduate and postgraduate medical students. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The impact of HIV/AIDS on human development in African countries.

PubMed

Boutayeb, Abdesslam

2009-11-18

In the present paper, we consider the impact of HIV/AIDS on human development in African countries, showing that, beyond health issues, this disease should and must be seen as a global development concern, affecting all components of human development. Consequently, we stress the necessity of multidisciplinary approaches that model, estimate and predict the real impact of HIV/AIDS on human development of African countries in order to optimise the strategies proposed by national countries, international institutions and their partners. In our search strategy, we relied on secondary information, mainly through National Human Development Reports of some African countries and regular publications released by the United Nations (UN), United Nations Development Programme (UNDP), World Health Organization (WHO) and the World Bank. We restricted ourselves to reports dealing explicitly with the impact of HIV/AIDS on human development in African countries. HIV/AIDS is affecting the global human development of African countries through its devastating impact on health and demographic indicators such as life expectancy at birth, healthcare assistance, age and sex distribution, economic indicators like income, work force, and economic growth, education and knowledge acquisition and other indicators like governance, gender inequality and human rights. On the basis of the national reports reviewed, it appears clearly that HIV/AIDS is no longer a crisis only for the healthcare sector, but presents a challenge to all sectors. Consequently, HIV/AIDS is a development question and should be viewed as such. The disease is impeding development by imposing a steady decline in the key indicators of human development and hence reversing the social and economic gains that African countries are striving to attain. Being at the same time a cause and consequence of poverty and underdevelopment, it constitutes a challenge to human security and human development by diminishing the chances of alleviating poverty and hunger, achieving universal primary education, promoting gender equality, reducing child and maternal mortality, and ensuring environmental sustainability.

Clinical nursing and midwifery research: grey literature in African countries.

PubMed

Sun, C; Dohrn, J; Omoni, G; Malata, A; Klopper, H; Larson, E

2016-03-01

This study reviewed grey literature to assess clinical nursing and midwifery research conducted in southern and eastern African countries over the past decade. The shortage of published nursing research from African countries severely limits the ability of practicing nurses and midwives to base clinical decisions on solid evidence. However, little is known regarding unpublished or unindexed clinical research ('grey literature'), a potentially rich source of information. Identifying these sources may reveal resources to assist nurses in providing evidence-based care. This scoping review of grey literature on clinical nursing and midwifery research in southern and eastern African countries helped to identify gaps in research and assess whether these gaps differ from published research. Systematic searches of grey literature were performed. Research was included if it was conducted by nurses in 1 of 25 southern or eastern African countries, between 2004 and 2014 and included patient outcomes. Data were extracted on location, institution, research topic, institutional connections and author information. Chi-square tests were performed to compare differences between indexed and non-indexed literature. We found 262 studies by 287 authors from 17 southern and eastern African countries covering 13 topics. Although all topics were also found in indexed literature and there were statistically significant differences between the number of times, fewer topics were covered in grey literature vs. indexed. Patient satisfaction and experience and traditional health practices were more likely to be published, whereas chronic disease, assault and paediatric-related research were less often published. Generally, there is a paucity of clinical nursing research in this region. This could reflect the shortage of nurses prepared to conduct research in this region. Nurses may find additional resources for evidence in the grey literature. A complete understanding of the state of nursing science in southern and eastern African countries will help nurses and midwives to understand gaps in clinical research knowledge, potentially direct their research to more critical topics, and inform funding bodies and policy-makers of the situation of nursing science in southern and eastern African countries. © 2016 International Council of Nurses.

L'Afrique en Francais (Africa in French). African Outreach Series, No. 6.

ERIC Educational Resources Information Center

Arlabosse, Severine

This handbook on francophone Africa is designed to provide supplemental material for a French class. Its objectives are: (1) to provide the teacher with ready-to-use material as an alternative to a textbook; (2) to present French speaking countries other than France and especially to present francophone African countries from an African viewpoint;…

Do You Speak African? Teaching for Diversity Awareness in an Era of Globalization

ERIC Educational Resources Information Center

Kambutu, John; Nganga, Lydiah

2014-01-01

Africa is a continent, not a country. Yet, a monolithic misunderstanding of Africa as a country is prevalent especially in the United States. Thus, Africans in the diaspora who speak heritage languages other than English are asked frequently if they speak African. This study countered existing misunderstandings through cultural immersion in Kenya,…

Leaving Home: The Challenges of Black-African International Students Prior to Studying Overseas

ERIC Educational Resources Information Center

Caldwell, Elizabeth Frances; Hyams-Ssekasi, Denis

2016-01-01

Much of the literature on international students centres on their experiences once they arrive in their host countries. This study explores the preparations of Black-African students for leaving their home countries to study abroad. Semi-structured interviews were carried out with 50 Black-African students studying at one British university. The…

Missed opportunities and barriers for vaccination: a descriptive analysis of private and public health facilities in four African countries

PubMed Central

Olorunsaiye, Comfort Zuyeali; Langhamer, Margaret Shaw; Wallace, Aaron Stuart; Watkins, Margaret Lyons

2017-01-01

Introduction Missed opportunities and barriers to vaccination limit progress toward achieving high immunization coverage and other global immunization goals. Little is known about vaccination practices contributing to missed opportunities and barriers among private healthcare providers in Africa. Methods Service Provision Assessments (SPA) of representative samples of health facilities in four African countries (Kenya, Tanzania, Senegal, Malawi) in 2010-2015 were used to describe missed opportunities and barriers for vaccination in public, private for-profit, private not-for-profit and faith-based facilities. Data included vaccination practices, observations during sick child and antenatal visits, and exit interviews following sick child visits. Results Data from 3,219 health facilities, 11,613 sick child visits and 8,698 antenatal visits were included. A smaller proportion of for-profit facilities offered child vaccination services (country range, 25-37%) than did public facilities (range, 90-96%). The proportion of facilities offering pentavalent vaccine (diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenza type b antigens) daily ranged 0-77% across countries and facility types. Less than 33% of for-profit facilities in any country offered measles vaccination daily. A minority of public or private providers assessed the child’s vaccination status during a sick child visit (range by country and facility type, 14-44%), or offered tetanus toxoid during antenatal visits (range, 19-51%). Very few providers discussed the importance of newborn vaccination. Conclusion Substantial missed opportunities for, and barriers to, vaccination were identified across this representative sample of health facilities in four African countries. Strategies are needed to ensure that private and public providers implement practices to minimize barriers and missed opportunities for vaccination. PMID:29296141

Indirect cost of maternal deaths in the WHO African Region in 2010.

PubMed

Kirigia, Joses Muthuri; Mwabu, Germano Mwige; Orem, Juliet Nabyonga; Muthuri, Rosenabi Deborah Karimi

2014-08-31

An estimated 147,741 maternal deaths occurred in 2010 in 45 of the 47 countries in the African Region of the World Health Organization (WHO). The objective of this study was to estimate the indirect cost of maternal deaths in the Region to provide data for use in advocacy for increased domestic and external investment in multisectoral policy interventions to curb maternal mortality. This study used the cost-of-illness method to estimate the indirect cost of maternal mortality, i.e. the loss in non-health gross domestic product (GDP) attributable to maternal deaths. Estimates on maternal mortality for 2010 from Trends in maternal mortality: 1990 to 2010 published by WHO, UNICEF, UNFPA and the World Bank were used in these calculations. Values for future non-health GDP lost were converted into their present values by applying a 3% discount rate. One-way sensitivity analysis at 5% and 10% discount rates assessed the impact on non-health GDP loss. Indirect cost analysis was undertaken for the countries, categorized under three income groups. Group 1 consisted of nine high and upper middle income countries, Group 2 of 12 lower middle income countries, and Group 3 of 26 low income countries. Estimates for Seychelles in Group 1 and South Sudan in Group 3 were not provided in the source used. The 147,741 maternal deaths that occurred in 45 countries in the African Region in 2010 resulted in a total non-health GDP loss of Int$ 4.5 billion (PPP). About 24.5% of the loss was in Group 1 countries, 44.9% in Group 2 countries and 30.6% in Group 3 countries. This translated into losses in non-health GDP of Int$ 139,219, Int$ 35,440 and Int$ 16,397 per maternal death, respectively, for the three groups. Using discount rates of 5% and 10% reduced the total non-health GDP loss by 19.1% and 47.7%, respectively. Maternal mortality is responsible for a noteworthy level of non-health GDP loss among the countries in the African Region. There is urgent need, therefore, to increase domestic and external investment to scale up coverage of existing cost-effective, multisectoral women's health interventions to reduce maternal morbidity and mortality.

Black versus Black: The Relationship among African, African American, and African Caribbean Persons.

ERIC Educational Resources Information Center

Jackson, Jennifer V.; Cothran, Mary E.

2003-01-01

Surveyed people of African descent regarding relationships among African, African-American, and African-Caribbean persons, focusing on contact and friendship, travel to countries of the diaspora, cross-cultural communication, thoughts and stereotypes, and education. Most respondents had contacts with the other groups, but groups had preconceived…

How dietary intake has been assessed in African countries? A systematic review.

PubMed

Vila-Real, Catarina; Pimenta-Martins, Ana; Gomes, Ana Maria; Pinto, Elisabete; Maina, Ndegwa Henry

2018-04-13

Dietary patterns are often considered as one of the main causes of non-communicable diseases worldwide. It is of utmost importance to study dietary habits in developing countries since this work is scarce. To summarize the most recent research conducted in this field in African countries, namely the most used methodologies and tools. A systematic review was conducted on MEDLINE®/PubMed, aiming to identify scientific publications focused on studies of dietary intake of different African populations, in a ten-year period. Papers not written in English/Portuguese/Spanish, studies developed among African people but not developed in African countries, studies aiming to assess a particular nutrient/specific food/food toxin and studies that assessed dietary intake among children were excluded. Out of 99 included studies, the 24-hour recall and the food-frequency questionnaire were the most used dietary intake assessment tools, used to assess diet at an individual level. It was also observed that often country-unspecific food composition databases are used, and the methodologies employed are poorly validated and standardized. There is an emergent need to improve the existing food databases by updating food data and to develop suitable country-specific databases for those that do not have their own food composition table.

How can psychological theory help to promote condom use in sub-Saharan African developing countries?

PubMed

Campbell, T

1997-06-01

Condom use for HIV prevention has been very inconsistent in most sub-Saharan African countries. Studies from around the continent report that knowledge about HIV transmission is variable and seems to be related to gender, socioeconomic and educational status. There is a large body of psychological knowledge about HIV prevention which has been applied to condom promotion campaigns in developed countries. These approaches to condom promotion, based on formal theory, have not been used on a wide scale in African countries and this paper explores ways in which psychological theory might be appropriately applied in a situation of high HIV prevalence.

Cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe: a literature review

PubMed Central

Agyemang, Charles; Addo, Juliet; Bhopal, Raj; de Graft Aikins, Ama; Stronks, Karien

2009-01-01

Background Most European countries are ethnically and culturally diverse. Globally, cardiovascular disease (CVD) is the leading cause of death. The major risk factors for CVD have been well established. This picture holds true for all regions of the world and in different ethnic groups. However, the prevalence of CVD and related risk factors vary among ethnic groups. Methods This article provides a review of current understanding of the epidemiology of vascular disease, principally coronary heart disease (CHD), stroke and related risk factors among populations of Sub-Sahara African descent (henceforth, African descent) in comparison with the European populations in Europe. Results Compared with European populations, populations of African descent have an increased risk of stroke, whereas CHD is less common. They also have higher rates of hypertension and diabetes than European populations. Obesity is highly prevalent, but smoking rate is lower among African descent women. Older people of African descent have more favourable lipid profile and dietary habits than their European counterparts. Alcohol consumption is less common among populations of African descent. The rate of physical activity differs between European countries. Dutch African-Suriname men and women are less physically active than the White-Dutch whereas British African women are more physically active than women in the general population. Literature on psychosocial stress shows inconsistent results. Conclusion Hypertension and diabetes are highly prevalent among African populations, which may explain their high rate of stroke in Europe. The relatively low rate of CHD may be explained by the low rates of other risk factors including a more favourable lipid profile and the low prevalence of smoking. The risk factors are changing, and on the whole, getting worse especially among African women. Cohort studies and clinical trials are therefore needed among these groups to determine the relative contribution of vascular risk factors, and to help guide the prevention efforts. There is a clear need for intervention studies among these populations in Europe. PMID:19671137

3 CFR 8741 - Proclamation 8741 of October 25, 2011. To Take Certain Actions Under the African Growth and...

Code of Federal Regulations, 2012 CFR

2012-01-01

...’Ivoire (Côte d’Ivoire), the Republic of Guinea (Guinea), and the Republic of Niger (Niger) meet the..., Guinea, and Niger as eligible sub-Saharan African countries and as beneficiary sub-Saharan African countries. 5. Côte d’Ivoire, Guinea, and Niger each satisfy the criterion for treatment as a “lesser...

Access to What? Creating a Composite Measure of Educational Quantity and Educational Quality for 11 African Countries

ERIC Educational Resources Information Center

Spaull, Nicholas; Taylor, Stephen

2015-01-01

The aim of the current study is to create a composite statistic of educational quantity and educational quality by combining household data (Demographic and Health Survey) on grade completion and survey data (Southern and Eastern African Consortium for Monitoring Educational Quality) on cognitive outcomes for 11 African countries: Kenya, Lesotho,…

Coordination as a best practice from the polio eradication initiative: Experiences from five member states in the African region of the World Health Organization.

PubMed

Okeibunor, Joseph; Nsubuga, Peter; Salla, Mbaye; Mihigo, Richard; Mkanda, Pascal

2016-10-10

As part of the efforts to eradicate polioviruses in the African Region, structures were put in place to ensure coordinated mobilization and deployment of resources within the framework of the global polio eradication initiative (PEI). The successes of these structures made them not only attractive to other public health interventions, but also caused them to be deployed to the response efforts of other diseases interventions, without any systematic documentation. This article documents the contributions of PEI coordination units to other public health interventions in the African Region of World Health Organization METHODS: We reviewed the contributions of PEI coordination units to other public health interventions in five countries in the African Region. The analysis identified significant involvement of PEI coordination structures in the implementation of routine immunization programs in all the countries analyzed. Similarly, maternal and child health programs were planned, implemented, monitored and evaluation the Inter-Agency Coordination Committees of the PEI programs in the different countries. The hubs system used in PEI in Chad facilitated the efficient coordination of resources for immunization and other public health interventions in Chad. Similarly, in the Democratic Republic of Congo PEI led coordination activities benefited other public health programs like disease control and the national nutrition program, the national malaria control program, and the tuberculosis control program. In Nigeria, the polio Expert Review Committee effectively deployed the Emergency Operation Center for the implementation of prioritized strategies and activities of the National Polio Eradication Emergency Plan, and it was utilized in the response to Ebola Virus Disease outbreak in the country. The PEI-led coordination systems are thus recognized as having made significant contribution to the coordination and delivery of other public health interventions in the African Region. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Under the Sun or in the Shade? Jua Kali in African Countries. National Policy Definition in Technical and Vocational Education: Beyond the Formal Sector. A Subregional Seminar for Eastern and Southern African Countries (Nairobi, Kenya, September 15-19, 1997). International project on Technical and Vocational Education (UNEVOC).

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Berlin (Germany).

This document is a comprehensive report a subregional seminar for eastern and southern African countries on the Jua Kali movement. (Jua Kali, "hot sun" in Swahili, refers to the informal or nonformal sector of the economy.) Section 1 explains the role of the International Project on Technical and Vocational Education (UNEVOC) in the…

E-health: Determinants, opportunities, challenges and the way forward for countries in the WHO African Region

PubMed Central

Kirigia, Joses M; Seddoh, Anthony; Gatwiri, Doris; Muthuri, Lenity HK; Seddoh, Janet

2005-01-01

Background The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. Methods The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. Results There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income countries in the Region. By focusing on the adoption of specific technologies we attempted to interpret correlates in terms of relationships instead of absolute "causals". Conclusion In order to improve access to health care, especially for the majority of Africans living in remote rural areas, there is need to boost the availability and utilization of e-health services. Thus, universal access to e-health ought to be a vision for all countries in the African Region. Each country ought to develop a road map in a strategic e-health plan that will, over time, enable its citizens to realize that vision. PMID:16364186

Patterns of chloroquine use and resistance in sub-Saharan Africa: a systematic review of household survey and molecular data

PubMed Central

2011-01-01

Background As a result of widespread chloroquine and sulphadoxine-pyrimethamine (SP) resistance, 90% of sub-Saharan African countries had adopted policies of artemisinin-based combination therapy (ACT) for treatment of uncomplicated malaria by 2007. In Malawi, cessation of chloroquine use was followed by the re-emergence of chloroquine-susceptible malaria. It was expected that introduction of ACT would lead to a return in chloroquine susceptibility throughout Africa, but this has not yet widely occurred. This observation suggests that there is continuing use of ineffective anti-malarials in Africa and that persistent chloroquine-resistant malaria is due to ongoing drug pressure despite national policy changes. Methods To estimate drug use on a national level, 2006-2007 Demographic Health Survey and Multiple Indicator Cluster Survey data from 21 African countries were analysed. Resistance data were compiled by systematic review of the published literature on the prevalence of the Plasmodium falciparum chloroquine resistance transporter polymorphism at codon 76, which causes chloroquine resistance. Results Chloroquine was the most common anti-malarial used according to surveys from 14 of 21 countries analysed, predominantly in West Africa. SP was most commonly reported in two of 21 countries. Among eight countries with longitudinal molecular resistance data, the four countries where the highest proportion of children treated for fever received chloroquine (Uganda, Burkina Faso, Guinea Bissau, and Mali) also showed no significant declines in the prevalence of chloroquine-resistant infections. The three countries with low or decreasing chloroquine use among children who reported fever treatment (Malawi, Kenya, and Tanzania) had statistically significant declines in the prevalence of chloroquine resistance. Conclusions This study demonstrates that in 2006-2007, chloroquine and SP continued to be used at high rates in many African countries. In countries reporting sustained chloroquine use, chloroquine-resistant malaria persists. In contrast, a low level of estimated chloroquine use is associated with a declining prevalence of chloroquine resistance. PMID:21554692

Economic Aspects of Agricultural Development in Africa. A Selective Annotated Reading List of Reports and Studies Concerning 40 African Countries During the Period 1960 - 1969.

ERIC Educational Resources Information Center

Neville-Rolfe, Edmund, Comp.

Some 1394 research studies from various African countries are annotated in this bibliography, which is divided into 37 country sections with a separate section (Africa General) for studies dealing with the continent as a whole, with geographical regions, or with groups of countries. The publications listed and summarized were published primarily…

The Audio-Visual Services in Fifteen African Countries. Comparative Study on the Administration of Audio-Visual Services in Advanced and Developing Countries. Part Four. First Edition.

ERIC Educational Resources Information Center

Jongbloed, Harry J. L.

As the fourth part of a comparative study on the administration of audiovisual services in advanced and developing countries, this UNESCO-funded study reports on the African countries of Cameroun, Republic of Central Africa, Dahomey, Gabon, Ghana, Kenya, Libya, Mali, Nigeria, Rwanda, Senegal, Swaziland, Tunisia, Upper Volta and Zambia. Information…

Is Africa a 'Graveyard' for Linear Accelerators?

PubMed

Reichenvater, H; Matias, L Dos S

2016-12-01

Linear accelerator downtimes are common and problematic in many African countries and may jeopardise the outcome of affected radiation treatments. The predicted increase in cancer incidence and prevalence on the African continent will require, inter alia, improved response with regard to a reduction in linear accelerator downtimes. Here we discuss the problems associated with the maintenance and repair of linear accelerators and propose alternative solutions relevant for local conditions in African countries. The paper is based on about four decades of experience in capacity building, installing, commissioning, calibrating, servicing and repairing linear accelerators in Africa, where about 40% of the low and middle income countries in the world are geographically located. Linear accelerators can successfully be operated, maintained and repaired in African countries provided proper maintenance and repair plans are put in place and executed. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Factors Influencing African Postgraduate International Students' Choice of South Africa as a Study Destination

ERIC Educational Resources Information Center

Mpinganjira, Mercy

2012-01-01

Many African countries are concerned with the targeting of international postgraduate students by developed countries for skilled migration. Increased provision of postgraduate studies within the continent would go a long way in dealing with the problem. Success will however depend on the ability of countries in the continent to attract…

Future leaders: Rwandan resolve « Coast Guard Compass

Science.gov Websites

Karama, an international cadet at the U.S. Coast Guard Academy, is from the African country of Rwanda , an international cadet at the U.S. Coast Guard Academy, is from the African country of Rwanda. U.S ; The Academy has several international cadets in attendance from countries spanning the globe. Bringing

Study on the Development of Museums for Improved Integration of the Cultural Heritage into the Education System in French-Speaking African Countries.

ERIC Educational Resources Information Center

Essomba, Joseph-Marie

Objectives for establishing museums in African countries for the purpose of teaching African history, languages, literature, and art are presented. Section 1 of the report focuses on the museum as a basis for creating an awareness of history, developing cultural individuality, laying groundwork for an endogenous form of development, and serving as…

Relationship between Distinct African Cholera Epidemics Revealed via MLVA Haplotyping of 337 Vibrio cholerae Isolates.

PubMed

Moore, Sandra; Miwanda, Berthe; Sadji, Adodo Yao; Thefenne, Hélène; Jeddi, Fakhri; Rebaudet, Stanislas; de Boeck, Hilde; Bidjada, Bawimodom; Depina, Jean-Jacques; Bompangue, Didier; Abedi, Aaron Aruna; Koivogui, Lamine; Keita, Sakoba; Garnotel, Eric; Plisnier, Pierre-Denis; Ruimy, Raymond; Thomson, Nicholas; Muyembe, Jean-Jacques; Piarroux, Renaud

2015-01-01

Since cholera appeared in Africa during the 1970s, cases have been reported on the continent every year. In Sub-Saharan Africa, cholera outbreaks primarily cluster at certain hotspots including the African Great Lakes Region and West Africa. In this study, we applied MLVA (Multi-Locus Variable Number Tandem Repeat Analysis) typing of 337 Vibrio cholerae isolates from recent cholera epidemics in the Democratic Republic of the Congo (DRC), Zambia, Guinea and Togo. We aimed to assess the relationship between outbreaks. Applying this method, we identified 89 unique MLVA haplotypes across our isolate collection. MLVA typing revealed the short-term divergence and microevolution of these Vibrio cholerae populations to provide insight into the dynamics of cholera outbreaks in each country. Our analyses also revealed strong geographical clustering. Isolates from the African Great Lakes Region (DRC and Zambia) formed a closely related group, while West African isolates (Togo and Guinea) constituted a separate cluster. At a country-level scale our analyses revealed several distinct MLVA groups, most notably DRC 2011/2012, DRC 2009, Zambia 2012 and Guinea 2012. We also found that certain MLVA types collected in the DRC persisted in the country for several years, occasionally giving rise to expansive epidemics. Finally, we found that the six environmental isolates in our panel were unrelated to the epidemic isolates. To effectively combat the disease, it is critical to understand the mechanisms of cholera emergence and diffusion in a region-specific manner. Overall, these findings demonstrate the relationship between distinct epidemics in West Africa and the African Great Lakes Region. This study also highlights the importance of monitoring and analyzing Vibrio cholerae isolates.

Reaching every child with rotavirus vaccine: Report from the 10th African rotavirus symposium held in Bamako, Mali.

PubMed

Sow, Samba O; Steele, A Duncan; Mwenda, Jason M; Armah, George E; Neuzil, Kathleen M

2017-10-09

The Center for Vaccine Development - Mali (CVD - Mali), the World Health Organization's regional office in Africa (WHO/AFRO), and the CVD at the University of Maryland School of Medicine hosted the 10th African Rotavirus Symposium in Bamako, Mali on 1-2 June 2016. The symposium is coordinated by WHO/AFRO, the Regional Rotavirus Reference Laboratories, and the African Rotavirus Network (ARN), with support from the Bill & Melinda Gates Foundation. The event brings together leading rotavirus researchers, scientists, and policy-makers from across Africa and the world. Over 150 participants, from 31 countries, including 27 in Africa, joined forces to address the theme "Reaching Every Child in Africa with Rotavirus Vaccines." This symposium, the first in francophone Africa, occurred at an unprecedented time when 33 African countries had introduced rotavirus vaccines into their national immunization programs. The symposium concluded with a Call to Action to introduce rotavirus vaccines in the 21 remaining African countries, to increase access in countries with existing vaccination programs, and to continue surveillance and research on rotavirus and other diarrheal diseases. Copyright © 2017.

A SNP test to identify Africanized honeybees via proportion of 'African' ancestry.

PubMed

Chapman, Nadine C; Harpur, Brock A; Lim, Julianne; Rinderer, Thomas E; Allsopp, Michael H; Zayed, Amro; Oldroyd, Benjamin P

2015-11-01

The honeybee, Apis mellifera, is the world's most important pollinator and is ubiquitous in most agricultural ecosystems. Four major evolutionary lineages and at least 24 subspecies are recognized. Commercial populations are mainly derived from subspecies originating in Europe (75-95%). The Africanized honeybee is a New World hybrid of A. m. scutellata from Africa and European subspecies, with the African component making up 50-90% of the genome. Africanized honeybees are considered undesirable for bee-keeping in most countries, due to their extreme defensiveness and poor honey production. The international trade in honeybees is restricted, due in part to bans on the importation of queens (and semen) from countries where Africanized honeybees are extant. Some desirable strains from the United States of America that have been bred for traits such as resistance to the mite Varroa destructor are unfortunately excluded from export to countries such as Australia due to the presence of Africanized honeybees in the USA. This study shows that a panel of 95 single nucleotide polymorphisms, chosen to differentiate between the African, Eastern European and Western European lineages, can detect Africanized honeybees with a high degree of confidence via ancestry assignment. Our panel therefore offers a valuable tool to mitigate the risks of spreading Africanized honeybees across the globe and may enable the resumption of queen and bee semen imports from the Americas. © 2015 John Wiley & Sons Ltd.

Diabetic nephropathy in Africa: A systematic review

PubMed Central

Noubiap, Jean Jacques N; Naidoo, Jashira; Kengne, Andre P

2015-01-01

AIM: To determine the prevalence and incidence of diabetic nephropathy in Africa. METHODS: We performed a systematic narrative review of published literature following the MOOSE Guidelines for Meta-Analysis and Systematic Reviews of Observational Studies. We searched PubMed-MEDLINE for all articles published in English and French languages between January 1994 and July 2014 using a predefined strategy based on the combination of relevant terms and the names of each of the 54 African countries and African sub-regions to capture the largest number of studies, and hand-searched the reference lists of retrieved articles. Included studies reported on the prevalence, incidence or determinants of chronic kidney disease (CKD) in people with diabetes within African countries. RESULTS: Overall, we included 32 studies from 16 countries; two being population-based studies and the remaining being clinic-based surveys. Most of the studies (90.6%) were conducted in urban settings. Methods for assessing and classifying CKD varied widely. Measurement of urine protein was the most common method of assessing kidney damage (62.5% of studies). The overall prevalence of CKD varied from 11% to 83.7%. Incident event rates were 94.9% for proteinuria at 10 years of follow-up, 34.7% for end-stage renal disease at 5 years of follow-up and 18.4% for mortality from nephropathy at 20 years of follow-up. Duration of diabetes, blood pressure, advancing age, obesity and glucose control were the common determinants of kidney disease. CONCLUSION: The burden of CKD is important among people with diabetes in Africa. High quality data from large population-based studies with validated measures of kidney function are still needed to better capture the magnitude and characteristics of diabetic nephropathy in Africa. PMID:26069725

Alcohol Control Policies in 46 African Countries: Opportunities for Improvement.

PubMed

Ferreira-Borges, Carina; Esser, Marissa B; Dias, Sónia; Babor, Thomas; Parry, Charles D H

2015-07-01

There is little information on the extent to which African countries are addressing alcohol consumption and alcohol-related harm, which suggests that evaluations of national alcohol policies are needed in this region. The aim of this article is to examine the strength of a mix of national alcohol control policies in African countries, as well as the relationship between alcohol policy restrictiveness scores and adult alcohol per capita consumption (APC) among drinkers at the national level. We examined national alcohol policies of 46 African countries, as of 2012, in four regulatory categories (price, availability, marketing and drink-driving), and analyzed the restrictiveness of national alcohol policies using an adapted Alcohol Policy Index (API). To assess the validity of the policy restrictiveness scores, we conducted correlational analyses between policy restrictiveness scores and APC among drinkers in 40 countries. Countries attained a mean score of 44.1 of 100 points possible, ranging from 9.1 (Sao Tomé and Principe) to 75.0 (Algeria), with low scores indicating low policy restrictiveness. Policy restrictiveness scores were negatively correlated with and APC among drinkers (rs = -0.353, P = 0.005). There is great variation in the strength of alcohol control policies in countries throughout the African region. Tools for comparing the restrictiveness of alcohol policies across countries are available and are an important instrument to monitor alcohol policy developments. The negative correlation between policy restrictiveness and alcohol consumption among drinkers suggests the need for stronger alcohol policies as well as increased training and capacity building at the country level. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

African medicinal plants and their derivatives: Current efforts towards potential anti-cancer drugs.

PubMed

Mbele, Mzwandile; Hull, Rodney; Dlamini, Zodwa

2017-10-01

Cancer is a leading cause of mortality and morbidity worldwide and second only to cardiovascular diseases. Cancer is a challenge in African countries because generally there is limited funding available to deal with the cancer epidemic and awareness and this should be prioritised and all possible resources should be utilized to prevent and treat cancer. The current review reports on the role of African medicinal plants in the treatment of cancer, and also outlines methodologies that can also be used to achieve better outcomes for cancer treatment. This review outlines African medicinal plants, isolated compounds and technologies that can be used to advance cancer research. Chemical structures of isolated compounds have an important role in anti-cancer treatments; new technologies and methods may assist to identify more properties of African medicinal plants and the treatment of cancer. In conclusion, African medicinal plants have shown their potential as enormous resources for novel cytotoxicity compounds. Finally it has been noted that the cytotoxicity depends on the chemical structural arrangements of African medicinal plants compounds. Copyright © 2017 Elsevier Inc. All rights reserved.

Diaspora engagement of African migrant health workers - examples from five destination countries.

PubMed

Wojczewski, Silvia; Poppe, Annelien; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Pentz, Stephen; Kutalek, Ruth

2015-01-01

Migrant health workers fill care gaps in their destination countries, but they also actively engage in improving living conditions for people of their countries of origin through expatriate professional networks. This paper aims to explore the professional links that migrant health workers from sub-Saharan African countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the United Kingdom) have to their countries of origin. Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan Africa (N=66). A qualitative content analysis of the material was performed using the software ATLAS.ti. Almost all migrant health workers have professional ties with their countries of origin supporting health, education, and social structures. They work with non-governmental organizations, universities, or hospitals and travel back and forth between their destination country and country of origin. For a few respondents, professional engagement or even maintaining private contacts in their country of origin is difficult due to the political situation at home. The results show that African migrant health workers are actively engaged in improving living conditions not only for their family members but also for the population in general in their countries of origin. Our respondents are mediators and active networkers in a globalized and transnationally connected world. The research suggests that the governments of these countries of origin could strategically use their migrant health workforce for improving education and population health in sub-Saharan Africa. Destination countries should be reminded of their need to comply with the WHO Global Code of Practice for the international recruitment of health professionals.

(Mis)Representation among U.S. Study Abroad Programs Traveling to the African Continent: A Critical Content Analysis of a Teach Abroad Program

ERIC Educational Resources Information Center

Onyenekwu, Ifeyinwa; Angeli, Julianne Marie; Pinto, Ransford; Douglas, Ty-Ron

2017-01-01

The Institute for International Education's Annual Open Doors Report (2014) indicates that less than 5% of study abroad college students travel to sub-Saharan African countries, with South Africa being the only African country to make the top 25 study abroad destinations for U.S. students, and it attracts only 1.8% of all collegians. Study abroad…

An overview of tobacco control and prevention policy status in Africa.

PubMed

Husain, Muhammad Jami; English, Lorna McLeod; Ramanandraibe, Nivo

2016-10-01

Tobacco smoking prevalence remains low in many African countries. However, growing economies and the increased presence of multinational tobacco companies in the African Region have the potential to contribute to increasing tobacco use rates in the future. This paper used data from the 2014 Global Progress Report on implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), as well as the 2015 WHO report on the global tobacco epidemic, to describe the status of tobacco control and prevention efforts in countries in the WHO African Region relative to the provisions of the WHO FCTC and MPOWER package. Among the 23 countries in the African Region analyzed, there are large variations in the overall WHO FCTC implementation rates, ranging from 9% in Sierra Leone to 78% in Kenya. The analysis of MPOWER implementation status indicates that opportunities exist for the African countries to enhance compliance with WHO recommended best practices for monitoring tobacco use, protecting people from tobacco smoke, offering help to quit tobacco use, warning about the dangers of tobacco, enforcing bans on tobacco advertising and promotion, and raising taxes on tobacco products. If tobacco control interventions are successfully implemented, African nations could avert a tobacco-related epidemic, including premature death, disability, and the associated economic, development, and societal costs. Published by Elsevier Inc.

An overview of tobacco control and prevention policy status in Africa

PubMed Central

Husain, Muhammad Jami; English, Lorna McLeod; Ramanandraibe, Nivo

2017-01-01

Tobacco smoking prevalence remains low in many African countries. However, growing economies and the increased presence of multinational tobacco companies in the African Region have the potential to contribute to increasing tobacco use rates in the future. This paper used data from the 2014 Global Progress Report on implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), as well as the 2015 WHO report on the global tobacco epidemic, to describe the status of tobacco control and prevention efforts in countries in the WHO African Region relative to the provisions of the WHO FCTC and MPOWER package. Among the 23 countries in the African Region analyzed, there are large variations in the overall WHO FCTC implementation rates, ranging from 9% in Sierra Leone to 78% in Kenya. The analysis of MPOWER implementation status indicates that opportunities exist for the African countries to enhance compliance with WHO recommended best practices for monitoring tobacco use, protecting people from tobacco smoke, offering help to quit tobacco use, warning about the dangers of tobacco, enforcing bans on tobacco advertising and promotion, and raising taxes on tobacco products. If tobacco control interventions are successfully implemented, African nations could avert a tobacco-related epidemic, including premature death, disability, and the associated economic, development, and societal costs. PMID:26876626

Using Examinations To Improve Education: A Study in Fourteen African Countries. World Bank Technical Paper Number 165. Africa Technical Department Series.

ERIC Educational Resources Information Center

Kellaghan, Thomas; Greaney, Vincent

A detailed description is presented of the types, functions, performance levels, governance, administration, and funding of public examinations in 14 Sub-Saharan African countries with different educational traditions, based on English, French, or other backgrounds. The countries are: (1) Kenya; (2) Lesotho; (3) Mauritius; (4) Swaziland; (5)…

Progress toward Global Polio Eradication - Africa, 2011.

PubMed

2012-03-23

By January 2012, 23 years after the Global Polio Eradication Initiative (GPEI) was begun, indigenous wild poliovirus (WPV) transmission had been interrupted in all countries except Afghanistan, Pakistan, and Nigeria. However, importation of WPV into 29 previously polio-free African countries during 2003-2011 led to reestablished WPV transmission (i.e., lasting >12 months) in Angola, Chad, Democratic Republic of the Congo (DRC), and Sudan (although the last confirmed case in Sudan occurred in 2009). This report summarizes progress toward polio eradication in Africa. In 2011, 350 WPV cases were reported by 12 African countries, a 47% decrease from the 657 cases reported in 2010. From 2010 to 2011, the number of cases decreased in Angola (from 33 to five) and DRC (from 100 to 93) and increased in Nigeria (from 21 to 62) and Chad (from 26 to 132). New WPV outbreaks were reported in 2011 in eight African countries, and transmission subsequently was interrupted in six of those countries. Ongoing endemic transmission in Nigeria poses a major threat to the success of GPEI. Vigilant surveillance and high population immunity levels must be maintained in all African countries to prevent and limit new outbreaks.

Health financing in the African Region: 2000–2009 data analysis

PubMed Central

2013-01-01

Background In order to raise African countries probability of achieving the United Nations Millennium Development Goals by 2015, there is need to increase and more efficiently use domestic and external funding to strengthen health systems infrastructure in order to ensure universal access to quality health care. The objective of this paper is to examine the changes that have occurred in African countries on health financing, taking into account the main sources of funding over the period 2000 to 2009. Methods Our analysis is based on the National Health Accounts (NHA) data for the 46 countries of the WHO African Region. The data were obtained from the WHO World Health Statistics Report 2012. Data for Zimbabwe was not available. The analysis was done using Excel software. Results Between 2000 and 2009, number of countries spending less than 5% of their GDP on health decreased from 24 to 17; government spending on health as a percentage of total health expenditure increased in 31 countries and decreased in 13 countries; number of countries allocating at least 15% of national budgets on health increased from 2 to 4; number of countries partially financing health through social security increased from 19 to 21; number of countries where private spending was 50% and above of total health expenditure decreased from 29 (64%) to 23 (51%); over 70% of private expenditure on health came from household out-of-pocket payments (OOPS) in 32 (71%) countries and in 27 (60%) countries; number of countries with private prepaid plans increased from 29 to 31; number of countries financing more than 20% of their total health expenditure from external sources increased from 14 to 19; number of countries achieving the Commission for Macroeconomics and Health recommendation of spending at least US$34 per person per year increased from 11 to 29; number of countries achieving the International Taskforce on Innovative Financing recommendation of spending at least US$44 per person per year increased from 11 to 24; average per capita total expenditure on health increased from US$35 to US$82; and average per capita government expenditure on health grew from US$ 15 to US$ 41. Conclusion Whilst the African Region (AFR) average government expenditure on health as a per cent of THE increased by 5.4 per cent, the average private health expenditure decreased by the same percentage between 2000 and 2009. The regional average OOPS as a per cent of private expenditure on health increased by 4.9 per cent. The average external resources for health as a percentage of THE increased by 3.7 per cent. Even though on average the quantity of health funds have increased, we cannot judge from the current study the extent to which financial risk protection, equity and efficiency has progressed or regressed. In 2009 OOPS made up over 20% of total expenditure on health in 34 countries. Evidence shows that where OOPS as a percentage of total health expenditure is less than 20%, the risk of catastrophic expenditure is negligible. Therefore, there is urgent need for countries to develop health policies that address inequities and health financing models that optimize the use of health resources and strengthen health infrastructure. Increased coverage of prepaid health-financing mechanisms would reduce over-reliance on potentially catastrophic and impoverishing out-of-pocket payments. PMID:23497637

Africans in America.

ERIC Educational Resources Information Center

Hart, Ayanna; Spangler, Earl

This book introduces African-American history and culture to children. The first Africans in America came from many different regions and cultures, but became united in this country by being black, African, and slaves. Once in America, Africans began a long struggle for freedom which still continues. Slavery, the Civil War, emancipation, and the…

Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: a multicountry observational study from the Africa Liver Cancer Consortium.

PubMed

Yang, Ju Dong; Mohamed, Essa A; Aziz, Ashraf O Abdel; Shousha, Hend I; Hashem, Mohamed B; Nabeel, Mohamed M; Abdelmaksoud, Ahmed H; Elbaz, Tamer M; Afihene, Mary Y; Duduyemi, Babatunde M; Ayawin, Joshua P; Gyedu, Adam; Lohouès-Kouacou, Marie-Jeanne; Ndam, Antonin W Ndjitoyap; Moustafa, Ehab F; Hassany, Sahar M; Moussa, Abdelmajeed M; Ugiagbe, Rose A; Omuemu, Casimir E; Anthony, Richard; Palmer, Dennis; Nyanga, Albert F; Malu, Abraham O; Obekpa, Solomon; Abdo, Abdelmounem E; Siddig, Awatif I; Mudawi, Hatim M Y; Okonkwo, Uchenna; Kooffreh-Ada, Mbang; Awuku, Yaw A; Nartey, Yvonne A; Abbew, Elizabeth T; Awuku, Nana A; Otegbayo, Jesse A; Akande, Kolawole O; Desalegn, Hailemichael M; Omonisi, Abidemi E; Ajayi, Akande O; Okeke, Edith N; Duguru, Mary J; Davwar, Pantong M; Okorie, Michael C; Mustapha, Shettima; Debes, Jose D; Ocama, Ponsiano; Lesi, Olufunmilayo A; Odeghe, Emuobor; Bello, Ruth; Onyekwere, Charles; Ekere, Francis; Igetei, Rufina; Mah'moud, Mitchell A; Addissie, Benyam; Ali, Hawa M; Gores, Gregory J; Topazian, Mark D; Roberts, Lewis R

2017-02-01

Hepatocellular carcinoma is a leading cause of cancer-related death in Africa, but there is still no comprehensive description of the current status of its epidemiology in Africa. We therefore initiated an African hepatocellular carcinoma consortium aiming to describe the clinical presentation, management, and outcomes of patients with hepatocellular carcinoma in Africa. We did a multicentre, multicountry, retrospective observational cohort study, inviting investigators from the African Network for Gastrointestinal and Liver Diseases to participate in the consortium to develop hepatocellular carcinoma research databases and biospecimen repositories. Participating institutions were from Cameroon, Egypt, Ethiopia, Ghana, Ivory Coast, Nigeria, Sudan, Tanzania, and Uganda. Clinical information-demographic characteristics, cause of disease, liver-related blood tests, tumour characteristics, treatments, last follow-up date, and survival status-for patients diagnosed with hepatocellular carcinoma between Aug 1, 2006, and April 1, 2016, were extracted from medical records by participating investigators. Because patients from Egypt showed differences in characteristics compared with patients from the other countries, we divided patients into two groups for analysis; Egypt versus other African countries. We undertook a multifactorial analysis using the Cox proportional hazards model to identify factors affecting survival (assessed from the time of diagnosis to last known follow-up or death). We obtained information for 2566 patients at 21 tertiary referral centres (two in Egypt, nine in Nigeria, four in Ghana, and one each in the Ivory Coast, Cameroon, Sudan, Ethiopia, Tanzania, and Uganda). 1251 patients were from Egypt and 1315 were from the other African countries (491 from Ghana, 363 from Nigeria, 277 from Ivory Coast, 59 from Cameroon, 51 from Sudan, 33 from Ethiopia, 21 from Tanzania, and 20 from Uganda). The median age at which hepatocellular carcinoma was diagnosed significantly later in Egypt than the other African countries (58 years [IQR 53-63] vs 46 years [36-58]; p<0·0001). Hepatitis C virus was the leading cause of hepatocellular carcinoma in Egypt (1054 [84%] of 1251 patients), and hepatitis B virus was the leading cause in the other African countries (597 [55%] of 1082 patients). Substantially fewer patients received treatment specifically for hepatocellular carcinoma in the other African countries than in Egypt (43 [3%] of 1315 vs 956 [76%] of 1251; p<0·0001). Among patients with survival information (605 [48%] of 1251 in Egypt and 583 [44%] of 1315 in other African countries), median survival was shorter in the other African countries than in Egypt (2·5 months [95% CI 2·0-3·1] vs 10·9 months [9·6-12·0]; p<0·0001). Factors independently associated with poor survival were: being from an African countries other than Egypt (hazard ratio [HR] 1·59 [95% CI 1·13-2·20]; p=0·01), hepatic encephalopathy (2·81 [1·72-4·42]; p=0·0004), diameter of the largest tumour (1·07 per cm increase [1·04-1·11]; p<0·0001), log α-fetoprotein (1·10 per unit increase [1·02-1·20]; p=0·0188), Eastern Cooperative Oncology Group performance status 3-4 (2·92 [2·13-3·93]; p<0·0001) and no treatment (1·79 [1·44-2·22]; p<0·0001). Characteristics of hepatocellular carcinoma differ between Egypt and other African countries. The proportion of patients receiving specific treatment in other African countries was low and their outcomes were extremely poor. Urgent efforts are needed to develop health policy strategies to decrease the burden of hepatocellular carcinoma in Africa. None. Copyright © 2017 Elsevier Ltd. All rights reserved.

The new World Health Organization recommendation on the 2-dose measles vaccine schedule and the way forward in African Region

PubMed Central

Biellik, Robin Julian; Davis, Robert

2017-01-01

The new W.H.O. recommendation, which drops the coverage criterion for adoption of the 2-dose measles vaccine schedule, makes some African countries eligible for the 2-dose schedule which were previously ineligible. We look at the implications of the new recommendation for Ethiopia and Nigeria, the two largest African countries which are eligible under the new recommendation. PMID:29296149

Les sous-prefectures de Sikensi et Dabakala, Cote-d'Ivoire. (The Regions of Sikensi and Dabakala, Ivory Coast.) Method de preparation de la carte scolaire: etudes de cas 9.

ERIC Educational Resources Information Center

Hallak, J.; And Others

This volume contains the results of the first study of the problems associated with using educational television in curriculum planning in the Ivory Coast. The study was conducted in two districts of this African country, one relatively developed and situated in the southern part of the country, and the other more characteristic of the poorer…

Composite measures of women's empowerment and their association with maternal mortality in low-income countries.

PubMed

Lan, Chiao-Wen; Tavrow, Paula

2017-11-08

Maternal mortality has declined significantly since 1990. While better access to emergency obstetrical care is partially responsible, women's empowerment might also be a contributing factor. Gender equality composite measures generally include various dimensions of women's advancement, including educational parity, formal employment, and political participation. In this paper, we compare several composite measures to assess which, if any, are associated with maternal mortality ratios (MMRs) in low-income countries, after controlling for other macro-level and direct determinants. Using data from 44 low-income countries (half in Africa), we assessed the correlation of three composite measures - the Gender Gap Index, the Gender Equity Index (GEI), and the Social Institutions and Gender Index (SIGI) - with MMRs. We also examined two recognized contributors to reduce maternal mortality (skilled birth attendance (SBA) and total fertility rate (TFR)) as well as several economic and political variables (such as the Corruption Index) to see which tracked most closely with MMRs. We examined the countries altogether, and disaggregated by region. We then performed multivariate analysis to determine which measures were predictive. Two gender measures (GEI and SIGI) and GDP per capita were significantly correlated with MMRs for all countries. For African countries, the SIGI, TFR, and Corruption Index were significant, whereas the GEI, SBA, and TFR were significant in non-African countries. After controlling for all measures, SBA emerged as a predictor of log MMR for non-African countries (β = -0.04, P = 0.01). However, for African countries, only the Corruption Index was a predictor (β = -0.04, P = 0.04). No gender measure was significant. In African countries, corruption is undermining the quality of maternal care, the availability of critical drugs and equipment, and pregnant women's motivation to deliver in a hospital setting. Improving gender equality and SBA rates is unlikely to reduce MMR in Africa unless corruption is addressed. In other regions, increasing SBA rates can be expected to lower MMRs.

Pre-service Science Teacher Education in Africa: Prospects and Challenges

NASA Astrophysics Data System (ADS)

Ogunniyi, M. B.; Rollnick, Marissa

2015-02-01

Since the independence era in the 1950s and 1960s, many African countries have recognised the important role that science plays in the socio-economic development of any country. As a result, various African governments have enacted policies and allocated a large proportion of their gross national product to the science and science education sector of the economy. For instance, many African countries introduced universal primary education and to cater for the bulging student population increased the number of their secondary schools considerably. However, the rapid expansion of educational facilities has to some degree compromised the quality of the science teaching in many African schools. Among the various problems facing science education in Africa since the independence era, however, the most frequently mentioned has been the shortage of qualified science teachers. Science teachers play a critical role in laying the foundation of scientific literacy of a country. Indeed, no education system can outperform the quality of its teachers.

Does a wife's education influence spousal agreement on approval of family planning?: Random-effects Modeling using data from two West African Countries.

PubMed

Hossain, Mian; Ahmed, Saifuddin; Rogers, Laurencia

2014-05-01

Spousal approval of family planning is critical for contraceptive use. Both contraceptive use rates and women's education are low in many West-African countries and this study examines the role of wives' education in spousal agreement on approval of family planning in two sub-Saharan West African countries. We used couples' data from Demographic Health Surveys in Senegal and in Niger, conducted in 2005 and 2006, respectively. Multiple logistic regression results using multilevel modeling show that the odds of spousal agreement on approval of family planning were slightly over three times [OR: 3.16; 95% CI: 1.32 to 7.57] in Senegal and were about three times [OR: 3.07; 95% CI: 1.64 to 5.76] in Niger higher for women with more than primary education. Findings suggest that improvement in women's education could lead to spousal agreement on approval of family planning, which may lead to use of family planning in sub-Saharan African countries.

Diaspora engagement of African migrant health workers – examples from five destination countries

PubMed Central

Wojczewski, Silvia; Poppe, Annelien; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Pentz, Stephen; Kutalek, Ruth

2015-01-01

Background Migrant health workers fill care gaps in their destination countries, but they also actively engage in improving living conditions for people of their countries of origin through expatriate professional networks. This paper aims to explore the professional links that migrant health workers from sub-Saharan African countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the United Kingdom) have to their countries of origin. Design Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan Africa (N=66). A qualitative content analysis of the material was performed using the software ATLAS.ti. Results Almost all migrant health workers have professional ties with their countries of origin supporting health, education, and social structures. They work with non-governmental organizations, universities, or hospitals and travel back and forth between their destination country and country of origin. For a few respondents, professional engagement or even maintaining private contacts in their country of origin is difficult due to the political situation at home. Conclusions The results show that African migrant health workers are actively engaged in improving living conditions not only for their family members but also for the population in general in their countries of origin. Our respondents are mediators and active networkers in a globalized and transnationally connected world. The research suggests that the governments of these countries of origin could strategically use their migrant health workforce for improving education and population health in sub-Saharan Africa. Destination countries should be reminded of their need to comply with the WHO Global Code of Practice for the international recruitment of health professionals. PMID:26652910

78 FR 16908 - Determinations Under the African Growth and Opportunity Act

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-19

... STATES TRADE REPRESENTATIVE Determinations Under the African Growth and Opportunity Act AGENCY... substantial progress toward implementing and following, the customs procedures required by the African Growth... lesser developed beneficiary sub-Saharan African country. In Proclamation 7350 (October 2, 2000), the...

African American Enrollment in Independent Schools, 1988-89. Research Notes on Education. No. 6.

ERIC Educational Resources Information Center

Institute for Independent Education, Inc., Washington, DC.

This report discusses the enrollment of African-American students in independent neighborhood schools across the country. Students in these schools constitute the second largest group of African-Americans outside the nation's public school systems. Over 52,000 African-American students are enrolled in independent schools. Data for African-American…

Temperament Styles of Children in Three Sub-Saharan African Countries

ERIC Educational Resources Information Center

Oakland, Thomas; Callueng, Carmelo

2015-01-01

This cross-national research examined temperament style preferences among children in three sub-Saharan African countries (i.e., Nigeria, South Africa, and Zimbabwe) and possible differences between them on four bipolar temperament styles: extroverted-introverted, practical-imaginative, thinking-feeling, and organized-flexible. Children in these…

Rotavirus landscape in Africa-Towards prevention and control: A report of the 8th African rotavirus symposium, Livingstone, Zambia.

PubMed

Rudd, Cheryl; Mwenda, Jason; Chilengi, Roma

2015-06-26

The 8th African Rotavirus Symposium was held in Livingstone, Zambia from the 12-13 June 2014. Over 130 delegates from 35 countries - 28 from African nations - participated in this symposium, which included scientists, clinicians, immunisation managers, public health officials, policymakers and vaccine manufacturers. The theme for the symposium was Rotavirus Landscape in Africa-Towards Prevention and Control. At the time of the symposium, a total of 21 African countries had introduced the rotavirus vaccine into their national immunisation schedules. This meeting was particularly timely and relevant to review early data on vaccine adoption and impact from these countries. The concluding panel discussion proposed several recommendations for areas of focus moving forward in rotavirus advocacy and research. Copyright © 2015. Published by Elsevier Ltd.. All rights reserved.

Appropriateness of no-fault compensation for research-related injuries from an African perspective: an appeal for action by African countries.

PubMed

Kamalo, Patrick Dongosolo; Manda-Taylor, Lucinda; Rennie, Stuart

2016-08-01

Compensation for research-related injuries (RRIs) remains a challenge in the current environment of global collaborative biomedical research as exemplified by the continued reluctance of the US government, a major player in international biomedical research, to enact regulation for mandatory compensation for RRIs. This stance is in stark contrast to the mandatory compensation policies adopted by other democracies like the European Union (EU) countries. These positions taken by the USA and the EU create a nexus of confusion when research is exported to low-income and middle-income countries which have no laws guiding compensation for RRIs. In this paper, we begin by exploring the background to policies concerning RRIs, how they reflect on the traditional dispute resolution mechanisms in African societies, and how this compares with the no-fault compensation model. We then explore the underlying African ethical framework of Ubuntu in the sub-Saharan region, guiding traditional practices of dispute resolution and compensation, and how this framework can help to form the moral justification for no-fault compensation as the preferred compensation model for RRIs for African countries. Finally, we call upon countries in the African Union (AU), to adopt a no-fault policy for compensation of RRIs, and enact it into a regulatory requirement for insurance-based no-fault compensation for biomedical research, which will then be enforced by member states of the AU. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Discovering Morocco: Using the Five Fundamental Themes of Geography in Order to Discover Morocco

ERIC Educational Resources Information Center

Fitzhugh, William P.

2005-01-01

This curriculum unit, intended to be used with elementary school students, provides information about a North African, Moslem, Arab, country: Morocco. The unit presents objectives, strategies, materials needed, background notes, evaluation methods, and assignments that fulfill National Social Studies Standards and National Geography standards. It…

Newcomer Immigrant Adolescents and Ambiguous Discrimination: The Role of Cognitive Appraisal

ERIC Educational Resources Information Center

Patel, Sita G.; Tabb, Kevin M.; Strambler, Michael J.; Eltareb, Fazia

2015-01-01

Cognitive appraisal has been shown to mediate the relationship between stressors and internalizing symptoms, but not among newcomer immigrant youth facing ambiguous discrimination. Using a mixed-methods design with a sample of newcomer adolescents from African, Arab, Asian, Caribbean, European, and Latin American countries, this study measured the…

Disparities in Cardiovascular Research Output and Citations From 52 African Countries: A Time‐Trend, Bibliometric Analysis (1999–2008)

PubMed Central

Bloomfield, Gerald S.; Baldridge, Abigail; Agarwal, Anubha; Huffman, Mark D.; Colantonio, Lisandro D.; Bahiru, Ehete; Ajay, Vamadevan S.; Prabhakaran, Poornima; Lewison, Grant; Prabhakaran, Dorairaj

2015-01-01

Background Cardiovascular research output and citations of publications from Africa have historically been low yet may be increasing. However, data from the continent are limited. Methods and Results To evaluate the cardiovascular research output and citations from 52 African countries between 1999 and 2008, we created a bibliometric filter to capture cardiovascular research articles published in the Web of Knowledge based on specialist journals and title words. Two coauthors with expertise in cardiovascular medicine tested and refined this filter to achieve >90% precision and recall. We matched retrieved records with their associated citation reports and calculated the running 5‐year citation count postpublication, including the year of publication. Publications from Africa were identified by author addresses. South Africa published 872 cardiovascular research papers, Egypt 393, Tunisia 264, and Nigeria 192 between 1999 and 2008. The number of publications increased over the time period for a small number of countries (range 0.1 to 4.8 more publications per year by fractional count). Most countries' citations were low (<50), but citations were greatest for South Africa (7063), Egypt (2557), Tunisia (903), and Nigeria (540). The same countries had the greatest annual increase in 5‐year citation index values: 65 (95% CI: 30, 99) for South Africa, 46 (34, 58) for Egypt, 22 (15, 28) for Tunisia, and 8 (2, 14) for Nigeria. The burden of cardiovascular disease had a weak and inconsistent relationship to cardiovascular publications (r2=0.07, P=0.05). Greater gross domestic product was associated with more cardiovascular publications in 2008 (r2=0.53, P<0.0001). Conclusions The increases in cardiovascular research outputs from Africa are concentrated in a few countries. The reasons for regional differences in research outputs require further investigation, particularly relative to competing disease burdens. Higher prioritization of cardiovascular research funding from African countries is warranted. PMID:25836056

Scientific Measure of Africa's Connectivity

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zennaro, M.; Canessa, E.; Sreenivasan, K.R.

2006-04-24

Data on Internet performance and the analysis of its trend can be useful for decision makers and scientists alike. Such performance measurements are possible using the PingER methodology. We use the data thus obtained to quantify the difference in performance between developed and developing countries, sometimes referred to as the Digital Divide. Motivated by the recent interest of G8 countries in African development, we particularly focus on the African countries.

Afrikaans Language Maintenance in Australia

ERIC Educational Resources Information Center

Hatoss, Aniko; Starks, Donna; van Rensburg, Henriette Janse

2011-01-01

Changes in the political climate in the home country have resulted in the emigration of South Africans to English speaking countries such as Britain, Canada, Australia and New Zealand. Despite the scale of movement of the South African population, language maintenance in these diasporic contexts has received little consideration. This paper…

Opportunities for Distance Education in the Commonwealth African Countries.

ERIC Educational Resources Information Center

INTELECON Research & Consultancy Ltd., Vancouver (British Columbia).

The geo-demographic, economic, and infrastructural makeup of 12 African countries (Botswana. Gambia, Kenya, Lesotho, Malawi, Nigeria, Sierra Leone, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe) were compared to determine the potential benefits to them of a Commonwealth of Learning (COL) distance education initiative. Data were collected on…

Adult Illiteracy: The Root of African Underdevelopment

ERIC Educational Resources Information Center

Jogwu, C. N. O.

2010-01-01

All African Nations belong to the category of third world underdeveloped countries of the world. UNDP Human Development Index uses factors like per capita income, health of the people, and educational attainment to classify countries. Adult literacy and gross enrolment ratios are indicators of education status. This paper uses Nigeria, a typical…

The contribution of the polio eradication initiative to narrowing the gaps in the health workforce in the African Region.

PubMed

Kamso, Jean; Mvika, Eddy S; Ota, M O C; Okeibunor, Joseph; Mkanda, Pascal; Mihigo, Richard

2016-10-10

The Global Polio Eradication Initiative (GPEI) massively invested to overcome the crippling disease in countries of the WHO African Region. In the context of economic crisis, almost all countries in the Region lack an adequate health workforce. Large amounts were invested by GPEI in human resources. This paper shows how the human resources funded by polio contributed to narrowing the gaps in health workforce and helped strengthening and supporting other priority health programmes in Angola, Chad, DRC, Nigeria, Tanzania, and Togo. The health workforce strengthening methods used in the five different countries included the following: policy development and strategic planning, microplanning, capacity building of public health and community workers, implementation and services, monitoring and evaluation, advocacy and social mobilization, and programme review. Staff funded by polio helped with achieving good coverage in vitamin A and insecticide-treated mosquito nets (Angola, Chad); improvement of EPI and integrated disease surveillance indicators, improved quality of data (all five countries), administrative support, smooth introduction of new vaccines, increased case detection, and early isolation of patients suffering from the Guinea worm (Chad); reduction of cholera, extension of directly observed TB short course treatment (Democratic Republic of Congo); significant staff performance improvement (Nigeria). GPEI investment achieved far beyond its primary goal, and contributed to narrowing the gaps in the health workforce in countries of the African Region, as demonstrated by the best practice documentation exercise. We recommend that expertise and experience of polio funded staff should be leveraged to strengthen, expand and support other public health programmes. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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

PubMed

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 health systems.

Essential evidence for guiding health system priorities and policies: anticipating epidemiological transition in Africa.

PubMed

Byass, Peter; de Savigny, Don; Lopez, Alan D

2014-01-01

Despite indications that infection-related mortality in sub-Saharan Africa may be decreasing and the burden of non-communicable diseases increasing, the overwhelming reality is that health information systems across most of sub-Saharan Africa remain too weak to track epidemiological transition in a meaningful and effective way. We propose a minimum dataset as the basis of a functional health information system in countries where health information is lacking. This would involve continuous monitoring of cause-specific mortality through routine civil registration, regular documentation of exposure to leading risk factors, and monitoring effective coverage of key preventive and curative interventions in the health sector. Consideration must be given as to how these minimum data requirements can be effectively integrated within national health information systems, what methods and tools are needed, and ensuring that ethical and political issues are addressed. A more strategic approach to health information systems in sub-Saharan African countries, along these lines, is essential if epidemiological changes are to be tracked effectively for the benefit of local health planners and policy makers. African countries have a unique opportunity to capitalize on modern information and communications technology in order to achieve this. Methodological standards need to be established and political momentum fostered so that the African continent's health status can be reliably tracked. This will greatly strengthen the evidence base for health policies and facilitate the effective delivery of services.

The collaborative African genomics network training program: a trainee perspective on training the next generation of African scientists

PubMed Central

Mlotshwa, Busisiwe C.; Mwesigwa, Savannah; Mboowa, Gerald; Williams, Lesedi; Retshabile, Gaone; Kekitiinwa, Adeodata; Wayengera, Misaki; Kyobe, Samuel; Brown, Chester W.; Hanchard, Neil A.; Mardon, Graeme; Joloba, Moses; Anabwani, Gabriel; Mpoloka, Sununguko W.

2017-01-01

Purpose: The Collaborative African Genomics Network (CAfGEN) aims to establish sustainable genomics research programs in Botswana and Uganda through long-term training of PhD students from these countries at Baylor College of Medicine. Here, we present an overview of the CAfGEN PhD training program alongside trainees’ perspectives on their involvement. Background: Historically, collaborations between high-income countries (HICs) and low- and middle-income countries (LMICs), or North–South collaborations, have been criticized for the lack of a mutually beneficial distribution of resources and research findings, often undermining LMICs. CAfGEN plans to address this imbalance in the genomics field through a program of technology and expertise transfer to the participating LMICs. Methods: An overview of the training program is presented. Trainees from the CAfGEN project summarized their experiences, looking specifically at the training model, benefits of the program, challenges encountered relating to the cultural transition, and program outcomes after the first 2 years. Conclusion: Collaborative training programs like CAfGEN will not only help establish sustainable long-term research initiatives in LMICs but also foster stronger North–South and South–South networks. The CAfGEN model offers a framework for the development of training programs aimed at genomics education for those for whom genomics is not their “first language.” Genet Med advance online publication 06 April 2017 PMID:28383545

Satisfaction des exigences minimales du marché du travail par le système éducatif: Evaluation dans un contexte de faible système d'information sur la formation et l'emploi

NASA Astrophysics Data System (ADS)

Pieume, Calice Olivier

2016-12-01

Satisfying the minimum requirements of the labour market through the education system: Assessment in a context of weak training and employment data - The number of young people entering the labour market in Africa will increase considerably over the next two decades. With nearly 200 million young people aged 15-24, Africa has the youngest population in the world; this volume will double by 2045. As the question of the professional integration of young people in Africa is set to become even more pressing over the next two decades, it is imperative that African countries prepare for this time bomb. The education system, while not the only deciding factor, bears a responsibility in the difficult professional integration of young people. To fully play its role, it must be organised according to the country's development needs and the demands of the labour market. Establishing a proven process of assessing, analysing and anticipating economic demand is an essential first step. Yet the majority of African countries have still not implemented such a system. Meanwhile, the education system must take steps to satisfy the minimum short-term requirements of the labour market. This article, which seeks to highlight these requirements, presents a method that enables countries to assess the minimum requirements of the labour market at specific periods and, in return, to assess the degree to which the education system satisfies these requirements. The method is developed especially for countries with weak systems of collecting data on education, training and employment, as is the case in most sub-Saharan countries.

African Games of Strategy: A Teaching Manual. African Outreach Series, No. 2.

ERIC Educational Resources Information Center

Crane, Louise

Appreciation of African games has increased in this country; especially board games which have been popularized through commercial versions. African games are invaluable resources for studying subjects requiring mathematical concepts, as well as social studies, history, geography, and languages. This manual presents some of the better known…

Triangulating the provenance of African elephants using mitochondrial DNA

PubMed Central

Ishida, Yasuko; Georgiadis, Nicholas J; Hondo, Tomoko; Roca, Alfred L

2013-01-01

African elephant mitochondrial (mt) DNA follows a distinctive evolutionary trajectory. As females do not migrate between elephant herds, mtDNA exhibits low geographic dispersal. We therefore examined the effectiveness of mtDNA for assigning the provenance of African elephants (or their ivory). For 653 savanna and forest elephants from 22 localities in 13 countries, 4258 bp of mtDNA was sequenced. We detected eight mtDNA subclades, of which seven had regionally restricted distributions. Among 108 unique haplotypes identified, 72% were found at only one locality and 84% were country specific, while 44% of individuals carried a haplotype detected only at their sampling locality. We combined 316 bp of our control region sequences with those generated by previous trans-national surveys of African elephants. Among 101 unique control region haplotypes detected in African elephants across 81 locations in 22 countries, 62% were present in only a single country. Applying our mtDNA results to a previous microsatellite-based assignment study would improve estimates of the provenance of elephants in 115 of 122 mis-assigned cases. Nuclear partitioning followed species boundaries and not mtDNA subclade boundaries. For taxa such as elephants in which nuclear and mtDNA markers differ in phylogeography, combining the two markers can triangulate the origins of confiscated wildlife products. PMID:23798975

The ''Complex Reality'' of Research Capacity Development in Mathematics Education in Southern African Development Community Countries

ERIC Educational Resources Information Center

Julie, Cyril; Mikalsen, Oyvind; Persens, Jan

2005-01-01

This paper explores how an aid-funded Ph.D.-programme in mathematics education instituted in some Southern African Development Community countries measures up to issues related to research capacity development projects. The research capacity development programme is described and reflected against mutual benefit, relevance, sustainability and…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-30

... of Apparel Articles Assembled in Beneficiary Sub-Saharan African Countries From Regional and Third... quota-free treatment for certain textile and apparel articles imported from designated beneficiary sub... apparel articles wholly assembled in one or more beneficiary sub-Saharan African countries from fabric...

Reemergence of African Swine Fever in Zimbabwe, 2015.

PubMed

van Heerden, Juanita; Malan, Kerstin; Gadaga, Biko M; Spargo, Reverend M

2017-05-01

Zimbabwe is the only country in southern Africa with no reported African swine fever (ASF) outbreaks during 1993-2014. However, the 2015 discovery of genotype II ASF virus in Zimbabwe indicates the reemergence of ASF in this country and suggests that this viral genotype may be spreading through eastern and southern Africa.

African International Doctoral Students in New Zealand: Englishes, Doctoral Writing and Intercultural Supervision

ERIC Educational Resources Information Center

Doyle, Stephanie; Manathunga, Catherine; Prinsen, Gerard; Tallon, Rachel; Cornforth, Sue

2018-01-01

While the experiences of international doctoral students, especially those from Asian countries, have been well researched, fewer studies have explored the experiences of African students in Southern countries like Australia and Aotearoa/New Zealand. This article reports on doctoral writing and student and supervisor perspectives on English…

Association between Contract Teachers and Student Learning in Five Francophone African Countries

ERIC Educational Resources Information Center

Chudgar, Amita

2015-01-01

This article investigates the association between studying with a contract teacher and a student's academic outcomes, using data from five Francophone African countries for two grade levels and two subjects. Based on this analysis, the evidence for or against this form of teacher hiring is inconclusive. The results indicate that these…

Road Maintenance in Africa: Approaches and Perspectives

NASA Astrophysics Data System (ADS)

M, Mostafa Hassan

2018-06-01

In Africa, roads are the dominant mode of passenger and freight transport, for which the need is growing rapidly. It is noticeable that most of the African countries do not do enough to ensure the sustainability of road infrastructure as it has been widely reported that roads are affected, to varying degrees, by premature deterioration. Most of the African countries have adopted institutional reforms, notably entailing the creation of road funds and road agencies, and made significant progress on road maintenance. However, many challenges remain to be addressed in all of them to ensure appropriate maintenance. Although spending on road maintenance has increased over time in all African countries it remains insufficient to cover the needs. Poorly maintained roads constrain mobility, significantly raise vehicle operating costs, increase accident rates and their associated human and property costs, and aggravate isolation, poverty, poor health, and illiteracy in rural communities. This paper focuses, in particular, on road maintenance in some African countries considering types of road maintenance and the different approaches aiming at a comparison to reflect on similarities and differences.

Oil crises and African economies: oil wave on a tidal flood of industrial price inflation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, W.R.; Wilson, E.J. III

Escalating oil-import prices have left the developing African economies with high debts, unfinished projects, and bitterness over what they see as economic assassination by OPEC. Much of the blame for their suffering, however, can be placed on African leaders who failed to control internal factors. The authors review the impact of OPEC's pricing changes in terms of its relation to internal financial and energy characteristics and the purchasing and policy choices made by African nations in response to the price increases. They describe the African nations' ability to solve their energy and economic problems as less favorable than other less-developedmore » countries. The richer OPEC and industrial countries can do more than they are to help relieve the economic strain and to diversify African energy sources. 53 references, 7 tables. (DCK)« less

Sources of international migration statistics in Africa.

PubMed

1984-01-01

The sources of international migration data for Africa may be classified into 2 main categories: administrative records and 2) censuses and survey data. Both categories are sources for the direct measurement of migration, but the 2nd category can be used for the indirect estimation of net international migration. The administrative records from which data on international migration may be derived include 1) entry/departure cards or forms completed at international borders, 2) residence/work permits issued to aliens, and 3) general population registers and registers of aliens. The statistics derived from the entry/departure cards may be described as 1) land frontier control statistics and 2) port control statistics. The former refer to data derived from movements across land borders and the latter refer to information collected at international airports and seaports. Other administrative records which are potential sources of statistics on international migration in some African countries include some limited population registers, records of the registration of aliens, and particulars of residence/work permits issued to aliens. Although frontier control data are considered the most important source of international migration statistics, in many African countries these data are too deficient to provide a satisfactory indication of the level of international migration. Thus decennial population censuses and/or sample surveys are the major sources of the available statistics on the stock and characteristics of international migration. Indirect methods can be used to supplement census data with intercensal estimates of net migration using census data on the total population. This indirect method of obtaining information on migration can be used to evaluate estimates derived from frontier control records, and it also offers the means of obtaining alternative information on international migration in African countries which have not directly investigated migration topics in their censuses or surveys.

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

PubMed

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.

Shared decision making in West Africa: The forgotten area.

PubMed

Diouf, Ndeye Thiab; Ben Charif, Ali; Adisso, Lionel; Adekpedjou, Rhéda; Zomahoun, Hervé Tchala Vignon; Agbadjé, Titilayo Tatiana; Dogba, Mama Joyce; Garvelink, Mirjam Marjolein

2017-06-01

Up to now, little attention has been paid to West Africa when it comes to shared decision making (SDM). West African countries seem to lag behind with regard to SDM initiatives compared to many other countries in the world. There is some interest in informed decision making or informed consent, but little in a full SDM process. Few decision-making tools are available for healthcare professionals and the majority are not designed to support decision-making with patients. Furthermore, to the best of our knowledge, there are no training programs for implementing SDM in healthcare teams. Many barriers exist to implementing SDM in West Africa, including lack of options, few or poor health resources and low levels of education. However, African countries present many opportunities for SDM as well. Existing SDM innovations developed for other populations with low literacy could be explored and adapted to the West African context, and research on implementation and outcomes in West Africa could contribute to SDM worldwide. West African countries are in an excellent position to both learn from other countries and contribute to SDM development in other parts of the world. In this paper we reflect on SDM challenges and opportunities, and propose a research agenda for West Africa. We hope to awaken interest in SDM in West Africa and encourage future collaborations on SDM with various West African stakeholders, including patients, healthcare professionals, policymakers, non-government organisations (NGOs) and academic institutions. Copyright © 2017. Published by Elsevier GmbH.

Burden and epidemiology of rotavirus diarrhea in selected African countries: preliminary results from the African Rotavirus Surveillance Network.

PubMed

Mwenda, Jason M; Ntoto, Kinkela Mina; Abebe, Almaz; Enweronu-Laryea, Christabel; Amina, Ismail; Mchomvu, Jackson; Kisakye, Annet; Mpabalwani, Evans M; Pazvakavambwa, Isoro; Armah, George E; Seheri, L M; Kiulia, Nicholas M; Page, N; Widdowson, Marc-Alain; Steele, A Duncan

2010-09-01

Severe rotavirus diarrhea in children <5 years of age is a major public health problem; however, limited regional and country specific data on rotavirus disease burden are available from sub-Saharan Africa. In June 2006, the World Health Organization Regional Office for Africa initiated rotavirus surveillance in selected African countries. With use of standardized methodology developed by the World Health Organization, children <5 years of age who were hospitalized with severe diarrhea were enrolled, and stool specimens were collected for detection of rotavirus strains with use of a commercial enzyme immunoassay. Rotavirus strains were further characterized for G and P types with use of a reverse-transcriptase polymerase chain reaction. From June 2006 through December 2008, rotavirus surveillance was established at 14 sites in 11 African countries. Of 5461 stool samples collected from children enrolled in 8 countries with 1 or 2 complete years of data, 2200 (40%) were positive for rotavirus. Ninety percent of all rotavirus hospitalizations occurred among children aged 3-12 months. Predominant types included G1P[8] (21%), G2P[4] (7%), and P [8] (29%); however, unusual types were also detected, including G8P[6] (5%), G8P[8] (1%), G12P[6] (1%), and G12P[6] (1%). A high percentage of mixed rotavirus infections was also detected. These preliminary results indicate that rotavirus is a major cause of severe diarrheal disease in African children.

Standard Setting Lessons Learned in the South African Context: Implications for International Implementation

ERIC Educational Resources Information Center

Pitoniak, Mary J.; Yeld, Nan

2013-01-01

Criterion-referenced assessments have become more common around the world, with performance standards being set to differentiate different levels of student performance. However, use of standard setting methods developed in the United States may be complicated by factors related to the political and educational contexts within another country. In…

Candida antifungal drug resistance in sub-Saharan African populations: A systematic review

PubMed Central

Africa, Charlene Wilma Joyce; Abrantes, Pedro Miguel dos Santos

2017-01-01

Background: Candida infections are responsible for increased morbidity and mortality rates in at-risk patients, especially in developing countries where there is limited access to antifungal drugs and a high burden of HIV co-infection.  Objectives: This study aimed to identify antifungal drug resistance patterns within the subcontinent of Africa.  Methods: A literature search was conducted on published studies that employed antifungal susceptibility testing on clinical Candida isolates from sub-Saharan African countries using Pubmed and Google Scholar.  Results: A total of 21 studies from 8 countries constituted this review. Only studies conducted in sub-Saharan Africa and employing antifungal drug susceptibility testing were included. Regional differences in Candida species prevalence and resistance patterns were identified.  Discussion: The outcomes of this review highlight the need for a revision of antifungal therapy guidelines in regions most affected by Candida drug resistance.  Better controls in antimicrobial drug distribution and the implementation of regional antimicrobial susceptibility surveillance programmes are required in order to reduce the high Candida drug resistance levels seen to be emerging in sub-Saharan Africa. PMID:28154753

Cross national study of leisure-time physical activity in Dutch and English populations with ethnic group comparisons.

PubMed

de Munter, Jeroen S L; Agyemang, Charles; van Valkengoed, Irene G M; Bhopal, Raj; Zaninotto, Paola; Nazroo, James; Kunst, Anton E; Stronks, Karien

2013-06-01

Variations between countries in leisure-time physical activity (LTPA) can be used to test the convergence thesis, which expects that ethnic minority groups change towards the LTPA levels of the native population of host countries. The aim of this study was to test whether similar differences in LTPA between the native populations of England and the Netherlands are also observed among the Indian and African descent groups living in these countries. We used English and Dutch population-based health surveys that included participants aged 35-60 years of European (n(english) = 14,723, n(dutch) = 567), Indian (n(english) = 1264, n(dutch) = 370) and African-Caribbean (n(english) = 1112, n(dutch) = 689) descent. Levels of LTPA (30-minute walking, any reported cycling, gardening, dancing and playing sports) were estimated with age-sex-standardized prevalence rates. Comparisons among groups were made using adjusted Prevalence Ratios (PRs). Within both countries and compared with the European group, Indian and African groups had lower levels of gardening and cycling, whereas the African groups had higher levels of dancing. Between countries, among the European groups, the Netherlands showed higher prevalence of cycling than England, PR = 2.26 (95% CI: 2.06-2.48), and this was 2.85 (1.94-4.19) among Indian descent, and 2.77 (2.05-3.73) among African descent. For playing sports, this was PR = 1.30 (1.23-1.38), 1.43 (1.24-1.66) and 1.22 (1.10-1.34), whereas for gardening this was PR = 0.71 (0.65-0.78), 0.65 (0.52-0.81) and 0.75 (0.62-0.90), respectively. Walking and dancing showed inconsistent differences between the countries and ethnic groups. This cross-national comparison supports the expectation that LTPA of Indian and African descent groups converge towards the national levels of England and the Netherlands respectively.

Alluvial diamond resource potential and production capacity assessment of the Central African Republic

USGS Publications Warehouse

Chirico, Peter G.; Barthelemy, Francis; Ngbokoto, Francois A.

2010-01-01

In May of 2000, a meeting was convened in Kimberley, South Africa, and attended by representatives of the diamond industry and leaders of African governments to develop a certification process intended to assure that rough, exported diamonds were free of conflict concerns. This meeting was supported later in 2000 by the United Nations in a resolution adopted by the General Assembly. By 2002, the Kimberly Process Certification Scheme (KPCS) was ratified and signed by diamond-producing and diamond-importing countries. Over 70 countries were included as members of the KPCS at the end of 2007. To prevent trade in "conflict diamonds" while protecting legitimate trade, the KPCS requires that each country set up an internal system of controls to prevent conflict diamonds from entering any imported or exported shipments of rough diamonds. Every diamond or diamond shipment must be accompanied by a Kimberley Process (KP) certificate and be contained in tamper-proof packaging. The objective of this study was (1) to assess the naturally occurring endowment of diamonds in the Central African Republic (potential resources) based on geological evidence, previous studies, and recent field data and (2) to assess the diamond-production capacity and measure the intensity of mining activity. Several possible methods can be used to estimate the potential diamond resource. However, because there is generally a lack of sufficient and consistent data recording all diamond mining in the Central African Republic and because time to conduct fieldwork and accessibility to the diamond mining areas are limited, two different methodologies were used: the volume and grade approach and the content per kilometer approach. Estimates are that approximately 39,000,000 carats of alluvial diamonds remain in the eastern and western zones of the CAR combined. This amount is roughly twice the total amount of diamonds reportedly exported from the Central African Republic since 1931. Production capacity is calculated to be 840,000 carats per year, a number that is nearly twice the 450,000 carats per year reported annually by the Central African Republic. The difference in the two numbers reflects the lack of sufficient data on diamond resource grades, worker productivity, and the number and locations of sites being worked.

Implementation of the Framework Convention on Tobacco Control in Africa: Current Status of Legislation

PubMed Central

Tumwine, Jacqueline

2011-01-01

Objective To describe, as of July 2011, the status of tobacco control legislation in Africa in three key areas of the Framework Convention on Tobacco Control (FCTC)—(1) Protection from exposure to tobacco smoke, (2) Packaging and labelling of tobacco products, and (3) Tobacco advertising, promotion and sponsorship. Methods Review and analysis of tobacco control legislation in Africa, media reports, journal articles, tobacco industry documents and data published in the 2011 WHO Report on the Global Tobacco Epidemic. Results Modest progress in FCTC implementation in Africa with many countries having legislation or policies on the protection from exposure to tobacco smoke, however, only a handful of countries meet the standards of the FCTC Article 8 and its Guidelines particularly with regards to designated smoking areas. Little progress on packaging and labelling of tobacco products, with few countries having legislation meeting the minimum standards of the FCTC Article 11 and its Guidelines. Mauritius is the only African country with graphic or pictorial health warnings in place and has the largest warning labels in Africa. Slightly better progress in banning tobacco advertising, promotion and sponsorship has been shown by African countries, although the majority of legislation falls short of the standards of the FCTC Article 13 and its Guidelines. Despite their efforts, African countries’ FCTC implementation at national level has not matched the strong regional commitment demonstrated during the FCTC treaty negotiations. Conclusion This study highlights the need for Africa to step up efforts to adopt and implement effective tobacco control legislation that is fully compliant with the FCTC. In order to achieve this, countries should prioritise resources for capacity building for drafting strong FCTC compliant legislation, research to inform policy and boost political will, and countering the tobacco industry which is a major obstacle to FCTC implementation in Africa. PMID:22163209

Mean reversion in the current account of forty-eight african countries: Evidence from the Panel SURADF test

NASA Astrophysics Data System (ADS)

Chu, Hsiao-Ping; Chang, Tsangyao; Chang, Hsu-Ling; Su, Chi-Wei; Yuan, Young

2007-10-01

Here, the Panel seemingly unrelated regressions augmented Dickey-Fuller test (SURADF) test, first introduced and advanced by Breuer et al. [Misleading inferences from panel unit-root tests with an illustration from purchasing power parity, Rev. Int. Econ. 9(3) (2001) 482-493], is used to investigate the mean-reverting behavior of the current account of 48 African countries during the 1980-2004 periods. The empirical results from numerous panel-based unit root tests, conducted earlier, indicated that the current account of each of these countries is stationary; however, when Breuer et al.'s (2001) Panel SURADF test is conducted, it is found that a unit root exists in the current account of 11 of the countries studied. These results have one extremely important policy implication for the 48 African countries studied: the current account deficit of most is sustainable, and thus signifying that those nations should have no incentive to default on their international debt.

Challenges associated with tracking resources allocation for reproductive health in sub-Saharan African countries: the UNFPA/NIDI resource flows project experience.

PubMed

Sidze, Estelle M; Beekink, Erik; Maina, Beatrice W

2015-05-05

Universal access to reproductive health services entails strengthening health systems, but requires significant resource commitments as well as efficient and effective use of those resources. A number of international organizations and governments in developing countries are putting efforts into tracking the flow of health resources in order to inform resource mobilization and allocation, strategic planning, priority setting, advocacy and general policy making. The UNFPA/NIDI-led Resource Flows Project ("The UNFPA/NIDI RF Project") has conducted annual surveys since 1997 to monitor progress achieved by developing countries in implementing reproductive health financial targets. This commentary summarizes the Project experiences and challenges in gathering data on allocation of resources for reproductive health at the domestic level in sub-Saharan African countries. One key lesson learnt from the Project experience is the need for strengthening tracking mechanisms in sub-Saharan African countries and making information on reproductive health resources and expenditures available, in particular the private sector resources.

Benchmarks for health expenditures, services and outcomes in Africa during the 1990s.

PubMed Central

Peters, D. H.; Elmendorf, A. E.; Kandola, K.; Chellaraj, G.

2000-01-01

There is limited information on national health expenditures, services, and outcomes in African countries during the 1990s. We intend to make statistical information available for national level comparisons. National level data were collected from numerous international databases, and supplemented by national household surveys and World Bank expenditure reviews. The results were tabulated and analysed in an exploratory fashion to provide benchmarks for groupings of African countries and individual country comparison. There is wide variation in scale and outcome of health care spending between African countries, with poorer countries tending to do worse than wealthier ones. From 1990-96, the median annual per capita government expenditure on health was nearly US$ 6, but averaged US$ 3 in the lowest-income countries, compared to US$ 72 in middle-income countries. Similar trends were found for health services and outcomes. Results from individual countries (particularly Ethiopia, Ghana, Côte d'Ivoire and Gabon) are used to indicate how the data can be used to identify areas of improvement in health system performance. Serious gaps in data, particularly concerning private sector delivery and financing, health service utilization, equity and efficiency measures, hinder more effective health management. Nonetheless, the data are useful for providing benchmarks for performance and for crudely identifying problem areas in health systems for individual countries. PMID:10916913

Natural history of chronic hepatitis B in Euro-Mediterranean and African countries.

PubMed

Hadziyannis, Stephanos J

2011-07-01

Data derived from population, case-control, and cohort studies conducted in several Euro-Mediterranean and African countries disclose impressive similarities in the age and modes of hepatitis B virus (HBV) transmission and in the prevalence, duration, and outcome of the four phases of the natural history of chronic infection. Perinatal HBV infection is rare while the vast majority of chronic infections originate from horizontal HBV transmission to infants and children. HBeAg loss and seroconversion to anti-HBe occur in a few years time, usually during the second decade of life. HBeAg-negative/anti-HBe-positive chronic hepatitis B (CHB), predominates in these countries being 7-9 times more frequent than HBeAg-positive CHB. The predominance of HBeAg-negative CHB is largely linked to the molecular characteristics of HBV genotype D prevailing in European and African countries of the Mediterranean basin and of genotype E and subgenotype A1 that prevail in the other parts of Africa. The molecular characteristics of the African subgenotype A1 differ from those of European subgenotype A2 explaining the fact that patients infected subgenotype A1 demonstrate an earlier loss of HBeAg and seroconversion to anti-HBe during the natural course of HBV infection compared to those infected with subgenotype A2. It is proposed that the molecular characteristics of HBV genotypes and subgenotypes prevailing in Euro-Mediterranean and African countries acting in concert with host and environmental factors largely determine the natural history of chronic HBV infection and its significant differences from countries of HBV genotype C and B and of subgenotype Ae predominance. The knowledge of the natural history of chronic HBV infection in Euro-Mediterranean and African countries combined with wide screening programs for prompt recognition and treatment of chronic HBV infection both in its HBeAg-positive and -negative immune reactive phases can be expected to increase the efficacy of current and future therapeutic strategies. Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Beyond new vaccine introduction: the uptake of pneumococcal conjugate vaccine in the African Region.

PubMed

Olayinka, Folake; Ewald, Leah; Steinglass, Robert

2017-01-01

The number of vaccines available to low-income countries has increased dramatically over the last decade. Overall infant immunization coverage in the WHO African region has stagnated in the past few years while countries' ability to maintain high immunization coverage rates following introduction of new vaccines has been uneven. This case study examines post-introduction coverage among African countries that introduced PCV between 2008 and 2013 and the factors affecting Pneumococcal Conjugate Vaccine (PCV) introduction. Nearly one-third of countries did not achieve 80% infant PCV3 coverage by two years post-introduction and 58% of countries experienced a decline in coverage between post introduction years two and four. Major factors affecting coverage rates included introduction without adequate preparation, insufficient supply chain capacity and management, poor communication between organizations and with the public, and data collection systems that were insufficient to meet information needs. Deliberately addressing these issues as well as longstanding weaknesses during new vaccine introduction can strengthen the immunization and broader health system. Further study is required to identify and address factors that affect maintenance of high coverage following introduction of new vaccines in the African region. Immunization with PCV is one of the most important interventions protecting against pneumonia, the second leading cause of death for children under five globally.

The Adaptation Process of International Lecturers in a South African University: The Centrality of Agency and Collegiality

ERIC Educational Resources Information Center

Jeannin, Loïse

2017-01-01

Teaching in a new country initiates a process of adaptation requiring emotional, cognitive and behavioural adjustments. This qualitative study explores international lecturers' perceptions of their adaptation process in a South African university. The findings, based on semi-structured interviews with six lecturers from six different countries,…

African Braille Production: A Statistical Review and Evaluation of Countries and Costs.

ERIC Educational Resources Information Center

Mayer, Marc; Cylke, Frank Kurt

A study was conducted in 52 African countries to determine the extent of braille facilities for the blind, with the aim of choosing a location for a central braille producing facility. To make the selection, the factors of ease of communication (i.e., central location), political stability, and extent of already existing organizations for the…

Migration from Developing Countries: The Case of South African Teachers to the United Kingdom

ERIC Educational Resources Information Center

De Villiers, Rian

2007-01-01

The United Kingdom (particularly England) is the main developed country that recruits teachers from South Africa. This article provides an overview of teacher migration from South Africa to the United Kingdom over the past decade. The research focuses on the following aspects of migration: the recruitment of South African teachers; motivation for…

Situation Report--Bahrain, Central African Republic, Gabon, Iraq, Jordan, Kuwait, Lesotho, Libya, Saudi Arabia, Swaziland, Syria, Yemen Arab Republic.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in twelve foreign countries are presented in these situation reports. Countries included are Bahrain, Central African Republic, Gabon, Iraq, Jordan, Kuwait, Lesotho, Libya, Saudi Arabia, Swaziland, Syria, and Yemen Arab Republic. Information is provided, where appropriate and available, under two…

Pre-Service Science Teacher Education in Africa: Prospects and Challenges

ERIC Educational Resources Information Center

Ogunniyi, M. B.; Rollnick, Marissa

2015-01-01

Since the independence era in the 1950s and 1960s, many African countries have recognised the important role that science plays in the socio-economic development of any country. As a result, various African governments have enacted policies and allocated a large proportion of their gross national product to the science and science education sector…

Challenges in reducing group B Streptococcus disease in African settings.

PubMed

Nishihara, Yo; Dangor, Ziyaad; French, Neil; Madhi, Shabir; Heyderman, Robert

2017-01-01

Group B Streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis in high-income settings and is associated with high rates of neonatal mortality and morbidity. There is now increasing evidence to suggest that there is a high GBS disease burden in resource-limited countries, and it is therefore critically important to identify suitable and practical preventive strategies. In Europe and North America, intrapartum antibiotic prophylaxis (IAP) has led to a dramatic reduction of early-onset GBS disease. However, the methods for identifying pregnant women who should receive IAP and how to reduce late-onset GBS disease are not without controversy and are challenging for most sub-Saharan African countries. GBS vaccines are approaching phase III trials but are still under development. This review aims to explore the current evidence related to strategies for reducing invasive GBS disease in an African setting, the development of a GBS vaccine and whether preventative measures against GBS disease can be practically implemented. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Oil industry in Uganda: The socio-economic effects on the people of Kabaale Village, Hoima, and Bunyoro region in Uganda

NASA Astrophysics Data System (ADS)

Kyomugasho, Miriam

This thesis examines the socio-economic effects of oil industry on the people of Kabaale Village, Hoima, and Bunyoro region in Uganda. The thesis analyses the current political economy of Uganda and how Uganda is prepared to utilize the proceeds from the oil industry for the development of the country and its people. In addition, the research examines the effects of industry on the people of Uganda by analyzing how the people of Kabaale in Bunyoro region were affected by the plans to construct oil refinery in their region. This field research was done using qualitative methods and the Historical Materialism theoretical framework guided the study. The major findings include; displacement of people from land especially women, lack of accountability from the leadership, and less citizen participation in the policy formulation and oil industry. Ugandans, East Africans and the wider Pan-African world need to re-organize their socio-economic structure to enable people own means of production; participate and form labor organizations. Additionally, there is a need for oil producing African countries to unite and setup and oil fund for resources and investment instead of relying on foreign multinationals or become rentier states.

Can countries of the WHO African Region wean themselves off donor funding for health?

PubMed

Kirigia, Joses Muthuri; Diarra-Nama, Alimata J

2008-11-01

More than 20% of total health expenditure in 48% of the 46 countries in the WHO African Region is provided by external sources. Issues surrounding aid effectiveness suggest that these countries ought to implement strategies for weaning off aid dependency. This paper broaches the following question: what are some of the strategies that countries of the region can employ to wean off donor funding for health? Five strategies are discussed: reduction in economic inefficiencies; reprioritizing public expenditures; raising additional tax revenues; increased private sector involvement in health development; and fighting corruption.

Selected French Speaking Sub-Saharan African Countries: Burundi, Cameroon (Eastern), Chad, Congo (Brazzaville), Dahomey, Gabon, Ivory Coast, Mali, Mauritania, Niger, Rwanda, Senegal, Togo, Upper Volta, Zaire. A Guide to the Academic Placement of Students from These Countries in Academic Institutions of the United States.

ERIC Educational Resources Information Center

Trudeau, Edouard J. C.

The educational systems of 15 Sub-Saharan African countries are described, and guidelines concerning the academic placement of students who wish to study in U.S. institutions are provided. Tables indicate the grades covered by primary education and secondary education (academic and technical). Burundi, Rwanda, and Zaire have followed the Belgian…

Surgical reconstruction in female genital mutilation

PubMed Central

Gültekin, İsmail Burak; Altınboğa, Orhan; Dur, Rıza; Kara, Osman Fadıl; Küçüközkan, Tuncay

2016-01-01

Female genital mutilation (FGM) is an unusual condition for our country. However, an increase in FGM in future days can be predicted with the increasing numbers of exchange students coming from African countries, migration of refugees and socioeconomic relations with the African countries. We want to share our experience of two FGM victims admitted to our clinic with the request of reconstructive vulvar surgery before their marriage. Both women had WHO Type III FGM. Physical examination findings and surgical reconstruction techniques were presented. PMID:27274899

Liftoff: The Blossoming of Contraceptive Implant Use in Africa.

PubMed

Jacobstein, Roy

2018-03-21

This article draws from national surveys of every sub-Saharan African country with at least 1 recent survey published between 2015 and 2017 and 2 prior surveys from 2003 to 2014. Twelve countries comprising over 60% of the region's population met these inclusion criteria. The analysis considers recent and longer-term changes in 3 key variables: modern contraceptive prevalence rate (mCPR), method-specific prevalence, and a method's share of the current modern method mix. As recently as 2011, implant CPR in sub-Saharan Africa was only 1.1%. Since then, sizeable price reductions, much-increased commodity supply, greater government commitment to rights-based family planning, broader WHO eligibility guidance, and wider adoption of high-impact service delivery practices have resulted in expanded client access and marked increases in implant prevalence and share of the method mix. Ten of the 12 countries now have an implant CPR around 6% or higher, with 3 countries above 11%. Increased implant use has been the main driver of the increased mCPR attained by 11 countries, with gains in implant use alone exceeding combined gains in use of injectables, pills, and intrauterine devices. In countries as diverse as Burkina Faso and Ethiopia, Democratic Republic of the Congo and Ghana, Kenya and Senegal, implant use now accounts for one-fourth to one-half of all modern method use. Implants have become the first or second most widely used method in 10 countries. In the 7 countries with multiple surveys conducted over a 2- to 3-year span between 2013-14 and 2016-17, average annual gains in implant prevalence range from 0.97 to 4.15 percentage points; this contrasts to historical annual gains in use of all modern methods of 0.70 percentage points in 42 sub-Saharan African countries from 1986 to 2008. Implant use has risen substantially and fairly equitably across almost all sociodemographic categories, including unmarried women, women of lower and higher parity, women in all 5 wealth quintiles, younger and older women, and women residing in rural areas. A notable exception is the category of nulliparous married women, whose implant use is mostly below 1%. These attainments represent a major success story not often seen in family planning programming. With continued program commitment and donor support, these trends in implant uptake and popularity are likely to continue for the next few years. This implies even greater need for the international family planning community to maintain its focus on rights-based programming, ensuring reliable access to implant removal as well as insertion services, and addressing issues of financing and sustainability. © Jacobstein.

Liftoff: The Blossoming of Contraceptive Implant Use in Africa

PubMed Central

Jacobstein, Roy

2018-01-01

This article draws from national surveys of every sub-Saharan African country with at least 1 recent survey published between 2015 and 2017 and 2 prior surveys from 2003 to 2014. Twelve countries comprising over 60% of the region's population met these inclusion criteria. The analysis considers recent and longer-term changes in 3 key variables: modern contraceptive prevalence rate (mCPR), method-specific prevalence, and a method's share of the current modern method mix. As recently as 2011, implant CPR in sub-Saharan Africa was only 1.1%. Since then, sizeable price reductions, much-increased commodity supply, greater government commitment to rights-based family planning, broader WHO eligibility guidance, and wider adoption of high-impact service delivery practices have resulted in expanded client access and marked increases in implant prevalence and share of the method mix. Ten of the 12 countries now have an implant CPR around 6% or higher, with 3 countries above 11%. Increased implant use has been the main driver of the increased mCPR attained by 11 countries, with gains in implant use alone exceeding combined gains in use of injectables, pills, and intrauterine devices. In countries as diverse as Burkina Faso and Ethiopia, Democratic Republic of the Congo and Ghana, Kenya and Senegal, implant use now accounts for one-fourth to one-half of all modern method use. Implants have become the first or second most widely used method in 10 countries. In the 7 countries with multiple surveys conducted over a 2- to 3-year span between 2013–14 and 2016–17, average annual gains in implant prevalence range from 0.97 to 4.15 percentage points; this contrasts to historical annual gains in use of all modern methods of 0.70 percentage points in 42 sub-Saharan African countries from 1986 to 2008. Implant use has risen substantially and fairly equitably across almost all sociodemographic categories, including unmarried women, women of lower and higher parity, women in all 5 wealth quintiles, younger and older women, and women residing in rural areas. A notable exception is the category of nulliparous married women, whose implant use is mostly below 1%. These attainments represent a major success story not often seen in family planning programming. With continued program commitment and donor support, these trends in implant uptake and popularity are likely to continue for the next few years. This implies even greater need for the international family planning community to maintain its focus on rights-based programming, ensuring reliable access to implant removal as well as insertion services, and addressing issues of financing and sustainability. PMID:29559495

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

PubMed Central

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

2011-01-01

Objective 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. Design Human capital cost analysis using publicly accessible data. Settings Sub-Saharan African countries. Participants 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. Main outcome measures 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. Results 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). Conclusions 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 health systems. PMID:22117056

Using ICTs (Educationally) for Development in an African Context: Possibilities and Limitations

ERIC Educational Resources Information Center

Carrim, Nazir; Taruvinga, Mandi

2015-01-01

This article examines the possibilities and limitations of using ICTs for development in an African context from an education perspective. Although we provide an account of the Pan-African Agenda on integrating ICTs, which covers many countries on the African continent, our focus is specifically on using ICTs for development in a South African…

Local Villages and Global Networks: The Language and Migration Experiences of African Skilled Migrant Academics

ERIC Educational Resources Information Center

Hurst, Ellen

2017-01-01

African skilled migrants and their circular and return migration strategies have received relatively little attention in the literature, with the previous focus of much African migration literature being on the net loss of skills to countries with developed economies in the global north. This article considers 13 interviews with African skilled…

African Education and Globalization: Critical Perspectives

ERIC Educational Resources Information Center

Abdi, Ali A., Ed.; Puplampu, Korbla P., Ed.; Dei, George J. Sefa, Ed.

2006-01-01

Containing both theoretical discussions of globalization and specific case analyses of individual African countries, this collection of essays examines the intersections of African education and globalization with multiple analytical and geographical emphases and intentions. The 11 essays critically analyze the issues from historical, cultural,…

Using Future Research Methods in Analysing Policies Relating to Open Distance Education in Africa

ERIC Educational Resources Information Center

Makoe, Mpine Elizabeth

2018-01-01

Many African countries have developed policies to reform their education system in order to widen participation in higher education. To achieve this, open, online and distance education based models have been advocated as the most viable delivery tools in expanding access to higher education. However, the policy analysis of Kenya, Rwanda and…

Just Deliberation: Can Communicative Rationality Support Socially Just Environmental Conservation in Rural Africa?

ERIC Educational Resources Information Center

Martin, Adrian; Rutagarama, Eugene

2012-01-01

This article evaluates the use of deliberative methods for filling the democratic deficit arising from the shift to management through partnerships in conservation in developing countries. We ask whether deliberative approaches are feasible in a rural African context and the extent to which they can form a basis for socially just environmental…

A Mixed Methods Study Examining a Successful International Collaborative Partnership: The Efficacy of Textbooks

ERIC Educational Resources Information Center

Drammeh, Lamin E.

2013-01-01

For nearly three decades, foreign assistance from the United States and Europe was the major contributor to funding education development in Sub-Saharan Africa. There was, however limited research on international collaboration as a strategic approach. Many African countries are facing a serious education crisis, at the heart of which lays a…

Policy challenges facing integrated community case management in Sub-Saharan Africa

PubMed Central

Bennett, Sara; George, Asha; Rodriguez, Daniela; Shearer, Jessica; Diallo, Brahima; Konate, Mamadou; Dalglish, Sarah; Juma, Pamela; Namakhoma, Ireen; Banda, Hastings; Chilundo, Baltazar; Mariano, Alda; Cliff, Julie

2014-01-01

Objective To report an in-depth analysis of policy change for integrated community case management of childhood illness (iCCM) in six sub-Saharan African countries. We analysed how iCCM policies developed and the barriers and facilitators to policy change. Methods Qualitative retrospective case studies drawing from document reviews, semi-structured interviews and in-country validation workshops were conducted in Burkina Faso, Kenya, Malawi, Mali, Mozambique and Niger. These countries were selected to maximise variation in iCCM policy status, community health worker (CHW) models and different African regions. Results Country iCCM policies evolved in an ad hoc fashion, but were substantially influenced by the history of primary health care and the nature of CHW programmes. Technical officers within Ministries of Health led iCCM policy change with support from international donors, but neither communities nor political leadership was mobilised. Concerns about achieving the Millennium Development Goals, together with recognition of the shortcomings of existing child health programmes, led to the adoption of iCCM policies. Availability of external financing played a critical role in facilitating policy change. Conclusions iCCM policy change has been promoted by international agencies, but national governments have struggled to align iCCM with country health systems. Greater investment is needed in tailoring global policy initiatives to match country needs. High-level, political ownership of iCCM policies could facilitate policy change, as could clearer strategies for ensuring the long-term sustainability of such policies. PMID:24750516

Eastern Bolivia: The White Promised Land. IWGIA Document 31.

ERIC Educational Resources Information Center

Lewis, Norman

The Indians of Bolivia, already exploited by a military dictatorship, will have to take up more of the white man's burden if South Africans and Rhodesians accept an invitation to colonize the country. White South Africans, accustomed to the excesses of their own police, will find much that is familiar in Bolivia. Bolivia is a poor country, its per…

Learning through South-South Development: Cuban-African Partnerships in Sport and Physical Education

ERIC Educational Resources Information Center

Darnell, Simon C.; Huish, Robert

2017-01-01

Since the 1990s, Cuba has offered scholarships to students from low-resource countries to attend the Escuela Internacional de Educación Física y Deporte (EIEFD) for a six-year degree in sport, physical education, and coaching. Drawing on the experiences of EIEFD graduates from four Southern African countries (Zambia, South Africa, Mozambique, and…

Language Policy and Science: Could Some African Countries Learn from Some Asian Countries?

ERIC Educational Resources Information Center

Brock-Utne, Birgit

2012-01-01

This article deals with the fact that most children in Africa are taught in a language neither they nor their teachers master, resulting in poor education outcomes. While there are also donor interests and donor competition involved in retaining ex-colonial languages, as well as an African elite that may profit from this system, one of the main…

Interrelationships of Non-Formal Mother Tongue Education and Citizenship in Guinea and Senegal

ERIC Educational Resources Information Center

Clemons, Andrea; Yerende, Eva

2009-01-01

Guinea and Senegal are multilingual countries that use French as a language of instruction in the formal educational sector with some significant exceptions. As in many other African countries, such exceptions in Guinea and Senegal, use local African languages primarily in the non-formal sector for a variety of purposes, such as adult literacy and…

The Features of Development in the Pacific Countries of the African, Caribbean and Pacific Group

ERIC Educational Resources Information Center

Cuenca Garcia, Eduardo; Rodriguez Martin, Jose Antonio; Navarro Pabsdorf, Margarita

2010-01-01

In this article we present a new proposal for the measurement of development, applied to the Pacific Countries of the African, Caribbean and Pacific Group (ACP), conditional on their insularity, and with privileged relations with the European Union. Our index has been constructed attending to the criteria defined in the Goals of the Millennium…

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

Federal Register 2010, 2011, 2012, 2013, 2014

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...

Canada's neglected tropical disease research network: who's in the core-who's on the periphery?

PubMed

Phillips, Kaye; Kohler, Jillian Clare; Pennefather, Peter; Thorsteinsdottir, Halla; Wong, Joseph

2013-01-01

This study designed and applied accessible yet systematic methods to generate baseline information about the patterns and structure of Canada's neglected tropical disease (NTD) research network; a network that, until recently, was formed and functioned on the periphery of strategic Canadian research funding. MULTIPLE METHODS WERE USED TO CONDUCT THIS STUDY, INCLUDING: (1) a systematic bibliometric procedure to capture archival NTD publications and co-authorship data; (2) a country-level "core-periphery" network analysis to measure and map the structure of Canada's NTD co-authorship network including its size, density, cliques, and centralization; and (3) a statistical analysis to test the correlation between the position of countries in Canada's NTD network ("k-core measure") and the quantity and quality of research produced. Over the past sixty years (1950-2010), Canadian researchers have contributed to 1,079 NTD publications, specializing in Leishmania, African sleeping sickness, and leprosy. Of this work, 70% of all first authors and co-authors (n = 4,145) have been Canadian. Since the 1990s, however, a network of international co-authorship activity has been emerging, with representation of researchers from 62 different countries; largely researchers from OECD countries (e.g. United States and United Kingdom) and some non-OECD countries (e.g. Brazil and Iran). Canada has a core-periphery NTD international research structure, with a densely connected group of OECD countries and some African nations, such as Uganda and Kenya. Sitting predominantly on the periphery of this research network is a cluster of 16 non-OECD nations that fall within the lowest GDP percentile of the network. The publication specialties, composition, and position of NTD researchers within Canada's NTD country network provide evidence that while Canadian researchers currently remain the overall gatekeepers of the NTD research they generate; there is opportunity to leverage existing research collaborations and help advance regions and NTD areas that are currently under-developed.

Canada's Neglected Tropical Disease Research Network: Who's in the Core—Who's on the Periphery?

PubMed Central

Phillips, Kaye; Kohler, Jillian Clare; Pennefather, Peter; Thorsteinsdottir, Halla; Wong, Joseph

2013-01-01

Background This study designed and applied accessible yet systematic methods to generate baseline information about the patterns and structure of Canada's neglected tropical disease (NTD) research network; a network that, until recently, was formed and functioned on the periphery of strategic Canadian research funding. Methodology Multiple methods were used to conduct this study, including: (1) a systematic bibliometric procedure to capture archival NTD publications and co-authorship data; (2) a country-level “core-periphery” network analysis to measure and map the structure of Canada's NTD co-authorship network including its size, density, cliques, and centralization; and (3) a statistical analysis to test the correlation between the position of countries in Canada's NTD network (“k-core measure”) and the quantity and quality of research produced. Principal Findings Over the past sixty years (1950–2010), Canadian researchers have contributed to 1,079 NTD publications, specializing in Leishmania, African sleeping sickness, and leprosy. Of this work, 70% of all first authors and co-authors (n = 4,145) have been Canadian. Since the 1990s, however, a network of international co-authorship activity has been emerging, with representation of researchers from 62 different countries; largely researchers from OECD countries (e.g. United States and United Kingdom) and some non-OECD countries (e.g. Brazil and Iran). Canada has a core-periphery NTD international research structure, with a densely connected group of OECD countries and some African nations, such as Uganda and Kenya. Sitting predominantly on the periphery of this research network is a cluster of 16 non-OECD nations that fall within the lowest GDP percentile of the network. Conclusion/Significance The publication specialties, composition, and position of NTD researchers within Canada's NTD country network provide evidence that while Canadian researchers currently remain the overall gatekeepers of the NTD research they generate; there is opportunity to leverage existing research collaborations and help advance regions and NTD areas that are currently under-developed. PMID:24340113

Fluoroquinolone-Resistant Enteric Bacteria in Sub-Saharan Africa: Clones, Implications and Research Needs

PubMed Central

Chattaway, Marie A.; Aboderin, Aaron O.; Fashae, Kayode; Okoro, Chinyere K.; Opintan, Japheth A.; Okeke, Iruka N.

2016-01-01

Fluoroquinolones came into widespread use in African countries in the early 2000s, after patents for the first generation of these drugs expired. By that time, quinolone antibacterial agents had been used intensively worldwide and resistant lineages of many bacterial species had evolved. We sought to understand which Gram negative enteric pandemic lineages have been reported from Africa, as well as the nature and transmission of any indigenous resistant clones. A systematic review of articles indexed in the Medline and AJOL literature databases was conducted. We report on the findings of 43 eligible studies documenting local or pandemic fluoroquinolone-resistant enteric clones in sub-Sahara African countries. Most reports are of invasive non-typhoidal Salmonella and Escherichia coli lineages and there have been three reports of cholera outbreaks caused by fluoroquinolone-resistant Vibrio cholerae O1. Fluoroquinolone-resistant clones have also been reported from commensals and animal isolates but there are few data for non-Enterobacteriaceae and almost none for difficult-to-culture Campylobacter spp. Fluoroquinolone-resistant lineages identified in African countries were universally resistant to multiple other classes of antibacterial agents. Although as many as 972 non-duplicate articles refer to fluoroquinolone resistance in enteric bacteria from Africa, most do not report on subtypes and therefore information on the epidemiology of fluoroquinolone-resistant clones is available from only a handful of countries in the subcontinent. When resistance is reported, resistance mechanisms and lineage information is rarely investigated. Insufficient attention has been given to molecular and sequence-based methods necessary for identifying and tracking resistant clones in Africa and more research is needed in this area. PMID:27148238

The South African fertility decline: Evidence from two censuses and a Demographic and Health Survey.

PubMed

Moultrie, Tom A; Timaeus, Ian M

2003-11-01

Inadequate data and apartheid policies have meant that, until recently, most demographers have not had the opportunity to investigate the level of, and trend in, the fertility of South African women. The 1996 South Africa Census and the 1998 Demographic and Health Survey provide the first widely available and nationally representative demographic data on South Africa since 1970. Using these data, this paper describes the South African fertility decline from 1955 to 1996. Having identified and adjusted for several errors in the 1996 Census data, the paper argues that total fertility at that time was 3.2 children per woman nationally, and 3.5 children per woman for African South Africans. These levels are lower than in any other sub-Saharan African country. We show also that fertility in South Africa has been falling since the 1960s. Thus, fertility transition predates the establishment of a family planning programme in the country in 1974.

Testing for purchasing power parity in 21 African countries using several unit root tests

NASA Astrophysics Data System (ADS)

Choji, Niri Martha; Sek, Siok Kun

2017-04-01

Purchasing power parity is used as a basis for international income and expenditure comparison through the exchange rate theory. However, empirical studies show disagreement on the validity of PPP. In this paper, we conduct the testing on the validity of PPP using panel data approach. We apply seven different panel unit root tests to test the validity of the purchasing power parity (PPP) hypothesis based on the quarterly data on real effective exchange rate for 21 African countries from the period 1971: Q1-2012: Q4. All the results of the seven tests rejected the hypothesis of stationarity meaning that absolute PPP does not hold in those African Countries. This result confirmed the claim from previous studies that standard panel unit tests fail to support the PPP hypothesis.

Cigarette smoking and cigarette marketing exposure among students in selected African countries: Findings from the Global Youth Tobacco Survey.

PubMed

Zhao, Luhua; Palipudi, Krishna M; Ramanandraibe, Nivo; Asma, Samira

2016-10-01

To investigate cigarette smoking prevalence and exposure to various forms of cigarette marketing among students in 10 African countries. We used data collected during 2009-2011 from the Global Youth Tobacco Survey (GYTS), a school-based cross-sectional survey of students aged 13-15years, to measure the prevalence of cigarette smoking and exposure to cigarette marketing; comparisons to estimates from 2005 to 2006 were conducted for five countries where data were available. Current cigarette smoking ranged from 3.4% to 13.6% among students aged 13-15 in the 10 countries studied, although use of tobacco products other than cigarettes was more prevalent in all countries except in Cote D'Ivoire. Cigarette smoking was higher among boys than girls in seven out of the 10 countries. Among the five countries with two rounds of surveys, a significant decrease in cigarette smoking prevalence was observed in Mauritania and Niger; these two countries also experienced a decline in three measures of cigarette marketing exposure. It is also possible that smoking prevalence might have risen faster among girls than boys. Cigarette smoking among youth was noticeable in 10 African countries evaluated, with the prevalence over 10% in Cote D'Ivoire, Mauritania, and South Africa. Cigarette marketing exposure varied by the types of marketing; traditional venues such as TV, outdoor billboards, newspapers, and magazines were still prominent. Published by Elsevier Inc.

Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliability

PubMed Central

Adair-Rohani, Heather; Zukor, Karen; Bonjour, Sophie; Wilburn, Susan; Kuesel, Annette C; Hebert, Ryan; Fletcher, Elaine R

2013-01-01

ABSTRACT Background: Access to electricity is critical to health care delivery and to the overarching goal of universal health coverage. Data on electricity access in health care facilities are rarely collected and have never been reported systematically in a multi-country study. We conducted a systematic review of available national data on electricity access in health care facilities in sub-Saharan Africa. Methods: We identified publicly-available data from nationally representative facility surveys through a systematic review of articles in PubMed, as well as through websites of development agencies, ministries of health, and national statistics bureaus. To be included in our analysis, data sets had to be collected in or after 2000, be nationally representative of a sub-Saharan African country, cover both public and private health facilities, and include a clear definition of electricity access. Results: We identified 13 health facility surveys from 11 sub-Saharan African countries that met our inclusion criteria. On average, 26% of health facilities in the surveyed countries reported no access to electricity. Only 28% of health care facilities, on average, had reliable electricity among the 8 countries reporting data. Among 9 countries, an average of 7% of facilities relied solely on a generator. Electricity access in health care facilities increased by 1.5% annually in Kenya between 2004 and 2010, and by 4% annually in Rwanda between 2001 and 2007. Conclusions: Energy access for health care facilities in sub-Saharan African countries varies considerably. An urgent need exists to improve the geographic coverage, quality, and frequency of data collection on energy access in health care facilities. Standardized tools should be used to collect data on all sources of power and supply reliability. The United Nations Secretary-General's “Sustainable Energy for All” initiative provides an opportunity to comprehensively monitor energy access in health care facilities. Such evidence about electricity needs and gaps would optimize use of limited resources, which can help to strengthen health systems. PMID:25276537

Prevalence of dementia in African-Caribbean compared with UK-born White older people: two-stage cross-sectional study.

PubMed

Adelman, Simon; Blanchard, Martin; Rait, Greta; Leavey, Gerard; Livingston, Gill

2011-08-01

Preliminary studies in the UK, all using screening instruments of unknown cultural validity, indicate that there may be an increased prevalence of dementia in African-Caribbean people, possibly related to vascular risk factors and potentially amenable to preventative measures. To determine the prevalence of dementia in older people of African-Caribbean country of birth compared with their White UK-born counterparts. A total of 218 people of African-Caribbean country of birth and 218 White UK-born people aged ≥60 years were recruited from five general practices in North London. Those who screened positive for cognitive impairment using a culturally valid instrument were offered a standardised diagnostic interview. Two independent assessors diagnosed dementia according to standard operationalised criteria. African-Caribbean participants were 2 years younger, and those with dementia nearly 8 years younger than their White counterparts. The prevalence of dementia was significantly higher in the African-Caribbean (9.6%) than the White group (6.9%) after adjustment for the confounders age and socioeconomic status (odds ratio (OR) = 3.1, 95%CI 1.3-7.3, P = 0.012). There is an increased prevalence of dementia in older people of African-Caribbean country of birth in the UK and at younger ages than in the indigenous White population. These findings have implications for service provision and preventive interventions. Further research is needed to explore the role of vascular risk factors and social adversity in the excess of dementia in this population.

With or without us? An audit of disability research in the southern African region

PubMed Central

Mji, Gubela; Gcaza, Siphokazi

2014-01-01

Background Disability research in the global South has not received significant critical consideration as to how it can be used to challenge the oppression and marginalisation of people with disabilities in low-income and middle-income countries. The Southern Africa Federation of the Disabled (SAFOD) embarked on a programme to use research to influence policy and practice relating to people with disabilities in Southern Africa, and commissioned an audit on research expertise in the region. In this article, a research audit is reported on and situated in a framework of emancipatory research. Objectives This article sets out to describe a preliminary audit of disability research in the southern African region and to draw conclusions about the current state of disability research in the region and make recommendations. Method The research method entailed working with disability researchers in the ten SAFOD member countries and utilising African disability networks hosted on electronic media. Disability researchers working in the region completed 87 questionnaires, which were reviewed through a thematic analysis. Results The discussion of results provides a consideration of definitions of disability; the understanding of disability rights, research topics and methodologies; the participation of people with disabilities in research; and the challenges and opportunities for using research to inform disability activism. Conclusion The conclusion highlights critical issues for future research in the region, and considers how a disability researcher database can be used as a tool for disability organisations to prioritise research that serves a disability rights agenda. PMID:28730009

A Case Study of the Development of African American Women Executives

ERIC Educational Resources Information Center

Brooks Greaux, Lisa

2010-01-01

Even in an era when the country elected an African American man as President of the United States, there is still a paucity of African American women executives within Fortune 500 companies. Although more African American women have joined the ranks of corporate management over the last two decades, the numbers, when compared to those of White…

HIV/AIDS information by African companies: an empirical analysis.

PubMed

Barako, Dulacha G; Taplin, Ross H; Brown, Alistair M

2010-01-01

This article investigates the extent of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Disclosures (HIV/AIDSD) in online annual reports by 200 listed companies from 10 African countries for the year ending 2006. Descriptive statistics reveal a very low level of overall HIV/AIDSD practices with a mean of 6 per cent disclosure, with half (100 out of 200) of the African companies making no disclosures at all. Logistic regression analysis reveals that company size and country are highly significant predictors of any disclosure of HIV/AIDS in annual reports. Profitability is also statistically significantly associated with the extent of disclosure.

Inventory on the dietary assessment tools available and needed in africa: a prerequisite for setting up a common methodological research infrastructure for nutritional surveillance, research, and prevention of diet-related non-communicable diseases.

PubMed

Pisa, Pedro T; Landais, Edwige; Margetts, Barrie; Vorster, Hester H; Friedenreich, Christine M; Huybrechts, Inge; Martin-Prevel, Yves; Branca, Francesco; Lee, Warren T K; Leclercq, Catherine; Jerling, Johann; Zotor, Francis; Amuna, Paul; Al Jawaldeh, Ayoub; Aderibigbe, Olaide Ruth; Amoussa, Waliou Hounkpatin; Anderson, Cheryl A M; Aounallah-Skhiri, Hajer; Atek, Madjid; Benhura, Chakare; Chifamba, Jephat; Covic, Namukolo; Dary, Omar; Delisle, Hélène; El Ati, Jalila; El Hamdouchi, Asmaa; El Rhazi, Karima; Faber, Mieke; Kalimbira, Alexander; Korkalo, Liisa; Kruger, Annamarie; Ledo, James; Machiweni, Tatenda; Mahachi, Carol; Mathe, Nonsikelelo; Mokori, Alex; Mouquet-Rivier, Claire; Mutie, Catherine; Nashandi, Hilde Liisa; Norris, Shane A; Onabanjo, Oluseye Olusegun; Rambeloson, Zo; Saha, Foudjo Brice U; Ubaoji, Kingsley Ikechukwu; Zaghloul, Sahar; Slimani, Nadia

2018-01-02

To carry out an inventory on the availability, challenges, and needs of dietary assessment (DA) methods in Africa as a pre-requisite to provide evidence, and set directions (strategies) for implementing common dietary methods and support web-research infrastructure across countries. The inventory was performed within the framework of the "Africa's Study on Physical Activity and Dietary Assessment Methods" (AS-PADAM) project. It involves international institutional and African networks. An inventory questionnaire was developed and disseminated through the networks. Eighteen countries responded to the dietary inventory questionnaire. Various DA tools were reported in Africa; 24-Hour Dietary Recall and Food Frequency Questionnaire were the most commonly used tools. Few tools were validated and tested for reliability. Face-to-face interview was the common method of administration. No computerized software or other new (web) technologies were reported. No tools were standardized across countries. The lack of comparable DA methods across represented countries is a major obstacle to implement comprehensive and joint nutrition-related programmes for surveillance, programme evaluation, research, and prevention. There is a need to develop new or adapt existing DA methods across countries by employing related research infrastructure that has been validated and standardized in other settings, with the view to standardizing methods for wider use.

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

PubMed

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.

Social inequalities, regional disparities and health inequity in North African countries.

PubMed

Boutayeb, Abdesslam; Helmert, Uwe

2011-05-31

During the last decades, North African countries have substantially improved economic, social and health conditions of their populations in average. In all countries, human development in general and life expectancy, literacy and per capita income in particular have increased. However, improvement was not equally shared between groups of different milieu, regions or level of income. Social inequalities and health inequity have persisted or even worsened. Data are generally scarce and few studies were devoted to this topic in North Africa as a region. In this paper, we carry out a comparative study on the achievements of these countries, not only in terms of human development and its components but also in terms of inequalities' reduction and health equity. This study is based on data available for comparison between North African countries. The main data sources are provided by reports released by the World Health Organisation (WHO), United Nations Development Programme (UNDP), United Nations Children's Fund (UNICEF), the World Bank, surveys such as Demographic Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) and finally recent papers published on equity in different countries of the region. There is no doubt that education, health and human development in general have improved in North Africa during the last decades. Improvement was, however, uneven and unequally enjoyed by different socioeconomic groups. Indeed, each country included in this study shows large urban-rural disparities, discrepancies between advantaged and disadvantaged regions and cities; and unacceptable differences between rich and poor. Health inequity is particularly seen through access to health services and infant mortality. During the last decades, North African decision makers have endeavoured to improve social and economic conditions of their populations. Globally, health, education and living standard in general have substantially improved in average. However, North African countries have still a long way to go to reduce social inequalities and health inequity at different levels: rural-urban, advantaged-marginalised regions and cities, between groups of different level of income and wealth. The challenge for the next decade is not only to improve economic, social and health conditions in average but also and mainly to reduce avoidable inequalities in parallel.

Counting the cost of child mortality in the World Health Organization African region.

PubMed

Kirigia, Joses M; Muthuri, Rosenabi Deborah Karimi; Nabyonga-Orem, Juliet; Kirigia, Doris Gatwiri

2015-11-06

Worldwide, a total of 6.282 million deaths occurred among children aged less than 5 years in 2013. About 47.4 % of those were borne by the 47 Member States of the World Health Organization (WHO) African Region. Sadly, even as we approach the end date for the 2015 Millennium Development Goals (MDGs), only eight African countries are on track to achieve the MDG 4 target 4A of reducing under-five mortality by two thirds between 1990 and 2015. The post-2015 Sustainable Development Goal (SDG) 3 target is "by 2030, end preventable deaths of new-borns and children under 5 years of age". There is urgent need for increased advocacy among governments, the private sector and development partners to provide the resources needed to build resilient national health systems to deliver an integrated package of people-centred interventions to end preventable child morbidity and mortality and other structures to address all the basic needs for a healthy population. The specific objective of this study was to estimate expected/future productivity losses from child deaths in the WHO African Region in 2013 for use in advocacy for increased investments in child health services and other basic services that address children's welfare. A cost-of-illness method was used to estimate future non-health GDP losses related to child deaths. Future non-health GDP losses were discounted at 3 %. The analysis was undertaken with the countries categorized under three income groups: Group 1 consisted of nine high and upper middle income countries, Group 2 of 13 lower middle income countries, and Group 3 of 25 low income countries. One-way sensitivity analysis at 5 % and 10 % discount rates assessed the impact of the expected non-health GDP loss. The discounted value of future non-health GDP loss due to the deaths of children under 5 years old in 2013 will be in the order of Int$ 150.3 billion. Approximately 27.3 % of the loss will be borne by Group 1 countries, 47.1 % by Group 2 and 25.7 % by Group 3. The average non-health GDP lost per child death will be Int$ 174 310 for Group 1, Int$ 57 584 for Group 2 and Int$ 25 508 for Group 3. It is estimated that the African Region will incur a loss of approximately 6 % of its non-health GDP from the future years of life lost among the 2 976 000 child deaths that occurred in 2013. Therefore, countries and development partners should in solidarity sustainably provide the resources essential to build resilient national health systems and systems to address the determinants of health and meet the other basic needs such as for clothing, education, food, shelter, sanitation and clean water to end preventable child morbidity and mortality.

Eradication of dracunculiasis from Pakistan.

PubMed

Hopkins, D R; Azam, M; Ruiz-Tiben, E; Kappus, K D

1995-09-02

In 1986 the World Health Organization targeted dracunculiasis (Guinea-worm disease), which seriously impairs socioeconomic development in 16 African countries, India, Pakistan, and Yemen, to be eradicated globally. The target date for eradication by the end of 1995 was established in 1991. Pakistan eradicated dracunculiasis from the country in October, 1993, after a national campaign which began in 1987 with a nationwide village-by-village search for cases. The infection, which is transmitted by drinking water from ponds containing infected water fleas, was eradicated by using health education, cloth filters, and the cyclopsicide, temephos; and in the later stages, by case containment. Methods pioneered in Pakistan's National Guinea Worm Eradication Program are now being applied in remaining endemic countries.

Higher Education Institutions and International Students' Hindrances: A Case of Students from the African Portuguese-Speaking Countries at Two European Portuguese Universities

ERIC Educational Resources Information Center

Ambrósio, Susana; Marques, João Filipe; Santos, Lucília; Doutor, Catarina

2017-01-01

We present a study to comprehend if the support given by higher education institution (HEI) to international students coming from the Portuguese-Speaking African Countries meets their academic and social hindrances. Our starting point was a set of semi-structured interviews focused on the perspectives of these students, their Professors and Course…

'You can't stay away from your family': a qualitative study of the ongoing ties and future plans of South African health workers in the United Kingdom.

PubMed

Taylor, Katherine; Blacklock, Claire; Hayward, Gail; Bidwell, Posy; Laxmikanth, Pallavi; Riches, Nicholas; Willcox, Merlin; Moosa, Shabir; Mant, David

2015-01-01

Migration of African-trained health workers to countries with higher health care worker densities adds to the severe shortage of health personnel in many African countries. Policy initiatives to reduce migration levels are informed by many studies exploring the reasons for the original decision to migrate. In contrast, there is little evidence to inform policies designed to facilitate health workers returning home or providing other forms of support to the health system of their home country. This study explores the links that South African-trained health workers who now live and work in the United Kingdom maintain with their country of training and what their future migration plans may be. Semi-structured interviews were conducted with South African trained health workers who are now living in the United Kingdom. Data extracts from the interviews relating to current links with South Africa and future migration plans were studied. All 16 participants reported strong ongoing ties with South Africa, particularly through active communication with family and friends, both face-to-face and remotely. Being South African was a significant part of their personal identity, and many made frequent visits to South Africa. These visits sometimes incorporated professional activities such as medical work, teaching, and charitable or business ventures in South Africa. The presence and location of family and spouse were of principal importance in helping South African-trained health care workers decide whether to return permanently to work in South Africa. Professional aspirations and sense of duty were also important motivators to both returning and to being involved in initiatives remotely from the United Kingdom. The main barrier to returning home was usually the development of stronger family ties in the United Kingdom than in South Africa. The issues that prompted the original migration decision, such as security and education, also remained important reasons to remain in the United Kingdom as long as they were perceived as unresolved at home. However, the strong residual feeling of identity and regular ongoing communication meant that most participants expressed a sense of duty to their home country, even if they were unlikely to return to live there full-time. This is a resource for training and short-term support that could be utilised to the benefit of African health care systems.

NEWS for Africa: adaptation and reliability of a built environment questionnaire for physical activity in seven African countries.

PubMed

Oyeyemi, Adewale L; Kasoma, Sandra S; Onywera, Vincent O; Assah, Felix; Adedoyin, Rufus A; Conway, Terry L; Moss, Sarah J; Ocansey, Reginald; Kolbe-Alexander, Tracy L; Akinroye, Kingsley K; Prista, Antonio; Larouche, Richard; Gavand, Kavita A; Cain, Kelli L; Lambert, Estelle V; Aryeetey, Richmond; Bartels, Clare; Tremblay, Mark S; Sallis, James F

2016-03-08

Built environment and policy interventions are effective strategies for controlling the growing worldwide deaths from physical inactivity-related non-communicable diseases. To improve built environment research and develop African specific evidence, it is important to first tailor built environment measures to African contexts and assess their psychometric properties across African countries. This study reports on the adaptation and test-retest reliability of the Neighborhood Environment Walkability Scale in seven sub-Saharan African countries (NEWS-Africa). The original NEWS comprising 8 subscales measuring reported physical and social attributes of neighborhood environments was systematically adapted for Africa through extensive input from physical activity and public health researchers, built environment professionals, and residents in seven African countries: Cameroon, Ghana, Kenya, Mozambique, Nigeria, South Africa and Uganda. Cognitive testing of NEWS-Africa was conducted among diverse residents (N = 109, 50 youth [12 - 17 years] and 59 adults [22 - 67 years], 69 % from low socioeconomic status [SES] neighborhoods). NEWS-Africa was translated into local languages and evaluated for 2-week test-retest reliability in adult participants (N = 301; female = 50.2 %; age = 32.3 ± 12.9 years) purposively recruited from neighborhoods varying in walkability (high and low walkable) and SES (high and low income) and from villages in six of seven participating countries. The original 67 NEWS items was expanded to 89 scores (76 individual NEWS items and 13 computed scales). Several modifications were made to individual items, and some new items were added to capture important attributes in the African environment. A new scale on personal safety was created, and the aesthetics scale was enlarged to reflect African specific characteristics. Over 95 % of all NEWS-Africa scores (items plus computed scales) demonstrated evidence of "excellent" (ICCs > .75 %) or "good" (ICCs = 0.60 to 0.74) reliability. Seven (53.8 %) of the 13 computed NEWS scales demonstrated "excellent" agreement and the other six had "good" agreement. No items or scales demonstrated "poor" reliability (ICCs < .40). The systematic adaptation and initial psychometric evaluation of NEWS-Africa indicates the instrument is feasible and reliable for use with adults of diverse demographic characteristics in Africa. The measure is likely to be useful for research, surveillance of built environment conditions for planning purposes, and to evaluate physical activity and policy interventions in Africa.

Comparative analysis of old-age mortality estimations in Africa.

PubMed

Bendavid, Eran; Seligman, Benjamin; Kubo, Jessica

2011-01-01

Survival to old ages is increasing in many African countries. While demographic tools for estimating mortality up to age 60 have improved greatly, mortality patterns above age 60 rely on models based on little or no demographic data. These estimates are important for social planning and demographic projections. We provide direct estimations of older-age mortality using survey data. Since 2005, nationally representative household surveys in ten sub-Saharan countries record counts of living and recently deceased household members: Burkina Faso, Côte d'Ivoire, Ethiopia, Namibia, Nigeria, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe. After accounting for age heaping using multiple imputation, we use this information to estimate probability of death in 5-year intervals ((5)q(x)). We then compare our (5)q(x) estimates to those provided by the World Health Organization (WHO) and the United Nations Population Division (UNPD) to estimate the differences in mortality estimates, especially among individuals older than 60 years old. We obtained information on 505,827 individuals (18.4% over age 60, 1.64% deceased). WHO and UNPD mortality models match our estimates closely up to age 60 (mean difference in probability of death -1.1%). However, mortality probabilities above age 60 are lower using our estimations than either WHO or UNPD. The mean difference between our sample and the WHO is 5.9% (95% CI 3.8-7.9%) and between our sample is UNPD is 13.5% (95% CI 11.6-15.5%). Regardless of the comparator, the difference in mortality estimations rises monotonically above age 60. Mortality estimations above age 60 in ten African countries exhibit large variations depending on the method of estimation. The observed patterns suggest the possibility that survival in some African countries among adults older than age 60 is better than previously thought. Improving the quality and coverage of vital information in developing countries will become increasingly important with future reductions in mortality.

Systematic review of school tobacco prevention programs in African countries from 2000 to 2016

PubMed Central

Saito, Junko; Tomokawa, Sachi; Kobayashi, Jun; Makino, Yuka; Akiyama, Takeshi; Miyake, Kimihiro; Yamamoto, Mayumi

2018-01-01

Background The World Bank has reported that global smoking rates declined from 2000 to 2012, with the only exception found in males in Sub-Saharan Africa. Sub-Saharan Africa is considered to be in stage one of the tobacco epidemic continuum. To address this problem, school-based programs for smoking prevention are considered cost-effective and promising. Since tobacco prevention programs are influenced by social competence or customs of each country, tobacco prevention programs that have success in Western countries are not always effective in African countries. Therefore, the current study systematically reviewed relevant literature to examine the effects of these types of programs in African countries. Method Online bibliographic databases and a hand search were used. We included the studies that examined the impact of school-based programs on preventing tobacco use in Africa from 2000 to 2016. Results Six articles were selected. Four were conducted in South Africa and two were performed in Nigeria. Four programs were systematically incorporated into annual curriculums, targeting 8th to 9th graders, while the other two were temporary programs. All programs were based on the hypothesis that providing knowledge and/or social skills against smoking would be helpful. All studies utilized smoking or polydrug use rates to compare outcomes before/after intervention. There were no significant differences between intervention and control groups in three studies, with the other three demonstrating only partial effectiveness. Additionally, three studies also examined change of knowledge/attitudes towards smoking as an outcome. Two of these showed significant differences between groups. Conclusion All RCTs studies showed no significant change of smoking-rate by the intervention. The effectiveness of intervention was observed only in some sub-group. The cohort studies showed school-based interventions may be effective in improving knowledge and attitudes about smoking. However, they reported no significant change of smoking-rate by the intervention. PMID:29408895

Dependence and Interdependence in Education: Two Case-Studies from Africa.

ERIC Educational Resources Information Center

Yoloye, E. Ayotunde

1985-01-01

The three phenomena of independence, dependence, and interdependence interact in rather complex ways in African countries. These interactions, in the context of education, are examined through case studies of two regional African educational organizations: the Science Education Programme for Africa and the African Curriculum Organization. (RM)

Infant oral mutilation - a child protection issue?

PubMed

Girgis, S; Gollings, J; Longhurst, R; Cheng, L

2016-04-01

Infant oral mutilation (IOM) is a primitive traditional practice involving the 'gouging out' of an infant's healthy primary tooth germs. This can lead to transmission of blood-borne diseases such as HIV/ AIDS, septicaemia and death. Other complications include eradication and/ or malformation of the child's permanent dentition. IOM is usually performed by village healers in low income countries as an accepted remedy for common childhood illness. The gingival swelling of the unerupted teeth is mistakenly thought to indicate the presence of 'tooth worms'. Crude methods to remove these are employed using unsterile tools. IOM has been reported in many African countries. More recently, some immigrants living in high income countries, such as the UK, have shown signs of IOM. Our aim is to raise awareness among clinicians about the existence of IOM practice being carried out among respective African immigrant groups. We encourage clinicians, particularly those working with paediatric patients to inform parents and carers of children with a history of IOM about the risks and consequences. As part of child safeguarding policies, dental practitioners and health care professionals should intervene if they are aware of any perceived plan that IOM is to be carried out in the future.

Access to Higher Education for National Development in Nigeria: Distance Education to the Rescue

ERIC Educational Resources Information Center

Bakare; Tewo V.

2012-01-01

The paper examined the place of Distance Education (DE) as a method of Adult Education in Nigeria and its contribution to national development. The paper discussed DE practice and challenges in some African countries and related this to the Nigerian situation. The paper further noted the challenge of the national admission body for regular…

Participation and performance trends of East-African runners in Swiss half-marathons and marathons held between 2000 and 2010

PubMed Central

2013-01-01

Background This study examined the changes in participation, performance and age of East African runners competing in half-marathons and marathons held in Switzerland between 2000 and 2010. Methods Race times, sex, age and origin of East African versus Non-African finishers of half-marathon and marathon finishers were analyzed. Results Across time, the number of Kenyan and Ethiopian finishers remained stable (P > 0.05) while the number of Non-African finishers increased for both women and men in both half-marathons and marathons (P < 0.05). In half-marathons, the top ten African women (71 ± 1.4 min) and top three (62.3 ± 0.6 min) and top ten (62.8 ± 0.4 min) African men were faster than their Non-African counterparts (P < 0.05). In marathons, however, there was no difference in race times between the top three African men (130.0 ± 0.0 min) and women (151.7 ± 2.5 min) compared to Non-African men (129.0 ± 1.0 min) and women (150.7 ± 1.2 min) (P > 0.05). In half-marathons and marathons was no difference in age between the best Non-African and the best African runners (P > 0.05). Conclusions During the last decade in Switzerland, the participation of Kenyan and Ethiopian runners in half- and full- marathons remained stable. In marathons there was no difference in age and performance between the top African and the top Non-African runners. Regarding half-marathons, the top African runners were faster but not younger than the top Non-African runners. Future insight should be gained by comparing the present results with participation, performance and age trends for East African runners competing in marathons held in larger countries. PMID:24289794

African Female Physicians and Nurses in the Global Care Chain: Qualitative Explorations from Five Destination Countries.

PubMed

Wojczewski, Silvia; Pentz, Stephen; Blacklock, Claire; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Kutalek, Ruth

2015-01-01

Migration of health professionals is an important policy issue for both source and destination countries around the world. The majority of migrant care workers in industrialized countries today are women. However, the dimension of mobility of highly skilled females from countries of the global south has been almost entirely neglected for many years. This paper explores the experiences of high-skilled female African migrant health-workers (MHW) utilising the framework of Global Care Chain (GCC) research. In the frame of the EU-project HURAPRIM (Human Resources for Primary Health Care in Africa), the research team conducted 88 semi-structured interviews with female and male African MHWs in five countries (Botswana, South Africa, Belgium, Austria, UK) from July 2011 until April 2012. For this paper we analysed the 34 interviews with female physicians and nurses using the qualitative framework analysis approach and the software atlas.ti. In terms of the effect of the migration on their career, almost all of the respondents experienced short-term, long-term or permanent inability to work as health-care professionals; few however also reported a positive career development post-migration. Discrimination based on a foreign nationality, race or gender was reported by many of our respondents, physicians and nurses alike, whether they worked in an African or a European country. Our study shows that in addition to the phenomenon of deskilling often reported in GCC research, many female MHW are unable to work according to their qualifications due to the fact that their diplomas are not recognized in the country of destination. Policy strategies are needed regarding integration of migrants in the labour market and working against discrimination based on race and gender.

African Female Physicians and Nurses in the Global Care Chain: Qualitative Explorations from Five Destination Countries

PubMed Central

Wojczewski, Silvia; Pentz, Stephen; Blacklock, Claire; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Kutalek, Ruth

2015-01-01

Migration of health professionals is an important policy issue for both source and destination countries around the world. The majority of migrant care workers in industrialized countries today are women. However, the dimension of mobility of highly skilled females from countries of the global south has been almost entirely neglected for many years. This paper explores the experiences of high-skilled female African migrant health-workers (MHW) utilising the framework of Global Care Chain (GCC) research. In the frame of the EU-project HURAPRIM (Human Resources for Primary Health Care in Africa), the research team conducted 88 semi-structured interviews with female and male African MHWs in five countries (Botswana, South Africa, Belgium, Austria, UK) from July 2011 until April 2012. For this paper we analysed the 34 interviews with female physicians and nurses using the qualitative framework analysis approach and the software atlas.ti. In terms of the effect of the migration on their career, almost all of the respondents experienced short-term, long-term or permanent inability to work as health-care professionals; few however also reported a positive career development post-migration. Discrimination based on a foreign nationality, race or gender was reported by many of our respondents, physicians and nurses alike, whether they worked in an African or a European country. Our study shows that in addition to the phenomenon of deskilling often reported in GCC research, many female MHW are unable to work according to their qualifications due to the fact that their diplomas are not recognized in the country of destination. Policy strategies are needed regarding integration of migrants in the labour market and working against discrimination based on race and gender. PMID:26068218

How students perceive medical competences: a cross-cultural study between the medical course in Portugal and African Portuguese speaking countries.

PubMed

Barbosa, Joselina; Severo, Milton; Fresta, Mário; Ismail, Mamudo; Ferreira, Maria Amélia; Barros, Henrique

2011-05-25

A global effort has been made in the last years to establish a set of core competences that define the essential professional competence of a physician. Regardless of the environment, culture or medical education conditions, a set of core competences is required for medical practice worldwide. Evaluation of educational program is always needed to assure the best training for medical students and ultimately best care for patients. The aim of this study was to determine in what extent medical students in Portugal and Portuguese speaking African countries, felt they have acquired the core competences to start their clinical practice. For this reason, it was created a measurement tool to evaluate self-perceived competences, in different domains, across Portuguese and Portuguese-speaking African medical schools. The information was collected through a questionnaire that defines the knowledge, attitudes and skills that future doctors should acquire. The Cronbach's Alpha and Principal Components Analysis (PCA) were used to evaluate the reliability of the questionnaire. In order to remove possible confounding effect, individual scores were standardized by country. The order of the domain's scores was similar between countries. After standardization, Personal Attitudes and Professional Behavior showed median scores above the country global median and Knowledge alone showed median score below the country global median. In Portugal, Clinical Skills showed score below the global median. In Angola, Clinical Skills and General Skills showed a similar result. There were only significant differences between countries in Personal Attitudes (p < 0.001) and Professional Behavior (p = 0.043). The reliability of the instrument in Portuguese and Portuguese-speaking African medical schools was confirmed. Students have perceived their level of competence in personal attitudes in a high level and in opposite, knowledge and clinical skills with some weaknesses.

A comparative review of governments' views on objectives and policy instruments in the field of population and development.

PubMed

1982-01-01

It is possible to assess population policies through statements and decisions taken by governments as they reflect the views and commitments of political authorities in the field of population and development. Cases in the following African countries are reviewed with focus on objectives and policy instruments: Algeria; Angola; Benin; Botswana; Cape Verde; Central African Republic; Congo; Djibouti; Egypt; Ethiopia; Guinea; Gabon; Gambia; Ghana; Equatorial Guinea; Guinea-Bissau; Ivory Coast; Kenya; Lesotho; Liberia; Libyan Arab Jamahiriya; Madagascar; Malawi; Mali; Mauritania; Mauritius; Morocco; Mozambique; Niger; Nigeria; Rwanda; Sao Tome and Principe; Senegal; Seychelles; Sierra Leone; Somalia; Sudan; Swaziland; Togo; Tunisia; Uganda; United Republic of Cameroon; Tanzania; Upper Volta; Zaire; Zambia; and Zimbabwe. The information presented was drawn from the following publications: UN Population Division, "Population Policy Briefs: Current Situation in Developing Countries and Selected Territories," and UNFPA, "Population Programs and Projects," Volume 2, 1980-1981. On the basis of this review the following conclusions are drawn, which could indicate areas in which technical assistance to the Economic Commission for Africa (ECA) member States would be required: among the 50 country members of ECA, 34 countries (68%) have as a development objective the reduction of mortality, and in particular, maternal and child mortality; the 2nd important objective is stabilizing or improving spatial distribution of population, and 44% of the 50 countries have adopted this objective which involves the distribution of population from 1 place to another within a country; the 3rd important objective consists of restricting the migratory flow from rural areas to urban areas; the countries of Botswana, Egypt, Ghana, Kenya, Lesotho, Mauritius, Morocco, Rwanda, Seychelles, Swaziland, and Tunisia adopted the objective of reducing the rate of population growth; 34% of African countries have decided to integrate family planning programs with health services; and only 20% of African countries have announced socioeconomic development as an instrument to solve their population problems.

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

PubMed Central

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

Tracing Africa's progress towards implementing the Non-Communicable Diseases Global action plan 2013-2020: a synthesis of WHO country profile reports.

PubMed

Nyaaba, Gertrude Nsorma; Stronks, Karien; de-Graft Aikins, Ama; Kengne, Andre Pascal; Agyemang, Charles

2017-04-05

Half of the estimated annual 28 million non-communicable diseases (NCDs) deaths in low- and middle-income countries (LMICs) are attributed to weak health systems. Current health policy responses to NCDs are fragmented and vertical particularly in the African region. The World Health Organization (WHO) led NCDs Global action plan 2013-2020 has been recommended for reducing the NCD burden but it is unclear whether Africa is on track in its implementation. This paper synthesizes Africa's progress towards WHO policy recommendations for reducing the NCD burden. Data from the WHO 2011, 2014 and 2015 NCD reports were used for this analysis. We synthesized results by targets descriptions in the three reports and included indicators for which we could trace progress in at least two of the three reports. More than half of the African countries did not achieve the set targets for 2015 and slow progress had been made towards the 2016 targets as of December 2013. Some gains were made in implementing national public awareness programmes on diet and/or physical activity, however limited progress was made on guidelines for management of NCD and drug therapy and counselling. While all regions in Africa show waning trends in fully achieving the NCD indicators in general, the Southern African region appears to have made the least progress while the Northern African region appears to be the most progressive. Our findings suggest that Africa is off track in achieving the NCDs indicators by the set deadlines. To make sustained public health gains, more effort and commitment is urgently needed from governments, partners and societies to implement these recommendations in a broader strategy. While donors need to suit NCD advocacy with funding, African institutions such as The African Union (AU) and other sub-regional bodies such as West African Health Organization (WAHO) and various country offices could potentially play stronger roles in advocating for more NCD policy efforts in Africa.

Hygiene behaviour and associated factors among in-school adolescents in nine African countries.

PubMed

Pengpid, Supa; Peltzer, Karl

2011-06-01

This report examines hygiene behaviour and associated factors among 13-15 year old in-school adolescents in nine African countries. The total sample included 25,760 school children aged 13-15 years from nationally representative samples from nine African countries. We examined the prevalence of and relationship between tooth brushing, hand washing before eating, hand washing after toileting, hand washing with soap and a range of psychosocial factors such as socio-demographic characteristics, health behaviour, mental health or well-being and protective factors. Overall, sub-optimal hygiene behaviour was reported, the proportions of school children reporting optimal (>once a day) tooth brushing (77.3%) was higher than the proportions reported for washing their hands regularly before meals (62.2%), after toileting (58.4%) and washing their hands with soap (35.0%). In multivariate analysis higher education, health-enhancing behaviours such as daily fruits or vegetable consumption, and protective factors such as caregiver supervision were associated with tooth brushing, hand washing before meals, hand washing after toileting and washing of hands with soap. The cross-national data on hygiene behaviour from nine African countries found sub-optimal hygiene behaviour. Various determinants of optimal hygiene behaviour were identified that can guide programmes to improve hygiene behaviour of this adolescent population.

The development of a screening tool for the early identification of risk for suicidal behaviour among students in a developing country

PubMed Central

Vawda, Naseema B. M.; Milburn, Norweeta G.; Steyn, Renier; Zhang, Muyu

2016-01-01

Objective Adolescent suicidal behaviour is a public health concern in South Africa. The purpose of this manuscript is to report on the development of a screening tool for teachers to identify South African students who are most at risk for suicidal behaviour. This need is addressed within the context of the limited number of mental health professionals available to provide screening and care services in South Africa. Method Grade 8 students participated by completing sociodemographic questionnaires and self-report psychometric instruments. A screening tool for suicidal behaviour was developed using a four phase approach. Results Twelve factors for high risk suicidal behaviour were identified and included in the screening tool. While further research is needed to validate the screening tool, the findings provide a useful preliminary starting point for teachers to refer students at high risk for suicidal behaviour to mental health services for treatment. Conclusion This screening tool is based on factors that were identified as being associated with suicidal behaviour from local research on South African adolescents. The tool contributes to research on adolescent mental health, particularly suicidal behaviour, in developing low and middle income countries like South Africa, with the aim of creating African prevention and intervention programmes. PMID:28459269

Fetal alcohol spectrum disorder in Africa.

PubMed

Adnams, Colleen M

2017-03-01

This review aims to summarize data published in the scientific literature and available on official websites on fetal alcohol spectrum disorder (FASD) in Africa. There is a paucity of published literature and evidence-based information on prenatal exposure to alcohol in the African continent and the majority of the continent's literature on FASD emanates from South Africa. A small number of scientific publications document FASD and drinking in pregnancy in other Sub-Saharan African countries and these findings provide evidence that FASD occurs across the continent. Further evidence shows that the world's highest reported rates of FASD occur in South Africa and that this confers a significant public health and neurodevelopmental disability burden on the region. There is an established body of epidemiological, diagnostic, neurobehavioral and neuroscientific knowledge from studies in South Africa. Universal and indicated case method preventions are effective in reducing maternal alcohol consumption in high-risk areas. Throughout Africa, a policy and service implementation gap exists that impedes translation of generated knowledge into effective prevention and intervention strategies. FASD is likely a widely occurring and largely unrecognized neurodevelopmental disability in Africa. A key future direction for global agencies and research partnerships is to collaboratively address evidence gaps and knowledge translation through scalable approaches and strategies that aim to ameliorate the burden of FASD in African and other countries.

Cancer and men from minority ethnic groups: an exploration of the literature.

PubMed

Lees, S; Papadopoulos, I

2000-12-01

The authors reviewed literature which has been published in the last 20 years. Cancer is the second leading cause of death in developed countries and is expected to become a significant cause of death in developing countries. Whilst there are a large number of studies on cancer and men, there is a paucity of data on men from minority ethnic groups. In the USA, African Americans are more likely to develop cancer than any other ethnic group. Although cancer rates amongst minority ethnic groups in the UK are thought to be low, 11% of Indian and African men and 19% of Caribbean men died from cancer during 1979-1983. There is also further evidence in the USA that African American, Filipinos and Native Americans have the lowest cancer survival rates. Service utilization, especially tertiary care, is also thought to be low amongst minority ethnic groups from the USA and the UK. Reasons for these variations include artefactual, cultural, materialist and social selectivist explanations as well as the effects of migration, racism and genetic disposition. This area is under-researched, in particular cultural beliefs about cancer. Further research into this area should apply culturally competent methods to ensure valid data to inform cancer policy, education and practice.

Greenhouse gases accounting and reporting for waste management--a South African perspective.

PubMed

Friedrich, Elena; Trois, Cristina

2010-11-01

This paper investigates how greenhouse gases are accounted and reported in the waste sector in South Africa. Developing countries (including South Africa) do not have binding emission reduction targets, but many of them publish different greenhouse gas emissions data which have been accounted and reported in different ways. Results show that for South Africa, inventories at national and municipal level are the most important tools in the process of accounting and reporting greenhouse gases from waste. For the development of these inventories international initiatives were important catalysts at national and municipal levels, and assisted in developing local expertise, resulting in increased output quality. However, discrepancies in the methodology used to account greenhouse gases from waste between inventories still remain a concern. This is a challenging issue for developing countries, especially African ones, since higher accuracy methods are more data intensive. Analysis of the South African inventories shows that results from the recent inventories can not be compared with older ones due to the use of different accounting methodologies. More recently the use of Clean Development Mechanism (CDM) procedures in Africa, geared towards direct measurements of greenhouse gases from landfill sites, has increased and resulted in an improvement of the quality of greenhouse gas inventories at municipal level. Copyright © 2010 Elsevier Ltd. All rights reserved.

Practices and discourses of ubuntu: Implications for an African model of disability?

PubMed Central

2017-01-01

Background Southern African scholars and activists working in disability studies have argued that ubuntu or unhu is a part of their world view. Objectives Thinking seriously about ubuntu, as a shared collective humanness or social ethics, means to examine how Africans have framed a struggle for this shared humanity in terms of decolonisation and activism. Method Three examples of applications of ubuntu are given, with two mainly linked to making explicit umaka. Firstly, ubuntu is linked to making visible the invisible inequalities for a common humanity in South Africa. Secondly, it becomes correlated to the expression of environmental justice in West and East African countries. Results An African model of disability that encapsulates ubuntu is correlated to how Africans have illustrated a social ethics of a common humanity in their grassroots struggles against oppression and disablement in the 20th century. Ubuntu also locates disability politically within the wider environment and practices of sustainability which are now important to the post-2105 agenda, Convention on the Rights of Persons with Disabilities (CRPD) and the (UN) Sustainable Development Goals linked to climate change. Conclusion A different kind of political action linked to social justice seems to be evolving in line with ubuntu. This has implications for the future of disability studies. PMID:28730067

Carbon emissions-income relationships with structural breaks: the case of the Middle Eastern and North African countries.

PubMed

El Montasser, Ghassen; Ajmi, Ahdi Noomen; Nguyen, Duc Khuong

2018-01-01

This article revisits the carbon dioxide (CO 2 ) emissions-GDP causal relationships in the Middle Eastern and North African (MENA) countries by employing the Rossi (Economet Theor 21:962-990, 2005) instability-robust causality test. We show evidence of significant causality relationships for all considered countries within the instability context, whereas the standard Granger causality test fails to detect causal links in any direction, except for Egypt, Iran, and Morocco. An important policy implication resulting from this robust analysis is that the income is not affected by the cuts in the CO 2 emissions for only two MENA countries, the UAE and Syria.

Community-Level Gender Equity and Extramarital Sexual Risk-Taking Among Married Men in Eight African Countries

PubMed Central

Stephenson, Rob

2014-01-01

CONTEXT In many parts of Africa, women are most likely to become infected with HIV by having unprotected sex with their husbands, who may have acquired the virus through extramarital sex. However, the ways in which aspects of community environments—particularly those related to gender equity—shape men’s extramarital sexual risk-taking are not well understood. METHODS Demographic and Health Survey data from eight African countries (Chad, Ghana, Malawi, Nigeria, Tanzania, Uganda, Zambia and Zimbabwe) were used to examine associations between married men’s engaging in risky extramarital sex (i.e., having had both unprotected sex and extramarital sex) and indicators of gender equity and other community characteristics. Separate multilevel logistic regression models that incorporated individual, household and community measures were created for each country. RESULTS In five countries, men who lived in communities with more equal ratios of women to men with at least a primary education were less likely to report risky extramarital sexual activity (odds ratios, 0.4–0.6). A similar relationship was found in four countries for the ratio of women to men who were employed (0.4–0.5). In three countries, men who lived in communities with more conservative attitudes toward wife-beating or male decision making had elevated odds of extramarital sexual risk-taking (1.1–1.5). CONCLUSIONS While HIV prevention programs should focus on reducing gender inequities, they also need to recognize the conservative cultural factors that influence the formation of men’s masculine identities and, in turn, affect their sexual behavior. PMID:21245024

Overcoming barriers to health-care access: A qualitative study among African migrants in Guangzhou, China.

PubMed

Lin, Lavinia; Brown, Katherine B; Hall, Brian J; Yu, Fan; Yang, Jingqi; Wang, Jason; Schrock, Joshua M; Bodomo, Adams B; Yang, Ligang; Yang, Bin; Nehl, Eric J; Tucker, Joseph D; Wong, Frank Y

2016-10-01

Guangzhou is China's third most populous city, and the region's burgeoning manufacturing economy has attracted many young African businessmen and entrepreneurs to the city. The aims of this study were to examine strategies that African migrants in Guangzhou have adopted in response to health-care barriers, and explore their perceptions of how to address their needs. Twenty-five semi-structured interviews and two focus groups were conducted among African migrants residing in Guangzhou, China. Facing multiple barriers to care, African migrants have adopted a number of suboptimal and unsustainable approaches to access health care. These included: using their Chinese friends or partners as interpreters, self-medicating, using personal connections to medical doctors, and travelling to home countries or countries that offer English-speaking doctors for health care. Health-care providers and health organisations in Guangzhou have not yet acquired sufficient cultural competence to address the needs of African migrants residing in the city. Introducing linguistically and culturally competent health-care services in communities concentrated with African migrants may better serve the population. With the growing international migration to China, it is essential to develop sustainable approaches to improving health-care access for international migrants, particularly those who are marginalised.

Mainstreaming biodiversity and wildlife management into climate change policy frameworks in selected east and southern African countries

PubMed Central

Nhamo, Godwell

2016-01-01

The Rio+20 outcomes document, the Future We Want, enshrines green economy as one of the platforms to attain sustainable development and calls for measures that seek to address climate change and biodiversity management. This paper audits climate change policies from selected east and southern African countries to determine the extent to which climate change legislation mainstreams biodiversity and wildlife management. A scan of international, continental, regional and national climate change policies was conducted to assess whether they include biodiversity and/or wildlife management issues. The key finding is that many climate change policy–related documents, particularly the National Adaptation Programme of Actions (NAPAs), address threats to biodiversity and wildlife resources. However, international policies like the United Nations Framework Convention on Climate Change and Kyoto Protocol do not address the matter under deliberation. Regional climate change policies such as the East African Community, Common Market for Eastern and Southern Africa and African Union address biodiversity and/or wildlife issues whilst the Southern African Development Community region does not have a stand-alone policy for climate change. Progressive countries like Rwanda, Uganda, Tanzania and Zambia have recently put in place detailed NAPAs which are mainstream responsive strategies intended to address climate change adaptation in the wildlife sector.

Enhancing collaboration between China and African countries for schistosomiasis control.

PubMed

Xu, Jing; Yu, Qing; Tchuenté, Louis-Albert Tchuem; Bergquist, Robert; Sacko, Moussa; Utzinger, Jürg; Lin, Dan-Dan; Yang, Kun; Zhang, Li-Juan; Wang, Qiang; Li, Shi-Zhu; Guo, Jia-Gang; Zhou, Xiao-Nong

2016-03-01

Schistosomiasis remains an important public health issue, with a large number of cases reported across sub-Saharan Africa, and parts of Asia and Latin America. China was once highly endemic, but has made substantial progress and is moving towards elimination of schistosomiasis. Meanwhile, despite long-term, repeated, school-based chemotherapy in many African countries, more than 90% of all schistosomiasis cases are concentrated in Africa, and hence, this continent constitutes the key challenge for schistosomiasis control. Opportunities and issues for international collaboration in the fight against schistosomiasis are outlined with a focus on China's experiences, including the role of public health authorities and intersectoral collaboration, use of new and effective snail control approaches and diagnostic tools adapted to the specific stage of control, as well as the strengthening of risk mapping and surveillance-response mechanisms. Training courses targeting African governmental officials and professionals, coupled with field visits of African scientists and control programme managers to China, and vice versa, are considered important for improved schistosomiasis control and elimination. The crucial question remains whether the Chinese experience can be translated and applied in African countries to improve the effectiveness of health interventions and scale-up. Copyright © 2016 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd.. All rights reserved.

The continuing problem of human African trypanosomiasis (sleeping sickness).

PubMed

Kennedy, Peter G E

2008-08-01

Human African trypanosomiasis, also known as sleeping sickness, is a neglected disease, and it continues to pose a major threat to 60 million people in 36 countries in sub-Saharan Africa. Transmitted by the bite of the tsetse fly, the disease is caused by protozoan parasites of the genus Trypanosoma and comes in two types: East African human African trypanosomiasis caused by Trypanosoma brucei rhodesiense and the West African form caused by Trypanosoma brucei gambiense. There is an early or hemolymphatic stage and a late or encephalitic stage, when the parasites cross the blood-brain barrier to invade the central nervous system. Two critical current issues are disease staging and drug therapy, especially for late-stage disease. Lumbar puncture to analyze cerebrospinal fluid will remain the only method of disease staging until reliable noninvasive methods are developed, but there is no widespread consensus as to what exactly defines biologically central nervous system disease or what specific cerebrospinal fluid findings should justify drug therapy for late-stage involvement. All four main drugs used for human African trypanosomiasis are toxic, and melarsoprol, the only drug that is effective for both types of central nervous system disease, is so toxic that it kills 5% of patients who receive it. Eflornithine, alone or combined with nifurtimox, is being used increasingly as first-line therapy for gambiense disease. There is a pressing need for an effective, safe oral drug for both stages of the disease, but this will require a significant increase in investment for new drug discovery from Western governments and the pharmaceutical industry.

Establishing sustainable GHG inventory systems in African countries for Agriculture and Land Use, Land-use Change and Forestry (LULUCF)

NASA Astrophysics Data System (ADS)

Wirth, T. C.; Troxler, T.

2015-12-01

As signatories to the United Nations Framework Convention on Climate Change (UNFCCC), developing countries are required to produce greenhouse gas (GHG) inventories every two years. For many developing countries, including many of those in Africa, this is a significant challenge as it requires establishing a robust and sustainable GHG inventory system. In order to help support these efforts, the U.S. Environmental Protection Agency (EPA) has worked in collaboration with the UNFCCC to assist African countries in establishing sustainable GHG inventory systems and generating high-quality inventories on a regular basis. The sectors we have focused on for these GHG inventory capacity building efforts in Africa are Agriculture and Land Use, Land-use Change and Forestry (LULUCF) as these tend to represent a significant portion of their GHG emissions profile and the data requirements and methodologies are often more complex than for other sectors. To support these efforts, the U.S. EPA has provided technical assistance in understanding the methods in the IPCC Guidelines, assembling activity data and emission factors, including developing land-use maps for representing a country's land base, and implementing the calculations. EPA has also supported development of various tools such as a Template Workbook that helps the country build the institutional arrangement and strong documentation that are necessary for generating GHG inventories on a regular basis, as well as performing other procedures as identified by IPCC Good Practice Guidance such as quality assurance/quality control, key category analysis and archiving. Another tool used in these projects and helps country's implement the methods from the IPCC Guidelines for the Agriculture and LULUCF sectors is the Agriculture and Land Use (ALU) tool. This tool helps countries assemble the activity data and emission factors, including supporting the import of GIS maps, and applying the equations from the IPPC Guidelines to estimate the carbon stock changes and emissions of non-CO2 GHG for all land uses and management practices as identified in the IPCC Guidelines at the Tier 1 or Tier 2 level.

Pedagogy of the Dispersed: A Cost-Benefit Analysis of the African Diaspora Phenomenon through the Human and Social Capital Lens

ERIC Educational Resources Information Center

Kivunja, Charles; Shizha, Edward

2015-01-01

With its origin in Greek where "diaspora" as a noun means "a dispersion" or as a verb means to "scatter about", the term is used in this paper to refer to the dispersion or scattering of Africans from their original African homeland and now live in countries other than their own. Indeed some Africans have dispersed…

Experiences of Chinese International Students Learning English at South African Tertiary Institutions

ERIC Educational Resources Information Center

Ayliff, D.; Wang, G.

2006-01-01

This article aims to provide insight into the experiences of Chinese international students in some South African tertiary institutions. The study investigates their successes and failures in endeavouring to learn English and the culture shock and "learning shock" they endure when registering to study in an African country with an…

Cultivating African Academic Capital--Intersectional Narratives of an African Graduate and His PhD Study Supervisor

ERIC Educational Resources Information Center

Bitzer, Eli; Matimbo, Fulgence

2017-01-01

Three theoretical axes, namely "habitus," "transformational learning" and "doctorateness" informed two narrative doctoral accounts. One is from a Tanzanian public official who graduated from a research-intensive South African university--mostly away from work, family and country. The other is from his study supervisor…

Parenting African American Children in the Context of Racism

ERIC Educational Resources Information Center

Keyes, Angela W.; Smyke, Anna T.; Middleton, Melissa; Black, Corey L.

2015-01-01

The legacy of slavery in the United States has impacted generations of African Americans, especially parents who must prepare their children to face the challenges associated with being a person of color in this country. The authors explore aspects of racism, White privilege, racial socialization, and African American parents' fears as they equip…

The state of the research for health environment in the ministries of health of the Economic Community of the West African States (ECOWAS)

PubMed Central

2013-01-01

Background An assessment of the state of the Research for Health (R4H) environment can provide relevant information about what aspects of national health research systems needs strengthening, so that research output can be relevant to meet national priorities for decision-making. There is limited information on the state of the R4H environment in the Economic Community of West African States (ECOWAS). This article describes the state of the R4H environment within the Ministries of Health of the ECOWAS member states and outlines of some possibilities to strengthen health research activities within the ECOWAS region. Methods Information on the national-level R4H environment (governance and management; existence of a national policy; strategic and research priorities documents; ethics committees; research funds; coordination structures; monitoring and evaluation systems; networking and capacity building opportunities) was collected from the Ministries of Health research units in 14 ECOWAS countries using self-administered questionnaires. A workshop was held where country report presentations and group discussions were used to review and validate responses. Data from the discussions was transcribed using Nvivo, and strengths, weaknesses, opportunities and threats (SWOT) analysis of the functioning of the units was done using Robert Preziosi’s organisational diagnosis tool. Results The findings indicate that as of January 2011, 50% of ECOWAS countries had established directorates for health research with defined terms of reference. The existing funding mechanisms were inadequate to support the research structures within and outside the MoHs, and for building the capacity of researchers. Networking and monitoring activities were weak and only 7% of the directors of research units were trained in research management. The majority (85.7%) of countries had broader national health policies, and 57% of the countries had some form of policy or strategic document for research development. Half of the countries had developed national research priorities. Conclusions These results call for urgent action to improve the research environment in the Ministries of Health in the West African sub-region. PMID:24025451

Attitudes, perceptions, and behaviors toward HIV testing among African American and East African immigrant women in Washington, D.C.: Implications for targeted HIV testing promotion and communication strategies

PubMed Central

De Jesus, Maria; Carrete, Claudia; Maine, Cathleen; Nalls, Patricia

2015-01-01

Objectives The objective of the study was to examine and compare the HIV testing attitudes, perceptions, and behaviors between African American and East African immigrant women in the Washington, D.C. Metropolitan area. Methods Adopting an inductive, qualitative methodological approach, we conducted a total of 40 in-depth, semi-structured interviews between October 2012 and March 2013. Qualitative thematic analysis was used to analyze the data. Results Overall, African American women held more favorable views toward HIV testing than East African immigrant women. Very few East African immigrant women sought HIV testing intentionally. The majority of East African participants were tested inadvertently, while others tested for immigration- or employment-related purposes. There were many barriers that impede women from seeking an HIV test including: negative assumptions (e.g., ‘Getting an HIV test implies that I am HIV positive’); negative emotions (e.g., ‘Fear of being diagnosed with HIV and what this will mean for me’); and potential negative reactions from partner or others (e.g., ‘Getting an HIV test can signal distrust, disrespect, or infidelity’). There were nuances in how each group articulated some of these barriers and East African women expressed unique concerns that originated from experiences in their home countries. Conclusions The study shed light into the complexity of factors that constrain women from presenting themselves voluntarily for an HIV test and highlighted the nuances between African American and East African perceptions. Implications of findings for effective targeted HIV screening promotion and communication strategies among these groups of women are discussed. PMID:25897146

Adverse Drug Reaction Reporting in Africa and a Comparison of Individual Case Safety Report Characteristics Between Africa and the Rest of the World: Analyses of Spontaneous Reports in VigiBase®.

PubMed

Ampadu, Haggar H; Hoekman, Jarno; de Bruin, Marieke L; Pal, Shanthi N; Olsson, Sten; Sartori, Daniele; Leufkens, Hubert G M; Dodoo, Alexander N O

2016-04-01

Following the start of the World Health Organization (WHO) Programme for International Drug Monitoring (PIDM) by 10 member countries in 1968, it took another 24 years for the first two African countries to join in 1992, by which time the number of member countries in the PIDM had grown to 33. Whilst pharmacovigilance (PV), including the submission of individual case safety reports (ICSR) to VigiBase(®), the WHO global ICSR database, is growing in Africa, no data have been published on the growth of ICSR reporting from Africa and how the features of ICSRs from Africa compare with the rest of the world (RoW). The objective of this paper was to provide an overview of the growth of national PV centres in Africa, the reporting of ICSRs by African countries, and the features of ICSRs from Africa, and to compare ICSRs from Africa with the RoW. The search and analysis interface of VigiBase(®)--VigiLyze(®)--was used to characterise ICSRs submitted by African countries and the RoW. The distribution of ICSRs by African countries was listed and characterised by anatomic therapeutic chemical (ATC) code, Medical Dictionary for Regulatory Activities (MedDRA(®)) system organ class (SOC) classification, and patient age and sex. The case-defining features of ICSRs between Africa and the RoW were also compared. The number of African countries in the PIDM increased from 2 in 1992 to 35 at the end of September 2015, and African PIDM members have cumulatively submitted 103,499 ICSRs (0.88 % of global ICSRs) to VigiBase(®). The main class of products in African ICSRs are nucleoside and nucleotide reverse transcriptase inhibitors (14.04 %), non-nucleoside reverse transcriptase inhibitors (9.09 %), antivirals for the treatment of HIV infections (5.50 %), combinations of sulfonamides and trimethoprim (2.98 %) and angiotensin-converting enzyme (ACE) inhibitors (2.42 %). The main product classes implicated in ICSRs from the RoW are tumour necrosis factor-α (TNFα) inhibitors (5.29 %), topical nonsteroidal anti-inflammatory preparations (2.26 %), selective immunosuppressants (2.08 %), selective serotonin reuptake inhibitors (2.04 %) and HMG CoA reductase inhibitors (1.85 %). The main SOCs reported from Africa versus the RoW include skin and subcutaneous tissue disorders (31.14 % vs. 19.58 %), general disorders and administration site conditions (20.91 % vs. 30.49 %) and nervous system disorders (17.48 % vs. 19.13 %). The 18-44 years age group dominated ICSRs from Africa, while the 45-64 years age group dominated the RoW. Identical proportions of females (57 % Africa and the RoW) and males (37 % Africa and the RoW) were represented. As at the end of September 2015, 35 of 54 African countries were Full Member countries of the PIDM. Although the number of ICSRs from Africa has increased substantially, ICSRs from Africa still make up <1 % of the global total in VigiBase(®). The features of ICSRs from Africa differ to those from the RoW in relation to the classes of products as well as age group of patients affected. The gender of patients represented in these ICSRs are identical.

Adherence barriers and facilitators for cervical screening amongst currently disadvantaged women in the greater Cape Town region of South Africa

PubMed Central

De Abreu, Chantelle; Horsfall, Hannah

2013-01-01

Abstract Background In South Africa cervical cancer is the second most commonly occurring cancer amongst women, and black African women have the highest risk of developing this disease. Unfortunately, the majority of South African women do not adhere to recommended regular cervical screening. Objectives The purpose of this research was to explore the perceptions, experiences and knowledge regarding cervical screening of disadvantaged women in two informal settlements in South African urban areas. Method The Health Belief Model (HBM) provided a theoretical framework for this study. Four focus groups (n = 21) were conducted, using questions derived from the HBM, and thematic analysis was used to analyse the data. The ages of the women who participated ranged from 21 to 53 years. Results The analysis revealed lack of knowledge about screening as a key structural barrier to treatment. Other structural barriers were: time, age at which free screening is available, and health education. The psychosocial barriers that were identified included: fear of the screening procedure and of the stigmatisation in attending screening. The presence of physical symptoms, the perception that screening provides symptom relief, HIV status, and the desire to know one's physical health status were identified as facilitators of cervical screening adherence. Conclusion This knowledge has the potential to inform healthcare policy and services in South Africa. As globalisation persists and individuals continue to immigrate or seek refugee status in foreign countries, increased understanding and knowledge is required for successful acculturation and integration. Developed countries may therefore also benefit from research findings in developing countries.

Epidemiology of hepatitis C virus and genotype distribution in immigrants crossing to Europe from North and sub-Saharan Africa.

PubMed

Daw, Mohamed A; El-Bouzedi, Abdallah; Ahmed, Mohamed O; Dau, Aghnyia A; Agnan, Mohamed M

The association between the prevalence of hepatitis C virus (HCV) and immigration is rarely studied, particularly for the immigrants crossing to the resettlement countries. Most of the published data are confined to those immigrants who were resident in European countries and rarely immigrated before they reach the final destination. Libya is a large country in North Africa with the longest coast of the Mediterranean Sea facing the European Union. It has been considered as the main transient station for African immigrants to Europe. The objectives of this study were to determine: (1) the prevalence of HCV in African immigrants gathered in Libya from different African countries on their way to Europe and (2) HCV genotype distribution in these immigrants and its correlation with different demographic factors. A total of 14 205 serum samples were collected in a 3-year period (2013-2015) from different immigrants from North and sub-Saharan Africa who resided in the African immigrant campus, Tripoli, Libya. The participants were interviewed, and relevant information was collected, including socio-demographic, ethnic, and geographic variables. Each serum sample was tested for anti-HCV antibody using ELISA. The genotypes were determined and assigned using a specific genotyping assay and correlated with demographic and potential risk factors of the recruited individuals. Of the immigrants studied, 1078 (7.6%) were positive for HCV. The prevalence of HCV infection ranged from 1.4% to 18.7%; it was higher among individuals arriving from Nile river (3.6-18.7%) of North Africa, followed by those who arrived from the West African region (2.1-14.1%), Horn of Africa (HOA, 6.8-9.9%), and Maghreb countries (1.4-2.7%). The relative risk factor attributable to gender variation was not significant (95% Cl: 0.8513-1.2381). Five genotypes were detected in 911 African immigrants. Genotypic analysis showed that the predominant HCV genotypes in this group were genotypes 4, 1, and 2 that accounted for 329 (36.1%), 326 (35.8%), and 131 (14.4%) strains, respectively, followed by genotype 3 that accounted for 87 (9.5%) strains. Genotype 5 was isolated mainly from 18 HOA (2%) and 20 West African (2.2%) individuals. The prevalence of HCV is considered high with a unique disparate distribution among African immigrants crossing to Europe. This indicated that the prevalence of HCV is high among these immigrants and thus may be reflected on the HCV prevalence in the guest countries. The broad genetic heterogeneity of HCV genotypes detected here may impact the efficacy of prevention and control efforts for HCV in both Europe and North and sub-Saharan Africa; hence, an integrated global policy of actions is needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Status of national health research systems in ten countries of the WHO African Region.

PubMed

Kirigia, Joses M; Wambebe, Charles

2006-10-19

The World Health Organization (WHO) Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4) which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country) bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. The key findings were as follows: the response rate was 21.7% (10/46); three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS); two countries confirmed the existence of a functional national health research management forum (NHRMF); six countries had a functional ethical review committee (ERC); five countries had a scientific review committee (SRC); five countries reported the existence of health institutions with institutional review committees (IRC); two countries had a health research programme; and three countries had a national health research institute (NHRI) and a faculty of health sciences in the national university that conducted health research. Four out of the ten countries reported that they had a budget line for health research in the Ministry of Health budget document. Governments of countries of the African Region, with the support of development partners, private sector and civil society, urgently need to improve the research policy environment by developing health research policies, strategic plans, legislations, programmes and rolling plans with the involvement of all stakeholders, e.g., relevant sectors, research organizations, communities, industry and donors. In a nutshell, development of high-performing national health research systems in the countries of the WHO African Region, though optional, is an imperative. It may be the only way of breaking free from the current vicious cycle of ill-health and poverty.

International migration and gestational diabetes mellitus: a systematic review of the literature and meta-analysis.

PubMed

Gagnon, Anita J; McDermott, Sarah; Rigol-Chachamovich, Juliana; Bandyopadhyay, Mridula; Stray-Pedersen, Babill; Stewart, Donna

2011-11-01

Influxes of migrant women of childbearing age to receiving countries have made their perinatal health status a key priority for many governments. The international research collaboration Reproductive Outcomes And Migration (ROAM) reviewed published studies to assess whether migrants in countries of resettlement have a greater risk of gestational diabetes mellitus (GDM) than women in receiving countries. A systematic review of the literature from Medline, Embase, PsychInfo and CINAHL from 1990 to 2009 included studies of migrant women and GDM. Studies were excluded if there was no cross-border movement or comparison group or if the receiving country was not the country of resettlement. Studies were assessed for quality, analysed descriptively and meta-analysed. Twenty-four reports (representing >120,000 migrants) met our inclusion criteria. Migrants were described primarily by geographic origin; other relevant aspects (e.g. time in country, language fluency) were rarely studied. Migrants' results for GDM were worse than those for receiving-country women in 79% of all studies. Meta-analyses showed that, compared with receiving-country women, Caribbean, African, European and Northern European women were at greater risk of GDM, while North Africans and North Americans had risks similar to receiving-country women. Although results of the 31 comparisons of Asians, East Africans or non-Australian Oceanians were too heterogeneous to provide a single GDM risk estimate for migrant women, only one comparison was below the receiving-country comparison group, all others presented a higher risk estimate. The majority of women migrants to resettlement countries are at greater risk for GDM than women resident in receiving countries. Research using clear, specific migrant definitions, adjusting for relevant risk factors and including other aspects of migration experiences is needed to confirm and understand these findings. © 2011 Blackwell Publishing Ltd.

A hybrid framework for assessing maize drought vulnerability in Sub-Saharan Africa

NASA Astrophysics Data System (ADS)

Kamali, B.; Abbaspour, K. C.; Wehrli, B.; Yang, H.

2017-12-01

Drought has devastating impacts on crop yields. Quantifying drought vulnerability is the first step to better design of mitigation policies. The vulnerability of crop yield to drought has been assessed with different methods, however they lack a standardized base to measure its components and a procedure that facilitates spatial and temporal comparisons. This study attempts to quantify maize drought vulnerability through linking the Drought Exposure Index (DEI) to the Crop Failure Index (CFI). DEI and CFI were defined by fitting probability distribution functions to precipitation and maize yield respectively. To acquire crop drought vulnerability index (CDVI), DEI and CFI were combined in a hybrid framework which classifies CDVI with the same base as DEI and CFI. The analysis were implemented on Sub-Saharan African countries using maize yield simulated with the Environmental Policy Integrated Climate (EPIC) model at 0.5° resolution. The model was coupled with the Sequential Uncertainty Fitting algorithm for calibration at country level. Our results show that Central Africa and those Western African countries located below the Sahelian strip receive higher amount of precipitation, but experience high crop failure. Therefore, they are identified as more vulnerable regions compared to countries such as South Africa, Tanzania, and Kenya. We concluded that our hybrid approach complements information on crop drought vulnerability quantification and can be applied to different regions and scales.

Refugees connecting with a new country through community food gardening.

PubMed

Harris, Neil; Minniss, Fiona Rowe; Somerset, Shawn

2014-09-05

Refugees are a particularly vulnerable population who undergo nutrition transition as a result of forced migration. This paper explores how involvement in a community food garden supports African humanitarian migrant connectedness with their new country. A cross-sectional study of a purposive sample of African refugees participating in a campus-based community food garden was conducted. Semi-structured interviews were undertaken with twelve African humanitarian migrants who tended established garden plots within the garden. Interview data were thematically analysed revealing three factors which participants identified as important benefits in relation to community garden participation: land tenure, reconnecting with agri-culture, and community belonging. Community food gardens offer a tangible means for African refugees, and other vulnerable or marginalised populations, to build community and community connections. This is significant given the increasing recognition of the importance of social connectedness for wellbeing.

A Risk Analysis Approach to Prioritizing Epidemics: Ebola Virus Disease in West Africa as a Case Study

PubMed Central

Chughtai, Abrar Ahmad; MacIntyre, C. Raina

2017-01-01

Abstract The 2014 Ebola virus disease (EVD) outbreak affected several countries worldwide, including six West African countries. It was the largest Ebola epidemic in the history and the first to affect multiple countries simultaneously. Significant national and international delay in response to the epidemic resulted in 28,652 cases and 11,325 deaths. The aim of this study was to develop a risk analysis framework to prioritize rapid response for situations of high risk. Based on findings from the literature, sociodemographic features of the affected countries, and documented epidemic data, a risk scoring framework using 18 criteria was developed. The framework includes measures of socioeconomics, health systems, geographical factors, cultural beliefs, and traditional practices. The three worst affected West African countries (Guinea, Sierra Leone, and Liberia) had the highest risk scores. The scores were much lower in developed countries that experienced Ebola compared to West African countries. A more complex risk analysis framework using 18 measures was compared with a simpler one with 10 measures, and both predicted risk equally well. A simple risk scoring system can incorporate measures of hazard and impact that may otherwise be neglected in prioritizing outbreak response. This framework can be used by public health personnel as a tool to prioritize outbreak investigation and flag outbreaks with potentially catastrophic outcomes for urgent response. Such a tool could mitigate costly delays in epidemic response. PMID:28810081

Key Issues and Policy Considerations in Promoting Lifelong Learning in Selected African Countries: Ethiopia, Kenya, Namibia, Rwanda and Tanzania. UIL Publication Series on Lifelong Learning Policies and Strategies. No. 1

ERIC Educational Resources Information Center

Walters, Shirley; Yang, Jim; Roslander, Peter

2014-01-01

This cross-national study focuses on key issues and policy considerations in promoting lifelong learning in Ethiopia, Kenya, Namibia, Rwanda, and Tanzania (the five African countries that took part in a pilot workshop on "Developing Capacity for Establishing Lifelong Learning Systems in UNESCO Member States: at the UNESCO Institute for…

Ideal Body Size as a Mediator for the Gender-Specific Association between Socioeconomic Status and Body Mass Index: Evidence from an Upper-Middle-Income Country in the African Region

ERIC Educational Resources Information Center

Yepes, Maryam; Maurer, Jürgen; Stringhini, Silvia; Viswanathan, Barathi; Gedeon, Jude; Bovet, Pascal

2016-01-01

Background: While obesity continues to rise globally, the associations between body size, gender, and socioeconomic status (SES) seem to vary in different populations, and little is known on the contribution of perceived ideal body size in the social disparity of obesity in African countries. Purpose: We examined the gender and socioeconomic…

Institutional radicalization, the state, and the development process in Africa.

PubMed

Mabogunje, A L

2000-12-05

The concept of "institutional radicalization" or "the changing of institutions from their roots" is put forward as critical for understanding the manner in which civil societies in most African countries have been grappling with the challenges of development. Given the well embedded precapitalist social formation in most African countries, various institutions have been radicalized around such critical identities as age, gender, land, occupation, credit, community, and rituals of solidarity to promote development. However, until the state intervenes to legitimize these initiatives of civil societies, their full impact on the development process is bound to be moot. The enormous tasks entailed in such legitimization through identifying, registering, realigning, providing incentives, directing, and monitoring these radicalized institutions remain critical and imperative for African countries if they are to accelerate and deepen the extent of their integration into the global free market economy and democratic governance.

UNAIDS director visits Denmark to discuss collaboration on AIDS crisis in Africa.

PubMed

1999-10-18

The executive director of the Joint United Nations Program on HIV/AIDS (UNAIDS), Peter Piot, visited Denmark to discuss collaboration on the AIDS crisis in sub-Saharan Africa. The discussion focused on the AIDS situation in the country and the need for resources and strategic investments from donor nations to help turn around the crisis. Piot stated that since the beginning of the epidemic, more than 11 million have died of AIDS and another 22 million are infected with HIV in Africa. In his visit, he stated the new international partnership against AIDS in Africa, which comprises African governments, donor countries, pan-African and other international organizations, UNAIDS and its co-sponsors, nongovernmental organizations, and the private sector. They will be working together in mobilizing governments, civil societies, and companies worldwide in increasing HIV/AIDS care and prevention strategies. Greater vigilance is stressed on the emergency nature of AIDS in many African countries.

Institutional radicalization, the state, and the development process in Africa

PubMed Central

Mabogunje, Akin L.

2000-01-01

The concept of “institutional radicalization” or “the changing of institutions from their roots” is put forward as critical for understanding the manner in which civil societies in most African countries have been grappling with the challenges of development. Given the well embedded precapitalist social formation in most African countries, various institutions have been radicalized around such critical identities as age, gender, land, occupation, credit, community, and rituals of solidarity to promote development. However, until the state intervenes to legitimize these initiatives of civil societies, their full impact on the development process is bound to be moot. The enormous tasks entailed in such legitimization through identifying, registering, realigning, providing incentives, directing, and monitoring these radicalized institutions remain critical and imperative for African countries if they are to accelerate and deepen the extent of their integration into the global free market economy and democratic governance. PMID:11087811

Role of mobile phone technology in health education in Asian and African countries: a systematic review.

PubMed

Sahu, Madhusmita; Grover, Ashoo; Joshi, Ashish

2014-01-01

The objective of this systematic review was to explore the role of mobile phone technologies in delivering health education programs in Asian and African countries. The search engine used was Pubmed during 2008-2011. Randomised controlled trials or controlled studies that improved health outcomes through delivery of health educational interventions using cell phone or text messaging were included in the review. Results showed studies from six Asian and African countries including Philippines, China, Kenya, South Korea, Taiwan and India. Mobile phone technology has shown to improve health outcomes for chronic disease conditions such as diabetes, heart disease and hypertension. Additional conditions include obesity and cardiopulmonary resuscitation guidance. Other studies have shown improvement in self management of breast cancer and post-hospitalisation HIV and pharmaceutical care. Overall results of the present review showed that mobile phone technologies can be a possible solution to improve healthcare outcome.

Africans in the American Labor Market

PubMed Central

Elo, Irma T.; Frankenberg, Elizabeth; Gansey, Romeo; Thomas, Duncan

2015-01-01

The number of migrants to the United States from Africa has grown exponentially since the 1930s. For the first time in America’s history, migrants born in Africa are growing at a faster rate than migrants from any other continent. The composition of African-origin migrants has also changed dramatically: in the mid-twentieth century, the majority were white and came from only three countries; but today, about one-fifth are white, and African-origin migrants hail from across the entire continent. Little is known about the implications of these changes for their labor market outcomes in the United States. Using the 2000–2011 waves of the American Community Survey, we present a picture of enormous heterogeneity in labor market participation, sectoral choice, and hourly earnings of male and female migrants by country of birth, race, age at arrival in the United States, and human capital. For example, controlling a rich set of human capital and demographic characteristics, some migrants—such as those from South Africa/Zimbabwe and Cape Verde, who typically enter on employment visas—earn substantial premiums relative to other African-origin migrants. These premiums are especially large among males who arrived after age 18. In contrast, other migrants—such as those from Sudan/Somalia, who arrived more recently, mostly as refugees—earn substantially less than migrants from other African countries. Understanding the mechanisms generating the heterogeneity in these outcomes—including levels of socioeconomic development, language, culture, and quality of education in countries of origin, as well as selectivity of those who migrate—remain important unresolved research questions. PMID:26304845

Africans in the American Labor Market.

PubMed

Elo, Irma T; Frankenberg, Elizabeth; Gansey, Romeo; Thomas, Duncan

2015-10-01

The number of migrants to the United States from Africa has grown exponentially since the 1930s. For the first time in America's history, migrants born in Africa are growing at a faster rate than migrants from any other continent. The composition of African-origin migrants has also changed dramatically: in the mid-twentieth century, the majority were white and came from only three countries; but today, about one-fifth are white, and African-origin migrants hail from across the entire continent. Little is known about the implications of these changes for their labor market outcomes in the United States. Using the 2000-2011 waves of the American Community Survey, we present a picture of enormous heterogeneity in labor market participation, sectoral choice, and hourly earnings of male and female migrants by country of birth, race, age at arrival in the United States, and human capital. For example, controlling a rich set of human capital and demographic characteristics, some migrants-such as those from South Africa/Zimbabwe and Cape Verde, who typically enter on employment visas-earn substantial premiums relative to other African-origin migrants. These premiums are especially large among males who arrived after age 18. In contrast, other migrants-such as those from Sudan/Somalia, who arrived more recently, mostly as refugees-earn substantially less than migrants from other African countries. Understanding the mechanisms generating the heterogeneity in these outcomes-including levels of socioeconomic development, language, culture, and quality of education in countries of origin, as well as selectivity of those who migrate-figures prominently among important unresolved research questions.

Poor Access for African Researchers to African Emergency Care Publications: A Cross-sectional Study

PubMed Central

Bruijns, Stevan R.; Maesela, Mmapeladi; Sinha, Suniti; Banner, Megan

2017-01-01

Introduction Based on relative population size and burden of disease, emergency care publication outputs from low- and middle-income regions are disproportionately lower than those of high-income regions. Ironically, outputs from regions with higher publication rates are often less relevant in the African context. As a result, the dissemination of and access to local research is essential to local researchers, but the cost of this access (actual and cost-wise) remains unknown. The aim of this study was to describe access to African emergency care publications in terms of publisher-based access (open access or subscription) and alternate access (self-archived or author provided), as well as the cost of access. Methods We conducted a retrospective, cross-sectional study using all emergency medicine publications included in Scopus between 2011 and 2015. A sequential search strategy described access to each article, and we calculated mean article charges against the purchasing power parity index (used to describe out-of-pocket expense). Results We included 666 publications from 49 journals, of which 395 (59.3%) were open access. For subscription-based articles, 106 (39.1%) were self-archived, 60 (22.1%) were author-provided, and 105 (38.8%) were inaccessible. Mean article access cost was $36.44, and mean processing charge was $2,319.34. Using the purchasing power parity index it was calculated that equivalent out-of-pocket expenditure for South African, Ghanaian and Tanzanian authors would respectively be $15.77, $10.44 and $13.04 for access, and $1,004.02, $664.36 and $830.27 for processing. Based on this, the corrected cost of a single-unit article access or process charge for South African, Ghanaian and Tanzanian authors, respectively, was 2.3, 3.5 and 2.8 times higher than the standard rate. Conclusion One in six African emergency care publications are inaccessible outside institutional library subscriptions; additionally, the cost of access to publications in low- and middle-income countries appears prohibitive. Publishers should strongly consider revising pricing for more equitable access for researchers from low- and middle-income countries. PMID:29085532

The collaborative African genomics network training program: A trainee perspective on training the next generation of African scientists

USDA-ARS?s Scientific Manuscript database

The Collaborative African Genomics Network (CAfGEN) aims to establish sustainable genomics research programs in Botswana and Uganda through long-term training of PhD students from these countries at Baylor College of Medicine. Here, we present an overview of the CAfGEN PhD training program alongside...

Gender and Racial Experiences in Executive School Leadership: Perceptions of African American Female Superintendents

ERIC Educational Resources Information Center

Colbert, Daveda Jean

2009-01-01

There is a leadership crisis that exists in our schools creating an urgent need for effective leadership. Even though African American women have made slight gains, throughout the country people of color and women are dramatically underrepresented in the superintendency. Therefore, the primary purpose of this study is to provide African American…

Not Merely a Matter of Academics: Student Experiences of a South African University as Study-Abroad Destination

ERIC Educational Resources Information Center

Paola, R. J.; Lemmer, E. M.

2013-01-01

Study abroad programmes attract considerable numbers of American college students; however, very few select an African country as their study-abroad destination. This article explores the experiences of American undergraduates who made the uncommon choice of a South African university as destination for a mid-length immersion type programme. The…

Advancement of Children's Rights in Africa: A Social Justice Framework for School Psychologists

ERIC Educational Resources Information Center

Pillay, Jace

2014-01-01

The United Nations Convention on Children's Rights and the subsequent African Charter on the Rights and Welfare of the Child together with the Bill of Children's Rights and numerous other policies and regulations in many African countries have set the precedent for children's rights to be respected and implemented across the African Continent.…

African Social Studies Program-2, 1990-91. A Master's Degree Program for African Social Studies Leaders. Final Report.

ERIC Educational Resources Information Center

Indiana Univ., Bloomington. School of Education.

Eight social studies educators from various African countries completed their masters degrees in education from the Indiana University School of Education during the 1990-91 school year. This report describes the program, including the selection process, the master of science in education program, specialized courses, social studies organizations,…

Socioeconomic inequalities in informal payments for health care: An assessment of the 'Robin Hood' hypothesis in 33 African countries.

PubMed

Kankeu, Hyacinthe Tchewonpi; Ventelou, Bruno

2016-02-01

In almost all African countries, informal payments are frequently made when accessing health care. Some literature suggests that the informal payment system could lead to quasi-redistribution among patients, with physicians playing a 'Robin Hood' role, subsidizing the poor at the expense of the rich. We empirically tested this assumption with data from the rounds 3 and 5 of the Afrobarometer surveys conducted in 18 and 33 African countries respectively, from 2005 to 2006 for round 3 and from 2011 to 2013 for round 5. In these surveys, nationally representative samples of people aged 18 years or more were randomly selected in each country, with sizes varying between 1048 and 2400 for round 3 and between 1190 and 2407 for round 5. We used the 'normalized' concentration index, the poor/rich gap and the odds ratio to assess the level of inequality in the payment of bribes to access care at the local public health facility and implemented two decomposition techniques to identify the contributors to the observed inequalities. We obtained that: i) the socioeconomic gradient in informal payments is in favor of the rich in almost all countries, indicating a rather regressive system; ii) this is mainly due to the socioeconomic disadvantage itself, to poor/rich differences in supply side factors like lack of medicines, absence of doctors and long waiting times, as well as regional disparities. Although essentially empirical, the paper highlights the need for African health systems to undergo substantial country-specific reforms in order to better protect the worse-off from financial risk when they seek care. Copyright © 2016 Elsevier Ltd. All rights reserved.

Skilled migration and health outcomes in developing countries.

PubMed

Uprety, Dambar

2018-04-30

Many studies have found that health outcomes decline when health professionals leave the country, but do such results remain consistent in gender- and income-disaggregated skilled migration? To help uncover explanations for such a pro-migration nature of health outcomes, the present study revisits this topic but allows for associations of skilled migration with mortality and life expectancy to differ between male and female, and between low- and high-income countries. Using a panel of 133 developing countries as source and 20 OECD countries as destination from 1980 to 2010 allowing the coefficient on emigration across different education levels to differ, the study finds the negative effect of high-skilled emigration on health outcomes. Such effect is more pronounced for high-skilled female migration than those for male and for low-income countries than for middle-and high-income countries. Results also show that such adverse effect is larger for African countries than non-African ones. However, the low-skilled migration appears to be insignificant to affect health outcomes in developing countries. Thus, skilled migration is detrimental to longevity in developing countries but unskilled migration is not.

Evaluation of all African clinical practice guidelines for hypertension: Quality and opportunities for improvement.

PubMed

Okwen, Patrick Mbah; Maweu, Irene; Grimmer, Karen; Margarita Dizon, Janine

2018-06-14

Good-quality clinical practice guidelines (CPGs) provide recommendations based on current best-evidence summaries. Hypertension is a prevalent noncommunicable disease in Africa, with disastrous sequelae (stroke, heart, and kidney disease). Its effective management relies on good quality, current, locally relevant evidence. This paper reports on an all African review of the guidance documents currently informing hypertension management. Attempts were made to contact 62 African countries for formal guidance documents used nationally to inform diagnosis and management of hypertension. Their quality was assessed by using Appraisal of Guidelines for Research & Evaluation (AGREE) II, scored by 2 independent reviewers. Differences in domain scores were compared between documents written prior to 2011 and 2011 onward. Findings were compared with earlier African CPG reviews. Guidelines and protocols were provided by 26 countries. Six used country-specific stand-alone hypertension guidelines, and 10 used protocols embedded in Standard Treatment Guidelines for multiple conditions. Six used guidelines developed by the World Health Organization, and 4 indicated ad hoc use of international guidance (US, Portugal, and Brazil). Only 1 guidance document met CPG construction criteria, and none scored well on all AGREE domain scores. The lowest-scoring domain was rigour of development. There was no significant quality difference between pre-2011 and post-2011 guidance documents, and there were variable AGREE II scores for the same CPGs when comparing the African reviews. The quality of hypertension guidance used by African nations could be improved. The need for so many guidance documents is questioned. Adopting a common evidence base from international good-quality CPGs and layering it with local contexts offer 1 way to efficiently improve African hypertension CPG quality and implementation. © 2018 John Wiley & Sons, Ltd.

Associations of government health expenditures, the supply of health care professionals, and country literacy with prenatal care use in ten West African countries.

PubMed

Taylor, Yhenneko J; Laditka, Sarah B; Laditka, James N; Brunner Huber, Larissa R; Racine, Elizabeth F

2017-03-01

Social and health care context may influence prenatal care use. We studied associations of government health expenditures, supply of health care professionals, and country literacy rates with prenatal care use in ten West African countries, controlling for individual factors. We used data from Demographic and Health Surveys (n = 58,512) and random effect logistic regression models to estimate the likelihood of having any prenatal care and adequate prenatal care. Each percentage increase in the literacy rate was associated with 4% higher odds of having adequate prenatal care (p = .029). Higher literacy rates among women may help to promote adequate prenatal care.

Lack of access to health care for African indigents: a social exclusion perspective

PubMed Central

2013-01-01

Background Lack of access to health care is a persistent condition for most African indigents, to which the common technical approach of targeting initiatives is an insufficient antidote. To overcome the standstill, an integrated technical and political approach is needed. Such policy shift is dependent on political support, and on alignment of international and national actors. We explore if the analytical framework of social exclusion can contribute to the latter. Methods We produce a critical and evaluative account of the literature on three themes: social exclusion, development policy, and indigence in Africa–and their interface. First, we trace the concept of social exclusion as it evolved over time and space in policy circles. We then discuss the relevance of a social exclusion perspective in developing countries. Finally, we apply this perspective to Africa, its indigents, and their lack of access to health care. Results The concept of social exclusion as an underlying process of structural inequalities has needed two decades to find acceptance in international policy circles. Initial scepticism about the relevance of the concept in developing countries is now giving way to recognition of its universality. For a variety of reasons however, the uptake of a social exclusion perspective in Africa has been limited. Nevertheless, social exclusion as a driver of poverty and inequity in Africa is evident, and manifestly so in the case of the African indigents. Conclusion The concept of social exclusion provides a useful framework for improved understanding of origins and persistence of the access problem that African indigents face, and for generating political space for an integrated approach. PMID:24238000

Cassava: constraints to production and the transfer of biotechnology to African laboratories.

PubMed

Bull, Simon E; Ndunguru, Joseph; Gruissem, Wilhelm; Beeching, John R; Vanderschuren, Hervé

2011-05-01

Knowledge and technology transfer to African institutes is an important objective to help achieve the United Nations Millennium Development Goals. Plant biotechnology in particular enables innovative advances in agriculture and industry, offering new prospects to promote the integration and dissemination of improved crops and their derivatives from developing countries into local markets and the global economy. There is also the need to broaden our knowledge and understanding of cassava as a staple food crop. Cassava (Manihot esculenta Crantz) is a vital source of calories for approximately 500 million people living in developing countries. Unfortunately, it is subject to numerous biotic and abiotic stresses that impact on production, consumption, marketability and also local and country economics. To date, improvements to cassava have been led via conventional plant breeding programmes, but with advances in molecular-assisted breeding and plant biotechnology new tools are being developed to hasten the generation of improved farmer-preferred cultivars. In this review, we report on the current constraints to cassava production and knowledge acquisition in Africa, including a case study discussing the opportunities and challenges of a technology transfer programme established between the Mikocheni Agricultural Research Institute in Tanzania and Europe-based researchers. The establishment of cassava biotechnology platform(s) should promote research capabilities in African institutions and allow scientists autonomy to adapt cassava to suit local agro-ecosystems, ultimately serving to develop a sustainable biotechnology infrastructure in African countries.

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

PubMed

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.

Situation analysis for cervical cancer diagnosis and treatment in east, central and southern African countries.

PubMed Central

Chirenje, Z. M.; Rusakaniko, S.; Kirumbi, L.; Ngwalle, E. W.; Makuta-Tlebere, P.; Kaggwa, S.; Mpanju-Shumbusho, W.; Makoae, L.

2001-01-01

OBJECTIVE: To determine the factors influencing cervical cancer diagnosis and treatment in countries of East, Central and Southern Africa (ECSA). METHODS: Data were collected from randomly selected primary health care centres, district and provincial hospitals, and tertiary hospitals in each participating country. Health care workers were interviewed, using a questionnaire; the facilities for screening, diagnosing, and treating cervical cancer in each institution were recorded, using a previously designed checklist. FINDINGS: Although 95% of institutions at all health care levels in ECSA countries had the basic infrastructure to carry out cervical cytology screening, only a small percentage of women were actually screened. Lack of policy guidelines, infrequent supply of basic materials, and a lack of suitable qualified staff were the most common reasons reported. CONCLUSIONS: This study demonstrates that there is an urgent need for more investment in the diagnosis and treatment of cervical cancer in ECSA countries. In these, and other countries with low resources, suitable screening programmes should be established. PMID:11242819

Implementation of a Regional Training Program on African Swine Fever As Part of the Cooperative Biological Engagement Program across the Caucasus Region

PubMed Central

De Nardi, Marco; Léger, Anaïs; Stepanyan, Tatul; Khachatryan, Bagrat; Karibayev, Talgat; Sytnik, Igor; Tyulegenov, Samat; Akhmetova, Assel; Nychyk, Serhiy; Sytiuk, Mykola; Nevolko, Oleg; Datsenko, Roman; Chaligava, Tengiz; Avaliani, Lasha; Parkadze, Otar; Ninidze, Lena; Kartskhia, Natia; Napetvaridze, Tsira; Asanishvili, Zviad; Khelaia, Demna; Menteshashvili, Ioseb; Zadayan, Meruzhan; Niazyan, Lyudmila; Mykhaylovska, Nataliya; Brooks, Bradford Raymond; Zhumabayeva, Gulnara; Satabayeva, Saltanat; Metreveli, Magda; Gallagher, Theresa; Obiso, Richard

2017-01-01

A training and outreach program to increase public awareness of African swine fever (ASF) was implemented by Defense Threat Reduction Agency and the Ministries of Agriculture in Armenia, Georgia, Kazakhstan, and Ukraine. The implementing agency was the company SAFOSO (Switzerland). Integration of this regional effort was administered by subject matter experts for each country. The main teaching effort of this project was to develop a comprehensive regional public outreach campaign through a network of expertise and knowledge for the control and prevention of ASF in four neighboring countries that experience similar issues with this disease. Gaps in disease knowledge, legislation, and outbreak preparedness in each country were all addressed. Because ASF is a pathogen with bioterrorism potential and of great veterinary health importance that is responsible for major economic instability, the project team developed public outreach programs to train veterinarians in the partner countries to accurately and rapidly identify ASF activity and report it to international veterinary health agencies. The project implementers facilitated four regional meetings to develop this outreach program, which was later disseminated in each partner country. Partner country participants were trained as trainers to implement the outreach program in their respective countries. In this paper, we describe the development, execution, and evaluation of the ASF training and outreach program that reached more than 13,000 veterinarians, farmers, and hunters in the partner countries. Additionally, more than 120,000 booklets, flyers, leaflets, guidelines, and posters were distributed during the outreach campaign. Pre- and post-ASF knowledge exams were developed. The overall success of the project was demonstrated in that the principles of developing and conducting a public outreach program were established, and these foundational teachings can be applied within a single country or expanded regionally to disseminate disease information across borders; overall, this method can be modified to raise awareness about many other diseases. PMID:29124058

Refugees Connecting with a New Country through Community Food Gardening

PubMed Central

Harris, Neil; Rowe Minniss, Fiona; Somerset, Shawn

2014-01-01

Refugees are a particularly vulnerable population who undergo nutrition transition as a result of forced migration. This paper explores how involvement in a community food garden supports African humanitarian migrant connectedness with their new country. A cross-sectional study of a purposive sample of African refugees participating in a campus-based community food garden was conducted. Semi-structured interviews were undertaken with twelve African humanitarian migrants who tended established garden plots within the garden. Interview data were thematically analysed revealing three factors which participants identified as important benefits in relation to community garden participation: land tenure, reconnecting with agri-culture, and community belonging. Community food gardens offer a tangible means for African refugees, and other vulnerable or marginalised populations, to build community and community connections. This is significant given the increasing recognition of the importance of social connectedness for wellbeing. PMID:25198684

Geoconservation - a southern African and African perspective

NASA Astrophysics Data System (ADS)

Reimold, Wolf Uwe

1999-10-01

In contrast to Europe, where geoconservation is actively pursued in most countries and where two international symposia on this subject have been staged in 1991 and 1996, geoconservation in Africa has indeed a very poor record. Considering the wealth of outstanding geological sites and the importance African stratigraphy has within the global geological record, pro-active geoconservation on this continent has not featured very prominently to date. In the interest of science, education and tourism, unique and typical geosites need to be identified, catalogued, and prioritised with the aim being their protection. Most African countries do not have vibrant non-governmental organisations such as a strong geological society, which could drive projects like geoconservation, or strong support from the private sector for environmental work. Here, a case is made for the role that established National Geological Surveys, some of which are already involved with retroactive environmental geological work, could play in the forefront of pro-active geoconservation and site protection.

Overcoming Barriers to Health Care Access: A Qualitative Study among African Migrants in Guangzhou, China

PubMed Central

Lin, Lavinia; Brown, Katherine B.; Hall, Brian J.; Yu, Fan; Yang, Jingqi; Wang, Jason; Schrock, Joshua M.; Bodomo, Adams B.; Yang, Ligang; Yang, Bin; Nehl, Eric J.; Tucker, Joseph D.; Wong, Frank Y.

2015-01-01

Guangzhou is China's third most populous city, and the region's burgeoning manufacturing economy has attracted many young African businessmen and entrepreneurs to the city. The aims of this study were to examine strategies that African migrants in Guangzhou have adopted in response to health care barriers, and explore their perceptions of how to address their needs. Twenty-five semi-structured interviews and two focus groups were conducted among African migrants residing in Guangzhou, China. Facing multiple barriers to care, African migrants have adopted a number of suboptimal and unsustainable approaches to access health care. These included: using their Chinese friends or partners as interpreters, self-medicating, using personal connections to medical doctors, and traveling to home countries or countries that offer English-speaking doctors for health care. Health care providers and health organizations in Guangzhou have not yet acquired sufficient cultural competence to address the needs of African migrants residing in the city. Introducing linguistically and culturally competent health care services in communities concentrated with African migrants may better serve the population. With the growing international migration to China, it is essential to develop sustainable approaches to improving health care access for international migrants, particularly those who are marginalized. PMID:26400191

The African Crane Database (1978-2014): Records of three threatened crane species (Family: Gruidae) from southern and eastern Africa.

PubMed

Smith, Tanya; Page-Nicholson, Samantha; Morrison, Kerryn; Gibbons, Bradley; Jones, M Genevieve W; van Niekerk, Mark; Botha, Bronwyn; Oliver, Kirsten; McCann, Kevin; Roxburgh, Lizanne

2016-01-01

The International Crane Foundation (ICF) / Endangered Wildlife Trust's (EWT) African Crane Conservation Programme has recorded 26 403 crane sightings in its database from 1978 to 2014. This sightings collection is currently ongoing and records are continuously added to the database by the EWT field staff, ICF/EWT Partnership staff, various partner organizations and private individuals. The dataset has two peak collection periods: 1994-1996 and 2008-2012. The dataset collection spans five African countries: Kenya, Rwanda, South Africa, Uganda and Zambia; 98% of the data were collected in South Africa. Georeferencing of the dataset was verified before publication of the data. The dataset contains data on three African crane species: Blue Crane Anthropoides paradiseus , Grey Crowned Crane Balearica regulorum and Wattled Crane Bugeranus carunculatus . The Blue and Wattled Cranes are classified by the IUCN Red List of Threatened Species as Vulnerable and the Grey Crowned Crane as Endangered. This is the single most comprehensive dataset published on African Crane species that adds new information about the distribution of these three threatened species. We hope this will further aid conservation authorities to monitor and protect these species. The dataset continues to grow and especially to expand in geographic coverage into new countries in Africa and new sites within countries. The dataset can be freely accessed through the Global Biodiversity Information Facility data portal.

Digital Divide in Sub-Saharan African Universities: Recommendations and Monitoring

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barry, Boubakar; /Assoc. Afr. Univ.; Chukwuma, Victor

The Digital Divide prevents Africa from taking advantages of new information technologies. One of the most urgent priorities is to bring the Internet in African Universities, Research, and Learning Centers to the level of other regions of the world. eGY-Africa, and the Sharing Knowledge Foundation are two bottom-up initiatives by scientists to secure better cyber-infrastructure and Internet facilities in Africa. Recommendations by the present scientific communities are being formulated at national, regional and international levels. The Internet capabilities are well documented at country level overall, but this is not the case at the University level. The snapshot of the Internetmore » status in universities in 17 African countries, obtained by a questionnaire survey, is consistent with measures of Internet penetration in the corresponding country. The monitoring of Internet performance has been proposed to those African universities to provide an information base for arguing the need to improve the coverage for Africa. A pilot program is recommended that will start scientific collaboration with Europe in western Africa using ICT. The program will lay the foundations for the arrival of new technologies like Grids.« less

Assessment of an undergraduate psychiatry course in an African setting

PubMed Central

Baig, Benjamin J; Beaglehole, Anna; Stewart, Robert C; Boeing, Leonie; Blackwood, Douglas H; Leuvennink, Johan; Kauye, Felix

2008-01-01

Background International reports recommend the improvement in the amount and quality of training for mental health workers in low and middle income countries. The Scotland-Malawi Mental Health Education Project (SMMHEP) has been established to support the teaching of psychiatry to medical students in the University of Malawi. While anecdotally supportive medical educational initiatives appear of value, little quantitative evidence exists to demonstrate whether such initiatives can deliver comparable educational standards. This study aimed to assess the effectiveness of an undergraduate psychiatry course given by UK psychiatrists in Malawi by studying University of Malawi and Edinburgh University medical students' performance on an MCQ examination paper. Methods An undergraduate psychiatry course followed by an MCQ exam was delivered by the SMMHEP to 57 Malawi medical students. This same MCQ exam was given to 71 Edinburgh University medical students who subsequently sat their own Edinburgh University examination. Results There were no significant differences between Edinburgh students' performance on the Malawi exam and their own Edinburgh University exam. (p = 0.65). This would suggest that the Malawi exam is a comparable standard to the Edinburgh exam. Malawi students marks ranged from 52.4%–84.6%. Importantly 84.4% of Malawi students scored above 60% on their exam which would equate to a hypothetical pass by UK university standards. Conclusion The support of an undergraduate course in an African setting by high income country specialists can attain a high percentage pass rate by UK standards. Although didactic teaching has been surpassed by more novel educational methods, in resource poor countries it remains an effective and cost effective method of gaining an important educational standard. PMID:18430237

Status of the recommendations on the African cyberinfrastructure expressed by the scientific community written in 2007

NASA Astrophysics Data System (ADS)

Petitdidier, M.

2009-04-01

In today's Information Age, an effective cyber-infrastructure and Internet access underpins development and human welfare by strengthening education and training, expanding science, technology and innovation capability, opening up collaboration opportunities with the rest of the world, and generating the knowledge base for decision-making. Poor Internet connectivity prevents many countries in Africa, especially Sub-Saharan ones, from taking advantage of these opportunities. There are many initiatives from local, governmental, African, European and international organisations to promote, survey and fund networking. The eGY (electronic Geophysical Year) and Sharing Knowledge Foundation initiatives are based on African scientific communities, and are complementary of other initiatives. Their bottom-up role is twofold: firstly to motivate and support the scientists in each country (1) to ask their government or organisations for a better Internet for research and for education and (2) to organize themselves to welcome new technologies, secondly to promote a better cyber-infrastructure for their universities towards international organisations. In 2007 during the IHY workshop that gathered African scientists from 20 countries eGY provided the results of the questionnaire sent to all the participants to describe the status of internet in the Universities and Research institutes. Then recommendations were written. In 2007 Sharing the knowledge foundation organized a meeting devoted to internet and Grids in Africa. The participants, scientists, industrialists and members of NGO originating from 14 countries wrote also recommendations. In 2009 the presentation in this session of R.L.A Cottrell and U. Kalim will provide an overview of the evolution of the networking. In parallel to the improvement of internet the development of scientific collaboration among African countries and with Europe by using ICT was considered as an essential point. This presentation will be focused on the recommendations, different achievements and plans (see presentation in this section by V. Ardizzone et al.) .

Spatiotemporal evolutionary epidemiology of H5N1 highly pathogenic avian influenza in West Africa and Nigeria, 2006-2015.

PubMed

Ekong, P S; Fountain-Jones, N M; Alkhamis, M A

2018-02-01

H5N1 highly pathogenic avian influenza virus (HPAIV) was first observed in Nigeria in early 2006 and has now spread to more than 17 African countries having severe economic and public health implications. Here, we explore the spatiotemporal patterns of viral dispersal both among West African countries and within Nigeria using sequence data from hemagglutinin (HA) gene region of the virus. Analyses were performed within a statistical Bayesian framework using phylodynamic models on data sets comprising of all publically available HA sequence data collected from seven West African countries and Egypt between 2006 and 2015. Our regional-level analyses indicated that H5N1 in West Africa originated in Nigeria in three geopolitical regions, specifically north central and north-east, where backyard poultry and wild birds are in frequent contact, as well as south-west, a major commercial poultry area, then dispersed to West African countries. We inferred significant virus dispersal routes between Niger and Nigeria on one side and Burkina Faso, Ivory Coast, Ghana and Egypt on the other. Furthermore, south-west Nigeria identified as a primary source for virus dispersal within Nigeria as well as to Niger in 2006 and 2008. Niger was an important epicentre for the virus spread into other West African countries in 2015. Egyptian introductions from West Africa were sporadic and resulted most likely from poultry trade with Nigeria rather than contact with infected wild birds. Our inferred viral dispersal routes reflected the large-scale unrestricted movements of infected poultry in the region. Our study illustrates the ability of phylodynamic models to trace important HPAIV dispersal routes at a regional and national level. Our results have clear implications for the control and prevention of this pathogen across scales and will help improve molecular surveillance of transboundary HPAIVs. © 2017 Blackwell Verlag GmbH.

African Regional Seminar for Advanced Training In Systematic Curriculum Development and Evaluation. (Achimota, Ghana, 14 July--15 August 1975). Report.

ERIC Educational Resources Information Center

Swedish International Development Authority (SIDA).

This report summarizes the African Regional Seminar for Advanced Training in Systematic Curriculum Development and Evaluation that was held at Achimota, Ghana, July 14-August 15 1975. Attending the seminar were 67 participants from 12 African countries, including Cameroon, Gambia, Ghana, Kenya, Liberia, Malawi, Nigeria, Sierra Leone, Swaziland,…

"We Also Wanted to Learn": Narratives of Change from Adults Literate in African Languages

ERIC Educational Resources Information Center

Trudell, Joel; Cheffy, Ian

2017-01-01

This article discusses the impact of literacy programmes on those who learned to read and write in their own African languages. It draws on adult learners' reflections on the significance of literacy and numeracy in their everyday lives as evidenced in interviews conducted in 2014 and 2015 in rural sites in five African countries: Ethiopia, Kenya,…

Older African American Female Adult Learners: Their Persistence in the Pursuit of Higher Education and Steady Academic Progress

ERIC Educational Resources Information Center

Ross, Patrice L.

2017-01-01

Colleges and universities throughout the country have seen an influx in enrollment amongst African American women. Many of these women are characterized as non-traditional students. In addition to possessing non-traditional traits, these women occupy two oppressed groups in society; African Americans and females. Along with them being a part of…

IFLA General Conference, 1984. Collections and Services Division. Sections on Acquisitions and Exchange, Interlending, Rare and Precious Books, and Serials Publications. Papers.

ERIC Educational Resources Information Center

International Federation of Library Associations, The Hague (Netherlands).

Papers on library acquisitions, special collections development, and special training for serials librarianship, presented at the 1984 IFLA general conference, include: (1) "The Development of the African Collection at the School of Oriental and African Studies in London and Its Importance for the Cultural History of African Countries"…

Investments in blood safety improve the availability of blood to underserved areas in a sub-Saharan African country

PubMed Central

Pitman, J. P.; Wilkinson, R.; Basavaraju, S. V.; von Finckenstein, B.; Sibinga, C. Smit; Marfin, A. A.; Postma, M. J.; Mataranyika, M.; Tobias, J.; Lowrance, D. W.

2015-01-01

Background and Objectives Since 2004, several African countries, including Namibia, have received assistance from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Gains have been documented in the safety and number of collected units in these countries, but the distribution of blood has not been described. Materials and Methods Nine years of data on blood requests and issues from Namibia were stratified by region to describe temporal and spatial changes in the number and type of blood components issued to Namibian healthcare facilities nationally. Results Between 2004 and 2007 (early years of PEPFAR support) and 2008–2011 (peak years of PEPFAR support), the average number of red cell units issued annually increased by 23.5% in seven densely populated but less-developed regions in northern Namibia; by 30% in two regions with urban centres; and by 35.1% in four sparsely populated rural regions. Conclusion Investments in blood safety and a policy decision to emphasize distribution of blood to underserved regions improved blood availability in remote rural areas and increased the proportion of units distributed as components. However, disparities persist in the distribution of blood between Namibia’s urban and rural regions. PMID:26478742

'I Am a Nurse': Oral Histories of African Nurses.

PubMed

Wall, Barbra Mann; Dhurmah, Krist; Lamboni, Bassan; Phiri, Benson Edwinson

2015-08-01

Much of African history has been written by colonial "masters" and is skewed by cultural bias. The voices of indigenous peoples have largely been ignored. The purpose of this study was to collect the oral histories of African nursing leaders who studied and practiced nursing from the late colonial era (1950s) through decolonization and independence (1960s-70s), in order to better understand their experiences and perspectives. This study relied on historical methodology, grounded specifically within the context of decolonization and independence. The method used was oral history. Oral histories were collected from 13 retired nurses from Mauritius, Malawi, and Togo. Participants' educational and work histories bore the distinct imprint of European educational and medical norms. Nursing education provided a means of earning a living and offered professional advancement and affirmation. Participants were reluctant to discuss the influence of race, but several recalled difficulties in working with both expatriate and indigenous physicians and matrons. Differences in African nurses' experiences were evident at the local level, particularly with regard to language barriers, gender-related divisions, and educational and practice opportunities. The data show that although institutional models and ideas were transported from colonial nursing leaders to African nursing students, the African nurses in this study adapted those models and ideas to meet their own needs. The findings also support the use of storytelling as a culturally appropriate research method. Participants' stories provide a better understanding of how time, place, and social and cultural forces influenced and affected local nursing practices. Their stories also reveal that nursing has held various meanings for participants, including as a means to personal and professional opportunities and as a way to help their countries' citizens.

The development of cardiac surgery in West Africa-the case of Ghana

PubMed Central

Edwin, Frank; Tettey, Mark; Aniteye, Ernest; Tamatey, Martin; Sereboe, Lawrence; Entsua-Mensah, Kow; Kotei, David; Baffoe-Gyan, Kofi

2011-01-01

West Africa is one of the poorest regions of the world. The sixteen nations listed by the United Nations in this sub-region have some of the lowest gross domestic products in the world. Health care infrastructure is deficient in most of these countries. Cardiac surgery, with its heavy financial outlay is unavailable in many West African countries. These facts notwithstanding, some West African countries have a proud history of open heart surgery not very well known even in African health care circles. Many African health care givers are under the erroneous impression that the cardiovascular surgical landscape of West Africa is blank. However, documented reports of open-heart surgery in Ghana dates as far back as 1964 when surface cooling was used by Ghanaian surgeons to close atrial septal defects. Ghana's National Cardiothoracic Center is still very active and is accredited by the West African College of Surgeons for the training of cardiothoracic surgeons. Reports from Nigeria indicate open-heart surgery taking place from 1974. Cote D'Ivoire had reported on its first 300 open-heart cases by 1983. Senegal reported open-heart surgery from 1995 and still runs an active center. Cameroon started out in 2009 with work done by an Italian group that ultimately aims to train indigenous surgeons to run the program. This review traces the development and current state of cardiothoracic surgery in West Africa with Ghana's National Cardiothoracic Center as the reference. It aims to dispel the notion that there are no major active cardiothoracic centers in the West African sub-region. PMID:22355425

Spousal concordance in attitudes toward violence and reported physical abuse in African couples.

PubMed

Alio, Amina P; Clayton, Heather B; Garba, Madeleine; Mbah, Alfred K; Daley, Ellen; Salihu, Hamisu M

2011-09-01

We examined the potential association between African couples' concordance on attitudes toward violence (ATV) and risk for intimate partner violence (IPV). Analyses included 13,837 couples from Demographic and Health Surveys conducted between 2003 and 2007, from six African countries. Concordance on ATV was defined as both spouses justifying physical abuse, and IPV was defined as incidence of a physically violent act against the wife. We constructed a concordance measure from the surveys to assess overall and country-level differences in couple's ATV concordance rates and assessed the association between concordance in ATV and IPV using hierarchical regression modeling that adjusted for multilevel influences on risk estimates. Negative concordance (perfect agreement in negative ATV) was used as referent category in all analyses. Overall, spousal ATV concordance was associated with higher likelihood for IPV (adjusted odds ratio [AOR] = 2.27, 95% confidence interval [CI] = [2.01, 2.56]). The level of wealth, educational attainment, rural/urban residence, presence of a cowife, religion, maternal age, and parity were characteristics that predicted the occurrence of IPV within couples. Spousal ATV concordance was significantly associated with violence in every African nation included in the analysis except Rwanda. African couples with high rates of ATV concor- dance experience higher risks for IPV, with some variation in magnitude of risk across countries. In African settings, ATV positive concordance could serve as a supplemental screening tool to detect spousal violence. Understanding ATV could potentially enhance our ability to formulate public health intervention to detect and prevent spousal abuse.

The public health effects of water and sanitation in selected West African countries.

PubMed

Alagidede, P; Alagidede, A N

2016-01-01

This paper examines access to water and improved sanitation target under the Millennium Development Goal 7c (MDG 7c) for six West African countries: Chad, Niger, Nigeria, Mauritania, Sierra Leone and Togo. The article outlines some possible causes for the slow progress in achieving the MDG 7c, examines the public health effects of missing the targets, and charts paths for policy makers to consider in bringing these targets to acceptable levels. The study is based on secondary data analysis of trends in water and sanitation indicators for the six countries from 2000 to 2014. The data are drawn from the World Development Indicators (WDI) of the World Bank, and the World Health Organisation Joint Monitoring Programme (WHO JMP) and WaterAid Africa Wash Map. The performance of each country in the two indicators is presented and judged against the target set under MDG 7c. Forecasts based on the expiry of the MDG's in 2015 and the time required to achieve the targets are carried out. The study showes that while some progress has been made in improved water, sanitation showed slow progress for all the countries between 2000 and 2014. The goal of attaining acceptable sanitation shows that the six West African countries have lagged behind the MDG 7c target and the progress is equally slow. At the current rate of progress if strong public and private sector intervention mechanisms are not instituted across the board, the six West African countries under study would continue to lag behind the rest of the world in terms of access to improved water and sanitation. This has consequences for poverty alleviation and the risk of the re-emergence of neglected tropical diseases. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

National laboratory policies and plans in sub-Saharan African countries: gaps and opportunities

PubMed Central

van der Broek, Ankie; Jansen, Christel; de Bruijn, Hilde; Schultsz, Constance

2017-01-01

Background The 2008 Maputo Declaration calls for the development of dedicated national laboratory policies and strategic plans supporting the enhancement of laboratory services in response to the long-lasting relegation of medical laboratory systems in sub-Saharan Africa. Objectives This study describes the extent to which laboratories are addressed in the national health policies and plans created directly following the 2008 momentum for laboratory strengthening. Method National health policies and plans from 39 sub-Saharan African countries, valid throughout and beyond 31 December 2010 were collected in March 2012 and analysed during 2013. Results Laboratories were addressed by all countries. Human resources were the most addressed topic (38/39) and finances and budget were the least addressed (< 5/39). Countries lagging behind in national laboratory strategic planning at the end of 2013 (17/39) were more likely to be francophone countries located in West-Central Africa (13/17) and have historically low HIV prevalence. The most common gaps anticipated to compromise the implementation of the policies and plans were the disconnect between policies and plans, under-developed finance sections and monitoring and evaluating frameworks, absence of points of reference to define gaps and shortages, and inappropriate governance structure. Conclusion The availability of laboratory policy and plan implementation can be improved by strictly applying a more standardised methodology for policy development, using harmonised norms to set targets for improvement and intensifying the establishment of directorates of laboratory services directly under the authority of Ministries of Health. Horizontal programmes such as the Global Health Security Agenda could provide the necessary impulse to take the least advanced countries on board. PMID:28879152

Hunger influenced life expectancy in war-torn Sub-Saharan African countries.

PubMed

Uchendu, Florence N

2018-04-27

Malnutrition is a global public health problem especially in developing countries experiencing war/conflicts. War might be one of the socio-political factors influencing malnutrition in Sub-Saharan African (SSA) countries. This study aims at determining the influence of war on corruption, population (POP), number of population malnourished (NPU), food security and life expectancy (LE) in war-torn SSA countries (WTSSA) by comparing their malnutrition indicators. Fourteen countries in WTSSA were stratified into zones according to war incidences. Countries' secondary data on population (POP), NPU, Food Security Index (FSI), corruption perceptions index (CPI), Global Hunger Index (GHI) and LE were obtained from global published data. T test, multivariate and Pearson correlation analyses were performed to determine the relationship between CPI, POP, GHI, FSI, NPU, male LE (MLE) and female LE (FLE) in WTSSA at p < .05. Data were presented in tables, means, standard deviation and percentages. Mean NPU, CPI, GHI, POP, FSI, MLE and FLE in WTSSA were 5.0 million, 28.3%, 18.2%, 33.8 million, 30.8%, 54.7 years and 57.1 years, respectively. GHI significantly influenced LE in both male and female POP in WTSSA. NPU, CPI, FSI, GHI and FLE were not significantly different according to zones except in MLE. Malnutrition indicators were similarly affected in WTSSA. Hunger influenced life expectancy. Policies promoting good governance, equity, peaceful co-existence, respect for human right and adequate food supply will aid malnutrition eradication and prevent war occurrences in Sub-Saharan African countries.

A Risk Analysis Approach to Prioritizing Epidemics: Ebola Virus Disease in West Africa as a Case Study.

PubMed

Ajisegiri, Whenayon Simeon; Chughtai, Abrar Ahmad; MacIntyre, C Raina

2018-03-01

The 2014 Ebola virus disease (EVD) outbreak affected several countries worldwide, including six West African countries. It was the largest Ebola epidemic in the history and the first to affect multiple countries simultaneously. Significant national and international delay in response to the epidemic resulted in 28,652 cases and 11,325 deaths. The aim of this study was to develop a risk analysis framework to prioritize rapid response for situations of high risk. Based on findings from the literature, sociodemographic features of the affected countries, and documented epidemic data, a risk scoring framework using 18 criteria was developed. The framework includes measures of socioeconomics, health systems, geographical factors, cultural beliefs, and traditional practices. The three worst affected West African countries (Guinea, Sierra Leone, and Liberia) had the highest risk scores. The scores were much lower in developed countries that experienced Ebola compared to West African countries. A more complex risk analysis framework using 18 measures was compared with a simpler one with 10 measures, and both predicted risk equally well. A simple risk scoring system can incorporate measures of hazard and impact that may otherwise be neglected in prioritizing outbreak response. This framework can be used by public health personnel as a tool to prioritize outbreak investigation and flag outbreaks with potentially catastrophic outcomes for urgent response. Such a tool could mitigate costly delays in epidemic response. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

Leveraging ongoing research to evaluate the health impacts of South Africa's salt reduction strategy: a prospective nested cohort within the WHO-SAGE multicountry, longitudinal study

PubMed Central

Charlton, Karen; Menyanu, Elias; Biritwum, Richard Berko; Naidoo, Nirmala; Pieterse, Chiné; Madurai, Savathree (Lorna); Baumgartner, Jeannine; Asare, George A; Thiele, Elizabeth; Schutte, Aletta E; Kowal, Paul

2016-01-01

Introduction Attempting to curb the rising epidemic of hypertension, South Africa implemented legislation in June 2016 mandating maximum sodium levels in a range of manufactured foods that contribute significantly to population salt intake. This natural experiment, comparing two African countries with and without salt legislation, will provide timely information on the impact of legislative approaches addressing the food supply to improve blood pressure in African populations. This article outlines the design of this ongoing prospective nested cohort study. Methods and analysis Baseline sodium intake was assessed in a nested cohort of the WHO Study on global AGEing and adult health (WHO-SAGE) wave 2 (2014–2015), a multinational longitudinal study on the health and well-being of adults and the ageing process. The South African cohort consisted of randomly selected households (n=4030) across the country. Spot and 24-hour urine samples are collected in a random subsample (n=1200) and sodium, potassium, creatinine and iodine analysed. Salt behaviour and sociodemographic data are captured using face-to-face interviews, alongside blood pressure and anthropometric measures. Ghana, the selected control country with no formal salt policy, provided a nested subsample (n=1200) contributing spot and 24-hour urine samples from the SAGE Ghana cohort (n=5000). Follow-up interviews and urine collection (wave 3) in both countries will take place in 2017 (postlegislation) to assess change in population-level sodium intake and blood pressure. Ethics and dissemination SAGE was approved by the WHO Ethics Review Committee (reference number RPC149) with local approval from the North-West University Human Research Ethics Committee and University of the Witwatersrand Human Research Ethics Committee (South Africa), and University of Ghana Medical School Ethics and Protocol Review Committee (Ghana). The results of the study will be published in peer-reviewed international journals, presented at national and international conferences, and summarised as research and policy briefs. PMID:27903563

Whipworm diversity in West African rodents: a molecular approach and the description of Trichuris duplantieri n. sp. (Nematoda: Trichuridae).

PubMed

Ribas, Alexis; Diagne, Christophe; Tatard, Caroline; Diallo, Mamoudou; Poonlaphdecha, Srisupaph; Brouat, Carine

2017-04-01

Whipworms were collected from rodents (Muridae) from six West African countries: Burkina-Faso, the Islamic Republic of Mauritania, and the Republics of Benin, Guinea, Mali and Senegal. Molecular sequences (ITS-1, 5.8S and ITS-2 of the ribosomal DNA gene) and morphometric characters were analysed in Trichuris (Nematoda: Trichuridae) specimens found in seven host species: Arvicanthis niloticus, Gerbilliscus gambianus, Gerbillus gerbillus, G. tarabuli, Mastomys erythroleucus, M. huberti and M. natalensis. Phylogenetic analyses revealed three clades, one recognised as Trichuris mastomysi, previously recorded in M. natalensis from Tanzania, and the other two previously undescribed. A new species named Trichuris duplantieri n. sp., found in Gerbillus spp. from Mauritania, was characterised using molecular and morphometric methods.

Training needs for research in health inequities among health and demographic researchers from eight African and Asian countries.

PubMed

Haafkens, Joke; Blomstedt, Yulia; Eriksson, Malin; Becher, Heiko; Ramroth, Heribert; Kinsman, John

2014-12-10

To support equity focussed public health policy in low and middle income countries, more evidence and analysis of the social determinants of health inequalities is needed. This requires specific know how among researchers. The INDEPTH Training and Research Centres of Excellence (INTREC) collaboration will develop and provide training on the social determinants of health approach for health researchers from the International Network for the Demographic Evaluation of Populations and Their Health in Low- and Middle-Income Countries (INDEPTH) in Africa and Asia. To identify learning needs among the potential target group, this qualitative study explored what INDEPTH researchers from Ghana, Tanzania, South Africa, Kenya, Indonesia, India, Vietnam, and Bangladesh feel that they want to learn to be able to conduct research on the causes of health inequalities in their country. Using an inductive method, online concept-mapping, participants were asked to generate statements in response to the question what background knowledge they would need to conduct research on the causes of health inequalities in their country, to sort those statements into thematic groups, and to rate them in terms of how important it would be for the INTREC program to offer instruction on each of the statements. Statistical techniques were used to structure statements into a thematic cluster map and average importance ratings of statements/clusters were calculated. Of the 150 invited researchers, 82 participated in the study: 54 from Africa; 28 from Asia. Participants generated 59 statements and sorted them into 6 broader thematic clusters: "assessing health inequalities"; "research design and methods"; "research and policy"; "demography and health inequalities"; "social determinants of health" and "interventions". African participants assigned the highest importance to further training on methods for assessing health inequalities. Asian participants assigned the highest importance to training on research and policy. The identified thematic clusters and statements provide a detailed understanding of what INDEPTH researchers want to learn in order to be able to conduct research on the social determinants of health inequalities. This offers a framework for developing capacity building programs in this emerging field of public health research.

Hope in Africa?: social representations of world history and the future in six African countries.

PubMed

Cabecinhas, Rosa; Liu, James H; Licata, Laurent; Klein, Olivier; Mendes, Júlio; Feijó, João; Niyubahwe, Aline

2011-10-01

Data on social representations of world history have been collected everywhere in the world except sub-Saharan Africa. Two studies using open-ended data involving university students from six African countries fill this gap. In Study 1, nominations from Cape Verde and Mozambique for the most important events in world history in the past 1000 years were dominated by war and politics, recency effects, and Western-centrism tempered by African sociocentrism on colonization and independence. The first three findings replicated previous research conducted in other parts of the world, but the last pattern contrasted sharply with European data. Study 2 employed a novel method asking participants how they would begin the narration of world history, and then to describe a major transition to the present. Participants most frequently wrote about the evolution of humanity out of Africa, followed by war and then colonization as a beginning, and then replicated previous findings with war, colonization, and technology as major transitions to the present. Finally, when asked about how they foresaw the future, many participants expressed hope for peace and cooperation, especially those facing more risk of collective violence (Burundi and Congo). A colonial/liberation narrative was more predominant in the data from former Portuguese colonies (Angola, Cape Verde, and Guinea-Bissau) than from former Belgian colonies (Burundi and Congo).

Getting It Right the First Time: Defining Regionally Relevant Training Curricula and Provider Core Competencies for Point-of-Care Ultrasound Education on the African Continent.

PubMed

Salmon, Margaret; Landes, Megan; Hunchak, Cheryl; Paluku, Justin; Malemo Kalisya, Luc; Salmon, Christian; Muller, Mundenga Mutendi; Wachira, Benjamin; Mangan, James; Chhaganlal, Kajal; Kalanzi, Joseph; Azazh, Aklilu; Berman, Sara; Zied, El-Sayed; Lamprecht, Hein

2017-02-01

Significant evidence identifies point-of-care ultrasound (PoCUS) as an important diagnostic and therapeutic tool in resource-limited settings. Despite this evidence, local health care providers on the African continent continue to have limited access to and use of ultrasound, even in potentially high-impact fields such as obstetrics and trauma. Dedicated postgraduate emergency medicine residency training programs now exist in 8 countries, yet no current consensus exists in regard to core PoCUS competencies. The current practice of transferring resource-rich PoCUS curricula and delivery methods to resource-limited health systems fails to acknowledge the unique challenges, needs, and disease burdens of recipient systems. As emergency medicine leaders from 8 African countries, we introduce a practical algorithmic approach, based on the local epidemiology and resource constraints, to curriculum development and implementation. We describe an organizational structure composed of nexus learning centers for PoCUS learners and champions on the continent to keep credentialing rigorous and standardized. Finally, we put forth 5 key strategic considerations: to link training programs to hospital systems, to prioritize longitudinal learning models, to share resources to promote health equity, to maximize access, and to develop a regional consensus on training standards and credentialing. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Lessons Learned from the Niger Delta Conflict: A Policy Recommendation for a New Framework for Relations Between Extractive Companies and Host Communities

NASA Astrophysics Data System (ADS)

Gilman, Alison

The tumultuous experience of the Shell Petroleum Development Company of Nigeria Ltd (SPDC) in the Niger Delta region of Nigeria has contributed to the debates surrounding the role of transnational companies in their host communities and the impact that resource extraction has on the economic development of emerging countries. The case study demonstrates that methods used by extraction companies for interacting with their host communities are ineffective and superficial. Using the lessons learned from the Niger Delta conflict, this thesis proposes a new strategy, entitled community- corporate diplomacy, and a protocol for companies to implement before opening production sites in Africa. The proposed strategy and an accompanying protocol offer a break from the status quo in that they are built upon an understanding of the specificities of the African continent, that host communities need to be respected as key stakeholders, and that extraction activities have a higher risk of negatively impacting neighboring communities. The recommendation could be applied to other countries and industries, but the increasing importance of African natural resources, the particularities of African political and social structures and the effects of extraction activities make this proposal especially important for extractive companies beginning production in Africa. Keywords: Nigeria, Niger Delta, Shell, corporate social responsibility, transnational advocacy networks, multi-stakeholder initiatives, community relations, corporate diplomacy, Africa, extractive industries.

Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries

PubMed Central

Drain, Paul K; Halperin, Daniel T; Hughes, James P; Klausner, Jeffrey D; Bailey, Robert C

2006-01-01

Background Both religious practices and male circumcision (MC) have been associated with HIV and other sexually-transmitted infectious diseases. Most studies have been limited in size and have not adequately controlled for religion, so these relationships remain unclear. Methods We evaluated relationships between MC prevalence, Muslim and Christian religion, and 7 infectious diseases using country-specific data among 118 developing countries. We used multivariate linear regression to describe associations between MC and cervical cancer incidence, and between MC and HIV prevalence among countries with primarily sexual HIV transmission. Results Fifty-three, 14, and 51 developing countries had a high (>80%), intermediate (20–80%), and low (<20%) MC prevalence, respectively. In univariate analyses, MC was associated with lower HIV prevalence and lower cervical cancer incidence, but not with HSV-2, syphilis, nor, as expected, with Hepatitis C, tuberculosis, or malaria. In multivariate analysis after stratifying the countries by religious groups, each categorical increase of MC prevalence was associated with a 3.65/100,000 women (95% CI 0.54-6.76, p = 0.02) decrease in annual cervical cancer incidence, and a 1.84-fold (95% CI 1.36-2.48, p < 0.001) decrease in the adult HIV prevalence among sub-Saharan African countries. In separate multivariate analyses among non-sub-Saharan African countries controlling for religion, higher MC prevalence was associated with a 8.94-fold (95% CI 4.30-18.60) decrease in the adult HIV prevalence among countries with primarily heterosexual HIV transmission, but not, as expected, among countries with primarily homosexual or injection drug use HIV transmission (p = 0.35). Conclusion Male circumcision was significantly associated with lower cervical cancer incidence and lower HIV prevalence in sub-Saharan Africa, independent of Muslim and Christian religion. As predicted, male circumcision was also strongly associated with lower HIV prevalence among countries with primarily heterosexual HIV transmission, but not among countries with primarily homosexual or injection drug use HIV transmission. These findings strengthen the reported biological link between MC and some sexually transmitted infectious diseases, including HIV and cervical cancer. PMID:17137513

Estimated reductions in hospitalizations and deaths from childhood diarrhea following implementation of rotavirus vaccination in Africa.

PubMed

Shah, Minesh P; Tate, Jacqueline E; Mwenda, Jason M; Steele, A Duncan; Parashar, Umesh D

2017-10-01

Rotavirus is the leading cause of hospitalizations and deaths from diarrhea. 33 African countries had introduced rotavirus vaccines by 2016. We estimate reductions in rotavirus hospitalizations and deaths for countries using rotavirus vaccination in national immunization programs and the potential of vaccine introduction across the continent. Areas covered: Regional rotavirus burden data were reviewed to calculate hospitalization rates, and applied to under-5 population to estimate baseline hospitalizations. Rotavirus mortality was based on 2013 WHO estimates. Regional pre-licensure vaccine efficacy and post-introduction vaccine effectiveness studies were used to estimate summary effectiveness, and vaccine coverage was applied to calculate prevented hospitalizations and deaths. Uncertainties around input parameters were propagated using boot-strapping simulations. In 29 African countries that introduced rotavirus vaccination prior to end 2014, 134,714 (IQR 112,321-154,654) hospitalizations and 20,986 (IQR 18,924-22,822) deaths were prevented in 2016. If all African countries had introduced rotavirus vaccines at benchmark immunization coverage, 273,619 (47%) (IQR 227,260-318,102) hospitalizations and 47,741 (39%) (IQR 42,822-52,462) deaths would have been prevented. Expert commentary: Rotavirus vaccination has substantially reduced hospitalizations and deaths in Africa; further reductions are anticipated as additional countries implement vaccination. These estimates bolster wider introduction and continued support of rotavirus vaccination programs.

Increasing the number of female primary school teachers in African countries: Effects, barriers and policies

NASA Astrophysics Data System (ADS)

Haugen, Caitlin S.; Klees, Steven J.; Stromquist, Nelly P.; Lin, Jing; Choti, Truphena; Corneilse, Carol

2014-12-01

Girls' education has been a high development priority for decades. While some progress has been made, girls are often still at a great disadvantage, especially in developing countries, and most especially in African countries. In sub-Saharan Africa, less than half of primary school teachers and only a quarter of secondary school teachers are women, and enrolment figures for girls are low. One common policy prescription is to increase the number of women teachers, especially in the many countries where teaching remains a predominantly male profession. This policy prescription needs to be backed by more evidence in order to significantly increase and improve its effective implementation. The available research seems to suggest that girls are more likely to enrol in schools where there are female teachers. Moreover, increasing the number of trained teachers in sub-Saharan Africa depends on more girls completing their school education. To date, however, there has been no comprehensive literature review analysing the effects of being taught by women teachers on girls' educational experience. This paper aims to make a start on filling this gap by examining the evidence on the effects in primary schools, especially in African countries. It also identifies and examines the barriers women face in becoming and staying teachers, and considers policies to remedy their situation.

Female genital mutilation in Djibouti.

PubMed

Martinelli, M; Ollé-Goig, J E

2012-12-01

The practice of female genital mutilation (we will use the latest definition adopted by WHO/UNFP: female genital mutilation/cutting or FGM/C) is still widespread in 28 African countries. The World Health Organisation (WHO) estimates that more than two million females undergo some form of genital mutilation every year. Its negative health impact and its ethical and human rights aspects have been discussed and attempts to eliminate it have been the objectives of several meetings promoted by national and international organisations thanks to an increased awareness related to FGM/C in those countries practicing it and also, maybe due to the number of Africans migrating to industrialized countries. We review the present situation in Djibouti, a small country in the Horn of Africa, where 98 % of the female population has suffered different forms of FGM/C.

A Founder Mutation in LEPRE1 Carried by 1.5% of West Africans and 0.4% of African Americans Causes Lethal Recessive Osteogenesis Imperfecta

PubMed Central

Cabral, Wayne A.; Barnes, Aileen M.; Adeyemo, Adebowale; Cushing, Kelly; Chitayat, David; Porter, Forbes D.; Panny, Susan R.; Gulamali-Majid, Fizza; Tishkoff, Sarah A.; Rebbeck, Timothy R.; Gueye, Serigne M.; Bailey-Wilson, Joan E.; Brody, Lawrence C.; Rotimi, Charles N.; Marini, Joan C.

2012-01-01

Purpose Deficiency of prolyl 3-hydroxylase 1, encoded by LEPRE1, causes recessive osteogenesis imperfecta. We previously identified a LEPRE1 mutation, exclusively in African Americans and contemporary West Africans. We hypothesized that this allele originated in West Africa and was introduced to the Americas with the Atlantic slave trade. We aimed to determine the frequency of carriers for this mutation among African Americans and West Africans, and the mutation origin and age. Methods Genomic DNA was screened for the mutation using PCR and restriction digestion, and a custom TaqMan genomic SNP assay. The mutation age was estimated using microsatellites and short tandem repeats spanning 4.2 Mb surrounding LEPRE1 in probands and carriers. Results Approximately 0.4% of Mid-Atlantic African Americans carry this mutation, estimating recessive OI in 1/260,000 births in this population. In Nigeria and Ghana, 1.48% of unrelated individuals are heterozygous carriers, predicting 1/18,260 births will be affected with recessive OI, equal to the incidence of de novo dominant OI. The mutation was not detected in Africans from surrounding countries. All carriers shared a haplotype of 63-770 Kb, consistent with a single founder for this mutation. Using linkage disequilibrium analysis, the mutation was estimated to have originated between 650 and 900 years before present (1100-1350 C.E.). Conclusions We identified a West African founder mutation for recessive OI in LEPRE1. Nearly 1.5% of Ghanians and Nigerians are carriers. The age of this allele is consistent with introduction to North America via the Atlantic slave trade (1501 – 1867 C.E). PMID:22281939

Bibliometric analysis of literature on female genital mutilation: (1930 - 2015).

PubMed

Sweileh, Waleed M

2016-10-10

Female genital mutilation/cutting (FGM/C) is a common harmful traditional practice in many communities in Africa and to a lesser extent in Middle East and other regions in the world. In order to better understand publishing on this topic, we conducted a bibliometric study on FGM/C. Bibliometric analyses can be used as an indicator of the extent of interaction of researchers, health authorities, and communities with a particular health issue. Scopus database was used to retrieve data on FGM/C. Keywords used were "female genital mutilation", "female genital circumcision", "female genital cutting" and "female circumcision". Specifically, the number of publications, top productive countries and institutions, highly cited articles, citation analysis, co-authorships, international collaboration, role of African countries, top active authors, and journals involved in publishing articles on FGM/C were reviewed and analyzed. We indirectly assessed the impact of publications using total number of citations received, average number of citations per article, Hirsch-index, percentage of highly cited articles, and journal's impact factor. One thousand and thirty-five publications on FGM/C were retrieved. The h-index of retrieved articles was 37. A steep rise in number of publications was noticed in mid-1990s and again in 2012. More than half of retrieved articles were published from 2006 - 2015. A total of 65 countries contributed. The top ten productive countries included ones from Northern America, Europe and Africa. Nigeria and Egypt were the most active African countries in FGM/C publications. At least nine African academic institutions were actively involved on FGM/C publications. Articles on FGM/C that received the highest number of citations were those that focused on negative physical and psychosexual consequences of FGM/C. Journal topic areas were obstetrics/gynecology, public health, and psychological sociology. Collaboration between African and European countries on FGM/C research was evident. Bibliometric analysis reveals that research publications on FGM/C have been increasing since the l970s, with collaboration between African and Western countries, and articles are being published in higher impact journals, not only obstetrics, but also public health and social sciences. FGM/C research can be helpful to international health agencies and governments not only to document negative outcomes, but also to identify best practices, and to note gaps in implementation and practice.

Web-based Teaching Radio Interferometer for Africa

NASA Astrophysics Data System (ADS)

Carignan, Claude

2015-08-01

Practical training for the future use of the African VLBI Network (AVN) or any VLBI experiment starts by understanding the basic principles of radio observations and radio interferometry. The aim of this project is to build a basic interferometer that could be used remotely via a web interface from any country on the African continent. This should turn out as a much less expensive and much more efficient way to train AVN researchers from SKA partner countries to the principles of radio astronomy and to interferometric data analysis. The idea is based on the very successful EUHOU (European Hands-On Universe) already very successful in Europe. The former EUHOU manager, Dr Yannick Liebert, arrived for a 3 years postdoc with Prof Claude Carignan at the University of Cape Town to implement the same project on the African continent (AHI: African Hands-on Interferometry). Besides the use of AHI for the AVN researchers, this web-based system could be used be any undergraduate program on radio astronomical techniques across the African continent as the EUHOU is used all across Europe.

[Collaborating for the development of nursing in Africa].

PubMed

Oguisso, T

1993-04-01

The support offered by the ICN to the african countries of portuguese language, is described in this paper. The countries that participated of the ICN' Project were Angola, Cabo Verde, Guiné-Bissau, Moçambique, São Tomé and Principe. The purposes of the project are: analyse development of nursing in these countries; identify the needs of the nurses of the these countries; to evaluate the health systems and work to introduce the nurse in these systems; to identify the strughts and issues of the nursing associations; to promote the relationship among nurses and to establish plan to reinforce the national Nursing Association. We don't think that nursing is ready and well structured now, but this Project will be the first step in this direction. We have results an had some example of this is affiliation to the ICN of some African countries that have been made.

Addressing research capacity for health equity and the social determinants of health in three African countries: the INTREC programme.

PubMed

Hofman, Karen; Blomstedt, Yulia; Addei, Sheila; Kalage, Rose; Maredza, Mandy; Sankoh, Osman; Bangha, Martin; Kahn, Kathleen; Becher, Heiko; Haafkens, Joke; Kinsman, John

2013-04-03

The importance of tackling economic, social and health-related inequities is increasingly accepted as a core concern for the post-Millennium Development Goal framework. However, there is a global dearth of high-quality, policy-relevant and actionable data on inequities within populations, which means that development solutions seldom focus on the people who need them most. INTREC (INDEPTH Training and Research Centres of Excellence) was established with this concern in mind. It aims to provide training for researchers from the INDEPTH network on associations between health inequities, the social determinants of health (SDH), and health outcomes, and on presenting their findings in a usable form to policy makers. As part of a baseline situation analysis for INTREC, this paper assesses the current status of SDH training in three of the African INTREC countries - Ghana, Tanzania, and South Africa - as well as the gaps, barriers, and opportunities for training. SDH-related courses from the three countries were identified through personal knowledge of the researchers, supplemented by snowballing and online searches. Interviews were also conducted with, among others, academics engaged in SDH and public health training in order to provide context and complementary material. Information regarding access to the Internet, as a possible INTREC teaching medium, was gathered in each country through online searches. SDH-relevant training is available, but 1) the number of places available for students is limited; 2) the training tends to be public-health-oriented rather than inclusive of the broader, multi-sectoral issues associated with SDH; and 3) insufficient funding places limitations on both students and on the training institutions themselves, thereby affecting participation and quality. We also identified rapidly expanding Internet connectivity in all three countries, which opens up opportunities for e-learning on SDH, though the current quality of the Internet services remains mixed. SDH training is currently in short supply, and there is a clear role for INTREC to contribute to the training of a critical mass of African researchers on the topic. This work will be accomplished most effectively by building on pre-existing networks, institutions, and methods.

A scoping review of training and deployment policies for human resources for health for maternal, newborn, and child health in rural Africa.

PubMed

Murphy, Gail Tomblin; Goma, Fastone; MacKenzie, Adrian; Bradish, Stephanie; Price, Sheri; Nzala, Selestine; Rose, Annette Elliott; Rigby, Janet; Muzongwe, Chilweza; Chizuni, Nellisiwe; Carey, Amanda; Hamavhwa, Derrick

2014-12-16

Most African countries are facing a human resources for health (HRH) crisis, lacking the required workforce to deliver basic health care, including care for mothers and children. This is especially acute in rural areas and has limited countries' abilities to meet maternal, newborn, and child health (MNCH) targets outlined by Millennium Development Goals 4 and 5. To address the HRH challenges, evidence-based deployment and training policies are required. However, the resources available to country-level policy makers to create such policies are limited. To inform future HRH planning, a scoping review was conducted to identify the type, extent, and quality of evidence that exists on HRH policies for rural MNCH in Africa. Fourteen electronic health and health education databases were searched for peer-reviewed papers specific to training and deployment policies for doctors, nurses, and midwives for rural MNCH in African countries with English, Portuguese, or French as official languages. Non-peer reviewed literature and policy documents were also identified through systematic searches of selected international organizations and government websites. Documents were included based on pre-determined criteria. There was an overall paucity of information on training and deployment policies for HRH for MNCH in rural Africa; 37 articles met the inclusion criteria. Of these, the majority of primary research studies employed a variety of qualitative and quantitative methods. Doctors, nurses, and midwives were equally represented in the selected policy literature. Policies focusing exclusively on training or deployment were limited; most documents focused on both training and deployment or were broader with embedded implications for the management of HRH or MNCH. Relevant government websites varied in functionality and in the availability of policy documents. The lack of available documentation and an apparent bias towards HRH research in developed areas suggest a need for strengthened capacity for HRH policy research in Africa. This will result in enhanced potential for evidence uptake into policy. Enhanced alignment between policy-makers' information needs and the independent research agenda could further assist knowledge development and uptake. The results of this scoping review informed an in-depth analysis of relevant policies in a sub-set of African countries.

HIV/AIDS-related social anxieties in adolescents in three African countries.

PubMed

Venier, J L; Ross, M W; Akande, A

1998-02-01

This study examines the social anxieties associated with HIV prevention in adolescents in three African countries (Nigeria, Kenya, and Zimbabwe). The subjects used in this study were black Africans in form 2 or grade 10 in public high schools (Nigeria, n = 387; Kenya, n = 274; Zimbabwe n = 313). Subjects responded to the 33 item AIDS Social Assertiveness Scale (ASAS). Data indicated similar factor structures for each of the three countries and included five factors. The combined sample factor intercorrelations were modestly but significantly correlated. The mean scores for each factor were compared, and ANOVA of the factors by country, by gender, and by interaction between country and gender were performed. The factor structures were very similar between countries, each including five factors that had similar themes: condom interactions, refusal of risk, confiding in significant others, contact with people with HIV/AIDS, and general assertiveness. These factor structures were also very similar to one found in previous studies of Australian adolescents on the ASAS. The Kenyan means for four of the five factors were significantly lower than those for Nigeria, and were also significantly lower than the Zimbabwean means for two of the five factors, suggesting that Kenyan students are less anxious about social situations related to HIV/AIDS than others. Significant variance was found for several factors due to gender, country, and the interaction between gender and country. These results have important implications for designing education programs. The similarities of anxieties regarding HIV/AIDS social situations suggest that these clusters of social barriers to reduction of HIV infection risk might form the basis of educational interventions, and that dimensions of HIV social anxieties are similar across countries.

Detection of Bartonella quintana in African Body and Head Lice

PubMed Central

Sangaré, Abdoul Karim; Boutellis, Amina; Drali, Rezak; Socolovschi, Cristina; Barker, Stephen C.; Diatta, Georges; Rogier, Christophe; Olive, Marie-Marie; Doumbo, Ogobara K.; Raoult, Didier

2014-01-01

Currently, the body louse is the only recognized vector of Bartonella quintana, an organism that causes trench fever. In this work, we investigated the prevalence of this bacterium in human lice in different African countries. We tested 616 head lice and 424 body lice from nine African countries using real-time polymerase chain reaction targeting intergenic spacer region 2 and specific B. quintana genes. Overall, B. quintana DNA was found in 54% and 2% of body and head lice, respectively. Our results also show that there are more body lice positive for B. quintana in poor countries, which was determined by the gross domestic product, than in wealthy areas (228/403 versus 0/21, P < 0.001). A similar finding was obtained for head lice (8/226 versus 2/390, P = 0.007). Our findings suggest that head lice in Africa may be infected by B. quintana when patients live in poor economic conditions and are also exposed to body lice. PMID:24935950

IDSR as a Platform for Implementing IHR in African Countries

PubMed Central

Kasolo, Francis; Yoti, Zabulon; Bakyaita, Nathan; Gaturuku, Peter; Katz, Rebecca; Fischer, Julie E.

2013-01-01

Of the 46 countries in the World Health Organization (WHO) African region (AFRO), 43 are implementing Integrated Disease Surveillance and Response (IDSR) guidelines to improve their abilities to detect, confirm, and respond to high-priority communicable and noncommunicable diseases. IDSR provides a framework for strengthening the surveillance, response, and laboratory core capacities required by the revised International Health Regulations [IHR (2005)]. In turn, IHR obligations can serve as a driving force to sustain national commitments to IDSR strategies. The ability to report potential public health events of international concern according to IHR (2005) relies on early warning systems founded in national surveillance capacities. Public health events reported through IDSR to the WHO Emergency Management System in Africa illustrate the growing capacities in African countries to detect, assess, and report infectious and noninfectious threats to public health. The IHR (2005) provide an opportunity to continue strengthening national IDSR systems so they can characterize outbreaks and respond to public health events in the region. PMID:24041192

Detection of Bartonella quintana in African body and head lice.

PubMed

Sangaré, Abdoul Karim; Boutellis, Amina; Drali, Rezak; Socolovschi, Cristina; Barker, Stephen C; Diatta, Georges; Rogier, Christophe; Olive, Marie-Marie; Doumbo, Ogobara K; Raoult, Didier

2014-08-01

Currently, the body louse is the only recognized vector of Bartonella quintana, an organism that causes trench fever. In this work, we investigated the prevalence of this bacterium in human lice in different African countries. We tested 616 head lice and 424 body lice from nine African countries using real-time polymerase chain reaction targeting intergenic spacer region 2 and specific B. quintana genes. Overall, B. quintana DNA was found in 54% and 2% of body and head lice, respectively. Our results also show that there are more body lice positive for B. quintana in poor countries, which was determined by the gross domestic product, than in wealthy areas (228/403 versus 0/21, P < 0.001). A similar finding was obtained for head lice (8/226 versus 2/390, P = 0.007). Our findings suggest that head lice in Africa may be infected by B. quintana when patients live in poor economic conditions and are also exposed to body lice. © The American Society of Tropical Medicine and Hygiene.

What School for Africa in the Year 2000? Report of the Proceedings of the Pan-African Conference on Education (Yaounde, Cameroon, April 2-9, 1984).

ERIC Educational Resources Information Center

World Confederation of Organizations of the Teaching Profession, Morges (Switzerland).

The Pan-African Conference on Education was organized by the World Confederation of Organisations of the Teaching Profession, with the cooperation of UNESCO and many other groups. The conference invited representatives of teacher organizations and education ministries in both English- and French-speaking African countries. Of the 26 African…

Tobacco use and its determinants in HIV-infected patients on antiretroviral therapy in West African countries

PubMed Central

Jaquet, Antoine; Ekouevi, Didier-Koumavi; Aboubakrine, Maiga; Bashi, Jules; Messou, Eugène; Maiga, Moussa; Traore, Hamar-Alassane; Zannou, Marcel; Guehi, Calixte; Ba-Gomis, Franck-Olivier; Minga, Albert; Allou, Gérard; Eholie, Serge-Paul; Dabis, Francois; Bissagnene, Emmanuel; Sasco, Annie-Jeanne

2009-01-01

INTRODUCTION Tobacco smoking is common in HIV-infected patients from industrialized countries. In West Africa, few data exist concerning tobacco consumption. METHODS A cross-sectional survey was conducted within the International epidemiological Database to Evaluate AIDS (IeDEA) network in West Africa. Health workers administered to patients receiving antiretroviral treatment a questionnaire assessing tobacco and cannabis consumption. Regular smokers were defined as present smokers who smoked >1 cigarette per day for ≥1 year. RESULTS Overall, 2920 patients were enrolled in three countries. The prevalence of ever smokers and present smokers were 46.2% (95% CI 42.8–49.5) and 15.6% (95% CI 13.2–18.0) in men and 3.7% (95% CI 2.9–4.5) and 0.6% (95% CI 0.3–0.9) in women, respectively. Regular smoking was associated being from Côte d’Ivoire or Mali compared to Benin (OR 4.6; 95% CI 2.9–7.3 and 7.7; 95% CI 4.4–13.6), a severely impaired immunological status at HAART initiation (OR 1.5; 95% CI 1.1–2.2) and a history of tuberculosis (OR 1.8; 95% CI 1.1–3.0). CONCLUSION Marked differences of smoking prevalence exist between these West African countries. This survey approach also provides evidences concerning the association between cigarette smoking and tuberculosis in HIV-infected patients, a major public health issue in this part of the world. PMID:19861019

Experiences in Tick Control by Acaricide in the Traditional Cattle Sector in Zambia and Burkina Faso: Possible Environmental and Public Health Implications.

PubMed

De Meneghi, Daniele; Stachurski, Frédéric; Adakal, Hassane

2016-01-01

Livestock, especially cattle, play a paramount role in agriculture production systems, particularly in poor countries throughout the world. Ticks and tick-borne diseases (TBDs) have an important impact on livestock and agriculture production in sub-Saharan Africa. The authors review the most common methods used for the control of ticks and TBDs. Special emphasis is given to the direct application of acaricides to the host animals. The possible environmental and public health adverse effects (i.e., risks for the workers, residues in the environment and in food products of animal origin) are mentioned. The authors present two case studies, describing different field experiences in controlling ticks in two African countries. In Zambia (Southern Africa), a strategic dipping regime was used to control Rhipicephalus appendiculatus ticks, vectors of theileriosis, a deadly disease affecting cattle in the traditional livestock sector in Southern Province. The dipping regime adopted allowed to reduce the tick challenge and cattle mortally rate and, at the same time, to employ less acaricide as compared to the intensive dipping used so far, without disrupting the building-up of enzootic stability. In Burkina Faso (West Africa), where dipping was never used for tick control, an acaricide footbath was employed as an alternative method to the traditional technique used locally (portable manual sprayers). This was developed from field observations on the invasion/attachment process of the Amblyomma variegatum ticks - vector of cowdriosis - on the animal hosts, leading to a control method aimed to kill ticks temporarily attached to the interdigital areas before their permanent attachment to the predilection sites. This innovative method has been overall accepted by the local farmers. It has the advantage of greatly reducing costs of treatments and has a minimal environmental impact, making footbath a sustainable and replicable method, adoptable also in other West African countries. Although the two methods described, developed in very different contexts, are not comparable - if public health and environmental implications are taken into account, if a balance among efficacy of the control method(s), cost-effectiveness and sustainability is reached - a way forward for the implementation of a One Health strategy can be set.

Health financing in the African Region: 2000-2009 data analysis.

PubMed

Sambo, Luis Gomes; Kirigia, Joses Muthuri; Orem, Juliet Nabyonga

2013-03-06

In order to raise African countries probability of achieving the United Nations Millennium Development Goals by 2015, there is need to increase and more efficiently use domestic and external funding to strengthen health systems infrastructure in order to ensure universal access to quality health care. The objective of this paper is to examine the changes that have occurred in African countries on health financing, taking into account the main sources of funding over the period 2000 to 2009. Our analysis is based on the National Health Accounts (NHA) data for the 46 countries of the WHO African Region. The data were obtained from the WHO World Health Statistics Report 2012. Data for Zimbabwe was not available. The analysis was done using Excel software. Between 2000 and 2009, number of countries spending less than 5% of their GDP on health decreased from 24 to 17; government spending on health as a percentage of total health expenditure increased in 31 countries and decreased in 13 countries; number of countries allocating at least 15% of national budgets on health increased from 2 to 4; number of countries partially financing health through social security increased from 19 to 21; number of countries where private spending was 50% and above of total health expenditure decreased from 29 (64%) to 23 (51%); over 70% of private expenditure on health came from household out-of-pocket payments (OOPS) in 32 (71%) countries and in 27 (60%) countries; number of countries with private prepaid plans increased from 29 to 31; number of countries financing more than 20% of their total health expenditure from external sources increased from 14 to 19; number of countries achieving the Commission for Macroeconomics and Health recommendation of spending at least US$34 per person per year increased from 11 to 29; number of countries achieving the International Taskforce on Innovative Financing recommendation of spending at least US$44 per person per year increased from 11 to 24; average per capita total expenditure on health increased from US$35 to US$82; and average per capita government expenditure on health grew from US$ 15 to US$ 41. Whilst the African Region (AFR) average government expenditure on health as a per cent of THE increased by 5.4 per cent, the average private health expenditure decreased by the same percentage between 2000 and 2009. The regional average OOPS as a per cent of private expenditure on health increased by 4.9 per cent. The average external resources for health as a percentage of THE increased by 3.7 per cent. Even though on average the quantity of health funds have increased, we cannot judge from the current study the extent to which financial risk protection, equity and efficiency has progressed or regressed.In 2009 OOPS made up over 20% of total expenditure on health in 34 countries. Evidence shows that where OOPS as a percentage of total health expenditure is less than 20%, the risk of catastrophic expenditure is negligible. Therefore, there is urgent need for countries to develop health policies that address inequities and health financing models that optimize the use of health resources and strengthen health infrastructure. Increased coverage of prepaid health-financing mechanisms would reduce over-reliance on potentially catastrophic and impoverishing out-of-pocket payments.

China's health assistance to Africa: opportunism or altruism?

PubMed

Lin, Shuang; Gao, Liangmin; Reyes, Melissa; Cheng, Feng; Kaufman, Joan; El-Sadr, Wafaa M

2016-12-03

China has made substantial health commitments to Africa in the past several decades. However, while much has been written regarding China-Africa aid overall, relatively little attention has been given to China's health aid. To better understand these investments, we provide an overview of the current framework and characteristics of China's health aid to Africa. China's health assistance has been perceived by some as opportunistic, largely as a demonstration of China's engagement in "soft power" and an attempt to enhance its access to natural resources and political favors by African countries. Others have attributed altruistic intent, aiming to support the advancement of the health of populations in the African continent with a "no strings attached" approach. Our overview demonstrated that despite the magnitude of China's health assistance, many questions remain regarding the scope of this aid, its effectiveness and the governance mechanisms that guide the conceptualization and implementation of such efforts. We also identified the need for a systematic and rigorous evaluation of the various elements of China's health assistance to African countries in order to gain a deeper understanding of how priorities and allocations for health aid are determined, how such aid fits within the specific African country's health strategies and to assess the effectiveness of such aid. Insights garnered through such an assessment could help determine future priorities for investment as well as inform efforts to optimize the value of China's aid for the populations of the recipient countries.

Early smoking initiation and associated factors among in-school male and female adolescents in seven African countries.

PubMed

Peltzer, K

2011-09-01

This report examines the prevalence and common correlates of early smoking initiation among male and female school children across seven African countries. The total sample included 17,725 school children aged 13 to 15 years from nationally representative samples in seven African countries. Univariate and multivariate analyses were conducted to assess the relationship between early smoking initiation, health compromising behaviours, mental distress, protective factors and socio-economic status variables. Overall 15.5% had experienced smoking initiation before age 14, with the percentages 20.1% among boys and 10.9% among girls. In multivariable analysis, early smoking initiation was among boys associated with ever drunk from alcohol use (OR = 4.73, p = 0.001), ever used drugs (OR = 2.36, p = 0.04) and ever had sex (OR = 1.63, p = 0.04). Among girls, it was associated with higher education (OR = 5.77, p = 0.001), ever drunk from alcohol use (OR = 4.76, p = 0.002), parental or guardian tobacco use (OR = 2.83, p = 0.001) and suicide ideation (OR = 2.05, p = 0.02). The study found a high prevalence of early smoking initiation among 13-15 year-olds in seven African countries. Various risk factors have been identified in boys and girls who initiate smoking before age 14, forming a distinct risk group in this setting. Specific interventions are needed for boys and girls in the preteen years, before smoking initiation.

Evaluation of Antimicrobial Susceptibility of Enterobacteriaceae Causing Urinary Tract Infections in Africa

PubMed Central

Tansarli, Giannoula S.; Athanasiou, Stavros

2013-01-01

Our objective was to evaluate the antimicrobial susceptibility of Enterobacteriaceae causing urinary tract infections (UTIs) in adults in Africa. The PubMed database was systematically searched to identify relevant studies published after 2000. Google, World Health Organization, and African Field Epidemiology networks were also searched. Twenty-eight studies, accounting for 381,899 urine isolates from 14 African countries, met the inclusion criteria. Escherichia coli, Klebsiella spp., and Proteus spp. were the most commonly encountered uropathogens. Cefotaxime, imipenem, fosfomycin, and ciprofloxacin were the antibiotics with the highest activity against E. coli isolates from outpatients, with susceptibility being 92 to 99, 100, 100, and 68 to 91%, respectively. The susceptibility among Klebsiella spp. isolates from outpatients varied from 80 to 100% for amikacin and from 53 to 100% for ciprofloxacin, while susceptibility was 74 to 78, 97, and 77% for ciprofloxacin, amikacin, and fosfomycin, respectively, among Klebsiella species isolates from inpatients or patients with hospital-acquired UTIs. With regard to Proteus spp., the highest activity was observed among fluoroquinolones; 71 to 100% of the P. mirabilis isolates were susceptible to ciprofloxacin in four studies, and 74 to 100% of the P. vulgaris isolates were susceptible to ofloxacin in two studies. The currently available evidence suggests that the antimicrobial susceptibility patterns of Enterobacteriaceae uropathogens in African countries were similar to those in countries of southeast Europe. Further original studies are warranted from African countries for which there is limited published data. PMID:23689709

Assessment of an undergraduate psychiatry course in an African setting.

PubMed

Baig, Benjamin J; Beaglehole, Anna; Stewart, Robert C; Boeing, Leonie; Blackwood, Douglas H; Leuvennink, Johan; Kauye, Felix

2008-04-22

International reports recommend the improvement in the amount and quality of training for mental health workers in low and middle income countries. The Scotland-Malawi Mental Health Education Project (SMMHEP) has been established to support the teaching of psychiatry to medical students in the University of Malawi. While anecdotally supportive medical educational initiatives appear of value, little quantitative evidence exists to demonstrate whether such initiatives can deliver comparable educational standards. This study aimed to assess the effectiveness of an undergraduate psychiatry course given by UK psychiatrists in Malawi by studying University of Malawi and Edinburgh University medical students' performance on an MCQ examination paper. An undergraduate psychiatry course followed by an MCQ exam was delivered by the SMMHEP to 57 Malawi medical students. This same MCQ exam was given to 71 Edinburgh University medical students who subsequently sat their own Edinburgh University examination. There were no significant differences between Edinburgh students' performance on the Malawi exam and their own Edinburgh University exam. (p = 0.65). This would suggest that the Malawi exam is a comparable standard to the Edinburgh exam. Malawi students marks ranged from 52.4%-84.6%. Importantly 84.4% of Malawi students scored above 60% on their exam which would equate to a hypothetical pass by UK university standards. The support of an undergraduate course in an African setting by high income country specialists can attain a high percentage pass rate by UK standards. Although didactic teaching has been surpassed by more novel educational methods, in resource poor countries it remains an effective and cost effective method of gaining an important educational standard.

Impact of immigration on HIV-1 molecular epidemiology in West Africa, Maghreb and Southern Europe.

PubMed

Miri, Lamia; Wakrim, Lahcen; Kassar, Hassène; Hemminki, Kari; Khyatti, Meriem

2014-01-01

There is global concern about the relation between international migration and the course of the AIDS epidemic. Maghreb is a North African region, which lies between sub-Saharan Africa and Europe. It has been turned recently into a region of immigration, since there are more and more flows of West African migrants hoping to reach European countries. Here we provide an overview on HIV-1 molecular epidemiology particularly in West African countries, Maghreb (Morocco, Algeria, Tunisia) and southern European countries (Spain, France, and Italy). The studies conducted in several countries of the region revealed different features of HIV-1 molecular epidemiology, especially for the distribution of viral subtypes and for transmitted drug resistance profiles. Furthermore, migration from West Africa to Europe seems to be a potential source of non-B subtype mobility to Maghreb and eventually to southern Europe, where HIV-1 non-B variants significantly increased in the last 10 to 15 years. As genetic differences between subtypes might impact the drug resistance pathways, it is important to provide continuous surveillance programs for the early detection of new variants spreading in the population before they become more prevalent, and to identify resistance profiles in different infected populations, especially migrants.

[People of African descent in the region of the Americas and health equity].

PubMed

Torres, Cristina

2002-01-01

The Region of the Americas and the Caribbean has a complex demographic profile from an ethnic and racial perspective. One of the largest groups is composed of persons of African descent, who in some countries, such as Brazil and the Dominican Republic, comprise 46 and 84% of the total population, respectively. Recent analyses of the statistics available in some countries of the Region show wide gaps in terms of living conditions and health in these communities, as well as gaps in access to health services. PAHO, through its Public Policy and Health Program, under the Division of Health and Human Development, supports sectorial efforts and those of civil organizations that aim to improve health conditions in this segment of the population, while taking into account their sociodemographic and cultural characteristics. This article briefly summarizes health conditions and access to health services in selected countries, as well as some aspects of the recent changes to the legislation in those countries. Finally, collaborative activities on the part of United Nations agencies and international financial institutions for the benefit of people of African descent and other ethnic minorities are described.

Not in wilderness: African vulture strongholds remain in areas with high human density

PubMed Central

Granadeiro, José Pedro; Monteiro, Hamilton; Nuno, Ana; Lecoq, Miguel; Cardoso, Paulo; Regalla, Aissa; Catry, Paulo

2018-01-01

Vultures constitute an important functional group in many ecosystems, providing crucial ecosystem services both in natural and humanized environments. These scavengers are facing massive declines worldwide, but in several African countries virtually nothing is known on populations’ status and threats, hampering the development of adequate conservation strategies. In Guinea-Bissau, globally important populations of Hooded Necrosyrtes monachus and African white-backed vultures Gyps africanus were recently reported. Using the country as a study area, we aim to characterize human-vulture interactions in West Africa applying a multidisciplinary approach. We assessed the status and distribution of vulture populations using data from 1711 km of roadside transects, examined predictors of their distribution, and produced a nationwide population estimate for the Hooded Vulture, using an innovative method based on the relationship between the size of human population in settlements and vulture numbers. We conducted 47 stakeholder interviews to assess perceived roles played by vultures, and to investigate potential anthropogenic threats. Hooded vultures were strongly associated with high human population densities, whereas no relation was found between African white-backed and Rüppell’s vultures and any of the tested predictors, which included cattle density, precipitation and Normalized Difference Vegetation Index, among others. We estimate a national population of 43347 Hooded vultures, the largest population reported in the species range. Respondents were generally aware of the services provided by vultures, especially waste and carcass removal, including in urban areas. Hunting for witchcraft and traditional medicine was the most frequently recognised threat, while poisoning was ranked as having the highest impact. We hypothesise that poisoning-related mortality may be affecting African white-backed and Rüppell’s vultures’ distribution and explain their scarcity in apparently highly suitable habitats. Our results suggest a mutualistic rather than a commensalistic relationship between vultures and humans, with important implications for designing and implementing conservation strategies. PMID:29385172

Not in wilderness: African vulture strongholds remain in areas with high human density.

PubMed

Henriques, Mohamed; Granadeiro, José Pedro; Monteiro, Hamilton; Nuno, Ana; Lecoq, Miguel; Cardoso, Paulo; Regalla, Aissa; Catry, Paulo

2018-01-01

Vultures constitute an important functional group in many ecosystems, providing crucial ecosystem services both in natural and humanized environments. These scavengers are facing massive declines worldwide, but in several African countries virtually nothing is known on populations' status and threats, hampering the development of adequate conservation strategies. In Guinea-Bissau, globally important populations of Hooded Necrosyrtes monachus and African white-backed vultures Gyps africanus were recently reported. Using the country as a study area, we aim to characterize human-vulture interactions in West Africa applying a multidisciplinary approach. We assessed the status and distribution of vulture populations using data from 1711 km of roadside transects, examined predictors of their distribution, and produced a nationwide population estimate for the Hooded Vulture, using an innovative method based on the relationship between the size of human population in settlements and vulture numbers. We conducted 47 stakeholder interviews to assess perceived roles played by vultures, and to investigate potential anthropogenic threats. Hooded vultures were strongly associated with high human population densities, whereas no relation was found between African white-backed and Rüppell's vultures and any of the tested predictors, which included cattle density, precipitation and Normalized Difference Vegetation Index, among others. We estimate a national population of 43347 Hooded vultures, the largest population reported in the species range. Respondents were generally aware of the services provided by vultures, especially waste and carcass removal, including in urban areas. Hunting for witchcraft and traditional medicine was the most frequently recognised threat, while poisoning was ranked as having the highest impact. We hypothesise that poisoning-related mortality may be affecting African white-backed and Rüppell's vultures' distribution and explain their scarcity in apparently highly suitable habitats. Our results suggest a mutualistic rather than a commensalistic relationship between vultures and humans, with important implications for designing and implementing conservation strategies.

Reliability and Validity of Instruments for Assessing Perinatal Depression in African Settings: Systematic Review and Meta-Analysis

PubMed Central

Tsai, Alexander C.; Scott, Jennifer A.; Hung, Kristin J.; Zhu, Jennifer Q.; Matthews, Lynn T.; Psaros, Christina; Tomlinson, Mark

2013-01-01

Background A major barrier to improving perinatal mental health in Africa is the lack of locally validated tools for identifying probable cases of perinatal depression or for measuring changes in depression symptom severity. We systematically reviewed the evidence on the reliability and validity of instruments to assess perinatal depression in African settings. Methods and Findings Of 1,027 records identified through searching 7 electronic databases, we reviewed 126 full-text reports. We included 25 unique studies, which were disseminated in 26 journal articles and 1 doctoral dissertation. These enrolled 12,544 women living in nine different North and sub-Saharan African countries. Only three studies (12%) used instruments developed specifically for use in a given cultural setting. Most studies provided evidence of criterion-related validity (20 [80%]) or reliability (15 [60%]), while fewer studies provided evidence of construct validity, content validity, or internal structure. The Edinburgh postnatal depression scale (EPDS), assessed in 16 studies (64%), was the most frequently used instrument in our sample. Ten studies estimated the internal consistency of the EPDS (median estimated coefficient alpha, 0.84; interquartile range, 0.71-0.87). For the 14 studies that estimated sensitivity and specificity for the EPDS, we constructed 2 x 2 tables for each cut-off score. Using a bivariate random-effects model, we estimated a pooled sensitivity of 0.94 (95% confidence interval [CI], 0.68-0.99) and a pooled specificity of 0.77 (95% CI, 0.59-0.88) at a cut-off score of ≥9, with higher cut-off scores yielding greater specificity at the cost of lower sensitivity. Conclusions The EPDS can reliably and validly measure perinatal depression symptom severity or screen for probable postnatal depression in African countries, but more validation studies on other instruments are needed. In addition, more qualitative research is needed to adequately characterize local understandings of perinatal depression-like syndromes in different African contexts. PMID:24340036

Correlation between national income, HIV/AIDS and political status and mortalities in African countries.

PubMed

Andoh, S Y; Umezaki, M; Nakamura, K; Kizuki, M; Takano, T

2006-07-01

To investigate associations between mortalities in African countries and problems that emerged in Africa in the 1990s (reduction of national income, HIV/AIDS and political instability) by adjusting for the influences of development, sanitation and education. We compiled country-level indicators of mortalities, national net income (the reduction of national income by the debt), infection rate of HIV/AIDS, political instability, demography, education, sanitation and infrastructure, from 1990 to 2000 of all African countries (n=53). To extract major factors from indicators of the latter four categories, we carried out principal component analysis. We used multiple regression analysis to examine the associations between mortality indicators and national net income per capita, infection rate of HIV/AIDS, and political instability by adjusting the influence of other possible mortality determinants. Mean of infant mortality per 1000 live births (IMR); maternal mortality per 100,000 live birth (MMR); adult female mortality per 1000 population (AMRF); adult male mortality per 1000 population (AMRM); and life expectancy at birth (LE) in 2000 were 83, 733, 381, 435, and 51, respectively. Three factors were identified as major influences on development: education, sanitation and infrastructure. National net income per capita showed independent negative associations with MMR and AMRF, and a positive association with LE. Infection rate of HIV/AIDS was independently positively associated with AMRM and AMRF, and negatively associated with LE in 2000. Political instability score was independently positively associated with MMR. National net income per capita, HIV/AIDS and political status were predictors of mortality indicators in African countries. This study provided evidence for supporting health policies that take economic and political stability into account.

Science and ethics of human immunodeficiency virus/acquired immunodeficiency syndrome controversies in Africa.

PubMed

Brewster, David

2011-09-01

The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic in Africa has raised important ethical issues for both researchers and clinicians. The most notorious controversy has been related to the zidovudine (AZT) trials in Africa in the late 1990s, in which the control groups were given a placebo rather than an effective drug to prevent vertical transmission. This raised concerns in the sponsoring country about exploitation of subjects, injustice and an ethical double standard between donor countries and resource-poor settings. However, the real double standard is between clinical practice standards in Western versus African countries, which must be addressed as part of the increasing global inequity of wealth both between countries and also within countries. There are important limitations to ethical declarations, principles and guidelines on their own without contextual ethical reasoning. The focus on research ethics with the HIV epidemic has led to a relative neglect of ethical issues in clinical practice. Although the scientific advances in HIV/AIDS have changed the ethical issues since the 1990s, there has also been progress in the bioethics of HIV/AIDS in terms of ethical review capability by local committees as well as in exposure to ethical issues by clinicians and researchers in Africa. However, serious concerns remain about the overregulation of research by bureaucratic agencies which could discourage African research on specifically African health issues. There is also a need for African academic institutions and researchers to progressively improve their research capacity with the assistance of research funders and donor agencies. © 2011 The Author. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Health financing in Africa: overview of a dialogue among high level policy makers

PubMed Central

2011-01-01

Background Even though Africa has the highest disease burden compared with other regions, it has the lowest per capita spending on health. In 2007, 27 (51%) out the 53 countries spent less than US$50 per person on health. Almost 30% of the total health expenditure came from governments, 50% from private sources (of which 71% was from out-of-pocket payments by households) and 20% from donors. The purpose of this article is to reflect on the proceedings of the African Union Side Event on Health Financing in the African continent. Methods Methods employed in the session included presentations, panel discussion and open public discussion with ministers of health and finance from the African continent. Discussion The current unsatisfactory state of health financing was attributed to lack of clear vision and plan for health financing; lack of national health accounts and other evidence to guide development and implementation of national health financing policies and strategies; low investments in sectors that address social determinants of health; predominance of out-of-pocket spending; underdeveloped prepaid health financing mechanisms; large informal sectors vis-à-vis small formal sectors; and unpredictability and non-alignment of majority of donor funds with national health priorities. Countries need to develop and adopt a comprehensive national health policy and a costed strategic plan; a comprehensive evidence-based health financing strategy; allocate at least 15% of the national budget to health development; use GFATM and PEPFAR funds for health systems strengthening; strengthen intersectoral collaboration to address health determinants; advocate among donors to implement the Paris Declaration on Aid Effectiveness and its Accra Agenda for Action; ensure universal access to health services for pregnant women, lactating mothers and children aged under five years; strengthen financial management capacities; and develop prepaid health financing systems, especially health insurance to complement tax funding. In addition, countries need to institutionalize national health accounts; undertake feasibility studies of various health financing mechanisms; and document and share best practices in health financing. Conclusion There was consensus that every country ought to have an evidence-based comprehensive health financing strategy with a road map for attaining universal health service coverage vision; and increase physical and financial access by pregnant women, lactating mothers and by children under five years to quality health services. PMID:21810212

E-health: determinants, opportunities, challenges and the way forward for countries in the WHO African Region.

PubMed

Kirigia, Joses M; Seddoh, Anthony; Gatwiri, Doris; Muthuri, Lenity H K; Seddoh, Janet

2005-12-20

The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income countries in the Region. By focusing on the adoption of specific technologies we attempted to interpret correlates in terms of relationships instead of absolute "causals". In order to improve access to health care, especially for the majority of Africans living in remote rural areas, there is need to boost the availability and utilization of e-health services. Thus, universal access to e-health ought to be a vision for all countries in the African Region. Each country ought to develop a road map in a strategic e-health plan that will, over time, enable its citizens to realize that vision.

The African Crane Database (1978-2014): Records of three threatened crane species (Family: Gruidae) from southern and eastern Africa

PubMed Central

Smith, Tanya; Page-Nicholson, Samantha; Gibbons, Bradley; Jones, M. Genevieve W.; van Niekerk, Mark; Botha, Bronwyn; Oliver, Kirsten; McCann, Kevin

2016-01-01

Abstract Background The International Crane Foundation (ICF) / Endangered Wildlife Trust’s (EWT) African Crane Conservation Programme has recorded 26 403 crane sightings in its database from 1978 to 2014. This sightings collection is currently ongoing and records are continuously added to the database by the EWT field staff, ICF/EWT Partnership staff, various partner organizations and private individuals. The dataset has two peak collection periods: 1994-1996 and 2008-2012. The dataset collection spans five African countries: Kenya, Rwanda, South Africa, Uganda and Zambia; 98% of the data were collected in South Africa. Georeferencing of the dataset was verified before publication of the data. The dataset contains data on three African crane species: Blue Crane Anthropoides paradiseus, Grey Crowned Crane Balearica regulorum and Wattled Crane Bugeranus carunculatus. The Blue and Wattled Cranes are classified by the IUCN Red List of Threatened Species as Vulnerable and the Grey Crowned Crane as Endangered. New information This is the single most comprehensive dataset published on African Crane species that adds new information about the distribution of these three threatened species. We hope this will further aid conservation authorities to monitor and protect these species. The dataset continues to grow and especially to expand in geographic coverage into new countries in Africa and new sites within countries. The dataset can be freely accessed through the Global Biodiversity Information Facility data portal. PMID:27956850

WHO still reeling from racism charges.

PubMed

1995-06-01

The World Health Organization (WHO) is not as prestigious as it used to be. It operates on a relatively small annual budget of $1.8 billion, the WHO 1995 audit suggested irregularities in the way contracts were awarded and criticized a lack of control over funds at the WHO's African headquarters in the Congo, and its director, Hiroshi Nakajima, has been accused of being a racist against Africans. Nakajima complained during a January 1995 WHO board meeting that some African members had poor English skills. Delegates from several African nations to the annual World Health Assembly, which began in Geneva on May 1, subsequently raised the issue and called for the Japanese director to resign. The release of the recent WHO health report, "Bridging the Gaps," was an attempt by the organization to regain some its international respect, but little new was reported. Basic messages were that poverty is the most important cause of ill health, 60% of all new HIV infections occur among people aged 15-24 in many countries, 50% of people with HIV globally are younger than 25 years old, 60% of infections in women occur by age 20, and life expectancy is increasing in all countries except Cote d'Ivoire, Central African Republic, Congo, Uganda, and Zambia, all countries hard-hit by HIV/AIDS. For now, Nakajima has retained his position, although British and US donors stress that they will keep closer watch over the organization and that reforms must be made.

Trial of labour and vaginal birth after previous caesarean section: A population based study of Eastern African immigrants in Victoria, Australia.

PubMed

Belihu, Fetene B; Small, Rhonda; Davey, Mary-Ann

2017-03-01

Variations in caesarean section (CS) between some immigrant groups and receiving country populations have been widely reported. Often, African immigrant women are at higher risk of CS than the receiving population in developed countries. However, evidence about subsequent mode of birth following CS for African women post-migration is lacking. The objective of this study was to examine differences in attempted and successful vaginal birth after previous caesarean (VBAC) for Eastern African immigrants (Eritrea, Ethiopia, Somalia and Sudan) compared with Australian-born women. A population-based observational study was conducted using the Victorian Perinatal Data Collection. Pearson's chi-square test and logistic regression analysis were performed to generate adjusted odds ratios for attempted and successful VBAC. Victoria, Australia. 554 Eastern African immigrants and 24,587 Australian-born eligible women with previous CS having singleton births in public care. 41.5% of Eastern African immigrant women and 26.1% Australian-born women attempted a VBAC with 50.9% of Eastern African immigrants and 60.5% of Australian-born women being successful. After adjusting for maternal demographic characteristics and available clinical confounding factors, Eastern African immigrants were more likely to attempt (OR adj 1.94, 95% CI 1.57-2.47) but less likely to succeed (OR adj 0.54 95% CI 0.41-0.71) in having a VBAC. There are disparities in attempted and successful VBAC between Eastern African origin and Australian-born women. Unsuccessful VBAC attempt is more common among Eastern African immigrants, suggesting the need for improved strategies to select and support potential candidates for vaginal birth among these immigrants to enhance success and reduce potential complications associated with failed VBAC attempt. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Scope and geographical distribution of African medical journals active in 2005.

PubMed

Siegfried, Nandi; Busgeeth, Karishma; Certain, Edith

2006-06-01

To identify all African medical journals actively publishing in 2005, and to create a geodatabase of these to evaluate and monitor future journal activity. A search was done for relevant African medical journals on electronic databases, library catalogues and internet sites, and a list was compiled of active journals. A survey was conducted via questionnaire of editors of all listed African medical journals defined as having an editorial base on the continent. One hundred and fifty-eight African medical journals were identified, published in 33 countries. One hundred and fifty-three editors were surveyed via email, post and/or fax. There was a 39% response rate from editors based in 17 countries. Fifty-one journals were published in English, 7 in French and 1 in Portuguese. Most journals were owned by an association or a society and were funded from a combination of sources. Journals covered general medical and specialist medical interest equally. Most (41 of 59 journals) had a circulation below 1 000, and most (52/59) published 4 or fewer issues a year. Almost all the journals included original research, and articles were peer reviewed. Few were indexed on Medline (N = 18) and EMBASE (N = 10). Plotting journal location using Geographic Information Systems (GIS) software provided a snapshot view of current journal activity. This study is likely to represent the most comprehensive list of current African medical journals. It confirms growth in African health care research and journal activity on the continent. Limited inclusion in international databases and accessibility to African researchers remain challenges in achieving publication of high-quality African research in high-quality African journals.

Imported malaria among African immigrants: is there still a relationship between developed countries and their ex-colonies?

PubMed Central

Millet, Juan Pablo; de Olalla, Patricia Garcia; Gascón, Joaquim; Prat, Jordi Gómez i; Treviño, Begoña; Pinazo, M Jesús; Cabezos, Juan; Muñoz, José; Zarzuela, Francesc; Caylà, Joan A

2009-01-01

Background The objective of this study was to compare cases of imported malaria originating from the Spanish ex-colony of Equatorial Guinea (EG) with those originating from the rest of Africa (RA). Methods All the African cases detected in Barcelona between 1989 and 2007 were investigated in a retrospective analysis. Clinical-epidemiological variables such as sex, age, visiting friends and relatives (VFR), species, hospital admission and chemo-prophylaxis were compared. Data were analysed by logistic regression, calculating the Odds Ratio (OR) and 95% Confidence Intervals (95% CI). Results Of the 489 African patients, 279 (57,1%) had been born in EG and 210 (42,9%) in the rest of Africa. The cumulative incidence of imported malaria among those from EG was 179.6 per thousand inhabitants, while in those from the RA it was 33.7 per thousand (p < 0.001). Compliance with chemoprophylaxis (CP) was very low, but there were no differences between the two groups. Comparing those from EG to those from RA, the former were characterized by having more patients in the visiting friends and relatives (VFR) category, and more individuals younger than 15 years or older than 37 years, and more women. They also visited a traveller's health centre more often, had fewer hospital admissions and were less likely to reside in the inner city. Conclusion Cases of imported malaria originating in Africa, are more likely to come from the Spanish ex-colony of EG, and VFR are more likely to be affected. It is recommended that developed countries promote prevention programmes, such as CP advice directed at African immigrants, and develop programmes of cooperation against malaria in their ex-colonies. PMID:19463171

Pilot study of quality of care training and knowledge in Sub-Saharan African medical schools

PubMed Central

Abbas, Yasmin; Odunleye, Temitope; Broughton, Edward; Bossert, Thomas

2017-01-01

Objectives To identify the level of knowledge and competencies related to quality of care during medical education in sub-Saharan African medical schools.  Methods A cross-sectional study design was utilized to examine the capacity of medical schools in sub-Saharan African (SSA) countries to teach about the concepts of quality of care and the inclusion of these concepts in their curriculum. A purposeful convenience sampling technique was used to select participants from 25 medical schools in 5 sub-Saharan African countries. Respondents included medical school deans or senior academic personnel.  A survey was developed using the Institute of Medicine’s definition of quality of care as the guiding framework.  Sample means and summary statistics were used to present the results of the survey responses. Results While 45% of the schools surveyed are teaching on at least one of the six domains of the Institute of Medicine’s definition of quality of care, there are some schools who report not teaching about quality at all, or that they “do not know”. Despite these low numbers, when asked about topics related to quality of care, many schools are teaching applied management related topics and almost all schools teach about equity and patient-centered care. Conclusions The results have important impacts both for incorporating quality of care into medical education and for practitioners.  The tool developed for this study can be used in future qualitative and quantitative studies to further understanding of how to improve the teaching and learning about quality of care in medical schools. Keywords: quality of care, medical schools, sub-Saharan Africa, medical errors, healthcare improvement PMID:28753130

Introduction of African swine fever into the European Union through illegal importation of pork and pork products.

PubMed

Costard, Solenne; Jones, Bryony Anne; Martínez-López, Beatriz; Mur, Lina; de la Torre, Ana; Martínez, Marta; Sánchez-Vizcaíno, Fernando; Sánchez-Vizcaíno, Jose-Manuel; Pfeiffer, Dirk Udo; Wieland, Barbara

2013-01-01

Transboundary animal diseases can have very severe socio-economic impacts when introduced into new regions. The history of disease incursions into the European Union suggests that initial outbreaks were often initiated by illegal importation of meat and derived products. The European Union would benefit from decision-support tools to evaluate the risk of disease introduction caused by illegal imports in order to inform its surveillance strategy. However, due to the difficulty in quantifying illegal movements of animal products, very few studies of this type have been conducted. Using African swine fever as an example, this work presents a novel risk assessment framework for disease introduction into the European Union through illegal importation of meat and products. It uses a semi-quantitative approach based on factors that likely influence the likelihood of release of contaminated smuggled meat and products, and subsequent exposure of the susceptible population. The results suggest that the European Union is at non-negligible risk of African swine fever introduction through illegal importation of pork and products. On a relative risk scale with six categories from negligible to very high, five European Union countries were estimated at high (France, Germany, Italy and United Kingdom) or moderate (Spain) risk of African swine fever release, five countries were at high risk of exposure if African swine fever were released (France, Italy, Poland, Romania and Spain) and ten countries had a moderate exposure risk (Austria, Bulgaria, Germany, Greece, Hungary, Latvia, Lithuania, Portugal, Sweden and United Kingdom). The approach presented here and results obtained for African swine fever provide a basis for the enhancement of risk-based surveillance systems and disease prevention programmes in the European Union.

U-Pb dating and isotopic signature of the alkaline ring complexes of Bou Naga (Mauritania): its bearing on late proterozoic plate tectonics around the West African craton

NASA Astrophysics Data System (ADS)

Blanc, A.; Bernard-Griffiths, J.; Caby, R.; Caruba, C.; Caruba, R.; Dars, R.; Fourcade, S.; Peucat, J. J.

1992-04-01

In the West African fold belt of Mauritania, high-grade metamorphic series, similar to those of Amsaga (Reguibat shield-West African Craton), are exposed in a window. At Bou Naga-Mauritania (19° N, 13° 15' W) in the South of this window, an alkaline ring complex has intruded the metamorphic country rocks. This complex consists of two geological formations: the Eastern formation is mainly composed of red rhyolite sills, whereas the Western formation is made up of several kinds of alkaline rocks both saturated and under-saturated which cross cut the earlier saturated units. Three U-Pb zircon age measurements have been made on the alkaline complex, and one on an orthogneiss from the metamorphic country rocks. The syenite and the alkaline granite of the Western block are 676 ± 8 and 687 ± 5 Ma old. The orthogneiss is Archaean with an age of 2709 ± 136 Ma, but the lower intercept of discordia on concordia, shows an age of 756 ± 25 Ma linked with the genesis of the alkaline complex. A major crustal contribution is recorded by Nd and O isotopes in the SiO 2-saturated rocks. These results provide evidence for the correlation of the metamorphic country rocks with the Reguibat Archaean basement and for an early Pan-African continental rifting phase in this area before the tectonometamorphic events in the Mauritanide belt. Furthermore, with regards with previous geodynamic works of the West African Craton, our results leads us to suggest a significant diachronism between late Proterozoic crustal evolution to the West and to the East of the West African Craton. This is a further evidence for modern-type plate tectonics at this time.

An ICT-Based Diabetes Management System Tested for Health Care Delivery in the African Context.

PubMed

Takenga, Claude; Berndt, Rolf-Dietrich; Musongya, Olivier; Kitero, Joël; Katoke, Remi; Molo, Kakule; Kazingufu, Basile; Meni, Malikwisha; Vikandy, Mambo; Takenga, Henri

2014-01-01

The demand for new healthcare services is growing rapidly. Improving accessibility of the African population to diabetes care seems to be a big challenge in most countries where the number of care centers and medical staff is reduced. Information and communication technologies (ICT) have great potential to address some of these challenges faced by several countries in providing accessible, cost-effective, and high-quality health care services. This paper presents the Mobil Diab system which is a telemedical approach proposed for the management of long-term diseases. The system applies modern mobile and web technologies which overcome geographical barriers, and increase access to health care services. The idea of the system is to involve patients in the therapy process and motivate them for an active participation. For validation of the system in African context, a trial was conducted in the Democratic Republic of Congo. 40 Subjects with diabetes divided randomly into control and intervention groups were included in the test. Results show that Mobil Diab is suitable for African countries and presents a number of benefits for the population and public health care system. It improves clinical management and delivery of diabetes care services by enhancing access, quality, motivation, reassurance, efficiency, and cost-effectiveness.

Strengthening Renal Registries and ESRD Research in Africa.

PubMed

Davids, M Razeen; Caskey, Fergus J; Young, Taryn; Balbir Singh, Gillian K

2017-05-01

In Africa, the combination of noncommunicable diseases, infectious diseases, exposure to environmental toxins, and acute kidney injury related to trauma and childbirth are driving an epidemic of chronic kidney disease and end-stage renal disease (ESRD). Good registry data can inform the planning of renal services and can be used to argue for better resource allocation, audit the delivery and quality of care, and monitor the impact of interventions. Few African countries have established renal registries and most have failed owing to resource constraints. In this article we briefly review the burden of chronic kidney disease and ESRD in Africa, and then consider the research questions that could be addressed by renal registries. We describe examples of the impact of registry data and summarize the sparse primary literature on country-wide renal replacement therapy in African countries over the past 20 years. Finally, we highlight some initiatives and opportunities for strengthening research on ESRD and renal replacement therapy in Africa. These include the establishment of the African Renal Registry and the availability of new areas for research. We also discuss capacity building, collaboration, open-access publication, and the strengthening of local journals, all measures that may improve the quantity, visibility, and impact of African research outputs. Copyright © 2017 Elsevier Inc. All rights reserved.

An ICT-Based Diabetes Management System Tested for Health Care Delivery in the African Context

PubMed Central

Takenga, Claude; Berndt, Rolf-Dietrich; Musongya, Olivier; Kitero, Joël; Katoke, Remi; Molo, Kakule; Kazingufu, Basile; Meni, Malikwisha; Vikandy, Mambo; Takenga, Henri

2014-01-01

The demand for new healthcare services is growing rapidly. Improving accessibility of the African population to diabetes care seems to be a big challenge in most countries where the number of care centers and medical staff is reduced. Information and communication technologies (ICT) have great potential to address some of these challenges faced by several countries in providing accessible, cost-effective, and high-quality health care services. This paper presents the Mobil Diab system which is a telemedical approach proposed for the management of long-term diseases. The system applies modern mobile and web technologies which overcome geographical barriers, and increase access to health care services. The idea of the system is to involve patients in the therapy process and motivate them for an active participation. For validation of the system in African context, a trial was conducted in the Democratic Republic of Congo. 40 Subjects with diabetes divided randomly into control and intervention groups were included in the test. Results show that Mobil Diab is suitable for African countries and presents a number of benefits for the population and public health care system. It improves clinical management and delivery of diabetes care services by enhancing access, quality, motivation, reassurance, efficiency, and cost-effectiveness. PMID:25136358

There has been little progress in implementing comprehensive alcohol control strategies in Africa.

PubMed

Peer, Nasheeta

2017-11-01

Alcohol is the most common substance of addiction and a threat not only to health but also to sustainable human development. Consequently, at least a 10% relative reduction in the harmful use of alcohol has been advocated by the World Health Organization (WHO). This perspective describes alcohol use in Africa, strategies to reduce harmful alcohol use, and the ability of African countries to meet this target. Although alcohol consumption in Africa was intermediate compared to other world regions, the total alcohol per capita among alcohol consumers was the second highest (19.5 liters); 19% of Sub-Saharan African men could be classified as binge drinkers. The alcohol industry is the key driver behind the uptake of alcohol use and misuse. The most cost-effective ways to reduce alcohol-related harm is to make alcohol less available and more expensive and to prohibit alcohol advertising. Most African countries have alcohol excise taxes, but these are not adjusted for inflation, meaning that the effectiveness of these taxes will likely decrease with time, leading to greater affordability. The majority of African countries do not have legally binding regulations for alcohol marketing. Alcohol misuse in Africa is not being addressed at a time when available strategies can efficiently and cost-effectively control alcohol-related harm.

Global Rotavirus Vaccine Introductions and Coverage: 2006 - 2016.

PubMed

Abou-Nader, Alice; Sauer, Molly; Steele, A Duncan; Tate, Jacqueline E; Atherly, Deborah; Parashar, Umesh D; Santosham, Mathuram; Nelson, E Anthony S

2018-05-22

An estimated 215,000 children died of rotavirus infections in 2013, accounting for 37% of diarrhea-related deaths worldwide, 92% of which occurred in low and lower-middle income countries. Since 2009 the World Health Organization (WHO) recommends the use of rotavirus vaccines in all national immunization programs. This review compares rotavirus vaccine (RV) introductions and vaccine coverage by region, country income status and Gavi-eligibility from 2006-2016. Gross National Income data from the World Bank and surviving infant population from United Nations Population Division was obtained for 2016. Data from WHO were collected on rotavirus vaccine coverage, national immunization schedules, and new vaccine introductions for 2016 while estimated rotavirus deaths were collected for 2013, the last year of available WHO data. As of December 2016, the majority of countries (57%, 110/194) had not introduced universal rotavirus vaccine despite WHO's 2009 recommendation to do so. Countries in the WHO African region had the greatest proportion of introductions (37%, 31/84) by December 2016 and a great majority of these (77%, 24/31) were supported by new vaccine introduction (NVI) grants from Gavi. Almost half (48%) of global introductions were in low and lower-middle income Gavi-eligible and Gavi-graduating countries. Conversely, countries in the Southeast Asia WHO region and those not eligible for Gavi NVI support have been slow to introduce rotavirus vaccine. High-income countries, on average, had poorer rotavirus vaccine coverage compared to low and lower-middle income countries. The over-representation of African countries within the Gavi subset and high estimated rotavirus deaths in these African countries, likely explains why introduction efforts have been focused in this region. While much progress has been made with the integration and implementation of rotavirus vaccine into national immunization programs, 110 countries representing 69% of the global birth cohort had yet to introduce the vaccine by December 2016.

Tobacco Control and Tobacco Farming in African Countries

PubMed Central

Hu, Teh-wei; Lee, Anita H.

2015-01-01

During the past decade, tobacco leaf production has shifted from high-income countries to developing countries, particularly those in Africa. Most African governments promote tobacco farming as a way to alleviate poverty. The economic benefit of tobacco farming has been used by the tobacco industry to block tobacco control policies. The tobacco industry is active in promoting the alleged positive aspects of tobacco farming and in “protecting” farmers from what they portray as unfair tobacco control regulations that reduce demand. Tobacco farming has many negative consequences for the health and wellbeing of farmers, as well as for the environment and the long-term wellbeing of the country concerned.1-3 We provide an overview of tobacco farming issues in Africa. Encompassing multi-dimensional issues of economic development, there is far more to it than tobacco control questions. PMID:25428192

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

PubMed

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.

African swine fever virus eradication in Africa.

PubMed

Penrith, Mary-Louise; Vosloo, Wilna; Jori, Ferran; Bastos, Armanda D S

2013-04-01

African swine fever was reported in domestic pigs in 26 African countries during the period 2009-2011. The virus exists in an ancient sylvatic cycle between warthogs (Phacochoerus africanus) and argasid ticks of the Ornithodoros moubata complex in many of the countries reporting outbreaks and in two further countries in the region. Eradication of the virus from the countries in eastern and southern Africa where the classic sylvatic cycle occurs is clearly not an option. However, the virus has become endemic in domestic pigs in 20 countries and the great majority of outbreaks in recent decades, even in some countries where the sylvatic cycle occurs, have been associated with movement of infected pigs and pig meat. Pig production and marketing and ASF control in Africa have been examined in order to identify risk factors for the maintenance and spread of ASF. These include large pig populations, traditional free-range husbandry systems, lack of biosecurity in semi-intensive and intensive husbandry systems, lack of organisation in both pig production and pig marketing that results in lack of incentives for investment in pig farming, and ineffective management of ASF. Most of these factors are linked to poverty, yet pigs are recognised as a livestock species that can be used to improve livelihoods and contribute significantly to food security. The changes needed and how they might be implemented in order to reduce the risk of ASF to pig producers in Africa and to the rest of the world are explored. Copyright © 2012 Elsevier B.V. All rights reserved.

Contribution of polio eradication initiative to effective new vaccine introduction in Africa, 2010-2015.

PubMed

Carole Tevi-Benissan, Mable; Moturi, Edna; Anya, Blanche-Philomene Melanga; Aschalew, Teka; Dicky, Akanmori Barthlomew; Nyembo, Poy Alain; Mbulu, Leon Kinuam; Okeibunor, Joseph; Mihigo, Richard; Zawaira, Felicitas

2016-10-10

Significant progress has been made to increase access to vaccines in Africa since the 1974 launch of the Expanded Programme on Immunization (EPI). Successes include the introduction of several new vaccines across the continent and likely eradication of polio. We examined the contribution of polio eradication activities (PEI) on new vaccine introduction in the countries of the African Region. We reviewed country specific PEI reports to identify best practices relevant to new vaccine introduction (NVI), and analyzed trends in vaccine coverage during 2010-2015 from immunization estimates provided by WHO/UNICEF. Of the 47 countries in African Region 35 (74%) have introduced PCV, 27 (57%) have introduced rotavirus, and 14 (30%) have introduced IPV. National introductions for HPV vaccine have been done in 5 countries, while 15 countries have held demonstration and pilot projects. In 2014, the regional coverage for the third dose of PCV (PCV3) and rotavirus vaccines was 50% and 30% respectively. By end of 2015, all countries within the meningitis belt will have introduced MenAfriVac™ vaccine. PEI activities had a positive effect in strengthening the process of new vaccine introduction in the African Region. The major contribution was in availing immunization funding and providing trained and experienced technical staff to introduce vaccines. More investment is needed to advocate and sustain funding levels to maintain the momentum gained in introducing new vaccines in the region. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Exploring HIV risks, testing and prevention among sub-Saharan African community members in Australia.

PubMed

Mullens, Amy B; Kelly, Jennifer; Debattista, Joseph; Phillips, Tania M; Gu, Zhihong; Siggins, Fungisai

2018-05-21

Significant health disparities persist regarding new and late Human Immunodeficiency Virus (HIV) diagnoses among sub-Saharan African (SSA) communities in Australia. Personal/cultural beliefs and practices influence HIV (risk, prevention, testing) within Australia and during visits to home countries. A community forum was conducted involving 23 male and female adult African community workers, members and leaders, and health workers; facilitated by cultural workers and an experienced clinician/researcher. The forum comprised small/large group discussions regarding HIV risk/prevention (responses transcribed verbatim; utilising thematic analysis). Stigma, denial, social norms, tradition and culture permeated perceptions/beliefs regarding HIV testing, prevention and transmission among African Australians, particularly regarding return travel to home countries. International travel as a risk factor for HIV acquisition requires further examination, as does the role of the doctor in HIV testing and Pre-exposure Prophylaxis (PrEP). Further assessment of PrEP as an appropriate/feasible intervention is needed, with careful attention regarding negative community perceptions and potential impacts.

Investigating the influence of African American and African Caribbean race on primary care doctors' decision making about depression.

PubMed

Adams, A; Vail, L; Buckingham, C D; Kidd, J; Weich, S; Roter, D

2014-09-01

This paper explores differences in how primary care doctors process the clinical presentation of depression by African American and African-Caribbean patients compared with white patients in the US and the UK. The aim is to gain a better understanding of possible pathways by which racial disparities arise in depression care. One hundred and eight doctors described their thought processes after viewing video recorded simulated patients presenting with identical symptoms strongly suggestive of depression. These descriptions were analysed using the CliniClass system, which captures information about micro-components of clinical decision making and permits a systematic, structured and detailed analysis of how doctors arrive at diagnostic, intervention and management decisions. Video recordings of actors portraying black (both African American and African-Caribbean) and white (both White American and White British) male and female patients (aged 55 years and 75 years) were presented to doctors randomly selected from the Massachusetts Medical Society list and from Surrey/South West London and West Midlands National Health Service lists, stratified by country (US v.UK), gender, and years of clinical experience (less v. very experienced). Findings demonstrated little evidence of bias affecting doctors' decision making processes, with the exception of less attention being paid to the potential outcomes associated with different treatment options for African American compared with White American patients in the US. Instead, findings suggest greater clinical uncertainty in diagnosing depression amongst black compared with white patients, particularly in the UK. This was evident in more potential diagnoses. There was also a tendency for doctors in both countries to focus more on black patients' physical rather than psychological symptoms and to identify endocrine problems, most often diabetes, as a presenting complaint for them. This suggests that doctors in both countries have a less well developed mental model of depression for black compared with white patients. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Trend in proportions of missed children during polio supplementary immunization activities in the African Region: evidence from independent monitoring data 2010-2012.

PubMed

Okeibunor, Joseph; Gasasira, Alex; Mihigo, Richard; Salla, Mbaye; Poy, Alain; Orkeh, Godwin; Shaba, Keith; Nshimirimana, Deo

2014-02-19

This is a comparative analysis of independent monitoring data collected between 2010 and 2012, following the implementation of supplementary immunization activities (SIAs) in countries in the three sub regional blocs of World Health Organization in the African Region. The sub regional blocs are Central Africa, West Africa, East and Southern Africa. In addition to the support for SIAs, the Central and West African blocs, threatened with importation and re-establishment of polio transmission received intensive coordination through weekly teleconferences. The later, East and Southern African bloc with low polio threats was not engaged in the intensive coordination through teleconferences. The key indicator of the success of SIAs is the proportion of children missed during SIAs. The results showed that generally there was a decrease in the proportion of children missed during SIAs in the region, from 7.94% in 2010 to 5.95% in 2012. However, the decrease was mainly in the Central and West African blocs. The East and Southern African bloc had countries with as much as 25% missed children. In West Africa and Central Africa, where more coordinated SIAs were conducted, there were progressive and consistent drops, from close to 20-10% at the maximum. At the country and local levels, steps were undertaken to ameliorate situation of low immunization uptake. Wherever an area is observed to have low coverage, local investigations were conducted to understand reasons for low coverage, plans to improve coverage are made and implemented in a coordinated manner. Lessons learned from close monitoring of polio eradication SIAs are will be applied to other campaigns being conducted in the African Region to accelerate control of other vaccine preventable diseases including cerebrospinal meningitis A, measles and yellow fever. Copyright © 2013 Elsevier Ltd. All rights reserved.

Regulatory challenges for GM crops in developing economies: the African experience.

PubMed

Nang'ayo, Francis; Simiyu-Wafukho, Stella; Oikeh, Sylvester O

2014-12-01

Globally, transgenic or genetically modified (GM) crops are considered regulated products that are subject to regulatory oversight during trans-boundary movement, testing and environmental release. In Africa, regulations for transgenic crops are based on the outcomes of the historic Earth Summit Conference held in Rio, Brazil two decades ago, namely, the adoption of the Convention on Biological Diversity (CBD) and the subsequent adoption of the Cartagena Protocol on Biosafety. To exploit the potential benefits of transgenic crops while safeguarding the potential risks on human health and environment, most African countries have signed and ratified the CBD and the Cartagena Protocol on Biosafety. Consequently, these countries are required to take appropriate legal, administrative and other measures to ensure that the handling and utilization of living modified organisms are undertaken in a manner that reduces the risks to humans and the environment. These countries are also expected to provide regulatory oversight on transgenic crops through functional national biosafety frameworks (NBFs). While in principle this approach is ideal, NBFs in most African countries are steeped in a host of policy, legal and operational challenges that appear to be at cross-purposes with the noble efforts of seeking to access, test and deliver promising GM crops for use by resource-limited farmers in Africa. In this paper we discuss the regulatory challenges faced during the development and commercialization of GM crops based on experiences from countries in Sub-Saharan Africa.

Cardiovascular diseases and diabetes as economic and developmental challenges in Africa.

PubMed

Kengne, Andre Pascal; June-Rose McHiza, Zandile; Amoah, Albert George Baidoe; Mbanya, Jean-Claude

2013-01-01

Current estimates and projections suggest that the burden of cardiovascular diseases (CVDs), diabetes and related risk factors in African countries is important, somewhat unique and rapidly growing. Various segments of the population are affected; however, the group mostly affected is young adults residing in urban areas, and increasingly those in the low socioeconomic strata. The African milieu/environment is compounded by weak health systems, which are unable to cope with the looming double burden of communicable and chronic non-communicable diseases. This review discusses the economic and developmental challenges posed by CVDs and diabetes in countries in Africa. Using several lines of evidence, we demonstrate that the cost of care for major CVDs and diabetes is beyond the coping capacities of individuals, households, families and governments in most African countries. We have reviewed modeling studies by the International Diabetes Federation (IDF) and other major international agencies on the current and projected impact that CVDs and diabetes have on the economy and development of countries in the region. Locally, appropriate strategies to limit the impact of the conditions on the economies and development of countries in Africa are suggested and discussed. These include monitoring diseases and risk factors, and primordial, primary and secondary preventions implemented following a life-course perspective. Structural, logistic, human capacity and organizational challenges to be surmounted during the implementations of these strategies will be reviewed. © 2013.

Social Determinants of Self-Reported Health in Women and Men: Understanding the Role of Gender in Population Health

PubMed Central

Hosseinpoor, Ahmad Reza; Stewart Williams, Jennifer; Amin, Avni; Araujo de Carvalho, Islene; Beard, John; Boerma, Ties; Kowal, Paul; Naidoo, Nirmala; Chatterji, Somnath

2012-01-01

Background Women and men share similar health challenges yet women report poorer health. The study investigates the social determinants of self-reported health in women and men, and male-female differences in health. Methods Data on 103154 men and 125728 women were analysed from 57 countries in the World Health Survey 2002–2004. Item Response Theory was used to construct a composite measure of health. Associations between health and determinants were assessed using multivariate linear regression. Blinder-Oaxaca decomposition partitioned the inequality in health between women and men into an “explained" component that arises because men and women differ in social and economic characteristics, and an “unexplained" component due to the differential effects of these characteristics. Decomposition was repeated for 18 countries in the World Health Organization (WHO) African region and 19 countries in the WHO European region. Results Women's health was significantly lower than men's. Health was associated with education, household economic status, employment, and marital status after controlling for age. In the pooled analysis decomposition showed that 30% of the inequality was “explained", of which almost 75% came from employment, education, marital status. The differential effects of being in paid employment increased the inequality. When countries in Africa and Europe were compared, the “explained" component (31% and 39% respectively) was largely attributed to the social determinants in the African countries and to women's longevity in the European countries. Being in paid employment had a greater positive effect on the health of males in both regions. Conclusions Ways in which age and the social determinants contribute to the poorer health status of women compared with men varies between groups of countries. This study highlights the need for action to address social structures, institutional discrimination and harmful gender norms and roles that differently influence health with ageing. PMID:22514667

Balancing Evidence and Uncertainty when Considering Rubella Vaccine Introduction

PubMed Central

Lessler, Justin; Metcalf, C. Jessica E.

2013-01-01

Background Despite a safe and effective vaccine, rubella vaccination programs with inadequate coverage can raise the average age of rubella infection; thereby increasing rubella cases among pregnant women and the resulting congenital rubella syndrome (CRS) in their newborns. The vaccination coverage necessary to reduce CRS depends on the birthrate in a country and the reproductive number, R0, a measure of how efficiently a disease transmits. While the birthrate within a country can be known with some accuracy, R0 varies between settings and can be difficult to measure. Here we aim to provide guidance on the safe introduction of rubella vaccine into countries in the face of substantial uncertainty in R0. Methods We estimated the distribution of R0 in African countries based on the age distribution of rubella infection using Bayesian hierarchical models. We developed an age specific model of rubella transmission to predict the level of R0 that would result in an increase in CRS burden for specific birth rates and coverage levels. Combining these results, we summarize the safety of introducing rubella vaccine across demographic and coverage contexts. Findings The median R0 of rubella in the African region is 5.2, with 90% of countries expected to have an R0 between 4.0 and 6.7. Overall, we predict that countries maintaining routine vaccination coverage of 80% or higher are can be confident in seeing a reduction in CRS over a 30 year time horizon. Conclusions Under realistic assumptions about human contact, our results suggest that even in low birth rate settings high vaccine coverage must be maintained to avoid an increase in CRS. These results lend further support to the WHO recommendation that countries reach 80% coverage for measles vaccine before introducing rubella vaccination, and highlight the importance of maintaining high levels of vaccination coverage once the vaccine is introduced. PMID:23861777

Using theories of practice to understand HIV-positive persons varied engagement with HIV services: a qualitative study in six Sub-Saharan African countries

PubMed Central

Wringe, Alison; Seeley, Janet; Renju, Jenny; Paparini, Sara; Wamoyi, Joyce; Moshabela, Mosa; Ddaaki, William; Nyamukapa, Constance; Ondenge, Kenneth; Bernays, Sarah; Bonnington, Oliver

2017-01-01

Objectives This article considers the potential of ‘theories of practice’ for studying and understanding varied (dis)engagement with HIV care and treatment services and begins to unpack the assemblage of elements and practices that shape the nature and duration of individuals’ interactions with HIV services. Methods We obtained data from a multicountry qualitative study that explores the use of HIV care and treatment services, with a focus on examining the social organisation of engagement with care as a practice and as manifested in the lives of people living with HIV in sub-Saharan Africa. The dataset comprised of 356 interviews with participants from six countries. Results We noted fluctuating interactions with HIV services in all countries. In line with theories of practice, we found that such varied engagement can be explained by (1) the availability, absence and connections between requisite ‘materialities’ (eg, health infrastructure, medicines), ‘competencies’ (eg, knowing how to live with HIV) and ‘meanings’ (eg, trust in HIV services, stigma, normalisation of HIV) and (2) a host of other life practices, such as working or parenting. These dynamics either facilitated or inhibited engagement with HIV services and were intrinsically linked to the discursive, cultural, political and economic fabric of the participating countries. Conclusion Practice theory provides HIV researchers and practitioners with a useful vocabulary and analytical tools to understand and steer people’s differentiated HIV service (dis)engagement. Our application of practice theory to engagement in HIV care, as experienced by HIV service users and providers in six sub-Saharan African countries, highlights the need for a practice-based approach in the delivery of differentiated and patient-centred HIV services. PMID:28736396

Zoom in at African country level: potential climate induced changes in areas of suitability for survival of malaria vectors

PubMed Central

2014-01-01

Background Predicting anopheles vectors’ population densities and boundary shifts is crucial in preparing for malaria risks and unanticipated outbreaks. Although shifts in the distribution and boundaries of the major malaria vectors (Anopheles gambiae s.s. and An. arabiensis) across Africa have been predicted, quantified areas of absolute change in zone of suitability for their survival have not been defined. In this study, we have quantified areas of absolute change conducive for the establishment and survival of these vectors, per African country, under two climate change scenarios and based on our findings, highlight practical measures for effective malaria control in the face of changing climatic patterns. Methods We developed a model using CLIMEX simulation platform to estimate the potential geographical distribution and seasonal abundance of these malaria vectors in relation to climatic factors (temperature, rainfall and relative humidity). The model yielded an eco-climatic index (EI) describing the total favourable geographical locations for the species. The EI values were classified and exported to a GIS package. Using ArcGIS, the EI shape points were clipped to the extent of Africa and then converted to a raster layer using Inverse Distance Weighted (IDW) interpolation method. Generated maps were then transformed into polygon-based geo-referenced data set and their areas computed and expressed in square kilometers (km2). Results Five classes of EI were derived indicating the level of survivorship of these malaria vectors. The proportion of areas increasing or decreasing in level of survival of these malaria vectors will be more pronounced in eastern and southern African countries than those in western Africa. Angola, Ethiopia, Kenya, Mozambique, Tanzania, South Africa and Zambia appear most likely to be affected in terms of absolute change of malaria vectors suitability zones under the selected climate change scenarios. Conclusion The potential shifts of these malaria vectors have implications for human exposure to malaria, as recrudescence of the disease is likely to be recorded in several new areas and regions. Therefore, the need to develop, compile and share malaria preventive measures, which can be adapted to different climatic scenarios, remains crucial. PMID:24885061

Liberia: America's Closest African Ally.

ERIC Educational Resources Information Center

Thompson, Samuel; Mowell, Barry

1997-01-01

Profiles Liberia, the West African nation patterned after the United States and colonized with freed U.S. slaves in the early 19th century. Reviews the country's history and its eruption into civil strife in 1990, showing how tensions have often characterized relationships between Liberians of different ethnic identities. (MJP)

Delivery of health care for cardiovascular and metabolic diseases among people living with HIV/AIDS in African countries: a systematic review protocol.

PubMed

Watkins, David A; Tulloch, Nathaniel L; Anderson, Molly E; Barnhart, Scott; Steyn, Krisela; Levitt, Naomi S

2016-04-16

People living with HIV (PLHIV) in African countries are living longer due to the rollout of antiretroviral drug therapy programs, but they are at increasing risk of non-communicable diseases (NCDs). However, there remain many gaps in detecting and treating NCDs in African health systems, and little is known about how NCDs are being managed among PLHIV. Developing integrated chronic care models that effectively prevent and treat NCDs among PLHIV requires an understanding of the current patterns of care delivery and the major barriers and facilitators to health care. We present a systematic review protocol to synthesize studies of healthcare delivery for an important subset of NCDs, cardiovascular and metabolic diseases (CMDs), among African PLHIV. We plan to search electronic databases and reference lists of relevant studies published in African settings from January 2003 to the present. Studies will be considered if they address one or both of our major objectives and focus on health care for one or more of six interrelated CMDs (ischemic heart disease, stroke, heart failure, hypertension, diabetes, and hyperlipidemia) in PLHIV. Our first objective will be to estimate proportions of CMD patients along the "cascade of care"-i.e., screened, diagnosed, aware of the diagnosis, initiated on treatment, adherent to treatment, and with controlled disease. Our second objective will be to identify unique barriers and facilitators to health care faced by PLHIV in African countries. For studies deemed eligible for inclusion, we will assess study quality and risk of bias using previously published criteria. We will extract study data using standardized instruments. We will meta-analyze quantitative data at each level of the cascade of care for each CMD (first objective). We will use meta-synthesis techniques to understand and integrate qualitative data on health-related behaviors (second objective). CMDs and other NCDs are becoming major health concerns for African PLHIV. The results of our review will inform the development of research into chronic care models that integrate care for HIV/AIDS and CMDs among PLHIV. Our findings will be highly relevant to health policymakers, administrators, and practitioners in African settings. PROSPERO CRD42015029375.

Variations in first-time caesarean birth between Eastern African immigrants and Australian-born women in public care: A population-based investigation in Victoria.

PubMed

Belihu, Fetene B; Small, Rhonda; Davey, Mary-Ann

2017-06-01

Caesarean section (CS) rates are known to vary by country, migration status and social group. However, little population-based, confounder adjusted evidence exists on caesarean rate for African immigrants in Australia. To investigate disparities in first-time caesarean, mainly unplanned caesarean in labour for women born in Eritrea, Ethiopia, Somalia and Sudan relative to Australian-born women in public care. A population-based study of 237 943 Australian and 4057 Eastern African singleton births between 1999 and 2007, was conducted using Victorian Perinatal Data Collection. Descriptive and multivariable logistic regression analysis by parity, adjusting for confounders selected a priori, was performed for first-time unplanned caesarean in labour and overall caesarean. Primiparae born in each of the Eastern African countries had elevated odds of unplanned caesarean in labour: Eritrea adjusted odds ratio (OR adj ) 2.04 95% CI (1.41, 2.97), Ethiopia OR adj 2.08 95% CI (1.62, 2.68), Somalia OR adj 1.62 95% CI (1.25, 2.10) and Sudan OR adj 1.39 95% CI (1.03, 1.87). Similarly, multiparae from Eastern African countries had elevated odds of unplanned caesarean in labour: Eritrea OR adj 2.13 95%CI(1.15, 3.97), Ethiopia OR adj 2.05 95% CI (1.38, 3.03), Somalia OR adj 2.16 95% CI (1.69, 2.77) and Sudan OR adj 1.81 95% CI (1.32, 2.49). The odds of any first-time caesarean (planned or unplanned) were elevated for primiparae born in all countries except Sudan and for multiparae born in Ethiopia and Somalia. We observed substantial variations in a first-time CS between Eastern African and Australian-born women in Victoria, Australia. However, these disparities were unexplained by socio-demographic and clinical risks, suggesting the potential importance of other factors such as communication difficulties, support systems for immigrant pregnant women and possible differences in care. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Mapping of Mycobacterium tuberculosis Complex Genetic Diversity Profiles in Tanzania and Other African Countries

PubMed Central

Mbugi, Erasto V.; Katale, Bugwesa Z.; Streicher, Elizabeth M.; Keyyu, Julius D.; Kendall, Sharon L.; Dockrell, Hazel M.; Michel, Anita L.; Rweyemamu, Mark M.; Warren, Robin M.; Matee, Mecky I.; van Helden, Paul D.; Couvin, David; Rastogi, Nalin

2016-01-01

The aim of this study was to assess and characterize Mycobacterium tuberculosis complex (MTBC) genotypic diversity in Tanzania, as well as in neighbouring East and other several African countries. We used spoligotyping to identify a total of 293 M. tuberculosis clinical isolates (one isolate per patient) collected in the Bunda, Dar es Salaam, Ngorongoro and Serengeti areas in Tanzania. The results were compared with results in the SITVIT2 international database of the Pasteur Institute of Guadeloupe. Genotyping and phylogeographical analyses highlighted the predominance of the CAS, T, EAI, and LAM MTBC lineages in Tanzania. The three most frequent Spoligotype International Types (SITs) were: SIT21/CAS1-Kili (n = 76; 25.94%), SIT59/LAM11-ZWE (n = 22; 7.51%), and SIT126/EAI5 tentatively reclassified as EAI3-TZA (n = 18; 6.14%). Furthermore, three SITs were newly created in this study (SIT4056/EAI5 n = 2, SIT4057/T1 n = 1, and SIT4058/EAI5 n = 1). We noted that the East-African-Indian (EAI) lineage was more predominant in Bunda, the Manu lineage was more common among strains isolated in Ngorongoro, and the Central-Asian (CAS) lineage was more predominant in Dar es Salaam (p-value<0.0001). No statistically significant differences were noted when comparing HIV status of patients vs. major lineages (p-value = 0.103). However, when grouping lineages as Principal Genetic Groups (PGG), we noticed that PGG2/3 group (Haarlem, LAM, S, T, and X) was more associated with HIV-positive patients as compared to PGG1 group (Beijing, CAS, EAI, and Manu) (p-value = 0.03). This study provided mapping of MTBC genetic diversity in Tanzania (containing information on isolates from different cities) and neighbouring East African and other several African countries highlighting differences as regards to MTBC genotypic distribution between Tanzania and other African countries. This work also allowed underlining of spoligotyping patterns tentatively grouped within the newly designated EAI3-TZA lineage (remarkable by absence of spacers 2 and 3, and represented by SIT126) which seems to be specific to Tanzania. However, further genotyping information would be needed to confirm this specificity. PMID:27149626

Nutrient retention values and cooking yield factors for three South African lamb and mutton cuts.

PubMed

van Heerden, Salomina M; Strydom, Phillip E

2017-11-01

Nutrient content of raw and cooked foods is important for formulation of healthy diets. The retention of nutrients during cooking can be influenced by various factors, including animal age, carcass characteristics and cooking method, and these factors are often unique to specific countries. Here the effects of animal age (lamb and mutton) and carcass cut (shoulder, loin and leg) combined with cooking method (moist heat and dry heat) on yield and nutrient retention of selected nutrients of South African sheep carcasses were studied. Cooking yields and moisture retention were lower for lamb loin but higher for lamb leg. Energy and fat retention were higher for all cuts of mutton compared with lamb, while higher retention values for cholesterol were recorded for lamb. Mutton retained more iron (P = 0.10) and zinc and also more vitamin B 2 , B 6 and B 12 than lamb. Shoulder cooked according to moist heat cooking method retained more magnesium, potassium and sodium. Incorporating these retention and yield values into the South African Medical Research Council's Food Composition Tables provides a reliable reference to all concerned with nutrient content of food. It will also guide practitioners and primary industry to adjust animal production aimed at optimum nutrient content to specific diets. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

The effect of illicit financial flows on time to reach the fourth Millennium Development Goal in Sub-Saharan Africa: a quantitative analysis.

PubMed

O'Hare, Bernadette; Makuta, Innocent; Bar-Zeev, Naor; Chiwaula, Levison; Cobham, Alex

2014-04-01

This paper sets out to estimate the cost of illicit financial flows (IFF) in terms of the amount of time it could take to reach the fourth Millennium Development Goal (MDG) in 34 African countries. We have calculated the percentage increase in gross domestic product (GDP) if IFFs were curtailed using IFF/GDP ratios. We applied the income (GDP) elasticity of child mortality to the increase in GDP to estimate the reduction in time to reach the fourth MDG in 34 African countries. children aged under five years. 34 countries in SSA. Reduction in time to reach the first indicator of the fourth MDG, under-five mortality rate in the absence of IFF. We found that in the 34 SSA countries, six countries will achieve their fourth MDG target at the current rates of decline. In the absence of IFF, 16 countries would reach their fourth MDG target by 2015 and there would be large reductions for all other countries. This drain on development is facilitated by financial secrecy in other jurisdictions. Rich and poor countries alike must stem the haemorrhage of IFF by taking decisive steps towards improving financial transparency.

PREVALENCE OF BENIGN PROSTATIC HYPERPLASIA AND PROSTATE CANCER IN AFRICANS AND AFRICANS IN THE DIASPORA.

PubMed

Yeboah, E D

2016-01-01

There have been several publications on population or community prevalence of benign prostatic hyperplasia and prostate cancer from various countries and races but few reports are from Africa on Africans. A review on the prevalence of benign prostatic hyperplasia and prostate cancer in Africans and other races. The current literature on prevalence of benign prostatic hyperplasia (BPH), prostate cancer (PC), and benign prostatic hyperplasia co-existing with prostate cancer in Africans and other races is reviewed. Benign prostatic hyperplasia (BPH) prevalence in Ghana is responsible for 60% acute retention of urine and 28.6% of haematuria. Worldwide prevalence of BPH varies from 20 - 62% in men over 50 years and this includes USA, UK, Japan and Ghana. Reports from South Africa indicate prevalence of over 50% in adult males of 60 years. BPH co-existing with PC - Reports from USA, UK and Japan and Ghana reveal moderate association of BPH and PC. The co-existence of PC in patients being treated for BPH is 3 - 20% Prostate Cancer prevalence - There is high prevalence in USA, Scandinavian Countries, African Americans (AA) and Caribbean blacks. Ghana, Trinidad & Tobago have reported high prevalence of 6 -10% in men aged 50 years and above but others reported low prevalence in Africans from Africa. The low reporting from Africa of 10 - 40:100,000 is attributable to under reporting, absence of PSA screening/testing, lack of reliable cancer registries and poor medical facilities. Economic Costs of BPH and PC: BPH in the USA national direct costs are estimated at U$4Billion and individual costs of US$1536 annually. In Ghana, individual costs for BPH medications range from US$300 - 550 per year and cost for simple prostatectomy/TURP is estimated at US$1100. For prostate cancer, individual direct costs from Europe range from 6,575 - 12,000 euros, £2818.00 UK and over U$12,000 - 20,000 in USA per annum. In Ghana, individual direct costs ranges, for radical prostatectomy and external beam radiotherapy US$1250 - 1500, for brachytherapy 9,000 Euros, for hormonal therapy US$1600 - 3200) per year and US$510 for orchidectomy. Recent evidence although sparse indicate there is high prevalence of BPH and PC in Africans and men of African descent in diaspora, the low prevalence of BPH and PC reported from some African countries is likely to under reporting and future prevalence studies both in the living and deceased are recommended to reveal the true prevalence of BPH and PC in Africans though screening for PC in the living remains controversial.

Sub-Saharan Africa Report, No. 2828

DTIC Science & Technology

1983-08-03

EEC Food Aid 59 - d - TEN MILLION AFRICANS MAY STARVE THIS WINTER Johannesburg THE STAR in English 7 Jul 83 p 1 INTER-AFRICAN AFFAIRS [Text...BULÄWAYÖ - At least 10 million people in five South- ern African countries will need emergency food aid if they are to survive the win- ter. This...about half the population of about one million are already receiving emergen- cy food rations while thousands of cattle are being slaughtered

Familial and Contextual Influences on Children’s Prosocial Behavior: South African Caregivers as Adult Protective Shields in Enhancing Child Mental Health

PubMed Central

Parchment, Tyrone M.; Small, Latoya; Osuji, Hadiza; McKay, Mary; Bhana, Arvin

2017-01-01

Background The mental health of children is too frequently overlooked in resource scarce low and middle-income countries. South Africa represents one of many country contexts struggling to meet the mental health needs of large numbers of young people. Family caregivers have been identified as potential protective influences on child mental health, even for those children being reared with high exposure to poverty. Methods This paper explores contextual influences on South African caregiver’s social-emotional health living in communities impacted by poverty and food insecurity as they attempt to support their children’s prosocial skills and behavior. Structural Equation Modeling (SEM) was employed to explore the relationship between neighborhood social cohesion and caregiver report of child’s prosocial behavior as mediated by the caregiver’s mental health (n=478). Results Results indicated that the more caregivers experience their communities as socially cohesive, the better their social-emotional well-being, thus positively related to their reports of children’s prosocial behavior. Furthermore, when there is a male head of household, caregivers reported better social-emotional well-being in comparison to female headed of household. The more food secure caregivers also were likely to report better general health. Conclusion South African community characteristics and caregivers, in particular male caregivers, are integral to child and caregiver mental health. Future research should examine the impact of interventions that mobilize community and caregiver supports for children’s prosocial behavior and mental health. PMID:28401033

Pre- and postnatal psychological wellbeing in Africa: a systematic review.

PubMed

Sawyer, Alexandra; Ayers, Susan; Smith, Helen

2010-06-01

Perinatal mental health disorders are recognised as an important public health issue in low-income countries as well as in developed countries. This paper reviews evidence on the prevalence and risk factors of maternal mental health disorders in African women living in Africa. A systematic review of the literature was conducted. Studies were mainly located through computerised databases, and additionally through hand searching references of identified articles and reviews. Thirty-five studies, with a total of 10,880 participants, were identified that reported prevalence rates of maternal psychological health in eight African countries. Depression was the most commonly assessed disorder with a weighted mean prevalence of 11.3% (95% CI 9.5%-13.1%) during pregnancy and 18.3% (95% CI 17.6%-19.1%) after birth. Only a small number of studies assessed other psychological disorders. Prevalence rates of pre- and postnatal anxiety were 14.8% (95% CI 12.3%-17.4%) and 14.0% (95% CI 12.9%-15.2%), respectively; and one study reported the prevalence of PTSD as 5.9% (95% CI 4.4%-7.4%) following childbirth. Lack of support and marital/family conflict were associated with poorer mental health. Evidence relating sociodemographic and obstetric variables to mental health was inconclusive. Most studies included in this review were cross-sectional and measures of mental health varied considerably. This paper demonstrates that maternal mental health disorders are prevalent in African women, and highlights the importance of maternal mental health care being integrated into future maternal and infant health policies in African countries. Copyright 2009 Elsevier B.V. All rights reserved.

Actual and predicted prevalence of alcohol consumption during pregnancy in the WHO African Region.

PubMed

Popova, Svetlana; Lange, Shannon; Probst, Charlotte; Shield, Kevin; Kraicer-Melamed, Hannah; Ferreira-Borges, Carina; Rehm, Jürgen

2016-10-01

To estimate the prevalence of alcohol consumption and binge drinking during pregnancy among the general population in the World Health Organization (WHO) African Region, by country. First, a comprehensive systematic literature search was performed to identify all published and unpublished studies. Then, several meta-analyses, assuming a random-effects model, were conducted to estimate the prevalence of alcohol consumption and binge drinking during pregnancy among the general population for countries in the WHO African Region with two or more studies available. Lastly, for countries with less than two studies or no known data predictions were obtained using regression modelling. The estimated prevalence of alcohol consumption during pregnancy among the general population ranged from 2.2% (95% confidence interval [CI]: 1.6-2.8%; Equatorial Guinea) to 12.6% (95% CI: 9.9-15.4%; Cameroon) in Central Africa, 3.4% (95% CI: 2.6-4.3%; Seychelles) to 20.5% (95% CI: 16.4-24.7%; Uganda) in Eastern Africa, 5.7% (95% CI: 4.4-7.1%; Botswana) to 14.2% (95% CI: 11.1-17.3%; Namibia) in Southern Africa, 6.6% (95% CI: 5.0-8.3%; Mauritania) to 14.8% (95% CI: 11.6-17.9%; Sierra Leone) in Western Africa, and 4.3% (95% CI: 3.2-5.3%; Algeria) in Northern Africa. The high prevalence of alcohol consumption and binge drinking during pregnancy in some African countries calls for educational campaigns, screening and targeted interventions for women of childbearing age. © 2016 John Wiley & Sons Ltd.

Complications of induced abortion and miscarriage in three African countries: a hospital-based study among WHO collaborating centers.

PubMed

Goyaux, N; Alihonou, E; Diadhiou, F; Leke, R; Thonneau, P F

2001-06-01

The aim of this study was to describe two of the outcomes of pregnancy, induced abortion and miscarriage, in three African countries. Major maternal risk factors were also evaluated. The study was prospective and based on the medical files of all 1,957 women admitted to participating health care structures. Overall, 988 women were admitted for complications of miscarriage, and 969 for complications of induced abortion. Gestational age was lower in women with miscarriages (p<0.002). The level of use of contraceptive methods ((p<0.003) and educational level ((p<0.005) were lower in women who had had an induced abortion. In our study, 26 maternal deaths were recorded, 22 of which were associated with induced abortion. Infection was the most important risk factor for death (OR=4.8; 1.9-12.4). Maternal deaths related to abortion complications often occurred shortly after hospital admission and with signs of sepsis. This demonstrates the importance of effective emergency services. Unfortunately, hospital-based studies alone cannot assess all maternal death risk factors, especially those for maternal death related to induced abortion complications. It is therefore important to determine what happened to the woman before hospital admission and during her stay in hospital. Combinations of qualitative and quantitative methods could be used to increase our understanding of this problem and to help us to solve it.

Chemical exposure reduction: Factors impacting on South African herbicide sprayers' personal protective equipment compliance and high risk work practices.

PubMed

Andrade-Rivas, Federico; Rother, Hanna-Andrea

2015-10-01

The high exposure risks of workers to herbicides in low- and middle-income countries is an important public health concern because of the potential resulting negative impacts on workers' health. This study investigated workers' personal protective equipment (PPE) compliance as a risk mitigation measure; particularly workers who apply herbicides for Working for Water (WfW) - a South African invasive alien vegetation control programme. The study aim was to understand workers' low PPE compliance by analysing their risk perceptions of herbicide use, working conditions and socio-cultural context. Research methods included ethnographic observations, informal interviews, visual media, questionnaires and a focus group. Study results indicated that low PPE compliance persists despite workers' awareness of herbicide exposure risks and as a result of the influence from workers' socio-cultural context (i.e. gender dynamics and social status), herbicide risk perceptions and working conditions (i.e. environmental and logistical). Interestingly, teams comprised of mostly women had the highest compliance rate. These findings highlighted that given the complexity of PPE compliance, especially in countries with several economic and social constraints, exposure reduction interventions should not rely solely on PPE use promotion. Instead, other control strategies requiring less worker input for effectiveness should be implemented, such as elimination and substitution of highly hazardous pesticides, and altering application methods. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Health transitions in sub-Saharan Africa: overview of mortality trends in children under 5 years old (1950-2000).

PubMed Central

Garenne, Michel; Gakusi, Enéas

2006-01-01

OBJECTIVE: To reconstruct and analyse mortality trends in children younger than 5 years in sub-Saharan Africa between 1950 and 2000. METHODS: We selected 66 Demographic and Health Surveys and World Fertility Surveys from 32 African countries for analysis. Death rates were calculated by yearly periods for each survey. When several surveys were available for the same country, overlapping years were combined. Country-specific time series were analysed to identify periods of monotonic trends, whether declining, steady or increasing. We tested changes in trends using a linear logistic model. FINDINGS: A quarter of the countries studied had monotonic declining mortality trends: i.e. a smooth health transition. Another quarter had long-term declines with some minor rises over short periods of time. Eight countries had periods of major increases in mortality due to political or economic crises, and in seven countries mortality stopped declining for several years. In eight other countries mortality has risen in recent years as a result of paediatric AIDS. Reconstructed levels and trends were compared with other estimates made by international organizations, usually based on indirect methods. CONCLUSION: Overall, major progress in child survival was achieved in sub-Saharan Africa during the second half of the twentieth century. However, transition has occurred more slowly than expected, with an average decline of 1.8% per year. Additionally, transition was chaotic in many countries. The main causes of mortality increase were political instability, serious economic downturns, and emerging diseases. PMID:16799731

A Tale of Two Cities: Access to Care and Services Among African-American Transgender Women in Oakland and San Francisco

PubMed Central

Cruz, Taylor M.; Iwamoto, Mariko; Sakata, Maria

2015-01-01

Abstract Purpose: The San Francisco Bay Area attracts people from all over the country due to the perception of lesbian, gay, bisexual, and transgender (LGBT) acceptance and affirmation. African-American transgender women are severely marginalized across society and as such have many unmet health and social service needs. This study sought to quantitatively assess unmet needs among African-American transgender women with a history of sex work by comparing residents of Oakland versus San Francisco. Methods: A total of 235 African-American transgender women were recruited from San Francisco (n=112) and Oakland (n=123) through community outreach and in collaboration with AIDS service organizations. Participants were surveyed regarding basic, health, and social needs and HIV risk behaviors. Pearson Chi-squared tests and a linear regression model examined associations between city of residence and unmet needs. Results: While participants from both cities reported unmet needs, Oakland participants had a greater number of unmet needs in receiving basic assistance, mental health treatment, and health care services. Oakland participants also reported less transgender community identification but higher social support from the family. Conclusion: These findings demonstrate the enormity of African-American transgender women's needs within the Bay Area. Greater resources are needed for social service provision targeting this marginalized group of people, particularly in Oakland. PMID:26788672

Gender attitudes and fertility aspirations among young men in five high fertility East African countries.

PubMed

Snow, Rachel C; Winter, Rebecca A; Harlow, Siobán D

2013-03-01

The relationship between women's attitudes toward gender equality and their fertility aspirations has been researched extensively, but few studies have explored the same associations among men. Using recent Demographic and Health Survey data from five high fertility East African countries, we examine the association between young men's gender attitudes and their ideal family size. Whereas several DHS gender attitude responses were associated with fertility aspirations in select countries, men's greater tolerance of wife beating was consistently associated with higher fertility aspirations across all countries, independent of education, income, or religion. Our findings highlight the overlapping values of male authority within marriage and aspirations for large families among young adult males in East Africa. Total lifetime fertility in East Africa remains among the highest worldwide: thus, governments in the region seeking to reduce fertility may need to explicitly scrutinize and address the reproduction of prevailing masculine values. © 2013 The Population Council, Inc.

The Development of Computational Biology in South Africa: Successes Achieved and Lessons Learnt

PubMed Central

Mulder, Nicola J.; Christoffels, Alan; de Oliveira, Tulio; Gamieldien, Junaid; Hazelhurst, Scott; Joubert, Fourie; Kumuthini, Judit; Pillay, Ché S.; Snoep, Jacky L.; Tastan Bishop, Özlem; Tiffin, Nicki

2016-01-01

Bioinformatics is now a critical skill in many research and commercial environments as biological data are increasing in both size and complexity. South African researchers recognized this need in the mid-1990s and responded by working with the government as well as international bodies to develop initiatives to build bioinformatics capacity in the country. Significant injections of support from these bodies provided a springboard for the establishment of computational biology units at multiple universities throughout the country, which took on teaching, basic research and support roles. Several challenges were encountered, for example with unreliability of funding, lack of skills, and lack of infrastructure. However, the bioinformatics community worked together to overcome these, and South Africa is now arguably the leading country in bioinformatics on the African continent. Here we discuss how the discipline developed in the country, highlighting the challenges, successes, and lessons learnt. PMID:26845152

The Development of Computational Biology in South Africa: Successes Achieved and Lessons Learnt.

PubMed

Mulder, Nicola J; Christoffels, Alan; de Oliveira, Tulio; Gamieldien, Junaid; Hazelhurst, Scott; Joubert, Fourie; Kumuthini, Judit; Pillay, Ché S; Snoep, Jacky L; Tastan Bishop, Özlem; Tiffin, Nicki

2016-02-01

Bioinformatics is now a critical skill in many research and commercial environments as biological data are increasing in both size and complexity. South African researchers recognized this need in the mid-1990s and responded by working with the government as well as international bodies to develop initiatives to build bioinformatics capacity in the country. Significant injections of support from these bodies provided a springboard for the establishment of computational biology units at multiple universities throughout the country, which took on teaching, basic research and support roles. Several challenges were encountered, for example with unreliability of funding, lack of skills, and lack of infrastructure. However, the bioinformatics community worked together to overcome these, and South Africa is now arguably the leading country in bioinformatics on the African continent. Here we discuss how the discipline developed in the country, highlighting the challenges, successes, and lessons learnt.

Field Application of the Micro Biological Survey Method for the Assessment of the Microbiological Safety of Different Water Sources in Horn of Africa and the Evaluation of the Effectiveness of Moringa Oleifera in Drinking Water Purification

PubMed Central

Losito, Francesca; Arienzo, Alyexandra; Somma, Daniela; Murgia, Lorenza; Stalio, Ottavia; Zuppi, Paolo; Rossi, Elisabetta; Antonini, Giovanni

2017-01-01

Water monitoring requires expensive instrumentations and skilled technicians. In developing Countries as Africa, the severe economic restrictions and lack of technology make water safety monitoring approaches applied in developed Countries, still not sustainable. The need to develop new methods that are suitable, affordable, and sustainable in the African context is urgent. The simple, economic and rapid Micro Biological Survey (MBS) method does not require an equipped laboratory nor special instruments and skilled technicians, but it can be very useful for routine water analysis. The aim of this work was the application of the MBS method to evaluate the microbiological safety of different water sources and the effectiveness of different drinking water treatments in the Horn of Africa. The obtained results have proved that this method could be very helpful to monitor water safety before and after various purification treatments, with the aim to control waterborne diseases especially in developing Countries, whose population is the most exposed to these diseases. In addition, it has been proved that Moringa oleifera water treatment is ineffective in decreasing bacterial load of Eritrea water samples. PMID:28748063

Field Application of the Micro Biological Survey Method for the Assessment of the Microbiological Safety of Different Water Sources in Horn of Africa and the Evaluation of the Effectiveness of Moringa Oleifera in Drinking Water Purification.

PubMed

Losito, Francesca; Arienzo, Alyexandra; Somma, Daniela; Murgia, Lorenza; Stalio, Ottavia; Zuppi, Paolo; Rossi, Elisabetta; Antonini, Giovanni

2017-06-23

Water monitoring requires expensive instrumentations and skilled technicians. In developing Countries as Africa, the severe economic restrictions and lack of technology make water safety monitoring approaches applied in developed Countries, still not sustainable. The need to develop new methods that are suitable, affordable, and sustainable in the African context is urgent. The simple, economic and rapid Micro Biological Survey (MBS) method does not require an equipped laboratory nor special instruments and skilled technicians, but it can be very useful for routine water analysis. The aim of this work was the application of the MBS method to evaluate the microbiological safety of different water sources and the effectiveness of different drinking water treatments in the Horn of Africa. The obtained results have proved that this method could be very helpful to monitor water safety before and after various purification treatments, with the aim to control waterborne diseases especially in developing Countries, whose population is the most exposed to these diseases. In addition, it has been proved that Moringa oleifera water treatment is ineffective in decreasing bacterial load of Eritrea water samples.

Wages and Labor Management in African Manufacturing

ERIC Educational Resources Information Center

Fafchamps, Marcel; Soderbom, Mans

2006-01-01

Using matched employer-employee data from ten African countries, we examine the relationship between wages, worker supervision, and labor productivity in manufacturing. Wages increase with firm size for both production workers and supervisors. We develop a two-tier model of supervision that can account for this stylized fact and we fit the…

Nathan Lee | NREL

Science.gov Websites

Economic Community of West African States, with an emphasis on Ghana, was used as a representative area of economic growth in developing countries Education Ph.D. and Diploma of Advanced Studies (M.S. equivalent members of the Economic Community of West African States, Renewable and Sustainable Energy Reviews (2014

Establishing Quality Assurance in the South African Context

ERIC Educational Resources Information Center

Strydom, A. H.; Strydom, J. F.

2004-01-01

This paper provides perspectives on the unique challenges and opportunities facing the national auditing and accreditation system in South African higher education. In doing so, the quality assurance contexts of developed countries, Africa and South Africa are considered and the issues of uncertainty and conformity are highlighted. This is…

African American Men in College

ERIC Educational Resources Information Center

Cuyjet, Michael J., Ed.

2006-01-01

This book is a much-needed resource that includes examples of real-world programs and activities to enhance academic success in the college environment for African American men. The examples are collected from a variety of institutions across the country. With contributions from leading practitioners and scholars in the field, this book explores…

Focus on South Africa. Varieties of English Around the World, Volume 15.

ERIC Educational Resources Information Center

de Klerk, Vivian, Ed.

Essays on English in South Africa and its neighboring countries include: "A History of English in South Africa" (Len Lanham); "English in South African Society: A Preliminary Overview" (Bill Branford); "Black English in South Africa" (David Gough); "Language Contact, Transmission, Shift: South African Indian…

Frames of Reference in African Proverbs on Disability.

ERIC Educational Resources Information Center

Devlieger, Patrick J.

1999-01-01

Fifty-five proverbs relating to disability were collected from sub-Saharan African countries and analyzed for larger frames of reference of personhood and cosmogony. Themes include warnings against laughing at a disabled person, personhood, existential insecurity, acceptance of what is, and the function and nature of disability. (DB)

Educational Policies and Priorities for Rural Women in Southern Africa.

ERIC Educational Resources Information Center

Mutanyatta, J. N. S.

Despite their significant role in African economies, women are still the victims of poverty, illiteracy, discrimination, and powerlessness. Most African countries are classified as "low" on the Human Development Index and exhibit a relationship between per capita gross domestic product and the adult literacy rate. Rural women appear to…

Uranium from Africa - An overview on past and current mining activities: Re-appraising associated risks and chances in a global context

NASA Astrophysics Data System (ADS)

Winde, Frank; Brugge, Doug; Nidecker, Andreas; Ruegg, Urs

2017-05-01

In 2003, nuclear power received renewed interest as a perceived climate-neutral way to meet high energy demands of large industrialized countries, such as China, India, Russia and the USA. It triggered a growing demand for uranium (U) as nuclear fuel. Dubbed the 'nuclear renaissance', the U-price rose over tenfold before the global credit crisis dampend the rush. Many efforts to capitalise on the renewed demand focused on Africa. This paper provides an overview on the type and extent of uranium mining, production and exploration on the African continent and discusses the economic benefits as well as the potential environmental and health risks and the long-term needs for remediation of legacy sites. The actual historical results of uranium mining activities in more than thirty African countries provide data against which to assess the existing risks of uranium development. The already existing uraniferous waste in several African countries threatens scarce water resources and the health of adjacent residents. Responsibility should rest with the governments and the companies to ensure that these threats are not realized.

Winning the battle against the scourge of poliomyelitis in the African Region.

PubMed

Moeti, Matshidiso

2016-10-10

Recently we have recorded some progress against the transmission of poliovirus in the African Region. This is attributable to a number of factors, including commitment of global partnerships against polio, improvement of existing strategies as well as a number of innovations in response to the disease in the Region. The WHO Regional Office in Africa documented these practices that led to the noticeable progress in the polio eradication initiative in the African Region, as lessons learnt and as part of polio legacy planning. The documentation exercise covered eight countries, namely Angola, Chad, Cote d'Ivoire, Democratic Republic of Congo, Ethiopia, Nigeria, Tanzania and Togo. A number of practices were identified. Some of these practices cut across countries while others were peculiar to specific countries. We have thus developed some manuscripts to capture these practices for publication in scientific journal so as to place them in the public domain for use. It is hoped that these practices will be deployed to other public health programmes in the Region and beyond. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Oncology pharmacy units: a safety policy for handling hazardous drugs and related waste in low- and middle-income African countries-Angolan experience.

PubMed

da Conceição, Ana Vaz; Bernardo, Dora; Lopes, Lygia Vieira; Miguel, Fernando; Bessa, Fernanda; Monteiro, Fernando; Santos, Cristina; Oliveira, Blasques; Santos, Lúcio Lara

2015-01-01

In African countries, higher rates of late-stage cancers at the time of first diagnosis are a reality. In this context, hazardous drugs (HDs), such as chemotherapy, play an important role and have immense benefits for patients' treatment. HDs should be handled under specific conditions. At least a class 5 environment primary engineering control (PEC), physically located in an appropriate buffer area, is mandatory for sterile HDs compounding, as well as administrative control, personal protective equipment, work practices and other engineering and environmental controls, in order to protect the environment, patient, and worker. The aim of this study is to describe the Angolan experience regarding the development of oncology pharmacy units and discuss international evidence-based guidelines on handling HDs and related waste. Measures to incorporate modern and economical solutions to upgrade or build adequate and safe facilities and staff training, in order to comply with international guidelines in this area, are crucial tasks for African countries of low and middle income.

Development and Use of a Serum Bactericidal Assay Using Pooled Human Complement To Assess Responses to a Meningococcal Group A Conjugate Vaccine in African Toddlers

PubMed Central

Lynn, Freyja; Mocca, Brian; Borrow, Ray; Findlow, Helen; Hassan-King, Musa; Preziosi, Marie-Pierre; Idoko, Olubukola; Sow, Samba; Kulkarni, Prasad; LaForce, F. Marc

2014-01-01

A meningococcal group A polysaccharide (PS) conjugate vaccine (PsA-TT) has been developed for African countries affected by epidemic meningitis caused by Neisseria meningitidis. Complement-mediated serum bactericidal antibody (SBA) assays are used to assess protective immune responses to meningococcal vaccination. Human complement (hC′) was used in early studies demonstrating antibody-mediated protection against disease, but it is difficult to obtain and standardize. We developed and evaluated a method for sourcing hC′ and then used the SBA assay with hC′ (hSBA) to measure bactericidal responses to PsA-TT vaccination in 12- to 23-month-old African children. Sera with active complement from 100 unvaccinated blood donors were tested for intrinsic bactericidal activity, SBA titer using rabbit complement (rSBA), and anti-group A PS antibody concentration. Performance criteria and pooling strategies were examined and then verified by comparisons of three independently prepared hC′ lots in two laboratories. hSBA titers of clinical trial sera were then determined using this complement sourcing method. Two different functional antibody tests were necessary for screening hC′. hSBA titers determined using three independent lots of pooled hC′ were within expected assay variation among lots and between laboratories. In African toddlers, PsA-TT elicited higher hSBA titers than meningococcal polysaccharide or Hib vaccines. PsA-TT immunization or PS challenge of PsA-TT-primed subjects resulted in vigorous hSBA memory responses, and titers persisted in boosted groups for over a year. Quantifying SBA using pooled hC′ is feasible and showed that PsA-TT was highly immunogenic in African toddlers. PMID:24671551

Implementation of Rotavirus Surveillance and Vaccine Introduction - World Health Organization African Region, 2007-2016.

PubMed

Mwenda, Jason M; Burke, Rachel M; Shaba, Keith; Mihigo, Richard; Tevi-Benissan, Mable Carole; Mumba, Mutale; Biey, Joseph Nsiari-Muzeyi; Cheikh, Dah; Poy MSc, Alain; Zawaira, Felicitas R; Aliabadi, Negar; Tate, Jacqueline E; Hyde, Terri; Cohen, Adam L; Parashar, Umesh D

2017-11-03

Rotavirus is a leading cause of severe pediatric diarrhea globally, estimated to have caused 120,000 deaths among children aged <5 years in sub-Saharan Africa in 2013 (1). In 2009, the World Health Organization (WHO) recommended rotavirus vaccination for all infants worldwide (2). Two rotavirus vaccines are currently licensed globally: the monovalent Rotarix vaccine (RV1, GlaxoSmithKline; 2-dose series) and the pentavalent RotaTeq vaccine (RV5, Merck; 3-dose series). This report describes progress of rotavirus vaccine introduction (3), coverage (using estimates from WHO and the United Nations Children's Fund [UNICEF]) (4), and impact on pediatric diarrhea hospitalizations in the WHO African Region. By December 2016, 31 (66%) of 47 countries in the WHO African Region had introduced rotavirus vaccine, including 26 that introduced RV1 and five that introduced RV5. Among these countries, rotavirus vaccination coverage (completed series) was 77%, according to WHO/UNICEF population-weighted estimates. In 12 countries with surveillance data available before and after vaccine introduction, the proportion of pediatric diarrhea hospitalizations that were rotavirus-positive declined 33%, from 39% preintroduction to 26% following rotavirus vaccine introduction. These results support introduction of rotavirus vaccine in the remaining countries in the region and continuation of rotavirus surveillance to monitor impact.

Improving the Quality of Host Country Ethical Oversight of International Research: The Use of a Collaborative 'Pre-Review' Mechanism for a Study of Fexinidazole for Human African Trypanosomiasis.

PubMed

Coleman, Carl H; Ardiot, Chantal; Blesson, Séverine; Bonnin, Yves; Bompart, Francois; Colonna, Pierre; Dhai, Ames; Ecuru, Julius; Edielu, Andrew; Hervé, Christian; Hirsch, François; Kouyaté, Bocar; Mamzer-Bruneel, Marie-France; Maoundé, Dionko; Martinent, Eric; Ntsiba, Honoré; Pelé, Gérard; Quéva, Gilles; Reinmund, Marie-Christine; Sarr, Samba Cor; Sepou, Abdoulaye; Tarral, Antoine; Tetimian, Djetodjide; Valverde, Olaf; Van Nieuwenhove, Simon; Strub-Wourgaft, Nathalie

2015-12-01

Developing countries face numerous barriers to conducting effective and efficient ethics reviews of international collaborative research. In addition to potentially overlooking important scientific and ethical considerations, inadequate or insufficiently trained ethics committees may insist on unwarranted changes to protocols that can impair a study's scientific or ethical validity. Moreover, poorly functioning review systems can impose substantial delays on the commencement of research, which needlessly undermine the development of new interventions for urgent medical needs. In response to these concerns, the Drugs for Neglected Diseases Initiative (DNDi), an independent nonprofit organization founded by a coalition of public sector and international organizations, developed a mechanism to facilitate more effective and efficient host country ethics review for a study of the use of fexinidazole for the treatment of late stage African Trypanosomiasis (HAT). The project involved the implementation of a novel 'pre-review' process of ethical oversight, conducted by an ad hoc committee of ethics committee representatives from African and European countries, in collaboration with internationally recognized scientific experts. This article examines the process and outcomes of this collaborative process. © 2014 The Authors. Developing World Bioethics published by John Wiley & Sons Ltd.

Measles mortality reduction--West Africa, 1996-2002.

PubMed

2004-01-23

The World Health Organization (WHO) estimates that, during 2000, measles accounted for approximately 777,000 deaths worldwide, of which 452,000 (58%) occurred in Africa. In response, in 2000, WHO's African Regional Office (AFRO) adopted a plan to reduce measles mortality >50% by 2005. The plan recommended 1) increasing measles vaccination by strengthening routine health services; 2) providing a second opportunity for measles vaccination for all children, primarily through wide--age-range supplemental immunization activities (SIAs); 3) enhancing measles surveillance; and 4) improving management of measles cases. The initial wide--age-range SIA targets all children aged 9 months-14 years, regardless of history of measles disease or vaccination. Follow-up SIAs are needed 3-5 years after the initial SIA to provide a second opportunity for vaccination to children born since the previous SIA (i.e., those aged 9 months-4 years). During the 1990s, the countries of the Americas and seven countries in southern Africa used this strategy to reduce the number of measles deaths to near zero. This report describes the recent implementation of this strategy in three West African countries, where reported measles cases declined 83%-97% during the first year after SIAs. Successful implementation of this strategy by other African countries should result in achieving the goal of >50% reduction in measles mortality by 2005.

Selected Bibliography of Educational Materials: Maghreb, Algeria, Libya, Morocco, Tunisia. Vol. 10, No. 1, 1976.

ERIC Educational Resources Information Center

Azzouz, Azzedine, Comp.; And Others

Ninety English-language annotations of newspaper articles and government publications about education in five north African countries are contained in this bibliography. Drawing from materials published during the early months of 1976, the bibliography examines all aspects of education in those countries. Organized by country, the bibliography…

Early Childhood Education in Eighteen Countries in the Middle East and North Africa.

ERIC Educational Resources Information Center

Khattab, Mohammad S.

1996-01-01

Examined the status of early childhood education (ECE) in 18 middle eastern and north African countries, incorporating country profiles, ECE institutions, teachers, and children. Identified the critical issues needing priority attention, and a set of indicators that could be used by educational planners and policymakers for monitoring and…

Private Schooling in Less Economically Developed Countries: Asian and African Perspectives

ERIC Educational Resources Information Center

Srivastava, Prachi, Ed.; Walford, Geoffrey, Ed.

2007-01-01

The increased marketisation and privatisation of schooling in economically developing countries struggling to achieve Education for All and Millennium Development Goals warrants a focused examination of the phenomenon. However, there is little work on the nature and extent of private provision in countries that, on the one hand, are striving to…

Embodied history. Uniqueness and exemplarity of South African AIDS.

PubMed

Fassin, Didier

2002-01-01

The exceptionality of AIDS in South Africa, both for its epidemiological features and public controversies, seems to have its correspondence in the exceptionalism of South African history, with its unprecedented regime of apartheid and its unexpected turn to democracy. The article shows that AIDS in this country can simultaneously be seen as unique (because of the historical context in which it is inscribed) and exemplar (of social determinants observed in other countries characterised by similar past or present of domination). As an alternative to cultural and behavioural models of the epidemic which have been widely spread on the African continent, the concept of embodiment of history is proposed in order to account for both the structural facts underlying the epidemic (inequality, violence, migration) and the construction of collective as well as individual narratives of the disease (including victimisation and accusation).

Missed opportunities and barriers for vaccination: a descriptive analysis of private and public health facilities in four African countries.

PubMed

Olorunsaiye, Comfort Zuyeali; Langhamer, Margaret Shaw; Wallace, Aaron Stuart; Watkins, Margaret Lyons

2017-01-01

Missed opportunities and barriers to vaccination limit progress toward achieving high immunization coverage and other global immunization goals. Little is known about vaccination practices contributing to missed opportunities and barriers among private healthcare providers in Africa. Service Provision Assessments (SPA) of representative samples of health facilities in four African countries (Kenya, Tanzania, Senegal, Malawi) in 2010-2015 were used to describe missed opportunities and barriers for vaccination in public, private for-profit, private not-for-profit and faith-based facilities. Data included vaccination practices, observations during sick child and antenatal visits, and exit interviews following sick child visits. Data from 3,219 health facilities, 11,613 sick child visits and 8,698 antenatal visits were included. A smaller proportion of for-profit facilities offered child vaccination services (country range, 25-37%) than did public facilities (range, 90-96%). The proportion of facilities offering pentavalent vaccine (diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenza type b antigens) daily ranged 0-77% across countries and facility types. Less than 33% of for-profit facilities in any country offered measles vaccination daily. A minority of public or private providers assessed the child's vaccination status during a sick child visit (range by country and facility type, 14-44%), or offered tetanus toxoid during antenatal visits (range, 19-51%). Very few providers discussed the importance of newborn vaccination. Substantial missed opportunities for, and barriers to, vaccination were identified across this representative sample of health facilities in four African countries. Strategies are needed to ensure that private and public providers implement practices to minimize barriers and missed opportunities for vaccination.

Implementation of the framework convention on tobacco control in Africa: current status of legislation.

PubMed

Tumwine, Jacqueline

2011-11-01

To describe, as of July 2011, the status of tobacco control legislation in Africa in three key areas of the Framework Convention on Tobacco Control (FCTC)-(1) Protection from exposure to tobacco smoke, (2) Packaging and labelling of tobacco products, and (3) Tobacco advertising, promotion and sponsorship. Review and analysis of tobacco control legislation in Africa, media reports, journal articles, tobacco industry documents and data published in the 2011 WHO Report on the Global Tobacco Epidemic. Modest progress in FCTC implementation in Africa with many countries having legislation or policies on the protection from exposure to tobacco smoke, however, only a handful of countries meet the standards of the FCTC Article 8 and its Guidelines particularly with regards to designated smoking areas. Little progress on packaging and labelling of tobacco products, with few countries having legislation meeting the minimum standards of the FCTC Article 11 and its Guidelines. Mauritius is the only African country with graphic or pictorial health warnings in place and has the largest warning labels in Africa. Slightly better progress in banning tobacco advertising, promotion and sponsorship has been shown by African countries, although the majority of legislation falls short of the standards of the FCTC Article 13 and its Guidelines. Despite their efforts, African countries' FCTC implementation at national level has not matched the strong regional commitment demonstrated during the FCTC treaty negotiations. This study highlights the need for Africa to step up efforts to adopt and implement effective tobacco control legislation that is fully compliant with the FCTC. In order to achieve this, countries should prioritise resources for capacity building for drafting strong FCTC compliant legislation, research to inform policy and boost political will, and countering the tobacco industry which is a major obstacle to FCTC implementation in Africa.

Measles resurgence in southern Africa: challenges to measles elimination.

PubMed

Shibeshi, Messeret E; Masresha, Balcha G; Smit, Sheilagh B; Biellik, Robin J; Nicholson, Jennifer L; Muitherero, Charles; Shivute, Nestor; Walker, Oladapo; Reggis, Katsande; Goodson, James L

2014-04-01

In seven southern African countries (Botswana, Lesotho, Malawi, Namibia, South Africa, Swaziland and Zimbabwe), following implementation of a measles mortality reduction strategy starting in 1996, the number of annually reported measles cases decreased sharply to less than one per million population during 2006-2008. However, during 2009-2010, large outbreaks occurred in these countries. In 2011, a goal for measles elimination by 2020 was set in the World Health Organization (WHO) African Region (AFR). We reviewed the implementation of the measles control strategy and measles epidemiology during the resurgence in the seven southern African countries. Estimated coverage with routine measles vaccination, supplemental immunization activities (SIA), annually reported measles cases by country, and measles surveillance and laboratory data were analyzed using descriptive analysis. In the seven countries, coverage with the routine first dose of measles-containing vaccine (MCV1) decreased from 80% to 65% during 1996-2004, then increased to 84% in 2011; during 1996-2011, 79,696,523 people were reached with measles vaccination during 45 SIAs. Annually reported measles cases decreased from 61,160 cases to 60 cases and measles incidence decreased to <1 case per million during 1996-2008. During 2009-2010, large outbreaks that included cases among older children and adults were reported in all seven countries, starting in South Africa and Namibia in mid-2009 and in the other five countries by early 2010. The measles virus genotype detected was predominantly genotype B3. The measles resurgence highlighted challenges to achieving measles elimination in AFR by 2020. To achieve this goal, high two-dose measles vaccine coverage by strengthening routine immunization systems and conducting timely SIAs targeting expanded age groups, potentially including young adults, and maintaining outbreak preparedness to rapidly respond to outbreaks will be needed. Published by Elsevier Ltd.

Assessing the risks for poliovirus outbreaks in polio-free countries--Africa, 2012-2013.

PubMed

2013-09-20

In 2012, the World Health Assembly of the World Health Organization (WHO) declared the completion of polio eradication a programmatic emergency. Indigenous wild poliovirus (WPV) transmission remains uninterrupted in Nigeria (in the WHO African Region [AFR]) and in Afghanistan and Pakistan (in the WHO Eastern Mediterranean Region [EMR]). In the WHO AFR, multiple WPV outbreaks have occurred since 2003 after importation of indigenous West African WPV into 21 previously polio-free countries in a "WPV importation belt"* that extends across the continent. The Global Polio Eradication Initiative (GPEI) and WHO regional offices have used indicators of population immunity, surveillance quality, and other factors (e.g., high-risk subpopulations and proximity to WPV-affected countries) to assess the risk for outbreaks in polio-free countries and guide the implementation of risk mitigation measures to limit poliovirus transmission after WPV importation and prevent the emergence of circulating vaccine-derived poliovirus (cVDPV). Despite risk mitigation efforts, a polio outbreak, first confirmed in May 2013, is ongoing; as of September 10, a total of 178 WPV type 1 (WPV1) cases have been reported in Somalia† (163 cases), Kenya (14 cases) and Ethiopia (1 case), after importation of WPV1 of West African origin. This report summarizes steps taken by the GPEI to assess and mitigate the risks for outbreaks after WPV importation or the emergence of cVDPV in polio-free countries within the WHO AFR's "WPV importation belt." All countries will continue to have some level of risk for WPV outbreaks as long as endemic circulation continues in Afghanistan, Nigeria, and Pakistan.

Assessment of Yellow Fever Epidemic Risk: An Original Multi-criteria Modeling Approach

PubMed Central

Briand, Sylvie; Beresniak, Ariel; Nguyen, Tim; Yonli, Tajoua; Duru, Gerard; Kambire, Chantal; Perea, William

2009-01-01

Background Yellow fever (YF) virtually disappeared in francophone West African countries as a result of YF mass vaccination campaigns carried out between 1940 and 1953. However, because of the failure to continue mass vaccination campaigns, a resurgence of the deadly disease in many African countries began in the early 1980s. We developed an original modeling approach to assess YF epidemic risk (vulnerability) and to prioritize the populations to be vaccinated. Methods and Findings We chose a two-step assessment of vulnerability at district level consisting of a quantitative and qualitative assessment per country. Quantitative assessment starts with data collection on six risk factors: five risk factors associated with “exposure” to virus/vector and one with “susceptibility” of a district to YF epidemics. The multiple correspondence analysis (MCA) modeling method was specifically adapted to reduce the five exposure variables to one aggregated exposure indicator. Health districts were then projected onto a two-dimensional graph to define different levels of vulnerability. Districts are presented on risk maps for qualitative analysis in consensus groups, allowing the addition of factors, such as population migrations or vector density, that could not be included in MCA. The example of rural districts in Burkina Faso show five distinct clusters of risk profiles. Based on this assessment, 32 of 55 districts comprising over 7 million people were prioritized for preventive vaccination campaigns. Conclusion This assessment of yellow fever epidemic risk at the district level includes MCA modeling and consensus group modification. MCA provides a standardized way to reduce complexity. It supports an informed public health decision-making process that empowers local stakeholders through the consensus group. This original approach can be applied to any disease with documented risk factors. PMID:19597548

New Liberian President Seeks to Rehabilitate Country's Education System: Finding Teachers Still Country's Main Hurdle

ERIC Educational Resources Information Center

Powell, Tracie

2007-01-01

Troubled by the difficulties of training teachers in Liberia, President Ellen Johnson Sirleaf says she hopes to attract them from U.S. colleges and universities. Sirleaf envisions the Liberian Education Trust as a way to help repair a country devastated by two civil wars. The trust seeks to raise money so that the West African country can build 50…

Contribution of polio eradication initiative to strengthening routine immunization: Lessons learnt in the WHO African region.

PubMed

Anya, Blanche-Philomene Melanga; Moturi, Edna; Aschalew, Teka; Carole Tevi-Benissan, Mable; Akanmori, Bartholomew Dicky; Poy, Alain Nyembo; Mbulu, Kinuam Leon; Okeibunor, Joseph; Mihigo, Richard; Zawaira, Felicitas

2016-10-10

Important investments were made in countries for the polio eradication initiative. On 25 September 2015, a major milestone was achieved when Nigeria was removed from the list of polio-endemic countries. Routine Immunization, being a key pillar of polio eradication initiative needs to be strengthened to sustain the gains made in countries. For this, there is a huge potential on building on the use of polio infrastructure to contribute to RI strengthening. We reviewed estimates of immunization coverage as reported by the countries to WHO and UNICEF for three vaccines: BCG, DTP3 (third dose of diphtheria-tetanus toxoid- pertussis), and the first dose of measles-containing vaccine (MCV1).We conducted a systematic review of best practices documents from eight countries which had significant polio eradication activities. Immunization programmes have improved significantly in the African Region. Regional coverage for DTP3 vaccine increased from 51% in 1996 to 77% in 2014. DTP3 coverage increased >3 folds in DRC (18-80%) and Nigeria from 21% to 66%; and >2 folds in Angola (41-87%), Chad (24-46%), and Togo (42-87%). Coverage for BCG and MCV1 increased in all countries. Of the 47 countries in the region, 18 (38%) achieved a national coverage for DTP3 ⩾90% for 2years meeting the Global Vaccine Action (GVAP) target. A decrease was noted in the Ebola-affected countries i.e., Guinea, Liberia and Sierra Leone. PEI has been associated with increased spending on immunization and the related improvements, especially in the areas of micro planning, service delivery, program management and capacity building. Continued efforts are needed to mobilize international and domestic support to strengthen and sustain high-quality immunization services in African countries. Strengthening RI will in turn sustain the gains made to eradicate poliovirus in the region. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

PubMed

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.

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

PubMed

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.

Drivers for animal welfare policies in Africa.

PubMed

Molomo, M; Mumba, T

2014-04-01

Livestock in Africa represent on average 30% of the agricultural gross domestic product (GDP) and about 10% of the national GDP. Up to 300 million people depend on livestock for their income and livelihood. Accordingly, livestock are considered to be important for the African continent. Despite this, little or no provision for animal welfare is made in the laws and regulations of most African countries. However, the World Organisation for Animal Health (OIE) Performance of Veterinary Services (PVS) Tool includes animal welfare as a critical competency in Veterinary Services, and most African countries have now conducted PVS appraisals. The development of a Regional Animal Welfare Strategy in Africa is also important because it will provide opportunities for full engagement by all relevant parties. Key elements in this process should include collaboration and coordination in information dissemination to all stakeholders, who should include all those in the value chain. The roles played by the OIE Member Delegates and Focal Points, and non-governmental organisations (NGOs), in driving animal welfare policy in most African countries are notable. Without a level of understanding of animal welfare that is sufficient to support clear animal welfare policy development and implementation, problems may appear in the near future which could jeopardise the attainment of increased animal productivity and product quality. This may have negative implications for economic growth and for national and international trade.

A French-speaking speech-language pathology program in West Africa: transfer of training between Minority and Majority World countries.

PubMed

Topouzkhanian, Sylvia; Mijiyawa, Moustafa

2013-02-01

In West Africa, as in Majority World countries, people with a communication disability are generally cut-off from the normal development process. A long-term involvement of two partners (Orthophonistes du Monde and Handicap International) allowed the implementation in 2003 of the first speech-language pathology qualifying course in West Africa, within the Ecole Nationale des Auxiliaires Medicaux (ENAM, National School for Medical Auxiliaries) in Lome, Togo. It is a 3-year basic training (after the baccalaureate) in the only academic training centre for medical assistants in Togo. This department has a regional purpose and aims at training French-speaking African students. French speech-language pathology lecturers had to adapt their courses to the local realities they discovered in Togo. It was important to introduce and develop knowledge and skills in the students' system of reference. African speech-language pathologists have to face many challenges: creating an African speech and language therapy, introducing language disorders and their possible cure by means other than traditional therapies, and adapting all the evaluation tests and tools for speech-language pathology to each country, each culture, and each language. Creating an African speech-language pathology profession (according to its own standards) with a real influence in West Africa opens great opportunities for schooling and social and occupational integration of people with communication disabilities.

Globalization, pharmaceutical pricing, and South African health policy: managing confrontation with U.S. firms and politicians.

PubMed

Bond, P

1999-01-01

Brewing since the advent of South African democracy in 1994 and promises of health sector transformation, an extraordinary drug war between President Nelson Mandela's African National Congress government and U.S. pharmaceutical manufacturers took on global proportions in 1998-1999. Within months of the passage of South African legislation aimed at lowering drug prices, the U.S. government quickly applied powerful pressure points to repeal a clause allowing potential importation of generic substitutes and imposition of compulsory licensing. At stake were not only local interpretations of patent law and World Trade Organization rules on Trade in Intellectual Property, but international power relations between developing countries and the pharmaceutical industry. In reviewing the ongoing debate, this article considers post-apartheid public health policy, U.S. government pressure to change the law, and pharmaceutical industry interests and links to the U.S. government, and evaluates various kinds of resistance to U.S. corporate and government behavior. The case thus raises--not for the first time--concerns about contemporary imperialism ("globalization"), the role of the profit motive as an incentive in vital pharmaceutical products, and indeed the depth of "democracy" in a country where high-bidding international drug firms have sufficient clout to embarrass Vice President Al Gore by pitting him against the life-and-death interests of millions of consumers of essential drugs in South Africa and other developing countries.

Global epidemiology of invasive meningococcal disease

PubMed Central

2013-01-01

Neisseria meningitidis is one of the leading causes of bacterial meningitis globally and can also cause sepsis, pneumonia, and other manifestations. In countries with high endemic rates, the disease burden places an immense strain on the public health system. The worldwide epidemiology of invasive meningococcal disease (IMD) varies markedly by region and over time. This review summarizes the burden of IMD in different countries and identifies the highest-incidence countries where routine preventive programs against Neisseria meningitidis would be most beneficial in providing protection. Available epidemiological data from the past 20 years in World Health Organization and European Centre for Disease Prevention and Control collections and published articles are included in this review, as well as direct communications with leading experts in the field. Countries were grouped into high-, moderate-, and low-incidence countries. The majority of countries in the high-incidence group are found in the African meningitis belt; many moderate-incidence countries are found in the European and African regions, and Australia, while low-incidence countries include many from Europe and the Americas. Priority countries for vaccine intervention are high- and moderate-incidence countries where vaccine-preventable serogroups predominate. Epidemiological data on burden of IMD are needed in countries where this is not known, particularly in South- East Asia and Eastern Mediterranean regions, so evidence-based decisions about the use of meningococcal vaccines can be made. PMID:24016339

Global epidemiology of invasive meningococcal disease.

PubMed

Jafri, Rabab Z; Ali, Asad; Messonnier, Nancy E; Tevi-Benissan, Carol; Durrheim, David; Eskola, Juhani; Fermon, Florence; Klugman, Keith P; Ramsay, Mary; Sow, Samba; Zhujun, Shao; Bhutta, Zulfiqar A; Abramson, Jon

2013-09-10

Neisseria meningitidis is one of the leading causes of bacterial meningitis globally and can also cause sepsis, pneumonia, and other manifestations. In countries with high endemic rates, the disease burden places an immense strain on the public health system. The worldwide epidemiology of invasive meningococcal disease (IMD) varies markedly by region and over time. This review summarizes the burden of IMD in different countries and identifies the highest-incidence countries where routine preventive programs against Neisseria meningitidis would be most beneficial in providing protection. Available epidemiological data from the past 20 years in World Health Organization and European Centre for Disease Prevention and Control collections and published articles are included in this review, as well as direct communications with leading experts in the field. Countries were grouped into high-, moderate-, and low-incidence countries. The majority of countries in the high-incidence group are found in the African meningitis belt; many moderate-incidence countries are found in the European and African regions, and Australia, while low-incidence countries include many from Europe and the Americas. Priority countries for vaccine intervention are high- and moderate-incidence countries where vaccine-preventable serogroups predominate. Epidemiological data on burden of IMD are needed in countries where this is not known, particularly in South- East Asia and Eastern Mediterranean regions, so evidence-based decisions about the use of meningococcal vaccines can be made.

Combining satellite imagery and machine learning to predict poverty.

PubMed

Jean, Neal; Burke, Marshall; Xie, Michael; Davis, W Matthew; Lobell, David B; Ermon, Stefano

2016-08-19

Reliable data on economic livelihoods remain scarce in the developing world, hampering efforts to study these outcomes and to design policies that improve them. Here we demonstrate an accurate, inexpensive, and scalable method for estimating consumption expenditure and asset wealth from high-resolution satellite imagery. Using survey and satellite data from five African countries--Nigeria, Tanzania, Uganda, Malawi, and Rwanda--we show how a convolutional neural network can be trained to identify image features that can explain up to 75% of the variation in local-level economic outcomes. Our method, which requires only publicly available data, could transform efforts to track and target poverty in developing countries. It also demonstrates how powerful machine learning techniques can be applied in a setting with limited training data, suggesting broad potential application across many scientific domains. Copyright © 2016, American Association for the Advancement of Science.

Ethnicity and association with disease manifestations and mortality in Behçet’s disease

PubMed Central

2014-01-01

Background Behçet’s disease (BD) significantly increases morbidity and mortality. BD mainly affects young adults with a peculiar geographical distribution. It has been suggested that BD varies in its phenotypic expression in different ethnic groups. Methods We investigated potential ethnicity-related differences relative to phenotype and prognosis of BD patients in a French multiethnic country. We included 769 consecutive patients fulfilling the international criteria of classification for BD, in the 3 largest ethnic groups of our cohort [European (n = 369), North African (n = 350) and sub Saharan African (n = 50)]. Factors that affect prognosis were assessed by multivariate analysis. Results 535 (69.6%) patients were male and the median (IQR) age at diagnosis was of 30.9 (24.9-37.2) years. Sub Saharan African BD patients had a higher frequency of CNS involvement (48% vs 32.3% vs 29.5%, p = 0 .035), a higher rate of death (12% vs 6% vs 3.5%, p = 0.029) and a lower frequency of HLA B51 allele (29.4% vs 49.2% vs 55.8%, p = 0.009) compared to those from North Africa and Europe, respectively. Multivariate analysis showed that male gender (HR: 5.01, CI: 1.51-16.65), cardiovascular involvement (HR: 2.24, CI: 1.15-4.36), and sub Saharan African origin (HR 2.62 (0.98-6.97) were independently associated with mortality. The 15-year mortality rate was of 19%, 9% and 6% in sub Saharan African, North African and European BD patients, respectively (p = 0.015). Conclusion We reported ethnicity-related differences with respect to phenotype of BD. Sub Saharan Africans patients exhibited a worse prognosis. PMID:24674137

Nuclear cardiology practices and radiation exposure in Africa: results from the IAEA Nuclear Cardiology Protocols Study (INCAPS)

PubMed Central

Bouyoucef, Salah E; Mercuri, Mathew; Einstein, Andrew J; Pascual, Thomas NB; Kashyap, Ravi; Dondi, Maurizio; Paez, Diana; Allam, Adel H; Vangu, Mboyo; Vitola, João V; Better, Nathan; Karthikeyan, Ganesan; Mahmarian, John J; Rehani, Madan M; Einstein, Andrew J

2017-01-01

Summary Objective: While nuclear myocardial perfusion imaging (MPI) offers many benefits to patients with known or suspected cardiovascular disease, concerns exist regarding radiationassociated health effects. Little is known regarding MPI practice in Africa. We sought to characterise radiation doses and the use of MPI best practices that could minimise radiation in African nuclear cardiology laboratories, and compare these to practice worldwide. Methods: Demographics and clinical characteristics were collected for a consecutive sample of 348 patients from 12 laboratories in six African countries over a one-week period from March to April 2013. Radiation effective dose (ED) was estimated for each patient. A quality index (QI) enumerating adherence to eight best practices, identified a priori by an IAEA expert panel, was calculated for each laboratory. We compared these metrics with those from 7 563 patients from 296 laboratories outside Africa. Results: to that of the rest of the world [9.1 (5.1–15.6) vs 10.3 mSv (6.8–12.6), p = 0.14], although a larger proportion of African patients received a low ED, ≤ 9 mSv targeted in societal recommendations (49.7 vs 38.2%, p < 0.001). Bestpractice adherence was higher among African laboratories (QI score: 6.3 ± 1.2 vs 5.4 ± 1.3, p = 0.013). However, median ED varied significantly among African laboratories (range: 2.0–16.3 mSv; p < 0.0001) and QI range was 4–8. Conclusion: Patient radiation dose from MPI in Africa was similar to that in the rest of the world, and adherence to best practices was relatively high in African laboratories. Nevertheless there remain opportunities to further reduce radiation exposure to African patients from MPI. PMID:28906538

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

PubMed Central

Ladner, Joël; Besson, Marie-Hélène; Rodrigues, Mariana; Saba, Joseph; Audureau, Etienne

2015-01-01

Background 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. Methods 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. Results 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. Conclusion 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 performance may help in the development and expansion of additional large PMTCT services in sub-Saharan Africa. PMID:26098311

Security and skills: the two key issues in health worker migration

PubMed Central

Bidwell, Posy; Laxmikanth, Pallavi; Blacklock, Claire; Hayward, Gail; Willcox, Merlin; Peersman, Wim; Moosa, Shabir; Mant, David

2014-01-01

Background Migration of health workers from Africa continues to undermine the universal provision of quality health care. South Africa is an epicentre for migration – it exports more health workers to high-income countries than any other African country and imports health workers from its lower-income neighbours to fill the gap. Although an inter-governmental agreement in 2003 reduced the very high numbers migrating from South Africa to the United Kingdom, migration continues to other high-income English-speaking countries and few workers seem to return although the financial incentive to work abroad has lessened. A deeper understanding of reasons for migration from South Africa and post-migration experiences is therefore needed to underpin policy which is developed in order to improve retention within source countries and encourage return. Methods Semi-structured interviews were conducted with 16 South African doctors and nurses who had migrated to the United Kingdom. Interviews explored factors influencing the decision to migrate and post-migration experiences. Results Salary, career progression, and poor working conditions were not major push factors for migration. Many health workers reported that they had previously overcome these issues within the South African healthcare system by migrating to the private sector. Overwhelmingly, the major push factors were insecurity, high levels of crime, and racial tension. Although the wish to work and train in what was perceived to be a first-class care system was a pull factor to migrate to the United Kingdom, many were disappointed by the experience. Instead of obtaining new skills, many (particularly nurses) felt they had become ‘de-skilled’. Many also felt that working conditions and opportunities for them in the UK National Health Service (NHS) compared unfavourably with the private sector in South Africa. Conclusions Migration from South Africa seems unlikely to diminish until the major concerns over security, crime, and racial tensions are resolved. However, good working conditions in the private sector in South Africa provide an occupational incentive to return if security did improve. Potential migrants should be made more aware of the risks of losing skills while working abroad that might prejudice return. In addition, re-skilling initiatives should be encouraged. PMID:25079286

Association of Socioeconomic Status with Overall and Cause Specific Mortality in the Republic of Seychelles: Results from a Cohort Study in the African Region

PubMed Central

Stringhini, Silvia; Rousson, Valentin; Viswanathan, Bharathi; Gedeon, Jude; Paccaud, Fred; Bovet, Pascal

2014-01-01

Background Low socioeconomic status (SES) is consistently associated with higher mortality in high income countries. Only few studies have assessed this association in low and middle income countries, mainly because of sparse reliable mortality data. This study explores SES differences in overall and cause-specific mortality in the Seychelles, a rapidly developing small island state in the African region. Methods All deaths have been medically certified over more than two decades. SES and other lifestyle-related risk factors were assessed in a total of 3246 participants from three independent population-based surveys conducted in 1989, 1994 and 2004. Vital status was ascertained using linkage with vital statistics. Occupational position was the indicator of SES used in this study and was assessed with the same questions in the three surveys. Results During a mean follow-up of 15.0 years (range 0–23 years), 523 participants died (overall mortality rate 10.8 per 1000 person-years). The main causes of death were cardiovascular disease (CVD) (219 deaths) and cancer (142 deaths). Participants in the low SES group had a higher mortality risk for overall (HR = 1.80; 95% CI: 1.24–2.62), CVD (HR = 1.95; 1.04–3.65) and non-cancer/non-CVD (HR = 2.14; 1.10–4.16) mortality compared to participants in the high SES group. Cancer mortality also tended to be patterned by SES (HR = 1.44; 0.76–2.75). Major lifestyle-related risk factors (smoking, heavy drinking, obesity, diabetes, hypertension, hypercholesterolemia) explained a small proportion of the associations between low SES and all-cause, CVD, and non-cancer/non-CVD mortality. Conclusions In this population-based study assessing social inequalities in mortality in a country of the African region, low SES (as measured by occupational position) was strongly associated with overall, CVD and non-cancer/non-CVD mortality. Our findings support the view that the burden of non-communicable diseases may disproportionally affect people with low SES in low and middle income countries. PMID:25057938

Nursing and midwifery regulation and HIV scale-up: establishing a baseline in east, central and southern Africa

PubMed Central

McCarthy, Carey F; Voss, Joachim; Verani, Andre R; Vidot, Peggy; Salmon, Marla E; Riley, Patricia L

2013-01-01

Introduction Shifting HIV treatment tasks from physicians to nurses and midwives is essential to scaling-up HIV services in sub-Saharan Africa. Updating nursing and midwifery regulations to include task shifting and pre-service education reform can help facilitate reaching new HIV targets. Donor-supported initiatives to update nursing and midwifery regulations are increasing. However, there are gaps in our knowledge of current practice and education regulations and a lack of information to target and implement regulation strengthening efforts. We conducted a survey of national nursing and midwifery councils to describe current nursing and midwifery regulations in 13 African countries. Methods A 30-item survey was administered to a convenience sample of 13 national nursing and midwifery regulatory body leaders in attendance at the PEPFAR-supported African Health Profession Regulatory Collaborative meeting in Nairobi, Kenya on 28 February, 2011. The survey contained questions on task shifting and regulations such as registration, licensure, scope of practice, pre-service education accreditation, continuing professional development and use of international guidelines. Survey data were analyzed to present country-level, comparative and regional findings. Results Task shifting to nurses and midwives was reported in 11 of the 13 countries. Eight countries updated their scope of practice within the last five years; only one reported their regulations to reflect task shifting. Countries vary with regard to licensure, pre-service accreditation and continuing professional development regulations in place. There was no consistency in terms of what standards were used to design national practice and education regulations. Discussion Many opportunities exist to assist countries to modernise regulations to incorporate important advancements from task shifting and pre-service reform. Appropriate, revised regulations can help sustain successful health workforce strategies and contribute to further scale-up HIV services and other global health priorities. Conclusions This study provides fundamental information from which to articulate goals and to measure the impact of regulation strengthening efforts. PMID:23531276

Making Space for Adult Education in Independent Namibia

ERIC Educational Resources Information Center

Ellis, Justin

2004-01-01

Namibia is a vast and arid African country neighbouring South Africa, Botswana, Zimbabwe, Zambia, Angola and the Atlantic Ocean, with a population of only two million. Namibia achieved its independence in 1990 after a protracted and brutal struggle, latterly against South African occupation, but rooted in the resistance to German colonisation that…

Dissecting the Dissectors: Knowledge, Attitude, and Practice of Body Bequests by Nigerian Anatomists

ERIC Educational Resources Information Center

Anyanwu, Emeka G.; Obikili, Emmanuel N.

2012-01-01

Anatomy education in most African countries is limited by an insufficient number of cadavers for students to undertake dissection. This already significant shortage is exacerbated by an increasing number of medical schools and students. Virtual dissections are impractical in alleviating such a shortfall in African anatomy education, and further…

Developing Ethical and Democratic Citizens in a Post-Colonial Context: Citizenship Education in Kenya

ERIC Educational Resources Information Center

Wainaina, Paul K.; Arnot, Madeleine; Chege, Fatuma

2011-01-01

Background: Youth citizenship is now on the international agenda with African countries increasingly interrogating their national perspectives on citizenship and citizenship education. In this emergent field of research, African scholars are beginning to challenge the prevailing (Western) theories of citizenship and democracy. Purpose: The aim of…

Career Choice and Unemployment Length: A Study of Graduates from a South African University

ERIC Educational Resources Information Center

Mncayi, Precious; Dunga, Steven Henry

2016-01-01

Graduate unemployment is especially problematic in a country where much emphasis is placed on furthering academic studies for economic and personal rewards. This article investigates the relationship between career choice and unemployment length among graduates from a South African university. Data were collected by means of a survey questionnaire…

I Didn't Know There Were Cities in Africa!

ERIC Educational Resources Information Center

Randolph, Brenda

2008-01-01

As Professor Michael Bamidele Adeyemi of the University of Botswana suggests, "Americans believe that Africa is a country, that Africa is "still uncivilized," that the average African is polygamous, and that Africa is not urbanized." In fact, the African continent encompasses a diverse set of more than 50 nations, each made up…

Multicampus University Systems: Africa and the Kenyan Experience. Routledge Research in International and Comparative Education

ERIC Educational Resources Information Center

Munene, Ishmael I.

2014-01-01

In the face of increasing social demand and cutbacks in state budgetary support, universities in African countries are now turning towards a multicampus system strategy. As African governments have adopted neoliberal education policies that place premium on entrepreneurialism, profit making, privatization, and markets as drivers of university…

Recruitment Is Not Enough: Retaining African American Students in Gifted Education

ERIC Educational Resources Information Center

Moore, James L., III; Ford, Donna Y.; Milner, H. Richard

2005-01-01

In public school systems all around the country, educators--teachers, counselors, and administrators--have made significant progress in identifying and recruiting diverse populations in gifted and enrichment programs. Despite the efforts, too many African American students and other students of color (e.g., Hispanic Americans and Native Americans)…

Determinants of Human Capital Formation and Economic Growth of African Countries

ERIC Educational Resources Information Center

Oketch, Moses O.

2006-01-01

Rapid economic growth and improving living standards have benefited almost all regions of the world since the industrial revolution. Africa stands out as one regional exception. While several factors such as civil wars and rampant corruption have been associated with poor economic performance of the African region in the international community,…

Mother Tongue Education: The West African Experience.

ERIC Educational Resources Information Center

Bamgbose, Ayo, Ed.

In the rapidly changing political, economic, and social life of West Africa, there is a renewed interest in cultural identity. This book describes the developments and the difficulties experienced by different West African countries in the use of mother tongues in multi-lingual society. The book was commissioned to give scholars, educators, and…

The Potential Skills Contribution of International Students to South Africa

ERIC Educational Resources Information Center

Aloyo, N.; Wentzel, A.

2011-01-01

There has been a significant increase in the number of international students, especially in those from other African countries, at South African universities over the last ten years. This has elicited some research, notably from Ramphele, Crush and McDonald (1999); Hall (2004); and Snowball and Antrobus (2005; 2006). However, none of these…

Maintaining Academic Integrity among East African University Students

ERIC Educational Resources Information Center

Mwamwenda, T. S.

2012-01-01

The purpose of this research was to examine the extent to which academic integrity is maintained in the academic programmes of three East African university students selected from one of the universities in each one of the three countries. For confidentiality and identification purposes, the universities were labeled A, B and C. The level of…

"Translanguaging" as a Socially Just Pedagogy

ERIC Educational Resources Information Center

Hurst, Ellen; Mona, Msakha

2017-01-01

South African higher education relies primarily on English as the medium of education. This is a result of the colonial history of the country, yet it disadvantages a large section of South African students who undertake their education in a language that is not their first language. It also reproduces the monolingual norm and anglonormativity.…

Documentation of polio eradication initiative best practices: Experience from WHO African Region.

PubMed

Okeibunor, Joseph; Nshimirimana, Deo; Nsubuga, Peter; Mutabaruka, Evariste; Tapsoba, Leonard; Ghali, Emmanuel; Kabir, Shaikh Humayun; Gassasira, Alex; Mihigo, Richard; Mkanda, Pascal

2016-10-10

The African Region is set to achieving polio eradication. During the years of operations, the Polio Eradication Initiative [PEI] in the Region mobilized and trained tremendous amount of manpower with specializations in surveillance, social mobilization, supplementary immunization activities [SIAs], data management and laboratory staff. Systems were put in place to accelerate the eradication of polio in the Region. Standardized, real-time surveillance and response capacity were established. Many innovations were developed and applied to reaching people in difficult and security challenged terrains. All of these resulted in accumulation of lessons and best practices, which can be used in other priority public health intervention if documented. The World Health Organization Regional Office for Africa [WHO/AFRO] developed a process for the documentation of these best practices, which was pretested in Uganda. The process entailed assessment of three critical elements [effectiveness, efficiency and relevance] five aspects [ethical soundness, sustainability, involvement of partners, community involvement, and political commitment] of best practices. A scored card which graded the elements and aspects on a scale of 0-10 was developed and a true best practice should score >50 points. Independent public health experts documented polio best practices in eight countries in the Region, using this process. The documentation adopted the cross-sectional design in the generation of data, which combined three analytical designs, namely surveys, qualitative inquiry and case studies. For the selection of countries, country responses to earlier questionnaire on best practices were screened for potential best practices. Another criterion used was the level of PEI investment in the countries. A total of 82 best practices grouped into ten thematic areas were documented. There was a correlation between the health system performances with DPT3 as proxy, level of PEI investment in countries with number of best practice. The application of the process for the documentation of polio best practices in the African Region brought out a number of advantages. The triangulation of data collected using multiple methods and the collection of data from all levels of the programme proved useful as it provided opportunity for data verification and corroboration. It also helped to overcome some of the data challenge. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Continent-wide survey reveals massive decline in African savannah elephants

PubMed Central

Schlossberg, Scott; Griffin, Curtice R.; Bouché, Philippe J.C.; Djene, Sintayehu W.; Elkan, Paul W.; Ferreira, Sam; Grossman, Falk; Kohi, Edward Mtarima; Landen, Kelly; Omondi, Patrick; Peltier, Alexis; Selier, S.A. Jeanetta; Sutcliffe, Robert

2016-01-01

African elephants (Loxodonta africana) are imperiled by poaching and habitat loss. Despite global attention to the plight of elephants, their population sizes and trends are uncertain or unknown over much of Africa. To conserve this iconic species, conservationists need timely, accurate data on elephant populations. Here, we report the results of the Great Elephant Census (GEC), the first continent-wide, standardized survey of African savannah elephants. We also provide the first quantitative model of elephant population trends across Africa. We estimated a population of 352,271 savannah elephants on study sites in 18 countries, representing approximately 93% of all savannah elephants in those countries. Elephant populations in survey areas with historical data decreased by an estimated 144,000 from 2007 to 2014, and populations are currently shrinking by 8% per year continent-wide, primarily due to poaching. Though 84% of elephants occurred in protected areas, many protected areas had carcass ratios that indicated high levels of elephant mortality. Results of the GEC show the necessity of action to end the African elephants’ downward trajectory by preventing poaching and protecting habitat. PMID:27635327

Continent-wide survey reveals massive decline in African savannah elephants.

PubMed

Chase, Michael J; Schlossberg, Scott; Griffin, Curtice R; Bouché, Philippe J C; Djene, Sintayehu W; Elkan, Paul W; Ferreira, Sam; Grossman, Falk; Kohi, Edward Mtarima; Landen, Kelly; Omondi, Patrick; Peltier, Alexis; Selier, S A Jeanetta; Sutcliffe, Robert

2016-01-01

African elephants (Loxodonta africana) are imperiled by poaching and habitat loss. Despite global attention to the plight of elephants, their population sizes and trends are uncertain or unknown over much of Africa. To conserve this iconic species, conservationists need timely, accurate data on elephant populations. Here, we report the results of the Great Elephant Census (GEC), the first continent-wide, standardized survey of African savannah elephants. We also provide the first quantitative model of elephant population trends across Africa. We estimated a population of 352,271 savannah elephants on study sites in 18 countries, representing approximately 93% of all savannah elephants in those countries. Elephant populations in survey areas with historical data decreased by an estimated 144,000 from 2007 to 2014, and populations are currently shrinking by 8% per year continent-wide, primarily due to poaching. Though 84% of elephants occurred in protected areas, many protected areas had carcass ratios that indicated high levels of elephant mortality. Results of the GEC show the necessity of action to end the African elephants' downward trajectory by preventing poaching and protecting habitat.

Does economic, financial and institutional developments matter for environmental quality? A comparative analysis of EU and MEA countries.

PubMed

Abid, Mehdi

2017-03-01

The aim of this study is to test the hypothesis of the Environmental Kuznets Curve (EKC) with a sample of 58 MEA (Middle East & African) and 41 EU (European Union) countries for the period 1990 to 2011. The empirical analysis is carried out using the GMM-system method to solve the problem of endogenous variables. We focused on direct and indirect effects of institutional quality (through the efficiency of public expenditure, financial development, trade openness and foreign direct investment) and the income-emission relationship. We found a monotonically increasing relationship between CO 2 emissions and GDP in both MEA and EU regions. The policy implication is clear: in order to have sustainable positive economic performance and to reduce carbon dioxide emission in the country at the same time, policy makers should regulate and enhance the role and efficiency of domestic institutions. Copyright © 2016 Elsevier Ltd. All rights reserved.

On the politics and practice of Muslim fertility: comparative evidence from West Africa.

PubMed

Johnson-Hanks, Jennifer

2006-03-01

Recent popular works have represented Muslim fertility as dangerously high, both a cause and consequence of religious fundamentalism. This article uses comparative, statistical methods to show that this representation is empirically wrong, at least in West Africa. Although religion strongly inflects reproductive practice, its effects are not constant across different communities. In West African countries with Muslim majorities, Muslim fertility is lower than that of their non-Muslim conationals; in countries where Muslims are in the minority, their apparently higher reproductive rates converge to those of the majority when levels of education and urban residence are taken into account. A similar pattern holds for infant mortality. By contrast, in all seven countries, Muslim women are more likely to report that their most recent child was wanted. The article concludes with a discussion of the relationship between autonomy and fertility desires.

Differences in markers of cardiovascular disease between professional football players of West-Asian and Black African descent.

PubMed

Wilson, M G; Hamilton, B; Sandridge, A L; Salah, O; Chalabi, H

2012-05-01

To examine the cardiovascular risk factors of professional football players of West-Asian and Black African descent competing in the 2010/11 Qatar Stars League. Ten out of twelve professional football clubs attended pre-participation screening. 100 West-Asian males from seven Gulf States and six Middle-Eastern countries and 90 Black males from seven African countries. All players were screened using the FIFA pre-competition medical assessment, incorporating a physical examination, resting 12-Lead ECG, echocardiogram, with determination of total cholesterol, high and low density lipoprotein (HDL/LDL) and triglycerides. West-Asian football players had a higher prevalence of a family history (FH) of coronary heart disease (CHD) (25% vs. 12%, p = 0.025) compared to Black African players predominantly due to CHD in their fathers (14% vs. 6%, p<0.05). West-Asian players had higher total cholesterol levels (4.4 vs. 4.2 mmol/L, p = 0.025) and lower HDL levels (1.3 vs. 1.4 mmol/L, p = 0.004) than Black African players; remaining significant after adjusting for a FH of CHD. Positively, all lipid levels were clinically acceptable for both ethnicities. Finally, one in eight West-Asian and one in eleven Black African football players were regular smokers. The prevalence of cardiovascular disease in West-Asia is increasing. This study observed clinically acceptable blood lipid profiles for both West-Asian and Black African football players. However, West-Asian players had a greater number of markers for CVD than their Black African counterparts despite being matched for physical activity levels. Targeted education with regards to diet, lifestyle and tobacco use is required for both ethnicities. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Gender Discrimination and Education in West Africa: Strategies for Maintaining Girls in School

ERIC Educational Resources Information Center

Tuwor, Theresa; Sossou, Marie-Antoinette

2008-01-01

Girls' enrolment in primary schools has achieved significant increase and parity with male enrolment in many countries in Africa since the 1960s. Some of these countries include Botswana, Namibia and Tanzania. However, in most Sub-Saharan African countries, female enrolment still lags behind male enrolment. This paper examines some of the reasons…

Resource Sharing in West Africa: Some Implications for the Development of National Information Policies.

ERIC Educational Resources Information Center

Sheriff, G. M.

This paper briefly examines the current state of library cooperation in the West African countries, in relation to the implementation of national information policies in these countries. Library cooperation within the framework of a national information policy in developing countries is considered as a primary need rather than the development of…

Distribution of Primary School Enrollments in Eastern Africa. World Bank Staff Working Papers Number 511.

ERIC Educational Resources Information Center

Maas, Jacob van Lutsenburg; Criel, Geert

Distribution of primary school enrollments within and among 15 countries of the Eastern African region was examined by drawing exclusively on routine annual statistics and by emphasizing simple computer-generated indicators. In its first phase, the study made inter-country comparisons that indicated which countries and which areas in the region…

Literacy for Development: An African Perspective (Notes from a Sabbatical).

ERIC Educational Resources Information Center

Bhola, H. S.

This report contains one man's impressions of the state of adult literacy education in several countries of Africa and in India. The first country reported on is Ethiopia, where signs of a capitalist society were evident in that officially Marxist country, where literacy education was still a priority in the midst of a waning famine. Ethiopia had…

Women's views on consent, counseling and confidentiality in PMTCT: a mixed-methods study in four African countries

PubMed Central

2012-01-01

Background Ambitious UN goals to reduce the mother-to-child transmission of HIV have not been met in much of Sub-Saharan Africa. This paper focuses on the quality of information provision and counseling and disclosure patterns in Burkina Faso, Kenya, Malawi and Uganda to identify how services can be improved to enable better PMTCT outcomes. Methods Our mixed-methods study draws on data obtained through: (1) the MATCH (Multi-country African Testing and Counseling for HIV) study's main survey, conducted in 2008-09 among clients (N = 408) and providers at health facilities offering HIV Testing and Counseling (HTC) services; 2) semi-structured interviews with a sub-set of 63 HIV-positive women on their experiences of stigma, disclosure, post-test counseling and access to follow-up psycho-social support; (3) in-depth interviews with key informants and PMTCT healthcare workers; and (4) document study of national PMTCT policies and guidelines. We quantitatively examined differences in the quality of counseling by country and by HIV status using Fisher's exact tests. Results The majority of pregnant women attending antenatal care (80-90%) report that they were explained the meaning of the tests, explained how HIV can be transmitted, given advice on prevention, encouraged to refer their partners for testing, and given time to ask questions. Our qualitative findings reveal that some women found testing regimes to be coercive, while disclosure remains highly problematic. 79% of HIV-positive pregnant women reported that they generally keep their status secret; only 37% had disclosed to their husband. Conclusion To achieve better PMTCT outcomes, the strategy of testing women in antenatal care (perceived as an exclusively female domain) when they are already pregnant needs to be rethought. When scaling up HIV testing programs, it is particularly important that issues of partner disclosure are taken seriously. PMID:22236097

A Statistical Model of the International Spread of Wild Poliovirus in Africa Used to Predict and Prevent Outbreaks

PubMed Central

O'Reilly, Kathleen M.; Chauvin, Claire; Aylward, R. Bruce; Maher, Chris; Okiror, Sam; Wolff, Chris; Nshmirimana, Deo; Donnelly, Christl A.; Grassly, Nicholas C.

2011-01-01

Background Outbreaks of poliomyelitis in African countries that were previously free of wild-type poliovirus cost the Global Polio Eradication Initiative US$850 million during 2003–2009, and have limited the ability of the program to focus on endemic countries. A quantitative understanding of the factors that predict the distribution and timing of outbreaks will enable their prevention and facilitate the completion of global eradication. Methods and Findings Children with poliomyelitis in Africa from 1 January 2003 to 31 December 2010 were identified through routine surveillance of cases of acute flaccid paralysis, and separate outbreaks associated with importation of wild-type poliovirus were defined using the genetic relatedness of these viruses in the VP1/2A region. Potential explanatory variables were examined for their association with the number, size, and duration of poliomyelitis outbreaks in 6-mo periods using multivariable regression analysis. The predictive ability of 6-mo-ahead forecasts of poliomyelitis outbreaks in each country based on the regression model was assessed. A total of 142 genetically distinct outbreaks of poliomyelitis were recorded in 25 African countries, resulting in 1–228 cases (median of two cases). The estimated number of people arriving from infected countries and <5-y childhood mortality were independently associated with the number of outbreaks. Immunisation coverage based on the reported vaccination history of children with non-polio acute flaccid paralysis was associated with the duration and size of each outbreak, as well as the number of outbreaks. Six-month-ahead forecasts of the number of outbreaks in a country or region changed over time and had a predictive ability of 82%. Conclusions Outbreaks of poliomyelitis resulted primarily from continued transmission in Nigeria and the poor immunisation status of populations in neighbouring countries. From 1 January 2010 to 30 June 2011, reduced transmission in Nigeria and increased incidence in reinfected countries in west and central Africa have changed the geographical risk of polio outbreaks, and will require careful immunisation planning to limit onward spread. Please see later in the article for the Editors' Summary PMID:22028632

Regulation of genomic and biobanking research in Africa: a content analysis of ethics guidelines, policies and procedures from 22 African countries.

PubMed

de Vries, Jantina; Munung, Syntia Nchangwi; Matimba, Alice; McCurdy, Sheryl; Ouwe Missi Oukem-Boyer, Odile; Staunton, Ciara; Yakubu, Aminu; Tindana, Paulina

2017-02-02

The introduction of genomics and biobanking methodologies to the African research context has also introduced novel ways of doing science, based on values of sharing and reuse of data and samples. This shift raises ethical challenges that need to be considered when research is reviewed by ethics committees, relating for instance to broad consent, the feedback of individual genetic findings, and regulation of secondary sample access and use. Yet existing ethics guidelines and regulations in Africa do not successfully regulate research based on sharing, causing confusion about what is allowed, where and when. In order to understand better the ethics regulatory landscape around genomic research and biobanking, we conducted a comprehensive analysis of existing ethics guidelines, policies and other similar sources. We sourced 30 ethics regulatory documents from 22 African countries. We used software that assists with qualitative data analysis to conduct a thematic analysis of these documents. Surprisingly considering how contentious broad consent is in Africa, we found that most countries allow the use of this consent model, with its use banned in only three of the countries we investigated. In a likely response to fears about exploitation, the export of samples outside of the continent is strictly regulated, sometimes in conjunction with regulations around international collaboration. We also found that whilst an essential and critical component of ensuring ethical best practice in genomics research relates to the governance framework that accompanies sample and data sharing, this was most sparingly covered in the guidelines. There is a need for ethics guidelines in African countries to be adapted to the changing science policy landscape, which increasingly supports principles of openness, storage, sharing and secondary use. Current guidelines are not pertinent to the ethical challenges that such a new orientation raises, and therefore fail to provide accurate guidance to ethics committees and researchers.

Large-scale mapping of hard-rock aquifer properties applied to Burkina Faso.

PubMed

Courtois, Nathalie; Lachassagne, Patrick; Wyns, Robert; Blanchin, Raymonde; Bougaïré, Francis D; Somé, Sylvain; Tapsoba, Aïssata

2010-01-01

A country-scale (1:1,000,000) methodology has been developed for hydrogeologic mapping of hard-rock aquifers (granitic and metamorphic rocks) of the type that underlie a large part of the African continent. The method is based on quantifying the "useful thickness" and hydrodynamic properties of such aquifers and uses a recent conceptual model developed for this hydrogeologic context. This model links hydrodynamic parameters (transmissivity, storativity) to lithology and the geometry of the various layers constituting a weathering profile. The country-scale hydrogeological mapping was implemented in Burkina Faso, where a recent 1:1,000,000-scale digital geological map and a database of some 16,000 water wells were used to evaluate the methodology.

Evidence for an African cluster of human head and body lice with variable colors and interbreeding of lice between continents.

PubMed

Veracx, Aurélie; Boutellis, Amina; Merhej, Vicky; Diatta, Georges; Raoult, Didier

2012-01-01

Human head lice and body lice have been classified based on phenotypic characteristics, including geographical source, ecotype (preferred egg laying site hair or clothes), shape and color. More recently, genotypic studies have been based on mitochondrial genes, nuclear genes and intergenic spacers. Mitochondrial genetic analysis reclassified lice into three genotypes (A, B and C). However, no previous study has attempted to correlate both genotypic and phenotypic data. Lice were collected in four African countries: Senegal, Burundi, Rwanda and Ethiopia and were photographed to compare their colors. The Multi-Spacer-Typing (MST) method was used to genotype lice belonging to the worldwide Clade A, allowing a comparison of phenotypic and genotypic data. No congruence between louse color and genotype has been identified. Phylogenetic analysis of the spacer PM2, performed including lice from other sources, showed the existence of an African cluster of human lice. However, the analysis of other spacers suggested that lice from different areas are interbreeding. We identified two geotypes of Clade A head and body lice including one that is specifically African, that can be either black or grey and can live on the head or in clothing. We also hypothesized that lice from different areas are interbreeding.

The West-African Special Operations Forces: Development and Integration in the Context of the Sub-Saharan Growing Threats

DTIC Science & Technology

2016-06-10

solutions to African problems.” In light of these aforementioned factors and given the low GDP of these nations and their difficulty in financing ...difficulty in financing needed operations and capabilities, the West African nations need to join their efforts in order to find a way to achieve a unified...which include the ability to finance international terrorism (UN General Assembly 2001). The close collaboration between the European countries and

E-Learning and North-South collaboration: the experience of two public health schools in France and Benin.

PubMed

Edouard, Guévart; Dominique, Billot; Moussiliou, Paraïso Noël; Francis, Guillemin; Khaled, Bessaoud; Serge, Briançon

2009-10-14

Distance learning (e-learning) can facilitate access to training. Yet few public health E-learning experiments have been reported; institutes in developing countries experience difficulties in establishing on-line curricula, while developed countries struggle with adapting existing curricula to realities on the ground. In 2005, two schools of public health, one in France and one in Benin, began collaborating through contact sessions organised for Nancy University distance-learning students. This experience gave rise to a partnership aimed at developing training materials for e-Learning for African students. The distance-learning public health course at Nancy teaches public health professionals through a module entitled "Health and Development." The module is specifically tailored for professionals from developing countries. To promote student-teacher exchanges, clarify content and supervise dissertations, contact sessions are organized in centres proximate and accessible to African students. The Benin Institute's main feature is residential team learning; distance-learning courses are currently being prepared. The two collaborating institutions have developed a joint distance-learning module geared toward developing countries. The collaboration provides for the development, diffusion, and joint delivery of teaching modules featuring issues that are familiar to African staff, gives the French Institute credibility in assessing research work produced, and enables modules on specific African issues and approaches to be put online. While E-learning is a viable educational option for public health professionals, periodic contact can be advantageous. Our analysis showed that the benefit of the collaboration between the two institutions is mutual; the French Institute extends its geographical, cultural and contextual reach and expands its pool of teaching staff. The Benin Institute benefits from the technical partnership and expertise, which allow it to offer distance learning for Africa-specific contexts and applications.

Early sexual debut and associated factors among in-school adolescents in eight African countries.

PubMed

Peltzer, Karl

2010-08-01

This report examines early sexual debut (

Past and Ongoing Tsetse and Animal Trypanosomiasis Control Operations in Five African Countries: A Systematic Review

PubMed Central

Holt, Hannah R.; Selby, Richard; Guitian, Javier

2016-01-01

Background Control operations targeting Animal African Trypanosomiasis and its primary vector, the tsetse, were covering approximately 128,000 km2 of Africa in 2001, which is a mere 1.3% of the tsetse infested area. Although extensive trypanosomiasis and tsetse (T&T) control operations have been running since the beginning of the 20th century, Animal African Trypanosomiasis is still a major constraint of livestock production in sub-Saharan Africa. Methodology/Principal Findings We performed a systematic review of the existing literature describing T&T control programmes conducted in a selection of five African countries, namely Burkina Faso, Cameroon, Ethiopia, Uganda and Zambia, between 1980 and 2015. Sixty-eight documents were eventually selected from those identified by the database search. This was supplemented with information gathered through semi-structured interviews conducted with twelve key informants recruited in the study countries and selected based on their experience and knowledge of T&T control. The combined information from these two sources was used to describe the inputs, processes and outcomes from 23 major T&T control programmes implemented in the study countries. Although there were some data gaps, involvement of the target communities and sustainability of the control activities were identified as the two main issues faced by these programmes. Further, there was a lack of evaluation of these control programmes, as well as a lack of a standardised methodology to conduct such evaluations. Conclusions/Significance Past experiences demonstrated that coordinated and sustained control activities require careful planning, and evidence of successes, failures and setbacks from past control programmes represent a mine of information. As there is a lack of evaluation of these programmes, these data have not been fully exploited for the design, analyses and justification of future control programmes. PMID:28027299

Educational attainment and adult literacy: A descriptive account of 31 Sub-Saharan Africa countries.

PubMed

Smith-Greenaway, Emily

2015-11-11

More than 60 years ago the international community declared literacy a basic human right. Recognition of its intrinsic value and evidence of its social and economic benefits have motivated an expansive international effort to estimate the percentage of adults that can read, especially in low-income countries where educational opportunities are limited. Population data on adults' educational attainment is commonly used to approximate adult literacy rates. Though increasing evidence from school-based studies of pupils confirm literacy achievement is not universal - even at advanced grades - it remains unclear whether adults' educational attainment is reflective of their literacy. This study leverages population-based data that include direct assessments of adults' literacy skills to provide a descriptive account of the proportion of adults that can read at each level of educational attainment. The study focuses on the Sub-Saharan African context, a world region where school participation has expanded rapidly in the last three decades. Because many African adults have discontinued their education at the primary level, the study focuses on basic reading skills at each level of primary school. The study focuses specifically on women, whose literacy has garnered extensive international interest. Demographic and Health Survey data from 31 African countries confirm that there are many instances in which women have several years of primary school but cannot read. In fact, in some countries, large proportions of African women who never went to school can read, even as some of their peers who have completed primary school cannot. The weak correlation between educational attainment and literacy is not specific to older cohorts of women, but is also observed among younger women. The findings demonstrate that educational attainment is generally a poor proxy for literacy, highlighting the need to measure, theorize, and study literacy as empirically distinct from education.

[Inequalities in access to care in Africa].

PubMed

Livinec, Bertrand; Milleliri, Jean-Marie; Rey, Jean-Loup; Saliou, Pierre

2013-05-01

Social inequalities in health are increasingly in the news in Africa. While appeals, international declarations and new strategies for health in Africa have succeeded one another over the years, we must admit that the health inequalities are increasing. It is perhaps time to take health out of its compartment and understand that it is one of the components of overall development and that we cannot act effectively against these health inequalities unless we also act on the pressing need to see all States (in the North and South) finally meet their financial commitments, demand of African leaders that they provide good government and fight against corruption, the leaders of African good government and a fight against corruption, and finally ensure that the strategies proposed in Africa focus on the health priorities of each country. If we mention the Scandinavian example, we must admit that the Nordic countries have demonstrated their capacity to obtain excellent results in health, to narrow social inequalities, and provide public transparency and aid to development. They constitute today an excellent example for most Western countries and for African countries - and also for African and western civil societies, which can be inspired by the concrete measures of transparency and strong public activity, which promote improvement in the overall statistics of their societies, in particular, in health. Accordingly we propose a new approach that looks at health statistics in the light of inequalities (especially via the Gini coefficient) and public transparency (especially via the benchmarks of perceived corruption). A New Deal for health in Africa is needed, and all the organization involved should be asked to act together for a holistic public health vision that will benefit the populations of Africa. Health cannot be separated from a political, ethical and equitable vision of society.

Assessment of the risk of African swine fever introduction into Finland using NORA-a rapid tool for semiquantitative assessment of the risk.

PubMed

Kyyrö, J; Sahlström, L; Lyytikäinen, T

2017-12-01

The NORA rapid risk assessment tool was developed for situations where there is a change in the disease status of easily transmissible animal diseases in neighbouring countries or in countries with significant interactions with Finland. The goal was to develop a tool that is quick to use and will provide consistent results to support risk management decisions. The model contains 63 questions that define the potential for entry and exposure by nine different pathways. The magnitude of the consequences is defined by 23 statements. The weight of different pathways is defined according to the properties of the assessed disease. The model was built as an Excel spreadsheet and is intended for use by animal health control administrators. As an outcome, the model gives the possible pathways of disease entry into the country, an overall approximation for the probability of entry and the subsequent exposure, an overall estimate for the consequences and a combined overall risk estimate (probability multiplied by magnitude of consequences). Model validity was assessed by expert panels. Outside Africa, African swine fever is currently established in Russia and Sardinia. In addition, there have been cases in both wild boar and domestic pigs in Latvia, Lithuania, Poland and Estonia. Finland has frequent contacts with Russia and Estonia, especially through passengers. The risk of African swine fever (ASF) introduction into Finland was tested with NORA for the situation in December 2015, when ASF was endemic in many parts of Russia, Africa and Sardinia and was present in Baltic countries and in Poland. African swine fever was assessed to have a high probability of entry into Finland, with high consequences and therefore a high overall risk. © 2017 Blackwell Verlag GmbH.

Prevalence and Severity of Oral Diseases in the Africa and Middle East Region.

PubMed

Abid, A; Maatouk, F; Berrezouga, L; Azodo, C; Uti, O; El-Shamy, H; Oginni, A

2015-07-01

This review aims to determine the prevalence and severity of oral health diseases in the Africa and Middle East region (AMER). The profile of oral diseases is not homogeneous across the AMER. There are large disparities between groups. Reliable data are scarce. The prevalence and severity of oral diseases appear to be increasing in the African region, as does associated morbidity. There are substantial differences in inequalities in oral health. Dental caries prevalence is less severe in most African countries than in developed countries, but the high rate of untreated caries reflects the limited resources available and difficulties of access and affordability to essential oral health care services. The prevalence of gingival inflammation is very high in all age groups in several African countries. The prevalence of maxillofacial trauma has increased in many countries, with a wide variation of the incidence and high prevalence of traumatic dental injuries in primary and permanent teeth. Orofacial clefts are among the most common birth defects. Annual incidence of oral cancer is estimated as 25 cases per 100,000 people in Africa. Noma is a major public health problem for the Middle East and North African (MENA) region. Data about human immunodeficiency virus/AIDS are limited, particularly in the MENA region. According to the World Health Organization Regional Committee for Africa report, some fundamental key basic knowledge gaps need to be underlined. They include inequalities in oral health, low priority for oral health, lack of adequate funding, inadequate dental student training, obstacles to medical and dental research, and poor databases. There are very few effective public prevention and oral health promotion programs in the AMER. Universal health coverage is not achievable without scientific research on the effectiveness of health promotion interventions. © International & American Associations for Dental Research 2015.

Pregnancy history and current use of contraception among women of reproductive age in Burundi, Kenya, Rwanda, Tanzania and Uganda: analysis of demographic and health survey data.

PubMed

Bakibinga, Pauline; Matanda, Dennis J; Ayiko, Rogers; Rujumba, Joseph; Muiruri, Charles; Amendah, Djesika; Atela, Martin

2016-03-10

To examine the relationship between pregnancy history and the use of contraception among women of reproductive age (15-49 years) in East Africa. Demographic and Health Surveys data from Burundi (2010), Kenya (2008-2009), Rwanda (2010), Tanzania (2010) and Uganda (2011) were used in the analysis. Logistic regression was used to determine the effects of women's pregnancy history on their use of contraception. Burundi, Kenya, Rwanda, Tanzania and Uganda. 3226, 2377, 4396, 3250 and 2596 women of reproductive age (15-49 years) from Burundi, Kenya, Rwanda, Tanzania and Uganda, respectively, were included in the analysis. Women who had experienced a mistimed pregnancy were more likely to use a modern contraceptive method during their most recent sexual encounter in Kenya, Rwanda, Burundi and Uganda. Other significant correlates of women's contraceptive use were: desire for more children, parity, household wealth, maternal education and access information through radio. In-country regional differences on use of modern contraceptive methods were noted across five East African countries. Women's birth histories were significantly associated with their decision to adopt a modern contraceptive method. This highlights the importance of considering women's birth histories, especially women with mistimed births, in the promotion of contraceptive use in East Africa. Variations as a result of place of residency, educational attainment, access to family planning information and products, and wealth ought to be addressed in efforts to increase use of modern contraceptive methods in the East African region. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The effect of illicit financial flows on time to reach the fourth Millennium Development Goal in Sub-Saharan Africa: a quantitative analysis

PubMed Central

Makuta, Innocent; Bar-Zeev, Naor; Chiwaula, Levison; Cobham, Alex

2014-01-01

Objectives This paper sets out to estimate the cost of illicit financial flows (IFF) in terms of the amount of time it could take to reach the fourth Millennium Development Goal (MDG) in 34 African countries. Design We have calculated the percentage increase in gross domestic product (GDP) if IFFs were curtailed using IFF/GDP ratios. We applied the income (GDP) elasticity of child mortality to the increase in GDP to estimate the reduction in time to reach the fourth MDG in 34 African countries. Participants children aged under five years. Settings 34 countries in SSA. Main outcome measures Reduction in time to reach the first indicator of the fourth MDG, under-five mortality rate in the absence of IFF. Results We found that in the 34 SSA countries, six countries will achieve their fourth MDG target at the current rates of decline. In the absence of IFF, 16 countries would reach their fourth MDG target by 2015 and there would be large reductions for all other countries. Conclusions This drain on development is facilitated by financial secrecy in other jurisdictions. Rich and poor countries alike must stem the haemorrhage of IFF by taking decisive steps towards improving financial transparency. PMID:24334911

Experiences in Tick Control by Acaricide in the Traditional Cattle Sector in Zambia and Burkina Faso: Possible Environmental and Public Health Implications

PubMed Central

De Meneghi, Daniele; Stachurski, Frédéric; Adakal, Hassane

2016-01-01

Livestock, especially cattle, play a paramount role in agriculture production systems, particularly in poor countries throughout the world. Ticks and tick-borne diseases (TBDs) have an important impact on livestock and agriculture production in sub-Saharan Africa. The authors review the most common methods used for the control of ticks and TBDs. Special emphasis is given to the direct application of acaricides to the host animals. The possible environmental and public health adverse effects (i.e., risks for the workers, residues in the environment and in food products of animal origin) are mentioned. The authors present two case studies, describing different field experiences in controlling ticks in two African countries. In Zambia (Southern Africa), a strategic dipping regime was used to control Rhipicephalus appendiculatus ticks, vectors of theileriosis, a deadly disease affecting cattle in the traditional livestock sector in Southern Province. The dipping regime adopted allowed to reduce the tick challenge and cattle mortally rate and, at the same time, to employ less acaricide as compared to the intensive dipping used so far, without disrupting the building-up of enzootic stability. In Burkina Faso (West Africa), where dipping was never used for tick control, an acaricide footbath was employed as an alternative method to the traditional technique used locally (portable manual sprayers). This was developed from field observations on the invasion/attachment process of the Amblyomma variegatum ticks – vector of cowdriosis – on the animal hosts, leading to a control method aimed to kill ticks temporarily attached to the interdigital areas before their permanent attachment to the predilection sites. This innovative method has been overall accepted by the local farmers. It has the advantage of greatly reducing costs of treatments and has a minimal environmental impact, making footbath a sustainable and replicable method, adoptable also in other West African countries. Although the two methods described, developed in very different contexts, are not comparable – if public health and environmental implications are taken into account, if a balance among efficacy of the control method(s), cost-effectiveness and sustainability is reached – a way forward for the implementation of a One Health strategy can be set. PMID:27882313

Measures for diffusion of solar PV in selected African countries

NASA Astrophysics Data System (ADS)

Nygaard, Ivan; Hansen, Ulrich Elmer; Mackenzie, Gordon; Pedersen, Mathilde Brix

2017-08-01

This paper investigates how African governments are considering supporting and promoting the diffusion of solar PV. This issue is explored by examining so-called 'technology action plans (TAPs)', which were main outputs of the Technology Needs Assessment project implemented in 10 African countries from 2010 to 2013. The paper provides a review of three distinct but characteristic trajectories for PV market development in Kenya (private-led market for solar home systems), Morocco (utility-led fee-for service model) and Rwanda (donor-led market for institutional systems). The paper finds that governments' strategies to promoting solar PV are moving from isolated projects towards frameworks for market development and that there are high expectations to upgrading in the PV value chain through local assembly of panels and local production of other system elements. Commonly identified measures include support to: local production; financing schemes; tax exemptions; establishment and reinforcement of standards; technical training; and research and development.

East African wetland-catchment data base for sustainable wetland management

NASA Astrophysics Data System (ADS)

Leemhuis, Constanze; Amler, Esther; Diekkrüger, Bernd; Gabiri, Geofrey; Näschen, Kristian

2016-10-01

Wetlands cover an area of approx. 18 Mio ha in the East African countries of Kenya, Rwanda, Uganda and Tanzania, with still a relative small share being used for food production. Current upland agricultural use intensification in these countries due to demographic growth, climate change and globalization effects are leading to an over-exploitation of the resource base, followed by an intensification of agricultural wetland use. We aim on translating, transferring and upscaling knowledge on experimental test-site wetland properties, small-scale hydrological processes, and water related ecosystem services under different types of management from local to national scale. This information gained at the experimental wetland/catchment scale will be embedded as reference data within an East African wetland-catchment data base including catchment physical properties and a regional wetland inventory serving as a base for policy advice and the development of sustainable wetland management strategies.

Symptoms of posttraumatic stress, depression, and anxiety as predictors of suicidal ideation among South African university students.

PubMed

Bantjes, Jason R; Kagee, Ashraf; McGowan, Taryn; Steel, Henry

2016-01-01

To investigate the 2-week prevalence of suicidal ideations and their associations to symptoms of posttraumatic stress, depression, and anxiety among South African university students. Data were collected from 1,337 students between May and August 2013. Hierarchical regression analysis was used to investigate the relationship between suicidal ideation and symptoms of posttraumatic stress, depression, and anxiety. Rates of suicidal ideation are higher among university students in South Africa than among the general population of the country and student populations in other parts of the world. Symptoms of depression and exposure to trauma predict suicidal ideation Conclusions: Findings bring into focus the high rates of suicidal ideation among a sample of university students in South African and the need for more research to investigate the psychosocial correlates of this phenomena within the cultural context of the country, especially given the correlation between suicidal ideation and other poor health outcomes.

Elimination of mother-to-child transmission of HIV and syphilis: A dual approach in the African Region to improve quality of antenatal care and integrated disease control.

PubMed

Newman Owiredu, Morkor; Newman, Lori; Nzomo, Theresa; Conombo Kafando, Ghislaine; Sanni, Saliyou; Shaffer, Nathan; Bucagu, Maurice; Peeling, Rosanna; Mark, Jennifer; Diop Toure, Isseu

2015-06-01

The World Health Organization's (WHO) Strategic Framework for the Elimination of New HIV Infections among Children in Africa by 2015 identifies important synergies for the elimination of mother-to-child transmission of HIV and syphilis in terms of prevention interventions, implementation logistics and service delivery, monitoring and evaluation systems, and need for sustained political commitment. The WHO advocates the use of an integrated, rights-based dual approach with partnerships and collaboration to make the best use of available resources. Through a consultative approach, six countries in the African Region committed to dual elimination and developed and implemented action plans for this purpose. Where interest and commitment are high, this may also be possible and effective in other African countries. Copyright © 2015. Published by Elsevier Ireland Ltd.

Demographics of cleft care providers in Africa and reported experience in training and practice: direct analysis of continent-based practitioners.

PubMed

Adetayo, Oluwaseun A; Martin, Mark C

2012-05-01

To elucidate the impact of several geographic, cultural, and socioeconomic variables on cleft care delivery in Africa, and to investigate the current status of cleft care delivery in Africa. Survey of practitioners attending the second Pan-African Congress on Cleft Lip and Palate (PACCLIP). The annual PACCLIP conference in Ibadan, Nigeria, West Africa, February 2007. To provide an analysis of the demographics and training experience of cleft care providers in Africa by collating information directly from the continent-based practitioners. Plastic surgeons and oral and maxillofacial surgeons provide the majority of cleft care. Most of the participants reported availability of formal training programs in their respective countries. The predominant practice settings were university and government-based. During training, half of the providers had encountered up to 30 cleft cases, and a quarter had managed more than 100 cases. Representation of visiting surgeons were equally distributed between African and non-African countries. This study provides initial and detailed analysis crucial to understanding the underlying framework of cleft care composition teams, demographics of providers, and training and practice experience. This awareness will further enable North American and other non-African plastic surgeons to effectively partner with African cleft care providers to have a further reaching impact in the region.

The Chemistry and Biological Activities of Natural Products from Northern African Plant Families: From Taccaceae to Zygophyllaceae.

PubMed

Ntie-Kang, Fidele; Njume, Leonel E; Malange, Yvette I; Günther, Stefan; Sippl, Wolfgang; Yong, Joseph N

2016-04-01

Traditional medicinal practices have a profound influence on the daily lives of people living in developing countries, particularly in Africa, since the populations cannot generally afford the cost of Western medicines. We have undertaken to investigate the correlation between the uses of plants in Traditional African medicine and the biological activities of the derived natural products, with the aim to validate the use of traditional medicine in Northern African communities. The literature is covered for the period 1959-2015 and part III of this review series focuses on plant families with names beginning with letters T to Z. The authors have focused on curating data from journals in natural products and phytomedicine. Within each journal home page, a query search based on country name was conducted. All articles "hits" were then verified, one at a time, that the species was harvested within the Northern African geographical regions. The current data partly constitutes the bases for the development of the Northern African natural compounds database. The review discusses 284 plant-based natural compounds from 34 species and 11 families. It was observed that the ethnobotanical uses of less than 40 % of the plant species surveyed correlated with the bioactivities of compounds identified.

Engaging One Health for Non-Communicable Diseases in Africa: Perspective for Mycotoxins

PubMed Central

Ladeira, Carina; Frazzoli, Chiara; Orisakwe, Orish Ebere

2017-01-01

The role of mycotoxins—e.g., aflatoxins, ochratoxins, trichothecenes, zearalenone, fumonisins, tremorgenic toxins, and ergot alkaloids—has been recognized in the etiology of a number of diseases. In many African countries, the public health impact of chronic (indoor) and/or repeated (dietary) mycotoxin exposure is largely ignored hitherto, with impact on human health, food security, and export of African agricultural food products. Notwithstanding, African scientific research reached milestones that, when linked to findings gained by the international scientific community, make the design and implementation of science-driven governance schemes feasible. Starting from Nigeria as leading African Country, this article (i) overviews available data on mycotoxins exposure in Africa; (ii) discusses new food safety issues, such as the environment–feed–food chain and toxic exposures of food producing animals in risk assessment and management; (iii) identifies milestones for mycotoxins risk management already reached in West Africa; and (iv) points out preliminary operationalization aspects for shielding communities from direct (on health) and indirect (on trade, economies, and livelihoods) effects of mycotoxins. An African science-driven engaging of scientific knowledge by development actors is expected therefore. In particular, One health/One prevention is suggested, as it proved to be a strategic and sustainable development framework. PMID:29085817

African swine fever: an epidemiological update.

PubMed

Sánchez-Vizcaíno, J M; Mur, L; Martínez-López, B

2012-03-01

African swine fever (ASF) is one of the most important swine diseases, mainly because of its significant sanitary and socioeconomic consequences. This review gives an update on the epidemiology of the disease and reviews key issues and strategies to improve control of the disease and promote its eradication. Several characteristics of ASF virus (ASFV) make its control and eradication difficult, including the absence of available vaccines, marked virus resistance in infected material and contaminated animal products, and a complex epidemiology and transmission involving tick reservoir virus interactions. The incidence of ASF has not only increased on the African continent over the last 15 years, so that it now affects West African countries, Mauritius and Madagascar, but it has also reached new areas, such as the Caucasus region in 2007. In fact, the rapid spread of the disease on the European continent and the uncontrolled situation in the Russian Federation places all countries at great risk as a result of intense global trade. The proximity of some affected areas to the European Union (EU) borders (<150 km) has increased concerns about the potential economic consequences of an ASF incursion into the EU pig sector. Establishing effective surveillance, control and eradication programmes that implicate all actors (veterinarians, farmers, and policy makers) is essential for controlling ASF. African swine fever -free countries should be aware of the potential risk of ASF incursion and implement risk reduction measures such as trade controls and other sanitary measures. This review will discuss lessons learnt so far about ASF control, current challenges to its control and future studies needed to support global efforts at prevention and control. © 2012 Blackwell Verlag GmbH.

Childhood cancer incidence patterns by race, sex and age for 2000-2006: a report from the South African National Cancer Registry.

PubMed

Erdmann, Friederike; Kielkowski, Danuta; Schonfeld, Sara J; Kellett, Patricia; Stanulla, Martin; Dickens, Caroline; Kaatsch, Peter; Singh, Elvira; Schüz, Joachim

2015-06-01

Higher childhood cancer incidence rates are generally reported for high income countries although high quality information on descriptive patterns of childhood cancer incidence for low or middle income countries is limited, particularly in Sub-Saharan Africa. There is a need to quantify global differences by cancer types, and to investigate whether they reflect true incidence differences or can be attributed to under-diagnosis or under-reporting. For the first time, we describe childhood cancer data reported to the pathology report-based National Cancer Registry of South Africa in 2000-2006 and compare our results to incidence data from Germany, a high income country. The overall age-standardized incidence rate (ASR) for South Africa in 2000-2006 was 45.7 per million children. We observed substantial differences by cancer types within South Africa by racial group; ASRs tended to be 3-4-fold higher in South African Whites compared to Blacks. ASRs among both Black and White South Africans were generally lower than those from Germany with the greatest differences observed between the Black population in South Africa and Germany, although there was marked variation between cancer types. Age-specific rates were particularly low comparing South African Whites and Blacks with German infants. Overall, patterns across South African population groups and in comparison to Germans were similar for boys and girls. Genetic and environmental reasons may probably explain rather a small proportion of the observed differences. More research is needed to understand the extent to which under-ascertainment and under-diagnosis of childhood cancers drives differences in observed rates. © 2014 UICC.

Local innovation for improving primary care cardiology in resource-limited African settings: an insight on the Cardio Pad(®) project in Cameroon.

PubMed

Noubiap, Jean Jacques N; Jingi, Ahmadou M; Kengne, André Pascal

2014-10-01

Cardiovascular disease (CVD) is an emerging threat to the health of populations in Africa. With the inadequate health infrastructures, understaffed and underfunded health systems, African countries are ill-prepared to cope with the increasing demand for care for CVD, particularly for populations in remote and underserved rural areas, where 60% of the population currently reside. Task shifting and telehealth have been suggested as strategies to overcome the current health workforce shortage in African countries, and to increase access to prevention and curative services for emerging CVD. However, strategies for promoting their incorporation into the existing health systems, have yet to be developed. The Cardio Pad(®) initiative (originating from Cameroon) seeks to provide appropriate solutions to improve the application of telemedicine for CVD prevention and control in remote African settings. The Cardio Pad(®) is a tele-cardiology device which provides a number of advantages in terms of cost, ease of use, autonomy and reduced technology requirements. It is a fully touch screen medical device which enables cardiac tests such as electrocardiograms (ECG) to be performed in remote underserved areas (rural areas for instance), while the test results are transferred wirelessly via mobile phone connection, to specialist physicians who can interpret them and provide assistance with case management. While most of the current telemedicine clinical services on the African continent receive most expertise from developed countries, the Cardio Pad(®), a local invention by a 26-year-old Cameroon-trained engineer demonstrates how much innovative solutions to combat CVD and other health issues could and should be developed locally in Africa.

The role of power in health policy dialogues: lessons from African countries.

PubMed

Mwisongo, Aziza; Nabyonga-Orem, Juliet; Yao, Theodore; Dovlo, Delanyo

2016-07-18

Policy-making is a dynamic process involving the interplay of various factors. Power and its role are some of its core components. Though power exerts a profound role in policy-making, empirical evidence suggests that health policy analysis has paid only limited attention to the role of power, particularly in policy dialogues. This exploratory study, which used qualitative methods, had the main aim of learning about and understanding policy dialogues in five African countries and how power influences such processes. Data were collected using key informant interviews. An interview guide was developed with standardised questions and probes on the policy dialogues in each country. This paper utilises these data plus document review to understand how power was manifested during the policy dialogues. Reference is made to the Arts and Tatenhove conceptual framework on power dimensions to understand how power featured during the policy dialogues in African health contexts. Arts and Tatenhove conceptualise power in policy-making in relational, dispositional and structural layers. Our study found that power was applied positively during the dialogues to prioritise agendas, fast-track processes, reorganise positions, focus attention on certain items and foster involvement of the community. Power was applied negatively during the dialogues, for example when position was used to control and shape dialogues, which limited innovation, and when knowledge power was used to influence decisions and the direction of the dialogues. Transitive power was used to challenge the government to think of implementation issues often forgotten during policy-making processes. Dispositional power was the most complex form of power expressed both overtly and covertly. Structural power was manifested socially, culturally, politically, legally and economically. This study shows that we need to be cognisant of the role of power during policy dialogues and put mechanisms in place to manage its influence. There is need for more research to determine how to channel power influence policy-making processes positively, for example through interactive policy dialogues.

Multiple Identities.

ERIC Educational Resources Information Center

Butler, John Sibley

1990-01-01

Discusses use of the term "African-American" in the context of relationships among country of origin, identification with that country, and the American experience. Finds no association between name identification and current Black social movements. Suggests that the issue should not overshadow continued effort to gain economic stability…

77 FR 34781 - Importation of Tomatoes From the Economic Community of West African States Into the Continental...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-12

..., and no displacement of tomato imports from other countries, the welfare loss for U.S. small-entity... and no displacement of tomato imports from other countries, the welfare loss for U.S. small-entity...

Making sense of condoms: social representations in young people's HIV-related narratives from six African countries.

PubMed

Winskell, Kate; Obyerodhyambo, Oby; Stephenson, Rob

2011-03-01

Condoms are an essential component of comprehensive efforts to control the HIV epidemic, both for those who know their status and for those who do not. Although young people account for almost half of all new HIV infections, reported condom use among them remains low in many sub-Saharan African countries. In order to inform education and communication efforts to increase condom use, we examined social representations of condoms among young people aged 10-24 in six African countries/regions with diverse HIV prevalence rates: Swaziland, Namibia, Kenya, South-East Nigeria, Burkina Faso, and Senegal. We used a unique data source, namely 11,354 creative ideas contributed from these countries to a continent-wide scriptwriting contest, held from 1(st) February to 15(th) April 2005, on the theme of HIV/AIDS. We stratified each country sample by the sex, age (10-14, 15-19, 20-24), and urban/rural location of the author and randomly selected up to 10 narratives for each of the 12 resulting strata, netting a total sample of 586 texts for the six countries. We analyzed the narratives qualitatively using thematic data analysis and narrative-based methodologies. Differences were observed across settings in the prominence accorded to condoms, the assessment of their effectiveness, and certain barriers to and facilitators of their use. Moralization emerged as a key impediment to positive representations of condoms, while humour was an appealing means to normalize them. The social representations in the narratives identify communication needs in and across settings and provide youth-focused ideas and perspectives to inform future intervention efforts. Copyright © 2011 Elsevier Ltd. All rights reserved.

Making sense of condoms: social representations in young people’s HIV-related narratives from six African countries

PubMed Central

Winskell, Kate; Obyerodhyambo, Oby; Stephenson, Rob

2011-01-01

Condoms are an essential component of comprehensive efforts to control the HIV epidemic, both for those who know their status and for those who do not. Although young people account for almost half of all new HIV infections, reported condom use among them remains low in many sub-Saharan African countries. In order to inform education and communication efforts to increase condom use, we examined social representations of condoms among young people aged 10–24 in six African countries/regions with diverse HIV prevalence rates: Swaziland, Namibia, Kenya, South-East Nigeria, Burkina Faso, and Senegal. We used a unique data source, namely 11,354 creative ideas contributed from these countries to a continent-wide scriptwriting contest, held from 1st February to 15th April 2005, on the theme of HIV/AIDS. We stratified each country sample by the sex, age (10–14, 15–19, 20–24), and urban/rural location of the author and randomly selected up to 10 narratives for each of the 12 resulting strata, netting a total sample of 586 texts for the six countries. We analyzed the narratives qualitatively using thematic data analysis and narrative-based methodologies. Differences were observed across settings in the prominence accorded to condoms, the assessment of their effectiveness, and certain barriers to and facilitators of their use. Moralization emerged as a key impediment to positive representations of condoms, while humour was an appealing means to normalize them. The social representations in the narratives identify communication needs in and across settings and provide youth-focused ideas and perspectives to inform future intervention efforts. PMID:21388731

The My Child Matters programme: effect of public-private partnerships on paediatric cancer care in low-income and middle-income countries.

PubMed

Howard, Scott C; Zaidi, Alia; Cao, Xueyuan; Weil, Olivier; Bey, Pierre; Patte, Catherine; Samudio, Angelica; Haddad, Laurie; Lam, Catherine G; Moreira, Claude; Pereira, Augusto; Harif, Mhamed; Hessissen, Laila; Choudhury, Salma; Fu, Ligia; Caniza, Miguela A; Lecciones, Julius; Traore, Fousseyni; Ribeiro, Raul C; Gagnepain-Lacheteau, Anne

2018-05-01

In low-income and middle-income countries, an excess in treatment failure for children with cancer usually results from misdiagnosis, inadequate access to treatment, death from toxicity, treatment abandonment, and relapse. The My Child Matters programme of the Sanofi Espoir Foundation has funded 55 paediatric cancer projects in low-income and middle-income countries over 10 years. We assessed the impact of the projects in these regions by using baseline assessments that were done in 2006. Based on these data, estimated 5-year survival in 2016 increased by a median of 5·1%, ranging from -1·5% in Venezuela to 17·5% in Ukraine. Of the 26 861 children per year who develop cancer in the ten index countries with My Child Matters projects that were evaluated in 2006, an estimated additional 1343 children can now expect an increase in survival outcome. For example, in Paraguay, a network of paediatric oncology satellite clinics was established and scaled up to a national level and has managed 884 patients since initiation in 2006. Additionally, the African Retinoblastoma Network was scaled up from a demonstration project in Mali to a network of retinoblastoma referral centres in five sub-Saharan African countries, and the African School of Paediatric Oncology has trained 42 physicians and 100 nurses from 16 countries. The My Child Matters programme has catalysed improvements in cancer care and has complemented the efforts of government, civil society, and the private sector to sustain and scale improvements in health care to a national level. Key elements of successful interventions include strong and sustained local leadership, community engagement, international engagement, and capacity building and support from government. Copyright © 2018 Elsevier Ltd. All rights reserved.

Space and place for WHO health development dialogues in the African Region.

PubMed

Kirigia, Joses Muthuri; Nabyonga-Orem, Juliet; Dovlo, Delanyo Yao Tsidi

2016-07-18

Majority of the countries in the World Health Organization (WHO) African Region are not on track to achieve the health-related Millennium Development Goals, yet even more ambitious Sustainable Development Goals (SDGs), including SDG 3 on heath, have been adopted. This paper highlights the challenges - amplified by the recent Ebola virus disease (EVD) outbreak in West Africa - that require WHO and other partners' dialogue in support of the countries, and debate on how WHO can leverage the existing space and place to foster health development dialogues in the Region. To realise SDG 3 on ensuring healthy lives and promoting well-being for all at all ages, the African Region needs to tackle the persistent weaknesses in its health systems, systems that address the social determinants of health and national health research systems. The performance of the third item is crucial for the development and innovation of systems, products and tools for promoting, maintaining and restoring health in an equitable manner. Under its new leadership, the WHO Regional Office for Africa is transforming itself to galvanise existing partnerships, as well as forging new ones, with a view to accelerating the provision of timely and quality support to the countries in pursuit of SDG 3. WHO in the African Region engages in dialogues with various stakeholders in the process of health development. The EVD outbreak in West Africa accentuated the necessity for optimally exploiting currently available space and place for health development discourse. There is urgent need for the WHO Regional Office for Africa to fully leverage the space and place arenas of the World Health Assembly, WHO Regional Committee for Africa, African Union, Regional economic communities, Harmonization for Health in Africa, United Nations Economic Commission for Africa, African Development Bank, professional associations, and WHO African Health Forum, when it is created, for dialogues to mobilise the required resources to give the African Region the thrust it needs to attain SDG 3. The pursuit of SDG 3 amidst multiple challenges related to political leadership and governance, weak health systems, sub-optimal systems for addressing the socioeconomic determinants of health, and weak national health research systems calls for optimum use of all the space and place available for regional health development dialogues to supplement Member States' efforts.

Towards Producing Black Nobel Laureates Affiliated with ``African Universities''

NASA Astrophysics Data System (ADS)

Kenneth, Jude

While Africa has produced a handful Nobel laureate in literature and peace, it has continued to shy away from producing any in the other categories. The reason is not farfetched; our university system is not up to standard. It is saddening that in this century, African countries place emphasis on certificates and not on knowledge. This has made the continent produce students that lack the intellectual capability, experimental ability, fundamental training, creativity, and motivation to excel except they get a foreign training. It is this backdrop that precipitated the research into the methods of teaching and research in universities across Africa. The study is designed to identify the problems and proffer solution to them. Two important questions immediately come to mind. (1) What factors account for the difficulty in producing Nobel laureates affiliated with African universities? (2) What strategies could be adopted to improve teaching and research in African universities? Several factors were investigated which revolve around funding, the competence of the lecturers, quality of students admitted, attitude of the students, parents and government. Nigerian universities were investigated and important deductions were made. During the study an inquiry was made on the method of instruction at various universities, from result obtained, the study therefore concluded that adequate funding, the presence of erudite scholars and brilliant minds will produce future Nobel laureate affiliated with the continent. The study therefore recommended admission and employment of only students and lecturers who have got a thing for academics into the universities and adequate funding of universities and research centres.

Current Status of Mycotoxin Contamination of Food Commodities in Zimbabwe.

PubMed

Nleya, Nancy; Adetunji, Modupeade Christianah; Mwanza, Mulunda

2018-05-03

Agricultural products, especially cereal grains, serve as staple foods in sub-Saharan Africa. However, climatic conditions in this region can lead to contamination of these commodities by moulds, with subsequent production of mycotoxins posing health risks to both humans and animals. There is limited documentation on the occurrence of mycotoxins in sub-Saharan African countries, leading to the exposure of their populations to a wide variety of mycotoxins through consumption of contaminated foods. This review aims at highlighting the current status of mycotoxin contamination of food products in Zimbabwe and recommended strategies of reducing this problem. Zimbabwe is one of the African countries with very little information with regards to mycotoxin contamination of its food commodities, both on the market and at household levels. Even though evidence of multitoxin occurrence in some food commodities such as maize and other staple foods exist, available published research focuses only on Aspergillus and Fusarium mycotoxins, namely aflatoxins, deoxynivalenol (DON), trichothecenes, fumonisins, and zearalenone (ZEA). Occurrence of mycotoxins in the food chain has been mainly associated with poor agricultural practices. Analysis of mycotoxins has been done mainly using chromatographic and immunological methods. Zimbabwe has adopted European standards, but the legislation is quite flexible, with testing for mycotoxin contamination in food commodities being done voluntarily or upon request. Therefore, the country needs to tighten its legislation as well as adopt stricter standards that will improve the food safety and security of the masses.

What are the emerging features of community health insurance schemes in East Africa?

PubMed Central

Basaza, Robert; Pariyo, George; Criel, Bart

2009-01-01

Background The three East African countries of Uganda, Tanzania, and Kenya are characterized by high poverty levels, population growth rates, prevalence of HIV/AIDS, under-funding of the health sector, poor access to quality health care, and small health insurance coverage. Tanzania and Kenya have user-fees whereas Uganda abolished user-fees in public-owned health units. Objective To provide comparative description of community health insurance (CHI) schemes in three East African countries of Uganda, Tanzania, and Kenya and thereafter provide a basis for future policy research for development of CHI schemes. Methods An analytical grid of 10 distinctive items pertaining to the nature of CHI schemes was developed so as to have a uniform lens of comparing country situations of CHI. Results and conclusions The majority of the schemes have been in existence for a relatively short time of less than 10 years and their number remains small. There is need for further research to identify what is the mix and weight of factors that cause people to refrain from joining schemes. Specific issues that could also be addressed in subsequent studies are whether the current schemes provide financial protection, increase access to quality of care and impact on the equity of health services financing and delivery. On the basis of this knowledge, rational policy decisions can be taken. The governments thereafter could consider an option of playing more roles in advocacy, paying for the poorest, and developing an enabling policy and legal framework. PMID:22312207

Demographic, epidemiological, and health transitions: are they relevant to population health patterns in Africa?

PubMed Central

Kuate Defo, Barthélémy

2014-01-01

Background Studies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed. Objective The aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa. Results Notwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1) theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2) simple summary indicators that can be used to evaluate their descriptive and predictive features; 3) marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4) the rapid decline in infant mortality and gains in life expectancy from the 1950s through the 1990s in a context of preponderant communicable diseases in all African countries; 5) the salient role of adult mortality, mostly ascribed to HIV/AIDS and co-morbidities, since the 1990s in reversing trends in mortality decline, its interruption of life expectancy improvements, and its reversal of gender differences in life expectancies disadvantaging women in several countries with the highest prevalence of HIV/AIDS; 6) the huge impact of wars in reversing the trends in under-five mortality decline in sub-Saharan countries in the 1990s and beyond. These assessments of these transition frameworks and these phenomena were not well documented to date for all five regions and 57 countries of Africa. Conclusion Prevailing frameworks of demographic, epidemiological, and health transitions as descriptive and predictive models are incomplete or irrelevant for charting the population and health experiences and prospects of national populations in the African context. PMID:24848648

EXPERIENCES OF HIV/AIDS STIGMA OF PERSONS LIVING WITH HIV/AIDS AND NURSES INVOLVED IN THEIR CARE FROM FIVE AFRICAN COUNTRIES

PubMed Central

Greeff, Minrie; Uys, Leana R; Holzemer, William L; Makoae, Lucia N; Dlamini, Priscilla S; Kohi, Thecla W; Chirwa, Maureen L; Naidoo, Joanne R; Phetlhu, Rene D.

2009-01-01

The concept of stigma has received significant attention in recent years in the HIV/AIDS literature. Although there is some change towards the positive, AIDS still remains a significantly stigmatized condition. AIDS stigma and discrimination continue to influence people living with and affected by HIV (PLWA), as well as their health-care providers. Unless stigma is conquered, the illness will not be defeated. Due to the burden that HIV/AIDS places on people living in Africa, a five-year project entitled Perceived AIDS Stigma: A Multinational African Study was undertaken. The focus of the first phase of this project was on exploring and describing the meaning and effect of stigma on PLWA from the experiences of PLWA and the nurses involved in their care in five African countries: Lesotho, Swaziland, Malawi, South Africa and Tanzania. An exploratory descriptive qualitative research design was used to explore and describe the experience of stigma through the critical incident method. Purposive voluntary sampling was utilized. Forty-three focus group discussions were held with respondents to relate incidences which they themselves observed, as well as those that they themselves experienced in the community and in families. The transcribed data was analyzed through the technique of open coding using the NVivo 2.0 analysis package. Three types of stigma (received stigma, internal stigma and associated stigma) and several dimensions for each of these types of stigma emerged from the data. Recommendations were made to pursue these findings further. PMID:20052299

Knowledge, Attitude, and Experience of Cervical Cancer and Screening among Sub-saharan African Female Students in a UK University

PubMed Central

Ogbonna, Faith Sopuruchukwu

2017-01-01

Background: Cervical cancer is one of the major diseases that affect women of child bearing age. Its main cause is the human papilloma virus; although, other associated factors have been evidenced to increase its risk. Pap-smear screening and vaccination which has been shown to be successful in reducing the incidence and prevalence of the disease in developed countries, has been neglected in developing countries due to lack of knowledge, misconceptions, and cultural beliefs. Materials and Methods: A cross-sectional study involving only female Sub-Saharan Africa (SSA) students in a UK university setting. Results: One hundred and eighty-six (42%) African female students were recruited from the 442 SSA students attending one of the major Universities in the UK. Seventy-one (38.2%) of the students were aware of cervical screening, but only 20 (10.8%) reported having knowledge of cervical cancer. A small percentage of about 26.9% (50 Students) were already part of this screening program; although, 81 (43.5%) showed willingness to participate in future screening programs. More so, it was evident that student's perception was dependent on their experience of the disease (P = 000) just as their participation in screening program was dependent on their awareness level (P ≤ 0.01). Conclusion: Female African students from the SSA region have poor knowledge of the disease which influenced their attitude toward screening. More needs to be carried out to increase awareness and uptake of screening within the school environment as university setting provides a viable platform to promote healthy behavior. PMID:28300047

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

PubMed Central

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 <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. 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

High occurrence and unusual serotype diversity of non-typhoidal Salmonella in non-clinical niches, Angola.

PubMed

Antunes, P; Campos, J; Mourão, J; Ribeiro, T G; Novais, C; Peixe, L

2017-04-01

Non-typhoidal Salmonella is an important burden, particularly in developing countries of the African region. We report for the first time in Angola, a sub-Saharan African country with commercial/travel relationships with Europe, an unexpectedly high occurrence of Salmonella (n = 12/63, 19%) from a high diversity of sources, particularly farm and wild animals. The detection of diverse serotypes (n = 12), involving putative new S. enterica subsp. salamae serotypes, is also of note, reinforcing the need for a comprehensive surveillance in Angola critical to identify animal/food/environmental sources of salmonellosis with impact on animal health, local people, tourists and exported products.

Pushing a Stone up a Hill: A Case Study of the Working Environment of South African Academics

ERIC Educational Resources Information Center

Portnoi, Laura M.

2015-01-01

South African higher education has been experiencing profound and vigorous transformations in the post-apartheid era. At the same time, global trends toward competition and employment equity contribute to the complexities of the country's higher education environment. These global and local developments combine to impact the working environment of…

Higher Education: A Qualitative Inquiry into the Educational Experiences of Seven African Women.

ERIC Educational Resources Information Center

Otieno, Tabitha N.

This study was a qualitative inquiry that focused on the educational experiences of seven African women students' attempt to pursue higher education in their home countries. It identified the problems they encountered, and how they overcame them, and explored their educational experiences in the United States. Data came from systematic interviews…

Why the South African NQF Failed: Lessons for Countries Wanting to Introduce National Qualifications Frameworks

ERIC Educational Resources Information Center

Allais, Stephanie Matseleng

2007-01-01

This article examines the South African National Qualifications Framework as a case study of a particular approach to the design of qualifications frameworks, which revolves around the specification of learning outcomes separate from educational institutions or programmes. It shows how an outcomes-led qualifications framework was seen as a…

Situating the Education of African Trinidadians within the Social and Historical Context of Trinidad and Tobago: Implications for Social Justice

ERIC Educational Resources Information Center

Nakhid, Camille; Barrow, Dorian; Broomes, Orlena

2014-01-01

Today, almost a century after gaining access to the country's most prestigious secondary schools, determining the academic achievement of African Trinidadian students remains a challenge as neither Trinidad and Tobago's Ministry of Education nor the Caribbean Examination Council, the regional agency responsible for administering standardized…

50 CFR 23.74 - How can I trade internationally in personal sport-hunted trophies?

Code of Federal Regulations, 2014 CFR

2014-10-01

... certificate must contain all the information that is given on the tag. (2) African elephant (Loxodonta... sport-hunted trophies of African elephant. The trophy ivory must be legibly marked by means of punch... corresponding two-letter ISO country code; the last two digits of the year in which the elephant was harvested...

Teaching of Chemical Bonding: A Study of Swedish and South African Students' Conceptions of Bonding

ERIC Educational Resources Information Center

Nimmermark, Anders; Ohrstrom, Lars; Mårtensson, Jerker; Davidowitz, Bette

2016-01-01

Almost 700 Swedish and South African students from the upper secondary school and first-term chemistry university level responded to our survey on concepts of chemical bonding. The national secondary school curricula and most common textbooks for both countries were also surveyed and compared for their content on chemical bonding. Notable…

Immigrant Students' Shifting Identifications in South African Schools

ERIC Educational Resources Information Center

Vandeyar, Saloshna

2012-01-01

The easing of legal and unauthorized entry to South Africa has made the country a new destination for Black immigrants. As this population continues to grow, its children have begun to experience South African schools in an array of uniquely challenging ways. For these immigrant youth, forging a sense of identity may be their single greatest…

Corporal Punishment in Schools and Fundamental Human Rights: A South African Perspective.

ERIC Educational Resources Information Center

Prinsloo, Justus

In many western countries, corporal punishment has been abolished as a form of punishment in criminal trials and in schools. Under South African common law, persons entitled to enforce discipline may inflict corporal punishment within certain guidelines established by the Supreme Court. For the first time in the Republic of South Africa (RSA), the…

New Controls and Accountability for South African Teachers and Schools: The Integrated Quality Management System

ERIC Educational Resources Information Center

Weber, Everard

2005-01-01

This article analyses the Integrated Quality Management System (IQMS), an agreement reached in 2003 between the South African Education Department and the major teacher organisations in the country by using discourse analysis. The IQMS was scheduled to be implemented in public schools in 2004. Three discursive tensions are identified and…

Intellectual Disability in the Context of a South African Population

ERIC Educational Resources Information Center

Kromberg, Jennifer; Zwane, Esther; Manga, Prashiela; Venter, Andre; Rosen, Eric; Christianson, Arnold

2008-01-01

Childhood disabilities, including intellectual disabilities (ID), are thought to occur in 5-17% of children in developing countries around the world. In order to identify and describe the childhood disabilities occurring in a rural South African population, as well as the context in which they occur, a study was carried out in the Bushbuckridge…

Congruence between the Intended, Implemented, and Attained ICT Curricula in Sub-Saharan Africa

ERIC Educational Resources Information Center

Mereku, Damian Kofi; Mereku, Cosmas Worlanyo Kofi

2015-01-01

The PanAfrican Research Agenda on the Pedagogical Integration of information and communication technology (ICT; PanAf) research project was initiated in 2006 to support initiatives in African countries to integrate ICT into teaching and learning through the frequent collection and analysis of data on ICT usage. The article examines the congruence…

African Virtual University: The Case of Kenyatta University, Kenya. Commonwealth Case Studies in Education.

ERIC Educational Resources Information Center

Juma, Magdallen N.

This booklet describes the African Virtual University (AVU), an interactive instructional telecommunications network established to provide distance education to the countries of sub-Saharan Africa. The AVU was piloted in 1997-1998, and in the 1998-1999 academic year, 27 institutions were slated to offer AVU courses. Supported by the World Bank,…

Psychological Essentialism and Cultural Variation: Children's Beliefs about Aggression in the United States and South Africa

ERIC Educational Resources Information Center

Giles, Jessica W.; Legare, Cristine; Samson, Jennifer E.

2008-01-01

The present study compared indigenous South African versus African-American schoolchildren's beliefs about aggression. Eighty 7-9 year olds (40 from each country) participated in interviews in which they were asked to make inferences about the stability, malleability, and causal origins of aggressive behaviour. Although a minority of participants…

Toxicovigilance Systems and Practices in Africa

PubMed Central

Bertrand, Pouokam Guy; Ahmed, Hatem Abdel Moniem; Ngwafor, Randolph; Frazzoli, Chiara

2016-01-01

African consumers and citizens are growingly aware of the wide range of toxic poisoning scenarios from different products and hazards. Recurrent episodes on poisoning that have been reported in Africa include toxic hazards in consumers’ products ranging from food to herbal medicine, drugs, and cosmetics. Chemical poisoning remains an issue that is overlooked by public health stakeholders in Africa. Available information on toxicovigilance systems and practices in African countries is reviewed in terms of increasing development, organization and articulation levels. Less than nine out of 54 African countries have a legally recognized toxicovigilance system. Of these, the majority have created toxicovigilance systems recently, and are facing many challenges in developing them, at regional and country levels. Basic structures for a good toxicovigilance system include a phone line service (available 24/7), and hospital facilities. Pesticides emerge as the hazard recognized by all of the toxicovigilance systems, and may represent a prototypic toxicant towards a toxicovigilance system that is inclusive of a wider spectrum of toxicological hazards for the protection of community health. Toxicovigilance today is more reactive than preventive in Africa, but some milestones are present that constitute some promising seminal efforts. PMID:29051419

A Comparison of Cardiovascular Disease Risk Factor Biomarkers in African Americans and Yoruba Nigerians

PubMed Central

Deeg, M.; Baiyewu, O.; Gao, S.; Ogunniyi, A.; Shen, J.; Gureje, O.; Taylor, S.; Murrell, J.; Unverzagt, F.; Smith-Gamble, V.; Evans, R.; Dickens, J.; Hendrie, H.; Hall, K.

2009-01-01

Objective Classical risk factors for coronary artery disease are changing in the developing world while rates of cardiovascular disease are increasing in these populations. Newer risk factors have been identified for cardiovascular disease, but these have been rarely examined in elderly populations and not those of developing countries. Methods This study was a cross-sectional comparison from a longitudinal, observational, epidemiologic study in which participants are interviewed at three-year intervals. The sample included 1510 African Americans from Indianapolis, Indiana, and 1254 Yoruba from Ibadan, Nigeria. We compared anthropomorphic measurements; biomarkers of endothelial dysfunction (plasminogen activator inhibitor type 1 [PAI-1] and E-selectin), inflammation (C-reactive protein), and lipid oxidation (8-isoprostane); and levels of lipids, homocysteine, folate, and vitamin B12. Results Cholesterol, triglycerides, and low-density lipoprotein cholesterol levels were higher in African Americans. For markers of endothelial dysfunction, E-selectin and homocysteine differed between men, and PAI-1 was higher in the Yoruba. C-reactive protein differed only in women, but 8-isoprostane was higher in the Yoruba. Conclusion Higher lipid levels in African Americans are consistent with their Western diet and lifestyle. Oxidative stress appears to be higher in the Yoruba than in African Americans, which may be secondary to dietary differences. Whether these differences in classical and emerging risk factors account for the different rates of cardiovascular disease, dementia, or other morbidities in these two populations remains to be determined. PMID:19157246

A Systematic Review of HIV Serostatus Disclosure Among African Immigrants in Europe.

PubMed

Whembolua, Guy-Lucien; Conserve, Donaldson F; Thomas, Kirstyn; Handler, Lara

2017-08-01

As the human immunodeficiency virus continues to devastate large parts of Africa, particularly the Sub-Saharan region, the number of immigrants migrating from these areas to European nations continues to grow. African men and women leave their countries for Europe because of armed conflicts, unemployment, or poverty. Thus, these migration patterns combined with newly contracted infections have resulted in a large and growing number of HIV-positive diagnoses among African immigrants living in Europe. Using the disclosure process model, this systematic review examines the reasons for HIV status disclosure and nondisclosure among African immigrants residing in Europe. PubMed, PsycINFO, Embase, Global Health, and Web of Science were searched. Bibliographies of retrieved studies were also reviewed for other relevant citations. Studies were eligible if they: (1) focused on HIV-positive immigrants from SSA residing in Europe; and (2) described or measured HIV status disclosure. Out of 166 articles found, a total of 17 articles and 1 brief report met the inclusion criteria. Factors such as stigma and social implications of disclosure contribute to avoidance goals leading to nondisclosure while approach goals or disclosure reasons were found to include health status and behaviors such as seeking support, and helping others. The findings highlight the importance of understanding the avoidance and approach goals involved in HIV status disclosure among African immigrants in Europe. Interventions and future research directed at increasing HIV disclosure among African immigrants in Europe should move beyond individual-level to consider multilevel factors including country-specific social behaviors.

Internationalization and Its Implications for the Quality of Higher Education in Africa

ERIC Educational Resources Information Center

Oyewole, Olusola

2009-01-01

African countries and other least developed countries could use knowledge to narrow the income gap between them and the developed world economies. Higher education (HE) is an important institution that these countries will need to develop and improve in order to meet this challenge. The world of HE is however changing everyday, and one of the…

Towards Sustainable Research Capacity Development and Research Ownership for Academic Institutes in Developing Countries: The Malawian Research Support Centre Model

ERIC Educational Resources Information Center

Gomo, Exnevia; Kalilani, Linda; Mwapasa, Victor; Trigu, Chifundo; Phiri, Kamija; Schmidt, Joann; van Hensbroek, Michael Boele

2011-01-01

In lesser-developed African countries, the lack of institutionalised support for research, combined with limited career opportunities and poor remuneration, have contributed to weak research infrastructure and capacity, and a continuing brain drain to developed countries. Malawi's Research Support Centre (RSC) model is novel in that it provides a…

Heterogeneity of Rotavirus Vaccine Efficacy Among Infants in Developing Countries.

PubMed

Gruber, Joann F; Hille, Darcy A; Liu, G Frank; Kaplan, Susan S; Nelson, Micki; Goveia, Michelle G; Mast, T Christopher

2017-01-01

Rotavirus is the leading cause of severe diarrhea worldwide in young children. Although rotavirus vaccine efficacy is high in developed countries, efficacy is lower in developing countries. Here, we investigated heterogeneity of rotavirus vaccine efficacy by infant characteristics in developing countries. An exploratory, post hoc analysis was conducted using randomized controlled trial data of the pentavalent rotavirus vaccine (RV5) conducted in Africa and Asia (NCT00362648). Infants received either 3 doses of vaccine/placebo and were followed for up to 2 years. Within subgroups, vaccine efficacies and 95% confidence intervals (CIs) against rotavirus gastroenteritis (RVGE) were estimated using Poisson regression. We assessed heterogeneity of efficacy by age at first dose, gender, breastfeeding status and nutrition status. African children receiving the first dose at <8 weeks had lower efficacy (23.7%; 95% CI: -8.2%-46.3%) than those vaccinated at ≥8 weeks (59.1%; 95% CI: 34.0%-74.6%). Marginally statistically significant differences were observed by age at first dose, gender and underweight status in Ghana and gender in Asian countries. Heterogeneity of efficacy was observed for age at first dose in African countries. This was an exploratory analysis; additional studies are needed to validate these results.

SUSTAINABLE WATER DEVELOPMENT PROGRAM FOR RURAL NIGERIA

EPA Science Inventory

Rural areas of Sub-Saharan Africa face the most acute water supply challenges in the world. Nigeria, the most populous African country, has considerable populations without basic access to safe drinking water, with over 50% of the country lacking coverage. The village of Adu A...

[The fight against rabies in Africa: from recognition to action].

PubMed

Dodet, B; Adjogoua, E V; Aguemon, A-R; Baba, B A; Bara Adda, S; Boumandouki, P; Bourhy, H; Brahimi, M; Briggs, D; Diallo, M K; Diarra, L; Diop, B; Diop, S A G; Fesriry, B; Gosseye, S; Kharmachi, H; Le Roux, K; Nakoune Yandoko, E; Nel, L; Ngome, J-M; Nzengue, E; Ramahefalalao, E F; Ratsitorahina, M; Rich, H; Simpore, L; Soufi, A; Tejiokem, M C; Thiombiano, R; Tiembre, I; Traore, A K; Wateba, M I; Yahaye, H; Zaouia, I

2010-02-01

As a follow-up to the first AfroREB (Africa Rabies Expert Bureau) meeting, held in Grand-Bassam (Côte-d'Ivoire) in March 2008, African rabies experts of the Afro-REB network met a second time to complete the evaluation of the rabies situation in Africa and define specific action plans. About forty French speaking rabies specialists from Northern, Western and Central Africa and Madagascar met in Dakar (Senegal), from March 16th to 19th, 2009. With the participation of delegates from Tunisia, who joined the AfroREB network this year, 15 French speaking African countries were represented. Experts from the Institut Pasteur in Paris, the Alliance for Rabies Control, and the Southern and Eastern African Rabies Group (SEARG, a network of rabies experts from 19 English speaking Southern and Eastern African countries) were in attendance, to participate in the discussion and share their experiences. AfroREB members documented 146 known human rabies cases in all represented countries combined for 2008, for a total population of 209.3 million, or an incidence of 0.07 cases per 100,000 people. Even admitting that the experts do not have access to all reported cases, this is far from the WHO estimation of 2 rabies deaths per 100,000 people in urban areas and 3.6 per 100,000 in rural Africa. It was unanimously agreed that the priority is to break the vicious cycle of indifference and lack of information which is the main barrier to human rabies prevention.

National surveys of radiofrequency field strengths from radio base stations in Africa

PubMed Central

Joyner, Ken H.; Van Wyk, Marthinus J.; Rowley, Jack T.

2014-01-01

The authors analysed almost 260 000 measurement points from surveys of radiofrequency (RF) field strengths near radio base stations in seven African countries over two time frames from 2001 to 2003 and 2006 to 2012. The results of the national surveys were compared, chronological trends investigated and potential exposures compared by technology and with frequency modulation (FM) radio. The key findings from thes data are that irrespective of country, the year and mobile technology, RF fields at a ground level were only a small fraction of the international human RF exposure recommendations. Importantly, there has been no significant increase in typical measured levels since the introduction of 3G services. The mean levels in these African countries are similar to the reported levels for countries of Asia, Europe and North America using similar mobile technologies. The median level for the FM services in South Africa was comparable to the individual but generally lower than the combined mobile services. PMID:24044904

Toxoplasma gondii infection in meat animals from Africa: Systematic review and meta-analysis of sero-epidemiological studies

PubMed Central

Tonouhewa, Aretas Babatoundé Nounnagnon; Akpo, Yao; Sessou, Philippe; Adoligbe, Camus; Yessinou, Eric; Hounmanou, Yaovi Gildas; Assogba, Marc Napoléon; Youssao, Issaka; Farougou, Souaïbou

2017-01-01

Aim: Toxoplasma gondii is an ubiquitous apicomplexan parasite which causes toxoplasmosis in humans and animals. Felids especially cats are definitive hosts and almost all warm-blooded mammals, including livestock and human can serve as intermediate hosts. Food animals can be reservoirs for T. gondii and act as one of the sources for parasite transmission to humans. The objective of this study is to collect serological data on the prevalence of anti-T. gondii antibody, and risk factors for certain food animals from Africa to provide a quantitative estimate of T. gondii infection among these species from different African countries. Materials and Methods: Four databases were used to search seroepidemiological data on the prevalence of anti-T. gondii antibody in food animals between 1969 and 2016 from African countries. The search focused on data obtained by serologic test in food animals and meta-analyses were performed per species. Results: A total of 30,742 individual samples from 24 countries, described in 68 articles were studied. The overall estimated prevalence for toxoplasmosis in chicken, camel, cattle, sheep, goat, pig were 37.4% (29.2-46.0%), 36% (18-56%), 12% (8-17%), 26.1% (17.0-37.0%), 22.9% (12.3-36.0%), and 26.0% (20-32.0%), respectively. Moreover, major risk factor of infection was age, farming system, and farm location. Conclusions: A significant variation in the seroepidemiological data was observed within each species and country. The results can aid in an updated epidemiological analysis but also can be used as an important input in quantitative microbial risk assessment models. Further studies are required for a better and continual evaluation of the occurrence of this zoonotic infection. PMID:28344403

Personal contact with HIV-positive persons is associated with reduced HIV-related stigma: cross-sectional analysis of general population surveys from 26 countries in sub-Saharan Africa

PubMed Central

Chan, Brian T; Tsai, Alexander C

2017-01-01

Abstract Introduction: HIV-related stigma hampers treatment and prevention efforts worldwide. Effective interventions to counter HIV-related stigma are greatly needed. Although the “contact hypothesis” suggests that personal contact with persons living with HIV (PLHIV) may reduce stigmatizing attitudes in the general population, empirical evidence in support of this hypothesis is lacking. Our aim was to estimate the association between personal contact with PLHIV and HIV-related stigma among the general population of sub-Saharan Africa. Methods: Social distance and anticipated stigma were operationalized using standard HIV-related stigma questions contained in the Demographic and Health Surveys and AIDS Indicator Surveys of 26 African countries between 2003 and 2008. We fitted multivariable logistic regression models with country-level fixed effects, specifying social distance as the dependent variable and personal contact with PLHIV as the primary explanatory variable of interest. Results: We analyzed data from 206,717 women and 91,549 men living in 26 sub-Saharan African countries. We estimated a statistically significant negative association between personal contact with PLHIV and desires for social distance (adjusted odds ratio [AOR] = 0.80; p < 0.001; 95% Confidence Interval [CI], 0.73–0.88). In a sensitivity analysis, a similar finding was obtained with a model that used a community-level variable for personal contact with PLHIV (AOR = 0.92; p < 0.001; 95% CI, 0.89–0.95). Conclusions: Personal contact with PLHIV was associated with reduced desires for social distance among the general population of sub-Saharan Africa. More contact interventions should be developed and tested to reduce the stigma of HIV. PMID:28362067

International migration and caesarean birth: a systematic review and meta-analysis

PubMed Central

2013-01-01

Background Perinatal health disparities including disparities in caesarean births have been observed between migrant and non-migrant women and some literature suggests that non-medical factors may be implicated. A systematic review was conducted to determine if migrants in Western industrialized countries consistently have different rates of caesarean than receiving-country-born women and to identify the reasons that explain these differences. Methods Reports were identified by searching 12 literature databases (from inception to January 2012; no language limits) and the web, by bibliographic citation hand-searches and through key informants. Studies that compared caesarean rates between international migrants and non-migrants living in industrialized countries and that did not have a ‘fatal flaw’ according to the US Preventative Services Task Force criteria were included. Studies were summarized, analyzed descriptively and where possible, meta-analyzed. Results Seventy-six studies met inclusion criteria. Caesarean rates between migrants and non-migrants differed in 69% of studies. Meta-analyses revealed consistently higher overall caesarean rates for Sub-Saharan African, Somali and South Asian women; higher emergency rates for North African/West Asian and Latin American women; and lower overall rates for Eastern European and Vietnamese women. Evidence to explain the consistently different rates was limited. Frequently postulated risk factors for caesarean included: language/communication barriers, low SES, poor maternal health, GDM/high BMI, feto-pelvic disproportion, and inadequate prenatal care. Suggested protective factors included: a healthy immigrant effect, preference for a vaginal birth, a healthier lifestyle, younger mothers and the use of fewer interventions during childbirth. Conclusion Certain groups of international migrants consistently have different caesarean rates than receiving-country-born women. There is insufficient evidence to explain the observed differences. PMID:23360183

Socioeconomic Differences in Dietary Patterns in an East African Country: Evidence from the Republic of Seychelles

PubMed Central

Mayén, Ana-Lucia; Bovet, Pascal; Marti-Soler, Helena; Viswanathan, Bharathi; Gedeon, Jude; Paccaud, Fred; Marques-Vidal, Pedro; Stringhini, Silvia

2016-01-01

Background In high income countries, low socioeconomic status (SES) is related to unhealthier dietary patterns, while evidence on the social patterning of diet in low and middle income countries is scarce. Objective In this study, we assess dietary patterns in the general population of a middle income country in the African region, the Republic of Seychelles, and examine their distribution according to educational level and income. Methods Data was drawn from two independent national surveys conducted in the Seychelles among adults aged 25–64 years in 2004 (n = 1236) and 2013 (n = 1240). Dietary patterns were assessed by principal component analysis (PCA). Educational level and income were used as SES indicators. Data from both surveys were combined as no interaction was found between SES and year. Results Three dietary patterns were identified: “snacks and drinks”, “fruit and vegetables” and “fish and rice”. No significant associations were found between SES and the “snacks and drinks” pattern. Low vs. high SES individuals had lower adherence to the “fruit and vegetables” pattern [prevalence ratio (95% CI) 0.71 (0.60–0.83)] but a higher adherence to the traditional “fish and rice” pattern [1.58 (1.32–1.88)]. Income modified the association between education and the “fish and rice” pattern (p = 0.02), whereby low income individuals had a higher adherence to this pattern in both educational groups. Conclusion Low SES individuals have a lower consumption of fruit and vegetables, but a higher consumption of traditional foods like fish and rice. The Seychelles may be at a degenerative diseases stage of the nutrition transition. PMID:27214139

Local discrepancies in measles vaccination opportunities: results of population-based surveys in Sub-Saharan Africa

PubMed Central

2014-01-01

Background The World Health Organization recommends African children receive two doses of measles containing vaccine (MCV) through routine programs or supplemental immunization activities (SIA). Moreover, children have an additional opportunity to receive MCV through outbreak response immunization (ORI) mass campaigns in certain contexts. Here, we present the results of MCV coverage by dose estimated through surveys conducted after outbreak response in diverse settings in Sub-Saharan Africa. Methods We included 24 household-based surveys conducted in six countries after a non-selective mass vaccination campaign. In the majority (22/24), the survey sample was selected using probability proportional to size cluster-based sampling. Others used Lot Quality Assurance Sampling. Results In total, data were collected on 60,895 children from 2005 to 2011. Routine coverage varied between countries (>95% in Malawi and Kirundo province (Burundi) while <35% in N’Djamena (Chad) in 2005), within a country and over time. SIA coverage was <75% in most settings. ORI coverage ranged from >95% in Malawi to 71.4% [95% CI: 68.9-73.8] in N’Djamena (Chad) in 2005. In five sites, >5% of children remained unvaccinated after several opportunities. Conversely, in Malawi and DRC, over half of the children eligible for the last SIA received a third dose of MCV. Conclusions Control pre-elimination targets were still not reached, contributing to the occurrence of repeated measles outbreak in the Sub-Saharan African countries reported here. Although children receiving a dose of MCV through outbreak response benefit from the intervention, ensuring that programs effectively target hard to reach children remains the cornerstone of measles control. PMID:24559281

Smoking in Africa: the coming epidemic.

PubMed

Taha, A; Ball, K

1982-01-01

This discussion describes the development of tobacco smoking in Africa, the increase in consumption, and how tobacco use is promoted. It also presents evidence to show that smoking-related diseases similar to those seen in Western nations may be emerging. Tobacco was first introduced into Africa in the 16th century by the Turks who brought it into Egypt. The smoking habits of today's Africans are governed by local custom and economic status. Cigarette smoking is replacing the traditional pipe (hookah), although the latter is still used, particularly in rural areas. The prevalence of smoking is higher in urban than rural areas. Traditionally, only men smoked, but the proportion of women smokers is now rising. Smoking is also increasing among African children and adolescents. Cigarette consumption was examined in the 6 African countries from which statistics were available. In all of them, it rose steeply between 1967-76 and actually doubled in Libya and Ethiopia. In Egypt domestic cigarette sales increased by 23% between 1976-78, but sales of imported cigarettes rose by 25% in 1 year alone. Consumption of imported cigarettes is rising in many African countries. Between 1965-76 the volume of tobacco imports almost doubled. Cigarette smuggling is common in some African countries and may account for about 1/3 of total cigarette consumption in the Sudan. Some African countries are expanding tobacco agriculture so that they can supply their own needs. Nigeria has increased tobacco cultivation by about 10% a year to meet local dmeands. Zaire's imports of tobacco increased by about 30% between 1969-73 but now expects to become self sufficient in tobacco production. Tanzania's tobacco output incrased 7-fold between 1962-74 and will continue to grow through the help of the International Development Association. Cigarettes are heavily promoted in Africa. The advertisements present smoking as socially desirable by showing young, happy people and by relating it to manliness and success. Smoking-related diseases have already made their appearance in Africa. The 2 most common types of cancer in the Natal Bantu are lung and esophageal tumors. Lung cancer in Natal men has increased 6-fold and in women about 5-fold over the past 11 years. Other studies from southern Africa show much higher smoking rates in patients with lung cancer than in controls. The incidence of esophageal cancer in blacks in Durban, South Africa, and Zimbabwe is among the highest in the world. Other suggestive associations with cigarette smoking in African subjects are bladder cancer, myocardial infarction, and chronic bronchitis. Many Western governments and health authorities now try to persuade people not to smoke, and in some developed countries consumption has already begun to fall. As a result, tobacco companies have started to diversify and intensify promotion of cigarettes and the growth of tobacco in the 3rd world.

Review: African medicinal plants with wound healing properties.

PubMed

Agyare, Christian; Boakye, Yaw Duah; Bekoe, Emelia Oppong; Hensel, Andreas; Dapaah, Susana Oteng; Appiah, Theresa

2016-01-11

Wounds of various types including injuries, cuts, pressure, burns, diabetic, gastric and duodenal ulcers continue to have severe socio-economic impact on the cost of health care to patients, family and health care institutions in both developing and developed countries. However, most people in the developing countries, especially Africa, depend on herbal remedies for effective treatment of wounds. Various in vitro and in vivo parameters are used for the evaluation of the functional activity of medicinal plants by using extracts, fractions and isolated compounds. The aim of the review is to identify African medicinal plants with wound healing properties within the last two decades. Electronic databases such as PubMed, Scifinder(®) and Google Scholar were used to search and filter for African medicinal plants with wound healing activity. The methods employed in the evaluation of wound healing activity of these African medicinal plants comprise both in vivo and in vitro models. In vivo wound models such as excision, incision, dead space and burn wound model are commonly employed in assessing the rate of wound closure (contraction), tensile strength or breaking strength determination, antioxidant and antimicrobial activities, hydroxyproline content assay and histological investigations including epithelialisation, collagen synthesis, and granulation tissue formation. In in vitro studies, single cell systems are mostly used to study proliferation and differentiation of dermal fibroblasts and keratinocytes by monitoring typical differentiation markers like collagen and keratin. In this study, 61 plants belonging to 36 families with scientifically demonstrated or reported wound healing properties were reviewed. Various plant parts including leaves, fruits, stem bark and root extracts of the plants are used in the evaluation of plants for wound healing activities. Although, a variety of medicinal plants for wound healing can be found in literature, there is a need for the isolation and characterization of the bioactive compounds responsible for the wound healing properties. Also, cytotoxicity studies should be performed on the promising agents or bioactive fractions or extracts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The challenge of linguistic and cultural diversity: Does length of experience affect South African speech-language therapists’ management of children with language impairment?

PubMed Central

Southwood, Frenette; van Dulm, Ondene

2015-01-01

Background South African speech-language therapists (SLTs) currently do not reflect the country's linguistic and cultural diversity. The question arises as to who might be better equipped currently to provide services to multilingual populations: SLTs with more clinical experience in such contexts, or recently trained SLTs who are themselves linguistically and culturally diverse and whose training programmes deliberately focused on multilingualism and multiculturalism? Aims To investigate whether length of clinical experience influenced: number of bilingual children treated, languages spoken by these children, languages in which assessment and remediation can be offered, assessment instrument(s) favoured, and languages in which therapy material is required. Method From questionnaires completed by 243 Health Professions Council of South Africa (HPCSA)-registered SLTs who treat children with language problems, two groups were drawn: 71 more experienced (ME) respondents (20+ years of experience) and 79 less experienced (LE) respondents (maximum 5 years of experience). Results The groups did not differ significantly with regard to (1) number of children (monolingual or bilingual) with language difficulties seen, (2) number of respondents seeing child clients who have Afrikaans or an African language as home language, (3) number of respondents who can offer intervention in Afrikaans or English and (4) number of respondents who reported needing therapy material in Afrikaans or English. However, significantly more ME than LE respondents reported seeing first language child speakers of English, whereas significantly more LE than ME respondents could provide services, and required therapy material, in African languages. Conclusion More LE than ME SLTs could offer remediation in an African language, but there were few other significant differences between the two groups. There is still an absence of appropriate assessment and remediation material for Afrikaans and African languages, but the increased number of African language speakers entering the profession may contribute to better service delivery to the diverse South African population. PMID:26304212

Language policy and science: Could some African countries learn from some Asian countries?

NASA Astrophysics Data System (ADS)

Brock-Utne, Birgit

2012-08-01

This article deals with the fact that most children in Africa are taught in a language neither they nor their teachers master, resulting in poor education outcomes. While there are also donor interests and donor competition involved in retaining ex-colonial languages, as well as an African elite that may profit from this system, one of the main reasons why teaching in ex-colonial languages persists lies in the fact that a large proportion of the general public still believes that the best way to learn a foreign language is to have it as a language of instruction. By contrast, research studies conducted in Africa, as well as examples from Asian countries such as Sri Lanka and Malaysia, have shown that children actually learn mathematics and science much better in local and familiar languages. Though the recent World Bank Education Strategy policy paper is entitled Learning for All, it does not specify which language learning should take place in. A claim one often hears in countries of so-called Anglophone Africa is that English is the language of science and technology, and that teaching these subjects through English (instead of teaching English as a subject in its own right as a foreign language) is best. The monolingual island of Zanzibar is in fact about to reintroduce English as the language of instruction in maths and science from grade 5 onwards in primary school. The author of this paper suggests that when it comes to language policy, some African and some Asian countries could learn from each other.

Human Resources for Health Challenges in Nigeria and Nurse Migration.

PubMed

Salami, Bukola; Dada, Foluke O; Adelakun, Folake E

2016-05-01

The emigration of sub-Saharan African health professionals to developed Western nations is an aspect of increasing global mobility. This article focuses on the human resources for health challenges in Nigeria and the emigration of nurses from Nigeria as the country faces mounting human resources for health challenges. Human resources for health issues in Nigeria contribute to poor population health in the country, alongside threats from terrorism, infectious disease outbreaks, and political corruption. Health inequities within Nigeria mirror the geographical disparities in human resources for health distribution and are worsened by the emigration of Nigerian nurses to developed countries such as the United States and the United Kingdom. Nigerian nurses are motivated to emigrate to work in healthier work environments, improve their economic prospects, and advance their careers. Like other migrant African nurses, they experience barriers to integration, including racism and discrimination, in receiving countries. We explore the factors and processes that shape this migration. Given the forces of globalization, source countries and destination countries must implement policies to more responsibly manage migration of nurses. This can be done by implementing measures to retain nurses, promote the return migration of expatriate nurses, and ensure the integration of migrant nurses upon arrival in destination countries. © The Author(s) 2016.

Market efficiency in foreign exchange markets

NASA Astrophysics Data System (ADS)

Oh, Gabjin; Kim, Seunghwan; Eom, Cheoljun

2007-08-01

We investigate the relative market efficiency in financial market data, using the approximate entropy(ApEn) method for a quantification of randomness in time series. We used the global foreign exchange market indices for 17 countries during two periods from 1984 to 1998 and from 1999 to 2004 in order to study the efficiency of various foreign exchange markets around the market crisis. We found that on average, the ApEn values for European and North American foreign exchange markets are larger than those for African and Asian ones except Japan. We also found that the ApEn for Asian markets increased significantly after the Asian currency crisis. Our results suggest that the markets with a larger liquidity such as European and North American foreign exchange markets have a higher market efficiency than those with a smaller liquidity such as the African and Asian markets except Japan.

Thriving public-private partnership to fortify cooking oil in the West African Economic and Monetary Union (UEMOA) to control vitamin A deficiency: Faire Tache d'Huile en Afrique de l'Ouest.

PubMed

Sablah, Mawuli; Klopp, Jennifer; Steinberg, Douglas; Touaoro, Zaoro; Laillou, Arnaud; Baker, Shawn

2012-12-01

In sub-Saharan Africa, more than 42% of children are at risk for vitamin A deficiency, and control of vitamin A deficiency will prevent more than 600,000 child deaths annually. In the West African Economic and Monetary Union (UEMOA), an estimated 54.3% of preschool-age children are vitamin A deficient and 13% of pregnant women have night blindness. To project the achievements of this West African coalition. This article documents the achievements, challenges, and lessons learned associated with the development of a public-private partnership to fortify vegetable oil in West Africa through project reports and industry assessments. National-level food consumption surveys identified cooking oil as a key vehicle for vitamin A. Stakeholders therefore advocated for the production of fortified vegetable oil at large scale, supported industrial assessments, and reinforced the capacity of cooking oil industries to implement vitamin A fortification through effective coordination of public and private partnerships tied with standards, regulations, and social marketing. Strong alliances for food fortification were established at the regional and national levels. Stakeholders also developed policies, adopted directives, built capacity, implemented social marketing, and monitored quality enforcement systems to sustain fortification for maximum public health impact. The synergy created resulted from the unique and complementary core competencies of all the partners under effective coordination. The initiative began with the 8 UEMOA member countries and now includes all 15 countries of the Economic Community of West African States (ECOWAS), plus Cameroon, Tanzania, and Mozambique, forming a sub-Saharan Africa-wide initiative on food fortification. All members of the Professional Association of Cooking Oil Industries of the West African Economic and Monetary Union (AIFO-UEMOA) now fortify edible oil with vitamin A. Through multisector cooperation, an estimated 70% of the population has access to vitamin A-fortified edible oil in participating countries. Sustainable fortification of cooking oil is now a reality in all UEMOA countries.

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

PubMed Central

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 sub-Saharan Africa. >90% of publications from EDCTP-funded research were published in high-impact journals and are highly cited. These findings corroborate the benefit of collaborative research on PRDs. PMID:26262756

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

PubMed

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-funded research were published in high-impact journals and are highly cited. These findings corroborate the benefit of collaborative research on PRDs.

Africa Adult Education. Chronologies in Commonwealth Countries.

ERIC Educational Resources Information Center

Draper, James A., Ed.

In this document, leading educators from 12 African Commonwealth countries trace the development of adult education in Africa and show how providers of adult education outside the formal education system (including government and nongovernment organizations, trade unions, women's groups, and religious organizations) have met the needs of their…

African Swine Fever Virus Biology and Vaccine Approaches.

PubMed

Revilla, Yolanda; Pérez-Núñez, Daniel; Richt, Juergen A

2018-01-01

African swine fever (ASF) is an acute and often fatal disease affecting domestic pigs and wild boar, with severe economic consequences for affected countries. ASF is endemic in sub-Saharan Africa and the island of Sardinia, Italy. Since 2007, the virus emerged in the republic of Georgia, and since then spread throughout the Caucasus region and Russia. Outbreaks have also been reported in Belarus, Ukraine, Lithuania, Latvia, Estonia, Romania, Moldova, Czech Republic, and Poland, threatening neighboring West European countries. The causative agent, the African swine fever virus (ASFV), is a large, enveloped, double-stranded DNA virus that enters the cell by macropinocytosis and a clathrin-dependent mechanism. African Swine Fever Virus is able to interfere with various cellular signaling pathways resulting in immunomodulation, thus making the development of an efficacious vaccine very challenging. Inactivated preparations of African Swine Fever Virus do not confer protection, and the role of antibodies in protection remains unclear. The use of live-attenuated vaccines, although rendering suitable levels of protection, presents difficulties due to safety and side effects in the vaccinated animals. Several African Swine Fever Virus proteins have been reported to induce neutralizing antibodies in immunized pigs, and vaccination strategies based on DNA vaccines and recombinant proteins have also been explored, however, without being very successful. The complexity of the virus particle and the ability of the virus to modulate host immune responses are most likely the reason for this failure. Furthermore, no permanent cell lines able to sustain productive virus infection by both virulent and naturally attenuated African Swine Fever Virus strains exist so far, thus impairing basic research and the commercial production of attenuated vaccine candidates. © 2018 Elsevier Inc. All rights reserved.

MEETING REPORT: UNESCO-MERCK AFRICA RESEARCH SUMMIT 2015- ACCELERATING ACCESS AND SUSTAINING INNOVATION ‘FROM AFRICA FOR AFRICA’

PubMed Central

Omange, R.W.; Ocholla, A.O.; Kwallah., A.O; Kageha, S. N.; Mwangi, J.; Cherutich, R. K; T.A., Odeny.; Nzomo, T.; Angwenyi, S.; Yonga., P; Kariuki, F.; Kyalo, M.; Mutai, P.C.; Nindo, F.; Songok, E.M

2017-01-01

Background: The Ebola virus disease outbreak of 2014 was the largest, longest and most devastating in the history of the disease. It demonstrated the social and economic impact an emerging infectious disease can have in a globalized world. Health systems in affected countries were stretched to the point of near collapse, while social relations and traditional practices were negatively impacted. Heads of African research institutions, African government representatives, leaders of global pharmaceutical companies, global infectious disease experts and close to 100 young African researchers from 25 countries; Assembled in Geneva on 19 and 20th October 2015, for the inaugural UNESCO-Merck Africa Summit sponsored by the United Nations Educational, Science and Culture Organization and Merck KGA Goal of Summit: The primary goal of the summit was to develop strategies to increase health research capacity in Africa, with special focus on Ebola and enhancing pandemic preparation for emerging infectious diseases. The summit was also provide a forum to showcase the research taking place in Africa, and provided platform for African researchers to network. Some of the key issues discussed included; strategies for enhancing policy frameworks to promote knowledge translation, strengthening of health systems, enhancing knowledge and data sharing, and increasing innovation in Africa. Conclusions: Summit attendees recognized that Africa still bore the heaviest burden of infectious disease, and increased commitment by African governments to fund health research, offered the best hope for developing health solutions and interventions to improve the health of Africans. Improved health in turn would enhance the productivity of Africans, further supporting the socio-economic transformation currently taking place on the continent. PMID:28337491

Condom availability in high risk places and condom use: a study at district level in Kenya, Tanzania and Zambia

PubMed Central

2012-01-01

Background A number of studies from countries with severe HIV epidemics have found gaps in condom availability, even in places where there is a substantial potential for HIV transmission. Although reported condom use has increased in many African countries, there are often big differences by socioeconomic background. The aim of this study was to assess equity aspects of condom availability and uptake in three African districts to evaluate whether condom programmes are given sufficient priority. Methods Data on condom availability and use was examined in one district in Kenya, one in Tanzania and one in Zambia. The study was based on a triangulation of data collection methods in the three study districts: surveys in venues where people meet new sexual partners, population-based surveys and focus group discussions. The data was collected within an overall study on priority setting in health systems. Results At the time of the survey, condoms were observed in less than half of the high risk venues in two of the three districts and in 60% in the third district. Rural respondents in the population-based surveys perceived condoms to be less available and tended to be less likely to report condom use than urban respondents. Although focus group participants reported that condoms were largely available in their district, they expressed concerns related to the accessibility of free condoms. Conclusion As late as thirty years into the HIV epidemic there are still important gaps in the availability of condoms in places where people meet new sexual partners in these three African districts. Considering that previous studies have found that improved condom availability and accessibility in high risk places have a potential to increase condom use among people with multiple partners, the present study findings indicate that substantial further efforts should be made to secure that condoms are easily accessible in places where sexual relationships are initiated. Although condom distribution in drinking places has been pinpointed in the HIV/AIDS prevention strategies of all the three countries, its priority relative to other HIV/AIDS measures must be reassessed locally, nationally and regionally. In practical terms very clear supply chains of condoms to both formal and informal drinking places could make condom provision better and more reliable. PMID:23181969

The Impact of Female Schooling on Fertility and Contraceptive Use: A Study of Fourteen Sub-Saharan Countries. Living Standards Measurement Study Working Paper No. 110.

ERIC Educational Resources Information Center

Ainsworth, Martha; And Others

This paper examines the relationship between female schooling and two behaviors--cumulative fertility and contraceptive use--in 14 Sub-Saharan African countries where Demographic and Health Surveys (DHS) have been conducted since the mid-1980s. Using multivariate regression analysis, the paper compares the effect of schooling across countries, in…

ACLED Country Report: Central African Republic

DTIC Science & Technology

2015-01-01

predominantly Muslim group was formed following the merger of multiple existing rebel groups from the north of the country ( Human Rights Watch...existing groups, there are important differences in the dynamics and behaviour of the groups at these different stages of unrest in the country. Comparing...meant that instructions to stop human rights violations went largely unheard (Huser & Umugwaneza, 2013; Amnesty, 2013). Motivated by règlement de

South African Zulu Widows in a Time of Poverty and Social Change

ERIC Educational Resources Information Center

Rosenblatt, Paul C.; Nkosi, Busisiwe Catherine

2007-01-01

Interviews were carried out with 16 South African Zulu widows. Much of what the widows had to say seemed like what one might hear from widows in economically developed countries, but there were also striking differences. All the widows lived in poverty, and for some their grief seemed much more about the poverty than about the husband's death.…

Managing Information for Development in the 21st Century: Prospects for African Libraries, Challenges to the World.

ERIC Educational Resources Information Center

Nwalo, Kenneth Ivo Ngozi

This paper discusses the role information can play in the development of African countries in the 21st century. It stresses that development information can only be guaranteed when libraries in Africa computerize their systems, form networks for resource sharing, and take advantage of the benefits of information technology (IT), especially CD-ROM…

World City/Regional City: Latinos and African-Americans in Chicago and St. Louis. JSRI Working Paper No. 46.

ERIC Educational Resources Information Center

Villanueva, Margaret; Erdman, Brian; Howlett, Larry

This paper traces the effects of economic restructuring through comparative socioeconomic profiles of African American and Latinos in the Midwest, with a focus on Chicago and Kansas City. Globalization has been associated with deindustrialization, relocation of jobs to developing countries with cheaper labor, and expansion of the service sector. A…

"O Mundo da Lingua Portuguesa," a Supplementary Cultural Lesson.

ERIC Educational Resources Information Center

Kennedy, James H.

The text of a classroom lesson on the distribution and use of the Portuguese language in African countries, written in Portuguese and containing an explanation of and practice in using the definite article with African place names, is presented. The lesson is accompanied by vocabulary notes in the margin, a list of questions on the text, and a mpa…

Culturally Relevant Beliefs of Teachers and Their Affect on the School Experience of African American Male Students

ERIC Educational Resources Information Center

Davenport, Reginald O.

2009-01-01

The study was conducted in two suburban middle schools. These schools are located in a very diverse public school district in Middlesex County New Jersey. Like many school districts throughout this country, many African American male students are experiencing school and schooling differently based on the differences still seen in the number of…

Learning Contexts, Black Cultural Ethos, and the Science Achievement of African American Students in an Urban Middle School

ERIC Educational Resources Information Center

Parsons, Eileen Carlton

2008-01-01

As other countries vigorously promote rapid advancement in science, optimizing the participation of all students in the United States in science is imperative. This study focused on African American students and examined their science achievement in relation to Black Cultural Ethos (BCE), a construct rooted in psychology. Via qualitative and…

A Local Response to the Global Human Rights Standard: The "Ubuntu" Perspective on Human Dignity

ERIC Educational Resources Information Center

Murithi, Tim

2007-01-01

Some African leaders have made the argument that the promotion of an international human rights standard is a strategy that is used and abused by hypocritical Western governments to justify their intervention into the affairs of African countries. The tacit objective behind this articulation is the desire to avoid an external evaluation or…

Genetic Variation among African Swine Fever Genotype II Viruses, Eastern and Central Europe

PubMed Central

Fernández-Pinero, Jovita; Pelayo, Virginia; Gazaev, Ismail; Markowska-Daniel, Iwona; Pridotkas, Gediminas; Nieto, Raquel; Fernández-Pacheco, Paloma; Bokhan, Svetlana; Nevolko, Oleg; Drozhzhe, Zhanna; Pérez, Covadonga; Soler, Alejandro; Kolvasov, Denis; Arias, Marisa

2014-01-01

African swine fever virus (ASFV) was first reported in eastern Europe/Eurasia in 2007. Continued spread of ASFV has placed central European countries at risk, and in 2014, ASFV was detected in Lithuania and Poland. Sequencing showed the isolates are identical to a 2013 ASFV from Belarus but differ from ASFV isolated in Georgia in 2007. PMID:25148518

The double burden household in sub-Saharan Africa: maternal overweight and obesity and childhood undernutrition from the year 2000: results from World Health Organization Data (WHO) and Demographic Health Surveys (DHS).

PubMed

Wojcicki, Janet M

2014-10-31

Previous studies have characterized an increasing trend of double burden households, or households with individuals experiencing both undernutrition and obesity, in countries undergoing a nutrition transition. Although most prior studies indicate the prevalence of double burden households is highest in middle-income countries, there is some support for an increase in double burden households in sub-Saharan African countries as well. Using data from the Demographic Health Surveys (DHS) and the World Health Organization (WHO), the prevalence of double burden households in sub-Saharan African countries was calculated and the associations between prevalence of overweight/obese adults and underweight, stunted and wasted children were evaluated at the country and household (DHS only) levels. Restricted analyses and frequencies were calculated using urban-only datasets. Surveys from 28 African countries were available using WHO data and 26 from the DHS surveys. Only surveys that were conducted after 2000 were included in analyses. Using the WHO datasets, there were inverse associations between the prevalence of overweight and obesity in adults and underweight, stunting and wasting in children. Correspondingly, there were positive associations between adult underweight and child underweight, stunting and wasting. These associations were not significant in a smaller sample size using urban-only surveys. The prevalence of double burden households in DHS datasets was low: under 5 percent for obese mothers and underweight, stunted or wasted child pairs with a slightly higher percentage for overweight mothers and children with undernutrition. Restricting the analysis to urban only populations did not increase the frequencies of double burden households significantly. There was a low prevalence of double burden households in recent data from sub-Saharan Africa. Countries that have a high prevalence of child undernutrition correspondingly have a high prevalence of adult underweight and low prevalence of adult overweight and obesity.

Global health initiatives in Africa - governance, priorities, harmonisation and alignment.

PubMed

Mwisongo, Aziza; Nabyonga-Orem, Juliet

2016-07-18

The advent of global health initiatives (GHIs) has changed the landscape and architecture of health financing in low and middle income countries, particularly in Africa. Over the last decade, the African Region has realised improvements in health outcomes as a result of interventions implemented by both governments and development partners. However, alignment and harmonisation of partnerships and GHIs are still difficult in the African countries with inadequate capacity for their effective coordination. Both published and grey literature was reviewed to understand the governance, priorities, harmonisation and alignment of GHIs in the African Region; to synthesise the knowledge and highlight the persistent challenges; and to identify gaps for future research. GHI governance structures are often separate from those of the countries in which they operate. Their divergent funding channels and modalities may have contributed to the failure of governments to track their resources. There is also evidence that basically, earmarking and donor conditions drive funding allocations regardless of countries' priorities. Although studies cite the lack of harmonisation of GHI priorities with national strategies, evidence shows improvements in that area over time. GHIs have used several strategies and mechanisms to involve the private sector. These have widened the pool of health service policy-makers and providers to include groups such as civil society organisations (CSOs), with both positive and negative implications. GHI strategies such as co-financing by countries as a condition for support have been positive in achieving sustainability of interventions. GHI approaches have not changed substantially over the years but there has been evolution in terms of donor funding and conditions. GHIs still largely operate in a vertical manner, bypassing country systems; they compete for the limited human resources; they influence country policies; and they are not always harmonised with other donors. To maximise returns on GHI support, there is need to ensure that their approaches are more comprehensive as opposed to being selective; to improve GHI country level governance and alignment with countries' changing epidemiologic profiles; and to strengthen their involvement of CSOs.

Pharmacogenomics Implications of Using Herbal Medicinal Plants on African Populations in Health Transition

PubMed Central

Thomford, Nicholas E.; Dzobo, Kevin; Chopera, Denis; Wonkam, Ambroise; Skelton, Michelle; Blackhurst, Dee; Chirikure, Shadreck; Dandara, Collet

2015-01-01

The most accessible points of call for most African populations with respect to primary health care are traditional health systems that include spiritual, religious, and herbal medicine. This review focusses only on the use of herbal medicines. Most African people accept herbal medicines as generally safe with no serious adverse effects. However, the overlap between conventional medicine and herbal medicine is a reality among countries in health systems transition. Patients often simultaneously seek treatment from both conventional and traditional health systems for the same condition. Commonly encountered conditions/diseases include malaria, HIV/AIDS, hypertension, tuberculosis, and bleeding disorders. It is therefore imperative to understand the modes of interaction between different drugs from conventional and traditional health care systems when used in treatment combinations. Both conventional and traditional drug entities are metabolized by the same enzyme systems in the human body, resulting in both pharmacokinetics and pharmacodynamics interactions, whose properties remain unknown/unquantified. Thus, it is important that profiles of interaction between different herbal and conventional medicines be evaluated. This review evaluates herbal and conventional drugs in a few African countries and their potential interaction at the pharmacogenomics level. PMID:26402689

On the Ethnic Origins of African Development: Chiefs and Precolonial Political Centralization

PubMed Central

Michalopoulos, Stelios; Papaioannou, Elias

2015-01-01

We report on recent findings of a fruitful research agenda that explores the importance of ethnic-specific traits in shaping African development. First, using recent surveys from Sub-Saharan African countries, we document that individuals identify with their ethnic group as often as with the nation pointing to the salience of ethnicity. Second, we focus on the various historical and contemporary functions of tribal leaders (chiefs) and illustrate their influence on various aspects of the economy and the polity. Third, we elaborate on a prominent dimension of ethnicity, that of the degree of complexity of pre-colonial political organization. Building on insights from the African historiography, we review recent works showing a strong association between pre-colonial centralization and contemporary comparative development both across and within countries. We also document that the link between pre-colonial political centralization and regional development -as captured by satellite images of light density at night-is particularly strong in areas outside the vicinity of the capitals, where due to population mixing and the salience of national institutions ethnic traits play a lesser role. Overall, our evidence is supportive to theories and narratives on the presence of a “dual” economic and institutional environment in Africa. PMID:27011760

Food safety management systems performance in African food processing companies: a review of deficiencies and possible improvement strategies.

PubMed

Kussaga, Jamal B; Jacxsens, Liesbeth; Tiisekwa, Bendantunguka Pm; Luning, Pieternel A

2014-08-01

This study seeks to provide insight into current deficiencies in food safety management systems (FSMS) in African food-processing companies and to identify possible strategies for improvement so as to contribute to African countries' efforts to provide safe food to both local and international markets. This study found that most African food products had high microbiological and chemical contamination levels exceeding the set (legal) limits. Relative to industrialized countries, the study identified various deficiencies at government, sector/branch, retail and company levels which affect performance of FSMS in Africa. For instance, very few companies (except exporting and large companies) have implemented HACCP and ISO 22000:2005. Various measures were proposed to be taken at government (e.g. construction of risk-based legislative frameworks, strengthening of food safety authorities, recommend use of ISO 22000:2005, and consumers' food safety training), branch/sector (e.g. sector-specific guidelines and third-party certification), retail (develop stringent certification standards and impose product specifications) and company levels (improving hygiene, strict raw material control, production process efficacy, and enhancing monitoring systems, assurance activities and supportive administrative structures). By working on those four levels, FSMS of African food-processing companies could be better designed and tailored towards their production processes and specific needs to ensure food safety. © 2014 Society of Chemical Industry.

Exploring HIV knowledge, risk and protective factors among west African forced migrants in New York City.

PubMed

Akinsulure-Smith, Adeyinka M

2014-06-01

Because of ongoing political and social instability throughout the continent, many Africans have become forced migrants. Unlike immigrants who choose to migrate, forced migrants flee their countries in search of safety and often endure multiple traumatic events during their migration. They are often unprepared for new risks in their adopted country. There is a high incidence of newly-diagnosed HIV cases among West African immigrants in the New York City metropolitan area, but little research to date to understand why this might occur. In order to gain insight, the current pilot study explored HIV knowledge, risk and protective behaviors among 52 West African-born forced migrants in New York City. HIV risk behavior came primarily from unprotected heterosexual activities. While most participants were very knowledgeable about HIV transmission and risk factors, almost half reported that they had not used condoms during sexual activities in the past 6 months. Women were more knowledgeable about HIV transmission, yet reported significantly more STDs than men. Many participants did not know about HIV/AIDS treatments and could not identify HIV/AIDS services and resources within their immigrant communities. Factors influencing HIV risk and protective behaviors among this population are identified and discussed. Suggestions for future research and strategies to reduce risky behaviors while enhancing protective ones among forced West African migrants are highlighted.