Returning HIV-1 viral load results to participant-selected health facilities in national Population-based HIV Impact Assessment (PHIA) household surveys in three sub-Saharan African Countries, 2015 to 2016

Abstract The units at the early stages of multi-stage area samples are generally sampled with probabilities proportional to their estimated sizes (PPES). With such a design, an overall equal probability (EP) sample design would yield a constant number of final stage units from each final stage cluster if the measures of size used in the PPES selection at each sampling stage were directly proportional to the number of final stage units. However, there are often sizable relative differences between the measures of size used in the PPES selections and the number of final stage units. Two common approaches for dealing with these differences are: (1) to retain a self-weighting sample design, allowing the sample sizes to vary across the sampled primary sampling units (PSUs) and (2) to retain the fixed sample size in each PSU and to compensate for the unequal selection probabilities by weighting adjustments in the analyses. This article examines these alternative designs in the context of two-stage sampling in which PSUs are sampled with PPES at the first stage, and an equal probability sample of final stage units is selected from each sampled PSU at the second stage. Two-stage sample designs of this type are used for household surveys in many countries. The discussion is illustrated with data from the Population-based HIV Impact Assessment surveys that were conducted using this design in several African countries.

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The Distribution of Consumption Expenditure in Sub-Saharan Africa: The Inequality Among All Africans

Journal of African Economies ◽

10.1093/jae/ejz016 ◽

2019 ◽

Vol 29 (1) ◽

pp. 1-25

Author(s):

La-Bhus Fah Jirasavetakul ◽

Christoph Lakner

Keyword(s):

Wide Distribution ◽

Living Standards ◽

Sub Saharan Africa ◽

Household Surveys ◽

Consumption Expenditure ◽

African Countries ◽

Full Sample ◽

Alternative Measures ◽

Sub Saharan ◽

Measures Of Inequality

Abstract This paper uses a set of national household surveys to study the regional Sub-Saharan Africa distribution of consumption expenditure among individuals during 1993–2008. The analysis puts the disparities in living standards that exist among all persons in Africa into context with the disparities that exist within and between African countries. We find some evidence that African interpersonal inequality has increased, but this depends on the measure of inequality. The Africa-wide Gini increased from 53% in 1993 to 56% in 2008 in the full sample, compared with an increase from 54% to 56% in the balanced sample of countries. In the full sample, this result is robust to alternative measures of inequality, while in the balanced sample, some bottom-sensitive measures show a decline. Disparities in living standards between countries have increased, while there has been no systematic increase in within-country inequality. For the Africa-wide distribution, the growth of consumption expenditure (from household surveys) has been low (between 0.9% and 1.6% per year depending on the sample). This growth has been uneven such that the richest 5% of Africans received around 40% of the total gains.

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Cross-sectional observational assessment of quality of newborn care immediately after birth in health facilities across six sub-Saharan African countries

BMJ Open ◽

10.1136/bmjopen-2016-014680 ◽

2017 ◽

Vol 7 (3) ◽

pp. e014680 ◽

Cited By ~ 16

Author(s):

Joseph de Graft-Johnson ◽

Linda Vesel ◽

Heather E Rosen ◽

Barbara Rawlins ◽

Stella Abwao ◽

...

Keyword(s):

Newborn Care ◽

Health Facilities ◽

Observational Assessment ◽

African Countries ◽

Cross Sectional ◽

Sub Saharan

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Estimates of HIV-1 prevalence from national population-based surveys as a new gold standard

The Lancet ◽

10.1016/s0140-6736(03)14967-7 ◽

2003 ◽

Vol 362 (9399) ◽

pp. 1929-1931 ◽

Cited By ~ 77

Author(s):

J Ties Boerma ◽

Peter D Ghys ◽

Neff Walker

Keyword(s):

Gold Standard ◽

Population Based ◽

National Population ◽

Hiv 1

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Integrating health services for HIV infection, diabetes and hypertension in sub-Saharan Africa: a cohort study

BMJ Open ◽

10.1136/bmjopen-2021-053412 ◽

2021 ◽

Vol 11 (11) ◽

pp. e053412

Author(s):

Josephine Birungi ◽

Sokoine Kivuyo ◽

Anupam Garrib ◽

Levicatus Mugenyi ◽

Gerald Mutungi ◽

...

Keyword(s):

Cohort Study ◽

Viral Load ◽

Hiv Infection ◽

Integrated Care ◽

Plasma Viral Load ◽

Integrated Management ◽

Retention In Care ◽

Health Facilities ◽

Sub Saharan Africa ◽

Sub Saharan

BackgroundHIV, diabetes and hypertension have a high disease burden in sub-Saharan Africa. Healthcare is organised in separate clinics, which may be inefficient. In a cohort study, we evaluated integrated management of these conditions from a single chronic care clinic.ObjectivesTo determined the feasibility and acceptability of integrated management of chronic conditions in terms of retention in care and clinical indicators.Design and settingProspective cohort study comprising patients attending 10 health facilities offering primary care in Dar es Salaam and Kampala.InterventionClinics within health facilities were set up to provide integrated care. Patients with either HIV, diabetes or hypertension had the same waiting areas, the same pharmacy, were seen by the same clinical staff, had similar provision of adherence counselling and tracking if they failed to attend appointments.Primary outcome measuresRetention in care, plasma viral load.FindingsBetween 5 August 2018 and 21 May 2019, 2640 patients were screened of whom 2273 (86%) were enrolled into integrated care (832 with HIV infection, 313 with diabetes, 546 with hypertension and 582 with multiple conditions). They were followed up to 30 January 2020. Overall, 1615 (71.1%)/2273 were female and 1689 (74.5%)/2266 had been in care for 6 months or more. The proportions of people retained in care were 686/832 (82.5%, 95% CI: 79.9% to 85.1%) among those with HIV infection, 266/313 (85.0%, 95% CI: 81.1% to 89.0%) among those with diabetes, 430/546 (78.8%, 95% CI: 75.4% to 82.3%) among those with hypertension and 529/582 (90.9%, 95% CI: 88.6 to 93.3) among those with multimorbidity. Among those with HIV infection, the proportion with plasma viral load <100 copies/mL was 423(88.5%)/478.ConclusionIntegrated management of chronic diseases is a feasible strategy for the control of HIV, diabetes and hypertension in Africa and needs evaluation in a comparative study.

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How polarized is sub-Saharan Africa? A look at the regional distribution of consumption expenditure in the 2000s

Oxford Economic Papers ◽

10.1093/oep/gpaa020 ◽

2020 ◽

Author(s):

Fabio Clementi ◽

Michele Fabiani ◽

Vasco Molini

Keyword(s):

Economic Growth ◽

Regional Distribution ◽

Southern Cone ◽

Sub Saharan Africa ◽

Household Surveys ◽

Consumption Expenditure ◽

African Countries ◽

Sub Saharan ◽

Main Criticism

Abstract The resurgence of economic growth over the last two decades in sub-Saharan Africa has recently come under scrutiny by scholars, the main criticism being the lack of inclusiveness. While studies on inequality in sub-Saharan Africa are becoming numerous, less attention has been devoted so far to the growing polarization the region is undergoing. Polarization, as distinct from inequality, refers to the tendency of shifting away from the centre of a distribution to its tails, creating a hollowed-out middle. This paper, using a set of sub-Saharan African national household surveys, provides a first estimate of the regional expenditures’ polarization. This latter steadily increased throughout the 2000s and its growth was mainly driven by increasing polarization between countries, meaning sub-Saharan Africa tended to polarize spatially, with the Southern cone countries and some Western African countries performing above the average, and the rest of the region lagging behind.

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