scholarly journals Promoting Scale-Up Across a Global Project Platform: Lessons from the Evidence to Action Project

2021 ◽  
Author(s):  
Laura Ghiron ◽  
Eric Ramirez-Ferrero ◽  
Rita Badiani ◽  
Regina Benevides ◽  
Alexis Ntabona ◽  
...  
Keyword(s):  
Family Planning ◽  
Scale Up ◽  
Scaling Up ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
Country Level ◽  
Look Ahead ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
Multi Stakeholder

AbstractThe USAID-funded flagship family planning service delivery project named Evidence to Action (E2A) worked from 2011 to 2021 to improve family planning and reproductive health for women and girls across seventeen nations in sub-Saharan Africa using a “scaling-up mindset.” The paper discusses three key lessons emerging from the project’s experience with applying ExpandNet’s systematic approach to scale up. The methodology uses ExpandNet/WHO’s scaling-up framework and guidance tools to design and implement pilot or demonstration projects in ways that look ahead to their future scale-up; develop a scaling-up strategy with local stakeholders; and then strategically manage the scaling-up process. The paper describes how a scaling-up mindset was engendered, first within the project’s technical team in Washington and then how they subsequently sought to build capacity at the country level to support scale-up work throughout E2A’s portfolio of activities. The project worked with local multi-stakeholder resource teams, often led by government officials, to equip them to lead the scale-up of family planning and health system strengthening interventions. Examples from project experience in the Democratic Republic of the Congo, Kenya, Nigeria, and Uganda illustrating key concepts are discussed. E2A also established a community of practice on systematic approaches to scale up as a platform for sharing learning across a variety of technical agencies engaged in scale-up work and to create learning opportunities for interacting with thought leaders around critical scale-up issues.

scholarly journals Scaling-up PrEP Delivery in Sub-Saharan Africa: What Can We Learn from the Scale-up of ART?

2019 ◽  
Vol 16 (2) ◽  
pp. 141-150 ◽  
Author(s):  
Gabrielle O’Malley ◽  
Gena Barnabee ◽  
Kenneth Mugwanya
Keyword(s):  
Scale Up ◽  
Scaling Up ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Correction to: Scaling-up PrEP Delivery in Sub-Saharan Africa: What Can We Learn from the Scale-up of ART?

2019 ◽  
Vol 16 (3) ◽  
pp. 257-257
Author(s):  
Gabrielle O’Malley ◽  
Gena Barnabee ◽  
Kenneth Mugwanya
Keyword(s):  
Scale Up ◽  
Scaling Up ◽  
Sub Saharan Africa ◽  
Correction To Scaling ◽  
Sub Saharan

Conflicts in Biafra, Katanga and Cabinda as a result of the geopolitical legacy of colonialism

2020 ◽  
Vol 2020 (10-3) ◽  
pp. 238-246
Author(s):  
Olga Dzhenchakova
Keyword(s):  
Democratic Republic ◽  
Economic Factor ◽  
Colonial Period ◽  
Sub Saharan Africa ◽  
Negative Consequences ◽  
Post Colonial ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
The Republic ◽  
The Impact

The article considers the impact of the colonial past of some countries in sub-Saharan Africa and its effect on their development during the post-colonial period. The negative consequences of the geopolitical legacy of colonialism are shown on the example of three countries: Nigeria, the Democratic Republic of the Congo and the Republic of Angola, expressed in the emergence of conflicts in these countries based on ethno-cultural, religious and socio-economic contradictions. At the same time, the focus is made on the economic factor and the consequences of the consumer policy of the former metropolises pursuing their mercantile interests were mixed.

scholarly journals Maintaining paediatric cardiac services during the COVID-19 pandemic in a developing country in sub-Saharan Africa: guidelines for a “scale up” in the face of a global “scale down”

2020 ◽  
Vol 30 (11) ◽  
pp. 1588-1594
Author(s):  
Ogochukwu J. Sokunbi ◽  
Ogadinma Mgbajah ◽  
Augustine Olugbemi ◽  
Bassey O. Udom ◽  
Ariyo Idowu ◽  
...  
Keyword(s):  
Scale Up ◽  
Global Scale ◽  
International Travel ◽  
Sub Saharan Africa ◽  
African Continent ◽  
Tertiary Centre ◽  
The Face ◽  
Scale Down ◽  
Sub Saharan ◽  
International Experts

AbstractThe COVID-19 pandemic is currently ravaging the globe and the African continent is not left out. While the direct effects of the pandemic in regard to morbidity and mortality appear to be more significant in the developed world, the indirect harmful effects on already insufficient healthcare infrastructure on the African continent would in the long term be more detrimental to the populace. Women and children form a significant vulnerable population in underserved areas such as the sub-Saharan region, and expectedly will experience the disadvantages of limited healthcare coverage which is a major fall out of the pandemic. Paediatric cardiac services that are already sparse in various sub-Saharan countries are not left out of this downsizing. Restrictions on international travel for patients out of the continent to seek medical care and for international experts into the continent for regular mission programmes leave few options for children with cardiac defects to get the much-needed care.There is a need for a region-adapted guideline to scale-up services to cater for more children with congenital heart disease (CHD) while providing a safe environment for healthcare workers, patients, and their caregivers. This article outlines measures adapted to maintain paediatric cardiac care in a sub-Saharan tertiary centre in Nigeria during the COVID-19 pandemic and will serve as a guide for other institutions in the region who will inadvertently need to provide these services as the demand increases.

scholarly journals Protest, Internet Activism, and Sociopolitical Change in Sub-Saharan Africa

2020 ◽  
pp. 000276422097506
Author(s):  
Oscar Mateos ◽  
Carlos Bajo Erro
Keyword(s):  
Field Work ◽  
Sub Saharan Africa ◽  
Third Wave ◽  
Sociopolitical Change ◽  
The Third ◽  
Political Protests ◽  
Street Protest ◽  
Internet Activism ◽  
Republic Of The Congo ◽  
Sub Saharan

Sub-Saharan Africa has been the scene of a sizeable wave of social and political protests in recent years. These protests have many aspects in common, while at the same time there is a certain historic continuity connecting them to previous protests, with which they also have much in common. What makes them new, however, is a hybrid nature that combines street protest and online action, making them similar to protests occurring in other parts of the world during the same period. Based on a literature review and field work on three countries, Senegal, Burkina Faso, and the Democratic Republic of the Congo, this article addresses some of the main features of what some authors have called the “third wave of African protests.” The study points out how the digital environment is galvanizing a new process of popular opposition and enabling both greater autonomy for actors promoting the protests and greater interaction at the regional level. With the sociopolitical impact in the short and medium term still uncertain, the third wave of African protests is giving birth to a new political and democratic culture in the region as a whole.

scholarly journals Wealth-related inequalities in demand for family planning satisfied among married and unmarried adolescent girls and young women in sub-Saharan Africa

2021 ◽  
Vol 18 (S1) ◽  
Author(s):  
Martin K. Mutua ◽  
Yohannes D. Wado ◽  
Monica Malata ◽  
Caroline W. Kabiru ◽  
Elsie Akwara ◽  
...  
Keyword(s):  
Family Planning ◽  
West Africa ◽  
Adolescent Girls ◽  
Young Women ◽  
Rate Of Change ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sexually Active ◽  
Sub Saharan ◽  
Over Time

Abstract Background The use of modern contraception has increased in much of sub-Saharan Africa (SSA). However, the extent to which changes have occurred across the wealth spectrum among adolescents is not well known. We examine poor-rich gaps in demand for family planning satisfied by modern methods (DFPSm) among sexually active adolescent girls and young women (AGYW) using data from national household surveys. Methods We used recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys to describe levels of wealth-related inequalities in DFPSm among sexually active AGYW using an asset index as an indicator of wealth. Further, we used data from countries with more than one survey conducted from 2000 to assess DFPSm trends. We fitted linear models to estimate annual average rate of change (AARC) by country. We fitted random effects regression models to estimate regional AARC in DFPSm. All analysis were stratified by marital status. Results Overall, there was significant wealth-related disparities in DFPSm in West Africa only (17.8 percentage points (pp)) among married AGYW. The disparities were significant in 5 out of 10 countries in Eastern, 2 out of 6 in Central, and 7 out of 12 in West among married AGYW and in 2 out of 6 in Central and 2 out of 9 in West Africa among unmarried AGYW. Overall, DFPSm among married AGYW increased over time in both poorest (AARC = 1.6%, p < 0.001) and richest (AARC = 1.4%, p < 0.001) households and among unmarried AGYW from poorest households (AARC = 0.8%, p = 0.045). DPFSm increased over time among married and unmarried AGYW from poorest households in Eastern (AARC = 2.4%, p < 0.001) and Southern sub-regions (AARC = 2.1%, p = 0.030) respectively. Rwanda and Liberia had the largest increases in DPFSm among married AGYW from poorest (AARC = 5.2%, p < 0.001) and richest (AARC = 5.3%, p < 0.001) households respectively. There were decreasing DFPSm trends among both married (AARC = − 1.7%, p < 0.001) and unmarried (AARC = − 4.7%, p < 0.001) AGYW from poorest households in Mozambique. Conclusion Despite rapid improvements in DFPSm among married AGYW from the poorest households in many SSA countries there have been only modest reductions in wealth-related inequalities. Significant inequalities remain, especially among married AGYW. DFPSm stalled in most sub-regions among unmarried AGYW.

scholarly journals Readiness of Sub-Saharan Africa Healthcare Systems for the New Pandemic, Diabetes: A Systematic Review

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Bernardo Nuche-Berenguer ◽  
Linda E. Kupfer
Keyword(s):  
Systematic Review ◽  
Health Systems ◽  
Diabetes Care ◽  
Healthcare Workers ◽  
Scale Up ◽  
Sub Saharan Africa ◽  
Diagnostic Tools ◽  
Inclusion Criteria ◽  
Care Health ◽  
Sub Saharan

Background. Effective health systems are needed to care for the coming surge of diabetics in sub-Saharan Africa (SSA). Objective. We conducted a systematic review of literature to determine the capacity of SSA health systems to manage diabetes. Methodology. We used three different databases (Embase, Scopus, and PubMed) to search for studies, published from 2004 to 2017, on diabetes care in SSA. Results. Fifty-five articles met the inclusion criteria, covering the different aspects related to diabetes care such as availability of drugs and diagnostic tools, the capacity of healthcare workers, and the integration of diabetes care into HIV and TB platforms. Conclusion. Although chronic care health systems in SSA have developed significantly in the last decade, the capacity for managing diabetes remains in its infancy. We identified pilot projects to enhance these capacities. The scale-up of these pilot interventions and the integration of diabetes care into existing robust chronic disease platforms may be a feasible approach to begin to tackle the upcoming pandemic in diabetes. Nonetheless, much more work needs to be done to address the health system-wide deficiencies in diabetes care. More research is also needed to determine how to integrate diabetes care into the healthcare system in SSA.

Migration as a Risk Factor for HIV Infection among Youths in Sub-Saharan Africa

2013 ◽  
Vol 648 (1) ◽  
pp. 136-158 ◽  
Author(s):  
Monica A. Magadi
Keyword(s):  
Risk Factor ◽  
Hiv Infection ◽  
Urban Areas ◽  
Young Female ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Country Level ◽  
Female Migrants ◽  
Sub Saharan ◽  
Living With Hiv

Of the estimated 10 million youths living with HIV worldwide, 63 percent live in sub-Saharan Africa. This article focuses on migration as a risk factor of HIV infection among the youths in sub-Saharan Africa. The study is based on multilevel modeling, applied to the youth sample of the Demographic and Health Surveys (DHS), conducted from 2003 to 2008 in nineteen countries. The analysis takes into account country-level and regional-level variations. The results suggest that across countries in sub-Saharan Africa, migrants have on average about 50 percent higher odds of HIV infection than nonmigrants. The higher risk among migrants is to a large extent explained by differences in demographic and socioeconomic factors. In particular, migrants are more likely to be older, to have been married, or to live in urban areas, all of which are associated with higher risks of HIV infection. The higher risk among youths who have been married is particularly pronounced among young female migrants.

The changing value of children among the Kikuyu of Central Province, Kenya

Africa ◽  
1996 ◽  
Vol 66 (3) ◽  
pp. 411-436 ◽  
Author(s):  
Neil Price
Keyword(s):  
Family Planning ◽  
Social Institutions ◽  
Sub Saharan Africa ◽  
High Fertility ◽  
Central Province ◽  
Economic Insecurity ◽  
Family Planning Services ◽  
Value Of Children ◽  
Sub Saharan ◽  
Demand For Children

Within demography, high fertility in sub-Saharan Africa was considered until recently to reflect a demand for children firmly rooted in indigenous social institutions, which were resistant to external forces of change. On the basis of findings from recent Demographic and Health Surveys, Caldwell et al. (1992) suggest that many of the institutional supports for high fertility in sub-Saharan Africa—such as lineage-based descent systems, polygyny, bridewealth, extended kinship structures, child fostering, and communal land tenure—are being eroded. This article considers changes in the value of children among the Kikuyu of Central Province, Kenya, and the extent to which the social institutions which have traditionally supported high fertility have persisted. Fieldwork undertaken in two ethnically homogenous communities, one rural and one peri-urban, reveals significant variation in the fertility motives and value of children in the two communities. In the rural community many of the indigenous social supports for high fertility, although modified, cohere. In the context of economic insecurity and lack of access to land (especially for women without sons), manipulation of customary kinship and marriage practices (supported by the persistence of many indigenous religious beliefs and ideologies about fertility) has become strategically important for realising fertility desires. There is, however, unmet demand for modern contraception, due largely to lack of access to and the poor quality of family planning services. In contrast, in the peri-urban community, where access to family planning services is relatively good, there has been effective legitimation of fertility regulation and the use of modern contraception is widespread. There is markedly less economic insecurity: wage labour opportunities are available, and some women have successfully challenged male control over land. Consequently, there is reduced demand for children, although a number of the indigenous cultural supports for high : fertility retain residual importance.

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