Introducing quality certification in staple food markets in Sub-Saharan Africa: Four Conditions for Successful Implementation

Cervical cancer is a critical public health issue in sub-Saharan Africa (SSA), where it is the second leading cause of cancer among women and the leading cause of female cancer deaths. Incidence and mortality rates are substantially higher than in high-income countries with population-based screening programs, yet implementing screening programs in SSA has so far proven to be challenging due to financial, logistical, and sociocultural factors. Human Papillomavirus (HPV) vaccination is an effective approach for primary prevention of cervical cancer and presents an opportunity to reduce the burden from cervical cancer in SSA. With a number of SSA countries now eligible for Global Alliance for Vaccines and Immunization (GAVI) support for vaccine introduction, it is timely to consider the factors that impede and facilitate implementation of vaccine programs in SSA. This article describes epidemiological features of cervical cancer in SSA and the current status of HPV vaccine implementation in SSA countries. Rwanda’s experience of achieving high vaccination coverage in their national HPV immunization program is used as a case study to explore effective approaches to the design and implementation of HPV vaccination programs in SSA. Key factors in Rwanda’s successful implementation included government ownership and support for the program, school-based delivery, social mobilization, and strategies for reaching out-of-school girls. These findings might usefully be applied to other SSA countries planning for HPV vaccination.

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Water reclamation for industrial use in sub-Saharan Africa – a critical review

Drinking Water Engineering and Science ◽

10.5194/dwes-12-45-2019 ◽

2019 ◽

Vol 12 (2) ◽

pp. 45-58

Author(s):

Noor Jehan Gulamussen ◽

André Marques Arsénio ◽

Nelson Pedro Matsinhe ◽

Louis Cornelis Rietveld

Keyword(s):

Water Scarcity ◽

Industrial Development ◽

Management Practices ◽

Sub Saharan Africa ◽

Successful Implementation ◽

World Population ◽

Water Reclamation ◽

Sanitation Services ◽

Industrial Use ◽

Sub Saharan

Abstract. The increasing world population and growth of industrial development lead to growing water scarcity that, combined with deficient sanitation services, represents serious challenges, particularly in regions like sub-Saharan Africa. Water reclamation is a promising approach to reduce water scarcity, serving as a driving force for better sanitation services and protecting the environment by treating sewage and redistributing for the benefit of other water-dependent applications (e.g., industries). This paper aims to give an overview of the global trends on water reclamation, with a focus on industrial use, and to derive lessons for implementation of water reclamation projects in sub-Saharan Africa. Findings show that extensive experience exists in technology and management practices that can allow successful implementation of water reclamation projects in the region. Under the conditions of deficient sanitation services and low levels of technical expertise, the main challenge is to develop a framework that can facilitate the integration of social and technological methodologies and help in introducing water reclamation in water allocation planning, including the development of specific legislation for industrial water use and disposal.

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Achieving Sustainability and Scale-Up of Mobile Health Noncommunicable Disease Interventions in Sub-Saharan Africa: Views of Policy Makers in Ghana (Preprint)

10.2196/preprints.11497 ◽

2018 ◽

Author(s):

Daniel Opoku ◽

Reinhard Busse ◽

Wilm Quentin

Keyword(s):

Mobile Health ◽

Scale Up ◽

Noncommunicable Disease ◽

Sub Saharan Africa ◽

Successful Implementation ◽

Policy Makers ◽

Context Factors ◽

Number Of Patients ◽

Sub Saharan

BACKGROUND A growing body of evidence shows that mobile health (mHealth) interventions may improve treatment and care for the rapidly rising number of patients with noncommunicable diseases (NCDs) in sub-Saharan Africa (SSA). A recent realist review developed a framework highlighting the influence of context factors, including predisposing characteristics, needs, and enabling resources (PNE), for the long-term success of mHealth interventions. The views of policy makers will ultimately determine implementation and scale-up of mHealth interventions in SSA. However, their views about necessary conditions for sustainability and scale-up remain unexplored. OBJECTIVE This study aimed to understand the views of policy makers in Ghana with regard to the most important factors for successful implementation, sustainability, and scale-up of mHealth NCD interventions. METHODS Members of the technical working group responsible for Ghana’s national NCD policy were interviewed about their knowledge of and attitude toward mHealth and about the most important factors contributing to long-term intervention success. Using qualitative methods and applying a qualitative content analysis approach, answers were categorized according to the PNE framework. RESULTS A total of 19 policy makers were contacted and 13 were interviewed. Interviewees had long-standing work experience of an average of 26 years and were actively involved in health policy making in Ghana. They were well-informed about the potential of mHealth, and they strongly supported mHealth expansion in the country. Guided by the PNE framework’s categories, the policy makers ascertained which critical factors would support the successful implementation of mHealth interventions in Ghana. The policy makers mentioned many factors described in the literature as important for mHealth implementation, sustainability, and scale-up, but they focused more on enabling resources than on predisposing characteristics and need. Furthermore, they mentioned several factors that have been rather unexplored in the literature. CONCLUSIONS The study shows that the PNE framework is useful to guide policy makers toward a more systematic assessment of context factors that support intervention implementation, sustainability, and scale-up. Furthermore, the framework was refined by adding additional factors. Policy makers may benefit from using the PNE framework at the various stages of mHealth implementation. Researchers may (and should) use the framework when investigating reasons for success (or failure) of interventions.

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Loss to Followup: A Major Challenge to Successful Implementation of Prevention of Mother-to-Child Transmission of HIV-1 Programs in Sub-Saharan Africa

ISRN AIDS ◽

10.5402/2012/589817 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 40

Author(s):

Fatch W. Kalembo ◽

Maggie Zgambo

Keyword(s):

Models Of Care ◽

Sub Saharan Africa ◽

Successful Implementation ◽

Mother To Child Transmission ◽

Child Transmission ◽

Great Loss ◽

Open Access Journals ◽

Sub Saharan ◽

Mother To Child ◽

Hiv 1

Purpose. The purpose of this paper was to explore how loss to followup (LFTU) has affected the successful implementation of prevention of mother to child transmission of HIV-1 (PMTCT) programs in sub-Saharan Africa. Methods. We conducted an electronic search from the following databases PubMed, ScienceDirect, Directory of Open Access Journals (DOAJs), and PyscINFO. Additional searches were made in WHO, UNAIDS, UNICEF, Google, and Google scholar websites for (1) peer-reviewed published research, (2) scientific and technical reports, and (3) papers presented on scientific conferences. Results. A total of 678 articles, published from 1990 to 2011, were retrieved. Only 44 articles met our inclusion criteria and were included in the study. The rates of LTFU of mother-child pairs ranged from 19% to 89.4 in the reviewed articles. Health facility factors, fear of HIV-1 test, stigma and discrimination, home deliveries and socioeconomic factors were identified as reasons for LTFU. Conclusion. There is a great loss of mother-child pairs to follow up in PMTCT programs in sub-Saharan Africa. There is need for more research studies to develop public health models of care that can help to improve followup of mother-child pairs in PMTCT programs in Sub-Saharan Africa.

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Implementation determinants and mechanisms for the prevention and treatment of adolescent HIV in sub-Saharan Africa: concept mapping of the NIH Fogarty International Center Adolescent HIV Implementation Science Alliance (AHISA) initiative

Implementation Science Communications ◽

10.1186/s43058-021-00156-3 ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Gregory A. Aarons ◽

Kendal Reeder ◽

Nadia A. Sam-Agudu ◽

Susan Vorkoper ◽

Rachel Sturke

Keyword(s):

Hiv Prevention ◽

Implementation Science ◽

Concept Mapping ◽

Scale Up ◽

Sub Saharan Africa ◽

Successful Implementation ◽

Evidence Based ◽

Treatment Implementation ◽

Prevention And Treatment ◽

Sub Saharan

Abstract Introduction Adolescent HIV prevention and treatment is a high priority for youth healthcare in sub-Saharan Africa. Methods This study employed concept mapping to identify factors that impact the implementation of HIV prevention and intervention programs for adolescents in sub-Saharan Africa. Key stakeholders including researchers, policymakers, and non-governmental organization (NGO) personnel constituting membership of the NIH-sponsored Adolescent HIV Prevention and Treatment Implementation Science Alliance responded to the question: “In your experience, what factors have facilitated or hindered implementation of evidence-based HIV prevention or treatment for adolescents in sub-Saharan Africa?” Participants generated statements in response to the focus question, sorted them into thematically relevant groups, and rated each statement on its importance and changeability. Results Through data analyses and participant feedback, 15 distinct themes were derived. “Workforce/Workflow” and “HIV Stigma and Adolescent Development” were rated highest for importance, and “Threshold Conditions for Treatment” and “Structure of Implementation Efforts” were rated most changeable. Conclusions Understanding implementation science determinants and mechanisms can facilitate the uptake of successful implementation and sustainment strategies for the prevention and treatment of HIV in a given context. We placed determinants and mechanisms within the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to provide greater contextual integration with broader theories in implementation science. Implementers across multiple disciplines can use these findings to improve the scale-up of evidence-based practices for adolescent HIV prevention and treatment in sub-Saharan Africa. Implementation approaches that consider the determinants and mechanisms identified in this study and integrated in implementation frameworks will likely have utility for other health conditions and contexts.

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Barriers to Implementing Clinical Pharmacogenetics Testing in Sub-Saharan Africa. A Critical Review

Pharmaceutics ◽

10.3390/pharmaceutics12090809 ◽

2020 ◽

Vol 12 (9) ◽

pp. 809

Author(s):

Emiliene B. Tata ◽

Melvin A. Ambele ◽

Michael S. Pepper

Keyword(s):

Health Care ◽

Large Scale ◽

Ethical Issues ◽

Care Delivery ◽

Clinical Care ◽

Cost Effective ◽

Communicable Diseases ◽

Sub Saharan Africa ◽

Successful Implementation ◽

Sub Saharan

Clinical research in high-income countries is increasingly demonstrating the cost- effectiveness of clinical pharmacogenetic (PGx) testing in reducing the incidence of adverse drug reactions and improving overall patient care. Medications are prescribed based on an individual’s genotype (pharmacogenes), which underlies a specific phenotypic drug response. The advent of cost-effective high-throughput genotyping techniques coupled with the existence of Clinical Pharmacogenetics Implementation Consortium (CPIC) dosing guidelines for pharmacogenetic “actionable variants” have increased the clinical applicability of PGx testing. The implementation of clinical PGx testing in sub-Saharan African (SSA) countries can significantly improve health care delivery, considering the high incidence of communicable diseases, the increasing incidence of non-communicable diseases, and the high degree of genetic diversity in these populations. However, the implementation of PGx testing has been sluggish in SSA, prompting this review, the aim of which is to document the existing barriers. These include under-resourced clinical care logistics, a paucity of pharmacogenetics clinical trials, scientific and technical barriers to genotyping pharmacogene variants, and socio-cultural as well as ethical issues regarding health-care stakeholders, among other barriers. Investing in large-scale SSA PGx research and governance, establishing biobanks/bio-databases coupled with clinical electronic health systems, and encouraging the uptake of PGx knowledge by health-care stakeholders, will ensure the successful implementation of pharmacogenetically guided treatment in SSA.

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A Quality Management Approach to Implementing Point-of-Care Technologies for HIV Diagnosis and Monitoring in Sub-Saharan Africa

Journal of Tropical Medicine ◽

10.1155/2012/651927 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 19

Author(s):

Joseph P. Shott ◽

Ronald M. Galiwango ◽

Steven J. Reynolds

Keyword(s):

Quality Management ◽

Hiv Infection ◽

Patient Care ◽

Point Of Care ◽

Sub Saharan Africa ◽

Great Promise ◽

Management Approach ◽

Portable Devices ◽

Successful Implementation ◽

Sub Saharan

Technology advances in rapid diagnosis and clinical monitoring of human immunodeficiency virus (HIV) infection have been made in recent years, greatly benefiting those at risk of HIV infection, those needing care and treatment, and those on antiretroviral (ART) therapy in sub-Saharan Africa. However, resource-limited, geographically remote, and harsh climate regions lack uniform access to these technologies. HIV rapid diagnostic tests (RDTs) and monitoring tools, such as those for CD4 counts, as well as tests for coinfections, are being developed and have great promise in these settings to aid in patient care. Here we explore the advances in point-of-care (POC) technology in the era where portable devices are bringing the laboratory to the patient. Quality management approaches will be imperative for the successful implementation of POC testing in endemic settings to improve patient care.

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Corporate social responsibility in Sub-Saharan Africa: hindering and supporting factors

African Journal of Economic and Management Studies ◽

10.1108/ajems-01-2012-0002 ◽

2014 ◽

Vol 5 (1) ◽

pp. 93-113 ◽

Cited By ~ 15

Author(s):

Richard Benon-be-isan Nyuur ◽

Daniel F. Ofori ◽

Yaw Debrah

Keyword(s):

Corporate Social Responsibility ◽

Social Responsibility ◽

Value Chain ◽

Sub Saharan Africa ◽

Successful Implementation ◽

Chain Model ◽

Content Type ◽

Stakeholder Groups ◽

Sub Saharan ◽

Corporate Social

Purpose – In recent years, the concept of corporate social responsibility (CSR) has gained recognition and importance in both business and political settings. While considerable research has been conducted on CSR in developed countries, the extant literature on CSR in Sub-Saharan Africa (SSA) is scant and CSR is seen in terms of philanthropy. This paper aims to examine CSR from a broader perspective and in particular to identify the factors that hinder and promote CSR activities in SSA using the Smit (2009) CSR Value Chain Model. Design/methodology/approach – This paper is based on data obtained from a survey conducted by GTZ (now GIZ) on factors promoting and hindering CSR in SSA. The study surveyed 85 companies from six countries, namely; South Africa, Ghana, Kenya, Malawi, Mozambique and Namibia. The study essentially examined the internal and external CSR environments of the companies in the participating countries. Findings – The study revealed that there are nine key promoting and hindering factors of CSR for businesses in SSA. These include: leadership and governance, policy framework, project management, monitoring, evaluation and reporting, stakeholder engagement, staff engagement, government, funding and beneficiation. The study recommends a systemic and context-sensitive approach that relies on the potential of organisations and communities to design and implement their own solution within global frameworks in order to further develop CSR in the region. Research limitations/implications – There are a number of limitations in this study. First, this study did not include any informants from the responding organisations’ stakeholder groups, but relied mainly on information obtained from single respondents from organisations. Further research should include responses from other stakeholder groups. Practical implications – To promote or achieve the successful implementation of CSR and broaden its scope within the region beyond its current focus on philanthropy, managers must build bridges with their stakeholders through both formal and informal dialogues and engagement practices. Additionally, firms may enhance and maximise both social and economic value created when managers link their CSR activities to areas that improve firms’ long-term competitive potential by collectively and systematically applying their distinctive strengths to such activities in accordance with the value chain model. Originality/value – The finding in this study is novel and adds an important contribution to the developing CSR literature in the SSA region.

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The costs of consumption smoothing: less schooling and less nutrition

Journal of Demographic Economics ◽

10.1017/dem.2019.7 ◽

2019 ◽

Vol 85 (3) ◽

pp. 181-208 ◽

Cited By ~ 3

Author(s):

Leandro De Magalhães ◽

Dongya Koh ◽

Räul Santaeulàlia-Llopis

Keyword(s):

Human Capital ◽

Old Age ◽

Rural Areas ◽

Nutritional Quality ◽

The Elderly ◽

Consumption Smoothing ◽

Sub Saharan Africa ◽

Staple Food ◽

Sub Saharan

AbstractUsing novel microdata, we explore lifecycle consumption in Sub-Saharan Africa. We find that households' ability to smooth consumption over the lifecycle is large, particularly, in rural areas. Consumption in old age is sustained by shifting to self-farmed staple food, as opposed to traditional savings mechanisms or food gifts. This smoothing strategy indicates two important costs. The first cost is a loss of human capital as children seem to be diverted away from school and into producing self-farmed food. Second, a diet largely concentrated in staple food (e.g., maize in Malawi) in old age results in a loss of nutritional quality for households headed by the elderly.

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