scholarly journals Socioeconomic development predicts a weaker contraceptive effect of breastfeeding

2021 ◽  
Vol 118 (29) ◽  
pp. e2025348118
Author(s):  
Nicolas Todd ◽  
Mathias Lerch
Keyword(s):  
Socioeconomic Development ◽  
Ovarian Function ◽  
Sub Saharan Africa ◽  
Breastfeeding Duration ◽  
Rapid Decline ◽  
Ovarian Activity ◽  
Middle Income ◽  
Contraceptive Effect ◽  
Negative Effect ◽  
Postpartum Amenorrhea

The contraceptive effect of breastfeeding remains essential to controlling fertility in many developing regions of the world. The extent to which this negative effect of breastfeeding on ovarian activity is sensitive to ecological conditions, notably maternal energetic status, has remained controversial. We assess the relationship between breastfeeding duration and postpartum amenorrhea (the absence of menstruation following a birth) in 17 World Fertility Surveys and 284 Demographic Health Surveys conducted between 1975 and 2019 in 84 low- and middle-income countries. We then analyze the resumption of menses in women during unsupplemented lactation. We find that a sharp weakening of the breastfeeding–postpartum amenorrhea relationship has globally occurred over the time period analyzed. The slope of the breastfeeding–postpartum amenorrhea relationship is negatively associated with development: higher values of the Human Development Index, urbanization, access to electricity, easier access to water, and education are predictive of a weaker association between breastfeeding and postpartum amenorrhea. Low parity also predicts shorter postpartum amenorrhea. The association between exclusive breastfeeding and maintenance of amenorrhea in the early postpartum period is also found in rapid decline in Asia and in moderate decline in sub-Saharan Africa. These findings indicate that the effect of breastfeeding on ovarian function is partly mediated by external factors that likely include negative maternal energy balance and support the notion that prolonged breastfeeding significantly helps control fertility only under harsh environmental conditions.

scholarly journals Reductions in NO2 burden over north equatorial Africa from decline in biomass burning in spite of growing fossil fuel use, 2005 to 2017

2021 ◽  
Vol 118 (7) ◽  
pp. e2002579118
Author(s):  
Jonathan E. Hickman ◽  
Niels Andela ◽  
Kostas Tsigaridis ◽  
Corinne Galy-Lacaux ◽  
Money Ossohou ◽  
...  
Keyword(s):  
Biomass Burning ◽  
Socioeconomic Development ◽  
Fossil Fuel ◽  
Dry Season ◽  
Sub Saharan Africa ◽  
Burned Area ◽  
Fuel Use ◽  
Middle Income ◽  
Equatorial Africa ◽  
Low And Middle Income

Socioeconomic development in low- and middle-income countries has been accompanied by increased emissions of air pollutants, such as nitrogen oxides [NOx: nitrogen dioxide (NO2) + nitric oxide (NO)], which affect human health. In sub-Saharan Africa, fossil fuel combustion has nearly doubled since 2000. At the same time, landscape biomass burning—another important NOx source—has declined in north equatorial Africa, attributed to changes in climate and anthropogenic fire management. Here, we use satellite observations of tropospheric NO2 vertical column densities (VCDs) and burned area to identify NO2 trends and drivers over Africa. Across the northern ecosystems where biomass burning occurs—home to hundreds of millions of people—mean annual tropospheric NO2 VCDs decreased by 4.5% from 2005 through 2017 during the dry season of November through February. Reductions in burned area explained the majority of variation in NO2 VCDs, though changes in fossil fuel emissions also explained some variation. Over Africa’s biomass burning regions, raising mean GDP density (USD⋅km−2) above its lowest levels is associated with lower NO2 VCDs during the dry season, suggesting that economic development mitigates net NO2 emissions during these highly polluted months. In contrast to the traditional notion that socioeconomic development increases air pollutant concentrations in low- and middle-income nations, our results suggest that countries in Africa’s northern biomass-burning region are following a different pathway during the fire season, resulting in potential air quality benefits. However, these benefits may be lost with increasing fossil fuel use and are absent during the rainy season.

scholarly journals Population cluster data to assess the urban-rural split and electrification in Sub-Saharan Africa

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Babak Khavari ◽  
Alexandros Korkovelos ◽  
Andreas Sahlberg ◽  
Mark Howells ◽  
Francesco Fuso Nerini
Keyword(s):  
World Bank ◽  
Population Distribution ◽  
Population Data ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Middle Income ◽  
Disease Response ◽  
The World Bank ◽  
The World ◽  
Urban Rural

AbstractHuman settlements are usually nucleated around manmade central points or distinctive natural features, forming clusters that vary in shape and size. However, population distribution in geo-sciences is often represented in the form of pixelated rasters. Rasters indicate population density at predefined spatial resolutions, but are unable to capture the actual shape or size of settlements. Here we suggest a methodology that translates high-resolution raster population data into vector-based population clusters. We use open-source data and develop an open-access algorithm tailored for low and middle-income countries with data scarcity issues. Each cluster includes unique characteristics indicating population, electrification rate and urban-rural categorization. Results are validated against national electrification rates provided by the World Bank and data from selected Demographic and Health Surveys (DHS). We find that our modeled national electrification rates are consistent with the rates reported by the World Bank, while the modeled urban/rural classification has 88% accuracy. By delineating settlements, this dataset can complement existing raster population data in studies such as energy planning, urban planning and disease response.

scholarly journals BioLPG for Clean Cooking in Sub-Saharan Africa: Present and Future Feasibility of Technologies, Feedstocks, Enabling Conditions and Financing

Energies ◽  
2021 ◽  
Vol 14 (13) ◽  
pp. 3916
Author(s):  
Kimball C. Chen ◽  
Matthew Leach ◽  
Mairi J. Black ◽  
Meron Tesfamichael ◽  
Francis Kemausuor ◽  
...  
Keyword(s):  
Agricultural Waste ◽  
Sub Saharan Africa ◽  
Green Economy ◽  
Energy Access ◽  
Liquefied Petroleum Gas ◽  
Public And Private ◽  
Middle Income ◽  
Private Sector Investment ◽  
Sub Saharan ◽  
Public And Private Sector

Energy supply for clean cooking is a priority for Sub-Saharan Africa (SSA). Liquefied petroleum gas (LPG, i.e., propane or butane or a mixture of both) is an economically efficient, cooking energy solution used by over 2.5 billion people worldwide and scaled up in numerous low- and middle-income countries (LMICs). Investigation of the technical, policy, economic and physical requirements of producing LPG from renewable feedstocks (bioLPG) finds feasibility at scale in Africa. Biogas and syngas from the circular economic repurposing of municipal solid waste and agricultural waste can be used in two groundbreaking new chemical processes (Cool LPG or Integrated Hydropyrolysis and Hydroconversion (IH2)) to selectively produce bioLPG. Evidence about the nature and scale potential of bioLPG presented in this study justifies further investment in the development of bioLPG as a fuel that can make a major contribution toward enabling an SSA green economy and universal energy access. Techno-economic assessments of five potential projects from Ghana, Kenya and Rwanda illustrate what might be possible. BioLPG technology is in the early days of development, so normal technology piloting and de-risking need to be undertaken. However, fully developed bioLPG production could greatly reduce the public and private sector investment required to significantly increase SSA clean cooking capacity.

scholarly journals Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

2020 ◽  
Vol 5 (11) ◽  
pp. e003423
Author(s):  
Dongqing Wang ◽  
Molin Wang ◽  
Anne Marie Darling ◽  
Nandita Perumal ◽  
Enju Liu ◽  
...  
Keyword(s):  
Weight Gain ◽  
North Africa ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Weight ◽  
Latin America And Caribbean ◽  
Nationally Representative ◽  
Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

scholarly journals Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments

2021 ◽  
Vol 6 (5) ◽  
pp. e004324
Author(s):  
John Whitaker ◽  
Nollaig O'Donohoe ◽  
Max Denning ◽  
Dan Poenaru ◽  
Elena Guadagno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Evidence Synthesis ◽  
Rapid Assessment ◽  
Sub Saharan Africa ◽  
Trauma Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Three Delays

BackgroundThe large burden of injuries falls disproportionately on low/middle-income countries (LMICs). Health system interventions improve outcomes in high-income countries. Assessing LMIC trauma systems supports their improvement. Evaluating systems using a Three Delays framework, considering barriers to seeking (Delay 1), reaching (Delay 2) and receiving care (Delay 3), has aided maternal health gains. Rapid assessments allow timely appraisal within resource and logistically constrained settings. We systematically reviewed existing literature on the assessment of LMIC trauma systems, applying the Three Delays framework and rapid assessment principles.MethodsWe conducted a systematic review and narrative synthesis of articles assessing LMIC trauma systems. We searched seven databases and grey literature for studies and reports published until October 2018. Inclusion criteria were an injury care focus and assessment of at least one defined system aspect. We mapped each study to the Three Delays framework and judged its suitability for rapid assessment.ResultsOf 14 677 articles identified, 111 studies and 8 documents were included. Sub-Saharan Africa was the most commonly included region (44.1%). Delay 3, either alone or in combination, was most commonly assessed (79.3%) followed by Delay 2 (46.8%) and Delay 1 (10.8%). Facility assessment was the most common method of assessment (36.0%). Only 2.7% of studies assessed all Three Delays. We judged 62.6% of study methodologies potentially suitable for rapid assessment.ConclusionsWhole health system injury research is needed as facility capacity assessments dominate. Future studies should consider novel or combined methods to study Delays 1 and 2, alongside care processes and outcomes.

Information technology and insurance development in Sub-Saharan Africa

2021 ◽  
pp. 026666692110289
Author(s):  
Taiwo Akinlo
Keyword(s):  
Information Technology ◽  
Mobile Phone ◽  
Life Insurance ◽  
Sub Saharan Africa ◽  
Method Of Moment ◽  
African Countries ◽  
Insurance Premiums ◽  
Negative Effect ◽  
Sub Saharan ◽  
Insurance Development

The study examined the relationship between information technology and insurance development in 40 sub-Saharan African countries during the period 2000-2017. The study employed System Generalised Method of Moment for the estimations. Life insurance premiums, non-life insurance premiums and total insurance premiums are used to measure life insurance, non-life insurance and total insurance, respectively. The information technology is measured by mobile phone, fixed telephone and Internet penetrations. The study found that the Internet promotes non-life insurance while its effect on life and total insurance is insignificant. The mobile phone produced a negative effect on life insurance, non-life insurance and total insurance. However, fixed telephone significantly contributed to life insurance, non-life insurance and total insurance. Based on these findings, there is a need for insurers to encourage their client to use information technology tools for insurance activities and also increase their interaction with their customers.

scholarly journals Are low and middle-income countries prioritising high-value healthcare interventions?

2020 ◽  
Vol 5 (2) ◽  
pp. e001850
Author(s):  
Ashley A Leech ◽  
David D Kim ◽  
Joshua T Cohen ◽  
Peter J Neumann
Keyword(s):  
Cost Effectiveness ◽  
Cost Saving ◽  
National Health ◽  
Sub Saharan Africa ◽  
Health Plans ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Priority ◽  
Sub Saharan ◽  
Low And Middle Income

IntroductionSince resources are finite, investing in services that produce the highest health gain ‘return on investment’ is critical. We assessed the extent to which low and middle-income countries (LMIC) have included cost-saving interventions in their national strategic health plans.MethodsWe used the Tufts Medical Center Global Health Cost-Effectiveness Analysis Registry, an open-source database of English-language cost-per-disability-adjusted life year (DALY) studies, to identify analyses published in the last 10 years (2008–2017) of cost-saving health interventions in LMICs. To assess whether countries prioritised cost-saving interventions within their latest national health strategic plans, we identified 10 countries, all in sub-Saharan Africa, with the highest measures on the global burden of disease scale and reviewed their national health priority plans.ResultsWe identified 392 studies (63%) targeting LMICs that reported 3315 cost-per-DALY ratios, of which 207 ratios (6%) represented interventions reported to be cost saving. Over half (53%) of these targeted sub-Saharan Africa. For the 10 countries we investigated in sub-Saharan Africa, 58% (79/137) of cost-saving interventions correspond with priorities identified in country plans. Alignment ranged from 95% (21/22 prioritised cost-saving ratios) in South Africa to 17% (2/12 prioritised cost-saving ratios) in Cameroon. Human papillomavirus vaccination was a noted priority in 70% (7/10) of national health prioritisation plans, while 40% (4/10) of countries explicitly included prenatal serological screening for syphilis. HIV prevention and treatment were stated priorities in most country health plans, whereas 40% (2/5) of countries principally outlined efforts for lymphatic filariasis. From our sample of 45 unique interventions, 36% of interventions (16/45) included costs associated directly with the implementation of the intervention.ConclusionOur findings indicate substantial variation across country and disease area in incorporating economic evidence into national health priority plans in a sample of sub-Saharan African countries. To make health economic data more salient, the authors of cost-effectiveness analyses must do more to reflect implementation costs and other factors that could limit healthcare delivery.

scholarly journals Understanding cause of stillbirth: a prospective observational multi-country study from sub-Saharan Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mamuda Aminu ◽  
Sarah Bar-Zeev ◽  
Sarah White ◽  
Matthews Mathai ◽  
Nynke van den Broek
Keyword(s):  
Sierra Leone ◽  
Cause Of Death ◽  
Expert Panel ◽  
Healthcare Providers ◽  
Sub Saharan Africa ◽  
Primary Data ◽  
Middle Income ◽  
Computer Based ◽  
Sub Saharan ◽  
Low And Middle Income

Abstract Background Every year, an estimated 2.6 million stillbirths occur worldwide, with up to 98% occurring in low- and middle-income countries (LMIC). There is a paucity of primary data on cause of stillbirth from LMIC, and particularly from sub-Saharan Africa to inform effective interventions. This study aimed to identify the cause of stillbirths in low- and middle-income settings and compare methods of assessment. Methods This was a prospective, observational study in 12 hospitals in Kenya, Malawi, Sierra Leone and Zimbabwe. Stillbirths (28 weeks or more) were reviewed to assign the cause of death by healthcare providers, an expert panel and by using computer-based algorithms. Agreement between the three methods was compared using Kappa (κ) analysis. Cause of stillbirth and level of agreement between the methods used to assign cause of death. Results One thousand five hundred sixty-three stillbirths were studied. The stillbirth rate (per 1000 births) was 20.3 in Malawi, 34.7 in Zimbabwe, 38.8 in Kenya and 118.1 in Sierra Leone. Half (50.7%) of all stillbirths occurred during the intrapartum period. Cause of death (range) overall varied by method of assessment and included: asphyxia (18.5–37.4%), placental disorders (8.4–15.1%), maternal hypertensive disorders (5.1–13.6%), infections (4.3–9.0%), cord problems (3.3–6.5%), and ruptured uterus due to obstructed labour (2.6–6.1%). Cause of stillbirth was unknown in 17.9–26.0% of cases. Moderate agreement was observed for cause of stillbirth as assigned by the expert panel and by hospital-based healthcare providers who conducted perinatal death review (κ = 0.69; p < 0.0005). There was only minimal agreement between expert panel review or healthcare provider review and computer-based algorithms (κ = 0.34; 0.31 respectively p < 0.0005). Conclusions For the majority of stillbirths, an underlying likely cause of death could be determined despite limited diagnostic capacity. In these settings, more diagnostic information is, however, needed to establish a more specific cause of death for the majority of stillbirths. Existing computer-based algorithms used to assign cause of death require revision.

Dividend Policy as a Driver of Corporate Growth in Sub-Saharan Africa: Evidence in Nigeria

2020 ◽  
Vol 4 (2) ◽  
pp. 4-13
Author(s):  
Emmanuel Otitolaiye ◽  
Tunji Siyanbola
Keyword(s):  
Dividend Policy ◽  
Sub Saharan Africa ◽  
Insurance Companies ◽  
Firm Age ◽  
Dividend Payout ◽  
Significant Negative Effect ◽  
Ex Post ◽  
Corporate Growth ◽  
Negative Effect ◽  
Sub Saharan

Dividend policy remains an important topic in modern corporate finance. Researchers, managers, and business owners seek to understand the optimal dividend policy. This study examined dividend policy as a driver of corporate growth in sub-Saharan Africa: evidence in Nigeria. The ex-post facto research design was adopted to analyse how dividend policy spur the growth of active insurance companies in the Nigerian Stock Exchange using secondary data of the sampled firms for 2007 – 2018 while utilising descriptive and inferential (regression) statistics in data analysis. The findings reveal that dividend policy in terms of dividend payout has an insignificant negative effect on corporate growth of insurance companies in Nigeria (?= -8.09E-05, p=0.77; Adjusted R2=0.4093; F(4,139)=3.29; p=0.00 with the controlling effect of efficiency, firm age and leverage which have a significant effect on corporate growth of insurance companies in Nigeria. Specifically, the study reveals that efficiency has a significant negative effect on corporate growth (?=-5.29, p<0.05); while firm age discloses a significant positive influence on corporate growth (?=0.417, p<0.05); as leverage exerts a significant negative effect on corporate growth (?=0.052, p<0.05). Therefore, the study concludes that dividend policy does not significantly drive insurance companies' dividend payout growth. The study recommends that insurance companies' management retain more of their profits, improve their efficiency, and control their leverage to further growth.

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