The real challenges for scaling up ART in sub-Saharan Africa

AIDS ◽  
2006 ◽  
Vol 20 (5) ◽  
pp. 653-656 ◽  
Author(s):  
Wim Van Damme ◽  
Katharina Kober ◽  
Marie Laga
Author(s):  
Laura Ghiron ◽  
Eric Ramirez-Ferrero ◽  
Rita Badiani ◽  
Regina Benevides ◽  
Alexis Ntabona ◽  
...  

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.


Author(s):  
Damalie Nakanjako ◽  
Florence Maureen Mirembe ◽  
Jolly Beyeza-Kashesya ◽  
Alex Coutinho

Author(s):  
Innocent K. Besigye ◽  
Jane F. Namatovu

It is evident that politicians, health managers and academics are realising the potential contribution of Family Medicine to health systems in sub-Saharan Africa. The challenge is in training institutions to recruit and train enough Family Physicians in order to meet expectations. The 3rd Family Medicine Conference in Uganda, held in October 2013, explored innovative ways of scaling up Family Medicine training and practice in Uganda.


1996 ◽  
Vol 40 (1) ◽  
pp. 92-103
Author(s):  
Jonathan Ikoba ◽  
Akorlie A. Nyatepe-Coo ◽  
Oluwole Owoye

This paper examines the relative contributions of domestic and external factors to real exchange rate changes in six sub-Sahara African countries during the period 1960–91. A vector autoregression (VAR) model is used to analyze the interrelationships between the current account, the budget balance and the real exchange rate. The results suggest that external factors such as the terms of trade and foreign income were as important as domestic policy mistakes in causing real exchange rate misalignment in sub-Saharan Africa.


1972 ◽  
Vol 10 (3) ◽  
pp. 383-408 ◽  
Author(s):  
I. M. Lewis

In the lives of nations, as of men, reputations all too often achieve their widest currency when they are already out of date. The Somali Republic is no exception to this general rule. Although the real circumstances had already significantly altered before the military brusquely seized power in October 1969, Somalia was still generally known for democracy at home and trouble abroad. The first of these characterisations referred to the striking persistance of a vigorous and effective multi-party parliamentary system, and the second to the seemingly uniquely intractable nature of the ‘Somali Dispute’ which committed the Republic to supporting the secessionist claims of the contiguous Somali populations of Kenya, Ethiopia, and French Somaliland, at the price of severely strained relations with these neighbouring states. These and other attributes unusual amongst the new states of sub-Saharan Africa appeared to be closely connected with the Republic's exuberant sense of national identity, a quality all the more remarkable in being firmly grounded in a long-standing and entirely traditional cultural nationalism.


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