Qualitative assessment of the impact of socioeconomic and cultural barriers on uptake and utilisation of tuberculosis diagnostic and treatment tools in East Africa: a cross-sectional study

ObjectivesEarly diagnosis and timely treatment are key elements of a successful healthcare system. We assessed the role of socioeconomic and cultural norms in accelerating or decelerating uptake and utilisation of health technologies into policy and practice.SettingSecondary and tertiary level healthcare facilities (HCFs) in three East African countries. Level of HCF was selected based on the WHO recommendation for implantation of tuberculosis (TB) molecular diagnostics.ParticipantsUsing implementation of TB diagnostics as a model, we purposively selected participants (TB patients, carers, survivors, healthcare practitioners, community members, opinion leaders and policy-makers) based on their role as stakeholders. In-depth interviews, key informant interviews and focus group discussions were held to collect the data between 2016 and 2018. The data were transcribed, translated, coded and analysed by thematic-content analysis.ResultsA total of 712 individuals participated in the study. Socioeconomic and cultural factors such as poverty, stigma and inadequate knowledge about causes of disease and available remedies, cultural beliefs were associated with low access and utilisation of diagnostic and treatment tools for TB. Poverty made people hesitate to seek formal healthcare resulting in delayed diagnosis and resorting to self-medication and cheap herbal alternatives. Fear of stigma made people hide their sickness and avoid reporting for follow-up treatment visits. Inadequate knowledge and beliefs were fertile ground for aggravated stigma and believing that diseases like TB are caused by spirits and thus cured by spiritual rituals or religious prayers. Cultural norms were also the basis of gender-based imbalance in accessing care, ‘I could not go to hospital without my husband’s permission’, TB survivor.ConclusionOur findings show that socioeconomic and cultural factors are substantial ‘roadblocks’ to accelerating the uptake and utilisation of diagnostic and treatment tools. Resolving these barriers should be given equal attention as is to health system barriers.

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Association of Livestock Ownership and Household Dietary Quality: Results from a Cross-Sectional Survey from Rural India

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116060 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6060

Author(s):

Adithya Pradyumna ◽

Mirko S. Winkler ◽

Jürg Utzinger ◽

Andrea Farnham

Keyword(s):

Rank Correlation ◽

Dietary Quality ◽

Milk Consumption ◽

African Countries ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Dairy Animals ◽

Livestock Ownership ◽

The Impact ◽

Dairy Animal

Studies from India and several eastern African countries found that the impact of dairy animal ownership on household nutrition varied greatly, depending on the socio-geographic context. The purpose of this study was to examine the association between livestock ownership and household dietary quality in rural Kolar district, India. We collected data from a household survey in four study villages (n = all 195 households of the four villages) of Kolar district, applying a cross-sectional design. Kendall’s rank correlation coefficient was employed to determine the correlation between milk consumption and other dietary variables. Multivariable logistic regression was used to describe the relationship between dairy animal ownership and household milk consumption. Households owning dairy animals more often had access to irrigation (58.3% vs. 25.2%) and were less often woman-headed (2.4% vs. 22.5%). Household milk consumption was significantly correlated with consumption of vegetable variety, egg, and meat (all p-values < 0.05). After adjusting for multiple confounders, the odds ratio of milk consumption between dairy animal-owning households as compared to other households was 2.11 (95% confidence interval 0.85, 5.45). While dairy animal ownership was found to be associated with improved dietary quality, larger households were in a better position to adopt dairy animals, which, in turn, might contribute to better household nutrition.

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Political Stability in Africa: A Cross-National Analysis

Journal of Asian and African Studies ◽

10.1177/00219096211054401 ◽

2021 ◽

pp. 002190962110544

Author(s):

Gizachew Tiruneh

Keyword(s):

Political Stability ◽

African Countries ◽

Cross Sectional ◽

Founding Fathers ◽

Colonial Legacy ◽

Development Regime ◽

French Colonial ◽

British Colonial ◽

National Analysis ◽

The Impact

The main objective of this paper is to test the influence of Africa’s founding fathers and the impact of British colonial legacy on the political stability of Africa. We relied on a sample of 50 African countries and employed cross-sectional research designs, which covered two separate periods (1960–1989 and 1990–2018). Using logistic regression and OLS estimators and controlling for French colonial legacy, economic development, regime type, ethnic heterogeneity, and ethnic polarization, we found that the founding fathers were conducive to Africa’s political stability between 1960 and 2018. We also found that British colonial legacy had some impact on former British colonies’ stability between 1960 and 2018. In addition, GDP per capita had a significant impact on Africa’s political stability over the two periods.

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Interest rate liberalization and economic growth nexus: does corruption matter?

Journal of Financial Crime ◽

10.1108/jfc-02-2020-0029 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Abdulhadi Aliyara Haruna ◽

Abu Sufian Abu Bakar

Keyword(s):

Economic Growth ◽

Interest Rate ◽

Positive Impact ◽

Reform Process ◽

Negative Effects ◽

African Countries ◽

Cross Sectional ◽

Content Type ◽

Interest Rate Liberalization ◽

The Impact

Purpose This paper aims to examine the impact of interest rate liberalization on economic growth and the relevance of corruption in the five selected sub-Saharan African countries. Design/methodology/approach The study used the modified version of Driscoll and Kraay’s model by Hoechle, which solved the effects of cross-sectional dependence and heteroscedasticity. Findings The findings reveal a positive impact of the index on economic growth, and it was found that foreign direct investment (FDI) and credit to private sector by banks (CPSB) all stimulate economic growth. The interaction terms of corruption with FDI and CPSB indicate negative effects that show how corruption erodes the benefits of liberalization. Finally, the paper recommends the pursuit of appropriate policies with the sole aim of eradicating corruption and providing a conducive environment for business. Originality/value The paper developed a composite domestic financial liberalization index to capture the timing and essential dimensions of the reform process. The study investigates the effect of interest rate liberalization on economic growth and the relevance of corruption. Most of the recent and past studies only examined the impact of interest rate reforms on growth without investigating the relevance of corruption.

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Social enterprises and organizational learning in South Africa

Journal of Entrepreneurship in Emerging Economies ◽

10.1108/jeee-02-2017-0010 ◽

2018 ◽

Vol 10 (1) ◽

pp. 117-133 ◽

Cited By ~ 5

Author(s):

Boris Urban ◽

Elena Gaffurini

Keyword(s):

South Africa ◽

Organizational Learning ◽

Social Innovation ◽

Emerging Market ◽

Cross Sectional Study ◽

Social Enterprises ◽

African Countries ◽

Cross Sectional ◽

Content Type ◽

The Impact

Purpose The purpose of this study is to determine the relationship between different dimensions of organizational learning capabilities (OLC) and levels of social innovation in social enterprises. Design/methodology/approach The empirical strategy adopted is a cross-sectional study based on primary survey data. Following a survey of social enterprises in South Africa, statistically analysis is conducted using regression analyses to test the study hypotheses. Findings The findings show that the OLC dimensions of knowledge conversion, risk management, organizational dialogue and participative decision-making all have a significant and positive relationship with social innovation. Research limitations/implications In many emerging economies, the notion of organizational learning appears to have considerable potential relevance, particularly as African countries are moving toward knowledge-based economies. By focusing on OLC, it is anticipated that social enterprises can configure and leverage the different factors in ways that enable them to overcome the constraints of the complex and unpredictable environments and increase their levels of social innovation. Originality/value The paper provides a pioneering empirical investigation into the impact that OLC has on levels of social innovation, in an under-researched emerging market context.

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Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-020-00811-9 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Jiayao Xu ◽

Xiaomin Wang ◽

Kai Sing Sun ◽

Leesa Lin ◽

Xudong Zhou

Keyword(s):

Antibiotic Use ◽

Antibiotic Prescribing ◽

Clinical Settings ◽

Cross Sectional Survey ◽

Self Medication ◽

Cross Sectional ◽

Prescribing Behavior ◽

The Past ◽

Outpatient Settings ◽

The Impact

Abstract Background Self-medication with antibiotics (SMA) is one of the most dangerous inappropriate antibiotic use behaviors. This study aims to investigate the impact of parental SMA for children before a consultation on their doctor’s subsequent antibiotic prescribing behavior, including intravenous (IV) antibiotic use in the clinical setting of China. Methods A cross-sectional survey was conducted between June 2017 and April 2018 in three provinces of China. A total of 9526 parents with children aged 0–13 years were investigated. Data from 1275 parents who had self-medicated their children and then visited a doctor in the past month were extracted and analyzed. Results One-third (410) of the studied children had parental SMA before the consultation and 83.9% of them were subsequently prescribed antibiotics by doctors. Children with parental SMA were more likely to be prescribed antibiotics (aOR = 7.79, 95% CI [5.74–10.58]), including IV antibiotics (aOR = 3.05, 95% CI [2.27–4.11]), and both oral and IV antibiotics (aOR = 3.42, 95% CI [2.42–4.84]), than children without parental SMA. Parents with SMA behaviors were more likely to request antibiotics (aOR = 4.05, 95% CI [2.59–6.31]) including IV antibiotics (aOR = 2.58, 95% CI [1.40–4.76]), and be fulfilled by doctors (aOR = 3.22, 95% CI [1.20–8.63]). Conclusions Tailored health education for parents is required in both community and clinical settings to discourage parental SMA for children. The doctors should not prescribe unnecessary antibiotics to reinforce parents’ SMA behaviors. We recommend expanding the current IV antibiotics ban in outpatient settings of China to cover outpatient pediatrics.

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IMPACT OF MATERNAL MORTALITY ON SUSTAINABLE DEVELOPMENT IN THE SELECTED WEST AFRICAN COUNTRIES

ACTA ECONOMICA ◽

10.7251/ace1931051a ◽

2019 ◽

Vol 17 (31) ◽

Author(s):

Joseph Afolabi Ibikunle

Keyword(s):

Health Care ◽

Sustainable Development ◽

Maternal Mortality ◽

Maternal Mortality Ratio ◽

West African ◽

African Countries ◽

The West ◽

Cross Sectional ◽

Cross Sectional Dependence ◽

The Impact

Over half a million females die every year as a result of pregnancy and birth complications. The vast majority of these fatalities can be avoided. SDG 3.1’s objective is to reduce the global maternal mortality ratio by 2030 to below 70 per 100,000 live births. Despite a number of policies put in place maternal mortality in Africa remains unacceptably high. This study investigates the impact of maternal mortal- ity on sustainable development in 9 selected West African countries for the period from 1990 to 2015. Data used were adjusted net savings, maternal mortality, consumer price index, per-capita income and financial development. The second-generation econometric methods were employed: cross sectional dependence, slope homogeneity, Westerlund cointegration, Eberhadt and Teal AMG regression, and the Emirmahmutoglu and Kose bootstrap Granger causality test. Findings confirm the following: First, cross-sectional dependence and slope heterogeneity exist among the West African countries. Second, there is a long run relationship between maternal mortality and sustainable development. Third, maternal mortality impacted negatively and signifi- cantly on sustainable development. Fourth, the direction of causality varies across countries between maternal mor- tality and sustainable development. Lastly, causality runs from maternal mortality to sustainable development when analyzing the causal relationship among all countries. The findings suggest that the West African government needs to commit more funding to the health care sector and ensure access to free healthcare service to pregnant women or at low cost with quality and effective health care services if the countries must attain sustainable development by 2030.

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Economics & Religious Implications On Adult Literacy In Sub-Saharan Africa

Journal of Applied Business Research (JABR) ◽

10.19030/jabr.v25i1.1050 ◽

2011 ◽

Vol 25 (1) ◽

Author(s):

Amon O. Okpala ◽

Comfort O. Okpala

Keyword(s):

Adult Literacy ◽

Urban Population ◽

Religious Affiliation ◽

Least Square ◽

Sub Saharan Africa ◽

African Countries ◽

Cross Sectional ◽

Ordinary Least Square ◽

Sub Saharan ◽

The Impact

Although literacy rates have improved somehow in recent years, there are still large numbers of people that are illiterates in developing countries.  This paper examines the impact of public education expenditures, the percentage of urban population and religious affiliation on adult literacy rate in Sub-Saharan Africa. In this study, a cross-sectional data of 34 Sub-Saharan African countries with adequate data information were analyzed. The results from the ANOVA and Ordinary Least Square (OLS) regression analysis are quite conclusive - that urban population, government expenditures on education and religious affiliations do have strong statistical impact on literacy.

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Governance and Domestic Investment in Africa

European Journal of Government and Economics ◽

10.17979/ejge.2019.8.1.4565 ◽

2019 ◽

Vol 8 (1) ◽

pp. 63-80 ◽

Cited By ~ 6

Author(s):

Chimere Okechukwu Iheonu

Keyword(s):

Fixed Effects ◽

Principal Component ◽

Domestic Investment ◽

Fixed Effects Model ◽

African Countries ◽

Cross Sectional ◽

Data Set ◽

Governance Indicators ◽

World Governance Indicators ◽

The Impact

The study empirically examined the impact of governance on domestic investment in 16 African countries with a balanced panel data set, between the years 2002 and 2015. The study employed six unbundled governance indicators from the World Bank, World Governance Indicators and constructed three bundled governance indicators using the Principal Component Analysis. The Driscoll and Kraay Fixed Effects model which accounts for serial correlation, groupwise heteroskedasticity and cross-sectional dependence were employed with empirical results revealing that all the indicators of governance positively and significantly influence domestic investment in Africa, except for government effectiveness which happens to be insignificant. Also, Voice/Accountability and the Control of Corruption exert more influence on domestic investment as indicated by their coefficient values. Furthermore, economic growth is also an important factor in explaining domestic investment in Africa. Policy recommendations are discussed.

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The Role Of School Life Expectancy And Urbanization On Adult Literacy Rates In Sub-Saharan Africa

International Business & Economics Research Journal (IBER) ◽

10.19030/iber.v13i2.8448 ◽

2014 ◽

Vol 13 (2) ◽

pp. 329

Author(s):

Amon Okpala ◽

Comfort Okpala

Keyword(s):

Life Expectancy ◽

Adult Literacy ◽

Percent Level ◽

Sub Saharan Africa ◽

School Life ◽

African Countries ◽

Cross Sectional ◽

Sub Saharan ◽

The Impact

It is important to examine the role of urbanization, government, and school life expectancy (the years of schooling a child is expected to have) on adult literacy because literacy contributes to economic success. Using cross-sectional data on 46 Sub-Saharan African countries, this study examines 1) the impact of school life expectancy on adult literacy, 2) the influence of urban population on adult literacy, and 3) the effectiveness of government educational expenditure on adult literacy. OLS regression analysis showed that the percentage of the population residing in urban centers and the school life expectancy were positively significant at the 5 percent level. Government expenditure, as a percentage of GDP, was positively significant at the 1 percent level.

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A multinational e-survey on the delivery of cardiology services in Africa during the COVID-19 pandemic: what should we expect after this pandemic?

10.1101/2020.07.24.20160390 ◽

2020 ◽

Author(s):

Chris Nadege Nganou-Gnindjio ◽

Mazou Ngou Temgoua ◽

Liliane Mfeukeu Kuate ◽

Clovis Nkoke ◽

Joel Noutakdie Tochie ◽

...

Keyword(s):

Care Delivery ◽

Cardiovascular Complications ◽

Survey Study ◽

African Countries ◽

Cross Sectional ◽

Outcomes Measures ◽

Number Of Patients ◽

Secondary Outcomes ◽

The Impact ◽

Study Setting

Abstract Objective: To evaluate the impact of the COVID-19 pandemic on the delivery of cardiology services in Africa. Design: Cross-sectional e-survey study. Setting: African countries Participants: Cardiologists Primary and Secondary outcomes measures: The primary outcome was the change in service delivery in African cardiology units during the on-going COVID-19 pandemic. The secondary outcomes were the satisfaction of cardiologists with regards to the workload and factors associated with this satisfaction. Results: There was a significant reduction in working time and the number of patients consulted by week during this pandemic (p<0.001). In general, there was a decrease in the overall activities in cardiovascular care delivery. The majority of cardiology services (76.5%) and consulting programs (85%) were adjusted to the pandemic. Only half of the participants were satisfied with their workload. Reconfiguration of the consultation schedule was associated with a reduced satisfaction of participants (p=0.02). Conclusions: COVID-19 is associated with an overall reduction in cardiology services rendered in Africa. Since the cardiovascular burdens continue to increase in this part of the World and the risk of cardiovascular complications linked to SARS COV2 remains unchanged cardiology, departments in Africa should anticipate a significant surge of cardiology services demanded by patients after the COVID-19 pandemic.

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