scholarly journals Health evaluations in Africa – A review of the health strand held at the 7th Biennial Conference of the African Evaluation Association

2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Edna Berhane
Keyword(s):  
Human Resources For Health ◽  
Scale Up ◽  
Health Sector ◽  
Monitoring And Evaluation ◽  
Sub Saharan Africa ◽  
Evaluation Methodology ◽  
African Countries ◽  
Political Factors ◽  
Biennial Conference ◽  
Sub Saharan

Although Africa has made significant progress in public health over the past several decades, it still faces a very high burden of disease compared to the rest of the world. This overwhelming disease burden is further aggravated by a lack of adequate financial and human resources for health, inequitable distribution of health services, and other social, economic and political factors. Given these constraints, it has become critical for African countries to ensure that health interventions are selected based on evidence and implemented efficiently and effectively to ensure desired outcomes and impact. This has led to an increasing appreciation for monitoring and evaluation as an integral element of programme planning, implementation and scale-up. The importance of M&E within the health sector was recently reflected in the fact that the health evaluation strand was the largest at AfrEA’s 7th Biennial International Conference, held over 3 days in March 2014 in Yaoundé, Cameroon. The health strand, which had nine sub-themes, was sponsored, managed, and supported by the USAID-funded AfricanStrategies for Health (ASH) project. This review summarises the health strand presentations, and panel and roundtable discussions. The evaluations featured in the strand were diverse interms of health area focus, evaluation methodology, language and authors’ affiliation. More than 21 African countries from all regions of sub-Saharan Africa were represented. Among thekey recurrent messages highlighted during the conference were the importance of: data use for planning and improving health programmes, data quality, well-functioning M&E systems and identifying and sharing best/good practices.

scholarly journals Are African primary physicians suspicious enough? Challenges of multiple myeloma diagnosis in Africa

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Erick Thokerunga ◽  
Christopher Ntege ◽  
Abdullahi Omar Ahmed
Keyword(s):  
Multiple Myeloma ◽  
Human Resource ◽  
Plasma Cells ◽  
Scale Up ◽  
Sub Saharan Africa ◽  
Bone Lesions ◽  
Main Body ◽  
Health Seeking ◽  
African Countries ◽  
Sub Saharan

Abstract Background Multiple myeloma is a hematological malignancy of plasma cells belonging to a spectrum of monoclonal protein-secreting disorders known as paraproteinemias. It is classically characterized by accumulated plasma cells in the bone marrow, renal insufficiency, hypercalcemia, and bone lesions (CRAB). Despite studies in the USA indicating that the incidence of multiple myeloma is twice as much in Americans of African descent compared to white Americans and those of Asian descent, African countries have some of the lowest incidence rates and prevalence of the cancer. It is generally thought that this is not entirely factual given the paucity of research into the cancer in sub-Saharan Africa, coupled with other diagnostic challenges such as economic hardships, and poor health-seeking behaviors. In this mini review, we explored the state of multiple myeloma diagnosis across sub-Saharan Africa, outlining the challenges to diagnosis and proposing possible solutions. Main body Due to the lack of routine checkups in people > 40 years across sub-Saharan Africa, monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) are often accidentally diagnosed. This is due to a very low awareness of multiple myeloma among primary care clinicians and the general population. Other major challenges to multiple myeloma diagnosis across Africa include a chronic shortage of human resource (pathologists, cytotechnologists, and histotechnologists), and a prohibitive cost of diagnostic services that discourages early diagnosis. Conclusion To improve multiple myeloma diagnosis in Africa, a systems approach to thinking among policy makers, philanthropic organizations, and oncologists must be adopted. Governments must invest in health insurance coverage for cancer patients concurrently with heavy investments in human resource training and diagnostic infrastructure scale up. Creative approaches such as digital pathology, online training of clinicians, research and capacity building collaborations among African institutions, European and American institutions, and pharmaceutical companies as seen with other cancers should be explored for multiple myeloma too.

scholarly journals Trends and drivers of government health spending in sub-Saharan Africa, 1995–2015

2019 ◽  
Vol 4 (1) ◽  
pp. e001159 ◽  
Author(s):  
Angela E Micah ◽  
Catherine S Chen ◽  
Bianca S Zlavog ◽  
Golsum Hashimi ◽  
Abigail Chapin ◽  
...  
Keyword(s):  
Purchasing Power Parity ◽  
Good Governance ◽  
Health Sector ◽  
National Income ◽  
Health Spending ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Individual Country ◽  
Government Health ◽  
Sub Saharan

IntroductionGovernment health spending is a primary source of funding in the health sector across the world. However, in sub-Saharan Africa, only about a third of all health spending is sourced from the government. The objectives of this study are to describe the growth in government health spending, examine its determinants and explain the variation in government health spending across sub-Saharan African countries.MethodsWe used panel data on domestic government health spending in 46 countries in sub-Saharan Africa from 1995 to 2015 from the Institute for Health Metrics and Evaluation. A regression model was used to examine the factors associated with government health spending, and Shapley decomposition was used to attribute the contributions of factors to the explained variance in government health spending.ResultsWhile the growth rate in government health spending in sub-Saharan Africa has been positive overall, there are variations across subgroups. Between 1995 and 2015, government health spending in West Africa grew by 6.7% (95% uncertainty intervals [UI]: 6.2% to 7.0%) each year, whereas in Southern Africa it grew by only 4.5% (UI: 4.5% to 4.5%) each year. Furthermore, per-person government health spending ranged from $651 (Namibia) in 2017 purchasing power parity dollars to $4 (Central African Republic) in 2015. Good governance, national income and the share of it that is government spending were positively associated with government health spending. The results from the decomposition, however, showed that individual country characteristics made up the highest percentage of the explained variation in government health spending across sub-Saharan African countries.ConclusionThese findings highlight that a country’s policy choices are important for how much the health sector receives. As the attention of the global health community focuses on ways to stimulate domestic government health spending, an understanding that individual country sociopolitical context is an important driver for success will be key.

scholarly journals Does the Leader's Ethnicity Matter? Ethnic Favoritism, Education, and Health in Sub-Saharan Africa

2012 ◽  
Vol 106 (2) ◽  
pp. 294-325 ◽  
Author(s):  
RAPHAËL FRANCK ◽  
ILIA RAINER
Keyword(s):  
Infant Mortality ◽  
Sub Saharan Africa ◽  
Ethnic Segregation ◽  
African Countries ◽  
Political Factors ◽  
Education And Health ◽  
Country Analysis ◽  
Sub Saharan ◽  
Using Data

In this article we reassess the role of ethnic favoritism in sub-Saharan Africa. Using data from 18 African countries, we study how the primary education and infant mortality of ethnic groups were affected by changes in the ethnicity of the countries’ leaders during the last 50 years. Our results indicate that the effects of ethnic favoritism are large and widespread, thus providing support for ethnicity-based explanations of Africa's underdevelopment. We also conduct a cross-country analysis of ethnic favoritism in Africa. We find that ethnic favoritism is less prevalent in countries with one dominant religion. In addition, our evidence suggests that stronger fiscal capacity may have enabled African leaders to provide more ethnic favors in education but not in infant mortality. Finally, political factors, linguistic differences, and patterns of ethnic segregation are found to be poor predictors of ethnic favoritism.

scholarly journals Control of schistosomiasis in sub-Saharan Africa: progress made, new opportunities and remaining challenges

Parasitology ◽  
2009 ◽  
Vol 136 (13) ◽  
pp. 1665-1675 ◽  
Author(s):  
J. R. STOTHARD ◽  
L. CHITSULO ◽  
T. K. KRISTENSEN ◽  
J. UTZINGER
Keyword(s):  
Large Scale ◽  
Neglected Tropical Diseases ◽  
Monitoring And Evaluation ◽  
Sub Saharan Africa ◽  
World Health ◽  
African Countries ◽  
Schistosomiasis Control ◽  
Sub Saharan ◽  
Gates Foundation ◽  
Made In

SUMMARYSeveral other journal supplements have documented progress made in the control of schistosomiasis in Egypt, China and Brazil, however, with more than 97% of the schistosome infections now estimated to occur in Africa, the relevance of this special issue in Parasitology cannot be overemphasized. In total, 18 articles are presented, inclusive of a lead-editorial from the WHO highlighting a seminal resolution at the 54th World Health Assembly in 2001 that advocated de-worming. Facilitated by a US$ 30 million grant from the Bill and Melinda Gates Foundation in 2002, the Schistosomiasis Control Initiative subsequently fostered implementation of large-scale schistosomiasis (and soil-transmitted helminthiasis) control programmes in six selected African countries. From 2005, CONTRAST, a European union-funded consortium, was formed to conduct multi-disciplinary research pertaining to optimisation of schistosomiasis control. Progress made in schistosomiasis control across sub-Saharan Africa since the turn of the new millennium is reviewed, shedding light on the latest findings stemming from clinical, epidemiological, molecular and social sciences research, inclusive of public health interventions with monitoring and evaluation activities. New opportunities for integrating the control of schistosomiasis and other so-called neglected tropical diseases are highlighted, but more importantly, several opportune questions that arise from it frame the remaining challenges ahead for an enduring solution.

scholarly journals One Health Landscape in Sub-Saharan African Countries

2020 ◽  
Author(s):  
Folorunso Oludayo Fasina ◽  
Olubunmi G. Fasanmi ◽  
Yilma J. Makonnen ◽  
Charles Bebay ◽  
Bernard Bett ◽  
...  
Keyword(s):  
One Health ◽  
Disease Outbreaks ◽  
Monitoring And Evaluation ◽  
Well Being ◽  
Emerging Diseases ◽  
Sub Saharan Africa ◽  
Theory Of Change ◽  
African Countries ◽  
Emerging Issues ◽  
Sub Saharan

An evaluation of emerging issues in One Health (OH) in Sub-Saharan Africa was undertaken to map the existing OH initiatives in Sub-Saharan African (SSA) countries. Desk review, expert opinions survey, limited interviews and wider consultations with selected OH stakeholders were conducted. The strengths, weaknesses, opportunities and threats to OH initiatives were identified. OH influence, interest and impacts were evaluated. One Health is transiting from multidisciplinary to transdisciplinary concepts and OH viewpoint should move from ‘proxy for zoonoses’, to include issues of climate change, nutrition and food safety, social sciences, geography, policy and planning, economics, welfare and well-being, antimicrobial resistance (AMR), vector-borne diseases, toxicosis and pesticides issues. While the identified major strengths should be boosted, the weaknesses should be addressed.OH Networks in SSA were spatially and temporally spread across SSA and stakeholders were classified as key, latent, marginal and OH defenders. Imbalance in stakeholders’ representation led to hesitation in buying-in from stakeholders who are outside the main networks. Theory of change, monitoring and evaluation frameworks, and tools to standardized evaluation of OH policies is needed for sustained future of OH and the future OH engagement should be outputs and outcomes-driven and not activity-driven.National roadmap for OH implementation and institutionalization is necessary and proofs of concepts in OH should be verified and scaled-up. Dependence on external funding is unsustainable and must be addressed. Necessary policy and legal instrument to support OH nationally and sub-nationally should be implemented taking cognizance of contemporary issues like urbanization, endemic poverty and other emerging issues. Utilizing current technologies and OH approach to address ongoing pandemic of COVID-19 and other emerging diseases is desirable. Finally, OH implementation should be anticipatory and not reactive to significantly benefit budgeting and contain disease outbreaks in animal sources before the risk of spillover to human can be envisaged.

scholarly journals Healthcare Expenditure and Economic Growth in Sub-Saharan Africa

2020 ◽  
pp. 1-7
Author(s):  
Birhanu Yimer Ali ◽  
Robert Moracha Ogeto
Keyword(s):  
Economic Growth ◽  
Foreign Direct Investment ◽  
Direct Investment ◽  
Health Expenditure ◽  
Generalized Method Of Moments ◽  
Health Sector ◽  
Sub Saharan Africa ◽  
Domestic Saving ◽  
African Countries ◽  
Sub Saharan

This paper investigated the effect of health expenditure on economic growth in Sub Saharan Africa. The linear dynamic generalized method of moments instrumental variable (GMM-IV) was used on a panel data of 38 Sub-Saharan African countries over the period 2000-2016. Findings reveal that health expenditure significantly improves economic growth in Sub Saharan Africa. The separate effects of Public and private health expenditures have also shown a significant positive relationship on economic growth. In addition to health expenditure, other determinants like gross domestic saving, foreign direct investment, and labor force brought a statistically significant improvement on economic growth, whereas official development assistance has a statistically insignificant effect on economic growth. This study concluded that health expenditure is an important element in attaining improved economic growth in Sub-Saharan African Countries as it assured a healthy workforce and the country’s populace. Therefore, increasing the amount of health expenditure allocated to the health sector yields a better economy. More on, revising policies to improve gross domestic savings and foreign direct investment also assure a better economic growth.

scholarly journals What has comprehensive HIV/AIDS knowledge got to do with HIV testing among men in Kenya and Mozambique? Evidence from Demographic and Health Surveys

2021 ◽  
pp. 1-14
Author(s):  
Eugene Budu ◽  
Abdul-Aziz Seidu ◽  
Ebenezer Kwesi Armah-Ansah ◽  
Aliu Mohammed ◽  
Collins Adu ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Health Surveys ◽  
Scale Up ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Odds Ratios ◽  
African Countries ◽  
Aids Knowledge ◽  
Sub Saharan ◽  
Hiv Aids

Abstract People living with undiagnosed HIV are big contributors to the transmission of the virus. Although measures have been made to scale up HIV prevention and voluntary counselling and testing in sub-Saharan Africa, testing coverage remains low in many sub-Saharan African countries, including Mozambique and Kenya, where most people live with HIV/AIDS. Studies have shown that, in most countries in sub-Saharan Africa, men are less likely to test for HIV compared with women. This study examined the relationship between comprehensive HIV/AIDS knowledge and HIV testing among men in Kenya and Mozambique. Data were from the men’s re-code file of the Demographic and Health Surveys of Mozambique and Kenya. Binary logistic regression models were generated and the results presented as crude odds ratios (cOR) and adjusted odds ratios (aOR). The prevalences of HIV testing in Kenya and Mozambique were 80.1% and 46.7%, respectively. Men in Mozambique who had comprehensive HIV/AIDS knowledge (aOR=1.26, CI: 1.07–1.47) were more likely to test for HIV compared with their counterparts who had no comprehensive HIV/AIDS knowledge. In Kenya, men who had comprehensive HIV/AIDS knowledge (aOR=1.23, CI: 1.09–1.39) were more likely to test for HIV compared with their counterparts who had no comprehensive HIV/AIDS knowledge. This study found a statistically strong significant association between comprehensive HIV/AIDS knowledge and HIV testing among men in Kenya and Mozambique. To improve HIV testing rate among men, it is important that interventions are geared towards improving men’s comprehensive HIV/AIDS knowledge, perhaps by expanding HIV/AIDS education programmes and campaigns. This could improve HIV testing rates and ensure the realization of the global HIV/AIDS target of 95-95-95 by the year 2030.

Crowdsourcing Covid-19 signals in sub-Saharan Africa: Leveraging digital contributor networks for participatory surveillance of Covid-19 symptoms and deaths (Preprint)

2020 ◽  
Author(s):  
Ngozi A Erondu ◽  
Sagal A Ali ◽  
Mohamed Ali ◽  
Schadrac C Agbla
Keyword(s):  
Public Health ◽  
Sub Saharan Africa ◽  
Specific Information ◽  
Surveillance Systems ◽  
Health Seeking ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Local Networks ◽  
The World ◽  
Sub Saharan

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.

Managing African Urbanization in the Context of Environmental Change

2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Shuaib Lwasa
Keyword(s):  
Climate Change ◽  
Economic Growth ◽  
Social Services ◽  
Urban Areas ◽  
Urban Governance ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Sub Saharan ◽  
Urbanization Rate ◽  
Development And Management

Africa’s urbanization rate has increased steadily over the past three decades and is reported to be faster than in any other region in the world . It is estimated that by 2030, over half of the African population will be living in urban areas . But the nature of Africa’s urbanization and subsequent form of cities is yet to be critically analyzed in the context of city authorities’ readiness to address the challenges . Evidence is also suggesting that urbanization in African countries is increasingly associated with the high economic growth that has been observed in the last two decades . Both underlying and proximate drivers are responsible for the urbanization, and these include population dynamics, economic growth, legislative designation, increasing densities in rural centers, as well as the growth of mega cities such as Lagos, Cairo and Kinshasa, that are extending to form urban corridors . With the opportunities of urbanization in Sub–Saharan Africa, there are also challenges in the development and management of these cities . Those challenges include provision of social services, sustainable economic development, housing development, urban governance, spatial development guidance and environmental management, climate change adaptation, mitigation and disaster risk reduction . The challenge involves dealing with the development and infrastructure deficit, in addition to required adaption to and mitigation of climate change . This paper examines the current state of urban management in Africa .

Monetary Policy in Sub-Saharan Africa

2018 ◽  
Keyword(s):  
Monetary Policy ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
African Countries ◽  
Policy Regimes ◽  
Export Prices ◽  
Policy Work ◽  
Sub Saharan ◽  
Policy Guidance

Having broadly stabilized inflation over the past two decades, many policymakers in sub-Saharan Africa are now asking more of their monetary policy frameworks. They are looking to avoid policy misalignments and respond appropriately to both domestic and external shocks, including swings in fiscal policy and spikes in food and export prices. In many cases they are finding current regimes—often characterized as ‘money targeting’—lacking, with opaque and sometimes inconsistent objectives, inadequate transmission of policy to the economy, and difficulties in responding to supply shocks. At the same time, little existing research on monetary policy is targeted to low-income countries. What do we know about the empirics of monetary transmission in low-income countries? (How) Does monetary policy work in countries characterized by a huge share of food in consumption, underdeveloped financial markets, and opaque policy regimes? (How) Can we use methods largely derived in advanced countries to answer these questions? And (how) can we use the results to guide policymakers? This book draws on years of research and practice at the IMF and in central banks from the region to shed empirical and theoretical light on these questions and to provide practical tools and policy guidance. A key feature of the book is the application of dynamic general equilibrium models, suitably adapted to reflect key features of low-income countries, for the analysis of monetary policy in sub-Saharan African countries.

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