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This paper investigates digital inequalities in usage within African informal sectors. In particular, we examine whether the uneven digital diffusion is embedded in pre‐existing socio‐economic inequalities. After identifying three segments of informal firms, we rely on multivariate and decomposition analyses to identify predictors of usage of digital technologies for business purposes and explain usage gaps between segments. Our findings suggest that digital inequalities are rooted in the vertical heterogeneity of informal sectors, with some firm characteristics significantly predicting professional use of digital technologies. In addition, we find that there are both common and segment‐specific levers for addressing digital inequalities between informal firms. [ABSTRACT FROM AUTHOR]

BACKGROUND: Maize varieties that are rich in carotenoids have been developed to combat vitamin A deficiency in Sub‐Saharan Africa. Unfortunately, after harvest, carotenoids degrade and off‐flavor volatiles develop, which affect nutrient intake and consumer acceptance. This study evaluated carotenoid retention and aroma compound stability in provitamin A biofortified maize, variety Pool 8A, as influenced by dry milling and storage in different packaging and temperature conditions. RESULTS: The lowest amount of total carotenoids was found in flour stored in laminated paper bags at 37 °C (only 16% retention after 180 days), attributable to the high storage temperature and oxygen permeability of the packaging material. No significant effect on carotenoid degradation was found for dry milling, either by rotor mill or freezer mill, but the formation of volatile compounds was significantly (P < 0.05) affected. Volatile compounds such as hexanal, 2‐pentylfuran, 1‐propanol, 2‐heptanone, butyrolactone, limonene, and hexanoic acid were found in different proportions after milling. The highest concentration of hexanal was in flour milled by rotor mill or freezer mill, and stored in laminated paper bags at 37 °C after 180 days, and the lowest concentrations were for flour in aluminium bags and double‐layered polyethylene bags stored at 4 °C. CONCLUSION: Maize flour stored in double‐layered polyethylene bags had the highest carotenoid retention and aroma stability. Importantly, the use of these bags is economically feasible in low‐income countries. Overall, our results show that effective control of storage conditions is crucial to prevent carotenoid loss and decrease off‐odor formation. © 2020 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Open access publication rates have been steadily increasing over time. In spite of this growth, academics in low income settings struggle to gain access to the full canon of research literature. While the vast majority of open access repositories and funding organizations with open access policies are based in high income countries, the geographic patterns of open access publication itself are not well characterized. In this study, we developed a computational approach to better understand the topical and geographical landscape of open access publications in the biomedical research literature. Surprisingly, we found a strong negative correlation between country per capita income and the percentage of open access publication. Open access publication rates were particularly high in sub-Saharan Africa, but vastly lower in the Middle East and North Africa, South Asia, and East Asia and the Pacific. These effects persisted when considering papers only bearing authors from within each region and income group. However, papers resulting from international collaborations did have a higher percentage of OA than single-country papers, and inter-regional collaboration increased OA publication for all world regions. There was no clear relationship between the number of open access policies in a region and the percentage of open access publications in that region. To understand the distribution of open access across topics of biomedical research, we examined keywords that were most enriched and depleted in open access papers. Keywords related to genomics, computational biology, animal models, and infectious disease were enriched in open access publications, while keywords related to the environment, nursing, and surgery were depleted in open access publications. This work identifies geographic regions and fields of research that could be priority areas for open access advocacy. The finding that open access publication rates are highest in sub-Saharan Africa and low income countries suggests that factors other than open access policy strongly influence authors’ decisions to make their work openly accessible. The high proportion of OA resulting from international collaborations indicates yet another benefit of collaborative research. Certain applied fields of medical research, notably nursing, surgery, and environmental fields, appear to have a greater proportion of fee-for-access publications, which presumably creates barriers that prevent researchers and practitioners in low income settings from accessing the literature in those fields. [ABSTRACT FROM AUTHOR]

Sub-Saharan African airports are struggling to meet the increasing demand for air travel generated by the region's growing economies. With their budgets spread over a range of infrastructure expansion programmes, including airports, governments have started to look at privatisation as an attractive option for shifting airport development and operations to the private sector. This paper describes the options available to airports, looks at how governments can optimise their financial returns, and examines at the advantages and disadvantages of public--private partnerships. The paper is based on the author's presentation at the ACI's World/Africa Annual General Assembly in Marrakech in November 2011. [ABSTRACT FROM AUTHOR]

In recent decades, Chinese FDI has become an integral investment source for African countries and has, therefore, engendered studies seeking to understand the determinants of these flows. In a quest to identify the factors that stimulate these flows, this paper assesses whether the ease of starting a business induces Chinese FDI flow to Africa. The analysis is based on panel data for 46 African countries between 2004 and 2018. The results from fixed-effects estimations suggest that Chinese FDI is attracted by the ease of starting a business in African economies. This finding also holds for sub-Saharan Africa (SSA) and is robust across all estimations. The results also provide corroborating evidence that identifies Chinese FDI as market and resource-seeking, attracted to large markets and economies with abundant natural resources. The findings suggest that improving business regulations could be a stimulant for Chinese FDI flow to Africa. In evaluating the nexus between Chinese FDI and business start-ups, this paper provides new evidence to complement the dated studies on this theme. [ABSTRACT FROM AUTHOR]

Crowdfunding in Africa is unique due to the unstable but budding macro-environment that enables offline backer contribution that fosters project success. This paper explores the reward-based crowdfunding macro-environment factors that motivate and demotivate backer contribution towards crowdfunding with a focus on Information Communication Technology Infrastructure, Social Capital, and Backer Identity fostered by the Geographical Location. We also offer solutions for improving rewards-based crowdfunding in Africa to ensure social and economic sustainability. The results of our predictive analysis reflect that creativity-oriented projects are the project categories with the highest success rate in Africa. The findings of this paper also shed light on the fact that the success of crowdfunding projects in Sub-Saharan Africa hinges on a type of hybrid model involving the "offline" community of backers. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to develop a hierarchical model that uncovers the relationships between challenges confronting Africa's organ transplant supply chain systems. Design/methodology/approach: Eleven challenges (variables) were identified after a comprehensive review of the existing literature. The contextual interactions among these variables were analysed from the perspectives of health-care stakeholders in two sub-Saharan Africa (SSA) countries (Nigeria and Uganda), using Delphi-interpretive structural modelling-cross-impact matrix multiplication applied to classification (MICMAC) techniques. Findings: The findings reveal that weak regulatory frameworks, insufficient information systems and a lack of necessary skills make it challenging for critical actors to perform the tasks effectively. The interaction effects of these challenges weaken organ supply chains and make it less efficient, giving rise to negative externalities such as black markets for donated organs and organ tourism/trafficking. Research limitations/implications: This paper establishes a solid foundation for a critical topic that could significantly impact human health and life once the government or non-profit ecosystem matures. The MICMAC analysis in this paper provides a methodological approach for future studies wishing to further develop the organ supply chain structural models. Practical implications: The study provides valuable insights for experts and policymakers on where to prioritise efforts in designing interventions to strengthen organ transplantation supply chains in developing countries. Originality/value: This study is one of the first to empirically examine the challenges of organ transplant supply chains from an SSA perspective, including theoretically grounded explanations from data collected in two developing countries. [ABSTRACT FROM AUTHOR]

The relationship between external debt and economic growth has been extensively studied by researchers and policymakers. However, the link between external debt and domestic investment remains an underexplored area of research. Therefore, this paper investigates the nexus between external debt and domestic investment, using institutional quality as a moderator. The sample consists of 47 sub-Saharan African countries with data spanning from 1996 to 2021. The empirical findings from conventional and robust estimators indicate that external debt negatively and significantly hampers domestic investment, while institutional quality plays a significant moderating role in this relationship. Additionally, the benefits of debt can only be realized by the SSA region when the average quality of institutions is above − 1.174 on the scale of − 2.5 to 2.5. The in-depth analysis offers insights that high-quality institutions (above a certain threshold) can help countries leverage debt for positive outcomes by promoting efficient resource allocation and attracting further investment. Thus, policymakers are advised to uphold debt management strategies and institutional reforms, such as reducing corruption, improving property rights, and strengthening the rule of law, to ensure transparency in debt use and maintain a sustainable debt burden. This will create a more attractive environment for both domestic and foreign investment. The results remain robust to alternative methodologies. [ABSTRACT FROM AUTHOR]

This study interrogates the experiences of Nigerian troops in the war against Boko Haram. The paper's contribution is bi-dimensional. First, it adds to the empirical literature on Boko Haram by analyzing the perspectives of rank-and-file troops. The study finds 10 forms of corruption affecting troops. These have contributed to the inability to defeat Boko Haram. Second, the paper adds to theoretical scholarship on civil–military relations and persistence of small wars. It challenges the bureaucratic-organizational model and the focus of civil–military relations theory on civilian control of the military. The study emphasizes the need to focus on the texture of the relationship between civilian and military leaders. The paper argues that the bureaucratic-organizational model has limited relevance to militaries in the postcolony and proposes a civilian–military leadership interest convergence thesis. The findings are relevant for understanding the spread of terrorism in sub-Saharan Africa and the persistence of small wars in non-Western, illiberal quasi-democratic societies. [ABSTRACT FROM AUTHOR]

Background: Counseling as part of the informed consent process is a prerequisite for cesarean section (CS). Postnatal debriefing allows women to explore their CS with their healthcare providers (HCPs). Objectives: To describe the practices and experiences of counseling and debriefing, the barriers and facilitators to informed consent for CS; and to document the effectiveness of the interventions used to improve informed consent found in the peer‐reviewed literature. Search Strategy: The databases searched were PubMed, EMBASE, PsycINFO, Africa‐wide information, African Index Medicus, IMSEAR and LILACS. Selection Criteria: English‐language papers focusing on consent for CS, published between 2011 and 2022, and assessed to be of medium to high quality were included. Data Collection and Analysis: A narrative synthesis was conducted using Beauchamp and Childress's elements of informed consent as a framework. Main Results: Among the 21 included studies reporting on consent for CS, 12 papers reported on counseling for CS, while only one reported on debriefing. Barriers were identified at the service, woman, provider, and societal levels. Facilitators all operated at the provider level and interventions operated at the service or provider levels. Conclusions: There is a paucity of research on informed consent, counseling, and debriefing for CS in sub‐Saharan Africa. Synopsis: This scoping review identified only a small number of peer‐reviewed papers on informed consent, counseling, and debriefing for cesarean section in sub‐Saharan Africa. [ABSTRACT FROM AUTHOR]

• The paper analyzes long-term impacts of electoral violence on health and education. • Areas exposed to violence in Kenya suffer inflation and fall in annual consumption. • Children and adolescents exposed to violence have stunted height as adults. • The sons of those exposed to violence during growing age also have stunted growth. • No long-term impact on education is found as violence peaks during school holidays. This paper examines whether prenatal, childhood, and teenage exposure to electoral violence has any long-term effects on height and human capital in Kenya. First, using the difference-in-difference estimator, we show that areas impacted by electoral violence see increases in local food prices and a decrease in annual nightlight, suggesting important local consumption shocks. We then identify people exposed to such violence using a nationally representative survey and take advantage of the temporal and spatial variation of electoral violence in Kenya between 1992 and 2013. Using coarsened exact matching, we find that exposure to electoral violence between prenatal and the age of sixteen reduces adult height. Previous research has demonstrated that protracted, large-scale armed conflicts can cause significant nutritional shocks and pass down stunting effects to descendants. In line with these studies, we find that the low-scale but recurrent electoral violence in Kenya has impacted the height-for-age of children whose parents were exposed to such violence while they were growing up. Only boys exhibit this intergenerational effect, possibly due to their increased susceptibility to malnutrition and stunting in Sub-Saharan Africa. The fact that most electoral violence in Kenya occurs over the school holidays may help explain why, in contrast to previous studies on large-scale conflicts, childhood exposure to electoral violence has no lasting impact on educational attainment. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to re-examine the corruption and sustainable development nexus in Africa and offer a contemporary analytical review and analysis of that relationship in the region. Design/methodology/approach: Drawing on the available and accessible relevant data from credible sources, this work quantifies, outlines and analyses the nexus between corruption and sustainable development, as it applies primarily to sub-Saharan Africa. It uses the relevant disaggregated data and also complements that with the results of reliable empirical studies to further cross-reference and demonstrate the corruption and sustainable development nexus. Findings: It is shown that corruption in Africa continues to be negatively associated with sustainable development objectives and that, in turn, will continue to affect the continent's progress in achieving sustainable development. Undoubtedly, corruption is very damaging to economies across all nations and regions. However, in Africa, this impact on sustainable development has been particularly severe and ongoing. Consequently, the views expressed several decades ago of corruption being able to grease the wheels and potentially contribute to economic development is not valid and, in fact, has been severally discredited over the years. Originality/value: The main value of the paper is the insights it provides, and with cross-reference to the empirical literature and time series data, on the corruption and sustainable development nexus in Africa. [ABSTRACT FROM AUTHOR]

This study examines the impact of entrepreneurship learning on individual propensities to entrepreneurial activities in the context of a turbulent environment. The paper draws from a crosssectional survey of 331 students of the University of Maiduguri in Maiduguri Northeast Nigeria, and Bayero University Kano, in Northwest Nigeria -- both cities heavily affected by conflict and terrorist insurgency. The results of the structural equation modelling indicate that the impact of entrepreneurship education (EE) on entrepreneurial intention is fully mediated by entrepreneurial and management skills. Further, the results show that entrepreneurial skills have significant impacts on respondents' risk taking and self-efficacy, and EE is an effective moderator of political instability in the sense that EE weakens the negative impact of perceived political instability on entrepreneurial intention. By bringing together the interactions of entrepreneurship education with individual attributes and environmental factors, the paper makes a significant contribution to a new body of research examining the impact of entrepreneurship education on entrepreneurial and micro/small business development in sub-Saharan Africa and conflict contexts. It also highlights the importance of entrepreneurship development as part of a multi-faceted policy intervention in conflict contexts characterised by widespread youth unemployment and alienation from the State. [ABSTRACT FROM AUTHOR]

Purpose – The papers in this special issue measure the pace of change and the employment consequences of rapid ongoing transformation of Sub-Saharan Africa’s agri-food system. After quantitatively assessing the pace of change in consumer diets, a succession of papers examines the resulting change in public health, employment structure, job skill requirements and the educational challenges facing agricultural education and training (AET) institutions charged with preparing African youth with workforce skill required to succeed in the continent’s rapidly changing, rapidly growing agri-food system. The paper aims to discuss these issues. Design/methodology/approach – Changes in consumer demand and workforce skill needs emerge from a quantitative projection model using Living Standards Measurement Studies in half a dozen countries in Eastern and Southern Africa. Based on surveys of employers, graduates and staff at AET institutions in a range of 14 different countries, the analyses evaluate the workforce skill needs and educational challenges for preparing Africa’s emerging youth bulge to seek productive careers on the farm and in post-farm segments of the agri-food system. Throughout, the papers contrast findings from countries at different stages in the food system transformation using a typology developed in this paper. Findings – The concluding paper in this issue by Kabasa, Kirsten and Minde summarizes key findings emerging from this collection. Originality/value – The contributions in this special issue report original research based on analysis of LSMS data and on interviews with agri-food system employers, agricultural education institutions and professionals in over a dozen African countries. [ABSTRACT FROM AUTHOR]

Research ethics education is critical to developing a culture of responsible conduct of research. Many countries in sub-Saharan Africa (SSA) have a high burden of infectious diseases like HIV and malaria; some, like Uganda, have recurring outbreaks. Coupled with the increase in non-communicable diseases, researchers have access to large populations to test new medications and vaccines. The need to develop multi-level capacity in research ethics in Uganda is still huge, being compounded by the high burden of disease and challenging public health issues. Only a few institutions in the SSA offer graduate training in research ethics, implying that the proposed ideal of each high-volume research ethics committee having at least one member with in-depth training in ethics is far from reality. Finding best practices for comparable situations and training requirements is challenging because there is currently no "gold standard" for teaching research ethics and little published information on curriculum and implementation strategies. The purpose of this paper is to describe a model of research ethics (RE) education as a track in an existing 2-year Master of Public Health (MPH) to provide training for developing specific applied learning skills to address contemporary and emerging needs for biomedical and public health research in a highly disease-burdened country. We describe our five-year experience in successful implementation of the MPH-RE program by the Mbarara University Research Ethics Education Program at Mbarara University of Science and Technology in southwestern Uganda. We used curriculum materials, applications to the program, post-training and external evaluations, and annual reports for this work. This model can be adapted and used elsewhere in developing countries with similar contexts. Establishing an interface between public health and research ethics requires integration of the two early in the delivery of the MPH-RE program to prevent a disconnect in knowledge between research methods provided by the MPH component of the MPH-RE program and for research in ethics that MPH-RE students are expected to perform for their dissertation. Promoting bioethics education, which is multi-disciplinary, in institutions where it is still "foreign" is challenging and necessitates supportive leadership at all institutional levels. [ABSTRACT FROM AUTHOR]

Objective: Genetic variants cause a significant portion of developmental disorders and intellectual disabilities (DD/ID), but clinical and genetic heterogeneity makes identification challenging. Compounding the issue is a lack of ethnic diversity in studies into the genetic aetiology of DD/ID, with a dearth of data from Africa. This systematic review aimed to comprehensively describe the current knowledge from the African continent on this topic. Method: Applicable literature published up until July 2021 was retrieved from PubMed, Scopus and Web of Science databases, following PRISMA guidelines, focusing on original research reports on DD/ID where African patients were the focus of the study. The quality of the dataset was assessed using appraisal tools from the Joanna Briggs Institute, whereafter metadata was extracted for analysis. Results: A total of 3,803 publications were extracted and screened. After duplicate removal, title, abstract and full paper screening, 287 publications were deemed appropriate for inclusion. Of the papers analysed, a large disparity was seen between work emanating from North Africa compared to sub-Saharan Africa, with North Africa dominating the publications. Representation of African scientists on publications was poorly balanced, with most research being led by international researchers. There are very few systematic cohort studies, particularly using newer technologies, such as chromosomal microarray and next-generation sequencing. Most of the reports on new technology data were generated outside Africa. Conclusion: This review highlights how the molecular epidemiology of DD/ID in Africa is hampered by significant knowledge gaps. Efforts are needed to produce systematically obtained high quality data that can be used to inform appropriate strategies to implement genomic medicine for DD/ID on the African continent, and to successfully bridge healthcare inequalities. [ABSTRACT FROM AUTHOR]

Outcomes of arthroplasty in sub-Saharan Africa are not widely reported. To our knowledge, this systematic review is the first to explore this topic. Scopus, EMBASE, Medline and PubMed databases were searched, utilising MeSH headings and Boolean search strategies. All papers from South Africa were excluded. Twelve papers reporting 606 total hip replacements (THRs) and 763 total knee replacements (TKRs) were included. Avascular necrosis was the most common indication for THR, whereas osteoarthritis was the main indication for TKR. HIV prevalence of up to 33% was seen. Improvements were seen in patient-reported outcome measures in both THR and TKR. The dislocation rate in THR was 1.6%. The deep infection rate was 1.6% for TKRs and 0.5% for THRs. Positive results were reported, with comparable complications to high-income countries. However, there is likely to be significant reporting bias and the introduction of mandatory registries would enable more accurate monitoring across the region. [ABSTRACT FROM AUTHOR]

This paper explores the role of contract farming arrangements in agricultural intensification in sub‐Saharan Africa, combining secondary literature and original case material from Mozambique. The paper extends the scope of "contract farming" beyond the formal contracts between large companies and small‐scale producers to include less formal credit agreements between farmers and traders. It argues that such informal contract arrangements are evidence of farmers' agency in "real markets." In the studied cases, farmers use contract farming opportunities to intensify agricultural production by investing in irrigation and inputs. While informal contracts typically concern locally consumed crops, thus with more possibilities for side selling than formal contracts for export crops with company‐controlled markets, informal contract compliance reflects closely knit social ties between the contracting parties. In both formal and informal contracts, purchasers tend to seek out producers who are already irrigating, thus obtaining gains from farmers' earlier investments. This also implies contract farming as a mechanism for accelerating social differentiation arising from unequal access to irrigation. The paper argues that the significance of informal contracts in the studied cases raises the possibility that informal contract farming by local traders plays a more important role in agrarian transformation in Africa than formal contract farming by large companies. [ABSTRACT FROM AUTHOR]

Despite the successful adoption of mobile money in sub-Saharan Africa, there is limited empirical evidence on how mobile money interacts with traditional financial services and the implications of this interaction for firm performance. In this paper, we investigate the effects of mobile money use and access to traditional financial services on labour productivity and test whether mobile money can accentuate the impact of traditional financial services on productivity. Using firm-level data from the World Bank Enterprise Survey across 14 sub-Saharan African countries, we find a significant effect of access to traditional financial services on firm labour productivity but no robust significant direct effect of mobile money use on labour productivity. However, when access to traditional financial services, particularly access to bank capital, is combined with mobile money, there is a productivity improvement. We find similar evidence in the sample of small and medium-sized enterprises. The productivity gain from combining mobile money use with traditional financial service is also found within firms from East Africa and especially firms from other regions where mobile money is emerging, but uptake is relatively low. Overall, the evidence suggests that mobile money can heighten the effects of traditional finance, and we attribute this effect to a reduction in transaction costs. The findings in this paper support that both mobile money and traditional financial services should be promoted at the firm level. Plain English Summary: Mobile money heightens the effect of traditional finance on firm performance. Based on firm-level data across 14 countries in sub-Saharan Africa, we find that mobile money has no statistically significant effect on labour productivity, but when it is used in combination with traditional financial services such as bank capital and accounts, then there is a productivity improvement, including in countries where mobile money adoption is relatively low. The evidence implies that mobile money can help formal firms derive maximum benefits from traditional financial services due to its potential to reduce transaction costs. Therefore, the use of both mobile money and traditional financial services should be encouraged among formal firms. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of First Aid Education is the property of International Journal of First Aid Education and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Sub-Saharan Africa is often presented as the continent most vulnerable to climatic change with major repercussions for food systems. Coupled with high rates of population growth, continued food insecurity and malnutrition, thus the need to enhance food production across the continent is seen as a major global imperative. We argue here, however, that current models of agricultural development in Eastern Africa frequently marginalise critical smallholder knowledge from the process of future agricultural design due to a lack of a methodological tools for engagement. This paper addresses this by outlining a potential means to capture and share locally produced agronomic information on a large scale. We report on a 'Citizen Science' pilot study that worked with smallholder farmers in Elgeyo-Marakwet County, Western Kenya, to co-design a mobile application using the well-developed Sapelli platform that easily allows farmers to identify, record and geolocate cropping patterns and challenges at multiple stages in the agricultural calendar using their own understanding. The pilot project demonstrated the technical and epistemological benefits of co-design, the abilities of smallholder farmers to co-design and use smartphone applications, and the potential for such technology to produce and share valuable agricultural and ecological knowledge in real time. Proof-of-concept data illustrates opportunities to spatially and temporally track and respond to challenges related to climate, crop disease and pests. Such work expounds how smallholder farmers are a source of largely untapped ecological and agronomic expert knowledge that can, and should, be harnessed to address issues of future agricultural resilience and food system sustainability. [ABSTRACT FROM AUTHOR]

Introduction. This paper analyses the trends in sugar and sugarcane production in sub-Saharan Africa, including the core drivers of production by reviewing the current institutional and production arrangements. Materials and methods. The analysis is based on 35 African countries Categorized into 4 regions based on the United Nations M49 classification. A detailed literature review was conducted to explain the observed trends and to provide context for the various institutional and production arrangements. The literature reviewed key sugar-related documents at national level, websites of the core companies producing sugar in each country including their annual reports and previous empirical studies undertaken in the major sugarcane producing countries. Results and discussion. The sugarcane industry in South Africa has grown significantly over the last 6 decades, with raw sugar production and sugarcane production increasing by 200 and 215%, respectively. In terms of regional production, the average growth rate for raw sugar production over the period 1961 to 2020 was 2, 3, 3, and 13% for Eastern, Middle, Southern and Western Africa regions, respectively. The Eastern and Southern Africa regions produce a major share of both sugar and sugarcane production accounting for 90 and 86% of total production. Yields have consistently remained low and only Eswatini, Malawi, Tanzania, South Africa, Uganda and Zambia have remained competitive and low cost producers in the region. Some countries like Kenya, Uganda, and Tanzania are not self-sufficient and have consistently been net importers of sugar. The countries in question have in the past imposed import restrictions particularly on import tariffs as a way of boosting domestic production. Threats to steady supply of sugar and sugarcane, especially for countries that depend on rain fed agriculture, have continued to emanate from periodic droughts, particularly the major producing Eastern and Southern regions in the early 1990s. The institutional review revealed that the proportion of sugarcane production supplied by smallholder farmers under outgrower schemes compared to the nucleus estate dictates the stability of sugar production in Africa. Outgrowers dominate the production of sugarcane, as is the case in South Africa (92%) and Kenya (90%), which poses a high risk to the steady supply of sugarcane to the milling company involved in sugar production. This may arise because outgrowers may fail to honor their contracts and engage in opportunistic behavior to side-sell their sugarcane to other offtakers. Conclusion. Key to resolving the low yields and threats to sustainable sugarcane production in sub-Saharan Africa will be addressing the institutional and production arrangements of sugarcane production, particularly addressing the issues surrounding outgrower schemes that are the major production models. [ABSTRACT FROM AUTHOR]

The paper studies the phenomenon of poverty in underdeveloped/third-world countries, particularly within the context and the failure of international organizations in Sub-Saharan Africa. The article analyzes that the increasing problem of poverty in the region's countries/Africa is a replication of the failure of the organizations such as the IMF and the World Bank policies such countries. Despite some projects such as Millennium Development Goals (MDG), Sustainable Development Goals (SDG), and many more by the United Nations. Many of these programs have failed to eradicate or reduce poverty. Instead, the situation has worsened most, especially in Africa, where the rate of poverty is increasing, with several regions in the continent experiencing the worse hunger epidemic in recent times. Therefore, the research posits that the failure of international institutions, the World Bank, and IMF policies have immensely become a significant contributing factor to the poverty level in Sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Domestic revenue mobilisation is fundamental if African countries are to fund investments in health, education, infrastructural development, economic growth, human capital development, security, and prosperity to attain the Sustainable Development Goals by 2030. Some goals focus on eradicating poverty, reducing inequalities, strengthening institutions, and providing decent work. This requires resources and investment, yet Sub-Saharan African countries continuously struggle to mobilise enough revenue to meet basic government objectives. Through a critical literature review, this paper focuses on sustainable tax revenue mobilisation in Sub-Saharan African Countries, discussing the challenges, opportunities, and prospects for possible amelioration of tax systems. Challenges identified to explain the ineffectiveness of revenue mobilisation in these countries include the presence of a significant informal sector, weak tax administration capacities, the growth in the digital economy, corruption, governance quality, and increased tax avoidance and evasion by multinational companies. Possible prospects include taxation of the digital economy, taxing the informal sector, the capacitation of tax authorities, and the broadening of tax bases. [ABSTRACT FROM AUTHOR]

In sub-Saharan Africa over 52 million children are living with the death of one or both parents. Drivers of this parental mortality include afflictions at levels endemic to the region, including: HIV; malaria and other parasites; lower respiratory infections; diarrhoeal illnesses; and road accidents, among others. This paper examines the impact of orphanhood on learning outcomes among girls and boys in sub-Saharan Africa, conditional on school enrolment. By analysing test scores for approximately 60,000 pupils in 12 countries, we estimate the effect on student test scores by comparing paternal, maternal, and double orphans to non-orphans in the sample, specifically for the subjects of reading, mathematics, and HIV-AIDS knowledge. No previous study has analysed how orphanhood might influence learning by using student test score data, making this paper's approach unique in the literature. This study employs two estimation techniques: Coarsened exact matching calculates the sample average treatment effect on the treated, while matching on students' family structure, household wealth, school resources, and geographic location; and double lasso (DL) regression applies applying machine-learning for variable selection with high-dimensional controls for regional and school identifiers, school location, and student age. Our results show both CEM and DL consistently report a significant negative impact of orphanhood on test scores among specific countries, especially those which faltered in addressing the HIV-AIDS crisis. [ABSTRACT FROM AUTHOR]

Copyright of Social & Cultural Geography is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

High fear reaction, preferential attention, or fast detection are only a few of the specific responses which snakes evoke in humans. Previous research has shown that these responses are shared amongst several distinct cultures suggesting the evolutionary origin of the response. However, populations from sub-Saharan Africa have been largely missing in experimental research focused on this issue. In this paper, we focus on the effect of snake threat display on human spontaneous attention. We performed an eye-tracking experiment with participants from Somaliland and the Czechia and investigated whether human attention is swayed towards snakes in a threatening posture. Seventy-one Somalis and 71 Czechs were tested; the samples were matched for gender and comparable in age structure and education level. We also investigated the effect of snake morphotype as snakes differ in their threat display. We found that snakes in a threatening posture were indeed gazed upon more than snakes in a relaxed (nonthreatening) posture. Further, we found a large effect of snake morphotype as this was especially prominent in cobras, less in vipers, and mostly non-significant in other morphotypes. Finally, despite highly different cultural and environmental backgrounds, the overall pattern of reaction towards snakes was similar in Somalis and Czechs supporting the evolutionary origin of the phenomenon. We concluded that human attention is preferentially directed towards snakes, especially cobras and vipers, in threatening postures. [ABSTRACT FROM AUTHOR]

Vaccine-preventable diseases (VPDs) remain a significant public health challenge, particularly in sub-Saharan Africa. The high burden of VPDs in this region necessitates the need for continued investigation and intervention. This paper presents a bibliometric analysis of research on VPDs in children in sub-Saharan Africa in the last 10 years to capture the current state of research in the field. This study used a systematic search for articles published between 2013 and 2022 in the Web of Science Core Collection database and, subsequently, scientometric techniques for data analyses and interpretation. Annual scientific production of publications on the research of VPDs in children in sub-Saharan Africa increased from 2013 to 2019 and then gradually declined. South Africa had the most VPD studies (n = 148; 16.2%), followed by Nigeria, Ghana, Kenya, The Gambia, Malawi, Ethiopia, and the Republic of Congo. The Vaccine journal published the most. The Pan African Medical Journal was the most frequent destination journal based in Africa. The commonly studied pathogens were Streptococcus pneumoniae and Haemophilus influenzae. Research productivity increased exponentially in the pre-COVID era and declined in the past two years, so more VPD research in this region is needed. [ABSTRACT FROM AUTHOR]

This paper examines three interrelated factors outside of formal provision of technical and vocational education and training (TVET) in sub-Saharan Africa that have undermined TVET systems. The first is the process, pace, and levels of industrialisation, which has had a direct effect on TVET provision: low numbers of well-paying jobs requiring technical expertise. This has an indirect effect, which is the second crucial factor: lack of economic development and change in labour markets. There are very few jobs that would be considered 'middle class' or 'mid-level' in wealthy countries. Most people are in survivalist work. An international consensus since the 2000s on palliative approaches to development which address the effects but not the causes of the lack of economic development in Africa has resulted in mass poor quality provision of education—the third factor. Education systems are rapidly expanding and achievement levels rising, in the context of very little possibility of labour market rewards for most people, and substantial labour market rewards confined mainly to graduates. This reinforces deeply embedded cultural preferences for general education, which originate in the type of education systems established by colonial powers, as well as the relationships between educational credentials and elite jobs. [ABSTRACT FROM AUTHOR]

Objective: The objective of the scoping review will be to understand and describe risk factors associated with surgical site infection (SSI) in an orthopaedic surgery population in Sub-Saharan Africa and South Africa. This paper describes the protocol that will be used for the scoping review. Method: A comprehensive literature search will be conducted using MEDLINE (PubMed), CINAHL (EBSCO), Embase and Cochrane Libraries to identify articles meeting the inclusion criteria, including both published and grey literature, in order to provide a broad overview of the reported risk factors associated with patients who have undergone an orthopaedic surgery with an outcome of SSI within 90 days of a procedure. Additional studies will be sourced by exploring the reference list of included eligible studies. By using a combination of the Population, Exposure, Outcome framework, terms and synonyms related to each category, in different variations, along with Boolean operators (AND, OR, NOT) in the search strategy, identified comprehensive and relevant literature for the scoping review. Results: It is anticipated the results will provide a baseline of risk factors that will inform the development of a risk assessment tool for clinical use. Conclusion: This protocol will inform the development of a scoping review to describe factors associated with SSIs following orthopaedic surgery in Sub-Saharan Africa and South Africa. [ABSTRACT FROM AUTHOR]

AbstractThis paper examines the influence of climate change vulnerability on the likelihood and severity of communal violence, with a particular emphasis on delineating large-scale regional patterns. Specifically, the analysis centres on Sub-Saharan Africa and South/South-East Asia – both regions being predominantly characterised by rain-fed agriculture and climate-sensitive economic activities – spanning the years 1995 to 2021. Relying on the ND-GAIN Vulnerability Index as a multidimensional measure for propensity of societies to be negatively impacted by climate change, we found robust evidence that greater vulnerability is conducive to a higher likelihood and severity of communal violence in Sub-Saharan Africa. On the other hand, in South/South-East Asia, results suggest that current climate variability, measured as rainfall deviations within the period, exerts a greater effect on communal violence outbreak than overall vulnerability to climate change. In both regions, greater access to productive means is significantly associated to the reduction of communal violence. [ABSTRACT FROM AUTHOR]

Exploring the nexus between oil prices and remittances is critical to both remitting and recipient countries. Employing non-linear panel autoregressive distributed lag (NARDL) approach, we examine the relationship for 32 sub-Sahara African countries over the period 1986-2019. The results reveal that: (1) changes in oil prices and remittance inflows are asymmetrically associated only in the short run for the entire sample; (2) when the sample is divided into middle and low-income subgroups, asymmetric effect is confirmed for former subgroup only in the long run, while it is confirmed for latter subgroup only in the short run, (3) in the long run, positive movement in oil prices reduces remittances for the sample and in the middle income subgroup, whereas it increases remittances in the low-income subgroup, (4) Negative oil price movement reduces remittances for the entire sample and the two subgroups; (5) in the short run, a reduction in oil prices increases remittance inflows only for the entire sample and for the low-income subgroup. These results suggest that policymakers in SSA should implement policies that will reduce oil price risks on remittance inflows especially in the long run. [ABSTRACT FROM AUTHOR]

This paper positions climate change against the backdrop of gender, premised on the understanding that neither climate change impacts nor responses are gender neutral, therefore institutions need to respond accordingly. Institutions play a central role in facilitating policy effects and forming major nodes of interaction as well as determining the accentuation of risk. Drawing on examples from different parts of Sub-Saharan Africa, the paper seeks to elucidate why women should be placed at the heart of climate change interventions. Establishing the appropriate connections between gender and climate change will enhance the opportunities for problem-solving and can increase the efficiency and effectiveness of policy-making. The gendered aspects of climate change and environmental relations are analysed by using an African feminist approach as the theoretical framework to expand and expound upon this position. This paper also investigates institutional matters pertaining to the management of environmental resources and highlights some of the constraints that need to be overcome in order to ensure the inclusion and empowerment of women in the management of these resources. It concludes by calling for a thorough understanding of the gender-based power relations in the agendas and activities of environmental governance institutions at all levels in society. [ABSTRACT FROM AUTHOR]

This paper challenges the dominant notion that globalisation has a neutral "winwin" outlook and the generalisation of "equal gains" and "equal pains" for all countries. The paper provides the dominant narrative on dimensions of globalisation but also dwells more on the global dichotomy approach in understanding this phenomenon. Drawing on analysis of secondary information, this paper examines the paradoxical problem of contested framing of the phenomenon and how it affects sub-Saharan African society. It distinguishes between the Western-oriented and sub-Saharan African perspectives in framing globalisation, which is a departure from the three other dominant narratives. Through a synthesis of available information and the author's lived experience, this paper confirms that globalisation is not a neutral "win-win" phenomenon but a being that brings disproportionate gain and pain to the detriment of sub-Saharan Africa in numerous social spheres, as demonstrated in this paper. Based on the realities, mitigating approaches are proffered for African future development and social progress. [ABSTRACT FROM AUTHOR]

This paper employs a recently constructed consumption-based carbon dioxide emissions data in which emissions computations are made based on fossil fuel usage domestically, in addition to emissions emanating from imports minus exports. We contrast this measure with the commonly measured territory-based carbon dioxide emissions data and examine how trade performance (split into imports, exports, and total trade) impacts these two measures of carbon dioxide. We focus on 22 sub-Saharan African countries over the period 1995–2014. Employing the system generalized method of moments, we find trade to generally have positive effect on emissions. The results are consistent across the different measures of trade and carbon dioxide emissions. The results of the paper allow us to give some policy suggestions regarding carbon dioxide emissions in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Background: Disasters are increasing worldwide, with Sub-Saharan Africa (SSA) being one of the most prone regions. Hospitals play a key role in disasters. This study provides a systematic review of the evidence on disaster preparedness by hospitals in SSA countries based on English literature. Methods: A systematic literature review was conducted of articles published between January 2012 and July 2022. We searched PubMed, Elsevier, Science Direct, Google Scholar, the WHO depository library and CDC sites for English language publications. The key inclusion criteria were: publications should have been published in the above period, deal with hospital disaster preparedness in SSA, the full paper should have been available, and studies should have presented a comparison between hospitals and/or a single hospital. Results: Results indicate improvements in disaster preparedness over time. However, health systems in SSA are generally considered vulnerable, and they find it difficult to adapt to changing health conditions. Inadequately skilled healthcare professionals, underfunding, poor knowledge, the absence of governance and leadership, lack of transparency and bureaucracy are the main preparedness barriers. Some countries are in an infancy stage of their health system development, while others are among the least developed health system in the world. Finally, a major barrier to disaster preparedness in SSA countries is the inability to collaborate in disaster response. Conclusions: Hospital disaster preparedness is vulnerable in SSA countries. Thus, improvement of hospital disaster preparedness is highly needed. [ABSTRACT FROM AUTHOR]

To what extent do colonial ties and knowledge spillovers continue to influence the development of scientific capabilities in sub-Saharan Africa? Using a new database of publication output of 46 sub-Saharan African countries over the period 1976–2016 and a production function approach, this paper gives evidence that knowledge produced in former colonizing countries continues to have a large and persistent effect on publication output in Africa. This relationship is growing stronger over time. Furthermore, the publication output of smaller countries and those at more advanced stages of scientific, economic and political development is more closely related to the publication output of their former colonizer. Overall, these findings have implications for programs and policies aiming to facilitate the development of scientific capacity in the region. [ABSTRACT FROM AUTHOR]

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Aim: Health and nutrition in early childhood are essential for survival, growth and adult life outcomes. As such, a number of global and national interventions have been pursued to improve early childhood health and nutrition. However, child malnutrition is pervasive and endemic across the sub Saharan Africa. This paper therefore assesses the nature and trends of socioeconomic inequalities in child stunting. The paper proceeds to decompose the causes of such socioeconomic-related inequalities over the period covered. Subjects and methods: We used data from Demographic and Health Surveys (DHSs) for ten sub-Saharan African countries conducted between 2000 and 2016. The study employs an extension to the concentration index for binary health outcomes to measure socioeconomic inequalities in stunting and decompose the causes of inequalities in stunting using a generalized decomposition technique based on recentered influence function regressions. Results: The results show substantial pro-rich inequalities in child stunting across sub-Saharan Africa. The incidence of stunting are concentrated among children living in households with low socioeconomic status. In spite of persistent declines in the prevalence of stunting among children under 5 years across the study countries since 2000, trends in socioeconomic inequalities in stunting are mixed. We find significant contributions of child, maternal, and household characteristics to inequalities in child stunting. Conclusion: The results suggest that there is the need to design and target nutrition-based interventions at children in low socioeconomic households. In addition, promoting female education and improving access to health and nutrition information will be key to improving child nutrition across the region. [ABSTRACT FROM AUTHOR]

Introduction: A previous review on brief alcohol interventions in sub-Sahara Africa showed most of the interventions were implemented in East and Southern Africa. We carried a scoping review to assess the current amount and types of alcohol interventions in SSA. Methods: We searched six databases (MEDLINE, EMBASE, Global Health, Africa-wide, CINAHL and PsycINFO) for publications prior to June 2018. We used the search terms for alcohol use, alcohol intervention and African countries' names. We identified 59 papers on alcohol interventions of which 26 were eligible for inclusion in the final analysis. Results: Of the 26 eligible papers, 18(69 %) were carried out in South Africa. Majority 15(58%) of the interventions were randomized clinical trial, followed by seven (27%) quasi-experimental and evaluation of the intervention and five (19%) cluster randomized trials. Most of the studies targeted patients and pregnant women. Only a few studies focused on sex workers and students. Conclusions: Our findings show that the assessment of effectiveness of individual level alcohol interventions is rare in SSA. In addition, these interventions were polarized in two countries. There is an urgent need for an evidence base on the effectiveness of alcohol interventions commensurate with the scope of the problem in SSA. [ABSTRACT FROM AUTHOR]

Many African towns and cities face a range of hazards, which can best be described as representing a "spectrum of risk" of events that can cause death, illness or injury, and impoverishment. Yet despite the growing numbers of people living in African urban centres, the extent and relative severity of these different risks is poorly understood. This paper provides a rationale for using a spectrum of methods to address this spectrum of risk, and demonstrates the utility of mixed‐methods approaches in planning for resilience. It describes activities undertaken in a wide‐ranging multi‐country programme of research, which use multiple approaches to gather empirical data on risk, in order to build a stronger evidence base and provide a more solid base for planning and investment. It concludes that methods need to be chosen in regard to social, political economic, biophysical and hydrogeological context, while also recognising the different levels of complexity and institutional capacity in different urban centres. The paper concludes that as well as the importance of taking individual contexts into account, there are underlying methodological principles – based on multidisciplinary expertise and multi‐faceted and collaborative research endeavours – that can inform a range of related approaches to understanding urban risk in sub‐Saharan Africa and break the cycle of risk accumulation. Many African towns and cities face a range of hazards, which can best be described as representing a "spectrum of risk" of events that can cause death, illness or injury, and impoverishment. This paper provides a rationale for using a spectrum of methods to address this spectrum of risk, and demonstrates the utility of mixed‐methods approaches in planning for resilience. [ABSTRACT FROM AUTHOR]

Historical data shows that large natural resource endowments have not translated into better quality of life in Sub-Saharan Africa ('Africa' for short). The problem is becoming more urgent, as new exploration technologies are rapidly expanding the number of countries whose fiscal revenues will grow, in many cases massively, with new oil, gas and mineral discoveries. A search is on for innovative approaches in managing this commodity bonanza. This paper focuses on the distribution of resource rents as cash transfers to citizens, so-called 'Direct Dividend Payments' (DDPs). It expands on recent related literature by calculating such transfers, whether universal or targeted, for every African country for which data is available, and compares them to measures of poverty depth under both national and global definitions. Furthermore, it extends the analysis to a different kind of resource flow enjoyed by most African countries-foreign aid. We found that DDPs can account for a large proportion of the income Africa's poor need to step over the poverty line. [ABSTRACT FROM AUTHOR]

The understanding of Thomas Hobbes’s analysis on the importance of reason signifies the essence for the establishment of human capacity project, which will be rooted and reckoned with in the quest for the development of human thoughts. The quest for right reason in Hobbes is a necessary point in Georg Hegel, which stipulates reason as the determinant of development in Hegel’s dialectism that development can only be realised in union with the ultimate realisation of the Spirit as reason rules the world. This is the fact that the principle of development enables a being to produce and reproduce itself, and by making itself actually what it already was potentially. It is pertinent to understand from the outset the significance of knowledge-based society as the foundation for security in the quest towards the attainment of authentic development. This means that security of lives and property is founded on the establishment of adequate knowledge necessary for action. Thus, human security for development is based on the level, attainment and utilisation of knowledge in human society. This paper will, therefore, employ analytic methodology to thematise that human security is a conditio sine qua non in the attainment of authentic development among societies of the Global South particularly subSahara Africa. It is expected that the intent of the paper will interrogate the extent and the ways human security would be struggled for, in order for development to be guaranteed, which would be premised and thematised from the stand-points of Hobbes and Hegel. [ABSTRACT FROM AUTHOR]

Introduction: Hip arthroplasty and revision surgery are growing exponentially in OECD countries. In developing countries, it is an infrequent intervention and its practice is limited. It is exposed to a higher rate of infectious and mechanical failures than in developed countries. The aim of the actual study is to provide a review of the literature on total hip arthroplasty series in sub-Saharan Africa followed by an overview of the interest and perspectives of the use of dual mobility (DM) cups. Materials and methods: Scopus, EMBASE, Medline, PubMed, and Safoonline databases were searched including papers published at any date. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. All papers from South Africa were excluded. Results: We identified 22 series of total hip arthroplasty in 14 SSA countries. The practice of total hip arthroplasty is not very widespread. The cups used are mostly conventional implants, and complications (mechanical and infectious) are frequent. Discussion: The interest for the use of dual mobility cups in sub-Saharan Africa can be summarized in two points: mechanical and socio-economical. Dual mobility cups provide more mechanical stability and a reduction in the overall cost of treatment by reducing the rate of complications. These prospects will make it possible to evaluate this medical device in the long term in a hostile environment conductive to complications. Conclusion: The use of dual mobility deserves to be developed in African settings. [ABSTRACT FROM AUTHOR]

Land acquisition is currently one of the main topics African Governments must handle. Land belongs generally to the first residents of the area. To claim ownership of a land, the owner must register their land and obtain the land title in urban areas or be recognized by rural community managers as the rightful owner. In the land acquisition process, land buyers face ownership and integrity challenges. Many people have been victims in the acquisition of a land by notoriously evil practice of multiple sale of the same land, falsified land title, false owner identification. In this paper, a Generic and Reliable Land Acquisition Architecture in Sub-Saharan Africa countries context is proposed. The platform keeps relevant land transaction information for administrators, managers, buyers, sellers, or for people consultation purpose. This information will be used in village, city, department, region, or country for land management decision making. [ABSTRACT FROM AUTHOR]

Public libraries and development organizations share many common goals that make them strong potential partners in the Global South. In spite of these commonalities, libraries are often overlooked as development partners. This is unfortunate because these partnerships could allow librarians to more fully and effectively participate in the development of their communities. This paper explores strategies that libraries might employ to make themselves more visible to development organizations. It does so through analysis of interviews with practitioners who have funded or implemented development projects across countries in Africa. We find that these practitioners are open to working more with libraries, but that it will take a lot of work on the part of public libraries to accomplish broad shifts in perception amongst development agencies. Collecting and openly sharing data on the output and impact of public libraries is a first step in this work, but these efforts must also be augmented through increased marketing and networking by libraries. Libraries need to build internal capacity to use data to drive advocacy efforts and attract funding from development donors. [ABSTRACT FROM AUTHOR]

This paper empirically investigates the impact of Turkey's embassies on trade with sub-Saharan Africa (SSA). It uses a panel data set that covers 28 African countries for the period of 2002 to 2020 in order to measure if the opening of an embassy increases Turkey's exports to relevant countries. The study found a positive relationship between exports and diplomatic representation via embassies. More precisely, the empirical results indicate that the presence of an embassy in an African country increases Turkey's exports to this country by 108%. The study also found that the presence of business councils has the same positive effect on Turkey's export performance albeit at a moderate level. [ABSTRACT FROM AUTHOR]

This paper examines the output effects of changes in public expenditure and revenue in sub-Saharan African countries during 1990–2016. Fiscal multipliers in sub-Saharan Africa are somewhat smaller than those estimated in the literature for advanced and emerging economies. The effect of changes in fiscal policy on output depends on the composition: Cutting public investment has a larger effect on output than cutting public consumption or raising revenue. Episodes of fiscal consolidation have short- and medium-term output effects, but here, too, composition matters: Fiscal consolidations based on reducing public investment have the largest effect on output, while fiscal consolidations based on revenue mobilization are less harmful. These findings suggest that the negative impact on growth can be mitigated through the design of fiscal adjustment. [ABSTRACT FROM AUTHOR]

This review examines the nexus of poverty, malnutrition and diseases in Africa, the challenges, implications and their mitigation. The paper takes a critical look at available literatures on the primary causes, modes, implications and solutions to the problems of poverty, malnutrition and diseases in Africa continent. Poverty and malnutrition are outcomes of uncontrolled rapid population growth, inefficient agricultural and industrial practices, high debt profile of many African countries due to poor governance and corruption, diseases such as AIDS epidemic, malaria, Ebola virus and COVID-19 pandemic, poor and inadequate health infrastructure and armed conflicts. African poverty scenario entails non-availability of basic human needs which makes many Africans to be very poor. Despite abundance of natural resources, the gross domestic product per capita of many African countries is among the lowest of list of nations of the world. According United Nation in 2009, 22 of 24 nations among the "Low Human Development" nations of the world on the UN's Human Development Index were found in sub-Saharan Africa. Out of the 50 countries on the United Nation list of least developed countries, 34 of them were in Africa. According to FAO data over 200 million people in sub-Saharan Africa were undernourished in 2014-2016. The prevalence of undernourishment in sub-Saharan Africa rose from 181 million in 2010 to 222 million in 2016. In 2016, Africa had the highest prevalence of undernourishment in the world and estimated to be 20% of the population. While this was alarming in Eastern Africa where one-third of the population is suspected to be undernourished. In a similar data, World Bank also found that sub-Saharan Africa Poverty and Equity Data was 47% with over 500 million people in abject poverty in 2012. Poverty is the major cause of hunger and malnutrition in Africa while hunger and malnutrition escalated the problem of diseases in African continent. Poverty has continued to torment Africa as a result of poor and harmful economic policies, conflict and war, environmental factors like drought and climate change and population growth, poor leadership and greed. With the advent of COVID-19, the problem of poverty, malnutrition and diseases has been escalated and in many African countries people find it difficult to make ends meet. [ABSTRACT FROM AUTHOR]

Leiomyomas, or uterine fibroids as they are commonly known, are mostly seen in women of reproductive age. However, they can go undetected in most women, and approximately 25% of women show clinical symptoms. Although fibroids are a global burden impacting 80% of premenopausal women, they are more prevalent among Black women than among women of other races. Based on clinical diagnosis, the estimated cumulative incidence of fibroids in women =50 years old is significantly higher for black (>80%) versus white women (~70%). The cause of leiomyomas is not clearly known, but studies have shown evidence of factors that drive the development or exacerbation of the disease. Evidence has linked risk factors such as lifestyle, age, environment, family history of uterine fibroids, and vitamin D deficiencies to an increased risk of uterine fibroids, which impact women of African descent at higher rates. Treatments may be invasive, such as hysterectomy and myomectomy, or noninvasive, such as hormonal or non-hormonal therapies. These treatments are costly and tend to burden women who have the disease. Sub-Saharan Africa is known to have the largest population of black women, yet the majority of uterine fibroid studies do not include populations from the continent. Furthermore, the prevalence of the disease on the continent is not well determined. To effectively treat the disease, its drivers need to be understood, especially with regard to racial preferences. This paper aims to review the existing literature and build a case for conducting future research on African women. [ABSTRACT FROM AUTHOR]