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Purpose: The 2030 Agenda and the sustainable development goals (SDG) have gained considerable attention in research and public debate. This calls for accounting research on the subject of SDG disclosure. Based on this premise, this paper aims to evaluate and analyze the extent of SDG reporting by 80 listed firms from 8 selected African countries for the period of 2016 to 2018. Design/methodology/approach: The study adopts a content analysis and survey method to evaluate the extent of SDG reporting by the selected African countries. This paper conducted content analysis through the use of the PricewaterhouseCoopers (PwC) framework and Global Reporting Initiative (GRI) framework to gauge the extent of firms' compliance with SDG reporting. Also, this paper uses the business reporting indicators for each SDG developed by GRI to determine the compliance level of the selected firms regarding SDG reporting. The survey was targeted at the big four audit firms (PwC, KPMG, Ernst and Young and Deloitte and Touche). Findings: The evaluation of SDG disclosure by the 80 listed firms in Africa is still at a very low level except for South African firms. Also, the findings of the business reporting indicators for each SDG target show that most of the firms show little or no concern to report on SDG activities. The result of the research survey indicates that voluntary disclosure, lack of management commitment, lack of regulatory enforcement and cost implications account for low SDG disclosure by the selected African firms. Research limitations/implications: This study fails to consider the qualitative research approach in determining the extent of SDG disclosure in Africa, as the study did not allow respondents to freely express their opinion on SDG disclosure, as a large part of the survey used close-ended questionnaires. Practical implications: This study's findings call for clear responsibility and a strong drive for SDG performance from corporate institutions in Africa. While the overall responsibility rests on the government, the actualization of SDG cannot be achieved without support from corporate organizations. The empirical approach used in this study emphasizes the need for corporate organizations to embrace sustainable practices and to integrate SDG information into their reporting cycle. Originality/value: This study contributes to growing literature in the area of corporate reporting, sustainability reporting and SDG research in Africa and other emerging economies. Also, this study provides original insight into the contribution of accounting research toward the achievement of SDG. [ABSTRACT FROM AUTHOR]

The Belt and Road Initiative (BRI) is a massive Chinese state/capitalist programme of transnational infrastructure construction initiated in 2013. Between 2013 and 2016, Chinese banks extended hundreds of billions of dollars –principally across Asia, but also Europe and Africa – for transportation and energy networks. Recently released statistics, however, suggest that project lending for the BRI collapsed from 2016 onwards. Our paper examines the reasons for this contraction through a case-study of the BRI in Africa. We contend that the lending contraction resulted from political and economic contradictions generated by this form of international interconnection, including the types of debt traps it helped create. This outcome is explained partly by the fact that the BRI is simultaneously a geopolitical and geoeconomic project. Whereas the balance of economic risks is arguably skewed against borrowers (in some cases leading to debt traps), from a geopolitical perspective, the Chinese state also seeks to expand influence in Africa and elsewhere in the developing world. This creates counter-pressure on further expansion of such financing, which, complemented by domestic economic implications of loan failure, helps to explain the contraction. [ABSTRACT FROM AUTHOR]

Relying on complex interdependence as a theoretical approach, this paper investigates the hypothetical damage that the U.S. withdrawal from the Paris Agreement could represent for Africa in terms of climate finance. In June 2017, President Donald Trump publicly declared the U.S. intention to withdraw from further participating in the multilateral Paris Agreement. To keen followers and analysts of the U.S. climate policy beyond its borders, such unilateral action was never a surprise. Rather, it is nostalgic of the experience of the Kyoto Protocol, particularly how more or less similar move unduly prolonged the global climate negotiations up till late 2015 when the Paris Agreement came about. Although the Paris Agreement is remarkable as it represents the first states-wide climate deal, it however left a number of issues unresolved. Notable among which is climate finance which has remained the most contentious and of critical concern to developing countries, particularly in Africa. Pitted against the fact that Africa contributes less to climate change and, ironically, the hardest-hit by the phenomenon, the U.S. withdrawal from the Paris Agreement aggravates concerns around climate finance and, indeed, portends additional burdens for a continent that is still struggling to cope with the untoward fallout of climate change. [ABSTRACT FROM AUTHOR]

Financial sanctions are often thought of as the “soft alternative” to armed conflict and are widely used in the 21st century. Nonetheless, sanctions are often criticized for being non-specific in their action, and having impact beyond their intended remit. One often-overlooked area affected by sanctions are academic systems of research and education. Sanctions place “invisible barriers” for research in these countries by limiting access to necessary resources and curtailing their effective use. In this paper we present a national survey of Sudanese academics focused on the impact of 20 years of economic sanctions on their work. It identifies key areas of academic research and education that have been impacted by international sanctions. Moreover, these data highlight how the impact of sanctions on academia is likely to persist long after they are formally lifted. The paper concludes by problematising the current interpretation of jus post bellum, or moral behaviour after conflict. It suggests that the responsibility to make reparations in the form of support for academic systems applies to countries who impose economic sanctions. [ABSTRACT FROM AUTHOR]

Copyright of Management international / International Management / Gestiòn Internacional is the property of Management International 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.)

• Discretionary or ex gratia payouts are widespread in parametric insurance programs. • Payouts attempt to secure social license to operate despite contractual basis risk. • Discretionary payouts obscure and entrench insurers' market power. • Attempts at conciliation often stoke further demands from aggrieved collectivities. • Geospatial monitoring alone cannot resolve questions of post-disaster distribution. The past decade has seen the dramatic proliferation of geospatial tools to remotely monitor, measure, and transfer weather and climate risk, particularly in the Global South. These "parametric" tools are calculative market devices used to commodify risk and facilitate its distantiated exchange via insurance markets. Yet the environmental estimates they generate are frequently wrong, sometimes grossly so. This paper investigates what happens after calculative market devices fail, analyzing so-called ex gratia ("from grace") practices in which insurers make payouts to aggrieved clients even when none are due under contractual terms. Though these payments are commonly deployed to dispel discontent, these "public secrets" of the industry have gone unnoticed in insurance scholarship. This paper documents numerous ex gratia payouts in parametric programs across Africa, disputing the myth of autonomous insurance markets that function according to formal, transparent rules administered by dispassionate calculative devices. Instead, these "discretionary" monetary transfers reintroduce human decision making in informal, black-boxed ways, cloaking the inadequacy of the parametric contracts they shore up. Far from incidental, I argue that these practices have been constitutive of the parametric insurance market's persistence and expansion. Though ex gratia payments sometimes give rise to negotiations over indemnification with aggrieved collectivities, these unfold on insurers' terms, informalizing power and delegitimizing complaint. The growing emphasis on parametric insurance as a tool for climate adaptation makes it all the more important to excavate the mechanics and politics of ex gratia, and to relinquish expectations that geospatial algorithms alone can resolve questions of post-disaster redistribution. [ABSTRACT FROM AUTHOR]

Ghana has made significant stride towards universal health coverage (UHC) by implementing the National Health Insurance Scheme (NHIS) in 2003. This paper investigates the progress of UHC indicators in Ghana from 1995 to 2015 and makes future predictions up to 2030 to assess the probability of achieving UHC targets. National representative surveys of Ghana were used to assess health service coverage and financial risk protection. The analyses estimated the coverage of 13 prevention and four treatment service indicators at the national level and across wealth quintiles. In addition, we calculated catastrophic health payments and impoverishment to assess financial hardship and used a Bayesian regression model to estimate trends and future projections as well as the probabilities of achieving UHC targets by 2030. Wealth-based inequalities and regional disparities were also assessed. At the national level, 14 out of the 17 health service indicators are projected to reach the target of 80% coverage by 2030. Across wealth quintiles, inequalities were observed amongst most indicators with richer groups obtaining more coverage than their poorer counterparts. Subnational analysis revealed while all regions will achieve the 80% coverage target with high probabilities for the prevention services, the same cannot be applied to the treatment services. In 2015, the proportion of households that suffered catastrophic health payments and impoverishment at a threshold of 25% non-food expenditure were 1.9% (95%CrI: 0.9–3.5) and 0.4% (95%CrI: 0.2–0.8), respectively. These are projected to reduce to 0.4% (95% CrI: 0.1–1.3) and 0.2% (0.0–0.5) respectively by 2030. Inequality measures and subnational assessment revealed that catastrophic expenditure experienced by wealth quintiles and regions are not equal. Significant improvements were seen in both health service coverage and financial risk protection over the years. However, inequalities across wealth quintiles and regions continue to be cause of concerns. Further efforts are needed to narrow these gaps. [ABSTRACT FROM AUTHOR]

Abstract African countries are in a unique position to reap the socio-economic and environmental benefits of renewable resources as a means for meeting increasing energy demand in a sustainable way. A critical obstacle for the deployment of renewable energy technologies in Africa is the difficulty of attracting sufficient and affordable finance. This paper compares the impact of financial conditions on the cost of electricity generation across six renewable and three fossil-based technologies in 46 African countries. The results show large cost variations and highlight the extent to which renewables are disadvantaged by current financial practices. The energy-economy-environment model TIAM-ECN is used to show how lowering financing costs results in a much higher deployment of renewables. For example, solar PV could account for 10–15% of total electricity generation by 2050, even without explicit climate policy, thanks to financial de-risking programmes. The results demonstrate that changes in financing schemes could outweigh the impact of technology learning. This paper also demonstrates that, once ambitious climate policies are in place, reducing financing costs for renewables could be an efficient way to lower greenhouse gas emissions. Financial de-risking is thus a key ingredient for unlocking the renewable energy potential in Africa. Highlights • We show how renewables are disadvantaged by today's financial practices in Africa. • We show how lower financing costs result in a higher deployment of renewables. • PV can account for 10–15% of electricity generation by 2050 without climate policy. • Changes in financing schemes could outweigh the impact of technology learning. • Financial de-risking is key for unlocking the renewable energy potential in Africa. [ABSTRACT FROM AUTHOR]

This paper responds to Vanessa Watson’s article on the inappropriate urban development plans that are increasingly common in sub-Saharan Africa as governments seek to make their cities “world class”. It describes how the government of Angola has been able to use financing from Chinese credit facilities to build prestige projects that include support for the public-privately developed Kilamba city with 20,000 apartments. The apartments were initially too expensive for most of the population, and the state has had to draw further funds from its housing budget for a subsidized rent-to-purchase scheme to make the units affordable for middle-level civil servants. The author argues that an opportunity is being missed to use today’s income from high-priced natural resources and the current easy access to Chinese credit lines and technical expertise to address the very large backlogs in urban upgrading of basic service infrastructure and housing for the poor. The paper also reflects on a previous post-independence period when a number of African new cities were built, leaving some countries with decades of debt and stagnant development. Can errors from the past offer lessons for future African urban development? [ABSTRACT FROM PUBLISHER]

Copyright of Problems of Sustainable Development / Problemy Ekorozwoju is the property of Faculty of Environmental Engineering 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.)

Purpose The study aims to examine the importance of access to finance in firm innovation by using firm-level data from the World Bank enterprise survey (WBES) on selected African countries.Design/methodology/approach This study utilises firm-level data from the WBES database and computes aggregate innovation index by using multiple correspondent analysis. The authors then apply instrumental variable models (to control for possible endogeneity between innovation and finance) to assess the link between finance and innovation.Findings The research finds that finance in the form of overdraft overwhelmingly drives innovation in all selected countries – Cameroon, Kenya, Morocco, Nigeria and South Africa. Trade credit enhances innovation among firms in Nigeria, South Africa and Cameroon, while asset finance drives innovation amongst firms in Cameroon, Nigeria and South Africa.Practical implications Policy incentives such as tax breaks could be put in place for financial intermediaries that have shown proof of extending loans to financially constraint firms to enable them to innovate. Furthermore, different financial institutions such as microfinance institutions can be supported to increase credit to enterprises. Partnerships with organisations willing to fund firms and support start-ups should be encouraged. One of such support mechanisms could be specialised schemes such as a credit guarantee scheme to encourage and secure lending to enterprises to promote innovation.Originality/value This paper provides empirical insights into how finance enhances innovation in African enterprises. It also shows how different finance structures (overdraft, asset finance and trade credit) affect firm innovation in different African countries. [ABSTRACT FROM AUTHOR]

Background: The Global Forum 2015 panel session dialogue entitled "From evidence to policy - thinking outside the box" was held on 26 August 2015 in the Philippines to debate why evidence was not fully translated into policy and practice and what could be done to increase its uptake. This paper reports the reasons and possible actions for increasing the uptake of evidence, and highlights the actions partners could take to increase the use of evidence in the African Region.Discussion: The Global Forum 2015 debate attributed African Region's low uptake of evidence to the big gap in incentives and interests between research for health researchers and public health policy-makers; limited appreciation on the side of researchers that public health decisions are based on multiple and complex considerations; perception among users that research evidence is not relevant to local contexts; absence of knowledge translation platforms; sub-optimal collaboration and engagement between industry and research institutions; lack of involvement of civil society organizations; lack of engagement of communities in the research process; failure to engage the media; limited awareness and debate in national and local parliaments on the importance of investing in research and innovation; and dearth of research and innovation parks in the African Region.Conclusion: The actions needed in the Region to increase the uptake of evidence in policy and practice include strengthening NHRS governance; bridging the motivation gap between researchers and health policy-makers; restoring trust between researchers and decision-makers; ensuring close and continuous intellectual intercourse among researchers, ministry of health policy-makers and technocrats during the life course of research projects or programmes; proactive collaboration between academia and industry; regular briefings of civil society, media, relevant parliamentary committees and development partners; development of vibrant knowledge translation platforms; development of action plans for implementing research recommendations, preferably in the context of the Sustainable Development Goals; and encouragement of competition on NHRS strengthening and research output and uptake among the countries using a barometer or scorecard to review their performance at various regional ministerial forums and taking into account the lessons learned from the MDG period. [ABSTRACT FROM AUTHOR]

This paper highlights the challenges and limitations faced by scholarly presses in South Africa, presenting the business and operational changes required (both individually and collectively) to meet overarching political and competitive pressures. The direct competition of international commercial publishers, a disconnect between national research imperatives and the business model of scholarly presses, and the lack of support for university presses, have perpetuated the knowledge gap between publishing in the 'north' and the 'global south'. Direct engagement with institutions and the state is necessary, as is a robust and confident approach to technology and services, while clarifying and articulating specific needs and aspirations. [ABSTRACT FROM AUTHOR]

In the past decade inclusive growth, that is job-rich growth, has topped the policy agenda in developing countries. This paper investigates how the access to finance affects employment in small and medium-sized enterprises (SMEs) in Sub-Saharan Africa. It first presents a model where firm creation requires entrepreneurial search and paying the start-up costs, while the firm's size in terms of employment depends on the access to credit. Under the financial market imperfections, access to credit can be a binding constraint on firm entry and employment even when the banks have sufficient liquidity. Using an impact evaluation-based approach on firm-level data from 42 African countries, we show that SMEs with access to formal financing create more jobs than firms without access, with employment in firms having access to more affordable and larger loans growing the fastest. The impact of access to finance is stronger for firms in manufacturing than in services, pointing to sectoral targeting of finance as a possible policy supporting industrialization. [ABSTRACT FROM AUTHOR]

The term "financial inclusion" implies access and use of banking services (current account, savings account, insurance, credit, payments, etc.) at a low cost for the disadvantaged and low-income population in a country. In fact, banking services constitute a public good. It is therefore necessary that the accessibility and equitable use of banking services by the entire population should be among the primary objectives of government policies and financial institutions. Indeed, this helps to meet the basic financial needs of the population in any given country. The main objective of our study is therefore to examine the determinants of current account holding, which is considered to be a basic dimension of the use of banking services and therefore of financial inclusion. In our paper, we adopt an empirical approach using cross-sectional data to analyze the determinants of current account holding in the African continent. [ABSTRACT FROM AUTHOR]

The quest for urgent solution to resolve the world liquidity problem has continued to generate enthusiastic debates among political economists, policy makers and the academia. The argument has focused on whether the World Bank Group was established to enhance the stability of international financial system or meant to enrich the developed nations. This study argues that the existing political interest of the World Bank Group in Africa may serve as lesson learned to other ambitious African Monetary Union. [ABSTRACT FROM AUTHOR]

The paper provides evidence on the number and volume of financial transactions undertaken by agents (local businesses that double as more convenient, lower cost alternatives to formal branches) of the largest microfinance institution operating in the Democratic Republic of Congo (DRC). To our knowledge, this is the first econometric study of the activities of agents in a country as underdeveloped as the DRC. More important than agents’ personal characteristics, transactions are higher in low income, densely populated areas with high levels of commercial development, suggesting that the agent network has been best at supporting financial transactions among the urban poor. In addition, branding and effective liquidity management are strongly linked to agent activity. The results suggest that agents can be effective providers of basic financial services among the urban poor who lack suitable alternatives. But it remains to be seen how the agent banking model will play out in less densely populated areas of the DRC and other developing countries. [ABSTRACT FROM AUTHOR]

This study aims at examining the debt threshold effects on economic growth in Africa. Non-dynamic and dynamic panel threshold regression approaches are used. The findings indicate that the estimated debt threshold is sensitive to the estimation technique used and to growth control variables included in the estimation. Existence of nonlinearities in the debt-growth nexus cannot be denied. The findings show that while low debt is neutral or growth-enhancing, high debt is consistently detrimental to growth for all the cases considered. This study shows that caution is needed when suggesting a debt threshold since this can be sensitive to modelling choice and to growth control variables. Nonlinearities in the debt-growth nexus are established but further analysis is needed to suggest a policy. [ABSTRACT FROM AUTHOR]

Globally, tobacco use claims millions of lives every year. This has necessitated policy responses including tax measures aimed at reducing the consumption of tobacco. Nonetheless, opponents of tobacco taxation posit that, it may hurt economic growth. This study, therefore, examines the effect of tobacco taxation on economic growth in 38 African countries from 2008 to 2018. The system generalised method of moments (GMM) regression is used as the estimation technique. The findings show that, tobacco taxation enhances economic growth both in the short‐ and long‐run periods, especially, through its effect on population health. Thus, African governments should be confident when increasing tobacco tax because, it has an added advantage of propelling economic growth. [ABSTRACT FROM AUTHOR]

Copyright of Gender & Development 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.)

Purpose: This study aims to examine the effect of anti-corruption disclosure on the profitability and financial stability of extractive firms in Africa. It also tests the convergence of profitability and financial stability. Design/methodology/approach: The study uses an unbalanced panel data of 27 firms operating in five African countries covering the period 2006–2018. Anti-corruption assessment is done in line with GRI 205: Anti-Corruption. Profitability is measured using the return on asset and return on equity, whereas the z-score measures financial stability. The study uses the panel-corrected error regression technique for estimation. Findings: There is evidence that corruption disclosure reduces the financial stability of firms. Disclosures on corruption analysis and corruption training are the main factors driving the reduction in financial stability. The effect on profitability is not significant except in the case of disclosure on corruption response, which also reduces profitability. There is strong statistical evidence to suggest that profitability and financial stability of extractive firms converge. This suggests that less-performing firms catch up with high performers. Research limitations/implications: The study has relevant implications for practitioners, policymakers and the academic community. The study uses data that is skewed towards large extractive firms. Originality/value: This study is premier in exploring the effect of anti-corruption disclosure on performance metrics among extractive firms in Africa. It is also unique in providing a test of both beta and sigma convergence of performance among the firms. [ABSTRACT FROM AUTHOR]

This study utilizes firm-level data from the World Bank's Enterprise Survey Indicator Database, conducted between 2009 and 2018 for 32 countries in Africa, to examine the causal relationship between firm productivity, innovation, and financial development. We show evidence that firm innovation significantly and positively affects firm productivity. We also show the mediating role of well-developed financial markets on productivity. In a well-developed financial market, the impact of firm innovation is significant through the facilitation and financing of innovation activities; and innovative firms to boost productivity and lower production costs. These findings are significant for countries in Africa (and other less-developed countries) who spend less on R&D but can adopt or imitate existing innovative ideas from technology-rich countries for accelerated economic growth and increased productivity. [ABSTRACT FROM AUTHOR]

What are the characteristics of recipient countries that attract more climate finance in mitigating and adapting to climate change? In this study, we address this question by looking at recipients in 43 Sub-Sahara African countries for the period 2006–2017, and implement several panel regression techniques, including system generalized methods of moments estimations to address potential endogeneity concerns. We also performed sensitivity analysis using panel quantile regressions. The findings show that Sub-Sahara African countries with higher population growth rate, higher poverty levels, better ease of doing business profile, weaker governance policies, weaker control of corruption, stronger rule of law enforcement, deepened social inequality, and better ICT usage, have attracted more climate finance. Policy implications of the study are discussed. [ABSTRACT FROM AUTHOR]

Earlier studies on threshold effects of financial sector development on international trade have relied on rudimentary approach which assumes exogenous inclusion of quadratic square terms of finance. However, findings from such studies are not instructive as it obscures country's unique domestic conditions such as differences in the levels of financial sector development. By relying on 46 countries in Africa over the period 1980–2016, this study employs a sample splitting and threshold estimation approach which allows finance–international trade to be mediated by the level of domestic financial sector development. We find evidence of threshold effects for a number of the countries suggesting that the precise impact of financial development on international trade is threshold–specific given the various indicators of finance. The study highlights that whether finance supports or limits international trade crucially depends on the attainment of a certain threshold which is both country and indicator–specific. [ABSTRACT FROM AUTHOR]

Copyright of Review of African Political Economy is the property of Review of Political Economy (ROAPE) 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.)

Background: Achieving Universal Health Coverage (UHC) by improving financial protection and effective service coverage is target 3.8 of the Sustainable Development Goals. Little is known, however, about the extent to which paying bribes within healthcare acts as a financial barrier to access and, thus, UHC. Methods: Using survey data in adults from 32 sub-Saharan African countries in 2014–2015, we constructed a multilevel model to evaluate the relationship between paying bribes and reported difficulties of obtaining medical care. We controlled for individual-, region-, and country-level variables. Results: Having paid bribes for medical care significantly increased the odds of reporting difficulties in obtaining care by 4.11 (CI: 3.70–4.57) compared to those who never paid bribes, and more than doubled for those who paid bribes often (OR = 9.52; 95% CI: 7.77–11.67). Respondents with higher levels of education and more lived poverty also had increased odds. Those who lived in rural areas or within walking distance to a health clinic had reduced odds of reporting difficulties. Sex, age, living in a capital region, healthcare expenditures per capita, and country Corruption Perception Index were not significant predictors. Conclusions: We found that bribery in healthcare is a significant barrier to healthcare access, negatively affecting the potential of African countries to make progress toward UHC. Future increases in health expenditures—which are needed in many countries to achieve UHC—should be accompanied by greater efforts to fight corruption in order to avoid wasting money. Measuring and tracking health sector-specific corruption is critical for progress toward UHC. [ABSTRACT FROM AUTHOR]

Background: Podoconiosis, also known as mossy foot or endemic non-filarial elephantiasis, is a preventable form of lower-leg lymphoedema caused by prolonged (typically barefoot) exposure to soil derived from volcanic rocks. Acute adenolymphangitis (also called ‘acute attack’) is a serious complication of podoconiosis resulting in significant symptoms and worsening disability. Despite the well-known morbidity associated with podoconiosis, to date there have been no studies looking at the impact, or burden, of podoconiosis on caregivers. This study explored the experiences and impact of acute attacks on the caregivers of those with podoconiosis in one endemic district of Ethiopia. Methods/Principal findings: This qualitative study was based in Wayu Tuka woreda (district), Oromia, Western Ethiopia. 27 semi-structured interviews of those with podoconiosis and their caregivers were conducted in June 2018. Here we report the findings from the caregiver’s interviews. Data were analysed using NVivo 12. Directed content analysis, a qualitative approach related to thematic analysis, was used to analyse the results. This study highlights a previously unreported impact of acute attacks on the caregivers of those affected by podoconiosis. The findings demonstrate the significant social and financial pressures placed on podoconiosis-affected families which are exacerbated during acute attacks. This study also highlighted the emotional burden experienced by caregivers, the range of care activities placed on them and the limited support available. Conclusions: This study found a significant impact on the caregivers of those with podoconiosis, especially during acute attacks, in in Wayu Tuka woreda. It also highlighted the limited support available to caregivers. Further research is needed to understand whether this impact applies to podoconiosis caregivers across Ethiopia, and beyond, and to establish if there are wider implications of this important consequence of podoconiosis, for example on the economy and caregivers’ mental and physical health. [ABSTRACT FROM AUTHOR]

Introduction: In 2016, for the very first time, the Ministry of Health in Zambia implemented a reactive outbreak response to control the spread of cholera and vaccinated at-risk populations with a single dose of Shancol—an oral cholera vaccine (OCV). This study aimed to assess the costs of cholera illness and determine the cost-effectiveness of the 2016 vaccination campaign. Methodology: From April to June 2017, we conducted a retrospective cost and cost-effectiveness analysis in three peri-urban areas of Lusaka. To estimate costs of illness from a household perspective, a systematic random sample of 189 in-patients confirmed with V. cholera were identified from Cholera Treatment Centre registers and interviewed for out-of-pocket costs. Vaccine delivery and health systems costs were extracted from financial records at the District Health Office and health facilities. The cost of cholera treatment was derived by multiplying the subsidized cost of drugs by the quantity administered to patients during hospitalisation. The cost-effectiveness analysis measured incremental cost-effectiveness ratio—cost per case averted, cost per life saved and cost per DALY averted—for a single dose OCV. Results: The mean cost per administered vaccine was US$1.72. Treatment costs per hospitalized episode were US$14.49–US$18.03 for patients ≤15 years old and US$17.66–US$35.16 for older patients. Whereas households incurred costs on non-medical items such as communication, beverages, food and transport during illness, a large proportion of medical costs were borne by the health system. Assuming vaccine effectiveness of 88.9% and 63%, a life expectancy of 62 years and Gross Domestic Product (GDP) per capita of US$1,500, the costs per case averted were estimated US$369–US$532. Costs per life year saved ranged from US$18,515–US$27,976. The total cost per DALY averted was estimated between US$698–US$1,006 for patients ≤15 years old and US$666–US$1,000 for older patients. Conclusion: Our study determined that reactive vaccination campaign with a single dose of Shancol for cholera control in densely populated areas of Lusaka was cost-effective. [ABSTRACT FROM AUTHOR]

Background: Community-based health insurance (CBHI) scheme is an emerging strategy for providing financial protection against health-related poverty. It is being piloted in the Sheko district, but community satisfaction with the scheme has not yet studied. Therefore, this study aimed to assess the level of household’s satisfaction to CBHI scheme and associated factors in a piloted Sheko district; southwest Ethiopia. Methods: A community-based cross-sectional study was conducted in Sheko district from March to April 2018. Data was collected on 528 households by using simple random sampling method. Trained data collectors gathered the data using a pre-tested and structured questionnaire. Descriptive statistics, bivariate and multivariable logistic regression analyses were performed. To determine the independent predictors of household’s satisfaction to CBHI, a cut point of p values < 0.05 were used. Results: This study showed that more than half (54.7%) of the households were satisfied with the CBHI scheme. Satisfaction to CBHI was positively associated with adequate knowledge of CBHI benefit packages (AOR = 2.29, 95% CI = 1.55–3.38), type of health facility visit (AOR = 1.93, 95% CI = 1.09–3.39), laboratory service provision (AOR = 2.07, 95% CI = 1.15–373) and length of enrollment (AOR = 1.53, 95% CI = 1.01–2.32). Conclusions: Household’s satisfaction to CBHI scheme was moderate. Modifiable factors, including adequate knowledge of CBHI benefit packages, type of health facility visit, laboratory service provision, and length of enrollment were independent determinants of satisfaction. In order to augment enrollee’s satisfaction to CBHI, efforts should be given to improving their knowledge of CBHI benefit packages through education and information campaigns. Furthermore, due consideration should also be given to improving the quality of health services. [ABSTRACT FROM AUTHOR]

Background: The Maternal Mortality Ratio in Mozambique has stagnated at 405 deaths per 100,000 live births with virtually no progress over the last 15 years. Low Institutional Birth Rates (IBRs) levelling around 50% in many rural areas constitute one of the contributing reasons. Demand-side financing has successfully increased usage of maternal health services in other countries, but little information exists on in-kind incentives in rural Africa. The objective was to test the impact on Institutional Birth Rates of giving a USD 5.50 baby package incentive to every woman who came to give birth in a health centre in a rural, poor district of Cabo Delgado, Mozambique. Methods and findings: The intervention was implemented in one district in 2010 with the remaining 15 districts serving as controls. The total population in the 16 districts in 2006 was just under 1.5 million people. IBRs were observed from 2006 to 2013 (53 months before and 55 months after the intervention began). The non-intervention districts showed a slight increase, from a mean IBR of 0.39 (SD = 0.10) in 2006 to 0.67 (SD = 0.13) in 2014. The intervention district had a dramatic increase in IBRs within six months of the start of the intervention in 2010, which was sustained until the end of the study. Adjusting for the background increase and for confounders, including health facilities and health personnel per district, and taking clustering in districts into account, the estimated rate ratio of institutional births in the intervention district was 1.80 (95% CI 1.72, 1.89 p<0.001). Conclusion: Women were almost twice as likely to have an institutional birth following the introduction of the baby package. [ABSTRACT FROM AUTHOR]

Despite the removal of user fees on public primary healthcare in Zambia, prior studies suggest that out-of-pocket payments are still significant. However, we have little understanding of the extent to which out-of-pocket payments lead patients to hardship methods of financing out-of-pocket costs. This study analyses the prevalence and determinants of hardship financing arising from out-of-pocket payments in healthcare, using data from a nationally-representative household health expenditure survey conducted in 2014. We employ a sequential logistic regression model to examine the factors associated with the risk of hardship financing conditional on reporting an illness and an out-of-pocket expenditure. The results show that up to 11% of households who reported an illness had borrowed money, or sold items or asked a friend for help, or displaced other household consumption in order to pay for health care. The risk of hardship financing was higher among the poorest households, female headed-households and households who reside further from health facilities. Improvements in physical access and quality of public health services have the potential to reduce the incidence of hardship financing especially among the poorest. [ABSTRACT FROM AUTHOR]

This article seeks to put the law–finance–growth nexus into the context of Africa. As of 2017, the African Securities Exchanges Association has 27 securities exchanges as full members. The Johannesburg Stock Exchange is the most developed of all, especially with respect to its market capitalization. Its socio-legal proximity with the English system may provide a good explanation to its phenomenal growth relative to the rest in the region. However, such a socio-legal proximity is indeed shared by a number of other former British colonies such as Nigeria and Zimbabwe. Law alone may not account for the rise of the Johannesburg Stock Exchange. Furthermore, this article seeks to argue whether there is a genuine need for the African countries to have a stock market, which requires highly evolved legal, market and governmental institutions and norms that often do not pre-exist in these countries. On the one hand, the article will look at Africa in general. On the other hand, it will put certain discussions into the context of selected African countries. [ABSTRACT FROM AUTHOR]

Considerable outside funding will be required to overcome the financial shortfalls faced by most of Africa’s protected areas. Given limited levels of external support, it will be essential to allocate these funds wisely. While most recent studies on conservation triage have recommended prioritizing reserves with the highest remaining conservation value (the “last best places”), such investments are complicated by the fact that these same reserves often attract the greatest revenues from ecotourism and thus the most attention from corrupt local governments. Alternatively, philanthropic organizations might achieve greater returns from investing in the management of neglected areas with lower current conservation value but with less financial leakage from corruption. We outline here how high levels of corruption could favor a strategy that shifts investments away from the last best places. [ABSTRACT FROM AUTHOR]

Africa is advancing in research and development (R&D) in space with a growing investment in satellites for communications and Earth observations, astronomical observatories, space launch vehicles, and ballistic missiles. These efforts are designed to develop capacity in space science and to advance human development and security in Africa. Nevertheless, there are emerging concerns within and outside the continent on the cost of R&D in space and the public priority it is receiving, given developmental priorities in Africa. This article examines the state of space-related R&D in Africa, its cost and benefits, and the imperative for a balanced policy priority and investment. Leading African states are encouraged to intensify international partnerships, internalize relevant know-how, improve their competitiveness, and support regional initiatives to minimize the domestic cost of spreading benefits of space technology across the continent. [ABSTRACT FROM PUBLISHER]

We organise a field experiment with smallholder farmers in Rwanda to measure the impact of financial literacy training on financial knowledge and behaviour. The training increased financial literacy of participants, changed their savings and borrowing behaviour and had a positive effect on the new business start-up. However, it failed to have a significant (short-term) impact on income. Using a two-stage regression framework, we identify enhanced financial literacy as one of the important factors explaining behavioural changes. We also test whether financial knowledge spillovers from trained farmers to their peers in local village banks but find no evidence for that. [ABSTRACT FROM AUTHOR]

Background: The advent of global health initiatives (GHIs) has changed the landscape and architecture of health financing in low and middle income countries, particularly in Africa. Over the last decade, the African Region has realised improvements in health outcomes as a result of interventions implemented by both governments and development partners. However, alignment and harmonisation of partnerships and GHIs are still difficult in the African countries with inadequate capacity for their effective coordination.Method: Both published and grey literature was reviewed to understand the governance, priorities, harmonisation and alignment of GHIs in the African Region; to synthesise the knowledge and highlight the persistent challenges; and to identify gaps for future research.Results: GHI governance structures are often separate from those of the countries in which they operate. Their divergent funding channels and modalities may have contributed to the failure of governments to track their resources. There is also evidence that basically, earmarking and donor conditions drive funding allocations regardless of countries' priorities. Although studies cite the lack of harmonisation of GHI priorities with national strategies, evidence shows improvements in that area over time. GHIs have used several strategies and mechanisms to involve the private sector. These have widened the pool of health service policy-makers and providers to include groups such as civil society organisations (CSOs), with both positive and negative implications. GHI strategies such as co-financing by countries as a condition for support have been positive in achieving sustainability of interventions.Conclusions: GHI approaches have not changed substantially over the years but there has been evolution in terms of donor funding and conditions. GHIs still largely operate in a vertical manner, bypassing country systems; they compete for the limited human resources; they influence country policies; and they are not always harmonised with other donors. To maximise returns on GHI support, there is need to ensure that their approaches are more comprehensive as opposed to being selective; to improve GHI country level governance and alignment with countries' changing epidemiologic profiles; and to strengthen their involvement of CSOs. [ABSTRACT FROM AUTHOR]

Background There is a growing recognition of China?s role as a global health donor, in particular in Africa, but there have been few systematic studies of the level, destination, trends, or composition of these development finance flows or a comparison of China?s engagement as a donor with that of more traditional global health donors. Methods Using newly released data from AidData on China?s development finance activities in Africa, developed to track under reported resource flows, we identified 255 health, population, water, and sanitation (HPWS) projects from 2000?2012, which we descriptively analyze by activity sector, recipient country, project type, and planned activity. We compare China?s activities to projects from traditional donors using data from the OECD?s Development Assistance Committee (DAC) Creditor Reporting System. Results Since 2000, China increased the number of HPWS projects it supported in Africa and health has increased as a development priority for China. China?s contributions are large, ranking it among the top 10 bilateral global health donors to Africa. Over 50% of the HPWS projects target infrastructure, 40% target human resource development, and the provision of equipment and drugs is also common. Malaria is an important disease priority but HIV is not. We find little evidence that China targets health aid preferentially to natural resource rich countries. Conclusions China is an important global health donor to Africa but contrasts with traditional DAC donors through China?s focus on health system inputs and on malaria. Although better data are needed, particularly through more transparent aid data reporting across ministries and agencies, China?s approach to South-South cooperation represents an important and distinct source of financial assistance for health in Africa. [ABSTRACT FROM AUTHOR]

The editor discusses the challenges of high education programs for college students in South Africa. The editor addresses the factors of finance for higher education of students, the public debates on free education services for citizens and the impacts of the country's economic performance. The editor also cites the impacts of decolonisation and racial discrimination against Black people of South Africa on higher education program.

REDD+, a climate change mitigation mechanism that values carbon in tropical forests, is expected to provide Africa with a range of environmental and socio-economic benefits. Drawing on a vast array of literature and personal experiences, this review analyzed particular features and challenges that REDD+ implementation has faced on the continent. The distinct contexts and major challenges regarding governance, finance and technical capacities are discussed, and mechanisms to fill these gaps are suggested. Radical land tenure reform and a perfect safeguard mechanism that transfers forest land and carbon to the communities are unlikely. REDD+ should rather look for systems that respect local institutional arrangements, and allow forest-based communities to participate in decision-making and benefit sharing, particularly benefits from emerging REDD+. Finances for REDD+ infrastructure and the results-based payment are in short supply. While negotiating for potential external sources in the short term, Africa should generate domestic financial resources and look for additional payments for ecosystem services. Africa should also negotiate for forest monitoring capacity building, while strengthening local community forest monitoring. This review contributes to an improved understanding of the contexts and challenges to consider in the capacity and policy development for REDD+ implementation. [ABSTRACT FROM AUTHOR]

The article discusses ways on how to manage illicit financial flows (IFF) from Africa. Topics cited include the importance of cooperative compliance between governments and multinational enterprises, forecast of Africa's growth in its economy and in foreign direct and portfolio investments, key factors that contributed to the high level of IFF in Africa, the role of tax system in social contract and in influencing investment, key components of promoting change, and obstacles to combat IFFs.

A correction to the editorial "Highway to Health" in volume 520 of the journal is presented that discusses the costs of hiring staff for the African Centres for Disease Control and Prevention.