Local Economic Development in Sub-Saharan Africa

10.1068/c5p ◽  
2007 ◽  
Vol 25 (4) ◽  
pp. 516-536 ◽  
Author(s):  
Andrés Rodríguez-Pose ◽  
Sylvia A R Tijmstra
Keyword(s):  
Economic Development ◽  
Urban Areas ◽  
Local Economic Development ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Design And Implementation ◽  
City Regions ◽  
The World ◽  
Sub Saharan

It has often been argued that Africa in general, and Sub-Saharan Africa (SSA) in particular, is ‘different’ and that it therefore requires ‘exceptional’ solutions to its development problems. In contrast, in this paper we argue that strong internal heterogeneity combined with general trends similar to those experienced elsewhere in the world make local economic development (LED) as likely to succeed in SSA as in other low- and middle-income countries. The likelihood of success depends mostly on place-specific conditions. Many of the most prosperous parts of the continent already have the basic enabling conditions for the design and implementation of LED strategies in place. Less favourable resource endowments, poor accessibility, and relatively weak civil societies can undermine the viability of LED outside the wealthier and most prosperous areas. In smaller urban areas and intermediate regions and city-regions, which lack only a few of the basic preconditions for LED, further capacity building may still enable the success of the approach. In contrast, LED may not be relevant for the poorest and most remote parts of SSA, where existing conditions do not provide a strong enough base on which to build LED strategies.

Abstract P137: Socioeconomic Status And Hypertension Control In Sub-saharan Africa: The Multination Eight Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Marie Antignac ◽  
Diane Macquart de Terline ◽  
Ibrahima Bara Diop ◽  
Kouadio E Kramoh ◽  
Dadhi M Balde ◽  
...  
Keyword(s):  
Low Income ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Uncontrolled Hypertension ◽  
Hypertension Control ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
The World ◽  
Sub Saharan

Introduction: Systemic hypertension is a rapidly growing epidemic in Sub-Saharan Africa. Adequacy of blood pressure(BP) control and the factors influencing it, especially the role of socio-economic status(SES) have not been well studied in this part of the world. Hypothesis: We therefore aimed to quantify the association of SES both at the individual and at the country level with BP control in Sub-Saharan Africa. Methods: We conducted a cross-sectional survey in urban clinics of twelve countries, both low-income and middle-income, in Sub-Saharan Africa. Data were collected on demographics, treatment and standardized BP measures were made among the hypertensive patients attending the clinics. BP control was defined as BP<140/90 mmHg and hypertension grades were defined according to European Society of Cardiology guidelines. Country income was retrieved from the World Bank database and patient’s individual wealth status was documented by the treating physician. The separate association between SES (both country-level income and individual patient wealth) and BP control was investigated using Generalized Linear Mixed-Effects Models adjusted on sex and age. Results: A total of 2198 hypertensive patients (58.4±11.8years; 39.9% male) were included, of whom 1017(46.3%) were from low-income and 1181(53.7%) from middle-income countries. Individual wealth level was low, mid and high in 376(17.6%), 1053(49.2%) and 713(33.3%) patients respectively. Uncontrolled hypertension was present in 1692 patients(77.4%) including 1044(47.7%) with ≥grade 2 hypertension. The proportion of uncontrolled hypertension progressively increased with decreasing level of patient individual wealth, respectively 72.8%, 79.3% and 81.8%(p for trend<0.01). Stratified analysis shows that these differences of uncontrolled hypertension according to individual wealth index were observed in low-income countries(p for trend=0.03) and not in middle-income countries(p for trend=0.26). In low-income countries the odds of uncontrolled hypertension increased 1.37 fold(OR=1.37 [0.99-1.90]) and 1.88 fold(OR=1.88 [1.10-3.21]) in patients with middle and low individual wealth as compared to high individual wealth. Similarly, the grade of hypertension increased progressively with decreasing level of individual patient wealth(p for trend <0.01). Conclusions: Low individual wealth was significantly associated with poor hypertension control, especially in low-income countries. Strategies for hypertension control in Sub-Saharan Africa should especially focus on people in the lowest individual wealth groups who also reside in low-income countries.

scholarly journals Global child health: What we have achieved and what needs to be done

2020 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Venkatraman Radhakrishnan
Keyword(s):  
Child Health ◽  
Sub Saharan Africa ◽  
World Health ◽  
Special Focus ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Important Health ◽  
Sub Saharan ◽  
Health Organization

Global child health has cemented itself as an important branch of global health. It is said that the development of a nation is gauged by its infant and under-5 mortality rates. Coordinated efforts by organizations such as the United Nations, the World Health Organization, and Governments are essential to maintain the momentum of improving the health of children across the world. Special focus needs to be put on areas such as Sub-Saharan Africa and conflict-prone regions where the initial positive gains are being erased. As we achieve success in controlling malaria, pneumonia, and diarrhea in many countries, we need to start focusing on areas such as cancer, accidents, climate change, and child abuse which will soon become important health problems in children in low- and middle-income countries.

scholarly journals Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

2020 ◽  
Vol 5 (11) ◽  
pp. e003423
Author(s):  
Dongqing Wang ◽  
Molin Wang ◽  
Anne Marie Darling ◽  
Nandita Perumal ◽  
Enju Liu ◽  
...  
Keyword(s):  
Weight Gain ◽  
North Africa ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Weight ◽  
Latin America And Caribbean ◽  
Nationally Representative ◽  
Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

scholarly journals Are low and middle-income countries prioritising high-value healthcare interventions?

2020 ◽  
Vol 5 (2) ◽  
pp. e001850
Author(s):  
Ashley A Leech ◽  
David D Kim ◽  
Joshua T Cohen ◽  
Peter J Neumann
Keyword(s):  
Cost Effectiveness ◽  
Cost Saving ◽  
National Health ◽  
Sub Saharan Africa ◽  
Health Plans ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Priority ◽  
Sub Saharan ◽  
Low And Middle Income

IntroductionSince resources are finite, investing in services that produce the highest health gain ‘return on investment’ is critical. We assessed the extent to which low and middle-income countries (LMIC) have included cost-saving interventions in their national strategic health plans.MethodsWe used the Tufts Medical Center Global Health Cost-Effectiveness Analysis Registry, an open-source database of English-language cost-per-disability-adjusted life year (DALY) studies, to identify analyses published in the last 10 years (2008–2017) of cost-saving health interventions in LMICs. To assess whether countries prioritised cost-saving interventions within their latest national health strategic plans, we identified 10 countries, all in sub-Saharan Africa, with the highest measures on the global burden of disease scale and reviewed their national health priority plans.ResultsWe identified 392 studies (63%) targeting LMICs that reported 3315 cost-per-DALY ratios, of which 207 ratios (6%) represented interventions reported to be cost saving. Over half (53%) of these targeted sub-Saharan Africa. For the 10 countries we investigated in sub-Saharan Africa, 58% (79/137) of cost-saving interventions correspond with priorities identified in country plans. Alignment ranged from 95% (21/22 prioritised cost-saving ratios) in South Africa to 17% (2/12 prioritised cost-saving ratios) in Cameroon. Human papillomavirus vaccination was a noted priority in 70% (7/10) of national health prioritisation plans, while 40% (4/10) of countries explicitly included prenatal serological screening for syphilis. HIV prevention and treatment were stated priorities in most country health plans, whereas 40% (2/5) of countries principally outlined efforts for lymphatic filariasis. From our sample of 45 unique interventions, 36% of interventions (16/45) included costs associated directly with the implementation of the intervention.ConclusionOur findings indicate substantial variation across country and disease area in incorporating economic evidence into national health priority plans in a sample of sub-Saharan African countries. To make health economic data more salient, the authors of cost-effectiveness analyses must do more to reflect implementation costs and other factors that could limit healthcare delivery.

scholarly journals Preventing Multimorbidity with Lifestyle Interventions in Sub-Saharan Africa: A New Challenge for Public Health in Low and Middle-Income Countries

2021 ◽  
Vol 18 (23) ◽  
pp. 12449
Author(s):  
Ahmad Alkhatib ◽  
Lawrence Achilles Nnyanzi ◽  
Brian Mujuni ◽  
Geofrey Amanya ◽  
Charles Ibingira
Keyword(s):  
Public Health ◽  
Cardiovascular Disease ◽  
Sub Saharan Africa ◽  
Lifestyle Interventions ◽  
African Countries ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Economic Disparity ◽  
Middle Income Countries ◽  
Sub Saharan

Objectives: Low and Middle-Income Countries are experiencing a fast-paced epidemiological rise in clusters of non-communicable diseases such as diabetes and cardiovascular disease, forming an imminent rise in multimorbidity. However, preventing multimorbidity has received little attention in LMICs, especially in Sub-Saharan African Countries. Methods: Narrative review which scoped the most recent evidence in LMICs about multimorbidity determinants and appropriated them for potential multimorbidity prevention strategies. Results: MMD in LMICs is affected by several determinants including increased age, female sex, environment, lower socio-economic status, obesity, and lifestyle behaviours, especially poor nutrition, and physical inactivity. Multimorbidity public health interventions in LMICs, especially in Sub-Saharan Africa are currently impeded by local and regional economic disparity, underdeveloped healthcare systems, and concurrent prevalence of communicable and non-communicable diseases. However, lifestyle interventions that are targeted towards preventing highly prevalent multimorbidity clusters, especially hypertension, diabetes, and cardiovascular disease, can provide early prevention of multimorbidity, especially within Sub-Saharan African countries with emerging economies and socio-economic disparity. Conclusion: Future public health initiatives should consider targeted lifestyle interventions and appropriate policies and guidelines in preventing multimorbidity in LMICs.

A Comparative Analysis of South Africa as a Semi-Industrialised Developing Country

1988 ◽  
Vol 26 (3) ◽  
pp. 473-493 ◽  
Author(s):  
J. B. Knight
Keyword(s):  
South Africa ◽  
Developing Economies ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
The World Bank ◽  
The World ◽  
Per Capita ◽  
Sub Saharan ◽  
Industrialised Countries

South Africa has neither a developed nor a typical underdeveloped economy. Too often it has been wrongly classified, along with, say, Australia and New Zealand, as one of the peripheral developed countries, because only a part of the economy and population have the characteristics we associate with that group. Yet its economy is distinctly different from others in sub-Saharan Africa. South Africa falls squarely into the category which the World Bank classifies as ‘upper middle-income’ developing economies, with G.N.P. per capita in 1982 ranging from $2,000 to $7,000 and averaging $2,500, thereby including South Africa, with $2,700.1 (By contrast, Kenya's G.N.P. per capita was $400 and Britain's $10,000). The World Bank's group includes Algeria, Argentina, Brazil, Chile, Mexico, South Korea, Venezuela, and Yugoslavia. South Africa shares many structural economic characteristics with these semi-industrialised countries.

P1586Research network in Africa (RNA): antihypertensive drugs strategies in 12 African countries

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kane ◽  
P Cavagna ◽  
I B Diop ◽  
B Gaye ◽  
J B Mipinda ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Low Income ◽  
Democratic Republic ◽  
Antihypertensive Drugs ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Sub Saharan

Abstract Background High Blood Pressure is the worldwide leading global burden of disease risk factor. In Sub-Saharan Africa, the number of adults with raised blood pressure has alarmingly increased from 0.59 to 1.13 billion between 1975 and 2015. Blood pressure-lowering medicines are cornerstone of cardiovascular risk reduction. Data on management of anti-hypertensive drugs in sub-Saharan Africa are squarce. Purpose Our study aims to describe antihypertensive drugs strategies in Africa. Methods We conducted a cross-sectional survey in urban clinics during outpatient consultation specialized in hypertension cardiology departments of 29 medical centers from 17 cities across 12 African countries (Benin, Cameroon, Congo, Democratic Republic of Congo, Gabon, Guinea, Ivory Coast, Mauritania, Mozambic, Niger, Senegal, Togo). Data were collected on demographics, treatment and standardized BP measures were made among the hypertensive patients attending the clinics. Country income was retrieved from the World Bank database. All analyses were performed through scripts developed in the R software (3.4.1 (2017–06–30)). Results A total of 2198 hypertensive patients (58.4±11.8 years; 39.9% male) were included. Among whom 2123 (96.6%) had at least one antihypertensive drug. Overall, 30.8% (n=653) received monotherapy and calcium-channel blockers (49.6%) were the most common monotherapy prescribed follow by diuretics (18.7%). Two-drug strategies were prescribed for 927 patients (43.6%). Diuretics and Angiotensin-converting enzyme inhibitors was the combination most frequently prescribed (33.7%). Combination of three drugs or more was used in 25.6% (n=543) of patients. The proportion of drugs strategies differed significantly according to countries (p<0.001), monotherapy ranged from 12.7% in Niger to 47.1% in Democratic Republic of the Congo (figure). Furthermore we observed a significantly difference of strategies between low and middle income countries (55.3% and 44.7% of monotherapy respectively) (p<0.001). According to hypertension grades 1, 2 and 3, the proportion of three-drugs or more combination was 25%, 28% and 34% in middle-income and lower in low-income countries (18%, 19% and 25%). Furthermore, Grade 3 hypertension in low income countries was still treated with monotherapy (36%) instead of 19% in middle income countries (p<0.01). Antihypertensive strategies by country Conclusion Our study described antihypertensive drugs use across 12 sub-Saharan countries, and identified disparities specific to the income context. Inequity in access to drugs combination is a serious barrier to tackle the burden of hypertension in Africa.

Strategies used to establish palliative care in rural low- and middle-income countries: an integrative review

2020 ◽  
Vol 35 (8) ◽  
pp. 1110-1129
Author(s):  
Atsede Aregay ◽  
Margaret O’Connor ◽  
Jill Stow ◽  
Nicola Ayers ◽  
Susan Lee
Keyword(s):  
Palliative Care ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Care Home ◽  
Sub Saharan Africa ◽  
Integrative Review ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Globally, 40 million people need palliative care; about 69% are people over 60 years of age. The highest proportion (78%) of adults are from low- and middle-income countries (LMICs), where palliative care still developing and is primarily limited to urban areas. This integrative review describes strategies used by LMICs to establish palliative care in rural areas. A rigorous integrative review methodology was utilized using four electronic databases (Ovid MEDLINE, Ovid Emcare, Embase classic+Embase and CINAHL). The search terms were: ‘palliative care’, ‘hospice care’, ‘end of life care’, ‘home-based care’, ‘volunteer’, ‘rural’, ‘regional’, ‘remote’ and ‘developing countries’ identified by the United Nations (UN) as ‘Africa’, ‘Sub-Saharan Africa’, ‘low-income’ and ‘middle- income countries’. Thirty papers published in English from 1990 to 2019 were included. Papers were appraised for quality and extracted data subjected to analysis using a public health model (policy, drug availability, education and implementation) as a framework to describe strategies for establishing palliative care in rural areas. The methodological quality of the reviewed papers was low, with 7 of the 30 being simple programme descriptions. Despite the inclusion of palliative care in national health policy in some countries, implementation in the community was often reliant on advocacy and financial support from non-government organizations. Networking to coordinate care and medication availability near-patient homes were essential features of implementation. Training, role play, education and mentorship were strategies used to support health providers and volunteers. Home- and community-based palliative care services for rural LMICs communities may best be delivered using a networked service among health professionals, community volunteers, religious leaders and technology.

scholarly journals Research on Invasive Nontyphoidal Salmonella Disease and Developments Towards Better Understanding of Epidemiology, Management, and Control Strategies

2020 ◽  
Vol 71 (Supplement_2) ◽  
pp. S127-S129
Author(s):  
Samuel Kariuki ◽  
Ellis Owusu-Dabo
Keyword(s):  
Burden Of Illness ◽  
Control Strategies ◽  
Sub Saharan Africa ◽  
Disease Entity ◽  
Middle Income ◽  
Diagnostic Strategies ◽  
Disease Epidemiology ◽  
Middle Income Countries ◽  
Sub Saharan ◽  
And Control

Abstract During the 11th International Conference on Typhoid and Other Invasive Salmonelloses held in Hanoi, Vietnam, a number of papers were presented on the burden of disease, epidemiology, genomics, management, and control strategies for invasive nontyphoidal Salmonella (iNTS) disease, which is increasingly becoming an important public health threat in low- and middle-income countries, but especially in sub-Saharan Africa (sSA). Although there were minor variations in characteristics of iNTS in different settings (urban vs rural, country to country), it was observed that iNTS has gained greater recognition as a major disease entity in children younger than 5 years. Renewed efforts towards greater understanding of the burden of illness, detection and diagnostic strategies, and management and control of the disease in communities in sSA through the introduction of vaccines will be important.

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