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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]

Spatial analysis is paramount for understanding, monitoring, and conserving ancient settlements and cultural landscapes. Advancing remote sensing and prospection techniques are expanding the methodological frame of archaeological settlement analysis by enabling remote, landscape‐scale approaches to mapping and investigation. Whilst particularly effective in arid lands and areas with sparse or open ground cover, such as vegetation and buildings, these approaches remain peripheral in tropical environments because of technical and contextual challenges. In tropical Eastern Africa, for example, scales, resolution and visibility are often compromised by thick vegetation cover, inadequate access to, if not lack of, imagery resources and technologies, and the availability of comparative archaeological data for interpretation. This paper presents the initial results of spatial analysis, using historic landscape characterisation, remote sensing, published and legacy data, and a pilot ground survey to examine the earliest settlement of Zanzibar, Unguja Ukuu. Comparing multiple strands of evidence in a Geographic Information System (GIS), we use each as a test on the others to draw out the strengths and weaknesses of each technique in the context of tropical and coastal Eastern Africa. Drone photogrammetry, geophysical prospection, and ground survey were compared with legacy remote sensing resources and the results of a coring survey conducted across the site during the 1990s into a GIS platform to produce multi‐phase hypothetical maps of the archaeological site in the context of its potential resource landscape. These were then tested against the results of recent excavations. The discussion highlights the challenges and potential of combining these techniques in the context of Eastern Africa and provides some suggested methods for doing so. We show that remote sensing techniques give an insight into current landscapes but are less useful in understanding or modelling how sites would have fitted into their surroundings in the past, when conditions were potentially very different. [ABSTRACT FROM AUTHOR]

This paper takes a new dimension on the foreign direct investment (FDI)–growth nexus through the lens of the allocation puzzle. We examine how the influx of FDI affects the broader economy through its impact on real economic sectors in a panel of 42 Sub‐Saharan African (SSA) countries over 1980–2017. Using a dynamic panel model and decomposing the real sector into its parts, we test for the possibility of a two‐way bi‐directional relationship between growth in agriculture, manufacturing, industry and service value additions, and FDI. There is no evidence of an allocation puzzle at the level of the real sector and the components parts, which suggests that SSA countries with relatively high growth in the real sector will attract more FDI. While the effect of FDI on the real sector is positive at the disaggregated level, there is a positive bi‐directional effect between FDI and growths in manufacturing, industry and service value additions. The results are robust to key determinants of the growth–FDI nexus. [ABSTRACT FROM AUTHOR]

The literature on climate exposures and human migration has focused largely on assessing short‐term responses to temperature and precipitation shocks. In this paper, we suggest that this common coping strategies model can be extended to account for mechanisms that link environmental conditions to migration behavior over longer periods of time. We argue that early‐life climate exposures may affect the likelihood of migration from childhood through early adulthood by influencing parental migration, community migration networks, human capital development, and decisions about household resource allocation, all of which are correlates of geographic mobility. After developing this conceptual framework, we evaluate the corresponding hypotheses using a big data approach, analyzing 20 million individual georeferenced records from 81 censuses implemented across 31 countries in tropical Africa, Latin America, and Southeast Asia. For each world region, we estimate regression models that predict lifetime migration (a change in residence between birth and ages 30–39) as a function of temperature and precipitation anomalies in early life, defined as the year prior to birth to age four. Results suggest that early‐life climate is systematically associated with changes in the probability of lifetime migration in most regions of the tropics, with the largest effects observed in sub‐Saharan Africa. In East and Southern Africa, the effects of temperature shocks vary by sex and educational attainment and in a manner that suggests women and those of lower socioeconomic status are most vulnerable. Finally, we compare our main results with models using alternative measures of climate exposures. This comparison suggests climate exposures during the prenatal period and first few years of life are particularly (but not exclusively) salient for lifetime migration, which is most consistent with the hypothesized human capital mechanism. [ABSTRACT FROM AUTHOR]

This paper investigates the within‐country location choices of a large sample of foreign and domestic firms in 19 Sub‐Saharan African countries. We show that foreign firms are more likely to locate in core regions compared to domestic ones but generate significantly more jobs per productive unit in the periphery. We find some evidence that foreign firms generate relatively better jobs in peripheral areas: more skill intensive and better paid. These results highlight a fundamental role that FDI in peripheral areas might play in rebalancing the spatial distribution of economic opportunities in developing countries where highly congested megacities exercise a strong centripetal force. [ABSTRACT FROM AUTHOR]

Burnout and related concepts such as resilience, wellness, and taking care of healthcare professionals have become increasingly prevalent in the medical literature. Most of the work in this area comes from high‐income countries, with the remainder from upper‐middle‐income countries, and very little from lower‐middle‐income or low‐income countries. Sub‐Saharan Africa is particularly poorly represented in this body of literature. Anglo‐American concepts are often applied to different jurisdictions without consideration of cultural and societal differences. However, anesthesia providers in this region have unique challenges, with both the highest burden of "surgical" disease in the world and the least resources, both in terms of human resources for health and in terms of essential drugs and equipment. The effect of burnout on healthcare systems is also likely to be very different with the current human resources for the health crisis in East and Central Africa. According to the Joint Learning Initiative Managing for Performance framework, the three essential factors for building a workforce to effectively support a healthcare system are coverage, competence, and motivation. Current efforts to build capacity in anesthesia in East and Southern Africa focus largely on coverage and competence, but neglect motivation at the risk of failing to support a sustainable workforce. In this paper, we include a review of the relevant literature, as well as draw from personal experience living and working in East and Southern Africa, to describe the unique issues surrounding burnout, resilience, and wellness in this region. [ABSTRACT FROM AUTHOR]

The paper empirically analyzes the financial development (FD)-growth nexus, and the financial development-total factor productivity (TFP) link in sub-Saharan Africa. The study is based on a VAR approach: Johansen cointegration tests and error correction models. The sample includes 22 countries over the period from 1960 to 2002. Results suggest that FD and economic growth and, FD and TFP are cointegrated for many countries. Moreover, in many cases, the relationship between FD and growth is characterized by bidirectional causality in the Granger sense, whereas the relation between FD and TFP is characterized by a unidirectional causality running from FD to TFP. With few exceptions, it appears that financial development spurs economic growth in countries where that growth is supported by technological progress. The implication of the findings is that any reform that causes betterment in the financial sector will foster economic growth through a sharp increase in technological progress. [ABSTRACT FROM AUTHOR]

Despite Africa's reputation as a place of political repression and limited popular agency, activism and popular mobilisation have been central to political change in colonial and post-colonial Africa. The social and cultural identity of activists has been neglected by historians, who have commonly studied activism through imposed normative frameworks (e.g. class struggle or decolonisation) that have not always been central to the motivations of activists themselves. This article identifies and analyses specific phases of popular activism. Mass mobilisation was crucial to the success of anti-colonial nationalism, but did not commonly result in governments that addressed the aspirations or grievances of activists. From the 1970s, African governments became vulnerable to popular pressure, in the form of urban riots and uprisings, but attempts to establish more institutionalised pressure groups for change were not generally successful. The pro-democracy movements of the early 1990s again utilised mass mobilisation to achieve their aims, but the advent of multi-party democracy across the continent did not translate into meaningful popular reform. Since 2000, popular movements have expressed discontent with neo-liberal economic policies and authoritarian governments. The Arab Spring has inspired new waves of activism, but it remains unclear whether this will bring about significant political change across the continent. Two underlying linked themes will be analysed in the paper. Firstly, the interaction between local activism and broader ideological movements and influences (nationalism, socialism, religious belief, etc): to what extent have these ideological frameworks, commonly introduced by external agents, assisted or hampered in the development of discourses of resistance or activism? Secondly, African activists, in contrast to their western counterparts, have commonly operated in relationship to both local state and western or international elites, including colonial governments, multinational corporations and international donors. The paper will examine the extent to which these relationships have shaped the ideas and behaviour of African movements. [ABSTRACT FROM AUTHOR]

Abstract: This paper studies the role played by the quality of property rights in the linkages of international capital flows into sub‐Saharan African (SSA) economies. Using panel data of 36 SSA countries over the period 1996–2015 and the ARDL procedure with the Pooled Mean Group regression method appropriate for non‐stationary panel data estimation, we account for the joint effects of property rights quality and openness to foreign capital flows on economic growth. We uncover the existence of a property rights quality threshold beyond which property rights either amplifies the spillovers effects or attenuates the negative effect of capital flows on economic growth. For instance, it takes a level of property rights of at least 60 to have a positive long‐term impact of capital flows on economic growth in natural resource‐poor African countries. The quality of property rights matters more to obtain spillover effects of capital flows on growth in natural resource‐poor countries than in their peer natural resource‐rich countries. Finally, with regard to the countries' income levels, capital flows have significant long‐term spillovers effects on economic growth in advanced African economies than in their low‐income peers. [ABSTRACT FROM AUTHOR]

This paper explores the impact of the institutional environment on the performance of 291 microfinance institutions in 34 sub-Saharan Africa countries during the period 2006 to 2014, by analysing the unbalanced panel data using fixed effects and generalized method of moments (GMM) estimation techniques. The panel regression results demonstrate strong evidence that a strong institutional environment has a positive effect on the performance of microfinance institutions in sub-Saharan Africa. More specifically, the findings reveal a positive and significant relationship between business freedom and microfinance performance in sub-Saharan Africa. These vital findings not only provide useful information to policy makers and key microfinance industry players, but also highlight the impact that institutional qualities have on microfinance performance. [ABSTRACT FROM AUTHOR]

This paper argues that food security and human development are intricately linked, and that meaningful progress on the one cannot be sustained without concomitant progress on the other. The paper surveys recent research on various aspects of the linkages between food security and human development and highlights areas where further research would enrich our understanding of the complex interactions and synergies between the two. It concludes by calling for a more systematic investigation of the human development-food security nexus with a view to generating new and practical insights for improving food security and advancing human development in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

This paper reflects on issues raised by work with children in an ongoing child mobility study in three sub-Saharan African countries: Ghana, Malawi and South Africa. There are now 70 school pupils of varying ages involved in the project, but the paper is particularly concerned with the participation of those children 14 years and under. We examine the significant ethical issues associated with working with younger child researchers, and linked questions concerning the spaces open to them in African contexts where local cultural constructions of childhood and associated economic imperatives (which commonly drive family and household endeavour) help shape the attitudes of adults to children’s rights and responsibilities and inter-generational power relations. [ABSTRACT FROM AUTHOR]

To the extent that in utero and childhood malnutrition negatively affects later stage mental and physical health, it can possibly constrain later stage human capital acquisition, which is an important driver of economic growth. This paper considers the impact of famine on aggregate adolescent human capital formation in sub-Saharan Africa. We parameterize a joint adolescent human capital and food nutrition production function to estimate the effects of famine on years of primary school completed by individuals aged 15-19. Mixed fixed and random coefficient parameter estimates for 32 sub-Saharan African countries between 1980 and 2010 reveal that years of primary school completed by adolescents is proportional to the quantity of food and nutrition produced during childhood and in utero. This suggests that declines in food production and nutrition associated with famine in sub-Saharan Africa have large negative effects on the acquisition of human capital by adolescents and on long-run material living standards. Our findings show that there is yet another consequence to famine, a long-run reduction in adolescent human capital, and this should reinforce the case for strong food security programmes in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

This paper reassesses the gains from trade for sub-Saharan Africa, and draws their implications for labour market adjustment and poverty reduction. It reviews previous studies on multilateral liberalization, focusing on the findings from Computable General Equilibrium (CGE) models with relevance to African economies. The implications of these findings for poverty reduction are discussed. Our own CGE exercise supports the hypothesis that African countries cannot expect substantial gains from further multilateral liberalization. Moreover, given the sharp contraction of import-competing sectors in response to trade liberalization in many African economies, coupled with insufficient compensation through labour market adjustments in other sectors, this study suggests that the ultimate impact on poverty reduction is likely to be small or even negative. [ABSTRACT FROM AUTHOR]

Introduction: Cash transfers have been promoted as a means to reduce HIV risk for adolescent girls and young women (AGYW) in sub‐Saharan Africa. One of the main mechanisms whereby they are hypothesized to reduce risk is by deterring transactional sex. In this paper, we use qualitative methods to explore participant experiences, perspectives and reported behaviours of a cash transfer plus financial education programme among out of school, 15‐ to 23‐year‐old AGYWs in rural Tanzania with a focus on partner choice and transactional sex. Methods: We conducted 60 in‐depth interviews (IDIs) and 20 narrative timeline interviews with participants of the PEPFAR DREAMS Sauti/WORTH+ cash transfer programme between June 2017 and July 2018. Interviews were taped, transcribed and translated from Kiswahili to English. Transcripts were coded and analysed for key themes. Results: We found that participants in a cash transfer plus programme discussed behaviours that could reduce HIV risk through decreasing their dependence on male sex partners. There appeared to be two main mechanisms for this. One, young women discussed the cash transfer providing for basic needs (e.g. food, toiletries) which appeared to reduce their dependence on male sex partners who previously provided these goods (e.g. transactional sex). This experience was more pronounced among the poorest participants. Two, young women discussed how the financial education/business development aspect of the programme empowered them to refuse some sex partners; unmarried women discussed these experiences more than married women. Social support from family and programme mentors appeared to strengthen young women's ability to successful start businesses, produce income and thus be less dependent on partners. Conclusions: The cash transfer programme may have reduced AGYW engagement in transactional sex that occurred to meet basic needs (one form of transactional sex). The financial education/business development and mentorship elements of the programme appeared important in building AGYW agency, self‐esteem and future orientation which may support AGYWs in refusing unwanted sex partners. Future cash plus programmes should consider adding or strengthening financial education and job skills training, mentorship and future orientation to see stronger and perhaps sustainable outcomes for HIV prevention. [ABSTRACT FROM AUTHOR]