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Background: For men who have sex with men (MSM) across sub-Saharan Africa (SSA), disclosure of same-sex practices to family and healthcare workers (HCWs) can facilitate access to HIV prevention services and support, but can also lead to experiences of stigma.Methods: We performed mixed-effects regressions on pooled data from MSM in Cameroon, Senegal, Côte d'Ivoire, Lesotho, and eSwatini to assess associations between disclosure and sexual behavior stigma in healthcare contexts; we used logistic regressions to analyze country-specific data.Results: Compared to participants who had not disclosed to either family or HCWs, those who had disclosed only to family were more likely to have been gossiped about by HCWs (aOR = 1.70, CI = 1.18, 2.45); the association between having disclosed to family and having felt mistreated in a health center approached, but did not achieve, statistical significance (aOR = 1.56, CI = 0.94, 2.59). Those who had disclosed only to HCWs were more likely to have feared to seek health services (aOR = 1.60, CI = 1.14, 2.25), avoided health services (aOR = 1.74, CI = 1.22, 2.50), and felt mistreated in a health center (aOR = 2.62, CI = 1.43, 4.81). Those who had disclosed to both were more likely to have feared to seek health services (aOR = 1.71, CI = 1.16, 2.52), avoided health services (aOR = 1.59, CI = 1.04, 2.42), been gossiped about by HCWs (aOR = 3.78, CI = 2.38, 5.99), and felt mistreated in a health center (aOR = 3.39, CI = 1.86, 6.20). Country-specific analyses suggested that data from Cameroon drove several of these associations.Conclusions: Research to determine the factors driving disclosure's differential effect on healthcare stigma across contexts is needed. Ultimately, supportive environments enabling safe disclosure is critical to understanding HIV-acquisition risks and informing differentiated HIV-prevention, treatment, and testing services for MSM across SSA. [ABSTRACT FROM AUTHOR]

There is growing recognition that hybrid organizations can play a critical role in tackling intractable global sustainable development challenges. At the same time, acute social, environmental, and economic challenges are opening up "opportunity" spaces for hybrids. Different institutional contexts are also leading to variable hybrid forms linked to the focus of their mission and their profit-oriented status. This article presents a process for identifying, mapping, and building impact indicators based on a study of 20 hybrid organizations in Sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

We exploit the West African Ebola epidemic as an event that necessitated the provision of a common-interest public good, Ebola control measures, to empirically investigate the effect of public good provision on state legitimacy. Our results show that state legitimacy, measured by trust in government authorities, increased with exposure to the epidemic. We argue, supported by results from SMS-message-based surveys, that a potentially important channel underlying this finding is a greater valuation of control measures in regions with intense transmission. Evidence further indicates that the effects of Ebola exposure are more pronounced in areas where governments responded relatively robustly to the epidemic. [ABSTRACT FROM AUTHOR]

Due to a lack of piped water, household members in sub-Saharan Africa, typically girls, fetch water from sources outside the home. We offer the first econometric study that considers a fetching water/schooling time tradeoff as a possible and partial explanation for the relatively high dropout rate for girls in school. Our empirical technique fist estimates a baseline probit where the dependent variable is one if the individual is enrolled in school and zero if the individual is not enrolled. The covariates are factors which may influence school attendance. However, such a specification may be vulnerable to omitted variable bias. To account for this possibility, we estimate the average treatment effect by augmenting the probit model with instruments which may induce 'treatment' of time spent fetching water i.e. whether the individual resides in a household connected to electricity. Our data is drawn from the 2004/2005 Kenya Integrated Household Budget Survey. Our findings shed new light. In particular, we find that the interaction between the female dummy variable and time spent fetching water is negative and statically significant suggesting that the incidence of not attending school, due to fetching water, is relatively higher for females. This finding is further reinforced by the coefficient on the female dummy variable which is negative and statistically significant, suggesting that being female in Kenya, and in much of SSA, reduces the probability of enrolling and spending time in school. Taken together, our findings are consistent with the notion, and provide evidence for the anecdotal view in the literature that the high dropout rate for girls in school may in part be explained by a fetching water/schooling time tradeoff. To reduce the time individuals spend fetching water from sources outside the home, we suggest that a policy prescription that offers a requisite infrastructure, typically provided for through public means, may reduce the cost for households of connecting piped water to their homes. Importantly, such a policy action would be effective in reducing the time spent fetching water not only for females but for males as well. [ABSTRACT FROM AUTHOR]

We consider a Markovian SIR-type (Susceptible → Infected → Recovered) stochastic epidemic process with multiple modes of transmission on a contact network. The network is given by a random graph following a multilayer configuration model where edges in different layers correspond to potentially infectious contacts of different types. We assume that the graph structure evolves in response to the epidemic via activation or deactivation of edges of infectious nodes. We derive a large graph limit theorem that gives a system of ordinary differential equations (ODEs) describing the evolution of quantities of interest, such as the proportions of infected and susceptible vertices, as the number of nodes tends to infinity. Analysis of the limiting system elucidates how the coupling of edge activation and deactivation to infection status affects disease dynamics, as illustrated by a two-layer network example with edge types corresponding to community and healthcare contacts. Our theorem extends some earlier results describing the deterministic limit of stochastic SIR processes on static, single-layer configuration model graphs. We also describe precisely the conditions for equivalence between our limiting ODEs and the systems obtained via pair approximation, which are widely used in the epidemiological and ecological literature to approximate disease dynamics on networks. The flexible modeling framework and asymptotic results have potential application to many disease settings including Ebola dynamics in West Africa, which was the original motivation for this study. [ABSTRACT FROM AUTHOR]

The presence of an exceptionally large youth population, that is, a youth bulge, is often associated with an elevated risk of civil conflict. In this article, we develop an instrumental variable approach in which the size of the youth cohorts in Sub-Saharan Africa is identified using variation in birth-year drought incidence. Our results show that an increase in the size of the population group aged fifteen to nineteen raises the risk of low-intensity conflict. A 1 percent increase in the size of this age-group augments the likelihood of civil conflict incidence (onset) by 2.3 (1.2) percentage points. On the other hand, we do not find any association between the size of the two adjacent youth cohorts, that is, the population groups aged ten to fourteen and twenty to twenty-four. [ABSTRACT FROM AUTHOR]

Cognitive health is an important dimension of well-being in older ages, but few studies have investigated the demography of cognitive health in sub-Saharan Africa’s growing population of mature adults (= persons aged 45+). We use data from the Malawi Longitudinal Study of Families and Health to document the age and gender patterns of cognitive health, the contextual and life-course correlates of poor cognitive health, and the understudied linkages between cognitive and physical/mental well-being. Surprisingly, the age pattern of decline in cognitive health is broadly similar to that observed in the USA. We also find that women have substantially worse cognitive health than men and experience a steeper age gradient in cognitive ability. Strong social ties and exposure to socially complex environments are associated with higher cognitive health, as is higher socioeconomic status. Poor cognitive health is associated with adverse social and economic well-being outcomes such as less nutrition intake, lower income, and reduced work efforts even in this subsistence agriculture context. Lower levels of cognitive health are also strongly associated with increased levels of depression and anxiety and are associated with worse physical health measured through both self-reports and physical performance. Our findings suggest that cognition plays a key—but understudied—role in shaping late-life well-being in low-income populations. [ABSTRACT FROM AUTHOR]

The article offers information on the Africa by the professor and Vice President of the Federal Republic of Nigeria, Oluyemi Oluleke Osinbajo. The topics addressed include details on experiences of Oluyemi during a talk at the Harvard Business School; unemployment in Africa; and details on malnutrition in children which is growth and poor development of the brain ability of both individual and society.

Community-based conservation (CBC) institutions are widely regarded as transformative bodies that benefit social and ecological processes in coupled social-ecological systems. Yet, limited empirical evidence for this claim exists, especially on the African continent where community-based conservancies (CBCs) are being rapidly adopted in diverse institutional forms across multiple countries. We provide the first large-scale systematic review of CBC outcomes in sub-Saharan Africa. We review the literature on CBCs and develop a conceptual model that illustrates the nested scales of interaction in which CBCs are embedded, the institutional processes ("conditions") reported as important for success, and the outcomes of CBCs on social and ecological systems. The mixed-method approach consists of inductive/deductive textual analysis of cases, geospatial visualization, descriptive statistics, and correlational analysis. Results indicate that more often than not, establishment of CBCs in Africa has led to negative or a mixture of positive and negative social outcomes, whereas ecological outcomes have been largely positive. The research conducted on CBC institutions has overwhelmingly focused on social outcomes, using qualitative methods. Monetary and nonmonetary incentives seem to be important but not sufficient on their own for positive outcomes. Devolution of rights to the local community is significantly associated with CBC outcomes but was not present in many cases, despite this feature being a hallmark of CBCs. A number of conditions were not reported in the cases reviewed, including leadership, social learning, consideration of cultural worldviews, and diverse partnerships. We provide indepth examples of the types and diversity of outcomes and contexts underpinning the presence or absence of societal processes, highlight important gaps in the existing research, and offer guidelines for research and evaluation moving forward. [ABSTRACT FROM AUTHOR]

In a continent that hordes many illnesses and conditions it is surprising that many do not have the means to see a healthcare specialist when they need one desperately. This discussion addressed the situation in which many Africans continue to find themselves when confronting their many ailments. The continent was deprived from its wealth of natural and affordable potent ways of curing diseases and today many who are sick often find themselves left to a dismal fate. There is a prospect and possibility to seize and engage in entrepreneurship: Investing in a healthcare system in many countries in the African continent, the beginning of the solution to the lack of healthcare access in Africa. This reflection breaks ground by offering a theoretical model of failed healthcare systems remedied by the creation of African Healthcare Corps, a call for the urgency for Africans to rethink the current untenable healthcare situation in Africa [ABSTRACT FROM AUTHOR]

Authoritarian resilience is not only a function of a state's domestic politics. International relations also may provide much support when authoritarian governments need it most. In the case of Zimbabwe, Robert Mugabe and the ruling Zimbabwe African National Union-Patriotic Front (ZANU-PF) relied on support from neighboring states in the Southern African Development Community (SADC), including a permissive South Africa, despite severely flawed elections in 2002, 2008, and 2013. Why have neighboring states often turned a blind eye to electoral abuses in Zimbabwe? Our main argument is that Zimbabwe's neighbors are complicit in allowing the erosion of democracy in Zimbabwe because political incumbents across Southern Africa give priority to ruling-group survival. In this instance, the domestic imperative of political survival is underpinned by a collective international norm of political solidarity that originated in a shared, formative experience of national liberation struggles against white settler colonialism. Resulting ruling-group solidarity has been a strong enough force to trump a ruling group's material interests. To sustain their support of ZANU-PF, the governments of Southern Africa have been willing to incur considerable costs in the form of reduced investment opportunities, impeded trade, unpaid public debts, and a burdensome flood of refugees and migrants. The concept of ruling-group solidarity helps explain an important mechanism that contributes to democracy prevention, particularly in the Southern African context. [ABSTRACT FROM AUTHOR]

Objectives: This paper presents the results of the consultations conducted with various stakeholders in Africa and other experts to document community perspectives on the types of research to be prioritised in outbreak conditions. The Delphi method was used to distill consensus. Results: Our consultations highlighted as key, the notion that in an infectious disease outbreak situation, the need to establish an evidence base on how to reduce morbidity and mortality in real time takes precedence over the production of generalizable knowledge. Research studies that foster understanding of how disease transmission could be prevented in the future remain important, implementation research that explores how to mitigate the impact of outbreaks in the present should be prioritized. Clinical trials aiming to establish the safety profile of therapeutic interventions should be limited during the acute phase of an epidemic with high fatality--and should preferably use adaptive designs. We concluded that community members have valuable perspectives to share about research priorities during infectious disease emergencies. Well designed consultative processes could help identify these opinions. [ABSTRACT FROM AUTHOR]

This article critically analyzes the popular metaphor of the "Development Ladder" within the theory of modernization. What assumptions underpin this metaphor and what problems are associated with the theory itself? I use the work of Sachs as a modern example of a text that relies extensively on the metaphor. I discuss the key assumptions informing the modernization theory and the metaphor of the Development Ladder. Next, I problematize the metaphor as rooted within modernization theory, discuss the assumptions of modernization theory, the implication of globalization on Africa and its relationship to the global market, and present and discuss the problems of historicity in development discourse. [ABSTRACT FROM AUTHOR]

"Education is the most powerful weapon that can be used to change the world." Many families in African countries have taken solace in education as means of liberating and empowering members for better living. This investigative study explored the factors that influence parents in their choice of schools for their children using Nigerian contexts as a sub-Saharan country for others. The aim of this study was to investigate various factors that determine choice of schools by parents for their children, and to determine whether parents' influence on the choice of school affect the academic performance of these adolescents. The theoretical framework of rational choice theory, market theory and choice theory provided empirical evidence. 100 senior secondary school students and 100 parents from Lagos were the participants for this study using the stratified sampling procedure. A descriptive cross sectional survey design with self-constructed questionnaire was used as the research instrument. The validity of the instrument was tested using the expert opinion method while the reliability was tested with a test re-test method which indicated a co-efficient of 0.71. The correlation coefficient method was used to analyze the data collected from the experiment at five percent level of significance, while five hypotheses were tested. The findings of the study revealed that there is a statistically significant relationship among parents' influence, socioeconomic and educational background, parents' educational aspirations for their children, adolescents' academic performance, parents' expectation on quality of education and choice of schools as related to cost of education. Recommendations were made to attract parents to schools. [ABSTRACT FROM AUTHOR]

Current discussions generally focus on “when” the first ‘Out of Africa’ hominin settlements occurred. We propose a short review of some of the assumptions underlying the ‘Out of Africa’ dispersal scenarios and their reappraisal in the light of the palaeoanthropological and archaeological records. Globally, these scenarios are still hypotheses; however, some of them can be outlined in more concrete terms, based on the discoveries in the Levant, the Caucasus and Eastern Asia. Dispersals from Africa were multidirectional, with many successive discontinuous occupations and episodes of turning back. Hominins displayed strong adaptive capacities to new environmental conditions, linked to the notion of versatility, which is already present in Early Pleistocene hominins. Factors often proposed to explain the first ‘Out of Africa’ settlements, such as climatic change, new cultural behavior, and increase in body size and brain size do not seem to be relevant according to the fossil and archaeological records. [ABSTRACT FROM AUTHOR]

The fall of the Berlin Wall in October 1989 bears a striking resonance with the biblical fracturing of the curtain in the Jerusalem temple. It presaged the death of the post-war dispensation of Church-state relations characterised by a Church that was, in the main, subservient, acquiescent and complicit to the apartheid regime in South Africa, as well as the oppressive one-party state regimes north of the Limpopo. As the Berlin Wall collapsed, the dispensation characterised by either neutrality or docility and co-option of the Church to the Apartheid and Independent states gave way to the birth of a 'prophetic' Church, which would not only gain a new lease on life, but would become a robust interlocutor of the post-Cold War state. The latter is exemplified by historical signposts such as the Rustenburg Declaration (1990), the Pastoral letter of the Zambia Catholic Bishops Conference (1990) and the Pastoral letter by the Catholic Bishops of Malawi (1992), among others. This paper is an analytical desktop study, which will be based on the published literature. [ABSTRACT FROM AUTHOR]

Background: Health systems are essential platforms for accessible, quality health services, and population health improvements. Global health initiatives have dramatically increased health resources; however, funding to strengthen health systems has not increased commensurately, partially due to concerns about health system complexity and evidence gaps demonstrating health outcome improvements. In 2009, the African Health Initiative of the Doris Duke Charitable Foundation began supporting Population Health Implementation and Training Partnership projects in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze significant advances in strengthening health systems. This manuscript reflects on the experience of establishing an evaluation framework to measure health systems strength, and associate measures with health outcomes, as part of this Initiative.Methods: Using the World Health Organization's health systems building block framework, the Partnerships present novel approaches to measure health systems building blocks and summarize data across and within building blocks to facilitate analytic procedures. Three Partnerships developed summary measures spanning the building blocks using principal component analysis (Ghana and Tanzania) or the balanced scorecard (Zambia). Other Partnerships developed summary measures to simplify multiple indicators within individual building blocks, including health information systems (Mozambique), and service delivery (Rwanda). At the end of the project intervention period, one to two key informants from each Partnership's leadership team were asked to list - in rank order - the importance of the six building blocks in relation to their intervention.Results: Though there were differences across Partnerships, service delivery and information systems were reported to be the most common focus of interventions, followed by health workforce and leadership and governance. Medical products, vaccines and technologies, and health financing, were the building blocks reported to be of lower focus.Conclusion: The African Health Initiative experience furthers the science of evaluation for health systems strengthening, highlighting areas for further methodological development - including the development of valid, feasible measures sensitive to interventions in multiple contexts (particularly in leadership and governance) and describing interactions across building blocks; in developing summary statistics to facilitate testing intervention effects on health systems and associations with health status; and designing appropriate analytic models for complex, multi-level open health systems. [ABSTRACT FROM AUTHOR]

The topic of pan-Africanism today brings to the fore questions of the unfinished humanistic project of decolonisation in Africa. When Kwasi Wiredu (1996) calls for the need for conceptual decolonisation in Africa, he recognises the intellectual price the continent continues to pay as a result of conceptual confusions and distortions caused by a colonial conceptual idiom implanted in the African mind. Reflecting on the potential which the ideology of pan-Africanism holds for the continent's future, my position is that the same passion and energy which brought about political independence should now be redirected to the epistemic front. A new form of pan-Africanism on the intellectual front is required to galvanise Africans to develop and deploy in their thinking veritable categories of analysis born out of the experiences of being African in Africa. It is in the generation and application of these alternative epistemologies that the future of the continent lies. [ABSTRACT FROM AUTHOR]

How can we analyse the dynamics of social structure in Africa today? This Debate piece argues that a Bourdieu-inspired, multidimensional class analysis opens promising perspectives for understanding class dynamics in Africa. This implies notably bridging objectivist and subjectivist approaches to class analysis, and working with a multidimensional idea of the social space. [ABSTRACT FROM AUTHOR]

The demand for energy in Sub-Saharan African (SSA) countries is rapidly increasing. This can be attributed to the increase in human population and standard of living in the region. Owing to the increasing energy demand, there is a need for proper energy planning. Energy system models are used in exploring the energy futures of countries and regions. Use of the wrong models has resulted in unrealistic projections and consequently poor energy policies. It is against this backdrop that this study was conceived. This paper aims to identify what class of energy system models that are most suitable for energy system analysis in SSA countries. Literature was initially reviewed to understand the basic characteristics of the energy systems of SSA countries. The paper then heads on to systematically identify what types of energy system models have been used in SSA countries, using the Scopus database search platform. The result of this extensive review suggests that the bottom-up optimization and the accounting framework class of energy models are best suited for SSA countries. However, the paper further opine that the existing energy system models are not capable of characterizing the energy system of SSA countries fully. Hence, there is a need to develop new energy system models or modify the already existing ones in order to capture all the features of SSA countries. Thus, this study will be of importance to energy analysts, researchers and policy makers when selecting energy system models. [ABSTRACT FROM AUTHOR]

The article discusses significance of climate change as a feminist issue. It states that possible impact of climate change on lives of women across the world, such as women and girls in sub-Saharan Africa, who are responsible for collection of water in the region, and mentions that diseases from contaminated water kill more people than any form of violence. It notes that women account for a majority of agricultural sector in Africa, but they remain vulnerable and poor.

This paper argues that in the seven novels of Ghanaian novelist Ayi Kwei Armah, beauty is approached as a trope, and that the absence of beauty denotes the postcolonial condition whose moral code translates horrid social relations, corrupt politics and massive failure. Thus, the beauty of the African locale should function as an incentive to alter the ugliness of the present, and advance the cultural renaissance that Armah envisages for Africa. As such beauty operates as an aesthetic incentive wherein inspiration from the natural locale is transmuted into university curricula, revamping authentic African values for the pressing need of development changes. [ABSTRACT FROM AUTHOR]

Concern about persecution of person(s) accused of witchcraft practices has long been recognized as a major issue in sub-Saharan Africa. In Nigeria, the persecution of elderly women suspected to be witches is predominantly widespread, and has been identified as one of the most important obstacle to the attainment of the December, 1993 Declaration of the UN General Assembly on elimination of violence against women on the continent. Torturing and various forms of violence against elderly women accused of witchcraft without evidence against them implies major infringements of their fundamental Human Rights as enshrined in Article 5 of the Universal Declaration of Human Rights which stipulates that no one shall be subjected to torture or to cruel, inhuman, or degrading treatment or punishment. Despite this and other similar instruments, persecution of elderly women suspected of witchcraft remains unabated in Nigeria. Furthermore, there is little scholarly work and insufficient government policies in Nigeria to address this issue. This paper is an attempt to bridge this gap. [ABSTRACT FROM AUTHOR]

Background: The problem of intermittent piped water supplies that exists in low- and middle-income countries is particularly severe in the slums of sub-Saharan Africa. However, little is known about whether there is deterioration of the microbiological quality of the intermittent piped water supply at a household level and whether it is a factor in reducing or increasing the occurrence of acute diarrhea among under-five children in slums of Addis Ababa. This study aimed to determine the association of intermittent piped water supplies and point-of-use (POU) contamination of household stored water by Escherichia coli (E. coli) with acute diarrhea among under-five children in slums of Addis Ababa. Methods: A community-based matched case-control study was conducted from November to December, 2014. Cases were defined as under-five children with acute diarrhea during the two weeks before the survey. Controls were matched by age and neighborhood with cases by individual matching. Data were collected using a pre-tested structured questionnaire and E. coli analysis of water from piped water supplies and household stored water. A five-tube method of Most Probable Number (MPN)/100 ml standard procedure was used for E. coli analysis. Multivariable conditional logistic regression with 95% confidence interval (CI) was used for data analysis by controlling potential confounding effects of selected socio-demographic characteristics. Main findings: During the two weeks before the survey, 87.9% of case households and 51.0% of control households had an intermittent piped water supply for an average of 4.3 days and 3.9 days, respectively. POU contamination of household stored water by E. coli was found in 83.3% of the case households, and 52.1% of the control households. In a fully adjusted model, a periodically intermittent piped water supply (adjusted matched odds ratio (adjusted mOR) = 4.8; 95% CI: 1.3–17.8), POU water contamination in household stored water by E. coli (adjusted mOR = 3.3; 95% CI: 1.1–10.1), water retrieved from water storage containers using handle-less vessels (adjusted mOR = 16.3; 95% CI: 4.4–60.1), and water retrieved by interchangeably using vessels both with and without handle (adjusted mOR = 5.4; 95% CI: 1.1–29.1) were independently associated with acute diarrhea. Conclusion: We conclude that provision of continuously available piped water supplies and education of caregivers about proper water retrieval methods of household stored water can effectively reduce POU contamination of water at the household level and thereby reduce acute diarrhea among under-five children in slums of Addis Ababa. Promotion of household water treatment is also highly encouraged until the City’s water authority is able to deliver continuously available piped water supplies. [ABSTRACT FROM AUTHOR]

BACKGROUND Cross-sectional analyses of the relationship between contraceptive prevalence and the total fertility rate of developing countries show the expected strong negative correlation. However, this correlation is much weaker in sub-Saharan Africa than in the developing world as a whole. OBJECTIVE This paper aims to explain the unexpected weak effect of contraceptive use on fertility in sub-Saharan African countries by using different regression models to obtain unbiased effects. METHOD Using DHS survey data from 40 developing countries, the analysis consists of three steps: 1) examine the conventional cross-sectional TFR-CPR relationship by region at the time of the latest available surveys; 2) remove known technical flaws in the comparisons of fertility and contraceptive prevalence; and 3) analyze multiple observations of TFR and CPR per country using pooled OLS and fixed effect regressions. RESULTS The conventional cross-sectional analyses produce biased results, in part because technical factors, in particular postpartum overlap, create a downward bias in the effect of contraceptive prevalence on fertility in sub-Saharan Africa. In addition, and more importantly, the cross-sectional regression OLS parameters have a bias due to confounding country fixed effects. Technical adjustments and the use of fixed-effect models remove these biases. CONCLUSION A rise in contraceptive prevalence among fecund women has the same average effect on fertility in sub-Saharan Africa as in other regions of the developing world. [ABSTRACT FROM AUTHOR]

Ebola virus causes a severe haemorrhagic fever in humans with high case fatality and significant epidemic potential. The 2013-2016 outbreak inWest Africa was unprecedented in scale, being larger than all previous outbreaks combined, with 28 646 reported cases and 11 323 reported deaths. It was also unique in its geographical distribution and multi country spread. It is vital that the lessons learned from the world's largest Ebola outbreak are not lost. This article aims to provide a detailed description of the evolution of the outbreak. We contextualize this outbreak in relation to previous Ebola outbreaks and outline the theories regarding its origins and emergence. The outbreak is described by country, in chronological order, including epidemiological parameters and implementation of outbreak containment strategies. We then summarize the factors that led to rapid and extensive propagation, as well as highlight the key successes, failures and lessons learned from this outbreak and the response. [ABSTRACT FROM AUTHOR]

The 2013-2016 Ebola outbreak in West Africa is the largest on record with 28 616 confirmed, probable and suspected cases and 11 310 deaths officially recorded by 10 June 2016, the true burden probably considerably higher. The case fatality ratio (CFR: proportion of cases that are fatal) is a key indicator of disease severity useful for gauging the appropriate public health response and for evaluating treatment benefits, if estimated accurately .We analysed individual-level clinical outcome data from Guinea, Liberia and Sierra Leone officially reported to the World Health Organization. The overall mean CFR was 62.9% (95% CI: 61.9% to 64.0%) among confirmed cases with recorded clinical outcomes. Age was the most important modifier of survival probabilities, but country, stage of the epidemic and whether patients were hospitalized also played roles. We developed a statistical analysis to detect outliers in CFR between districts of residence and treatment centres (TCs), adjusting for known factors influencing survival and identified eight districts and three TCs with a CFR significantly different from the average. From the current dataset, we cannot determine whether the observed variation in CFR seen by district or treatment centre reflects real differences in survival, related to the quality of care or other factors or was caused by differences in reporting practices or case ascertainment. [ABSTRACT FROM AUTHOR]

The recent Ebola epidemic in West Africa highlights how engaging with the sociocultural dimensions of epidemics is critical to mounting an effective outbreak response. Community engagement was pivotal to ending the epidemic and will be to post-Ebola recovery, health system strengthening and future epidemic preparedness and response. Extensive literatures in the social sciences have emphasized how simple notions of community, which project solidarity onto complex hierarchies and politics, can lead to ineffective policies and unintended consequences at the local level, including doing harm to vulnerable populations. This article reflects on the nature of community engagement during the Ebola epidemic and demonstrates a disjuncture between local realities and what is being imagined in post-Ebola reports about the lessons that need to be learned for the future. We argue that to achieve stated aims of building trust and strengthening outbreak response and health systems, public health institutions need to reorientate their conceptualization of 'the community' and develop ways of working which take complex social and political relationships into account. [ABSTRACT FROM AUTHOR]

The Ebola epidemic in West Africa was stopped by an enormous concerted effort of local communities and national and international organizations. It is not clear, however, how much the public health response and behavioural changes in affected communities, respectively, contributed to ending the outbreak. Here, we analyse the epidemic in Lofa County, Liberia, lasting from March to November 2014, by reporting a comprehensive time line of events and estimating the time-varying transmission intensity using a mathematical model of Ebola transmission. Model fits to the epidemic show an alternation of peaks and troughs in transmission, consistent with highly heterogeneous spread. This is combined with an overall decline in the reproduction number of Ebola transmission from early August, coinciding with an expansion of the local Ebola treatment centre. We estimate that healthcare seeking approximately doubled over the course of the outbreak, and that isolation of those seeking healthcare reduced their reproduction number by 62%(mean estimate, 95% credible interval (CI) 59-66). Both expansion of bed availability and improved healthcare seeking contributed to ending the epidemic, highlighting the importance of community engagement alongside clinical intervention. [ABSTRACT FROM AUTHOR]

During the initial months of the 2013-2016 Ebola epidemic, rapid geographical dissemination and intense transmission challenged response efforts across West Africa. Contextual behaviours associated with increased risk of exposure included travel to high-transmission settings, caring for sick and preparing the deceased for traditional funerals. Although such behaviours are widespread in West Africa, high-transmission pockets were observed. Superspreading and clustering are typical phenomena in infectious disease outbreaks, as a relatively small number of transmission chains are often responsible for the majority of events. Determining the characteristics of contacts at greatest risk of developing disease and of cases with greatest transmission potential could therefore help curb propagation of infection. Our analysis of contact tracing data from Montserrado County, Liberia, suggested that the probability of transmission was 4.5 times higher for individuals who were reported as having contact with multiple cases. The probability of individuals developing disease was not significantly associated with age or sex of their source case but was higher when they were in the same household as the infectious case. Surveillance efforts for rapidly identifying symptomatic individuals and effectively messaged campaigns encouraging household members to bring the sick to designated treatment centres without administration of home care could mitigate transmission. [ABSTRACT FROM AUTHOR]

We present evidence that the traditional structure of society is an important determinant of the scope of trust today. Within Africa, individuals belonging to ethnic groups that organized society using segmentary lineages exhibit a more limited scope of trust, measured by the gap between trust in relatives and trust in non-relatives. This trust gap arises because of lower levels of trust in non-relatives and not higher levels of trust in relatives. A causal interpretation of these correlations is supported by the fact that the effects are primarily found in rural areas where these forms of organization are still prevalent. [ABSTRACT FROM AUTHOR]

An interview with Nahas Angula, former prime minister of the Republic of Namibia, is presented. He discusses the establishment of the Pan-African Institute for the Study of African Society (PAISAS) by a group of Pan-Africanists. Angula explains the aim of PAISAS to research and document the African experience and the African condition. He also comments on the relationship between PAISAS and the African Union.

Background: Civil wars and wars between states have occurred less frequently since the start of the 21st century, but civil insecurity outside the contexts of official wars continues to plague many parts of the world. The nutritional consequences of civil insecurity may disproportionately affect children, especially if experienced during sensitive developmental periods. Objectives: This study estimated the associations between localized nonviolent and violent civil insecurity during key child nutritional periods and subsequent height-for-age z scores (HAZs) in 145,948 children born between 1998 and 2014 in Africa and examined the type of place of residence as a mediating factor. Design: A collection of 61 geo-referenced Demographic and Health Surveys implemented between 1998 and 2014 were merged with data from the high-resolution Armed Conflict Location and Event Data Project to construct a repeat cross-sectional database, which was analyzed by using a difference-in-differences model with maternal fixed-effects. Results: Exposure to 1 nonviolent localized civil insecurity event (mean ± SD: 0.42 ± 1.87 events) during pregnancy for children living in rural areas was associated with a reduction of 0.01 SD in HAZ (P = 0.024). Exposure to 5 localized civil conflict fatalities (mean ± SD: 1.41 ± 10.21 fatalities) for children living in rural areas during the complementary feeding stage was associated with a 0.002-SD decrease in HAZ (P = 0.030). There were no measurable associations between civil insecurity and child heights in urban areas, even though children in urban areas experience more civil insecurity. Conclusions: Exposure to both violent and nonviolent civil insecurity had negative associations with subsequent HAZ, but only in rural areas. The associations found were small in magnitude but still meaningful from a child-development perspective, because these events do not necessarily occur in the context of official wars, they are often nonviolent, and they are endemic to the region. [ABSTRACT FROM AUTHOR]

Strengthening civil society through the provision of financial resources and technical assistance is viewed by aid donors as an effective means of fostering political pluralism and consolidating fragile democracies in developing countries. Starting from the premise that donors lack a well-defined notion of civil society which obscures its conflictual nature, this article considers a range of potential problems that aid donors might encounter in relation to the process of democratic consolidation when supporting civil society organizations. It argues that since donors are not well-equipped to handle these types of interventions, they need to avoid undermining the autonomy and legitimacy of recipient organizations: their absorptive capacity is limited, only certain types of organization are able to contribute effectively to democracy promotion, and little is known about their impact. The objective of strengthening civil society may be laudable but since it is a difficult and potentially hazardous area for external intervention, donors should proceed cautiously and with modest expectations about what might be achieved. [ABSTRACT FROM AUTHOR]

As an exploratory analysis, this research investigates the factors influencing public confidence in the court systems of five African nations; namely, South Africa, Ghana, Burkina Faso, Mali and Zambia. Incorporating frequency descriptive measurements and ordinal logistic regression, this research provides a comparative assessment across varying political, cultural, social and historical contexts to foster continued research within the criminal justice institutions, specifically the courts. The findings indicate that public confidence in the courts remains high, despite popular speculation to the contrary. There were, however, varying levels of confidence between the five nations; differences at theoretical and practical levels are discussed. [ABSTRACT FROM AUTHOR]

This article examines the possibility that the trans-Atlantic slave trade influenced the political institutions of villages and towns in precolonial Africa. Using anthropological data, it shows that villages and towns of ethnic groups with higher slave exports were more politically fragmented during the precolonial era. Instrumental variables are used to show that the relationship is causal. It is argued that this fragmentation is important for relative economic development because it still influences political institutions today. This argument is supported by the use of more contemporary data to show that in contemporary Nigeria and Tanzania, areas with higher levels of precolonial political fragmentation have a higher incidence of bribery. [ABSTRACT FROM AUTHOR]

The article presents the author's comment on the significance of the North-South diplomatic dialogue in context with social developments in Africa. In this dialogue process, various issues concerning industrialized and developing countries were discussed. The author discussed how the political systems act as constraints to development in Africa.