Middle East And North Africa Region Research Articles

The impact of bank capital, liquidity and funding liquidity on sustainable bank lending: Evidence from MENA region

This research analyzes the impact of bank capital, liquidity and funding liquidity on sustainable bank lending in the Middle East and North Africa (MENA) region. An unbalanced panel dataset covering 55 banks using ESG scoring criteria from 2010–2020 was employed for this purpose. Results indicate that higher capital and liquidity ratios hinder the MENA banking sector’s ability to improve its sustainable lending capacity. Funding liquidity has a positive and significant effect on sustainable bank lending growth, which suggests that funding liquidity raises sustainable bank lending capacity. Furthermore, the impact of funding liquidity on sustainable bank lending growth remains positive and statistically significant to all capital ratios. It implies that bank capital improves the relationship between funding liquidity and banks’ capacity to issue loans in the MENA region. Finally, the results of too-big-to-fail banks indicate that bank lending growth is positively affected by higher capital ratios. Hence, it may help them to increase their capacity to issue sustainable bank loans in the market. Overall the results are robust to principal component analysis and other estimation techniques like bootstrapped-based bias correction fixed effects.

The moderating role of CEO overconfidence on debt maturity decisions: evidence from the MENA region

Purpose This study aims to analyze how cultural variations impact the relationship between long-term debt use and managerial overconfidence. Investigate into how the relationship between growth prospects and the utilization of long-term debt is moderated by managerial overconfidence. In addition, the research explores the moderating effect of managerial overconfidence on cash flow levels. Design/methodology/approach The study used long-term debt as the dependent variable and used generalized method of moments–instrumental variables regression analysis to examine data from 356 firms across 11 Middle East and North Africa (MENA) countries and 5 industries between 2013 and 2021. Findings CEO overconfidence moderately boosts the link between long-term debt maturity and growth potential, particularly for firms with limited internal funding. Cultural factors, such as masculinity and uncertainty avoidance, play a significant role in moderating the relationship between managerial overconfidence and debt maturity choices. Practical implications To understand the impact of managerial overconfidence on a company’s debt maturity decision, it is essential for boards and shareholders to consider and monitor the CEO’s behavioral traits, particularly for growing companies. Regulators and policymakers must also be wary of the risk of internal control weakening due to overconfident managers, especially in MENA markets. Originality/value The authors’ contribution to the literature lies in exploring how managerial overconfidence moderates the agency conflict between shareholders and debtholders in MENA region firms, which has received minimal attention in previous studies. This study expands the knowledge of the impact of managerial overconfidence on emerging economies and provides evidence that national culture plays a vital role in determining debt financing decisions.

Public service motivation research in the Middle East and North Africa (MENA) region: A systematic review of progress and implications for public administration theory and practice

The research on public service motivation (PSM) has seen a growing internationalization, necessitating efforts to organize and systematize its findings to assess research progress and enhance the value of PSM theory in various contexts, including public administration. This paper aims to review the progress of PSM research in the Middle East North Africa (MENA) region over the past decade. The primary methodology employed is a systematic literature review, where a total of 20 papers published between 2013 and 2020 were located and analyzed. The assessment of these papers includes an examination of their country of origin, publication source, underlying theory, research design, and lines of study. A critical evaluation of the findings is conducted, focusing on their theoretical and practical contributions to PSM scholarship. The key conclusion drawn from this review is that while PSM research in the MENA region is advancing, it reveals certain methodological limitations and underexplored themes that need to be addressed. Consequently, this paper significantly contributes to public administration research and PSM-specific studies by providing the long-awaited organization, systematization, and integration of regional research. The outcomes of this review enable the identification of relevant contextual factors that can enrich the conceptualization and operationalization of PSM on a regional basis. Additionally, this paper offers a comprehensive overview of existing PSM knowledge in the MENA region, thereby guiding future research in this domain. By acknowledging both the methodological strengths and weaknesses, as well as the thematic aspects of the reviewed studies, specific suggestions are put forth to enhance the quality and depth of future PSM research in the MENA region. This paper thus serves as a valuable resource for researchers seeking to further develop the understanding of PSM within the context of the MENA region.

Research in environmentally induced human mobility: an analysis of methodological and theoretical dimensions

Purpose This paper aims to define a proposal of a theoretical–methodological framework aimed at supporting researchers in conducting studies on the topic of environmental mobility. Design/methodology/approach The complexity of environmental change and the frequent subsequent human mobility raises challenges in the research process. The variety of theoretical and methodological approaches that can be applied to each of the phenomena contributes to different layers of analysis when focusing on the decision-making process of migration due to environmental factors. Drawing from the theoretical and methodological frameworks used by scholars, this paper includes an analysis of how they are applied in empirical studies that focus on environmental change and mobility in the Middle East and North Africa (MENA) region. Findings Empirical studies in this field for the MENA region are focused on collecting and analyzing data but are not linking it with wider human mobility theoretical and methodological frameworks. The proposal included in this study privileges the use of a qualitative methodology, aimed at obtaining an overview of the individuals’ experience. Originality/value This study adds to existing overviews of empirical studies of environmentally induced mobility by analyzing in detail the dimensions used to frame the methodological and theoretical research approaches in the empirical studies used in different disciplines that study the environment and/or human mobility. The studies analyzed focus on the different countries in the MENA region, which has the highest level of forced migratory movements in the world while facing challenges in terms of environmental degradation.

How Do Economic Conditions Influence Support for Democracy?

Abundant political economy work has found that societies tend to be less supportive of the political system that governs their country when the economy deteriorates. This paper seeks to enrich the existing literature on economic and democratic assessments by including the relatively under-explored group of developing countries in the Middle East and North Africa (MENA) region, many of which are Muslim countries. Using public opinion data from the World Values Survey of 78 countries from 2005 to 2020, the author applies multi-level regressions to test whether the relationship between democratic support and economic growth varies along three dimensions: country affluence, MENA versus non-MENA regions, and type of political regime. Consistent with past studies, the findings in this paper confirm that higher real gross domestic product (GDP) per capita growth significantly enhances public support for democracy. However, it also identifies that the more robustly significant predictors of public support for democracy are political variables, particularly evaluation of government performance. The interaction variables analysis reveals that the effects of economic growth on public support for democracy is weaker in the presence of higher country affluence as well as in more liberal democracies, while being located in the MENA region strengthens the relationship between economic growth and public support for democracy. In addition, respondents who consider free and fair elections as well as protection of civil liberties to be essential features of democracy tend to be more supportive of democracy itself. Meanwhile, those who associate democracy with redistributive policies tend to have a more negative assessment of democracy.

Global and regional trends of the century+ in the Middle East: A new interpretation

The study focuses on a set of issues related to the assessment of key trends in the development of the Middle East and North Africa (MENA), which has been raised in the research published by Russian academicians V.G. Baranovskii and V.V. Naumkin in 2018. The aim of this paper is to reexamine their estimates and forecasts in the light of recent developments and on this basis to take a fresh look at the future of the MENA region. To that end, the first section of the paper revisits the main findings of the 2018 research. It shows which of the global and regional trends outlined there have retained their relevance under modern conditions, and which ones need serious reappraisal. In particular, the authors note that the trend towards the universalization of regional political systems stemmed from their overall modernization is being increasingly counterbalanced by the revival of archaic socio-political practices. The recent developments in the region have had an even greater impact on the process of democratization and the globalization-regionalization dichotomy. The authors argue that these changes were not completely unforeseen; on the contrary, they were anticipated if one looks at them through the lens of neo-modernism. The second section analyzes current trends in regional development. It shows that though the most acute regional conflicts in the MENA region are gradually de-escalating, centrifugal tendencies are becoming more evident, as heterogeneity of political systems and regimes increases. In this context, the discourses of decolonization and neocolonialism, as well as symbolic politics in general, are gaining a whole new meaning.

Osteoporosis and vitamin D consumption: knowledge and practice in different Arab countries.

Osteoporosis is the most common skeletal disease, which usually remains silent until fractures occur. Vitamin D deficiency impairs bone mineralization and increases the risk of osteoporosis. Despite being relatively sunny, the Middle East and North Africa (MENA) region has a high prevalence of osteoporosis and hypovitaminosis D. This study aims to assess the knowledge about osteoporosis and vitamin D-related practices and to determine the correlation between them in some countries of the MENA region. A cross-sectional study was performed in Lebanon, Syria, Egypt, Palestine, Iraq, Jordan, and Saudi Arabia. From each country, 600 participants were enrolled. The survey included four sections: sociodemographic information, past medical history, Osteoporosis Knowledge Assessment Tool to assess the knowledge about osteoporosis, and Practice Towards Vitamin D scale to assess vitamin D-related practices. Our study found that 67.14% of respondents had moderate knowledge about osteoporosis and 42.31% had moderate vitamin D-related practices. Higher knowledge level was reported in the young, females, Syrians, singles, postgraduates, and healthcare employees (p < 0.05). Better vitamin D-related practices were detected in the elderly, males, Egyptians, married, and high school or below educational level (p < 0.05). The Internet was the most listed source of information. Adequate osteoporosis knowledge was associated with better vitamin D-related practices (p < 0.001). Most participants, representing some countries of the MENA region, displayed moderate knowledge regarding osteoporosis and moderate vitamin D-related practices. Adequate knowledge about osteoporosis is essential to improve practices, so awareness campaigns and screening programs should be more frequently implemented.

710-P: Material-Needs Security and Food Insecurity in Adults with Type 2 Diabetes in Lebanon

Food insecurity is known to impair diabetes self-management and clinical outcomes. Little is known about the prevalence and social determinants of food insecurity among people with type 2 diabetes (T2DM) in the Middle East and North Africa (MENA) region. Thus, the aim of this study was to assess food insecurity and its relationship with material needs security in Lebanese adults with T2DM of low socioeconomic status. Subjects with T2DM (n=299) were recruited from primary health care centers in Lebanon; sociodemographic and material need variables were collected using self-reported questionnaires. Food insecurity was assessed using the validated US Household Food Security Survey Module: Six-Item Short Form (USDA, 2012). Around 25% of the sample were food insecure. Compared to the food secure group, there were significantly (p&amp;lt;0.05) more participants who were females (58% vs. 44%), and who had low education level (82% vs. 58%) low income (49% vs. 24%), and no health insurance (65% vs. 49%), compared to the food secure group. Sum of material needs security was lower in the food insecure group (7.8±2.0 vs. 9.4±2.1, p&amp;lt;0.05). Results from the fully adjusted logistic regression model showed that material needs security (OR: 1.26; 95% CI: 1.06-1.49; p&amp;lt;0.007) and higher income (OR: 3.34; 95% CI: 1.39-8.05; p&amp;lt;0.007) were independent predictors of food security. Our study highlights the importance of material needs in achieving food security in T2DM in the MENA region. Further research is needed to explore other social determinants of health in this population and potential pathways/mechanisms to guide programs for effective interventions. Disclosure M.Bassil: None. O.Sukkarieh: None. L.E.Egede: None.

720-P: Material Needs Security and Mental Health Outcomes in Adults with Type 2 Diabetes in Lebanon

Despite their documented significance in type 2 diabetes (T2DM) management, social determinants of health (SDOHs) including material needs security and mental health outcomes (herein referred to as depression and diabetes fatalism) are understudied in the Middle East and North Africa (MENA) region. This study aims to assess the relation between material needs security and mental health outcomes in Lebanese adults with T2DM. Subjects with T2DM (N=299) were recruited from primary health care centers in Lebanon; sociodemographic, material need variables, depression measured by Patient Health Questionnaire (PHQ-9) and Diabetes Fatalism measured by Diabetes Fatalism Scale (DFS) were used. Depression and diabetes fatalism were used as outcome variables. Most of the participants were men, married and with lower educational levels. Multivariate analyses revealed that having material needs security was associated with diabetes fatalism (β=-0.63(-1.13; -0.12)), and depression (β=-0.46(-0.78; -0.13)) after controlling for all relevant confounding variables. Results from the fully adjusted logistic regression model showed that material needs security (OR: 0.82; 95% CI: 0.69; p&amp;lt;0.001). Our study highlights the importance of material needs security on mental health outcomes for adults with T2DM in the MENA region. Clinicians are encouraged to assess impact of material needs on mental health outcomes. Further research is needed to understand potential pathways/mechanisms and options for effective interventions and policy making. Disclosure O.Sukkarieh: None. M.Bassil: None. L.E.Egede: None.

Problematizing Exclusionary Politics (or Fascism) in the Middle East and North Africa

In the absence of anti-fascist public education and debates, the marginalized majority, minority groups, and their political allies will continue to be brutalized in the region. Problematizing exclusionary politics is essential for recognizing the ongoing democratic struggles of the peoples of the Middle East and North Africa (MENA) region. This article aims to stimulate more academic and public debates about fascism in MENA. Critically investigating the history of several waves of nationalism and their affinity with the first historical rise of fascism could enable us to better appreciate the challenges resistance movements in the MENA region have been facing. To that end, the persisting threat of fascism in Turkey, the Arab world, and Iran are examined critically. While the article applies the ideology form theory, a new critical theory of fascism, the soundness of the central argument regarding the significance of and the need for critiquing exclusionary, racist, and genocidal ideologies, movements, regimes, and politics does not rely on the theoretical application of the concept of fascism.

Corporate governance, enforcement institutions and corporate liquidity in the MENA region

Purpose The study examines the effects of corporate governance and countrywide institutions and risk factors on corporate liquidity.Design/methodology/approach Using firm-level data, the authors analyze the effect of corporate governance and various economic, regulatory and social institutions on the liquidity of firms operating in the Middle East and North Africa (MENA) region. The authors use fixed-effects, firm-specific and country-level controls, disaggregated analysis, sensitivity and endogeneity analysis to test the robustness of the estimates.Findings The corporate governance characteristics of firms influence in diverse ways their liquidity decisions. The independence and diversity of the board and institutional ownership are especially strong predictors. The effect also depends on the size of the firm and the degree of economic development and exhibits time sensitivity and nonlinearity. Enforcement institutions and risk factors play a strong role.Originality/value The analysis contributes to the literature by using a large sample of countries and firms over a larger period, distinguishing between poorer and richer countries and using sensitivity and endogeneity analysis. The analysis considers explicitly the role of regulatory and enforcement conditions, social structures and religious beliefs.

Banking system stability in the MENA region: the impact of market power and capital requirements on banks’ risk-taking behavior

PurposeThis paper aims to investigate the impact of capital requirements and bank competition on banks' risk-taking behavior in the Middle East and North Africa (MENA) region.Design/methodology/approachThe study combines both descriptive and analytical approaches. It considers panel data sets and adopts panel data econometric techniques like fixed effects/random effects and generalized method of moments estimator.FindingsRegulatory capital and market competition have different effects according to the bank’s type (Islamic or conventional). The results show that the capital adequacy ratio has a significant impact on the credit risk of conventional banks (CBs) while this effect is irrelevant for Islamic banks (IBs). However, market competition plays a significant role in shaping risk-taking behavior of Islamic banking institutions. Our results indicate that banks with strong market power may pursue risky strategies in the face of increased regulatory pressure (e.g. increased minimum capital requirements). The results were robust to alternative profitability measures and endogeneity checks.Research limitations/implicationsThe most important limitation is the lack of data for some banks and years, and this paper had to exclude some variables because of missing observations. The second limitation concerns the number of IBs in the sample. However, this can be overcome by including more countries from MENA and other regions where Islamic banking is a growing phenomenon.Practical implicationsOur findings call for a change in Islamic banking’s traditional business model based on the prohibition of interest. The analysis indicates that market concentration moderates the association between capital requirements and the insolvency risk of IBs but not CBs. Therefore, regulatory authorities concerned with improving financial stability in the MENA region should set up their policies differently depending on the level of banking market concentration. Finally, bank managers are requested to apply a more disciplined approach to their lending decisions and build sufficient capital conservation buffers to limit the impact of downside risk from the depletion of capital buffers during the pandemic.Originality/valueThis study addresses banks’ risk-taking behavior and stability in the MENA region, which includes banks of different types (Islamic and conventional). This paper also contributes to the literature on bank stability by identifying the most critical factors that affect bank risk and stability in the MENA region, which can be relevant in the context of the new global (COVID-19) crisis.

The burden of musculoskeletal disorders in the Middle East and North Africa (MENA) region: a longitudinal analysis from the global burden of disease dataset 1990—2019

BackgroundMusculoskeletal (MSK) disorders are one of the main causes of disability among adults globally. The burden of MSK disorders varies greatly between different regions and is the highest in low- and middle income- countries. This study sought to investigate trends in the burden of MSK disorders across the MENA region, utilizing the GBD 2019 dataset.MethodsThis ecological study utilized data from the Global Burden of Disease (GBD) to report on the burden of musculoskeletal (MSK) disorders in The Middle East and North Africa (MENA) region between 1990 and 2019. Our analysis involved descriptive statistics and sociodemographic trends and did not employ any specific statistical analyses. Using age-standardized rates of prevalence and disability-adjusted life-years (DALYs), we reported trends in the burden of MSK disorders, as well as national variation between different countries. Furthermore, we analyzed trends in risk factors contributing to MSK disorders by age and gender.ResultsThe longitudinal analysis from 1990 to 2019 showed an increase in the age-standardized rate for prevalence and DALYs of MSK disorders by 5% and 4.80%, respectively. Low back pain continued to be the most prevalent MSK condition, while RA and other MSK disorders had the largest percentage increase for DALYs between 1990 and 2019. The study found that Afghanistan had the lowest age standardized DALYs rate attributed to MSK disorders, while Iran, Turkey, and Jordan had the highest. Further, Syria showed the most dramatic decrease while Saudi Arabia had the most notable increase in age standardized DALY rates from 1990 to 2019. In 2019, occupational risks, high body mass index, and tobacco smoking were the main risk factors for MSK disorders, with occupational risks being the largest contributor, and between 1990 and 2019, there was a decrease in the contribution of occupational risks but an increase in the contribution of high body mass index as a risk factor.ConclusionThis study highlights the significant burden of MSK disorders in the MENA region, with various risk factors contributing to its increasing prevalence in recent decades. Further research is needed to better understand the underlying factors and potential interventions that could improve health outcomes. Addressing MSK disorders should be a public health priority in the region, and efforts should be made to develop effective strategies to prevent and manage this debilitating condition.

Impacts of the COVID-19 pandemic on subjective wellbeing in the Middle East and North Africa: A gender analysis.

The pathways through which the COVID-19 pandemic has impacted population mental health are potentially gendered. Little research has explored these pathways in low- and middle-income country contexts, such as in the Middle East and North Africa (MENA) region, where socioeconomic roles are highly gendered. To address this gap, we examine the relationships between pandemic-related socioeconomic changes and subjective wellbeing in the MENA region. Our core hypothesis is that the COVID-19 pandemic affected men and women's subjective wellbeing differently in part because these effects were mediated by gendered socioeconomic roles. We exploit multiple waves of longitudinal, nationally-representative phone survey data across Egypt, Jordan, Morocco, Sudan, and Tunisia. The data were collected between November 2020 and August 2021 and include 32,296 observations of 20,256 unique individuals. Mental health is measured through the WHO-5 subjective wellbeing scale. Our key independent variables capture pandemic-related employment loss, income loss, experience of limitations on food access, enrollment of children in alternative schooling modalities, and receipt of formal and informal transfers. We find significantly worse subjective wellbeing for women in Egypt and Morocco during the pandemic, but not the three other countries. There were negative associations between employment and income loss during the pandemic and subjective wellbeing, but not gender-differentiated ones. In contrast, high levels of limitations on food access were associated with worse mental health for men than women. Receipt of transfers generally did not have any association with subjective wellbeing. Further research is needed into how social assistance programs implemented in response to pandemics may be designed so as to address the negative mental health consequences of such events.

Corruption and Economic Growth Nexus: What has the Arab Spring Changed?

Corruption is an everlasting phenomenon in the Middle East and North Africa (MENA). It is considered one of the fundamental reasons for the Arab incidents that started in Tunisia in 2011. Considering its devastating effects, this paper concentrates on the impacts of corruption at the macro level following the Arab uprisings. Notably, it investigates the impact of corruption on economic growth between 1996-2020 in 18 MENA countries. The paper utilizes panel estimators with country-fixed effect regressions given the results of the Hausman test. Panel estimators help control time-variant unobserved heterogeneity and capture both time and country-specific differences. The results indicate that after the Arab Spring, corruption lowers economic growth. One unit increase in control of corruption score of World Governance Indicators (WGI) decreases economic growth between 1.64-2.98 percentage points depending on the model. The results are robust with alternative corruption indexes such as the International Country Risk Guide (ICRG), Varieties of Democracy (V-Dem), and the Corruption Perception Index (CPI). Furthermore, the Chow test confirms that 2011 constitutes a structural break in the history of the MENA region. The outcomes indicate that specific policies need to be implemented to alleviate the adverse impacts of corruption in MENA countries.

The Dimensions of Sociopolitical Destabilization in MENA Region in Comparative Global Perspective

Much has been written about the destabilizing factors in the Middle East and North Africa (MENA) (and the Afrasian instability macrozone in general) since 2011; however, the characteristics of its destabilization dimensions have been little discussed. Our principal component analysis based on the CNTS, Global Terrorism and Center for Systemic Peace databases, shows that some MENA countries are the most violently destabilized in the entire world for the period of 1970–2018 compared to all other countries. These results are supported by the mean factor scores of the principal components of socio-political destabilization for four world-system regions for three observation periods which show that both for the 1970–2018 and post-2011 periods, the Afrasian instability macrozone in general, and the MENA region in particular, emerge as the areas with the highest mean values of bloody destabilization factor scores. Moreover, the tests conducted show that MENA is the only region where destabilization component of mass protest is associated with repressions both for the general observation period (1970–2018) and for the post-Arab Spring period (since 2011) while for other regions the correlation with the purges/repressions indicator is insignificant, albeit positive (South America and sub-Saharan Africa) or even insignificant and negative (Western Europe). This seems to imply that in the MENA region protests are much more systematically accompanied by mass repressions than in other parts of the world. On the other hand, for Sub-Saharan Africa we find the presence of a number of terrorist attacks among the significant contributors to mass protest destabilization, suggesting that mass protest destabilization in this part of the world is also of a rather special nature, with a very substantial violent component. Meanwhile, the principal component analysis of destabilization in the MENA region (considered as a semi-peripheral world-system area) in comparison with South America (another world-system area), Western Europe (considered as a part of the world-system core), and Sub-Saharan Africa (considered as a part of the world-system core) has yielded the following results. In general, we find that the highest percentage of destabilization variance is explained by the mass protest principal component for the world-system core (represented by Western Europe); on the other hand, the lowest percentage of the destabilization variance is explained by the bloody destabilization principal component precisely for this part of the world. We also find that the highest percentage of destabilization variance is explained by the bloody principal component for the world-system periphery (represented by sub-Saharan Africa); on the other hand, the lowest percentage of the destabilization variance is explained by the mass protest destabilization principal component precisely for sub-Saharan Africa. The world-system semi-periphery appears here between these poles. The MENA region (which is the core of the Afrasian instability macrozone) ranks second in terms of both mass protest and bloody destabilization, with very high levels of both (while South America occupies an intermediate position between MENA and Western Europe).

The burden of pancreatic cancer and its attributable risk factors in the Middle East and North Africa region, 1990-2019.

Globally, pancreatic cancer is recognized as one of the most lethal types of cancers. We report the burden of pancreatic cancer and its attributable risk factors in the Middle East and North Africa (MENA) region, from 1990 to 2019, by age, sex, and socio-demographic index. Publicly available data from the Global Burden of Disease 2019 study were used to report the incidence, deaths, and disability-adjusted life years (DALYs) attributable to pancreatic cancer, as counts and age-standardized rates with 95% uncertainty intervals. In 2019, pancreatic cancer had an age-standardized incidence rate of 5.3 and a death rate of 5.5 (per 100000) in MENA, which have increased by 97.5% and 93.4%, respectively, since 1990. There were 563.6 thousand DALYs attributable to pancreatic cancer in 2019, with an age-standardized DALY rate of 123.0, which has increased by 84.9% since 1990. The highest number of incident cases was found in the 60-64 and 65-69 age groups, among male and female, respectively. In addition, the MENA/global DALY ratios were higher in all age groups for both sexes in 2019, than they were in 1990. There was a positive association between socio-demographic index and the burden of pancreatic cancer. Smoking, high fasting plasma glucose, and high body mass index were responsible for 19.2%, 9.3%, and 9.3% of the attributable DALYs in 2019, respectively. There was a clear and substantial increase in the burden of pancreatic cancer in the MENA region. Prevention programs should be implemented in the region that target these three risk factors.

A Bibliometric Study of Scientific Literature on Obesity Research in Web of Science Database (2008-2020): Evidence from the MENA Region.

Obesity has increasingly become a health threat in the Middle East and North Africa (MENA) countries. This study aimed to investigate the scientific publications on obesity in the MENA countries during 2008-2020. A longitudinal analysis of 13 years (2008-2020) of bibliographic data from obesity-related articles was performed. Web of Science core collection (WoS) was searched for bibliographic data. The bibliometric indicators including overall productivity and collaboration along with the prevalence of obesity and socioeconomic status were used to assess and compare the context of obesity research efforts in the MENA region. The overall obesity-related articles of the MENA countries cumulated to 23680 publications. The MENA region accounted for a 6.5% global publication share in obesity research. Turkey contributed the highest rate of total publications (n=6162) followed by Iran (n=5302) and Israel (n=2847). Iran and Turkey had the lowest rates of international collaborations. The overall obesity research was not significantly associated with socio-demographic index (SDI) measure (r=-0.26, P=0.27). No significant association was found between Gross National Income (GNI) per capita and the overall production of obesity research (r=0.41, P=0.08). Additionally, obesity research was not significantly associated with the prevalence of obesity in the countries (r=0.24, P=0.30). This study observed an increased share of scientific productivity in the field of obesity from the MENA countries. Neither SDI, GNI per capita, nor obesity prevalence was not significantly associated with the overall productivity of the region.

Assessing secular trends in HIV rapid diagnostic test uptake and positivity in Northeast Iran, a country in MENA region; ingredients for target-specific prevention policies

BackgroundIran is amongst the first three countries in Middle East and North Africa (MENA) region where two-thirds of region’s new HIV infections are reported. HIV testing at the population level is key to interrupting the HIV transmission chain. The current study aimed to evaluate the history of HIV rapid diagnostic testing (HIV-RDT) and its correlates in northeast Iran.MethodsIn this cross-sectional study, de-identified records of HIV-RDTs were extracted by the census method from the electronic health information system of 122 testing facilities between 2017 and 2021. Descriptive, bivariate, and multiple logistic regression analyses were performed to identify the factors associated with HIV-RDT uptake and risks and drivers of HIV-RDT positivity, separately among men and women.ResultsConducting 66,548 HIV-RDTs among clients with a mean age of 30.31 years, 63% female, 75.2% married, and 78.5% with high school education or below, yielded 312 (0.47%) positive results. Test uptake was comparatively low among men and the unmarried sub-population. Prenatal care and high-risk heterosexual intercourse were the most frequent reasons for taking HIV-RDT among women and men, respectively (76% and 61.2%). High-risk heterosexual contact, tattooing, mother-to-child transmission (MTCT), having a partner at risk of HIV infection, and injecting drugs were test seekers’ most reported transmission routes. One-third of the newly-infected female clients were identified through prenatal testing. Multivariate analysis revealed older age at the time of testing (Adjusted Odd Ratio (AOR) = 1.03), divorce (AOR = 2.10), widowhood (AOR = 4.33), education level of secondary school (AOR = 4.67), and unemployment (AOR = 3.20) as significant demographic predictors of positive HIV-RDT (P-value < 0.05). However, clients’ nationality, testing history, duration of HIV exposure, and reported reasons for taking HIV-RDT were not associated with the test result (P-value > 0.05).ConclusionInnovative strategies are required to scale up test uptake and positive yields among the key population in the region. The current evidence strongly suggests implementing gender-targeted strategies, according to the differences in demographic and behavioral risk between men and women.

Environment-growth nexus and corruption in the MENA region: Novel evidence based on method of moments quantile estimations

This study contributes to the environment-growth nexus literature by examining corruption's effect on environmental quality in 17 Middle East and North Africa (MENA) countries between 1984 and 2018. We use four different indicators of environmental degradation (ecological footprint, carbon dioxide emissions, greenhouse gas emissions, and carbon emission intensity) to gain a comprehensive view of the relationship. This study's methodological value added is the application of the method of moments quantile regression, which enables us to account for different relationships between the independent variables and environmental quality at different levels of environmental degradation. The results indicate that corruption worsens environmental quality based on three of the four indicators of environmental degradation, while the impact appears to become less severe at higher levels of environmental deterioration. The results also indicate that traditional mean-based panel data estimation methods provide an incomplete picture of the factors behind environmental problems: The explanatory variables' impacts tend to vary at different levels of environmental quality, and the impact's sign can even change when moving from the lowest to the highest environmental degradation quantiles. Overall, the results highlight the importance of curbing corruption to enable enforcement of more stringent environmental regulations.