Middle Eastern And North African Region Research Articles

Why developing countries need a new central bank paradigm: Evidence from the Middle East and North Africa region

This study utilizes a panel of Middle Eastern and North African (MENA) economies to argue that developing countries need a new central bank paradigm. The study measures central bank independence in the MENA region. We leverage this measure of central bank independence to analyze its impact on inflation rates, economic growth rates, and unemployment rates. Our robust empirical results reveal that central bank independence has no effect on inflation rates, plays no role in economic growth, and does not contribute to job creation. The findings suggest that fixed exchange rates—rather than central bank independence—have been responsible for price stability in the MENA region over the past three decades. The prevailing central bank paradigm assumes that achieving and maintaining price stability would encourage private investment, which would subsequently promote sustained economic growth and job creation in the long term. As developing countries have failed to sustain economic growth and create decent jobs over the past thirty years, the study argues that price stability cannot be maintained, and central bank independence in these countries is likely to diminish. Consequently, the study calls for a new central bank paradigm that empowers central banks to play a more active role both in financing short-term government needs and in creating decent jobs in developing countries.

Does the board of directors play a role in mitigating real and accrual-based earnings management in the MENA context?

PurposeIn light of the key role attributed to the board of directors as a monitoring tool to constrain earnings management practices, this study aims to examine the effect of some board attributes on accrual-based earnings management and real earnings management in the Middle Eastern and North African (MENA) context, whose institutional, economic and legal environment is markedly different from that of most organization for economic cooperation and development countries.Design/methodology/approachThe authors selected a sample of 161 nonfinancial companies from nine MENA countries between 2014 and 2021 (corresponding to an unbalanced data panel of 486 observations). The authors used the generalized least squares regression test to examine the relationship between board attributes and earnings management.FindingsThe authors found that three board attributes (size, independence and gender diversity) have no effect on both types of earnings management practices, while CEO duality has no effect on accrual-based earnings management but has a significant and negative effect on real earnings management. Overall, the results suggest that most board attributes do not play a crucial role in reducing earnings management.Research limitations/implicationsThe results provide valuable insights into the universal role of corporate governance mechanisms and raise questions about the role of the board of directors in improving reporting quality in the MENA context.Practical implicationsRegulators should adapt corporate governance mechanisms to the characteristics of the institutional context in which they are inserted.Originality/valueTo the best of the authors’ knowledge, this study is the first to examine the effect of various board characteristics on both types of earnings management practices in the MENA context. It also provides the first empirical evidence of the relationship between board gender diversity and earnings management in the MENA region.

The impact of financial assets’ classification according to IFRS 9 on firm value: the case of MENA region’s banks

Purpose The purpose of this study is twofold. On the one hand, it studies the impact of IFRS 9 adoption on the firm value; and on the other hand, it investigates the impact of the classification of financial assets on the firm value. Design/methodology/approach The study covers a sample of 55 listed banks in the Middle Eastern and North African (MENA) region. Data is collected for three years (2017–2019). Findings The findings show that banks’ value is not impacted by IFRS 9 adoption but by financial assets’ classification. Firm value is positively affected by fair value through other comprehensive income assets, while it is negatively affected by amortized cost and fair value through profit or loss assets. The results of the additional analysis show consistent outcomes. Practical implications This research reveals important managerial implications. Priority should be given to the financial assets’ classification strategy following the adoption of IFRS 9 to boost the market valuation of banks. It may be useful for investors, managers and regulators in their decision-making. Originality/value This study enriches previous research as IFRS 9 is a new standard, and its adoption consequences need to be investigated. A few recent studies have focused on IFRS 9 as a whole or on other parts of IFRS 9, namely, the impairment regime and hedge accounting and concern developed contexts. However, this research adds to the knowledge of capital market studies by investigating the application of IFRS 9 in terms of classification in the MENA region.

Inclusion of Middle Eastern and North African populations in diabetes clinical research

The need for diverse representation in clinical trials has recently been reinforced by the Food and Drug Administration's (FDA) guidance for industry entitled, “Diversity Plans to Improve Enrollment of Participants from Underrepresented Racial and Ethnic Populations in Clinical Trials.” By ensuring inclusion of underrepresented racial and ethnic minority populations in clinical trials, results can be more generalizable and the safety and efficacy can be accurately assessed within the diverse U.S. population. Limitations exist in the interpretation and implementation of clinical trial results reported using the current racial and ethnic categories, as these standards do not reflect the true diversity of the U.S. population. This is particularly true for the Middle Eastern and North African (MENA) population, which is usually overlooked given the lack of an established category. Although the international MENA region demonstrates the highest prevalence of diabetes in the world at 12.2%, the actual prevalence among MENA individuals living in the U.S. may be “hidden” within the White category. Therefore, data on the MENA population should be disaggregated from data within the White category to not only unmask health disparities, but also to ensure adequate representation in clinical trials. This paper discusses the importance of appropriate representation and inclusion of the MENA population in diabetes clinical trials, which is a critical public health issue domestically and globally.

Coverage and methods of surveillance of healthcare-associated infections in Middle Eastern and North African countries

BackgroundSurveillance of healthcare-associated infections (HAIs) is a cornerstone for effective infection prevention and control (IPC) programs. The objective was to evaluate the coverage and methods of HAI surveillance in Middle Eastern and North African (MENA) countries. MethodsA cross-sectional study targeted IPC staff working in MENA countries using the Infection Control Network electronic database of the Arab countries. The study focused on self-reported surveillance-related characteristics of IPC staff, facilities, and the IPC program. ResultsA total of 269 IPC staff were included. They were mainly females (68%), nurses (63%), and working in GCC countries (83%). Approximately 69% of covered facilities had surveillance activities. Hand hygiene, multidrug-resistant organisms, central line-associated bloodstream infections, and catheter-associated urinary tract infections were the most common surveillance activities (>90%). The surveillance workload consumed 27% of the average weekly working time. The scores of performing multiple surveillance, with appropriate methods and tools, were 83%, 67%, and 61% (respectively). Appropriate surveillance methods and/or tools were linked to GCC region, CBIC qualifications, surveillance training, specific setting (acute care and long term), staff-to-bed ratio, presence and active function of IPC committee, presence of IPC annual plan, communications with health care workers, and leadership support. ConclusionsWhile most health care facilities in the MENA region perform multiple surveillance, surveillance methods and tools are still suboptimal and their optimization should be a priority.

Quod vadis? The effect of youth unemployment and demographic pressure on migration in the MENA region

AbstractRecent trends in international migration reveal increasing migration outflows from Middle Eastern and North African (MENA) countries. This development is accompanied by a massive rise in youth unemployment and a major increase in the young population in this region. This paper provides a quantitative assessment of migration patterns and analyses the interacting effect of the unfavourable combination of youth unemployment and demographic pressure on migration decisions. Based on an assessment of bilateral migration flows from 19 MENA to 34 OECD countries between 1995 and 2020, we find that youth unemployment plays a significant role in explaining emigration flows from MENA countries. We also find that the migration‐generating effect of youth unemployment is contingent upon demographic pressure in the youth cohorts and increases with an increasing number of youths.

The perspective of antibiotic therapeutic challenges of brucellosis in the Middle East and North African countries: Current situation and therapeutic management.

Brucellosis is among the most prevalent zoonotic infections in Middle Eastern and North African (MENA) countries, critically impacting human and animal health. A comprehensive review of studies on antibiotic susceptibility and therapeutic regimes for brucellosis in ruminants and humans in the MENA region was conducted to evaluate the current therapeutic management in this region. Different scientific databases were searched for peer-reviewed original English articles published from January 1989 to February 2021. Reports from research organizations and health authorities have been taken into consideration. Brucella melitensis and Brucella abortus have been reported from the majority of MENA countries, suggesting a massive prevalence particularly of B. melitensis across these countries. Several sporadic cases of brucellosis relapse, therapeutic failure, and antibiotic resistance of animal and human isolates have been reported from the MENA region. However, several studies proved that brucellae are still in-vitro susceptible to the majority of antibiotic compounds and combinations in current recommended World Health Organization (WHO) treatment regimens, for example, levofloxacin, tetracyclines, doxycycline, streptomycin, ciprofloxacin, chloramphenicol, gentamicin, tigecycline, and trimethoprim/sulfamethoxazole. The current review presents an overview on resistance development of brucellae and highlights the current knowledge on effective antibiotics regimens for treating human brucellosis.

The Impact of Corporate Governance on the Financial Performance of the Banking Sector in the MENA (Middle Eastern and North African) Region: An Immunity Test of Banks for COVID-19

The purpose of this paper is to measure the impact of internal and external corporate governance mechanisms on the financial performance of banks in the under-researched Middle Eastern and North African (MENA) region during the COVID-19 pandemic period. Bank annual reports, the Orbis Bank Focus database, and World Bank reports were used to collect both financial and non-financial information on the banking sector, followed by fixed effects regressions and two-stage least squares. Results showed that the corporate governance measures of presence of independent members on the board of directors, high ownership concentration, lack of political pressure on board members, and strong legal protection, had positive effects on bank financial performance. Corporate governance mechanisms, such as performance-based compensation, the presence of women on boards, moderate size of the board, and anti-takeover mechanisms had no significant impact on bank performance during the crisis period. An effective internal and external corporate governance mechanism could improve the financial performance of banks in MENA countries in times of pandemics and crises.

Efficiency in the MENA banking industry, the stochastic frontier approach (SFA)

The main focus of this paper is the study of efficiency in the Middle Eastern and North African (MENA) banking industries throughout the period 1999-2017. The study of efficiency in many other regions reveals the existence of failures in the allocation of resources for banking sectors which results in the appearance of banking inefficiency in terms of cost. The empirical results, using a parametric cost frontier applied, show a fluctuating yet improving efficiency in the MENA and are used to rank efficiency of banking industries by country over the years (1999- 2017). Promoting a strong and stable banking system reduces uncertainties and systemic risk which leads to greater efficiency. A stable and efficient banking system is then, necessary, for economic development. Since 1990s, and due to reforms required by supervisory authorities, banks in the MENA region have faced many structural changes and have tried to develop their activities by seeking to enter new markets and new sectors of activity in order to adapt to the economic and institutional environment changes by adopting internal and / or external growth strategies. These strategies can increase banks market power and diversify banking industries’ activities in order to achieve efficiency gains.

Diagnosis and Management of Cushing's Disease: A Survey of Endocrinologists from the Middle East and North Africa

Abstract Background Cushing's disease is the most prevalent cause of endogenous Cushing's syndrome. This study aimed to scope the current clinical practice pattern in managing Cushing's disease by endocrinologists in the Middle Eastern and North African (MENA) region. Methods A questionnaire dealing with diagnosis, treatment, and follow-up of patients with Cushing's disease was adopted and sent electronically to a convenience sample of endocrinologists from the MENA region. Results Out of 125 responses received, 88 were eligible for inclusion in the analysis. Most respondents selected the overnight dexamethasone suppression test (ONDST) and 24-hour urinary-free cortisol (UFC) as the best screening tests, 58 (66.7%) and 50 (57.5%) respectively, followed by midnight serum cortisol and midnight salivary cortisol. Measurement of serum adrenocorticotropic hormone (ACTH; 86.2%) and classic high-dose dexamethasone suppression test (40.2%) were selected for localization of the primary lesion. The primary choice of treatment was transsphenoidal pituitary surgery (98.8%). For the recurrence of Cushing's disease, medical therapy was the preferred modality followed by repeated pituitary surgery or bilateral adrenalectomy. In case of treatment failure following the first pituitary surgery and ketoconazole treatment, 36.9% selected pasireotide, while 32.1% chose bilateral adrenalectomy. Conclusion ONDST and UFC are the two most common tests used to screen an index case with features of hypercortisolism. Pituitary surgery is the primary choice of treatment in Cushing's disease. However, medical treatment by ketoconazole is preferred for recurrent cases. Bilateral adrenalectomy is followed by pasireotide may be chosen in case of treatment failure after pituitary surgery and ketoconazole.

IFRS adoption and financial reporting quality in the MENA region

PurposeGlobal interest in adopting the International Financial Reporting Standards (IFRS) has risen rapidly; however, the Middle Eastern and North African (MENA) countries have reacted differently towards the international diffusion. The purpose of this study is to examine the impact of the IFRS adoption/rejection decision on the quality of MENA region firms' financial reporting.Design/methodology/approachThe quality of accounting is examined through five metrics models to measure earnings smoothing, managing earnings towards a target and timely loss recognition. The research sample consists of nine countries over a period of ten years (2006–2015), resulting in 3,040 firm-year observations in the main phase, and 2,580 firm-year observations in the additional analysis.FindingsThe findings reveal that the overall sample of IFRS adopters in the MENA region has benefited from the adoption of IFRS, as the results show that there is a reduction in earnings management for IFRS adopters in comparison to local standards adopters. The sub-sample analyses also reveal that firms that adopted IFRS, in both the rentier (oil-dependent states) and non-rentier states, have a higher financial reporting quality than non-IFRS adopters. However, the magnitude of the financial reporting quality was higher for IFRS adopters in rentier states.Research limitations/implicationsSimilarly to previous research in this field, this study adopts a strict sample selection approach. Such an approach may limit the sample size, although the researchers have taken every possible step to ensure the use of an adequate sample size. The researchers acknowledge the strict period of ten years, despite having stated its rationale and importance of a more extended period to the quest of the paper.Practical implicationsThis research provides valuable input by evaluating the current status of MENA region firms' financial reporting quality, based on their followed accounting regime. The implications of this paper result in better-informed decisions for investors as the information contents of the annual reports enhance comparisons that facilitate the further flow of investments. This research also provides significant insight into the International Accounting Standards Board (IASB). The findings of this study will assist the IASB in understanding the MENA region by measuring the consequences of the countries' decisions on the quality of firms' financial reporting.Originality/valueThe findings of this study contribute to the literature by revealing that countries with medium levels of governance quality have benefited the most from the IFRS adoption, while IFRS adopters in countries with stronger governance quality demonstrate lower financial reporting quality.

Basel III liquidity regulatory framework and bank liquidity creation in MENA countries

PurposeThis paper aims to investigate the potential impact of the Basel III liquidity requirements, namely, the net stable funding ratio (NSFR) and the liquidity coverage ratio (LCR), on bank liquidity creation.Design/methodology/approachThe authors developed a dynamic panel model using the Quasi-Maximum Likelihood estimation on an unbalanced panel dataset of 129 commercial banks operating in 10 Middle Eastern and North African (MENA) countries from 2009 to 2017.FindingsThe results show that the NSFR significantly negatively affects liquidity creation. Similarly, the LCR exerts a substantial negative impact on the liquidity creation of the sampled MENA banks. These findings suggest that complying with both liquidity requirements tends to curtail liquidity creation. Moreover, further regression analysis of large and small bank sub-samples uncovered results similar to the overall MENA sample.Research limitations/implicationsThe findings raise interesting policy implications and suggest a trade-off between the benefits of the financial resiliency induced by implementing liquidity requirements and the creation of liquidity essential for promoting economic growth in the region.Originality/valueMost empirical research focuses on the relationship between bank capital and liquidity creation. To the knowledge, this paper is the first to provide empirical evidence on the effect of both the NSFR and LCR regulatory liquidity standards on bank liquidity creation in the MENA region.

Teaching of the repair of defective composite restorations in Middle Eastern and North African Dental Schools

ObjectivesTo evaluate the status of teaching of repair of defective resin-based composite restorations in dental schools in the Middle Eastern and North African (MENA) countries. MethodsA validated 14-item questionnaire was mailed to the directors of the operative/restorative dentistry department in 40 MENA dental schools. Data were collected on teaching, including whether the repair of resin-based composite restorations was part of the dental school curriculum; the rationale behind the teaching; how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability and expected longevity of the repair procedure. ResultsThirty-two schools responded to the survey (response rate of 80%). Twenty-two (69%) schools reported the teaching of resin-based composite repairs as an alternative to the replacement of restorations. Of the schools not teaching repairs, 80% indicated that they plan to include this topic in the curriculum within the next five years. Most schools taught theoretical and practical aspects of repair at a clinical level only. Two-thirds of schools reported tooth substance preservation being the main reason for teaching repair techniques. The main indications for repair treatment were marginal defects (59%), followed by partial loss of restoration (56%). Most schools that performed repairs reported high patient acceptability. Considerable variation was noted in relation to expected longevity of resin- based composite repairs. ConclusionsThe repair of defective resin-based composite restorations is actively taught within most of the surveyed schools. Advantages of repair, compared to replacement include minimum intervention, preservation of tooth structure, and savings of time and cost. Clinical significanceThe decision between replacing or repairing a defective resin-based composite restoration in the MENA region tends to be based on clinicians’ subjective experience and judgement. However, to further enhance the teaching of resin-based composite repair standardised guidelines need to be developed based on existing evidence.

Compliance and Determinants of the AAOIFI Financial Standards: Evidence from the MENA Region

This paper analyses the level of compliance of financial disclosure with accounting standards of the Accounting and Auditing Organization for Islamic Financial Institutions (AAOIFI) and its determinants in Middle Eastern and North African (MENA) Islamic banks. Based on 40 Islamic banks in seven MENA countries over the period 2010-2016, the authors used a disclosure index to measure the compliance level and the effect of governance characteristics and the Sharia Board on the extent of compliance with the AAOIFI accounting standards. Results show a high level of compliance (67%). Using the Feasible General Least Square Regression, we found that the presence of women on the board of directors, the reputation of the Sharia Board, and the cross membership of Sharia Board members are key determinants of compliance. While independence of board of directors is significantly associated to reduced financial disclosure. The research contributes to the literature on accounting and the Islamic banking sector. These findings will be useful for regulatory authorities to better- understand the accounting disclosure practices of Islamic banks. Although findings are encouraging, the sample is limited only to banks. Future researches could deal with a larger sample and review other disclosure items to ensure compliance with the AAOIFI standards. Few empirical studies have explored the determinants of compliance with the AAOIFI standards for Islamic banks in MENA countries. Therefore, this work complements and enriches the research in the field in the MENA region. Keywords: financial disclosure, AAOIFI compliance, Islamic banks, governance characteristics, Sharia board

Dietary Management of Type 2 Diabetes in the MENA Region: A Review of the Evidence.

The alarmingly rising trend of type 2 diabetes constitutes a major global public health challenge particularly in the Middle Eastern and North African (MENA) region where the prevalence is among the highest in the world with a projection to increase by 96% by 2045. The economic boom in the MENA region over the past decades has brought exceptionally rapid shifts in eating habits characterized by divergence from the traditional Mediterranean diet towards a more westernized unhealthy dietary pattern, thought to be leading to the dramatic rises in obesity and non-communicable diseases. Research efforts have brought a greater understanding of the different pathways through which diet and obesity may affect diabetes clinical outcomes, emphasizing the crucial role of dietary interventions and weight loss in the prevention and management of diabetes. The purpose of this review is to explore the mechanistic pathways linking obesity with diabetes and to summarize the most recent evidence on the association of the intake of different macronutrients and food groups with the risk of type 2 diabetes. We also summarize the most recent evidence on the effectiveness of different macronutrient manipulations in the prevention and management of diabetes while highlighting the possible underlying mechanisms of action and latest evidence-based recommendations. We finally discuss the need to adequately integrate dietetic services in diabetes care specific to the MENA region and conclude with recommendations to improve dietetic care for diabetes in the region.

Decentring Norms in EU Relations with the Southern Neighbourhood

AbstractThe EU's external promotion of norms and the idea of normative power Europe itself are increasingly contested, which is especially true in the EU's southern neighbourhood. However, whereas scholars of EU foreign policy acknowledge the contestation of external norms, they find it difficult to understand why other normative frameworks could be equally or more appealing to Middle Eastern and North African (MENA) countries, as they entail norms that are less prominent in the Western catalogue of liberal values. To facilitate the detection and analysis of a wider set of norms, we situate them along several continua of norm orientations and apply this framework to the EU's southern neighbourhood. EU foreign policy scholars can then examine whether different norms overlap or compete or are complementary or even incompatible, and the extent to which values promoted by European actors are congruent with normative frameworks in the MENA region.

Poultry production and its effects on food security in the Middle Eastern and North African region

The Middle Eastern and North African (MENA) region is the largest importer of food in the World, and the development and growth of any of its agricultural sectors contributes to improved food security. The production of poultry meat and eggs in the MENA region has been increasing steadily and moving to become a highly sophisticated industry since the 1960s. In this study, data were collected on production of eggs, chicken meat, and turkey meat from 1961 to 2016 for 20 MENA countries (9 countries in the Near East, 5 in North Africa, and 6 Gulf countries). Production of eggs, chicken meat, and turkey meat increased significantly from 1961 to 2016, with increases in chicken meat more so than for eggs and turkey meat. Significant correlations were observed between production and population growth in all MENA regions except in the Gulf where production increased at a faster rate than population growth. Results also revealed that the mean % animal protein of total protein increased by 10% from 1961 to 2016 in North Africa, while the increase was only 5% in the Near East and 6% in the Gulf. Increases in egg protein consumption as % of total protein were only significant in North Africa during the 1980s, while increases in poultry meat protein consumption were significant in North Africa in the 1980s and 1990s and in the Gulf from 1970 to 2010. Analysis showed largest significant increases in contribution of poultry products in the Gulf compared with the other 2 regions.

Impact of Islamic banking share on financial inclusion: evidence from MENA

PurposeThis study aims to investigate how the Islamic banking share (percentage of total Islamic banking assets relative to total banking sector assets) and individual characteristics (gender, age, income and education) affect financial inclusion in 14 Middle Eastern and North African (MENA) countries with different income levels.Design/methodology/approachThis study uses data from the 2014 World Bank Global Findex database to analyze the impact of individual characteristics, Islamic banking share and countries’ developmental levels on financial inclusion and its barriers in MENA countries. The probit estimation method is used for estimations.FindingsThe findings indicate that financial inclusion, particularly in middle-income MENA countries, is lower than the global average. While being male, rich and older positively affects financial inclusion in these countries, education does not. Islamic banking practises also contribute to financial inclusion, especially for individuals with strong religious affiliations. The effect of Islamic banking on financial inclusion is found to be greater in middle-income MENA countries.Practical implicationsIslamic banking institutions could play a greater role in promoting financial inclusion in the MENA region by offering Sharia-compliant products that meet individuals’ needs, matching the specific requirements and status of each country with affordable costs and offering adequate information to customers. Governments should promote more Islamic banking and incentivise investments in technology, which helps expand financial inclusion.Originality/valueThis is the first study to examine the influence of Islamic banking share and countries’ levels of development on financial inclusion in the MENA region.

Update on invasive fungal infections in the Middle Eastern and North African region.

In the recent years, the epidemiology of invasive fungal infections (IFIs) has changed worldwide. This is remarkably noticed with the significant increase in high-risk populations. Although surveillance of such infections is essential, data in the Middle Eastern and North African (MENA) region remain scarce. In this paper, we reviewed the existing data on the epidemiology of different IFIs in the MENA region. Epidemiological surveillance is crucial to guide optimal healthcare practices. This study can help to guide appropriate interventions and to implement antimicrobial stewardship and infection prevention and control programs in countries.

“Donorship” and strategic policy‐making: Germany’s Middle Eastern and North African aid programme since the Arab uprisings

AbstractMotivationGermany’s official aid to Middle Eastern and North African (MENA) countries has more than doubled since 2011, ostensibly to support their own responses to development and humanitarian challenges following the Arab uprisings. The dramatic increases in aid have not been accompanied by a public strategy setting out Germany’s objectives in the region, and the role of aid in conjunction with other policy tools in achieving them.PurposeWhat strategic objectives does the German government have for its MENA aid, and have these objectives changed in response to the Arab uprisings? Does the practice of Germany’s aid spending actually address development and humanitarian challenges in the MENA region, as these are defined by MENA countries themselves? In order to address these questions, this article develops key insights from the historical institutionalist and aid effectiveness literature that explain strategic policy‐making in complex decision‐making systems.Approach and MethodsTwo propositions are discussed in a structured review of the policy and practice dimensions of Germany’s MENA aid programme: first, that Germany’s aid and foreign policy system has not been able to articulate a clear strategy due to political differences and bureaucratic inertia; and second that the priorities tend to favour German and European security interests rather than the region’s own development and humanitarian priorities.FindingsThe analysis reveals that, while new priorities for development co‐operation in response to the Arab uprisings have been set, Germany’s MENA aid programme shows signs of policy incoherence and fragmentation. This is unlikely to change without a “whole‐of‐government” strategy for Germany’s MENA engagement. Furthermore, while there is little evidence of purposeful securitization of aid, short‐term stability has been privileged over support for political change.Policy ImplicationsA whole‐of‐government strategy based on the Sustainable Development Goals could balance German interests with the MENA region’s development priorities, ironing out the most problematic incoherencies, and thereby increasing partner country ownership.