Programmes In sub-Saharan Africa Research Articles

Strengthening neurosurgical training programs in Sub-saharan Africa: a medical student's perspective.

This article provides a nuanced exploration of the state and exigencies of neurosurgical training in sub-Saharan Africa (SSA), viewed through the discerning lens of a medical student. The region has a pronounced scarcity of neurosurgical services, further compounded by sociocultural intricacies and infrastructural inadequacies, resulting in elevated mortality and morbidity rates. The insufficiency of neurosurgeons, facilities, and training centers, particularly in remote areas, exacerbates this predicament. The imperative to fortify neurosurgical training programs is underscored, necessitating a multifaceted approach inclusive of international collaborations and innovative strategies. The challenges impeding neurosurgical training program implementation range from constrained infrastructure to faculty shortages and financial constraints. Recommendations encompass infrastructural investments, faculty development initiatives, and augmented community engagement. An exploration of neurosurgical training programs across diverse African regions reveals commendable strides and imminent deficits, warranting heightened international collaboration. Furthermore, technological innovations, including virtual reality, robotics, and artificial intelligence, are posited as transformative conduits for augmenting neurosurgical training in SSA. The article concludes with a sagacious compendium of recommendations, encompassing standardized curricula, mentorship paradigms, and stringent evaluation mechanisms, all combining efficaciously fortifying neurosurgical insight in SSA and producing transformative improvements in healthcare outcomes.

Development of portfolio management tools in crop breeding programs: a case study of cassava in sub-Saharan Africa

The response to the diverse needs along the cassava value chain, the urge to increase genetic gain, and the need for rapid varietal turnover will necessitate not only technological innovations but also transformation of public breeding programs in sub-Saharan Africa (SSA). We developed guiding, flexible and adaptative tools for portfolio management of cassava breeding. The cassava breeding and product development pipeline process was mapped to illustrate activities of each stage, as well as to clarify key decision points. Stakeholders involved at all stages of breeding were identified. This allowed for identification of gaps and new crucial functions. To clarify accountability and reduce complexity in the decision-making at key decision points, the roles were mapped against decision-rights at each stage-gate. Cassava crop calendars for the different regions in SSA were developed to facilitate better planning. A product advancement template was developed to guide product advancement. The tools that have been developed and stage-gate mapping, will support regional efforts to establish more structured, transparent, participatory, efficient, inclusive, and demand-driven cassava breeding in the region. These approaches could be customized to other commodities.

Effects of paediatric schistosomiasis control programmes in sub-Saharan Africa: A systematic review.

Preventive chemotherapy by mass drug administration is globally recommended as the primary method of reaching the elimination of schistosomiasis, especially in the high risk-paediatric population. This systematic review provides a summary of the effects of paediatric schistosomiasis control programs on eliminating schistosomiasis in sub-Saharan Africa. A systematic search was conducted in PubMed, EBSCOhost, and other databases to obtain studies regarding the effects of paediatric schistosomiasis control programmes in sub-Saharan Africa. 3455 studies were screened for eligibility, included articles reported on both paediatrics control programmes and schistosomiasis, and articles were excluded when they did not report on schistosomiasis control programmes in paediatrics exclusively. 40 selected studies were critically appraised using the JBI critical appraisal tools for relevance and 30 studies were included in the study. An in-depth quantitative descriptive analysis was conducted, and a comprehensive narrative summary explained the results within the scope of the review questions. The results show that despite preventive chemotherapy lowering schistosomiasis prevalence, chances of re-infection are high in endemic areas. Preventive chemotherapy without complementary interventions including safe water provision and proper sanitation, snail control and health education on the aetiology of schistosomiasis, transmission pattern and control practices might not eliminate schistosomiasis.

The sustainability of developmental programs by the U.S. and China in Sub-Saharan Africa: a comparison of effectiveness

This descriptive comparative qualitative case study examines the sustainability of development programs in Sub-Saharan Africa. We evaluated economic, social, environmental, and institutional development programs from the People’s Republic of China (PRC) and the U.S. to Sub-Saharan Africa for sustainable development to fill the research gap on these technique’s success and effects on Sub-Saharan Africa. Using purposive sampling, we chose eight Sub-Saharan African countries representing distinct geographies and economies. The College of William & Mary’s AID Data-GeoCoded Chinese Official Finance Dataset, China Africa Research Initiative, and USAID’s Foreign Aid Explorer provided data. Results revealed a complex view of Sub-Saharan Africa’s development policy success. Proposition 1, which claims China’s economic tactics exceed those of the U.S., is supported by significant infrastructure investments but presents sustainability problems. Proposition 2, praising the social development initiatives of the U.S., is supported by gains in healthcare and education in other countries. However, context-specific issues persist. Proposition 3 shows that U.S. conservation collaborations have improved environmental preservation. Proposition 4 claims that both countries’ institutional development plans fail. The results highlight local government buy-in issues and the need for adaptation. Some of the ideas find support in recent research; however, country and context differences require unique tactics. Development efforts in Sub-Saharan Africa should focus on long-term sustainability, local objectives, and environmental implications. Effective institutional growth requires adaptation and a strong awareness of local governing dynamics, and policymakers, development practitioners, and scholars may gain insight into sustainability and development projects in Sub-Saharan Africa from this research. A holistic approach that balances economic, social, environmental, and institutional factors is needed to attain sustainable development goals.

The impact of smart input subsidy program on farm productivity: Evidence from Tanzania

Policymakers have a renewed interest in input subsidy programs in sub-Saharan Africa. However, the evidence of the program's impact is mixed. This paper uses the case of Tanzania's National Agricultural Input Voucher Scheme (NAIVS) to examine its effect on farm productivity. To account for the endogeneity problem arising from the non-random targeting of beneficiaries, this study employed a staggered difference-in-differences approach with a double robust estimator method on a three-wave panel survey. This approach is relevant because the treatment variable—NAIVS participation was gradually rolled out to households over multiple periods and groups. The results do not show evidence that the NAIVS program increased farm productivity. However, the group aggregate effects suggest that the group initially treated in 2010 experienced a positive and significant impact on maize production and income. This could indicate that during the early stages of the NAIVS program, extra effort was likely invested to ensure its effectiveness. Furthermore, the heterogeneous effect of farm size reveals that the NAIVS program increased the participation of beneficiary households with large-scale farms rather than small-scale farms. This suggests that the program did not effectively target resource-poor households. Finally, this paper calls for effective targeting and careful implementation of programs to improve farmer productivity.

Socioeconomic inequalities in uptake of HIV testing during antenatal care: evidence from Sub-Saharan Africa

BackgroundMeasuring socioeconomic inequalities in healthcare usage represents a critical step towards promoting health equity, in alignment with the principles of universal health coverage and the United Nations’ Sustainable Development Goals. In this study, we assessed the socioeconomic inequalities in HIV testing during antenatal care (ANC) in sub-Saharan Africa.MethodsSub-Saharan Africa was the focus of this study. Benin, Burundi, Cameroon, Ethiopia, Gambia, Guinea, Liberia, Malawi, Mali, Mauritania, Mozambique, Rwanda, Sierra Leone, Uganda, Zambia, and Zimbabwe were the countries included in the study. This study used current Demographic and Health Surveys data spanning from 2015 to 2022. A total of 70,028 women who tested for HIV as part of antenatal contacts formed the sample for analysis. We utilized the standard concentration index and curve to understand the socioeconomic inequalities in HIV testing during antenatal care among women. Additionally, a decomposition analysis of the concentration index was ran to ascertain the contributions of each factor to the inequality.ResultsOverall, 73.9% of women in sub-Saharan Africa tested for HIV during ANC. The countries with the highest proportions were Malawi, Rwanda, Zambia, and Zimbabwe. Mali Benin, Guinea, Mali, and Mauritania were the countries with the lowest proportions of HIV testing. Being among the richer [AOR 1.10, 95% CI: 1.02,1.18] and richest [AOR 1.41, 95% CI:1.30, 1.54] wealth quintiles increased the odds of HIV testing during ANC. The concentration value of 0.03 and the curve show that HIV testing is more concentrated among women in the highest wealth quintile. Hence, wealthy women are advantaged in terms of HIV testing. As the model’s residual value is negative (-0.057), the model overestimates the level of inequality in the outcome variable (HIV during ANC), which means that the model’s explanatory factors can account for higher concentration than is the case.ConclusionWe found that there is substantial wealth index-related inequalities in HIV testing, with women of the poorest wealth index disadvantaged in relation to the HIV testing. This emphasizes the necessity for sub-Saharan Africa public health programs to think about concentrating their limited resources on focused initiatives to grasp women from these socioeconomic circumstances. To increase women’s access to HIV testing, maternal and child health programs in sub-Saharan Africa should attempt to minimize female illiteracy and poverty. Consequently, health education may be required to provide women with comprehensive HIV knowledge and decrease the number of lost opportunities for women to get tested for HIV. Given the link between knowledge of HIV and HIV testing, it is important to focus on community education and sensitization about HIV and the need to know one’s status.

Simulation-based education to facilitate clinical readiness in nursing and midwifery programmes in sub-Saharan Africa: a meta-synthesis

Purpose The purpose of this study was to explore the clinical readiness of simulation-based education (SBE) in preparing nursing and midwifery students for clinical practice in sub-Saharan Africa. This study has synthesised the findings from existing research studies and provides an overview of the current state of SBE in nursing and midwifery programs in the region.Design/methodology/approach A qualitative meta-synthesis of previous studies was conducted using the following steps: developing a review question, developing and a search strategy, extracting and meta-synthesis of the themes from the literature and meta-synthesis of themes. Five databases were searched for from existing English literature (PubMed, Cumulative Index for Nursing and Allied Health Professional Literature [CINAHL], PsycINFO, EMBASE and ScienceDirect Medline, CINAHL and Science Direct), including grey literature on the subject. Eight qualitative studies conducted in sub-Saharan Africa between 2014 and 2022 were included. Hawker et al.'s framework was used to assess quality.Findings The following themes emerged from the literature. Theme 1: Improved skills and competencies through realism and repetition. Theme 2: Improved skills and competencies through realism and repetition. Theme 3: Improved learning through debriefing and reflection. Theme 4: Constraints of simulation as a pedagogical teaching strategy.Research limitations/implications The qualitative meta-synthesis intended to cover articles from 2012 to 2022. Between 2012 and 2013, the authors could not identify purely qualitative studies from sub-Saharan Africa. The studies identified were either mixed methods or purely quantitative. This constitutes a study limitation.Practical implications Findings emphasise educator training in SBE. Comprehensive multidisciplinary training, complemented by expertise and planned debriefing sessions, serves as a catalyst for fostering reflective learning. Well-equipped simulation infrastructure is essential in preparing students for their professional competencies for optimal patient outcomes. Additional research is imperative to improve the implementation of SBE in sub-Saharan Africa.Originality/value The originality and value of SBE in nursing and midwifery programs in sub-Saharan Africa lie in its contextual relevance, adaptation to resource constraints, innovative teaching methodologies, provision of a safe learning environment, promotion of interprofessional collaboration and potential for research and evidence generation. These factors contribute to advancing nursing and midwifery education and improving healthcare outcomes in the region. This study fills this gap in the literature.

Effective bilingual education in Francophone West Africa: constraints and possibilities

ABSTRACT Bilingual education that incorporates a local language alongside the official language has become an increasingly common approach in sub-Saharan Africa for improving literacy rates and learning outcomes. Evidence suggests that bilingual instruction is largely associated with positive learning and literacy outcomes globally. However, the adoption of bilingual education does not guarantee positive learning outcomes. This paper reviews bilingual programs in sub-Saharan Africa, with a particular focus on programs in six Francophone West African countries (Niger, Senegal, Mali, Burkina Faso, Côte d’Ivoire, Cameroon). We identified factors critical to high-quality and effective bilingual programs. Implementation factors, such as teacher training and classroom resources, and socio-cultural factors, such as perceptions of local languages in education, constrain and contribute to the quality of bilingual education. These insights may help inform policy-makers and other stakeholders seeking to improve bilingual education programs in Francophone West Africa and other contexts.

Women's empowerment and food consumption: Evidence from female-headed households in Tanzania

Despite the growing recognition of women's increasing role in the household and corresponding empowerment programs in sub-Saharan Africa, intensive research on the relationship between women's influence and household food consumption is minimal. Using the most recent (2017–2018) national household survey data from Tanzania, this study examined the influence of women's empowerment on household food consumption. First, we compared the monthly consumption of eight food categories between female-headed households (FHHs) and male-headed households (MHHs) using both descriptive statistics and the propensity score matching (PSM) method. Furthermore, we adopted the two-stage Linear Expenditure System and Almost Ideal Demand System model (LES-AIDS) to estimate income and price elasticities for the two household types. The results show that FHHs consume bread and cereals, fish, oils and fats, vegetables, and confectionery (sugar, jam, honey, chocolate, etc.) more than MHHs. Moreover, FHHs have a significantly higher income elasticity of demand for all food groups than MHHs. They are also more price elastic than MHHs in meat, fish, oils, fats, sugar, jam, honey, chocolate, etc.

Balancing economic development, social responsibility, and environmental conservation through financial assurance programs in sub-Saharan Africa’s mining industry

Balancing economic development, social responsibility, and environmental conservation through financial assurance programs in sub-Saharan Africa’s mining industry

Gendered investment differences among smallholder farmers: evidence from a microcredit programme in western kenya

The advent of microcredit programmes in sub-Saharan Africa provides opportunities for rural households to acquire agricultural inputs and consumer goods. This study analysed gender differences in investment behaviour and repayment performance using a unique dataset—the complete client database (21,386 clients) of a microcredit programme operating in Western Kenya. Products purchased via the microcredit programme include seeds, fertilisers, post-harvesting technologies (drying sheets, storage bags, and pesticides), chicken feed packages, and different solar panel products. A machine learning-based basket analysis identified combinations of products purchased by male and female clients. Our results showed that female farmers usually made smaller investments, had higher repayment rates, and purchased more post-harvesting technologies than male farmers. In addition, female farmers used their loans to purchase less expensive products, whereas male farmers usually purchased more fertiliser and expensive solar panel products. The basket analysis revealed that female farmers purchased multiple products simultaneously more often than male farmers did. Finally, households without mobile phones had low repayment capabilities. Collectively, our findings show that microcredit programmes serving smallholder farmers can capitalise on their business data to learn about their clients’ gendered investment preferences and repayment behaviour.

Molecular characterization of patients with chronic hepatitis C virus infection in Jordan: implications on response to direct-acting antiviral therapy

ObjectivesTo investigate the molecular characteristics of Hepatitis C Virus (HCV) detected in patients with chronic HCV infection in Jordan. MethodsThe study included 48 Jordanian treatment-naïve patients with active chronic HCV recruited from seven governorates. HCV genotype and the resistance-associated substitutions (RAS) profile were investigated by next-generation sequencing of the NS5B, NS5A, and NS3 regions of HCV. Results“Unusual genotype 4 subtypes” were detected in four (8.3%) patients (4n-n = 1, 4o-n = 2, 4v-n = 1); one patient (2.1%) was co-infected by genotypes 1b+4a. Overall prevalence of NS5A RASs was 38.3% (3% cutoff); genotype 4a showed the highest NS5A RAS prevalence (n = 11, 55.0%). Overall prevalence of NS3 RASs was 21.8% (7/32), all genotype 1a-infected patients. ConclusionsWe report, for the first time in Jordanian patients with chronic HCV infection, the detection of unusual genotype 4 subtypes 4n, 4o, and 4v. Baseline RASs in NS5A are frequent, with complex RASs patterns in some of the unusual subtypes. Our data support the need for sequencing surveillance programs in sub-Saharan Africa, Asia, and the Middle East and North African region to monitor response to treatment in these subtypes and to facilitate the World Health Organization's 2030 elimination strategy.

Assessing the barriers and facilitators of access to diabetic retinopathy screening in sub- Saharan Africa: a literature review.

Diabetic retinopathy (DR) is the leading cause of blindness in working age adults. An increase in visual loss has been projected for sub-Saharan Africa (SSA) with the diabetes epidemic in the region. Screening is a cost-effective way to reduce this scourge, but adequate services are scarce. This review aims to evaluate the evidence on barriers and facilitators of access to DR screening with a view to making evidence-based recommendations for the development of effective and sustainable programmes in SSA. A systematic literature search of Africa-Wide Information, Embase, Cochrane library, Global Health, and Medline databases was done using diabetic retinopathy, screening, and Sub-Saharan Africa as concepts. Google Scholar was also searched to identify relevant literature. Studies were included if they were done in SSA and reported on barriers and/or facilitators of access to DR screening. The database search yielded 616 papers and google scholar yielded 9223 papers. Of these, 54 papers were assessed for eligibility and 18 met the inclusion criteria. These were appraised with appropriate checklists. Fourteen themes were synthesised. Most were supply challenges affecting all dimensions of access and the six components of the health systems building blocks. Several studies had poor methodologies, and this has implications for the evidence provided. The findings of this review show a weakness in the health systems suggesting this is the major indirect barrier to DR screening in SSA. Measures to strengthen the health system for DR screening is strongly recommended.

Antimicrobial stewardship in the era of the COVID-19 pandemic: A systematic review protocol on the opportunities and challenges for Sub-Saharan Africa.

Antimicrobial resistance (AMR) remains one of the leading threats to global public health and this may increase following COVID-19 pandemic. This is particularly the case in Africa where regulations on antimicrobial usage are weak. This protocol outlines the steps to undertake a systematic review to synthesize evidence on drivers of AMR and evaluate existing approaches to strengthening antimicrobial stewardship (AMS) programs in Sub-Saharan Africa (SSA). On the basis of the evidence generated from the evidence synthesis, the overarching goal of this work is to provide recommendations to support best practices in AMS implementation in SSA. A systematic search will be conducted using the following databases: Global Health Library, PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Google Scholar, Global Health, Embase, African Journals Online Library, Web of Science, antimicrobial databases (WHO COVID-19, TrACSS, NDARO, and JPIAMR), and the Cochrane databases for systematic reviews. Studies will be included if they assess AMR and AMS in SSA from January 2000 to January 31, 2023. The primary outcomes will include the drivers of AMR and approaches to AMS implementation in SSA. The Preferred Reporting Items for Systematic Reviews and Meta-analyses will guide the reporting of this systematic review. The findings are expected to provide evidence on best practices and resource sharing for policy consideration to healthcare providers and other stakeholders both at the local and international levels. Additionally, the study seeks to establish drivers specific to AMR during the COVID-19 era in the SSA, for example, with the observed increasing trend of antimicrobial misuse during the first or second year of the pandemic may provide valuable insights for policy recommendation in preparedness and response measures to future pandemics. CRD42022368853.

Evaluation of a knowledge translation intervention for HIV and rehabilitation advocacy in physiotherapy in three sub-Saharan African countries

Purpose To evaluate a knowledge translation intervention to determine knowledge, attitudes and self-efficacy related to HIV and rehabilitation advocacy in physiotherapy students. Methods A pre and post-test study was conducted at three physiotherapy-training programs in Sub Saharan Africa – the University of the Witwatersrand (Wits), the University of Zambia (UNZA) and Kenya Medical Technical College (KMTC). For each site, the knowledge, attitude and self-efficacy of physiotherapy students were tested pre- and post-intervention using a standardized questionnaire. Results Students’ knowledge improved with regard to being able to describe the challenges faced by their patients, knowing what resources are available and understanding their role as an advocate. In terms of self-efficacy, they felt more confident clinically, as well as being a resource person to colleagues and an advocate for their patients. Conclusion: This study highlights the need to contextualize knowledge translation interventions to meet the unique needs of individual academic sites. Students who have clinical experience working with people living with HIV are more likely to embrace their role as advocates in the area of HIV and rehabilitation. Implications for Rehabilitation The knowledge translation process used in this study gives a concrete example of how to use research evidence on HIV knowledge in rehabilitation applied within the advocacy process. Applying the principles of advocacy translates to understanding the management of HIV practically. Clinical experience in managing people living with HIV strengthens knowledge and improves the attitude of physiotherapy students Physiotherapy students need guidance in realizing their potential as advocates for holistic rehabilitation care for people living with HIV.

Healthcare provider-focused antimicrobial stewardship in sub-Saharan Africa: opportunities and challenges.

To address the antimicrobial resistance (AMR) crisis, governments around the world have created action plans to optimize antimicrobial use (AMU). These plans include antimicrobial stewardship (AMS) that encompasses educational programs for healthcare workers. We discuss these programs in sub-Saharan Africa, including the opportunities and challenges arising from a highly constrained healthcare environment.

22. Paradigms for Plastic Surgery Training Programs in sub-Saharan Africa

Background: Sub-Saharan Africa (SSA) is one of the world’s geographic regions with the greatest need for expanded plastic surgery training and infrastructure to address its burden of surgical disease. The present study reviews the educational structure and existing training programs in Plastic and Reconstructive Surgery (PRS) throughout SSA to provide transparency as to the educational paradigms and help identify where unmet needs are the greatest. Methods: The respective websites of the College of Surgeons of East, Central, and Southern Africa (COSECSA), the West African College of Surgeons (WACS), and the Colleges of Medicine of South Africa (CMSA) were reviewed by the authors. Additionally, anecdotal evidence informed by authors who have trained or are currently members of these colleges was utilized when available website information was lacking. Results: After completing medical school and a governmentally sponsored internship, COSECSA, including 19 countries, requires 2 years of general surgery training prior to 3 years of PRS. There are currently 13 accredited programs in COSECSA to train PRS trainees, with 5 graduates completing their training in 2020. CMSA similarly requires 2 years of general surgery and 3 years of PRS training at one of the 8 accredited programs in South Africa. WACS, including 14 countries, requires 2.5-3 years of general surgery in addition to 3 years of PRS. There are 32 accredited programs, 29 in Nigeria and 3 in Ghana, approved for 116 resident positions. In April 2022, 5 WACS trainees passed their exams to become board certified plastic surgeons. The ratio of PRS-accredited programs to the number of countries in each region is demonstrated. Conclusion: The requirements for plastic surgery training in SSA are fairly consistent throughout the region. However, COSECSA, which includes the largest number of African countries, has less than 1/3 the ratio of accredited programs per country compared to any other region in SSA. Increased transparency and collaboration between SSA and other African regions will help each of these programs continue to expand to meet their surgical needs.

Assessing the suitability of stress tolerant early‐maturing maize (Zea mays) inbred lines for hybrid development using combining ability effects and DArTseq markers

AbstractIdentification of hybrids for commercialization is crucial for sustainable maize production in sub‐Saharan Africa (SSA). One hundred and ninety test crosses, 10 tester × tester crosses + 10 hybrid checks were evaluated across 11 environments, 2017 to 2019. Inheritance of grain yield under Striga infestation, optimal and across environments was influenced by additive genetic action, but there was greater influence of nonadditive gene action under drought stress conditions. Nine, seven and two inbreds had significant and positive general combining ability (GCA) effects for grain yield under Striga‐infested, optimal and drought stress environments, respectively, and would contribute high grain yield to their progenies. Heterotic grouping methods based on specific and GCA, GCA effects of multiple traits and DArTseq markers classified the inbreds into five, three and two heterotic groups, respectively, across research conditions. The DArTseq markers method that classified the inbred lines into two major heterotic groups and was one of the most efficient methods should be adopted for practical purposes in maize breeding programmes in SSA. Hybrids TZEI 7 × TZdEI 352, TZEI 1238 × TZEI 7 and TZEI 1252 × TZEI 7 had outstanding grain yield under contrasting environments and should be tested on‐farm for commercialization in SSA.

Lessons learned through developing and implementing simulation-based education in nursing education programmes in sub-Saharan Africa

Based on the authors’ experiences, this paper aims to describe and reflect on the project of developing and implementing simulation-based education in two nursing education programmes in Tanzania and Madagascar.The project lasted from August 2017 to December 2019. The essential aspects that contributed to the project’s achievements were the school’s interest in developing and implementing simulation-based education and the many opportunities for sharing theoretical knowledge and practicing simulation. Notably, the teachers adapted simulation-based education as a pedagogical method to their own context, developing scenarios related to their local culture and national curriculum. In the debriefing session, the teachers asked open-ended questions to promote reflection, however, they mostly used directive feedback to highlight performance issues and correct performance gaps. The students also expected directives to learn from their mistakes.Overall, the reflection on the experience may provide new insights into developing and implementing simulation-based education in low-resource settings.

Structural adjustment programmes in Sub-Saharan Africa in the 1980s and 1990s

The paper discusses the World Bank’s and International Monetary Fund’s Structural Adjustment Programmes (SAPs) in Sub-Saharan Africa in the 1980s and 1990s. Most countries in this region did not demonstrate autonomy in regard to national economic management and public policy processes, but acquiesced to the economic austerity prescriptions of the international financial institution, which were supposed to have resuscitated their economies. The paper seeks to provide some insights pertaining to how multilateral financial agencies engaged national governments, not as partners in a contractual relationship, but as servile actors. This situation was not mutually beneficial to both parties as interventions in local economies through financial injections had not resulted in easier repayment of loans by Sub-Saharan African governments. However, conditionalities tied to loans resulted in the erosion of social policies and social rights in Sub-Saharan Africa in the said period. Instead of shoring up economies of the countries in the region, SAPs had helped to weaken or even implode them. SAPs also eroded the social policy gains which were attained in the decade of independence in this region. The paper’s main contention is that Sub-Saharan African countries should bolster their institutions, policy-making mechanisms, and not make the same mistakes they did during that period, if they want to develop and be prosperous this century.