Region Of Mali Research Articles

Anti-microtubular activity of total alkaloids and aqueous extract of Detarium microcarpum a medicinal plant harvested in Mali.

Detarium microcarpum, is a species confined to drier regions of west and central Africa used to treat various diseases including cancer. Phytochemical screening revealed the presence of secondary metabolites (alkaloids) The aim of this work is to study the effect of total aqueous extracts and alkaloid fractions from D. microcarpum leaves, bark and roots on Nicotiana tabacum L. cv. 'Bright Yellow 2' (BY-2) tobacco cell line GFP-TuA3 expressing a N-terminal fusion of GFP. The plant was harvested in two different regions of Mali with a contrasting climate. The effects of the extracts on the microtubules was followed by spinning disc confocal microscopy. We showed that the anti-microtubular effect of the extracts is dose-dependent, depends of the sampling site and the part of the plant used. Total alkaloids extracted of D. microcarpum bark have more effect on microtubules than leaf and root. The bioactivity-guided fractionation should be used to screen out the biologically active compounds of the total alkaloid extracts of the bark of D. microcarpum.

Direct Interdental Wiring as Alternative Method in the Treatment of Mandibular Fracture at Inaccessible War Zone: A Case Report

The Region of Tombouctou is considered as one of landlocked regions in Mali, unstable war zone. The frequency of mandibular fracture becomes more than usual in the last years with lack of oral and maxillofacial team; limited complementary exams; and limited surgical tools. In purpose to reduce; to fix fracture line; and to restore function of maxillofacial areas, we decided to practice direct interdental wiring as alternative method for the treatment of limited displacement of mandibular fractures. Direct interdental wiring in Intermaxillary fixation for closed reduction in the mandibular fracture is rarely used today.

The effects of armed conflicts on local economic dynamics in the Mopti and Ségou regions of Mali

Armed conflicts significantly affect the social and economic conditions of societies in turmoil, disrupting the normal functioning of local economies. The study described in this article seeks to delve into the repercussions of armed conflicts on the dynamics of local economies in Ségou and Mopti, Mali, since the conflict outbreak in 2012. Employing a case study method, the research uses field observations and in-depth interviews with various stakeholders, including residents, displaced individuals, local authorities, former hostages, herders, farmers, traders, officials, and members of non-governmental organizations. The examination of the Ségou and Mopti cases underscores how armed conflicts have disrupted local production processes and curtailed population consumption patterns. Notably, weekly fairs that are pivotal for economic exchanges have been either prevented or abandoned by the populations. Additionally, farms face restrictions by enforced cultivation prohibition or the intentional burning of crops upon maturity. These findings contribute valuable insights into the nuanced effects of armed conflicts, cautioning against oversimplified generalizations derived from more aggregate analyses. The study sheds light on the intricacies of the local responses to conflict-induced economic challenges, offering a deeper understanding of the complexities involved. This article is based on WIDER Working Paper 2024/53. Helsinki: UNU-WIDER. Available at: https://doi.org/10.35188/UNU-WIDER/2024/515-8 .

APSIM-based modeling approach to understand sorghum production environments in Mali

Sorghum production system in the semi-arid region of Africa is characterized by low yields which are generally attributed to high rainfall variability, poor soil fertility, and biotic factors. Production constraints must be well understood and quantified to design effective sorghum-system improvements. This study uses the state-of-the-art in silico methods and focuses on characterizing the sorghum production regions in Mali for drought occurrence and its effects on sorghum productivity. For this purpose, we adapted the APSIM-sorghum module to reproduce two cultivated photoperiod-sensitive sorghum types across a latitude of major sorghum production regions in Western Africa. We used the simulation outputs to characterize drought stress scenarios. We identified three main drought scenarios: (i) no-stress; (ii) early pre-flowering drought stress; and (iii) drought stress onset around flowering. The frequency of drought stress scenarios experienced by the two sorghum types across rainfall zones and soil types differed. As expected, the early pre-flowering and flowering drought stress occurred more frequently in isohyets < 600 mm, for the photoperiod-sensitive, late-flowering sorghum type. In isohyets above 600 mm, the frequency of drought stress was very low for both cultivars. We quantified the consequences of these drought scenarios on grain and biomass productivity. The yields of the highly-photoperiod-sensitive sorghum type were quite stable across the higher rainfall zones > 600 mm, but was affected by the drought stress in the lower rainfall zones < 600 mm. Comparatively, the less photoperiod-sensitive cultivar had notable yield gain in the driest regions < 600 mm. The results suggest that, at least for the tested crop types, drought stress might not be the major constraint to sorghum production in isohyets > 600 mm. The findings from this study provide the entry point for further quantitative testing of the Genotype × Environment × Management options required to optimize sorghum production in Mali.

Evaluation of the Performance of Rapid Diagnostic Tests for Malaria Diagnosis and Mapping of Different Plasmodium Species in Mali.

The first-line diagnosis of malaria in Mali is based on the use of rapid diagnostic tests (RDT) that detect the Histidin Rich Protein 2 (HRP2) antigen specific to Plasmodium falciparum. Our study, based on a real-time polymerase chain reaction (qPCR) gold standard, aimed to describe the distribution of the Plasmodium species in each administrative region of Mali and to assess the performance of RDTs. We randomly selected 150 malaria-negative and up to 30 malaria-positive RDTs in 41 sites distributed in 9 regions of Mali. DNA extracted from the RDT nitrocellulose strip was assayed with a pan-Plasmodium qPCR. Positive samples were then analyzed with P. falciparum-, P. malariae-, P. vivax-, or P. ovale-specific qPCRs. Of the 1496 RDTs, 258 (18.6%) were positive for Plasmodium spp., of which 96.9% were P. falciparum. The P. vivax prevalence reached 21.1% in the north. RDT displayed acceptable diagnostic indices; the lower CI95% bounds of Youden indices were all ≥0.50, except in the north (Youden index 0.66 (95% CI [0.44-0.82]) and 0.63 (95% CI [0.33-0.83]. Overall, RDT diagnostic indices are adequate for the biological diagnosis of malaria in Mali. We recommend the use of RDTs detecting P. vivax-specific antigens in the north.

Intimate partner violence and malnutrition among women of reproductive age in Western Africa: A geostatistical analysis.

Intimate partner violence (IPV) is a public health issue, and the experience varies among population sub-groups in Africa. In the West African sub-region, IPV perpetrated against women remains high and is exacerbated by the pertaining cultural milieu. It affects women's health, wellbeing, and nutritional status. We examined the association between women's lifetime experiences of physical, sexual, and emotional IPV and undernutrition by quantifying the association at smaller geographical settings in West African countries. We used a bivariate probit geostatistical technique to explore the association between IPV and undernutrition, combining data from the latest Demographic and Health Survey conducted in ten Western African countries. Bayesian inference relies on Markov chain Monte Carlo simulation. The findings demonstrate spatial clustering in the likelihood of experiencing IPV and being underweight in the regions of Mali, Sierra Leone, Liberia and neighboring Cote d'Ivoire, Ghana, Togo, Benin, Cameroon, and Nigeria. The pattern of clustering was somewhat similar when physical violence was combined with underweight and emotional violence combined with underweight. The findings also indicate protective effects of education, wealth status, employment status, urban residence, and exposure to mass media. Further, the likelihood of experiencing IPV and the likelihood of being underweight or thin declined with age and age-gap between the woman and her partner. The findings provide insight into the location-specific variations that can aid targeted interventions, and underscore the importance of empowering women holistically, in the domains of education, socio-economic and socio-cultural empowerment, in addressing women's vulnerability to IPV and malnutrition (underweight and thinness). Furthermore, IPV prevention programmes will need to address gender inequality and cultural factors such as male dominance that may heighten women's risk of experiencing IPV.

Mobile Money and the importance of timely, complete payments to frontline health campaign workers in the fight to eradicate polio: pilot experience from a World Health Organization digital payment platform in Africa

BackgroundIn response to the increase in vaccine-derived poliovirus type 2 in Côte d’Ivoire, Mali, and many other African countries from 2017 to 2019, concentrated efforts are needed to improve the effectiveness of vaccination campaigns. Frontline polio health campaign worker engagement and job retention are critical to successful campaign implementation, as well as timely, in-full payment to these workers via an electronic system.MethodsThe Global Polio Eradication Initiative and its partners designed a road map to implement the World Health Organization Mobile Money digital payment system for health campaign workers across designated African Region countries and country-specific areas. The road map included: (1) strategy communication about Mobile Money to key stakeholders; (2) prioritization of Mobile Money pilot countries; (3) establishment of a digital finance team to support Mobile Money rollout for polio campaigns; (4) implementation of Mobile Money in select pilot areas; and (5) documentation by the digital finance team of Mobile Money implementation across pilot areas. At the country-specific level, and as described in the first pilot campaign in Côte d’Ivoire, implementation of Mobile Money occurred in 3 phases: precampaign, campaign, and postcampaign.ResultsMobile Money was piloted in Côte d’Ivoire, Democratic Republic of the Congo, Ghana, Mali, and Republic of the Congo. Although program reach varied by country, the percentages of payments successfully made via Mobile Money in pilot countries were high: In campaign round 1, 99% of campaign workers in 2 regions in Mali, and 99% of campaign workers in 5 districts in Ghana were paid successfully. In Cote d’Ivoire, Mobile Money was piloted in all 113 districts for campaign rounds 1, 2 and 3, and in 4 districts in Abidjan for campaign round 3. In rounds 1, 2 and 3, 99.6%, 99.6%, and 99.9% of payments to polio health campaign workers, respectively, were made successfully.ConclusionImplementation of the Mobile Money pilot program, particularly across Côte d’Ivoire, demonstrates the value of an electronic payment system in addressing frontline polio health campaign worker need for timely, in-full payment. The World Health Organization-led Mobile Money pilot program can serve as a model for agencies committed to delivering greater efficiencies and improved health campaigns in resource-challenged settings.

Evaluating the effects of an intervention to improve the health environment for mothers and children in health centres (BECEYA) in Mali: a qualitative study.

an intervention aiming to improve the maternal and children environment in healthcare facilities (BECEYA) was launched in three regions of Mali. This study aimed to explore the perceptions and experiences of patients and their companions, community actors, and healthcare facilities staff on the effects of the BECEYA intervention in two regions of Mali. we conducted a qualitative study using an empirical phenomenological approach. Through purposive sampling, women who attended antenatal care in the selected healthcare centres, companions, and health facility staff members were recruited. Data were collected during January and February 2020 through semi-structured individual interviews and focus groups. According to Braun and Clarke's approach, audio recordings were transcribed verbatim, and a thematic analysis was conducted in five main steps. Donabedian conceptual framework of quality of care was used to present the perceived changes following the implementation of the BECEYA project. we recruited 26 participants in individual interviews (20 women attending prenatal care and maternity services, 10 per health centre, four companions, and two healthcare centre managers) and 21 healthcare centre staff members (10 in Babala, 11 in Wayerma 2) in focus groups. Themes that emerged from data analysis are perceived changes in terms of infrastructure (perceived changes in the characteristics of the healthcare facilities setting, including the infrastructure introduced by the BECEYA project), process (changes in the delivery and use of care introduced or resulting from BECEYA activities), and outcome (the direct and indirect effects of these changes on the health status of patients and the population). the study highlighted some positive effects on women users of the services, their companions, and health centre staff following the implementation of the intervention. This study contributes to showing some links between improving the environment of healthcare centres and the quality of care in developing countries.

SITUATION AND CONDITIONS OF ACCESSIBILITY OF POOR ELDERLY PEOPLE TO HEALTH CARE AND BASIC SOCIAL SERVICES IN MALI

The care of the elderly in need is a topical issue today. As a result of the consequences of scientific progress, Most of the elderly are destitute seems to be facing difficulties in accessing basic needs. This study, whose main objective is to contribute to the implementation and application of support policies for the elderly in need, took place in the first five regions of Mali and in the District of Bamako. It involved 1200 destitute elderly people and heads of certain institutions in charge of managing support for the elderly. The results obtained showed that 3% of respondents said they could not take care of themselves, 83% were not affiliated with social networks, 98% said they needed help on a daily basis, 73% had an annual income of less than 200,000 FCFA and finally 71% said they were unaware of the existence of the priority card. This study highlighted the lack of social protection for the elderly in need and calls for more policy interventions

Ethnobotanical and Floristic Investigations of Datura Species in Mali

Aims: This work aimed to investigate the floristic composition and the different medicinal uses of Datura species in addition to people perceptions about them.&#x0D; Place and Duration of Study: The floristic study has been conducted in three sites located in the region of Sikasso (Mali) during October, 2019. The ethnobotanical one was carried out in five zones located in different regions of Mali in order to register the maximum of relevant information about Datura’s therapeutic virtues.&#x0D; Methodology: A floristic and ethnobotanical investigation on Datura species was carried out based on a stratified probabilistic sampling plan. The free consent and the availability of the respondents was an important criterion during the ethnobotanical survey. Besides, the characteristic parameters of floristic diversity and relative frequencies were calculated based on literature formula.&#x0D; Results: The floristic survey allowed to register three species of Datura: D. stramonium (65.38%), D. innoxia (19.23%) et de D. ferox (15.38%). Around these species, 148 plants belonging to 39 species divided in 32 genus and 18 families. Herbaceous represented 94.87% of these inventoried species. With high coefficients of similarity (Cs&gt;50%), we noted an identical floristic diversity inside the three sites. Moreover, Tousseguela had the highest specific diversity index (1.21). The ethnobotanical survey targeted 118 people in five 5 localities with about 77% of men. If 50% of them found Datura to be useful, 50% considered it to be useful with distrust or dangerous. The data showed that the local populations use Datura in the treatment of many diseases; the most cited were dermatosis (16.98%) and swelling (14.15%). The leaves (93.83%) and seeds (14.81%) were the most exploited organs mainly in the form of decoction (61.18%) and by oral route, massage (15.66%) and bath (13.25%).&#x0D; Conclusion: These results reveal the floristic richness of Datura genus and its associated species.

Inventory of Local Practices of Use and Conservation of Baobab Products in Two Regions of Mali

The baobab (Adansonia digitata) occupies an important place in the diet of local populations in Mali. This work aimed to conduct an ethnobotanical survey in two regions of Mali: Ségou (municipality of Cinzana) and Mopti (municipalities of Bankass and Kopropin) in order to determine the forms of use of baobab organs. The survey was conducted using a semi-structured questionnaire and direct interviews. The results showed that all parts of the baobab were used, with the leaves (100%) and the fruit pulp (98.30%) as the most consumed. In addition, the barks (68.30%), the branches, and the trunks (60%) were also widely used for socio-economic and therapeutic needs. All the edible organs were consumed in the sauce. The pulp was mainly consumed in the form of cream (96.70%), porridge (43.30%), and juice and syrup (10%). Despite their nutritional values, the seeds were little used (8.30%) and transformed into soap, oil "soumbala" and "datou" (forms of local spices). The taste (30-66.70%) and the color (1.70-38.30%) were the main criteria used to assess the quality of edible organs. The sun drying (100%) was the main method of preservation. Due to the bad storage conditions, the populations are facing problems of termite and worm infestation (20%). These results indicate the need to develop improved technologies to better preserve the nutritional quality of baobab products.

Defining functional groups of tree species according to rural stakeholder perceptions in Central Mali

In the dry areas of western Africa, the over-exploitation of forestry resources and the lack of tree regeneration lead to the degradation of agroforestry parklands. Such parklands could be better managed if the multiple services provided by the trees were well identified and valorized. However, there is little information on the local knowledge of' tree species regarding their functions, uses and services. Likewise, local stakeholders' perceptions of the relation between the species aptness for the above functions and uses and their functional traits is not well known. This study focuses on local knowledge of tree species in parklands of the Segou region in Mali, in order to identify specific uses or multifunctionalities that could be highlighted in improving agroforestry systems. Qualitative surveys have been carried out to identify users' perceptions of tree functions and functional traits. Findings show the possibility of classifying species by relevant functional groups, i.e. woody/timber trees, fruit/cash crop trees and trees related to livestock. Functional traits were not easily identified by farmers and the related information was difficult to analyze. Moreover, the perception of functions and traits depended on user groups (craftsmen, crop farmers, livestock farmers, traditional health practitioners, women etc.) and on agro-environmental and socio-economic contexts (activities, knowledge, means and practices). Therefore, scientific databases composed of lists of functions and traits for a given species have no generic value and must be valued depending on the context which may or may not enhance the substitutions between species for each use.

Building a Culture of Biosafety, Biosecurity, and Responsible Conduct in the Life Sciences: A View from Mali

Adherence to biosafety and biosecurity standards and practices by those involved in the life sciences is essential to protecting the health of humans, animals, and the environment. Fostering a culture of responsibility is one of the underlying tenets of the Biological Weapons Convention, the Global Health Security Agenda, Joint External Evaluation of International Health Regulations, and the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction. It also underpins national and international efforts to protect science from misuse and to protect workers and the public from laboratory incidents. Unlike the nuclear domain, there is no available guidance or unified perspective on the nature of this culture or how it may be assessed. The International Working Group on Strengthening the Culture of Biosafety, Biosecurity, and Responsible Conduct in the Life Sciences developed a framework to assess organizational culture in biological laboratories based on the model developed by the International Atomic Energy Agency for nuclear facilities. This framework encompasses 1) management systems; 2) behavior of leadership and personnel; 3) principles for guiding decisions and behaviors; and 4) beliefs, opinions and attitudes. Here we present an example of how the beliefs, opinions, and attitudes element was employed to assess the organizational culture of laboratorians from five regions in Mali. This is the first assessment using the framework and, as such, provides a model for others seeking to improve biosafety and biosecurity, and may ultimately lead to international harmonization of this concept and provide a pathway to strengthen Mali’s laboratory system.

Prevalence and factors associated with HIV infection among people with disabilities in Mali

ABSTRACT Previous studies on HIV and disability have reported the vulnerability of people with disabilities (PWDs) to HIV and the need to include them in HIV prevention programs. However, in Mali, data on HIV among this population is scarce. This study aims to estimate HIV prevalence and risk factors among people with disabilities in Mali. We conducted a household-based cross-sectional study in six regions of Mali. The Washington Group (WG) short questionnaire was used to identify PWDs in the household. A total of 1051 PWDs were included in the study. The prevalence of HIV infection among people with disabilities in Mali was 2.38% (25/1051), with a 95% confidence interval (CI) of 1.58%–3.44%. HIV prevalence was higher in women (3.31% [95%CI: 2.14–4.88]) than in men (0.78% [95%CI: 0.22–2.06]). People with visual or intellectual functional limitations were the most affected, with 3.93% (95%CI: 2.22–6.44) and 2.67% (95%CI: 0.56–8.28), respectively. Multivariate analysis shows that age, sex, type of disability and sexual violence are the risk factors for HIV infection among people with disabilities in Mali. These results suggest that HIV strategies should include people with disabilities in order to achieve the target of ending the HIV/AIDS epidemic by 2030 in Mali.

Preprocessing approaches in machine-learning-based groundwater potential mapping: an application to the Koulikoro and Bamako regions, Mali

Abstract. Groundwater is crucial for domestic supplies in the Sahel, where the strategic importance of aquifers will increase in the coming years due to climate change. Groundwater potential mapping is a valuable tool to underpin water management in the region and, hence, to improve drinking water access. This paper presents a machine learning method to map groundwater potential. This is illustrated through its application in two administrative regions of Mali. A set of explanatory variables for the presence of groundwater is developed first. Scaling methods (standardization, normalization, maximum absolute value and max–min scaling) are used to avoid the pitfalls associated with reclassification. Noisy, collinear and counterproductive variables are identified and excluded from the input dataset. A total of 20 machine learning classifiers are then trained and tested on a large borehole database (n=3345) in order to find meaningful correlations between the presence or absence of groundwater and the explanatory variables. Maximum absolute value and standardization proved the most efficient scaling techniques, while tree-based algorithms (accuracy &gt;0.85) consistently outperformed other classifiers. The borehole flow rate data were then used to calibrate the results beyond standard machine learning metrics, thereby adding robustness to the predictions. The southern part of the study area presents the better groundwater prospect, which is consistent with the geological and climatic setting. Outcomes lead to three major conclusions: (1) picking the best performers out of a large number of machine learning classifiers is recommended as a good methodological practice, (2) standard machine learning metrics should be complemented with additional hydrogeological indicators whenever possible and (3) variable scaling contributes to minimize expert bias.

Challenges and difficulties in implementing and adopting isolation and quarantine measures among internally displaced people during the COVID-19 pandemic in Mali (161/250)

IntroductionIsolation and quarantine are among the key measures that protect internally displaced people (IDPs) against COVID-19. This study aims to identify the challenges encountered by humanitarian actors, and health, political, and administrative stakeholders in implementing these measures. It also describes the difficulties faced by IDPs when adopting them, and the local initiatives developed to overcome those difficulties. MethodWe conducted a qualitative survey consisting of individual interviews and focus groups among IDPs, humanitarian actors, and health, political, and administrative stakeholders. The data was collected between November and December 2020 in the Bamako and Ségou Regions of Mali. Interviews were recorded with audio recorders, then transcribed and thematically analyzed using the NVivo 13 software. FindingsThe study involved 36 individual interviews and eight focus groups with 68 participants of whom IDPs represented 72.3%. The main challenges reported on IDP sites included difficulties in contacting positive cases, a lack of facilities for quarantine and isolation, a lack of physical space for building new facilities, and a lack of financial resources to support IDPs during isolation and quarantine. The difficulties reported included: changes in social behavior and practices, fear of stigma, a poor level of literacy, and language barriers. To address those difficulties, the local initiatives developed by IDPs included strengthening the awareness of IDPs on COVID-19, early warning of sites’ leaders about positive and suspected cases, and setting up a toll-free number to facilitate access to appropriate information on COVID-19. ConclusionThe findings of this study could be used as evidence to guide policy, adjust current strategies and take into account with more focus IDPs, a group with increased vulnerability, in COVID-19 response, more precisely during the implementation of isolation and quarantine measures. By doing so, they will help improve the response to COVID-19, IDPs health, and population health.

Segmented terrorism in the Sahara-Sahel zone. The second stage: 2016-2021

Several distinctive points characterize the second stage under analyses: the expansion of new armed alliances - Jamā’at Nuṣrat al Islām wal Muslimīn (JNIM) and Islamic State of the Greater Sahara (ISGS); the rise of resistance movement; the growth of inter- and intra-communal tensions. Conflicts embraced the regions of Central Mali, Niger and Burkina Faso, populated predominantly by ethnic Fulani. Armed jihadi groups spread alarmingly in the northern border zones of Benin, Côte d’Ivoire and Western Nigeria. Trying to stop destabilization, Mali, Niger and Burkina Faso harshly and unduly pressed local population (predominantly the cattle-breeder Fulani) instead of mounting preventive measures. Indiscriminating state military campaigns further provoked radicalisation of ethno-militias aggravating struggle for meager resources, retaliatory actions and ethnic cleansing. The net result of the government’s policies has been inflation of its legitimacy in the Fulani populated regions of Mali, Niger and Burkina Faso. It became the best situation for JNIM and ISGS to recruit. In contrast with the previous stage, JNIM and ISGS are deeply rooted in local clan-cast structures and enjoy more support from wider population. For some years theу have effectively managed access to pastures and water resources, resolve communal disputes and protect willing pastoralists, hunters, traders and peasants from bandits and corrupt state officials. Drivers and deep causes of the situation cannot be explained from the perspective of ‘common enemy’ in the ‘war on terror’ - implicit impetus of many anti-terror studies and related international laws, both in dire need of revaluation.

Effects of low-cost agricultural technology package on income, cereal surplus production, household expenditure, and food security in the drylands of Mali

&lt;abstract&gt; &lt;p&gt;This study assessed the effects of introducing a technology package consisting of seed priming and microdosing of mineral fertilizer on sorghum and pearl millet yield, cereal production, net value of cereal production, household expenditure, adoption rate of technology and household food security in the millet and sorghum producing areas in Mopti, Segou and Koulikoro regions of Mali. Three different surveys were undertaken to collect the data during the period from 2013 to 2015. The first survey assessed the farmers practices (360 households), the second survey assessed production, household expenditure and food security in the households (54 households) and the third survey assessed the adoption rates of the technologies (108 households). The surplus cereal production was in average 1155 kg/household for adopting households while non-adopting households had a surplus of only 196 kg/household. The monetary surplus increased from 31.2 Euro for non-adopting households to 215.6 Euro for adopting households. Households using the package spent 167.8 Euro on health, children's education, and other necessities while non-adopting households spent only 29.5 Euro. Furthermore, households using the package spent 55.9 Euro on fertilizer against close to zero for non-adopting households. Finally, the number of food insecure months were significantly reduced from 3.57 months for the adopting households to 1.24 months for non-adopting households. The technology package initiated positive development pathways characterized by increased production and income, surplus grain production, investments in livelihood assets and yield-enhancing technologies and improved food security. This link from technology introduction to improved food security is very important from a development perspective, but there is a lack of research that clearly demonstrate this effect in the drylands of West Africa. Future interventions to ensure a more broad-based development should focus on continued investment in yield-enhancing technologies, diversification of production to ensure better access to high quality food, strengthening the role of women, and building institutions to support farmers' livelihood and agency.&lt;/p&gt; &lt;/abstract&gt;

THE IMZAD AND TUAREG MUSIC: GENDER DEBATES VERSUS BELIEFS, VALUES AND PROMOTIONS

This paper discusses the Tuareg people of the Central Sahara, outlining salient issues relating to the imzad (a Targai musical instrument) and gender. It examines the various ways in which gender and gendered meanings are derived in musical instruments. Drawing upon Veronica Doubleday’s theory on gendered meanings constructed within relationships between humans and musical instruments, the paper examines the dual instrumental monopolies of the Targai (Tuareg women musicians) and the Targui (Tuareg men musicians) living in the region of Mali, Niger and Algeria. It argues that gendered monopolies and dominance in music and musical instruments is not a necessary debate; beliefs, value systems and hereditary among other factors, may necessitate the observed male-female monopolies in music performances (voice or instrument). Our cultural beliefs, values and safeguarding practices are of more importance when rightly channelled by our indigenous music, they can attract investors and promotions on the international scale. The paper contributes to the vast ethnomusicological literature on music and gender.

Combined Clinical Audits and Low-Dose, High-frequency, In-service Training of Health Care Providers and Community Health Workers to Improve Maternal and Newborn Health in Mali: Protocol for a Pragmatic Cluster Randomized Trial.

BackgroundAlthough most births in Mali occur in health facilities, a substantial number of newborns still die during delivery and within the first 7 days of life, mainly because of existing training deficiencies and the challenges of maintaining intrapartum and postpartum care skills.ObjectiveThis trial aims to assess the effectiveness and cost-effectiveness of an intervention combining clinical audits and low-dose, high-frequency (LDHF) in-service training of health care providers and community health workers to reduce perinatal mortality.MethodsThe study is a three-arm cluster randomized controlled trial in the Koulikoro region in Mali. The units of randomization are each of 84 primary care facilities. Each trial arm will include 28 facilities. The facilities in the first intervention arm will receive support in implementing mortality and morbidity audits, followed by one-day LDHF training biweekly, for 6 months. The health workers in the second intervention arm (28 facilities) will receive a refresher course in maternal neonatal and child health (MNCH) for 10 days in a classroom setting, in addition to mortality and morbidity audits and LDHF hands-on training for 6 months. The control arm, also with 28 facilities, will consist solely of the standard MNCH refresher training delivered in a classroom setting. The main outcomes are perinatal deaths in the intervention arms compared with those in the control arm. A final sample of approximately 600 deliveries per cluster was expected for a total of 30,000 newborns over 14 months. Data sources included both routine health records and follow-up household surveys of all women who recently gave birth in the study facility 7 days postdelivery. Data collection tools will capture perinatal deaths, complications, and adverse events, as well as the status of the newborn during the perinatal period. A full economic evaluation will be conducted to determine the incremental cost-effectiveness of each of the case-based focused LDHF hands-on training strategies in comparison to MNCH refresher training in a classroom setting.ResultsThe trial is complete. The recruitment began on July 15, 2019, and data collection began on July 23, 2019, and was completed in November 2020. Data cleaning or analyses began at the time of submission of the protocol.ConclusionsThe results will provide policy makers and practitioners with crucial information on the impact of different health care provider training modalities on maternal and newborn health outcomes and how to successfully implement these strategies in resource-limited settings.Trial RegistrationClinicalTrials.gov NCT03656237; https://clinicaltrials.gov/ct2/show/NCT03656237International Registered Report Identifier (IRRID)DERR1-10.2196/28644