Relationships In sub-Saharan Africa Research Articles

What do voters want from their legislators? evidence from ghana

Abstract Legislators make trade-offs when allocating their time and resources to their multiple tasks of representation, legislation, executive oversight, and constituency service. Furthermore, they must decide how much effort to exert or the balance to strike when undertaking a specific function. Existing research provides limited insights into citizens’ preferences over these officeholder multifaceted decisions in sub-Saharan Africa. I offer novel insights into citizens’ preferences using a conjoint survey experiment of Ghanaians to address this knowledge gap. My findings are threefold. First, I find that citizens put more ‘weight’ on constituency-related activities than parliamentary work. Second, in the constituency, citizens value political representation activities more than constituency services. Third, they weigh public-good-oriented constituency services higher than private ones. The research contributes to our understanding of citizen–legislator accountability relationships in sub-Saharan Africa.

Corruption-inequality relationship in Sub-Saharan Africa

This paper investigates the effect of corruption on income inequality in Sub-Saharan Africa (SSA) over the period 1996–2022. Applying a threshold model approach notably the Panel Smooth Transition Regression (PSTR), two major results emerge from this analysis. First, the results reveal a U-shaped relationship between corruption and income inequality, with a different inflection point depending on the type of corruption. Second, we obtained strong evidence that corruption significantly increases income inequality in Sub-Saharan Africa only if the level of corruption is above a certain threshold, otherwise the effect of corruption is not detrimental. Furthermore, the results indicate that judicial corruption has the most detrimental effect on income inequality, followed by executive and legislative corruption. The paper suggests that public authorities promote transparency and good governance. Also, allocating resources to improving the education and healthcare systems will also help reduce inequalities.

Bank capital and liquidity creation in Sub-Saharan Africa: the role of quality institutions

PurposeThis study investigates the relationship between bank capital and liquidity creation and further examines the effect that institutional quality has on this relationship in Sub-Saharan Africa (SSA).Design/methodology/approachThe data comprise 41 universal banks in nine SSA countries from 2010 to 2022. The study employs the two-step system generalized methods of moments and further uses alternative estimators such as the fixed-effect and two-stage least squares methods.FindingsThe empirical results show that bank capital has a direct positive and significant effect on liquidity creation. In addition, the positive effect of bank capital on liquidity creation is enhanced, particularly in a strong institutional environment. The results imply that nonconstraining capital regulatory policies bolster bank solvency, improve risk-absorption capacity and increase liquidity creation.Practical implicationsThis study has several policy implications. First, it provides empirical evidence on the position of banks in SSA on the financial fragility and risk-absorption hypothesis of bank capital and liquidity creation debates. This study shows that the effect of bank capital on liquidity creation in SSA countries is positive and supports the risk-absorption hypothesis. Second, this study highlights that a country's quality institutions can complement bank capital to increase liquidity creation. In addition, this study highlights that nonconstraining capital regulatory policies will bolster bank solvency, improve risk-absorption capacity and increase liquidity creation.Originality/valueThe novelty of this study is that it introduces the country's quality institutional environment into bank capital and liquidity creation links for the first time in SSA.

Organization–government relationships in sub-Saharan Africa: the emerging public affairs industry in Kenya

PurposeThis paper offers grounded insights on organization–government relationships, or the practice of public affairs, in Kenya.Design/methodology/approachIn-depth interviews were conducted with senior Kenyan practitioners. Interviewees represent national corporations, multinational corporations with offices in Kenya, consulting agencies, parastatal intergovernmental organizations, national government and county governments.FindingsResults suggest Kenyan public affairs is centered on relationship management, research and intelligence gathering, risk management and strategic communication. Second, while lobbying is a tactic, it is not synonymous with the broader scope of public affairs strategy. Third, the absence of educational training, a professional body to oversee the profession and the perception of public affairs as “bribery” are threats to the profession's growth.Research limitations/implicationsFindings should not be interpreted to represent “Africa's public affairs industry,” rather a snapshot of the profession contextualized in Kenya.Practical implicationsKenya needs a professional body to manage the public affairs profession at a national level. It also needs an established curriculum in its higher education environment. Lastly, as one of the fastest growing markets in the world, understanding the public policy environment will benefit multinational organizations looking to expand and operate in Kenya.Originality/valueThis study contributes diverse and inclusive insights on the practice of public affairs in a leading economic and political actor in sub-Saharan Africa. It also expands organization–public relationship theory to articulate engagement with governmental stakeholders.

Agricultural Productivity and Climate Change: An Evidence of a Non-linear Relationship in Sub-Saharan Africa

Agricultural Productivity and Climate Change: An Evidence of a Non-linear Relationship in Sub-Saharan Africa

Men's Reflections on Romantic Jealousy and Intimate Partner Violence in Mwanza, Tanzania.

Romantic jealousy is a prominent trigger for intimate partner violence. Yet, there are few studies on this relationship in sub-Saharan Africa and none captures men's perspectives. To expand the existing knowledge on romantic jealousy and its relation to intimate partner violence, our study analyzed 30 in-depth interviews with male participants. Triggers of romantic jealousy included suspicion or confirmed infidelity, reduced attention from their partners, and challenges to male supremacy. Men reported that intimate partner violence was a frequently used response to triggers of romantic jealousy. Social norms and inequitable gender norms were key underlying factors to all those triggers.

Towards achievement of Sustainable Development Goal 3: multilevel analyses of demographic and health survey data on health insurance coverage and maternal healthcare utilisation in sub-Saharan Africa.

Improving maternal health and achieving universal health coverage (UHC) are important expectations in the global Sustainable Development Goals (SDGs) agenda. While health insurance has been shown as effective in the utilisation of maternal healthcare, there is a paucity of literature on this relationship in sub-Saharan Africa (SSA). We examined the relationship between health insurance coverage and maternal healthcare utilisation using demographic and health survey data. This was a cross-sectional study of 195 651 women aged 15-49 y from 28 countries in SSA. We adopted bivariable and multivariable analyses comprising χ2 test and multilevel binary logistic regression in analysing the data. The prevalence of maternal healthcare utilisation was 58, 70.6 and 40.7% for antenatal care (ANC), skilled birth attendance (SBA) and postnatal care (PNC), respectively. The prevalence of health insurance coverage was 6.4%. Women covered by health insurance were more likely to utilise ANC (adjusted OR [aOR]=1.48, 95% CI 1.41 to 1.54), SBA (aOR=1.37, 95% CI 1.30 to 1.45) and PNC (aOR=1.42, 95% CI 1.37 to 1.48). Health insurance coverage was an important predictor of maternal healthcare utilisation in our study. To accelerate progress towards the achievement of SDG 3 targets related to the reduction of maternal mortality and achievement of UHC, countries should adopt interventions to increase maternal insurance coverage, which may lead to higher maternal healthcare access and utilisation during pregnancy.

Contraceptive use and fertility transitions: The distinctive experience of sub-Saharan Africa

Continued rapid population growth in sub-Saharan Africa is driven predominantly by high fertility. Contraceptive use was a key determinant of past fertility transitions. An analysis of this relationship in sub-Saharan Africa can yield a better understandin

Association Between Girl-child Marriage and Intimate Partner Violence in Sub-Saharan Africa: Insights From a Multicountry Analysis of Demographic and Health Surveys.

While considerable attention has been given to the health consequences of child marriage in Sub-Saharan Africa (SSA), limited studies exist on its impact on intimate partner violence (IPV) in the region. We address this gap by examining the link between child marriage and IPV. We tested our study hypothesis using demographic and health survey data of 28,206 young women aged 20-24 years from 16 SSA countries with recent surveys (2015-2019). Binary logistic regression models were used to examine the effect of child marriage on IPV. Child marriage prevalence ranged from 13.5% in Rwanda, in East Africa, to 77% in Chad, in Central Africa, while IPV ranged from 17.5% in Mozambique in Southern Africa to 42% in Uganda, in East Africa. Past year experience of IPV was higher among young women who married or begun cohabiting before the age of 18 (36.9%) than those who did at age 18 or more (32.5%). This result was consistent for all forms of violence: physical violence (22.7% vs 19.7%), emotional violence (25.3% vs 21.9%), and sexual violence (12% vs 10.4%). After controlling for covariates, we found that young women in SSA who married before 18 years were more likely to experience IPV than those who married as adults (AOR: 1.20; 95% CI [1.12, 1.29]). Significant heterogeneity was observed in the country-level results, with a higher likelihood of IPV found in 14 of the 16 countries and lower in Angola and Chad. Child marriage is associated with a higher likelihood of IPV in most SSA countries, suggesting that ending child marriage will result in a substantial reduction in IPV. There is a need to institute policies to support and protect women who marry as children from abusive relationships in SSA.

Systolic blood pressure and 6-year mortality in South Africa: a country-wide, population-based cohort study

Improving hypertension control is an important global health priority yet, to our knowledge, there is no direct evidence on the blood pressure (BP)-mortality relationship in sub-Saharan Africa. We investigate the BP-mortality relationship in South Africa and assess the comparative effectiveness of different care targets for clinical care and population-wide hypertension management efforts. We use country-wide population-based longitudinal data from five waves (2008 - 2017) of the South African National Income Dynamics Study (N = 4,993). We estimate the relationship between systolic BP (SBP) and six-year all-cause mortality and compare the mortality reductions associated with lowering SBP to different targets. We then estimate the number needed to treat to avert one death (NNT) under different hypothetical population-wide scale up scenarios. We found a weak, nonlinear, SBP-mortality relationship with larger incremental mortality benefits at higher SBP values: reducing SBP from 160 to 150 mmHg was associated with a mortality risk ratio of 0.95 (95% CI: 0.90, 0.99, p = 0.033), incrementally reducing SBP from 150 to 140 mmHg a risk ratio of 0.96 (95% CI: 0.91, 1.01, p = 0.12), with no evidence of incremental benefits of reducing BP below 140 mmHg. At the population level, reducing SBP to 150 mmHg among all those with an SBP > 150 mmHg had the lowest NNT (50) at 3.3 deaths averted (95% CI: -0.6, 0.3) per 1,000 population while requiring BP management for 16% (95% CI: 15.2, 17.3) of individuals. The SBP-mortality association is weaker in South Africa than in high-income and many low- and middle-income countries. As such, we do not find compelling evidence in support of targets below 140 mmHg and find that scaling up management based on a 150 mmHg target is more efficient in terms of the NNT compared to strategies to reduce SBP to lower values.

Positive Deviance for Promoting Dual-Method Contraceptive Use Among Women in Uganda: A Cluster Randomized Controlled Trial

Background: Dual-method use, or using condoms with highly effective contraceptives, is effective at preventing both pregnancies and HIV infections. Although it remains uncommon among women in long-term relationships in sub-Saharan Africa, some do practice it. The positive deviance approach aims to promulgate practices of such individuals to other members in the community. We examined the effects of a positive deviance intervention on dual-method use among married or in-union women. Methods: We conducted a cluster randomized controlled trial in 20 health facilities in Mbarara District, Uganda, with 960 women aged 18–49 years. The intervention was a combination of clinic- and phone-based counseling and a participatory workshop, which was developed based on the qualitative study of women using dual-method in the study area and delivered by them. The control group received regular clinic-based counseling and health-related messages via phone. We assessed dual-method use at the last sexual intercourse and consistent dual-method use at two, four, six and eight months after enrollment. Findings: More women in the intervention group reported dual-method use at the last sexual intercourse at two months (AOR = 4·29; 95% CI: 2·12–8·69; p < 0·001) and at eight months (AOR = 2·19; 95% CI: 1·07–4·48; p = 0·032). Consistent dual-method use was also more prevalent in the intervention group at two months (AOR = 13·71; 95% CI: 3·59–52·43; p < 0·001), and the intervention effect remained at four, six, and eight months. Interpretation: The intervention can be a potential option for promoting dual-method use among women in long-term relationships in Uganda. Trial Registration: The protocol was registered at UMIN-CTR Clinical Trial under identifier number UMI37065. Funding: Scholarship grant from Foundation for Advanced Studies on International Development (FASID), Tokyo, Japan. Declaration of Interests: The authors declare no conflict of interest. S.M. works at UNICEF Uganda, but the information in this article represents S.M.’s personal views and opinions and does not necessarily represent UNICEF Uganda’s position. Ethics Approval Statement: The study was approved by the Research Ethics Committee of the Graduate School of Medicine, University of Tokyo (2019085NI), Institutional Research and Ethics Committee of Mbarara University of Science and Technology (IRB15/06-19), and Uganda National Council of Science and Technology (HS439ES). Participation was voluntary, and the participants provided written informed consent.

Psychiatric Comorbidity in A Dermatology Outpatient Clinic in A Lagos Tertiary Hospital

Background and Purpose: The significant association between dermatological disorders and psychopathology has been established globally. However, little work has been documented about this relationship in sub-Saharan Africa. The objective of this study was to determine the prevalence of psychiatric morbidity and its correlation with age, gender and marital status among adult patients attending the dermatology outpatient clinic in Lagos, Nigeria. Methodology: Seven hundred and nine consecutive new adult patients attending the dermatology outpatients’ clinic at the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria were recruited and invited to complete the Hospital Anxiety and Depression Scale. Results: There were 305 (43.0%) males and 404 (57.0%) females. Of the total number of participants, 33.9% and 15.6% had various degrees of probable anxiety and depression respectively with an overall prevalence of 9.0%. There were no significant associations between the psychometric and sociodemographic variables. Conclusion and Recommendation: This study also demonstrated that dermatological diseases can comorbid with psychiatric disorders. Therefore, early detection and psychological intervention of identified and diagnosed of psychiatric symptoms or disorders in dermatological patients is of significant therapeutic importance.

The Information Communication Technology, Social Media, International Migration and Migrants’ Relations with Kin in Nigeria

Studies abound on international migration and remittances across the world and studies are particularly not lacking on the subject in Africa. There are however few studies on the moderating roles of information communication technology (ICT) and social media in the relationships among international migration, remittances and relationships in Sub-Saharan Africa. This article examines the dimension of ICT and social media in migration studies. This is an aspect that has often been ignored and overlooked even though ICT and social media have great contributions in the international migration process particularly as migrants and relatives in sending and receiving countries both have the primary experience. Research objectives include: reasons for emigration; information technology/social media used by migrants and their kin as they relate across spaces; and how ICT affects relationships of kin and international migrants. Secondary data were gathered through journals, books, documents and reliable Internet sources. Primary data were gathered in Ibadan, Nigeria in 2018 through 30 in-depth interviews analysed through content analysis. Findings reveal the nature of ICT used by international migrants and their kin and purpose of utilization and the effects of ICT on international migration, remittances and kinship networks. The article presents detailed data, narratives, interpretations and implications of relationships among international migration, ICT/social media and kinship networks. This article argues that ICT/social media is central to international migration decision-making, access of migrants and kin to social forces and factors motivating international migration, and it is very important to how migrants and kin maintain and/or weaken relationships and access to remittances and utilization.

Human papillomavirus and abnormal cervical lesions among HIV-infected women in HIV-discordant couples from Kenya

ObjectiveHIV infection increases the risk of high-grade cervical neoplasia and invasive cervical carcinoma. The study addresses the limited data describing human papillomavirus (HPV) infection and cervical neoplasia among HIV-infected women...

Forming mixed-type inter-organisational relationships in Sub-Saharan Africa: The role of institutional logics, social identities and institutionally embedded agency

Neo-liberal reforms in Sub-Saharan African countries, under pressure from international donors, have increased the number of mixed-type inter-organisational relationships in their public sectors. However, existing accounting studies often ignore the role of institutional environments and institutionally embedded agents in shaping these relationships. This is an important omission in Sub-Saharan Africa given its institutional complexity. This paper reports a case study of a national public pension fund in a Sub-Saharan African country which invests in real estate developments through mixed-type inter-organisational relationships. We show how it develops new inter-organisational management controls by selectively coupling its private sector and public sector logics at the organisational level, while at the individual level institutionally embedded organisational actors, drawing on social identities which enact societal-level logics, can impede (and possibly subvert) these controls. For this purpose, we develop a conceptual framework by drawing on the institutional logics perspective, and especially microfoundations provided by Thornton and her colleagues, which recognises institutional logics at various levels and highlights the importance of social identity and embedded agency. We argue that, rather than implementing the ‘best practices’ from developed countries, research should look for African solutions which build on and adapt traditional institutional logics and practices.

Linking Vegetation-Climate-Fire Relationships in Sub-Saharan Africa to Key Ecological Processes in Two Dynamic Global Vegetation Models

Africa is largely influenced by fires, which play an important ecological role influencing the distribution and structure of grassland, savanna and forest biomes. Here vegetation strongly interacts with climate and other environmental factors, such as herbivory and humans. Fire-enabled Dynamic Global Vegetation Models (DGVMs) display high uncertainty in predicting the distribution of current tropical biomes and the associated transitions, mainly due to the way they represent the main ecological processes and feedbacks related to water and fire. The aim of this study is to evaluate the outcomes of two state-of-the–art DGVMs, LPJ-GUESS and JSBACH, also currently used in two Earth System Models (ESMs), in order to assess which key ecological processes need to be included or improved to represent realistic interactions between vegetation cover, precipitation and fires in sub-Saharan Africa. To this end, we compare models and remote-sensing data, analyzing the relationships between tree and grass cover, mean annual rainfall, average rainfall seasonality and average fire intervals, using generalized linear models, and we compare the patterns of grasslands, savannas, and forests in sub-Saharan Africa. Our analysis suggests that LPJ-GUESS (with a simple fire-model and complex vegetation description) performs well in regions of low precipitation, while in humid and mesic areas the representation of the fire process should probably be improved to obtain more open savannas. JSBACH (with a complex fire-model and a simple vegetation description) can simulate a vegetation-fire feedback that can maintain open savannas at intermediate and high precipitation, although this feedback seems to have stronger effects than observed, while at low precipitation JSBACH needs improvements in the representation of tree-grass competition and drought effects. This comparative process-based analysis permits to highlight the main factors that determine the tropical vegetation distribution in models and observations in sub-Saharan Africa, suggesting possible improvements in DGVMs and, consequently, in ESM simulations for future projections. Given the need to use carbon storage in vegetation as a climate mitigation measure, these models represent a valuable tool to improve our understanding of the sustainability of vegetation carbon pools as a carbon sink and the vulnerability to disturbances such as fire. (Less)

Risk of HIV infection among adolescent girls and young women in age-disparate relationships in sub-Saharan Africa.

To determine the association between age-disparate relationships and risk of HIV infection among adolescent girls and young women (AGYW) aged 15-24 years. Systematic review and meta-analysis of published studies until January 5, 2020 in sub Saharan Africa (SSA). We searched several electronic databases, grey literature, and hand searched reference list of included studies to identify eligible studies for data abstraction. We assessed the quality of included studies using Newcastle-Ottawa Scale for nonrandomized studies. The DerSimonian-Laird random effects model was used to pool the overall results using risk ratios (RR), presented in a forest plot with 95% confidence interval (CI) and predictive interval. Heterogeneity was assessed with Cochrane's Q-test and quantified with I values. Publication bias was checked with funnel plots and Egger's test. We included 24 studies with an overall sample size of 33 390. Data show that age-disparate relationships were significantly associated with unprotected sexual intercourse (pooled RR, 1.57; 95% CI, 1.34-1.83; 95% predictive interval, 1.22-2.02), and higher risk for HIV infection (pooled RR, 1.39; 95 CI, 1.21-1.60; 95% predictive interval, 0.80-2.42). Studies included in pooling risk of unprotected sexual intercourse were largely homogeneous (I-value= 0.0, P = 0.79) whereas those for HIV infection were heterogeneous (I- value = 89.0%, P < 0.01). We found no publication bias and no study influenced the meta-analytic results. Age-disparate relationships among AGYW are associated with increased risk of unprotected sexual intercourse and HIV infection in SSA. HIV prevention interventions should target this sub-population.

Alcohol use and relationship quality among South African couples

Objective: The HIV literature has largely ignored the importance of alcohol use in the quality of intimate relationships in sub-Saharan Africa (SSA), despite evidence of alcohol’s role in relational behaviors that increase risk for HIV infection and other harms. The present study explored the association of alcohol use with relationship functioning among heterosexual couples from rural South Africa. Method: Dyadic analyses were conducted with 443 sexually active, heterosexual, South African couples (886 individuals) to examine the association between male partners’ alcohol use (abstinent, nonhazardous, and hazardous), and male and female partners’ reports of relationship intimacy, trust, mutually constructive communication, demand/withdraw communication, and satisfaction. Five structural equation models were fit using male partner alcohol use as a predictor of male and female reports of relationship quality. Results: Women with a hazardous-drinking male partner (compared to an abstainer) reported significantly higher levels of intimacy (p <.05) and significantly more demand/withdraw communication (p <.001); men who were hazardous drinkers reported significantly less trust in their relationship compared to men who were abstainers (p < .01). Conclusions: Hazardous alcohol use among South African couples is positively correlated with women’s relationship intimacy and maladaptive communication patterns, yet negatively correlated with men’s perceived trust.

FDI And Economic Growth Relationship In Sub-Saharan Africa: Is The Domestic Financial System A Significant Intermediator?

This paper contributes to the literature on the effect of Foreign Direct Investment (FDI) on economic growth by examining the role of financial development as a source of absorptive capacity in the FDI-economic growth relationship in Sub-Saharan Africa (SSA). Using panel data econometric techniques and an unbalanced dataset of 1989-2013, we examine the independent effect of FDI on economic growth, as well as the impact of an interactive relationship between FDI and financial development on economic growth in SSA. We find that FDI does not directly lead to economic growth in SSA. However, the financial system through banking sector development enhances the effect of FDI on economic growth in the region. This finding is linked to the existence of a causal relationship between banking sector development and FDI, which is stronger in the low-income subsample relative to the middle-income subsample and the full SSA sample. We also estimate the threshold financial development levels essential for the expected FDI-economic growth effect to occur. Finally, the study recommends that strategies toward the attraction of foreign capital in SSA must be complemented by measures to develop the domestic financial system.

Structural and functional network characteristics and facility delivery among women in rural Ghana

BackgroundHealth facility births contribute to the prevention of maternal deaths. Although theoretical and empirical evidence suggest that social network characteristics influence facility delivery, examination of this relationship in sub-Saharan Africa is limited. We determined whether network structural and functional characteristics were associated with, or had an interactive effect on health facility delivery in rural Ghana.MethodsData on mothers (n = 783) aged 15–49 years came from a Maternal and Newborn Health Referral (MNHR) project in Ghana, and included egocentric network data on women’s social network characteristics. Using multivariate logistic regression we examined the relationship between facility delivery and women’s network structure and functions, as well as the interaction between network characteristics and facility delivery.ResultsHigher levels of instrumental support (e.g. help with daily chores or seeking health care [OR: 1.60, CI: 1.10–2.34]) and informational support (OR: 1.66, CI: 1.08–2.54) were significantly associated with higher odds of facility delivery. Social norms, such as knowing more women who had received pregnancy-related care in a facility, were significantly associated with higher odds of facility delivery (OR: 2.20, CI: 1.21–4.00). The number of network members that respondents lived nearby moderated the positive relationship between informational support and facility delivery. Additionally, informational support moderated the positive relationship between facility delivery and the number of women the respondents knew who had utilized a facility for pregnancy-related care.ConclusionsSocial support from network members was critical to facilitating health facility delivery, and support was further enhanced by women’s network structure and norms favoring facility delivery. Maternal health interventions to increase facility delivery uptake should target women’s social networks.