International commodity prices, growth and the outbreak of Civil War in Sub-Saharan Africa

To learn more about the effect of economic conditions oncivil war, we examine whether Sub-Saharan civil wars aremore likely to start following downturns in the internationalprice of countries main export commodities. The data showa robust effect of commodity price downturns on the outbreakof civil wars. We also find that Sub-Saharan countries aremore likely to see civil wars following economic downturnsin their main OECD export destinations.

Improving energy access in rural sub-Saharan Africa

XVII Convocatòria d’ajuts a accions de cooperació - 2009GRECDH – UPC. Improving Energy Access In Rural sub- Saharan Africa. O-006/09. Informe

Clinico-Pathological discrepancies in the Diagnosis of Causes of Maternal Death in Sub-Saharan Africa: Retrospective Analysis

Background Maternal mortality is a major public-health problem in developing countries. Extreme differences in maternal mortality rates between developed and developing countries indicate that most of these deaths are preventable. Most information on the causes of maternal death in these areas is based on clinical records and verbal autopsies. Clinical diagnostic errors may play a significant role in this problem and might also have major implications for the evaluation of current estimations of causes of maternal death. Methods and Findings A retrospective analysis of clinico-pathologic correlation was carried out, using necropsy as the gold standard for diagnosis. All maternal autopsies (n ¼ 139) during the period from October 2002 to December 2004 at the Maputo Central Hospital, Mozambique were included and major diagnostic discrepancies were analyzed (i.e., those involving the cause of death). Major diagnostic errors were detected in 56 (40.3%) maternal deaths. A high rate of false negative diagnoses was observed for infectious diseases, which showed sensitivities under 50%: HIV/AIDS-related conditions (33.3%), pyogenic bronchopneumonia (35.3%), pyogenic meningitis (40.0%), and puerperal septicemia (50.0%). Eclampsia, was the main source of false positive diagnoses, showing a low predictive positive value (42.9%). Conclusions Clinico-pathological discrepancies may have a significant impact on maternal mortality in sub-Saharan Africa and question the validity of reports based on clinical data or verbal autopsies. Increasing clinical awareness of the impact of obstetric and nonobstetric infections with their inclusion in the differential diagnosis, together with a thorough evaluation of cases clinically thought to be eclampsia, could have a significant impact on the reduction of maternal mortality.

Clinico-Pathological discrepancies in the Diagnosis of Causes of Maternal Death in Sub-Saharan Africa: Retrospective Analysis

Background Maternal mortality is a major public-health problem in developing countries. Extreme differences in maternal mortality rates between developed and developing countries indicate that most of these deaths are preventable. Most information on the causes of maternal death in these areas is based on clinical records and verbal autopsies. Clinical diagnostic errors may play a significant role in this problem and might also have major implications for the evaluation of current estimations of causes of maternal death. Methods and Findings A retrospective analysis of clinico-pathologic correlation was carried out, using necropsy as the gold standard for diagnosis. All maternal autopsies (n ¼ 139) during the period from October 2002 to December 2004 at the Maputo Central Hospital, Mozambique were included and major diagnostic discrepancies were analyzed (i.e., those involving the cause of death). Major diagnostic errors were detected in 56 (40.3%) maternal deaths. A high rate of false negative diagnoses was observed for infectious diseases, which showed sensitivities under 50%: HIV/AIDS-related conditions (33.3%), pyogenic bronchopneumonia (35.3%), pyogenic meningitis (40.0%), and puerperal septicemia (50.0%). Eclampsia, was the main source of false positive diagnoses, showing a low predictive positive value (42.9%). Conclusions Clinico-pathological discrepancies may have a significant impact on maternal mortality in sub-Saharan Africa and question the validity of reports based on clinical data or verbal autopsies. Increasing clinical awareness of the impact of obstetric and nonobstetric infections with their inclusion in the differential diagnosis, together with a thorough evaluation of cases clinically thought to be eclampsia, could have a significant impact on the reduction of maternal mortality.

A genomic analysis identifies a novel component in the genetic structure of sub-Saharan African populations

Studies of large sets of SNP data have proven to be a powerful tool in the analysis of the genetic structure of human populations. In this work, we analyze genotyping data for 2,841 SNPs in 12 Sub-Saharan African populations, including a previously unsampled region of south-eastern Africa (Mozambique). We show that robust results in a world-wide perspective can be obtained when analyzing only 1,000 SNPs. Our main results both confirm the results of previous studies, and show new and interesting features in Sub-Saharan African genetic complexity. There is a strong differentiation of Nilo-Saharans, much beyond what would be expected by geography. Hunter-gatherer populations (Khoisan and Pygmies) show a clear distinctiveness with very intrinsic Pygmy (and not only Khoisan) genetic features. Populations of the West Africa present an unexpected similarity among them, possibly the result of a population expansion. Finally, we find a strong differentiation of the south-eastern Bantu population from Mozambique, which suggests an assimilation of a pre-Bantu substrate by Bantu speakers in the region.

Seeds of hope: Assessing the effect of development aid on the reduction of child mortality

The Millennium Declaration (2000) set as one of its targets a substantial reduction in child mortality. This paper studies whether the massive increase in development aid can account for part of the reduction in child mortality observed in developing countries since the year 2000. To do so, we analyze a panel of more than 130 developing countries over the 2000-2008 period. We use the time trend evolution of aid to identify an exogenous source of variation. Total aid has had no statistically significant effect on child mortality. However, a disaggregate analysis identifies certain sectors of aid that have had a significant impact. The effects have been larger in high mortality countries, including Sub-Saharan Africa. Projections based on our estimates strongly support the concern that most countries in that region will miss the Millennium Goals target on child mortality.

State Failure – A Rationale for EU Foreign Policy?

'Estats fallits' ha arribat a ser un lema popular per als acadèmics i els polítics per igual. En opinió dels governs occidentals i les institucions internacionals, els estats fallits no compleixen amb les condicions necessàries per assolir el desenvolupament econòmic i social i alhora proporcionar un terreny fèrtil per als actors violents conflictes i no estatals que participen en la delinqüència internacional. La Unió Europea té una relació de llarga data amb els països de l'Àfrica subsahariana, molts dels quals es caracteritzen per ser fallat. En aquest treball es pretén analitzar si el compromís retòric de la UE per fer front a la insuficiència de l'Estat es tradueix en un enfocament coherent davant les causes profundes de la fragilitat de l'Estat i pregunta pels factors que expliquen el compromís de la UE amb els problemes que enfronten aquests estats. Mitjançant la comparació de les polítiques europees cap a la República Democràtica del Congo, Sierra Leone i la República Centreafricana, s'argumenta que la resposta de la UE als Estats fallits es desenvolupa d'una manera incoherent esbiaixada cap a les situacions de conflicte en lloc de ser guiat per una preocupació més general per fragilitat . L'anàlisi suggereix que la participació de la UE es deu principalment a interessos coincidents en els Estats membres i de la UE.

Menores, educación y conflicto armado: un análisis desde la realidad africana 15 años después del Informe Machel

Si bien en los últimos años África Subsahariana ha registrado un notable descenso del número de conflictos armados, un buen número de países sigue padeciendo las consecuencias de la violencia armada, especialmente algunos contextos como el de la República Democrática del Congo, la región de Darfur (oeste de Sudán) o Somalia, por citar algunos ejemplos. Tal y como desde el ámbito institucional (Naciones Unidas u ONG) o el académico llevan señalando desde hace varios años, la principal víctima de la violencia suele ser la población civil, principalmente los menores y las mujeres. El presente artículo tiene como objetivo analizar el impacto que los conflictos armados africanos tienen en la infancia y en aspectos tan importantes como su educación. Este objeto de estudio cuenta en los últimos años con un importante referente como fue la publicación en el año 1996 del denominado «Informe Machel». Quince años después de la aparición de este documento, resulta de interés hacer un pequeño balance sobre algunos de los avances, déficits y principales retos de la protección de los menores en conflictos armados.

A qualitative study about immigrant workers’ perceptions of their working conditions in Spain

Background: Spain has recently become an inward migration country. Little is known about the occupational health of immigrant workers. This study aimed to explore the perceptions that immigrant workers in Spain had of their working conditions.Methods: Qualitative, exploratory, descriptive study. Criterion sampling. Data collected between September 2006 and May 2007 through semi-structured focus groups and individual interviews, with a topic guide. One hundred and fifty-eight immigrant workers (90 men/68 women) from Colombia (n = 21), Morocco (n = 39), sub-Saharan Africa (n = 29), Romania (n = 44) and Ecuador (n = 25), who were authorised (documented) or unauthorised (undocumented) residents in five medium to large cities in Spain.Results: Participants described poor working conditions, low pay and health hazards. Perception of hazards appeared to be related to gender and job sector. Informants were highly segregated into jobs by sex, however, so this issue will need further exploration. Undocumented workers described poorer conditions than documented workers, which they attributed to their documentation status. Documented participants also felt vulnerable because of their immigrant status. Informants believed that deficient language skills, non-transferability of their education and training and, most of all, their immigrant status and economic need left them with little choice but to work under poor conditions.Conclusions: The occupational health needs of immigrant workers must be addressed at the job level, while improving the enforcement of existing health and safety regulations. The roles that documentation status and economic need played in these informants' work experiences should be considered and how these may influence health outcomes.

Economic shocks and civil conflict: A comment

Miguel, Satyanath, and Sergenti (2004) argue that lowerrainfall levels and negative rainfall shocks increase conflictrisk in Sub-Saharan Africa. This conclusion rests on theirfinding of a negative correlation between conflict in t andrainfall growth between t-1 and t-2. I argue that this findingis driven by a positive correlation between conflict in t andrainfall levels in t-2. If lower rainfall levels or negativerainfall shocks increased conflict, one might have expectedMSS s finding to reflect a negative correlation betweenconflict in t and rainfall levels in t-1. In the latest data,conflict is unrelated to rainfall.

Emergency hospital services utilization in Lleida (Spain): a cross-sectional study of immigrant and Spanish-born populations

Background: The use of emergency hospital services (EHS) has increased steadily in Spain in the last decade while the number of immigrants has increased dramatically. Studies show that immigrants use EHS differently than native-born individuals, and this work investigates demographics, diagnoses and utilization rates of EHS in Lleida (Spain). Methods: Cross-sectional study of all the 96,916 EHS visits by patients 15 to 64 years old, attended during the years 2004 and 2005 in a public teaching hospital. Demographic data, diagnoses of the EHS visits, frequency of hospital admissions, mortality and diagnoses at hospital discharge were obtained. Utilization rates were estimated by group of origin. Poisson regression was used to estimate the rate ratios of being visited in the EHS with respect to the Spanish-born population. Results: Immigrants from low-income countries use EHS services more than the Spanish-born population. Differences in utilization patterns are particularly marked for Maghrebi men and women and sub-Saharan women. Immigrant males are at lower risk of being admitted to the hospital, as compared with Spanish-born males. On the other hand, immigrant women are at higher risk of being admitted. After excluding the visits with gynecologic and obstetric diagnoses, women from sub-Saharan Africa and the Maghreb are still at a higher risk of being admitted than their Spanish-born counterparts. Conclusion: In Lleida (Spain), immigrants use more EHS than the Spanish born population. Future research should indicate whether the same pattern is found in other areas of Spain and whether EHS use is attributable to health needs, barriers to access to the primary care services or similarities in the way immigrants access health care in their countries of origin.

Diet-related buccal dental microwear patterns in central african pygmy foragers and bantu-speaking farmer and pastoralist populations.

Pygmy hunter-gatherers from Central Africa have shared a network of socioeconomic interactions with non-Pygmy Bantu speakers since agropastoral lifestyle spread across sub-Saharan Africa. Ethnographic studies have reported that their diets differ in consumption of both animal proteins and starch grains. Hunted meat and gathered plant foods, especially underground storage organs (USOs), are dietary staples for pygmies. However, scarce information exists about forager-farmer interaction and the agricultural products used by pygmies. Since the effects of dietary preferences on teeth in modern and past pygmies remain unknown, we explored dietary history through quantitative analysis of buccal microwear on cheek teeth in well-documented Baka pygmies. We then determined if microwear patterns differ among other Pygmy groups (Aka, Mbuti, and Babongo) and between Bantu-speaking farmer and pastoralist populations from past centuries. The buccal dental microwear patterns of Pygmy hunter-gatherers and non-Pygmy Bantu pastoralists show lower scratch densities, indicative of diets more intensively based on nonabrasive foodstuffs, compared with Bantu farmers, who consume larger amounts of grit from stoneground foods. The Baka pygmies showed microwear patterns similar to those of ancient Aka and Mbuti, suggesting that the mechanical properties of their preferred diets have not significantly changed through time. In contrast, Babongo pygmies showed scratch densities and lengths similar to those of the farmers, consistent with sociocultural contacts and genetic factors. Our findings support that buccal microwear patterns predict dietary habits independent of ecological conditions and reflect the abrasive properties of preferred or fallback foods such as USOs, which may have contributed to the dietary specializations of ancient human populations.

In a better world (2011): the ethics of a doctor facing violence

The main theme"In a Better World" (S. Bier, 2011), is violence and its possible answers: forgiveness and revenge. The film revolves around a doctor Anton who works in a refugee camp in sub-Saharan Africa. His family lives in a quiet village in Denmark, where his teenage son suffers bullying at school. This movie shows the fragility of a modern society, normal in appearance but with deep fissures that reflect the tragedies plaguing much of the African continent. It helps to understand the reality experienced by more than 10 million refugees and 15 million internally displaced persons surviving in sub-Saharan Africa. Hævnen, the original title whose meaning in Spanish is revenge, invites reflection on another possible response to violence-forgiveness. It is an excellent film for teaching and learning issues related to humanitarian work developed by health professionals in refugee camps around world.

In a better world (2011): the ethics of a doctor facing violence

The main theme"In a Better World" (S. Bier, 2011), is violence and its possible answers: forgiveness and revenge. The film revolves around a doctor Anton who works in a refugee camp in sub-Saharan Africa. His family lives in a quiet village in Denmark, where his teenage son suffers bullying at school. This movie shows the fragility of a modern society, normal in appearance but with deep fissures that reflect the tragedies plaguing much of the African continent. It helps to understand the reality experienced by more than 10 million refugees and 15 million internally displaced persons surviving in sub-Saharan Africa. Hævnen, the original title whose meaning in Spanish is revenge, invites reflection on another possible response to violence-forgiveness. It is an excellent film for teaching and learning issues related to humanitarian work developed by health professionals in refugee camps around world.

Did colonization matter for growth? An empirical exploration into the historical causes of Africa's underdevelopment

We investigate the impact of 20th--century European colonizationon growth in Africa. We find that in the 1960--88 period growth has beenfaster for dependencies than for colonies; for British and Frenchcolonies than for Portuguese, Belgian and Italian ones; and for countrieswith less economic penetration during the colonial period. On average,African growth accelerates after decolonization. Proxies for colonialheritage add explanatory power to growth regressions and make indicatorsfor human capital, political and ethnic instability lose significance.Colonial variables capture the same effects of a sub--Saharan dummy andreduce its significance when jointly included in a cross sectionalregression with 98 countries.