Evaluation use within a humanitarian non-governmental organization’s health care user-fee exemption program in West Africa

L’évaluation de l’action humanitaire (ÉAH) est un outil valorisé pour soutenir l’imputabilité, la transparence et l’efficience de programmes humanitaires contribuant à diminuer les inéquités et à promouvoir la santé mondiale. L’EAH est incontournable pour les parties prenantes de programme, les bailleurs de fonds, décideurs et intervenants souhaitant intégrer les données probantes aux pratiques et à la prise de décisions. Cependant, l’utilisation de l’évaluation (UÉ) reste incertaine, l’ÉAH étant fréquemment menée, mais inutilisé. Aussi, les conditions influençant l’UÉ varient selon les contextes et leur présence et applicabilité au sein d’organisations non-gouvernementales (ONG) humanitaires restent peu documentées. Les évaluateurs, parties prenantes et décideurs en contexte humanitaire souhaitant assurer l’UÉ pérenne détiennent peu de repères puisque rares sont les études examinant l’UÉ et ses conditions à long terme. La présente thèse tend à clarifier ces enjeux en documentant sur une période de deux ans l’UÉ et les conditions qui la détermine, au sein d’une stratégie d’évaluation intégrée au programme d’exemption de paiement des soins de santé d’une ONG humanitaire. L’objectif de ce programme est de faciliter l’accès à la santé aux mères, aux enfants de moins de cinq ans et aux indigents de districts sanitaires au Niger et au Burkina Faso, régions du Sahel où des crises alimentaires et économiques ont engendré des taux élevés de malnutrition, de morbidité et de mortalité. Une première évaluation du programme d’exemption au Niger a mené au développement de la stratégie d’évaluation intégrée à ce même programme au Burkina Faso. La thèse se compose de trois articles. Le premier présente une étude d’évaluabilité, étape préliminaire à la thèse et permettant de juger de sa faisabilité. Les résultats démontrent une logique cohérente et plausible de la stratégie d’évaluation, l’accessibilité de données et l’utilité d’étudier l’UÉ par l’ONG. Le second article documente l’UÉ des parties prenantes de la stratégie et comment celle-ci servit le programme d’exemption. L’utilisation des résultats fut instrumentale, conceptuelle et persuasive, alors que l’utilisation des processus ne fut qu’instrumentale et conceptuelle. Le troisième article documente les conditions qui, selon les parties prenantes, ont progressivement influencé l’UÉ. L’attitude des utilisateurs, les relations et communications interpersonnelles et l’habileté des évaluateurs à mener et à partager les connaissances adaptées aux besoins des utilisateurs furent les conditions clés liées à l’UÉ. La thèse contribue à l’avancement des connaissances sur l’UÉ en milieu humanitaire et apporte des recommandations aux parties prenantes de l’ONG.

Cultural valuation and biodiversity conservation in the Upper Guinea forest, West Africa

The cultural valuation of biodiversity has taken on renewed importance over the last two decades as the ecosystem services framework has become widely adopted. Conservation initiatives increasingly use ecosystem service frameworks to render tropical forest landscapes and their peoples legible to market-oriented initiatives such as REDD+ and biodiversity offsetting schemes. Ecosystem service approaches have been widely criticized by scholars in the social sciences and humanities for their narrow focus on a small number of easily quantifiable and marketable services and a reductionist and sometimes simplistic approach to culture. We address the need to combine methods from each of the “three cultures” of natural science, quantitative social science, and qualitative social science/humanities in conceptualizing the relationship between cultural valuation and biodiversity conservation. We combine qualitative data with forest inventories and a quantitative index of cultural value to evaluate the relationship between cultural valuation and biodiversity conservation in Upper Guinea forest in Liberia, West Africa. Our study focuses on “sacred agroforests,” spaces that are associated with Mande macro-language speaking groups such as the Loma. We demonstrate that sacred agroforests are associated with different cultural values compared with secondary forests. Although biodiversity and biomass are similar, sacred agroforests exhibit a different species composition, especially of culturally salient species, increasing overall landscape agro-biodiversity. Sacred agroforests are also shaped and conserved by local cultural institutions revolving around ancestor worship, ritual, and the metaphysical conceptual category “salɛ.” We conclude that to understand the relationship between cultural valuation and biodiversity conservation, interpretivist approaches such as phenomenology should be employed alongside positivist ecosystem service frameworks.

Insufficient Evidence of Jatropha curcas L. Invasiveness: Experimental Observations in Burkina Faso, West Africa

Biofuel plants such as Jatropha curcas L. have potential to support the livelihoods of rural communities and contribute to sustainable rural development in Africa, if risks and uncertainties are minimized. Yet, recent papers have warned of the risk of biological invasions in such tropical regions as a consequence of the introduction of exotic biofuel crops. We investigated the seed dispersal risk and invasiveness potential of both J. curcas monoculture plantations and live fences into adjacent cultivated and uncultivated land use systems in Sissili province, Burkina Faso. Invasiveness potential was assessed through (i) detecting evidence of natural regeneration in perimeters around J. curcas plantations and live fences, (ii) assessing seed dispersal mechanisms, and (iii) assessing seedling establishment potential through in situ direct seed sowing. Spontaneous regeneration around the plantation perimeters of the three sites was very low. Individual seedling density around J. curcas live fences was less than 0.01 m⁻² in all sites. Seventy percent of the seedlings were found close to the live fence and most of them derived from the same year (96 %), which indicates low seed-bank longevity and seedling survival. J. curcas can be dispersed by small mammals and arthropods, particularly rodents and ants. In some sites, such as in Onliassan, high secondary seed dispersal by animals (up to 98 %) was recorded. There were highly significant differences in germination rates between seeds at the soil surface (11 %) and those buried artificially at 1–2-cm depth (64 %). In conclusion, we failed to find convincing evidence of the spreading of J. curcas or any significant impact on the surrounding environment.

Endoscopic capacity in West Africa.

Background: Levels of endoscopic demand and capacity in West Africa are unclear. Objectives: This paper aims to: 1. describe the current labor and endoscopic capacity, 2. quantify the impact of a mixed-methods endoscopy course on healthcare professionals in West Africa, and 3. quantify the types of diagnoses encountered. Methods: In a three-day course, healthcare professionals were surveyed on endoscopic resources and capacity and were taught through active observation of live cases, case discussion, simulator experience and didactics. Before and after didactics, multiplechoice exams as well as questionnaires were administered to assess for course efficacy. Also, a case series of 23 patients needing upper GI endoscopy was done. Results: In surveying physicians, less than half had resources to perform an EGD and none could perform an ERCP, while waiting time for emergency endoscopy in urban populations was at least one day. In assessing improvement in medical knowledge among participants after didactics, objective data paired with subjective responses was more useful than either alone. Of 23 patients who received endoscopy, 7 required endoscopic intervention with 6 having gastric or esophageal varices. Currently the endoscopic capacity in West Africa is not sufficient. A formal GI course with simulation and didactics improves gastrointestinal knowledge amongst participants.

Prevalence of intestinal parasitic infections among school children in capital areas of the Democratic Republic of São Tomé and Príncipe, West Africa.

Background: Although the Democratic Republic of Sao Tome and Principe (DRSTP) has undertaken school children-based deworming programs against intestinal parasitic infections (IPIs) using a single dose of mebendazole annually since 2005, it remains unclear as to the outcome to date. The present study intends to investigate the recent IPIs status among school children living in capital areas of the DRSTP. Methods: A total of 252 school children (121 boys and 131 girls) of grades 4 and 5 from 4 primary schools located in the capital areas participated in the present study and their fresh fecal specimens were examined for the presence of any parasites using the merthiolate- iodine-formaldehyde concentration method as conducted. Results: The overall prevalence of IPIs was 64.7% (163/ 252). No significant gender difference in prevalence between boys (67.8%) and girls (61.8%) was found (p = 0.3). The majority of school children were infected with a single species of parasite (55.8%). Altogether, 12 different intestinal parasite species were identified in DRSTP school children, of which 9 species were pathogenic and the remaining 3 were non-pathogenic. Conclusion: Improving the detection method, sanitation facilities and personal hygiene as well as utilizing combined drugs are all important measures to greatly reduce IPIs in DRSTP school children.

Evaluation use within a humanitarian non-governmental organization’s health care user-fee exemption program in West Africa

L’évaluation de l’action humanitaire (ÉAH) est un outil valorisé pour soutenir l’imputabilité, la transparence et l’efficience de programmes humanitaires contribuant à diminuer les inéquités et à promouvoir la santé mondiale. L’EAH est incontournable pour les parties prenantes de programme, les bailleurs de fonds, décideurs et intervenants souhaitant intégrer les données probantes aux pratiques et à la prise de décisions. Cependant, l’utilisation de l’évaluation (UÉ) reste incertaine, l’ÉAH étant fréquemment menée, mais inutilisé. Aussi, les conditions influençant l’UÉ varient selon les contextes et leur présence et applicabilité au sein d’organisations non-gouvernementales (ONG) humanitaires restent peu documentées. Les évaluateurs, parties prenantes et décideurs en contexte humanitaire souhaitant assurer l’UÉ pérenne détiennent peu de repères puisque rares sont les études examinant l’UÉ et ses conditions à long terme. La présente thèse tend à clarifier ces enjeux en documentant sur une période de deux ans l’UÉ et les conditions qui la détermine, au sein d’une stratégie d’évaluation intégrée au programme d’exemption de paiement des soins de santé d’une ONG humanitaire. L’objectif de ce programme est de faciliter l’accès à la santé aux mères, aux enfants de moins de cinq ans et aux indigents de districts sanitaires au Niger et au Burkina Faso, régions du Sahel où des crises alimentaires et économiques ont engendré des taux élevés de malnutrition, de morbidité et de mortalité. Une première évaluation du programme d’exemption au Niger a mené au développement de la stratégie d’évaluation intégrée à ce même programme au Burkina Faso. La thèse se compose de trois articles. Le premier présente une étude d’évaluabilité, étape préliminaire à la thèse et permettant de juger de sa faisabilité. Les résultats démontrent une logique cohérente et plausible de la stratégie d’évaluation, l’accessibilité de données et l’utilité d’étudier l’UÉ par l’ONG. Le second article documente l’UÉ des parties prenantes de la stratégie et comment celle-ci servit le programme d’exemption. L’utilisation des résultats fut instrumentale, conceptuelle et persuasive, alors que l’utilisation des processus ne fut qu’instrumentale et conceptuelle. Le troisième article documente les conditions qui, selon les parties prenantes, ont progressivement influencé l’UÉ. L’attitude des utilisateurs, les relations et communications interpersonnelles et l’habileté des évaluateurs à mener et à partager les connaissances adaptées aux besoins des utilisateurs furent les conditions clés liées à l’UÉ. La thèse contribue à l’avancement des connaissances sur l’UÉ en milieu humanitaire et apporte des recommandations aux parties prenantes de l’ONG.

West & North Africa, ca. 1710 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Carte de la Barbarie, le [sic] la Nigritie et del la Guinée, par Guillaume de l'Isle de l'Academie Royale des Sciences. It was published by ex officina Nicolai Visscher, ca. 1710. Scale [ca.1:9,000,000]. Covers West and North Africa. Map in French.The image inside the map neatline is georeferenced to the surface of the earth and fit to the Africa Sinusoidal projected coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, cities and other human settlements, routes and roads, territorial boundaries, shoreline features, and more. Relief shown pictorially. Includes notes.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.

West & North Africa, ca. 1730 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Carte de la Barbarie, le la Nigritie et de la Guinée, par Guill[au]me Del'Isle, de l'Academie Royale des Sciences. It was published by Chez Jean Cóvens et Corneille Mortier, Geographes ca. 1730. Scale [ca.1:9,250,000]. Covers West and North Africa. Map in French.The image inside the map neatline is georeferenced to the surface of the earth and fit to the Africa Sinusoidal projected coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, cities and other human settlements, roads and routes, territorial boundaries, shoreline features, and more. Relief shown pictorially. Includes notes.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.

West & Central Africa, ca. 1690 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Effigies ampli Regni auriferi Guineae in Africa siti, extensum inde ad insulis Atlanticis, vulgo dictis, de Cabo Verde : ad flumen Benin, us[que], ad cujus ripam sita est Regia urbs et magna Benin, at[que] inde ad promontorium Lopi Gonsalvi, delineata per S. Rovelascum, et politioribus lineamentis figurata per Lodovicum Texeram, protocosmographum Regis Hispaniarum ; Baptista Doetechomius sculpsit ; Carolus Allardt excudit. It was published by Carolus Allardt ca. 1690. Scale [ca. 1:8,000,000]. Covers portions of West and Central Africa. Map in Latin and Portuguese.The image inside the map neatline is georeferenced to the surface of the earth and fit to the World Miller Cylindrical projected coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, cities and other human settlements, shoreline features, and more. Includes also illustrations and text.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.

West & Central Africa, ca. 1752 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Guinea propria : nec non Nigritiae vel terrae Nigrorum maxima pars : Geographis hodiernis dicta utraque Aethiopia Inferior, & huius quidem pars australis ex delineationibus Anvillianis itineri Guineensi D. de Marchais insertis secundum Leges proiectionis stereographicae Hasianae, designata & edita studio & labore Homannianorum Heredum A. 1743 = Guinée de meme que la plus grande parties du pais des Negres : appellées par les geographes modernes Ethiopie inferieure et meridionale, tirées des morceaux geographiques de Mr. d'Anville, qu'il a inseres au voyage du Chev. de Marchais, & puis dessinées suivant les loix de la nouvelle projection de feu Mr. le prof. Has, par les Heritiers d'Homan. A 1743. It was published by edita studio & labore Homannianorum Heredum ca. 1752. Scale [ca. 1:7,400,000]. Covers portions of West and Central Africa. Map in Latin.The image inside the map neatline is georeferenced to the surface of the earth and fit to the World Miller Cylindrical projected coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, cities and other human settlements, territorial boundaries, shoreline features, and more. Relief shown pictorially. Includes also notes.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.

West & Central Africa, ca. 1753 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: A new and correct map of the coast of Africa : from Cape Blanco lat. 20°40'. N. to the coast of Angola lat. 11°. S. : with explanatory notes of all the forts and settlements belonging to the several European powers, R. W. Seale, sculp. It was published by J. & P. Knapton ca. 1753. Scale [ca. 1:10,000,000]. Covers portions of West and Central Africa.The image inside the map neatline is georeferenced to the surface of the earth and fit to the World Miller Cylindrical projected coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, cities and other human settlements, territorial claims, forts, factories, shoreline features, and more. Includes also notes, index, and inset: A separate map of the Gold Coast, upon a larger scale.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.

West & Central Africa, 1809 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Charte von Senegambien und Ober-Guinea : nebst dem innern Nigritien : nach den neuesten Nachrichten entworfen. It was published by im Verl. des Geograph. Instituts in 1809. Scale [ca. 1:9,250,000]. Covers portions of West and Central Africa. Map in German.The image inside the map neatline is georeferenced to the surface of the earth and fit to the World Miller Cylindrical projected coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, roads, cities and other human settlements, territorial boundaries, shoreline features, and more. Relief shown pictorially. Includes also notes.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.

West & Central Africa, 1873 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Stanford's map of the Guinea Coast, West Africa including the whole course of the Niger, and shewing Ashanti and its surroundings. It was published by E. Stanford in 1873. Scale 1:6,336,000. Covers portions of West and Central Africa.The image inside the map neatline is georeferenced to the surface of the earth and fit to the Africa Sinusoidal projected coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, cities and other human settlements, territorial boundaries and claims, roads, exploration routes, shoreline features, and more. Relief shown by hachures and spot heights. Includes notes.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.