<p>The current study aimed to describe the extent and reasons for substituting and switching HAART at the Katutura Intermediate Hospital in Windhoek, Namibia</p>

<p><font face="Times New Roman"> <p align="left"><font face="Times New Roman"><b><font face="Times New Roman">Aim</font><font face="Times New Roman">: To obtain baseline data on adherence levels and the major determinants of adherence among patients on HAART at Rundu Hospital, Namibia.</font></b></font></p> </font></p>

<p>Sub-Saharan Africa is home to two thirds of the 33 million HIV infected individuals worldwide. In 2007 there were an estimated 1.5 million Kenyans infected with HIV, and 166 000 new infections in 2008. The introduction of antiretroviral therapy [ART] brought new hope to HIV patients. It has transformed a fatal disease to a chronic manageable condition. Kenya has made great strides in ensuring access to ART and by 2009, 308 610 patients in the country were receiving ART - which is the second highest number worldwide. The success of ART requires a sustained adherence rate to medication of more than 95% to prevent viral replication and the development of drug resistant HIV strains. Identifying the factors that influence adherence, is essential for the long-term success of public ART programmes. The current study explored patient, socio-economic, cultural, and religious and health systems factors that influence adherence to ART at the Coast Provincial General Hospital [CPGH] in Mombasa, Kenya.</p>

The main objective of this thesis is to contribute to our better understanding of the main factors behind large and persistent gender disparities in Africa's labour markets. This work looks at three key dimensions of labour market gender inequality in Africa: (i) the gender wage gap, (ii) gender inequalities in allocating time to market and household work, and (iii) the gender-differentiated income effect of informality. Chapter 2 shows that, in Ethiopia, progress towards gender equity in education is important to improve women's wages but not enough to close most of the gender wage differential. Other interventions would be needed as, for instance, information campaigns and other awareness-raising efforts in support of the anti-discriminatory provisions of Ethiopia's own constitution and legislation, to compensate for the adverse impact of unobservable factors (discriminatory practices, social and cultural norms...), that directly contribute to the gender wage gap and indirectly, through job selection. Chapter 3 highlights the coexistence of two phenomena in Ethiopia, a strong gender-based division of labour and a double work burden on women. The country would benefit from pursuing and intensifying its efforts to ensure better access to education at all levels for women, and from providing better information and enforcement of the law in support of women's economic and social well-being, as it would help changing mentalities and attitudes that impede women to take full advantage of their abilities and that keep them subordinated to men. Finally, in Chapter 4 we observe that, in Tanzania, women face a significantly higher informal employment wage penalty than men. To explain this result, we conjecture that the exclusion hypothesis, according to which individuals are denied access to formal jobs due to the disproportionate constraints they face (burden of household responsibilities, lack of adequate infrastructure...), is more acute among women.JEL classification : J16, J22, J24, J31, J42, J71

Rural electrification is a critical tool for accelerating and enhancing development throughout Sub-Saharan Africa. The challenge for modern policymakers is to identify and implement programs that will effectively facilitate rural electrification. This analysis develops a model for comparing the performance of nations' electrification policies using a fixed effects regression model based on World Bank data from 1990, 2000 and 2010. To identify the key policies for driving rural electrification, this analysis then compares the programs and reforms employed in six nations from Sub-Saharan Africa. As a result, three reform measures are identified that are conditional on outside factors for their contribution to success, and three universal policies are identified that may be broadly applied to improve rural electrification throughout the region.

This thesis examines the relationship between received remittances and education using random samples from panel survey data from households in rural Malawi collected between 2008 and 2010. Past research as well as that conducted in this paper point to the fact that remittances and education share an important correlation. The results of this study indicate that on a microeconomic level, remittances have a highly significant and positive impact on household education. Other remittance-related factors such as the distance from agent, the remittance amount, and the type of account held by an individual also have a significant impact on the highest level of education attained by an individual, whereas the account type, age, gender, and marital status are important determinants in the probability of an individual ever having attended school. The results from this study raise questions as to whether the “brain drain” can actually have a positive impact on developing nations. The study also discusses policy implications for money transfer operators in Sub-Saharan Africa.

Background and objectives: Childhood sexual abuse (CSA) is a substantial public health and human rights problem, as well as a growing concern in sub-Saharan Africa (SSA). It has both short and long term effects on girls: physical and psychological, including negative sexual outcomes. Up to one-third of adolescent girls report their first sexual experience as being forced. Despite growing evidence supporting a link between contextual factors and violence, no studies have investigated the connection between CSA and contextual factors. It is therefore important to identify the extent of CSA and understand factors associated with it in SSA in order to develop interventions aimed to address the scale of the problem. Aim: The overall aim of this thesis is to assess the individual and contextual factors associated with CSA. In addition, the thesis aims to quantify the magnitude of CSA and describe the factors associated with CSA among women from SSA (Study I). This thesis also examines the independent contribution of individual and community socio-economic status on CSA (Study II). Moreover, it scrutinises the effect of social disorganisation on CSA (Study III) and explores the relationship between CSA and sexual risk behaviours as well as potential mediators (Study IV). Methods: This thesis used the Demographic and Health Survey (DHS) datasets conducted between 2006 and 2008 from six SSA countries. The thesis used multiple logistic regression models to describe and explore factors associated with CSA among 69,977 women (Study I).  It used multivariable multilevel logistic regression analysis to explore the effect of contextual level variables (neighbourhood socio-economic status) on CSA among 6,351 girls (Study II). Neighbourhood socio-economic status was operationalized with a principal component analysis using the proportion of respondents who were unemployed, illiterates, living below poverty level and rural residents. Study III applied multivariable multilevel logistic regression analysis on 6,351 girls and considered five measures of social disorganisation at the community level: neighbourhood poverty, female-headed households, residential mobility, place of residence, population density, and ethnic diversity. In study IV, 12,800 women from the Nigerian DHS were used. Structural equation modelling was applied using a two-step approach. The first step used a confirmatory factor analysis to develop an acceptable measurement model while the second step involved modifying the measurement model to represent the postulated causal model framework. Results: In study I, the reported prevalence of CSA ranged from 0.3% in Liberia to 4.3% in Zambia when the prevalence was based on all respondents aged between 15 and 49 years and who were present during the survey. None of the socio-economic factors were associated with CSA. In study II, where the data was restricted to permanent residents aged between 15 and 18 years, the prevalence ranged between 1.04% in Liberia to 5.8% in Zambia. At the individual level, there was no significant association between CSA and wealth status while at the community level, there was no significant association between CSA and socio-economic position. However, 22% of the variation in CSA was attributed to the community level factors. In study III, there was significant variation in the odds of reporting CSA across the communities, with community level factors accounting for 18% of the variation. In addition, respondents from communities with a high family disruption rate were 57% more likely to have reported sexual abuse in childhood. Study IV showed that there was a significant association between CSA and sexual risk behaviours and the association was mediated by alcohol and cigarette use. Conclusions: The study provides evidence that adolescents in the same community were subjected to common contextual influences. It also highlighted the significance of mediators in the relationship between CSA and sexual risk behaviours. It is therefore important that effective preventive strategies are developed and implemented that will cut across all socio-economic spheres in a context that both permits and encourages disclosure as well as identifying predisposing circumstances for recurrence.

In recent years, physical activity and fitness transitions, described as declines in physical activity and aerobic fitness, coupled with increased sedentary behaviour, have been observed among school-aged children. Consequently, the prevalence of childhood overweight/obesity has also increased considerably. While there is a wealth of evidence supporting such behavioural transitions in higher income countries, there exists a paucity of data on the situation in lower income countries, such as those in Sub-Saharan Africa (SSA). The premise of this thesis was to investigate the robustness of these relationships in other global regions. The first objective was to investigate the evidence for an overweight/obesity, physical activity, and fitness transition among SSA’s school-aged children. Systematic review methodology was used to examine temporal trends and correlates of overweight/obesity, physical activity, fitness, and sedentary behaviour in apparently healthy or population based samples of children (5 - 17 years). The second objective of this thesis was to determine the prevalence and correlates of overweight/obesity and physical activity among Kenyan children aged 9 to 11 years, having contextualised Kenya within the broader situation in SSA. Further, the relationships between self-reported and directly assessed measures of physical activity and sedentary time by weight status in Kenyan children were investigated. The third objective was to examine moderate-to-vigorous physical activity (MVPA) patterns accrued by time of day among Kenyan children using the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE)-Kenya data. Activity patterns in the Kenyan setting were then compared to similar ISCOLE-Canada data from Canadian children, revealing differences and similarities in the accumulation of MVPA, light physical activity, and sedentary time. Systematic review data syntheses revealed a trend towards increasing proportions of overweight/obesity among Sub-Saharan Africa’s school-aged children. Further, urbanization and higher socioeconomic status (SES) were associated with decreased physical activity and aerobic fitness, and increased sedentary behaviours and body composition measures. ISCOLE-Kenya data analyses found a prevalence of childhood overweight/obesity of 20.8% in Nairobi, with few children meeting global physical activity guidelines (12.6%). Mean daily sedentary time was 398 minutes, time spent in light physical activity was 463 minutes, and time spent in MVPA was 36 minutes. Higher SES and parental education attainment were associated with a higher likelihood of children being overweight/obese and a lower likelihood of children meeting the physical activity recommendations. Data analyses also revealed considerable discrepancies in both self-report and direct measures of physical activity by weight status, and weak to moderate correlations between self-report and direct measures of physical activity. Under/healthy weight children had significantly higher directly measured mean daily minutes of MVPA compared to overweight/obese children (39 verses 20 minutes); had lower mean weekend-day minutes of sedentary time (346 verses 365 minutes); and had a higher proportion who met physical activity guidelines (15.5% versus 2.6%). Lastly, while MVPA patterns among urban Kenyan children were largely similar to those of urban Canadian children with regard to relationships by sex, BMI category, and weekday/weekend days; in the Kenyan sample, much unlike many higher income countries, lower SES was associated with higher MVPA.

Thesis (doctoral)--Université de Limoges, 2005. / Includes abstract in French and English. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (p. 488-507) and index.

Transitional justice is an essential part of the peacebuilding process, as the need to obtain justice for victims of conflict has been recognised as imperative when constructing peace. Subsequent to the established role of justice, the debate on approaches to justice has emerged. A debate concerned with whether restorative or retributive justice is suitable for the context, as the two are frequently presented as exclusive alternatives in academic debates.   Restorative justice favours inclusion and participation as instruments to repair harm caused by crimes, while retributive justice favours accountability through criminal punishment. This study, aspires to influence the discussion by analysing if the debate on restorative versus retributive justice is present in practice and if there is a trend of implementing restorative approaches to justice in this context. The objective of this study is relevant for transitional justice as there is a debate among scholars on the applicability of restorative justice in transitional societies.    The method of structured, focused comparison is applied to detect which mechanisms are implemented in four Sub-Saharan African post-conflict countries. The countries were selected based on their similarities, as it allows for a focused comparison. The theoretical framework adopted is the TARR-model. The elements of the model are applied as a basis for the structured, focused comparison. Further, the model is used to detect restorative and retributive mechanisms and to assess the restorative basis of transitional justice. The model was selected, as it is the only restorative value-based model available.   The findings detected the approaches to not be exclusive alternatives in practice. Further, a trend of fully restorative approaches to justice was not found in the four cases. However, retributive mechanisms were found to be contributing to restorative outcomes. A trend of combining the two approaches was detected. It is, therefore suggested, future research is conducted on hybrid approaches to justice, local ownership and traditional mechanisms.   Keywords: Restorative Justice, Retributive Justice, Sub-Saharan Africa, Transitional Justice.