Thesis (doctoral) - WHU - Otto Beisheim School of Management, Vallendar, 2007. / Includes bibliographical references (p. [233]-246).

Thesis (Th. M.)--Dallas Theological Seminary, 2002. / Includes bibliographical references (leaves 78-86).

Thesis (Th. M.)--Dallas Theological Seminary, 2002. / Includes bibliographical references (leaves 78-86).

Thesis (doctoral)--Göteborgs universitet, 2008. / Extra t.p. with thesis statement inserted. Includes bibliographical references (p. [250]-273).

Revised (doctorial) thesis. - University of London, 19-- / Previous ed.: 1996. Includes bibliographical references (p. 320-341) and index.

Thesis (Ph. D.)--Miami University, Dept. of Political Science, 2006. / Title from second page of PDF document. Includes bibliographical references (p. 129-139).

Thesis (MComm (Logistics))--Stellenbosch University, 2008. / Although global changes like political security, depletion of natural resources, energy supply and global warming are affecting all continents; Africa struggle the most to cope with these changes. This is due to the many historical impediments that Africa still has to overcome. Examples of these impediments are the negative effects caused by civil wars, poverty, poor infrastructure and a lack of skills. Providing reliable, effective and efficient infrastructure underpins all attempts to facilitate trade, grow the economy and reduce poverty in Sub-Saharan Africa (SSA). SSA transportation related infrastructure is limited and generally in a poor condition. This poor state of transport infrastructure impedes SSA's development. However, it is not only the state of the infrastructure that challenges Africa - complicated customs and administrative procedures and inefficiencies when goods are handled at terminals and transferred from one transport mode to another also impede its potential for economic growth. In spite of these limitations, the SSA economy has been growing. As many as 28 countries (out of 48) in SSA recorded improvements in growth in 2006 and 2007. This growth was underpinned by improvement in macro-economic management in many countries, and a strong global demand for key African export commodities (sustaining high export prices, especially for crude oil, metals and minerals). Greater flows of capital to Africa, debt relief and increasing trade with the developing Asia have also helped increase resources and lift growth across SSA. The strong economic growth in the region also reflects the institutional improvements, structural reforms, and more rigorous economic policies that have started to bear fruit in many countries.

abstract: Children with dis/abilities the world over are widely required to sacrifice their human rights to education, equity, community, and inclusion. Fewer than 10% of children with dis/abilities in developing countries attend school. Namibia, Africa, where this study took place, is no different. Despite Namibia's adoption of international covenants and educational policy initiatives, children with dis/abilities continue to be overwhelmingly excluded from school. The body of literature on exclusion in sub-Saharan Africa is laden with the voices of teachers, principals, government education officials, development organizations, and scholars. This study attempted to foreground the voices of rural Namibian families of children with dis/abilities as they described their lived experiences via phenomenological interviews. Their stories uncovered deeply held assumptions, or cultural models, about dis/abilities. Furthermore, the study examined how policy was appropriated by local actors as mediated by their shared cultural models. Ideas that had been so deeply internalized about dis/abilities emerged from the data that served to illustrate how othering, familial obligation, child protection, supernatural forces, and notions of dis/ability intersect to continue to deny children with dis/abilities full access to educational opportunities. Additionally, the study describes how these cultural models influenced cognition and actions of parents as they appropriated local educational policy vis-à-vis creation and implementation; thereby, leaving authorized education policy for children with dis/abilities essentially obsolete. The top down ways of researching by international organizations and local agencies plus the authorized policy implementation continued to contribute to the perpetuation of exclusion. This study uncovered a need to apply bottom up methods of understanding what parents and children with dis/abilities desire and find reasonable for education, as well as understanding the power parents wield in local policy appropriation. / Dissertation/Thesis / Ph.D. Educational Leadership and Policy Studies 2010

OBJECTIVE: It is already known from earlier research studies that block grant support can provide educational benefit to students that are orphaned and vulnerable in secondary schools in East Africa. This thesis examines the impact of block grant support given to secondary schools in Southwest Uganda to see whether or not block grant support benefits the entire student population. STUDY POPULATION: The Republic of Uganda is located in East Africa. Block grant support was given to secondary schools starting in 2006 in the districts of Isingiro, Mbarara, and Ntungamo, all located in Southwest Uganda. The NGOs that provided block grants were Africare and Integrated Community Based Initiatives (ICOBI). MEASUREMENT: School-wide indicators, such as the number of secondary schools, the number of students who took the Year IV National Exam, and the proportion of students that failed the exam, were analyzed retrospectively. The main variable of interest was the percent failure rate of students who took the national exam in schools with and without block grant support (intervention vs control schools). The average failure rates for all students who took the exams, male students, and female students were also calculated. Graphs showing the exam failure rate for each year from 2001 to 2010, excluding 2009, for both intervention and control schools were produced to assess patterns and trends. Data for 2009 was unavailable. STATISTICAL ANALYSIS: Excel Data Analysis RESULTS: No statistically significant difference was found in the percent failure rates between control and intervention schools before and after implementation of the block grant support in 2006. However, for male students in 2001 and 2010, there was a statistically significant difference between the percent failure rates at control (6.9% in 2001; 3.3% in 2010) and intervention (11.2% in 2001; 2.2% in 2010) schools. Between genders in intervention schools, a statistically significant difference was found from 2002 to 2006, and 2010. In other words, the percent failure rates of female students were significantly higher than those of male students for those years. Unlike the quantitative analysis, qualitative analysis shows that the majority of stakeholders believe that the block grants benefited the school as a whole. CONCLUSION: As there was no statistically significant difference in percent failure rates between control and intervention schools prior to when block grant support began in 2006, schools targeted by NGOs in 2006 seem to not have been “poor performing” schools. As there was no statistically significant difference in percent failure rates between control and intervention schools after 2006, block grant support seems to have made no significant impact at the school level. According to the qualitative data, the majority of stakeholders interviewed expressed approval of block grants and believed that they benefited the school as a whole.

The success of scale up of antiretroviral therapy (ART) in low- and middle-income countries (LMICs) is in large part due to the introduction of a “public health approach” to access advocated by the World Health Organization (WHO) which emphasized standardized treatment regimens that could be purchased in large quantities and delivered at scale. In 2010 the WHO updated their global HIV treatment guidelines recommending the substitution of stavudine with tenofovir (both of which are members of the non-nucleoside reverse transcriptase inhibitor (NRTI) class of drugs) in first-line antiretroviral therapy (ART). Given the size of treatment programs in sub-Saharan Africa, changing the NRTI used in first-line therapy for HIV could have a substantial impact on treatment outcomes. We conducted three prospective cohort studies using clinical datasets from several sub-Saharan African countries to answer questions surrounding the impacts of exposure to tenofovir in first-line therapy. The first study examines the frequency of stavudine use and single-drug substitutions (substituting the NRTI in first-line ART) in three regions in sub-Saharan Africa by calendar year, 2004–2014. We found a total of 33,441 (8.9%; 95% CI: 8.7–8.9%) single-drug substitutions occurred among 377,656 patients in the first 24 months on ART, close to 40% of which were amongst patients on stavudine. The decrease in single-drug substitutions corresponded with the phasing out of stavudine. We saw an 80% reduction in the risk of single-drug substitutions when comparing tenofovir to stavudine and close to a 70% reduction in the risk when comparing zidovudine to stavudine. The second study uses a regression discontinuity design to evaluate the impact of national HIV treatment guideline changes in South Africa and Zambia recommending tenofovir in first-line ART on treatment outcomes. We found that updated WHO guidelines increased the proportion of patients initiating tenofovir (risk difference (RD) (South Africa): 81%; 95% CI: 73%, 89%; RD (Zambia): 42%; 95% CI: 38%, 45%). Intent to treat estimates showed a decrease in single-drug substitutions in South Africa (RD: -15%; 95% CI: -18%, -12%) and Zambia (RD: -2.0%; 95% CI: -3.6%, -0.3%). In both countries, there was no effect on mortality, attrition or viral load failure (South Africa only). The third study investigates the effect of the 2012 tenofovir stock shortage in South Africa on provider and patient level outcomes, using data from four public-sector Right to Care clinics, two of which experienced a tenofovir stock shortage and two that did not. While imprecise, our results suggest a potential shift in how providers managed patients during the period of the shortage, mainly, a noticeable decrease in the average number of days between visits during the shortage compare to before or after at all four clinics and a significant difference in the proportion of patients missing visits. Difference-in-difference regression results showed a small, but significant, increase in the risk of missed visits during the shortage compared to after (RD: 1.2%; 95% CI: 0.5%, 2.0%), mainly driven by ACTs clinic. No significant difference was seen in other outcomes. Great strides have been made to extend access to ART as well as increase the quality of the services provided to patients in sub-Saharan Africa. Continued access to and a consistent supply of tenofovir in this setting is necessary for patients to receive drugs that are comparable to those used for HIV treatment in high-income countries, as we show that phasing out of stavudine and for either zidovudine or tenofovir potentially reduced toxicities and potentially improved quality of life in multiple regions throughout sub-Saharan Africa. While we show little effect on treatment outcomes when comparing patients accessing care and treatment during the shortage of tenofovir compared to those that did not, this most likely reflects the clinics’ ability to offset the crisis by continuing to initiate newly diagnosed and eligible patients on treatment and keep treatment experienced patients on their current regimen.