HIV infection persists in Swaziland with the highest prevalence of the disease globally – 1 in 4 Swazis aged 15-49 are HIV-positive. Women have a higher rate of infection than men (31.1% of women are HIV-positive, whereas 19.7% of men are HIV-positive). The difference in prevalence between the sexes raises some concerns, particularly due to the possibility of vertical transmission from mothers to infants because the average number of children ever born per woman is 2.28 for all women and 3.58 children for married women. This research aimed to determine if there was a significant difference regarding the knowledge and personal beliefs about HIV transmission between men and women. Obtaining correct knowledge regarding the transmission of HIV and where to get tested for HIV is vital to preventing further transmission of the disease. The Demographic and Health Surveys Program (DHS) gathered data in 2006-2007 to determine the baseline knowledge of individuals about the transmission of HIV. Comparisons of data collected from Swazi men (n = 4,156) and women (n = 4,987) concerning their knowledge and beliefs about HIV were made in order to obtain descriptive statistics, including chi-square to determine the presence or absence of significance (p-values) and percent differences between the sexes. Statistical Package for the Social Sciences (SPSS) software was utilized to perform all statistical analyses using both the chi-square and percent difference functions. Data was weighted accordingly prior to analyses being run in SPSS. Questions regarding the individuals’ personal beliefs about the transmission of HIV were included on surveys for both sexes, specifically addressing the following: 1) the outward appearance of those who are HIV-positive (96.1% of women and 95.7% of men believed healthy-looking individuals can be infected with HIV; p = 0.336, % difference = 0.3999, χ2 = 0.926), 2) the role (or lack thereof) of mosquitoes in transmitting HIV (65.7% of women and 66.1% of men believed mosquitoes cannot transmit HIV; p = 0.688, % difference = 0.3999, χ2 = 0.161), 3) supernatural involvement in the transmission of HIV (92.3% of women and 91.7% of men believed supernatural means do not contribute to the spread of HIV; p = 0.292, % difference = 0.5999, χ2 = 1.112), 4) and the ability of HIV to be spread via food intake (82.2% of women and 82.3% of men believe they cannot becoming infected with HIV by sharing food with an HIV-positive individual; p = 0.901, % difference = 0.0999, χ2 = 0.016). Despite no statistically significant differences between the beliefs about HIV transmission held by both men and women, the data indicated only 51.9% of women and 51.4% of men possess comprehensively correct knowledge about the transmission of HIV. Furthermore, although 91.8% of women knew where to get tested for HIV, only 78.1% of men knew where to get tested for HIV. However, an encouraging 73.8% of women and 71.8% of men between the ages of 18 and 19 stated they believed adolescents between the ages of 12 and 14 should be taught proper condom use to prevent HIV infection. Comprehensive adolescent and adult sex education programs are indicated to ensure all adolescents and sexually active men and women possess correct knowledge about the transmission of HIV and where to seek assistance for HIV testing and treatment.

Adult women bear a disproportionate burden of overweight and obesity in Sub-Saharan Africa (SSA). Precise information to understand disease distribution and assess determinants is lacking. Therefore, this dissertation aimed to: (i) analyze the prevalence of adult female overweight and obesity combined in lower-level administrative units; (ii) analyze the effect modification of educational attainment and age on the association between household wealth and adult female overweight and obesity; (iii) synthesize qualitative research evidence to describe contextual factors contributing to female overweight and obesity at different life stages. Bayesian and logistic regression models were constructed with Demographic and Health Survey (DHS) data to respectively estimate the prevalence of overweight and obesity and assess the interaction of education on the association between household wealth and overweight. The synthesis of qualitative research studies was conducted in accordance with PRISMA guidelines and findings were grouped by themes. Prevalence estimates revealed heterogeneity at second-level administrative units in the seven SSA countries examined, which was not visible in first-level administrative units. The combined prevalence of overweight and obesity ranged from 7.5 – 42.0% in Benin, 1.4 – 35.9% in Ethiopia, 1.6 – 44.7% in Mozambique, 1.0 – 67.9% in Nigeria, 2.2 - 72.4% in Tanzania, 3.9 – 39.9% in Zambia, and 4.5 - 50.6% in Zimbabwe. Additionally, education did not have a statistically significant modifying effect on the positive association between household wealth and overweight in the 22 SSA countries eligible for the study. Body shape and size ideals, barriers to healthy food choices and physical activity were key themes in the research synthesis encompassing four SSA countries. Positive symbolism, including beauty, was linked to overweight and obesity in adult women. Among adolescents, although being overweight or obese was not accepted, girls were expected to be voluptuous. Body image dissatisfaction and victimization characterized the experiences of non-conforming women and girls. Barriers to healthy nutrition included migration and the food environment. Whereas, barriers to physical activity included ageism. While additional work is encouraged to validate the prevalence estimates, overweight and obesity interventions must consider whether the determinants identified in this study are relevant to their context to inform improved outcomes.

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The purpose of this thesis is to investigate some of the contending issues associated with economic underdevelopment in sub-Saharan African states. Specifically, this thesis focuses on the combined effects of World Bank and International Monetary Fund (IMF) economic austerity programs, the increased spread of the HIV/AIDS pandemic, and the continuous democratic deficit on the sluggish economic performance within four sub-Saharan African countries – Ghana, Kenya, Botswana and the Democratic Republic of Congo. The research questions are: are there any unique political, cultural, and economic issues that underscore and determine the path of sub-Saharan African development? What are the potentials for sub-Saharan Africa going beyond its present state of socioeconomic and political underdevelopment? Can sub-Saharan African nation-states truly claim the 21st century? It is hoped that what is learned from examining the situation in these four countries may be generalizeable to other sub-Saharan African states. This thesis has been written with the conviction that sub-Saharan Africa, although it has missed opportunities over the past thirty years, has not completely closed the door on economic development. Although sub-Saharan African conditions have not favored development and there is no simple solution for sub-Saharan Africa's economic and social ills, there are a number of 'common sense' approaches toward sustainable economic and social development. This thesis examines why sub-Saharan Africa's economic crisis has persevered for three decades, and why efforts to establish and uphold more effective economic policies and functioning public institutions have been so much more difficult in sub-Saharan Africa than elsewhere. My account concentrates on political and institutional factors: I explore how the predicament has progressed over the last thirty years, and the repercussions of the long-term nature of this predicament. The focal purpose is to identify and explain the causes which have kept sub-Saharan Africa for several decades mired in an ostensibly permanent crisis. The general theme of the thesis emphasizes that politics and economics are interconnected in sub-Saharan Africa. Moreover, the thesis focuses on the changing role of politics and markets in the process of economic development since the 1970s – and prospects for the future of this region.

The EFA conference in Dakar 2000 ushered in new momentum for ensuring universal access to education and advocacy for improved educational quality in all aspects (UNESCO, 2000). While significant progress has been made in expanding access in sub-Saharan Africa, particularly for girls, efforts to ensure improved educational quality in terms of learning, have not matched the drive for universal educational access. Rather, educational quality in most countries in sub-Saharan Africa has been seriously compromised by rapid expansion given the limited resources. In many attempts to ensure the delivery of quality education in developing countries, the thrust of delivery strategies has focused on increased allocation of inputs/resources to infrastructure development and supply of textbooks. However, the literature on the effect of such resources on student achievement is rather mixed and inconclusive with many studies noting that resources make little or no difference. While such approaches may be theoretically sound, most fail to focus on microelements at the school or classroom level such as capturing the teaching and learning experiences of both students and teachers and students. In an attempt to fill this gap, a new line of research has emerged which looks more closely at how resources are used by schools to support and improve instruction. This study follows this trend and examines the extent to which the Rehabilitation of the Basic Education Project (REBEP) in Sierra Leone contributed to improved learning and academic performance of students in five target schools after a series of interventions. Using a case study approach, the study revealed that while REBEP contributed to a significant increase in educational access, particularly for girls, performance in the terminal National Primary School Examination (NPSE) did not improve despite huge investments in the target schools. The study concludes that, in the context of Sierra Leone, and perhaps in many more countries in sub-Saharan Africa, unless and until critical school-level factors are appropriately and comprehensively addressed by policy makers, educational standards and quality will continue to be eroded particularly in terms of learning and that achievement of critical EFA goals and MDG by 2015 would remain an unfulfilled dream.

The thesis examines factors that influence sustainability and success of microfinance institutions in Ghana. The topic is important, particularly in poverty stricken Africa, where microfinance institutions play a significant role in supporting governments¿ initiatives to reduce/alleviate poverty. The developed model is tested using data collected from 14 face-to-face interviews and 114 questionnaires. The data is analysed using different techniques- descriptive statistics, cross-tabulations and regression analysis. The research design and scale of the study are appropriate to both the problem addressed and doctoral level research. A number of factors in the model developed were found to be influencing the sustainability and success of microfinance institutions. A model was proposed that seeks to offer an explanation of sustainability and success of Microfinance Institutions in Ghana. The proposed model identified five categories being: institutional characteristics, agency costs, business strategy, environment/governance and success. Single factor analysis established positive relationships between sustainability and all the five factors but placed more emphasis on three out of the five factors namely; success, business strategy and environment/ governance. Multiple factor analysis established no significant differences in the sustainability with respect to the type of MFI, ownership and source of funding. Multiple Regression which allows for the testing of theories or models established a significant relationship between the Operational Self Sufficiency (OSS) and the predictors, especially the drop-out rate of clients and average loans. The Subsidy Dependence Index (SDI) was calculated for the various types of MFIs and the result was a high dependency ratio especially among the FNGOs. Though the dependency is on the decline, it is very slow indicating that most MFIs will depend on subsidies for a very long time to come. Finally it was observed that the relatively high interest rates charged by most of the MFIs tended to defeat the purpose for which the microfinance movement came about. Not only did the study confirm the research model, but it also revealed that most owners did not exhibit a deep sense of involvement and used general knowledge to practice in Ghana. The study concluded that success factors, business strategy, and environment/governance were the most critical of the sustainability factors in Ghana. It is therefore important that managers develop institutional capacities especially in managing the agency problem effectively if they have to be sustainable and successful.

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