Background: Recent stalls in fertility decline have been observed in a few countries in sub-Saharan Africa, and so far no plausible common reason has been identified in the literature. This paper develops the hypothesis that these fertility stalls could be associated with stalls in the progress of education among the women of the relevant cohorts, possibly resulting partly from the Structural Adjustment Programs (SAPs) of the 1980s. Methods: We descriptively link the change in the education composition of successive cohorts of young women in sub-Saharan Africa and the recent fertility stalls. We use reconstructed data on population by age, gender, and level of education from www.wittgenstein centre.org/dataexplorer, and fertility rates from the United Nations. Results: In most sub-Saharan African countries, we observe that the same countries that had fertility stalls had a stall in the progress of education, particularly for young women who were of primary school age during the 1980s, when most of the countries were under structural adjustment. Conversely, stalls in fertility are less common in countries that did not have an education stall, possibly in relation to SAPs. Conclusions: The results point to the possibility of a link between the recent fertility stalls and discontinuities in the improvement of the education of the relevant cohorts, which in turn could be related to the SAPs in the 1980s. This descriptive finding now needs to be corroborated through more detailed cohort-specific fertility analysis. If the education-fertility link can be further established, it will have important implications for the projections of population growth in affected countries.

Magister Chirurgiae Dentium (MChD) / The World Health Organisation estimated that in 2002 more than 13,772 000 deaths in developing countries were caused by infections. This accounted for more than 45% of all deaths, making up 7 of the top 10 causes of death (World Health Organisation, 2004). Sub-Saharan Africa is the epicentre of the devastating HIV pandemic. The country leading with the highest HIV rate in the world is South Africa, with approximately 5.5 million people infected(UNAIDS, 2008; South Africa Country Progress Report, 2008).The development from HIV to AIDS progressively weakens the immune system, making the individual more susceptible to numerous infections, e.g.various forms of orofacial sepsis (Mindel, and Tenant-Flowers, 2001). HIVpositive individuals are eighteen times more likely to become infected with community-acquired methicillin-resistant Staphylococcus aureus than the general population. (Crum-Cianflone et al., 2006). The management of sepsis is of great concern with regard to human morbidity and mortality, as well as its financial implications, especially in cases of antibiotic resistance (Kimleck et al., 1976; Panlilo et al., 1992; Kirkland et al., 1999). Currently, there is no published peer-reviewed literature assessing the impact of HIV on orofacial sepsis. This study aimed to assess the impact of HIV on orofacial sepsis, investigating the clinical and microbiological profiles of the population. These results were used as a guide in the adaptation of current treatment protocols.The study population consisted of patients with orofacial sepsis (requiring incision and drainage or admission) who were referred to the Maxillo-Facial and Oral Surgery Units at either Groote Schuur or Tygerberg Hospitals. These patients were examined, diagnosed and treated as per standard protocol. The empiric antibiotic treatment was tailored according to microscopy and sensitivity results when it became available. The exclusion criteria of the study were refusal of HIV testing or unwillingness of patients to participate in the study.The ratio of HIV positive patients treated was much higher than the population prevalence (2.4:1.1). Odontogenic infections (71.11%), followed by septic jaw fractures (15.56%) were the most common causes of sepsis. The most common causative teeth were the mandibular posterior teeth (43.75%)(excluding the mandibular 3rd molars). The most common fascial spaces involved in the HIV positive group were the submandibular spaces (36%),followed by the submasseteric and canine spaces (27% each). In the HIV negative group, the buccal (41%) and submandibular spaces (33%) were the most common fascial spaces infected.The HIV negative group had the most multi-fascial space involvement, with 35% having more than one fascial space involved. In comparison, the HIV positive group had only 18% involvement of more than one fascial space. This was also reflected by the HIV negative group, which included five cases of Ludwig’s Angina as compared to one case in the HIV positive group. The Gram Stain showed a predominance of Gram positive cocci for both the HIV positive and negative groups. Gram positive bacilli were significantly more prevalent in the HIV negative group (p = 0.0409). Pre-treatment antibiotics were associated with sterile abscesses in 20% of the cases. No growth on culture occurred only in the HIV negative group (statistically significant with p = 0.00488).A statistically significant increased length of admission was found for the cases with penicillin-resistant bacteria (Wicoxin Rank Sum Test p =0.0072). Penicillin resistance was found in 17.78% (8 cases) with ten strains of five types of bacteria (S. aureus, K. pneumonia, Enterobacter, E. coli,Alpha-haemolytic Streptococcus). Eight percent (5) of these cases were also resistant to co-amoxiclav®.In the HIV positive group the following trends (p>0.005) were found:• The average platelet counts of this group was 112.34 x108/L (lower than the HIV negative group);• The length of admission for the HIV positive group was slightly longer by 0.25 days even though this group had fewer fascial spaces infected;• A larger number of bacteria with penicillin-resistance was more prevalent in the HIV positive group (six resistant bacteria in four cases compared to four resistant bacteria in four cases).Greater numbers of orofacial infections were seen in HIV positive subjects relative to their population prevalence rates. Added to this, was the higher rate of antibiotic resistance and longer hospital admissions.These findings may warrant further investigation of the relationship between HIV positive and negative groups with regard to orofacial sepsis.

Abstract not available.

Becoming an effective agent of development in the challenging and complex context of the development NGO in Sub-Saharan Africa necessitates prioritizing learning and adaptation. But NGOs are often not characterized by such a strong learning culture and commitment; and Christian NGOs are no exception. Reforming both the commitment to learning and the structures that support it is a pressing challenge facing Christian NGOs committed to being effective agents of development. Such reform requires careful analysis of the context of Sub-Saharan Africa, special consideration of the complex broader socio-political structure of the NGO world, and systematic research into understanding organizational dynamics that facilitate learning. Data from this research contributes to building an integrated learning model. Applying this model through a case study of specific Christian NGO—World Vision Burundi—leads to both identifying factors that undermine learning and proposing a set of recommendations that will help this NGO become a more effective learning organization.

Les conflits sont tellement fréquents en Afrique sub-saharienne depuis les indépendances qu'on en a malheureusement pris l'habitude. Cette fréquence semble conforter l'idée que les Africains sont dans l'incapacité congénitale à gérer leurs pays et leurs ressources. Très souvent également, on considère que les conflits africains procèdent de la "culture" africaine qui serait par définition violente et agressive . Si les conflits sont manifestement une entrave au développement, ils sont aussi le résultat de l'absence de développement en Afrique.L'objectif de cette thèse est de comprendre les fondements économiques des conflits armés en Afrique sub-saharienne. c'est-à-dire que nous allons partir à la recherche des causes économiques des conflits. Les principales variables observées sont, le PIB par tête, l'aide internationale, les matières premières exportables, la dette du gouvernement, l'investissement direct étranger, la population, l'alimentation et l'eau. Nous postulons que tout processus permettant d'améliorer le développement économique des pays de l'Afrique noire est un moyen pour éviter un commencement de conflits. / Conflicts are frequent in sub-saharan African countries since their independence and unfortunately people consider such situation to be normal. This frequency seems to reinforce the idea that Africans are naturally unable to manage their resources. African conflicts are also very often considered as a result of African culture, which is termed as a violent and agressuve. If conflicts are obviously an obstacle to development, they are also the consequence of undevelopment in Africa.The objective of the PhD is to understand the ceonomic basis of armed conflicts in sub-saharan Africa. In other words, we seek toidentify economic causes of conflicts. The main variables observed are GDP per capita, international aid, raw materials for export, government debt, foreign direct investment, population, food and water. We confirm that any process that helps improve economic development in sub-saharan African countries is a way to avoid new conflicts.

Sub-Saharan economies need structural changes that would enhance their productivity, increase economic growth and development. In this regard, industrialization plays a key role. Using regression analysis, the aim of this dissertation thesis is to identify main factors (determinants) of industrialization in sub-Saharan Africa. The results indicate that infrastructure and economy size (measured by population size) represent main determinants of industrialization in the region. The thesis also deals with possibilities for development of those determinants. Case study of infrastructure development in Mauritius emphasizes privatization, cooperation with external subjects etc. Negative consequences of small economy size can be overcome by preferential trade agreements (under certain circumstances), as shown by analysis of the three smallest economies in the region.

Empowerment-based approaches to social development has attracted substantial attention in the last two decades. At the core of this debate is the preposition that empowering marginalised groups can improve their agency, with possible favourable implications for their life outcomes. The household bargaining literature has examined the effect of women’s empowerment/bargaining power on development outcomes (e.g. health, education, agriculture and household expenditure). A core issue in this literature is the measurement of what constitute women’s empowerment. The literature in economics and human development has tended to rely on the use of proxies that capture women’s access to resources and or capabilities/functioning. This approach tends to ignore or deemphasise the importance of social norms/informal institutions (norms, values, traditions, beliefs etc), which via patriarchal gender stereotypes, restrict women’s voice and access to resources. Although some researchers in demography have used proxies that capture social norms, they have been used alone, thus telling a single sided story as in the case of the economics and human development literature. Secondly, the discussion on the instrumental importance of women’s empowerment in this literature seem to have focused mainly on mean development outcomes compared to the distributions of such outcomes in the population (inequality). Thus, the current study, using Demographic and Health Survey (DHS) data from 20 Sub-Saharan African (SSA) countries, computes a composite women’s empowerment Index (CWEI), together with two sub-indices (social norms and access to resources) representing two dimensions of CWEI. The study further examines the comparative effect of social norms and women’s access to resources on household health (i.e. mean health outcomes for women and children and poor child health inequality). Results suggest that in general, women from Southern Africa have a higher score on CWEI compared to their counterparts from East and Central Africa and West Africa. In addition, Southern African women are more able to negotiate social norms that constrain their voice and agency, whiles women from West Africa perform better on the access to resources index. Information from the DHS data and other external data sources (World Development Indicators database, International Labour Office and WEIGO), together with the SSA literature on the politics of liberation struggles and the formal/informal dichotomy of SSA economies, suggest that the sub-regional differences may be due to the unique history of liberation struggles in Southern Africa and the relatively large size of the informal sector in West Africa. Multivariate results also confirm the long held view that women’s empowerment positively influences household health (mean health outcomes and inequality), with social norms having a much higher effect on household health compared to women’s access to resources. In addition, the results suggest that other factors such as women’s education, household wealth, access to and availability of health services, rural/urban and provincial differences have a higher effect on household health compared to the two dimensions of women’s empowerment. The study concludes, advocating that interventions aimed at improving women’s empowerment and bargaining emphasise issues of social norms, since they are likely to constrain women’s voice, access to resources and consequently implications on household outcomes. This emphasis must however take into consideration the importance of other equally important factors (women’s education, household wealth, access to and availability of health services etc), given that women’s empowerment (especially informal institutions such as social norms) could take a long time to change and their effect realized in the long-term.

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.

This dissertation examines the factors that account for the variation in policy choices and implementation among sub-Saharan African countries that pursued neoliberal economic reforms since the 1980s. It shows that governments’ response varied both across time and policy areas. Using process tracing and cross-case analysis, this dissertation examines the influence of both international and domestic level factors regarding neoliberal policy choices and implementation in Ghana, Kenya, Zimbabwe, and Botswana. While the strength of the various explanations varies across cases, the empirical evidence shows that crisis, interest groups, and epistemic community are more powerful in explaining governments’ policy choices. Domestic institutions and epistemic community offer the strongest support for policy implementation. Since the epistemic community variable is strong in explaining both policy choice and implementation, these findings are more supportive of the Constructivist explanation for policy reforms. The evidence shows that neoliberal economic reforms in Ghana have been successful while those in Kenya and Zimbabwe have been less successful. Botswana, however, does not fit the crisis-driven conceptual model adopted in this dissertation and therefore requires further examination.

This dissertation investigates labor demand constraints and labor supply barriers to informal employment opportunities in Johannesburg using a micro-macro linkage methodology. Existing literature often characterizes the “informal sector” as voluntarist, or as the result of rationing due to labor market imperfections. Such models acknowledge no explicit role for macroeconomic factors to affect employment outcomes. I argue that, far from being structurally disconnected, both formal and informal employment conditions, including those in street trading, are shaped by the macroeconomic environment. The results highlight mechanisms through which conditions in the informal economy, in which traders operate and make decisions, are shaped by macroeconomic policies, and how these policies affect employment security. Based on qualitative field research on self-employed street traders conducted in 2008, I develop an analysis of trading from the level of the macroeconomy, through the retail sector, to traders and their households. The macroeconomic analysis estimates a consumption function to model impacts of alternative fiscal policy to that adopted in the post-apartheid years. The analysis uses an input-output model to isolate the impact of deficit spending on consumption by industrial sector and assess earnings and employment effects in the retail sector. Interview-based survey data enrich and contextualize the analysis, incorporating traders’ experiences and perceived challenges to self-employment. I find evidence of multiple interacting constraints on labor demand and labor supply, which helps make sense of the South African paradox of high unemployment coincident with a small informal economy. Street traders have limited profitability due, in part, to constrained consumption demand, which provides some explanation for the persistence of the paradox despite low barriers to entry. Further, constraints have disproportionate impacts on certain groups: female traders perceive their self-employment as significantly more threatened by demand constraints because their households tend to rely more on trading income than do male traders' households.