Indiana University-Purdue University Indianapolis (IUPUI) / The exportation of institutions from developed economies to developing countries has been a development strategy that international actors have employed for decades. In the 1990s and early 2000s international donors introduced philanthropic foundations into African countries. The Ford Foundation was instrumental in setting up a number of foundations in African countries to promote the mobilization of local philanthropic resources for self-reliant community-driven development. However, more than a decade after their establishment the Ford-founded philanthropic institutions continued to depend heavily on international funding. This dissertation investigates why Ford’s exportation of foundation philanthropy to African countries for the promotion of local resource mobilization was unsuccessful. Current explanations attribute the local resource mobilization ineffectiveness of donor-founded philanthropic institutions to domestic factors --- developing country governments’ failure to provide an enabling environment for the development of nonprofit institutions. Drawing on quantitative and qualitative data, I go beyond the endogenous explanations to examine the role and institutional transplantation strategies of the external actor, the Ford Foundation. Based on in-depth interviews with former staff and consultants of the Ford Foundation, as well as staff of selected Ford-founded African foundations in Kenya, Ghana, and Senegal (namely The Kenya Community Development Foundation, the African Women's Development Fund, and TrustAfrica) I contend that the oft-cited domestic “obstacles” are actually the preexisting local conditions that Ford should have taken into consideration during the formulation and implementation of its philanthropy promotion program in African countries. Using institutional transplantation theories as a framework, I argue that Ford failed to achieve its local resource mobilization goal in African countries because the American-inspired foundation model that it transplanted in those countries for the purpose was incompatible with the local African cultures of giving and philanthropy.

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BACKGROUND: Previous studies show a positive association between household wealth and overweight in sub-Saharan African (SSA) countries; however, the manner in which this relationship differs in the presence of educational attainment has not been well-established. This study examined the multiplicative effect modification of educational attainment on the association between middle-income and rich household wealth and overweight status among adult females in 22 SSA countries. We hypothesized that household wealth was associated with a greater likelihood of being overweight among middle income and rich women with lower levels of educational attainment compared to those with higher levels of educational attainment. METHODS: Demographic and Health Survey (DHS) data from 2006 to 2016 for women aged 18-49 years in SSA countries were used for the study. Overweight was defined as a body mass index (BMI) ≥ 25 kg/m2. Household wealth index tertile was the exposure and educational attainment, the effect modifier. Potential confounders included age, ethnicity, place of residence, and parity. Descriptive analysis was conducted, and separate logistic regression models were fitted for each of the 22 SSA countries to compute measures of effect modification and 95% confidence intervals. Analysis of credibility (AnCred) methods were applied to assess the intrinsic credibility of the study findings and guide statistical inference. RESULTS: The prevalence of overweight ranged from 12.6% in Chad to 56.6% in Swaziland. Eighteen of the 22 SSA countries had measures of effect modification below one in at least one wealth tertile. This included eight of the 12 low-income countries and all 10 middle income countries. This implied that the odds of overweight were greater among middle-income and rich women with lower levels of educational attainment than those with higher educational attainment. On the basis of the AnCred analysis, it was found that the majority of the study findings across the region provided some support for the study hypothesis. CONCLUSIONS: Women in higher wealth strata and with lower levels of educational attainment appear to be more vulnerable to overweight compared to those in the same wealth strata but with higher levels of educational attainment in most low- and middle- income SSA countries.

Promotion of cycling is important to reach the goals for climate mitigation of the Paris Agreement and Goals ofthe Agenda 2030. Sustainable transport, both rural and urban, could contribute to at least seven of the 17 Sustainable Development Goals (ITDP 2015). There is relatively little research on cycling in Africa, and there is also much less research on cycling at night. Some studies show the importance of road lighting for minimising the reduction in the numbers of cyclists after-dark and suggest 'only a minimal amount of lighting can promote cycling after-dark, making it an attractive mode of transport year-round' (Uttley at el. 2020). So far, these studies have little relation to the situation in developing countries, which is why a first study in Nairobi, Kenya, is carried out here as an example. ... [From: Introduction]

Urban quality of life is measured by how clean the environment is, how safe people feel, how close they are to green spaces, and in general by the quality of outdoor space. Good quality public spaces are spaces that reduce road accidents through managing appropriately different transport modes, especially walking and cycling [1]. Cycling is healthy, economical, and environmentally sound form of mobility that is fundamental to life. More than one billion of the people in African cities walk or cycle for more than 55 minutes every day - to reach work, home, school, and other essential services [2]. One-third of the population of the African continent uses active mobility as a daily means of transport. This reveals that there is a potential of using cycling as a daily mode of travel in Africa. However, the poor quality of infrastructure for cycling sends a message that cyclists are not welcome in the urban environment. Despite the widespread use of non-motorized modes, transport planning and the provision of infrastructure in most of the cities in Africa have become carcentered, undermining the importance of cycling and walking. While the majority in the global south are active mobility users, they are not being respected by the public policies and experience 93% of the world's traffic fatalities and injuries [3]. Road traffic accidents are a major shes are not different in Africa. The World Health Organization Global Status report on Road Safety 2018 showed that the African region had 26.6 deaths per 100,000 populations, which is the highest among all regions [5]. Sub-Saharan Africa still has the highest per capita rate of road fatalities of any region in the world. Unfortunately, in most cases, the victims of traffic casualties are primarily pedestrians and cyclists [6]. Much of that is linked to the neglect of the infrastructure needs for pedestrians' and cyclists' safety. [From: Introduction]

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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