African Population Studies (UAPS) / Etude de la Population Africaine (UEPA)
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Migration, lien social et développement dans les Hautes Terres de Madagascar
Get PDFRésumé La connaissance des causes et des modalités de l’émigration rurale peut-être un pas en avant dans la compréhension des difficultés économiques des campagnes malgaches. Quelles sont les conséquences des migrations rurales sur l’économie locale des villages de départ ? Notre travail, à une échelle ponctuelle et réduite, à la mesure de nos moyens, se propose d’apporter certains éléments de compréhension du phénomène migratoire sur deux sites particuliers des Hautes Terres, Ampitatafika et Sandrandahy. Le principal objectif de notre recherche est l’identification des conséquences des migrations à partir du milieu rural des Hautes Terres malgaches sur le développement socioéconomique local de ces régions d’origine. En quoi et comment agissent-elles sur l’économie locale et les conditions de vie des ménages des zones de départ ? Contribuent-elles à aggraver la pauvreté des villages quittés ? Constituent-elles un levier pour le développement des ces zones ? Mots-clés : Migration, développement, transferts, lien social, MadagascarAbstract Knowing the causes and conditions of rural out-migration may be a step forward in understanding poverty and economic problems in rural Madagascar. What are the consequences of rural migration on the local economy of villages in the first place? Our work, at a microlevel proposes to bring several elements to migration on two particular areas in the Highlands, Ampitatafika and Sandrandahy. The main objective of our research is to identify the effects of rural out-migration from Malagasy Highlands on the local socio-economic development in origin area. How do they impact on the local economy and living conditions of households in origin area? Do they contribute to alleviate poverty in villages? Are they an efficient development tool?Keywords: Migration; development; remittances; social tie; Madagasca
Setting up a Demographic Surveillance System in Northern Angola
Get PDFAbstract As in many regions of the developing world, the lack of accurate and up to date demographic information in Angola is a handicap to demographic and health research. To overcome this gap, a Health and Demographic Surveillance System (HDSS) was designed to support the research activities of CISA Project, a health research centre created in 2007 and located within Dande municipality in northern Angola. Here we report the methodology for setting up the HDSS-Dande as well as the adjustments made to improve the data collection process since the conclusion of the baseline census in April 2010. The HDSS data is instrumental for the support of epidemiological and other health studies.Resumé Comme dans de nombreuses régions du monde en développement, en Angola le manque d'informations démographiques exactes et à jour est un handicap pour la recherché démographique et de santé. Pour surmonter cette lacune un système de surveillance démographique et de santé (SSDS) a été conçu pour soutenir les activités de recherche de CISA Project, qui est un centre de recherche médicale, créé en 2007 et situé dans la municipalité du Dande, dans le nord del'Angola. Nous rapportons ici la méthodologie choisie pour la mise en place de la SSDSDande ainsi que les ajustements effectués pour améliorer le processos de collecte des données depuis le recensement de base conclu en avril 2010. Les données du SSDS sont instrumentales pour le soutien des études épidémiologiques et d'autres études de santé
Correlates of contraceptive use among HIV discordant couples in Kenya
Get PDFDespite risks of HIV transmission to infants born of the HIV positive women, contraceptive use is uncommon among women in HIV discordant partnerships. The aim of this study was to determine the factors associated with contraceptive use in a clinical trial cohort of HIV serodiscordant couples based in Thika and Eldoret, Kenya. Data were analyzed from 481 HIV discordant couples enrolled in the Partners in Prevention HSV/HIV Transmission Study at the Thika and Eldoret sites. The primary study outcome was self-reported use of contraception other than condoms. Using a marginal longitudinal logistic model based on generalized estimating equations (GEE) approach we assessed the association of various demographic and behavioral factors with contraceptive use. At baseline the prevalence of non barrier contraceptive use among HIV positive and negative women was 24.3% and 25.7%, respectively. At month 12 of follow-up, the prevalence of contraceptive use was 44.4% among the HIV positive and 26% among the HIV negative women while at month 24, the prevalence of contraceptive use was 38.6% among the HIV positive and 18.2% among the HIV negative women. HIV positive women were more likely to report using contraception than HIV negative women (odds ratio (OR) 1.61 95% confidence interval (CI) 1.04-2.47). Additionally, being married (OR 2.4, 95% CI 1.2-5.0), attending Thika site clinic (OR 6.1, 95% CI 4.2-9.0), and having two or more children (OR 1.9, 95% CI 1.3-2.8) were significantly associated with use of non barrier contraceptives. Future programs should focus on interventions to increase contraceptive use among HIV serodiscordant couples, with a special emphasis on HIV negative women, unmarried women and women with few children
Ethnicity and child survival in Nigeria
Get PDFAbstract This study examined specific socio-cultural practices, which vary among different ethnic groups, as they affect childhood morbidity and mortality in Nigeria. Data from Nigeria Demographic and Health Survey (NDHS) 2003 were complemented with 40 focus group discussions and 40 in-depth interviews among selected ethnic groups in Nigeria. An examination of the Direct Estimates and Cox regression on childhood mortality indicate significant differences, with ethnic groups in the northern part of Nigeria having the highest risk. The values placed on children among all ethnic groups are reflected in different socio-cultural beliefs and practices with significant influence of maternal education. Although the assumption that specific socio-cultural practices might be salient to exposure of children under five years to childhood mortality was supported in the study, the differences observed are more a reflection of the mother’s household environment and socioeconomic variables.Keywords: Nigeria; childhood mortality; socio-economic; culture; ethnicityRésumé Cette étude a examiné les pratiques socio-culturelles spécifiques, qui varient entre les différents groupes ethniques, car elle affecte la morbidité et la mortalité infantiles au Nigeria. Les données en provenance du Nigeria Demographic and Health Survey (enquête démographique et sanitaire) 2003 ont été complétées avec 40 groupes de discussion et 40 entrevues en profondeur auprès de certains groupes ethniques au Nigeria. Un examen du Budget des dépenses directes et de régression de Cox sur la mortalité infantile montrent des différences significatives, avec des groupes ethniques dans la partie nord du Nigéria ayant le plus de risques. Les valeurs placées sur les enfants dans tous les groupes ethniques se retrouvent dans les différentes croyances socio-culturelles et des pratiques ayant une influence significative de l'éducation maternelle. Bien que, l'hypothèse que les pratiques socio culturelles spécifiques pourraient être saillants de l'exposition des enfants de moins de cinq ans pour la mortalité infantile a été pris en charge dans l'étude, les différences observées sont plus d'une réflexion de l'environnement ménage de la mère et les variables socio-économiques.Mots clés: Nigeria; la mortalité infantile; socio-économique; la culture; l'ethnicit
Barriers to health care by women infected with Tuberculosis in Kibera slums in Nairobi, Kenya
Get PDFAlthough more men than women die from TB, the disease causes more deaths among women than all causes of maternal mortality combined. Despite TB testing and treatment being free of charge in all government health facilities in Kenya, fewer women than men access this care. This descriptive study explores the TB awareness level among Kibera residents and the barriers faced by women infected with the disease in accessing TB health care. The data used are from 100 household interviews, 5 case studies with female TB patients and 5 key informant interviews with health workers. While an awareness level of TB is above average, there are still some gaps in the knowledge regarding TB treatment, leading to poor compliance with treatment. There is also high stigma associated with TB and HIV/AIDS and poverty. Efforts to improve care seeking among female TB patients in Kibera have to target all these barriers
Socioeconomic status and elderly adult mortality in rural Ghana: evidence from the Navrongo DSS.
Get PDFElderly adult health and issues affecting them in Africa have not been adequately addressed by research. This study explored the relationship between socioeconomic status and elderly adult mortality in the Kassena-Nnakana District (KND) of northern Ghana using data from the Navrongo Health and Demographic Surveillance System (HDSS) in 2005-2006. 15,030 adults aged 60 years and over were included in the study, of whom 1315 died. Using Cox proportional hazards regression, we found that socioeconomic status (SES) was not a determinant of elderly mortality. Compared to the lowest SES quintile, the adjusted hazards ratios were: 0.94 (95%CI: 0.79–1.12) for second quintile, 0.91 (95%CI: 0.76– 1.08) for third quintile, 0.89 (95%CI: 0.75–1.07) for fourth quintile and 1.02 (95%CI: 0.86–1.21) for the highest income quintile. However, living without a spouse [HR=1.98, 95%CI: 1.74–2.25], being male [HR=1.80, 95%CI: 1.59– 2.04] and age [HR=1.05, 95%CI: 1.04–1.05] were significant factors for elderly adult mortality. This shows that companionship and social/family ties are of more importance than household socioeconomic status in determining elderly adult mortality. Efforts should therefore be made to introduce programs and policies to support the elderly, especially those living alone
Africa and the francophonie of tomorrow: An attempt to measure the population of the Francophonie from now to 2060
Get PDFHabib Bourgiba, Hamani Diori and Léopold Sédar Senghor are considered the fathers of the Organisation Internationale de la Francophonie (OIF), an international community created in the early 1960s that currently unites more than thirty countries where the French language is given a major role in public life, education, the arts, law, the media, etc. Some present the OIF as a neo-colonial organization, while others think of it as protecting the world’s cultural diversity in the face of globalization. Regardless, this assembly of countries around the world has played and should continue to play a significant role in international politics. However, the configurational changes this Francophone community has experienced since its inception in the 1960s are nothing compared with those we predict for the next 50 years. In fact, the most recent demographic trends outlined in the United Nations’ latest population projections are leading to a major reconfiguration of the demographic weight of the countries of the world, particularly in Africa. In this context, we were interested to try a forward-looking exercise based on these most recent projections from the UN that could allow us to define the Francophonie of tomorrow by exploring the evolution of Africa’s demographic weight. In the coming decades, what will be the size and the geographic distribution of the Francophone population? How has Africa’s demographic weight in the espace francophone evolved? And how will it evolve in the future? In this article, we try to better define the demographic outline of tomorrow’s Francophonie by drawing on different definitions of the espace francophone, while highlighting some of the political and social issues of this forward-looking exercise for the Francophone community in general, and for Africa in particular
Reflections on international migration and development in sub-Saharan Africa
Get PDFThis reflective article sketches the specificity of migratory flows in sub-Saharan Africa, which is essentially intra-regional. While changing dynamically, the distinctive features include increasing female migration, diversification of migration destinations, transformation of labour flows into commercial migration, and emigration of skilled health and other professionals. These migrations take place largely within the context of sub-regional economic unions which are dominated by the economies of a single country, and movements of persons have been directed to a limited number of countries within these unions. Emigration pressure is fuelled by unstable politics, poverty and rapidly growing populations. In general, remittances have been rising steeply and are an important source of income for many poor countries and serve as lifeline to pay for basic services, health care, education of siblings and children and to enhance agricultural production. Yet, millennium development goals and other development agendas are being compromised by the emigration of scarce skilled manpower. A major challenge now facing the region is how to retain, attract back and effectively utilise the rare skills of nationals living abroad for national development. The paper concludes by stressing the need for rich countries to help poor African countries foster local development, reduce poverty and create domestic employment in the spirit of co-responsibility
A review of the role of civil society in advocacy and lobbying for enforcement of health policy in Kenya
Get PDFAbstract Advocacy and lobbying are more taking an ever more central place in health agendas of African countries. It is impossible to have a conversation about public policy these days without someone mentioning ‘civil society’. Unfortunately, clarity and rigor are conspicuously absent within civil society. Advocacy and lobbying for enforcement of health policy is called for because of civil society’s tendency to concentrate on commercial interests rather than health equity. A States’ first duty towards citizens is to respect the right to health by refraining from adopting laws or measures that directly impinge on people’s health. There is evidence from the literature of civil society organization (CSO) intervention in support of primary health care, equity in health and state health services. Our desk review yields 38 online documents. Information obtained from the desk review is analyzed vis a vis interviews from visits to three selected key informants who are a government official involved in health policy formulation at the ministry of health and two civil society organizations officials from the health NGO network. Key themes emerging from our consultations are discussed during the 27Th annual scientific conference hosted by the Tanzania Public health association at St. Gasper conference centre, Dodoma, Tanzania 2-6th November 2009. From a PowerPoint “oral” presentation participant’s queries are input. Based on our interpolation of the civil society consensus articulated at the Tanzania Conference we establish that the centrality of a right to health framework is an important basis for policy. Our interviews establish that countries should ensure that public health principles and priorities are clear and legally binding; countries should have a clear coordinating mechanism on issues of trade and health that involve government, particularly health ministries and civil society. Civil society needs to disseminate health and trade information in assessable ways. Challenges faced by lobbyists are foreign funding for capacity building initiatives and availability of technical expertise to inform the policy making process adequately.Keywords: Advocacy; representation; lobbying; HENNET, policyRésumé Le plaidoyer et le lobbying prennent de plus en plus une place importante dans les programmes de santé des pays africains. Il est devenu quasiment impossible de tenir une conversation sur la politique publique sans que quelqu’un ne parle de “société civile”. Malheureusement, il manque de la clarté et de la rigueur dans la notion de société civile. Le plaidoyer et le lobbying dans le renforcement des politiques de santé est nécessaire à cause de la tendance de la société civile à se concentrer sur les intérêts commerciaux plutôt que l’éthique en santé. Le premier devoir des États envers les citoyens, est de respecter le droit à la santé en s'abstenant d'adopter des lois ou des mesures qui pourraient toucher directement la santé des individus. IL existe des preuves de la littérature des organisations de la société civile (OSC) des interventions en faveur des soins de santé primaires, l'équité dans la santé et les services de santé d’état. Notre étude théorique a fait la revue de 38 documents en ligne. Les informations obtenues de la revue ont été analyses et ont servi à faire des entretiens individuels avec trois informateurs-clés que sont un fonctionnaire du gouvernement impliqué dans la formulation de politiques au niveau du ministère de la santé, et deux membres des organisations de la société civile et du réseau des ONG de santé. Les principaux thèmes émergents de nos entretiens ont été discutés lors de la 27ième conférence scientifique annuelle de l’association tanzanienne de santé publique tenue du 2-6 Novembre 2009 au centre de conférence St Gasper à Dodoma en Tanzanie. Après une présentation “orale” par power point, les contributions des participants ont été prises en compte. Sur la base de notre interpellation au consensus de la société civile définie à la Conférence de Tanzanie, nous montrons que la centralité du droit à un cadre de santé est une base importante pour la politique. Nos entretiens permettent d’établir que les pays devraient s'assurer que les principes et les priorités de la santé publique sont clairs et juridiquement contraignantes; les pays devraient avoir un mécanisme clair de coordination sur les questions du commerce et de la santé qui impliquent le gouvernement, en particulier les ministères de la santé et la société civile. La société civile a besoin de diffuser l'information sanitaire et commerciale de façon évaluable. Les difficultés rencontrées par les lobbyistes sont les fonds étrangers pour des initiatives de renforcement des capacités et la disponibilité des compétences techniques afin d'informer le processus décisionnel de manière adéquate.Mots clés: Plaidoyer, Représentation, Lobbying, HENNET, Politiqu
Fifty years of research in African demography: progresses and challenges
Get PDFAbstract The paper presents and discusses the progress in knowledge of African populations and their dynamics over the past 50 years. It takes as a starting point the landmark series of studies published in The Demography of Tropical Africa. Since then major progresses in data collection and data analysis were made, which are reviewed and discussed, with special reference to direct and indirect methods of demographic estimation. A major change occurred about 25 years ago with the development of DHS surveys and the focus on epidemiology and public health issues. Demographic research had to change its paradigms, and major advances were made in our understanding of population dynamics in relation with health issues. In a last part, the paper addresses special topics, unforeseeable events such as the HIV/AIDS epidemics which had major consequences for many demographic processes, and new fields for research around environmental issues. Keywords: Demography; public health; demographic methods; history; sub-Saharan AfricaRésumé en français Cette communication présente et discute les progrès faits depuis un demi-siècle sur la connaissance des populations africaines et leurs dynamiques. Elle part d’une série d’études pionnières publiées dans l’ouvrage intitulé : The Demography of Tropical Africa. Depuis cette époque, de nombreux progrès ont été faits en matière de collecte et d’analyse des données, qui sont présentés et discutés, en mettant l’accent sur les méthodes directes et indirectes d’estimation démographique. Un changement majeur se produit 25 ans plus tard avec le développement des enquêtes démographiques et sanitaires (EDS), l’intérêt se portant alors sur les questions épidémiologiques et de santé publique. La recherche démographique a dû changer ses paradigmes, permettant de réaliser des avancées majeures sur la compréhension des dynamiques de population en relation avec les questions de santé. Dans une dernière partie, la communication traite de sujets spéciaux, d’évènements imprévisibles comme l’émergence du VIH/sida, qui a eu d’énormes conséquences sur les phénomènes démographiques, et de nouvelles questions comme celles qui ont trait aux questions d’environnement.Mots clé: Démographie; Santé publique; Méthodes d’estimation; Histoire; Afrique sub-Saharienne