41 research outputs found

    Legitimation of the economic community of West African states (ECOWAS): a normative and institutional inquiry

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    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University LondonThis study is an attempt at determining the normative legitimacy of the Economic Community of West African States (ECOWAS). At its core, it scrutinizes the current mandate of the organization following the layering of economic integration objectives with human rights protection, sustenance of democracy, and the rule of law. The study discusses the elements of legitimacy across disciplines mainly, international law, international relations and political science. Legitimacy is eventually split along two divides, the normative and descriptive/sociological aspects. The study traces the normative content (shared/common values) underlying integration in Africa, concluding that integration has been born on new ideals such as human rights, democracy and the rule of law. Expectedly, Regional Economic Communities (RECs) as building blocks of the prospective African Economic Community (AEC) under the African Union (AU) regime are mandated to play a vital role in moving the continent forward upon these values. The inquiry is extended to the institutions of ECOWAS to determine their capacity to effectively implement the new mandate of the organization and operate supranationally. In the process, key legal and institutional shortcomings are discussed, particularly in relation to national institutions. It is argued that while human rights protection enhances the normative legitimacy of ECOWAS, it must not be pursued in isolation. Economic integration and protection of citizens’ rights are co-terminus and mutually reinforcing. Hence, community institutions must reflect this link if they are to be effective. The study concludes on the note that, while ECOWAS possesses layers of legitimacy, and have carried out legitimation steps, it cannot be considered a legitimate organization if Member States continue to be non-compliant with community objectives and if key legal questions remain unaddressed. It is submitted that ECOWAS is merely undergoing legitimation, whether it can eventually be considered a legitimate organization is dependent on addressing the identified challenges

    Sociodemographic Correlates of HIV Discordant and Concordant Couples in Anambra State, Nigeria

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    BACKGROUND: The contribution of discordant partnerships to the burden of HIV/AIDS is significant. An understanding of the characteristics of HIV- affected couples will help modify preventive strategies. The aim of this study was to compare the HIV discordant and concordant partnerships for sociodemographic determinants in comprehensive health centers in Anambra State, Nigeria.METHODS: This was an institution based case-control study of 289 (148 HIV-concordant and 141 HIV-discordant) couples, selected using multistage sampling technique. Data collection was done through nterview using semi-structured questionnaire, while analysis was performed with Statistical Package for Social Sciences version 22.0. Chi-square and t tests were used to identify statistically significant associations between variables. Significance level was set at p value of < 0.05.RESULTS: There were more HIV-discordant positive males 83(28.6%) than females 58(20.1%) (p = 0.043). The mean age (SD) of respondents was 37.8(9.8) years. Concordant couples tended to be younger than discordant couples, with differences in mean ages of 2.41 years (p = 0.028) for males and 2.87 years (p = 0.007) for females. There were no significant differences in proportion of remarriages (p = 0.625) and type of marriage (p = 0.900). The majority of remarriages among discordant couples 15(65.2%), were due to divorce of previous spouses (p = 0.054).CONCLUSIONS: This study found that there were more HIV positive males than females among discordant couples; females in discordant relationships were generally younger than their concordant counterparts. Concordant couples tended to be younger than discordant couples. Such knowledge should be factored in designing novel couple-targeted preventive strategies.KEYWORDS: Sero-concordant, couples, sero-discordant, HIV, determinants, Nigeri

    Balancing the need for investment and environmental protection : a case study of The Gambia

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    Investment is globally considered as an expeditious and sustainable method of assuring economic growth and development. The case is no different for The Gambia who has constantly made it its priority to boost its economy and improve the standard of living of its citizens. However, recent economic downturns and global economic instabilities all indicate that The Gambia could be in need of more investment inflows, if her economy is to remain afloat. One idea that has constantly challenged the validity of investment is the sacrifice the environment is made to bear for its increase. Since 2016, this conflict has been exacerbated by the numerous environmental violations committed by investors and their investments in the country. There has been a collective outcry from the communities affected by these violations and The Gambian government seems to find some difficulty in attending to the complaints of these communities as well as pursuing its desire to increase investment inflows. This research therefore aims to discuss the need to balance investment and environmental protection. To achieve this, it specifically focuses on The Gambia’s investment and environmental regimes and examines the ways by which the government can address this conflict. The paper commences by looking into the evolution of both fields and picks out the global attempts that have been made to reconcile the two. It then analyzes the domestic and regional environmental protection regime of The Gambia and assesses its effectiveness in dealing with environmental violations committed by investors. The research further digs into the investment agreements signed by The Gambia and examines whether and how they address environmental and sustainable development considerations. In doing this, it also provides a general overview on how regional and international tribunals view environmental provisions particularly with respect to investment agreements. Finally, this research concludes by proposing recommendations on how The Gambian Government can better balance the two fields as opposed to being placed in a position of choosing one or the other.Mini Dissertation (LLM (International Trade and Investment Law in Africa))--University of Pretoria, 2021.Centre for Human RightsLLM (International Trade and Investment Law in Africa)Unrestricte

    Trial of Labour after Caesarean Section in a Secondary Health Facility in Abakaliki, Nigeria

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    Background: The mode of delivery of a parturient is influenced by previous caesarean section (CS) scar. Objective: The objective of the study is to evaluate the pregnancy outcomes of a parturient with one previous caesarean delivery that was managed in Mile Four hospital, Abakaliki, Nigeria. Materials and Methods: A 5‑year retrospective study of women with one previous CS who delivered in Mile Four hospital between January 2011 and December 2015 was done. IBM SPSS version 20 was used for data analysis, and data were represented using frequency tables, charts, and Chi‑square. The level of significance was set at an alpha level of 0.05. Results: Three hundred and twenty‑two (322) women with one previous CS were selected for a trial of labor after A C/S (TOLAC). More than half of the women (53.1%) had successful TOLAC while 46.9% had a repeat CS. Of the 53.1% of women who had a successful TOLAC, One hundred and forty-one patients had spontaneous vertex delivery. Seventeen women (9.9%) on the TOLAC arm had a ruptured uterus, while seven patients (4.6%) failed the TOLAC group had uterine dehiscence. Haemorrhage was the most common maternal complication. Severe asphyxia and perinatal death were present in 5.9% and 5.3% of neonates on TOLAC arm, respectively. Conclusion: Trial of labour after a CS can result in an excellent outcome in a well‑selected patient. The success rate of 53.1% in our study is encouraging. However, adequate intrapartum monitoring is recommended to reduce maternal and fetal complications

    Burns in pregnancy: Five-year experience in a tertiary hospital in southeastern Nigeria

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    BackgroundBurns in pregnancy is often associated with high maternal and fetal morbidity and mortality especially when the total burn surface area (TBSA) involved is high. This study aims to review management outcome of cases of burns in pregnancy at Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA).MethodsA five year retrospective study of all pregnant women that presented at AE-FUTHA with burn injury between April 2014 and March 2019. Information was collected from the medical records using a proforma and analyzed with IBM SPSS Statistics version 20.0 (IBM Corp., Armonk, NY, USA) using descriptive statistics.ResultsA total of 222 cases of burns were managed but only 8 were pregnant, giving an incidence of 3.6%. The commonest causes were flame (62.5%), scald (25%) and friction (12.5%) occurring mostly during the harmattan season. The median age of participants was 25-34 years. The burns affected 12.5% of the patients in the first trimester and 62.5% and 25% in the 2nd and 3rd trimesters respectively. Most patients (62.5%) had superficial burns while 25% had other associated injuries in addition to burns. About 87.5% had term spontaneous vaginal delivery. There was no maternal death but, there was an early neonatal death.ConclusionThe good outcome observed in this study with a 100% survival, could be explained by inter-disciplinary management approach given, even as most cases were minor degrees of burns. Early involvement of obstetricians in all burns affecting pregnant women is advised especially in burn centres where obstetricians are hardly in the employ

    Profiling cervical ripening for induction of labour with Foley’s balloon catheter in Ebonyi state, Nigeria: a randomized controlled trial

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    Background: The ripeness of the cervix is an important prerequisite to a successful labour induction. Use of extra-amniotic Foley catheter is a mechanical method of cervical ripening with proven efficacy. This study compared the difference in efficacy between 30 ml and 60 ml of water for inflation of Foley catheter balloon when used for cervical ripening during induction of labour.Methods: A single-blind randomized controlled study where 260 term pregnant women with intact membranes and unfavourable cervix were selected for induction of labour and randomized into two equal groups (30 ml- and 60 ml- groups) from October, 2019 to July 2020. Each participant had cervical ripening with the catheter bulb inflated with either 30 ml or 60 ml of sterile water (as assigned to the individual). After achieving favourable cervix (BS ≥6), oxytocin titration was commenced and the labour monitored with the outcomes well documented and statistically analysed.Results: Mean duration to favourable Bishop Score significantly reduced in the 60 ml group (10.8 hours±2.99) as against 12.7 hours±10.0 in 30ml group (p=0.038). Mean duration of active phase of labour was significantly reduced in 60 ml group (5.6 hours±2.4) as against 8.4 hours±3.2 in 30 ml group (p=0.010). Caesarean delivery rate was significantly reduced in the 60 ml groups (p=0.027).Conclusions: The use of 60 ml inflated Foley’s balloon catheter when compared with 30mls to ripen the cervix effectively reduced the duration to favourable Bishop Score, duration of the active phase of labour and the rate of Caesarean sections.

    Extension for Community Healthcare Outcomes-Palliative Care in Africa Program: Improving Access to Quality Palliative Care

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    Purpose: There is limited access to quality palliative care (PC) for patients with advanced cancer in sub-Saharan Africa. Our aim was to describe the development of the Project Extension for Community Healthcare Outcomes- Palliative Care in Africa (ECHO-PACA) program and describe a preliminary evaluation of attitudes and knowledge of participants regarding the ability of the program to deliver quality PC. Methods: An interdisciplinary team at the MD Anderson Cancer Center, guided by experts in PC in sub-Saharan Africa, adapted a standardized curriculum based on PC needs in the region. Participants were then recruited, and monthly telementoring sessions were held for 16 months. The monthly telementoring sessions consisted of case presentations, discussions, and didactic lectures. Program participants came from 14 clinics and teaching hospitals in Ghana, Kenya, Nigeria, South Africa, and Zambia. Participants were surveyed at the beginning, midpoint, and end of the 16-month program to evaluate changes in attitudes and knowledge of PC. Results: The median number of participants per session was 30. Thirty-three (83%) of 40 initial participants completed the feedback survey. Health care providers’ self-reported confidence in providing PC increased with participation in the Project ECHO-PACA clinic. There was significant improvement in the participants’ attitudes and knowledge, especially in titrating opioids for pain control (P = .042), appropriate use of non-opioid analgesics (P = .012), and identifying and addressing communication issues related to end-of-life care (P = .014). Conclusion: Project ECHO-PACA was a successful approach for disseminating knowledge about PC. The participants were adherent to ECHO PACA clinics and the completion of feedback surveys. Future studies should evaluate the impact of Project ECHO-PACA on changes in provider practice as well as patient outcomes

    The impact of COVID-19 on the supply chain of wheat bread in Nigeria

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    No pandemic has hit the modern world as much as the COVID-19 pandemic has. For a developing country like Nigeria, its effects have rippled through every section of human life and have even caused irreparable demand in some sections. The research focused on how a basic household commodity like wheat bread and how its supply chain has been affected by the pandemic. Wheat, which is the basic raw material for bread is largely imported from temperate countries. This research addressed questions with regards to three aspects of the economics of the wheat bread market which is a national staple: demand, supply, and price. These questions are: what is the effect of the COVID19 pandemic on the price of wheat bread in Nigeria? What is the effect of the COVID19 pandemic on the supply of wheat bread in Nigeria? What is the effect of the COVID19 pandemic on the demand for wheat bread in Nigeria? To answer these questions, a well-structured questionnaire using the Likert scale model was presented using the online Google form platform. The three Nigeria states of Lagos, Abuja and Plateau were used as study areas knowing they were most affected by the restrictions put in place by the Government of Nigeria (GON). These states provided 161 respondents across several locations. Using multiple regression to analyse the data, the results show that the economics of demand, supply and price of wheat demand were affected by the COVID-19 pandemic. Therefore, current and future policy considerations for any form of lockdown must have a tripartite outlook as regards demand, supply and price without neglecting any of the three aspects. The research can help the GON better position its policies to address the economics of a basic household commodity like wheat bread, given that the pandemic is still ongoing
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