Relief or agricultural development? Emergency seed projects, farmer seed systems and the dissemination of modern varieties in Mali and Niger

Emergency seed projects tend to be implemented in response to natural disasters such as drought, flooding, cyclones, hurricanes, and civil conflict, particularly those involving population displacement or return. The assumption on which these projects are based presumes that farmers lose or eat their seed so that seed is no longer locally available or accessible. Recent research, however, haschallenged this assumption (Longley and Sperling 2002). Studies undertaken in southern Sudan (Jones et al. 2002), Somalia (Longley et al. 2001), southern Africa (Friis-Hansen and Rohrbach 1993), Rwanda (Sperling 1996), and Sierra Leone (Longley 1997) have shown that not all farmers lose their seed, and - even if they do - seed is often locally available through grain markets or from farmers in neighboring areas. Implicit in such findings is the need to reconsider the aims and modalities of conventional emergency seed projects. If it is assumed that farmers affected by disaster have no seed, then the aim of an emergency seed project is ostensibly to provide farmers with something to plant in the forthcoming season. However, as we shall see in section 5, there are, in practice, various other underlying objectives - often unarticulated - for which seed is given in emergencies. One of these underlying aims is the promotion of modern varieties. Some of the existing guidelines on emergency seed provisioning recommend the use of local varieties which tend to be more appropriate than modern or improved varieties (Chemonics 1996); others present a more nuanced view, advising that the choice of varieties will depend on the farming community's pre-disaster situation (ODI 1996). If the objective of an emergency seed intervention is 'to return the local farming system to a situation as close to its predisaster status as possible' (ODI 1996: 16), then modern varieties should only be given if farmers depended on modern varieties prior to the emergency. This paper challenges this position, suggesting that - in some recurrent or long-lasting crisis situations, and provided that adequate varietal trials have been undertaken - carefully chosen modern varieties may usefully increase varietal diversity. Rather than returning to the pre-disaster situation, such an approach aims to enhance the capacity of farmers' seed and agricultural systems. But an intervention that sets out to promote varietal diversity and strengthen local agricultural systems must be implemented very differently to an intervention that aims to provide emergency seed aid. As such, it might best be considered as part of a longer-term rehabilitation strategy as opposed to a short-term relief activity; in other words, seed system support rather than emergency seed provisioning1 (ODI 1996)

An Economic Assessment of Sorghum Improvement in Mali, Impact Assessment Report No. 2

Since the Sahelian droughts of the 1970s and 1980s, raising sorghum productivity through development of higher-yielding varieties has been a policy priority for the Government of Mali, in partnership with ICRISAT. ICRISAT’s involvement in sorghum improvement in the Sahel dates to 1975. Sorghum is one of the two main dryland cereals (the other is pearl millet) produced in Mali, and is both a food staple and ready source of cash for majority of the country’s predominantly rural population. This report consists of two analytical components, (a) a census of sorghum variety and hybrid seed use in 58 villages in the Cercles of Dioila, Kati, and Koutiala, where new sorghum materials have been tested in farmers’ fields; and (b) an assessment of the economic impact of major varieties of improved sorghum released since the study by Yapi et al. (2000), including recently released sorghum hybrids, based on an economic surplus model. The report also presents an ex post assessment of returns to research investment..

Human resources for primary health care in sub-Saharan Africa: progress or stagnation?

BACKGROUND: The World Health Organization defines a "critical shortage" of health workers as being fewer than 2.28 health workers per 1000 population and failing to attain 80% coverage for deliveries by skilled birth attendants. We aimed to quantify the number of health workers in five African countries and the proportion of these currently working in primary health care facilities, to compare this to estimates of numbers needed and to assess how the situation has changed in recent years. METHODS: This study is a review of published and unpublished "grey" literature on human resources for health in five disparate countries: Mali, Sudan, Uganda, Botswana and South Africa. RESULTS: Health worker density has increased steadily since 2000 in South Africa and Botswana which already meet WHO targets but has not significantly increased since 2004 in Sudan, Mali and Uganda which have a critical shortage of health workers. In all five countries, a minority of doctors, nurses and midwives are working in primary health care, and shortages of qualified staff are greatest in rural areas. In Uganda, shortages are greater in primary health care settings than at higher levels. In Mali, few community health centres have a midwife or a doctor. Even South Africa has a shortage of doctors in primary health care in poorer districts. Although most countries recognize village health workers, traditional healers and traditional birth attendants, there are insufficient data on their numbers. CONCLUSION: There is an "inverse primary health care law" in the countries studied: staffing is inversely related to poverty and level of need, and health worker density is not increasing in the lowest income countries. Unless there is money to recruit and retain staff in these areas, training programmes will not improve health worker density because the trained staff will simply leave to work elsewhere. Information systems need to be improved in a way that informs policy on the health workforce. It may be possible to use existing resources more cost-effectively by involving skilled staff to supervise and support lower level health care workers who currently provide the front line of primary health care in most of Africa

Assessing the presence of Wuchereria bancrofti in vector and human populations from urban communities in Conakry, Guinea

The Global Programme to Eliminate Lymphatic Filariasis was launched in 2000 with the goal of interrupting transmission of lymphatic filariasis (LF) through multiple rounds of mass drug administration (MDA). In Guinea, there is evidence of ongoing LF transmission, but little is known about the most densely populated parts of the country, including the capital Conakry. In order to guide the LF control and elimination efforts, serological and entomological surveys were carried out to determine whether or not LF transmission occurs in Conakry.; The prevalence of circulating filarial antigen (CFA) of Wuchereria bancrofti was assessed by an immuno-chromatography test (ICT) in people recruited from all five districts of Conakry. Mosquitoes were collected over a 1-year period, in 195 households in 15 communities. A proportion of mosquitoes were analysed for W. bancrofti, using dissection, loop-mediated isothermal amplification (LAMP) assay and conventional polymerase chain reaction (PCR).; CFA test revealed no infection in the 611 individuals examined. A total of 14,334 mosquitoes were collected; 14,135 Culex (98.6 %), 161 Anopheles (1.1 %) and a few other species. Out of 1,312 Culex spp. (9.3 %) and 51 An. gambiae (31.7 %) dissected, none was infected with any stage of the W. bancrofti parasite. However, the LAMP assay revealed that 1.8 % of An. gambiae and 0.31 % of Culex spp. were positive, while PCR determined respective prevalences of 0 % and 0.19 %.; This study revealed the presence of W. bancrofti DNA in mosquitoes, despite the apparent absence of infection in the human population. Although MDA interventions are not recommended where the prevalence of ICT is below 1 %, the entomological results are suggestive of the circulation of the parasite in the population of Conakry. Therefore, rigorous surveillance is still warranted so that LF transmission in Conakry would be identified rapidly and adequate responses being implemented

Etude épidémiologique, clinique et thérapeutique des hydrocèles dans trois districts sanitaires de la région de Sikasso/Mali: Epidemiological, Clinical and Therapeutic Study of Hydroceles in Three Health Districts in the Sikasso Region / Mali

Context and objective. Hydrocele is one of the most common urogenital manifestations of lymphatic filariasis. It is a common cause of enlarged scrotum in the tropics. This study aims to describe the epidemiological, clinical and therapeutic aspects of hydroceles. Methods. This cross-sectional descriptive study of hydroceles in three endemic filarial Sikasso areas in Mali was conducted from November 2017 to December 2018. The variables studied were: frequency of hydrocele, age of patients, duration of evolution, type of anesthesia, surgical technique, volume, operative time and postoperative results. Results. Three hundred fifty-eight patients were operated on in fourteen months. The frequency of hydrocele‘s surgery was 31%. Their average age was 47.1 years old (extremes 4 months and 94 years). The duration of evolution was 10.7 years (extremes 6 months and 21 years). The right side was the most affected with 44.1% followed by the left side with 31.3%. Hydrocele was bilateral in 19%. Local anesthesia (with xylocaine 2%) was used in 88%. All patients underwent a successful vaginal resection. Conclusion. The hydrocele remains a common urological pathology in these endemic areas. The diagnosis is made after a long period of evolution of the disease. Treatment in outpatient surgery is undertaken using local anesthesia. These hydrocele management campaigns should be encouraged to treat the maximum number of patients. Contexte et objectif. L’hydrocèle constitue l’une des manifestations urogénitales les plus fréquentes de la filariose lymphatique. Elle est une cause fréquente de grosse bourse dans les régions tropicales. L’objectif de cette étude est de décrire les aspects épidémiologiques, cliniques et thérapeutiques des hydrocèles. Méthodes. Il s’agissait d’une étude transversale et descriptive sur les hydrocèles, réalisée entre novembre 2017 et décembre 2018 ; dans trois zones endémiques filariennes dans la région de SIKASSO au Mali. Les variables étudiées étaient : la fréquence de l’hydrocèle, l’âge des patients, la durée d’évolution, le type d’anesthésie, la technique chirurgicale, le volume, le temps opératoire et les résultats postopératoires. Résultats. Trois cent cinquante-huit patients ont été opérés en quatorze mois. L’intervention de l’hydrocèle rendait compte de 31% des activités chirurgicales. Leur âge moyen était de 47,1 ans (extrêmes 4 mois et 94 ans). La durée d’évolution était de 10,7 ans (extrêmes de 6 mois et 21 ans). Le testicule droit était le plus touché (44,1 %) suivi du côté gauche (31,3%). L’hydrocèle était bilatérale dans 19 %. L’anesthésie locale à la xylocaïne 2 % a été réalisée dans 88%. La résection vaginale a été réalisée chez tous les patients avec succès. Conclusion. L’hydrocèle reste une pathologie urologique fréquente en zone d’endémie filarienne. Le diagnostic se fait après une longue durée d’évolution de la maladie. Le traitement en chirurgie ambulatoire réalisée sous anesthésie locale a montré des résultats satisfaisants. Ces campagnes de prise en charge de l’hydrocèle sont à encourager pour pouvoir traiter le maximum de patients

Assessing Early Access to Care and Child Survival during a Health System Strengthening Intervention in Mali: A Repeated Cross Sectional Survey

Background: In 2012, 6.6 million children under age five died worldwide, most from diseases with known means of prevention and treatment. A delivery gap persists between well-validated methods for child survival and equitable, timely access to those methods. We measured early child health care access, morbidity, and mortality over the course of a health system strengthening model intervention in Yirimadjo, Mali. The intervention included Community Health Worker active case finding, user fee removal, infrastructure development, community mobilization, and prevention programming. Methods and Findings: We conducted four household surveys using a cluster-based, population-weighted sampling methodology at baseline and at 12, 24, and 36 months. We defined our outcomes as the percentage of children initiating an effective antimalarial within 24 hours of symptom onset, the percentage of children reported to be febrile within the previous two weeks, and the under-five child mortality rate. We compared prevalence of febrile illness and treatment using chi-square statistics, and estimated and compared under-five mortality rates using Cox proportional hazard regression. There was a statistically significant difference in under-five mortality between the 2008 and 2011 surveys; in 2011, the hazard of under-five mortality in the intervention area was one tenth that of baseline (HR 0.10, p<0.0001). After three years of the intervention, the prevalence of febrile illness among children under five was significantly lower, from 38.2% at baseline to 23.3% in 2011 (PR = 0.61, p = 0.0009). The percentage of children starting an effective antimalarial within 24 hours of symptom onset was nearly twice that reported at baseline (PR = 1.89, p = 0.0195). Conclusions: Community-based health systems strengthening may facilitate early access to prevention and care and may provide a means for improving child survival

The impact of participation in Diversity Field Fora on farmer management of millet and Sorghum varieties in Mali

Malian farmers have been cultivating millet and sorghum for millennia, but they are slow to adopt and develop modern varieties because it is difficult to observe the difference in yields in their fields, given the challenging local growing conditions. Farmer participatory approaches are therefore recommended. This paper applies an instrumental variables method to survey data from Mali to evaluate the impacys of Diversity Field Fora, a type of farmer field school which aims to boost millet and sorghum yields by showing farmers how to manage diverse varieties. Impact indicators are expected and recalled millet and sorghum yields. the total number of unique attributes of millet and sorghum varieties stocked as seed, and the relative deprivation of the household farm with respect to these indicators. The findings suggest the project has had results at one of two sites where it has been implemented with the same local leadership and more intensively over a longer time frame

Markets and climate are driving rapid change in farming practices in Savannah West Africa

Agricultural practices have constantly changed in West Africa, and understanding the factors that have driven the changes may help guide strategies to promote sustainable agriculture in the region. To contribute to such efforts, this paper analyzes drivers of change in farming practices in the region using data obtained from surveys of 700 farming households in five countries (Burkina Faso, Ghana, Mali, Niger and Senegal). The results showed that farmers have adopted various practices in response to the challenges they have faced during the last decade. A series of logit models showed that most changes farmers made to their practices are undertaken for multiple reasons. Land use and management changes including expanding farmed areas and using mineral fertilization and manure are positively related to perceived changes in the climate, such as more erratic rainfall. Planting new varieties, introducing new crops, crop rotation, expanding farmed area and using pesticides are positively associated with new market opportunities. Farm practices that require relatively high financial investment such as use of pesticides, drought-tolerant varieties and improved seeds were positively associated with the provision of technical and financial support for farmers through development projects and policies. Changes in markets and climate are both helping to promote needed changes in farming practices in West Africa. Therefore, policies that foster the development of markets for agricultural products, and improved weather- and climate-related information linked to knowledge of appropriate agricultural innovations in different environments are needed