The impact of derivative use on firm risk and firm value. Evidence from South African non-financial firms

This dissertation investigates the extent of derivatives use in South Africa. In addition, it examines the effect of derivatives use on firm risk and value. The dissertation is based on a sample of 91 South African non-financial firms listed on the FTSE/JSE Africa All Share Index on the JSE over the sample period 2012 to 2016. Firm risk is measured using total risk, systematic risk and unsystematic risk while the Tobin's Q is used as the proxy for firm value. The results of this dissertation show that 62% of firms included in this sample use derivatives. Foreign currency derivatives were the most commonly used as 80.3% of firms used them followed by interest rate derivatives at 46% and then commodity price derivatives at 21.8%. This dissertation provides evidence that the use of derivatives significantly reduces total risk and unsystematic risk. However, the use of derivative does not have an effect on systematic risk. The use of derivatives increases firm value although this increase is not statistically significant. Overall, this dissertation finds evidence of risk reduction related to derivative usage but fails to establish the value premium that is created by derivative use

The New Lex Mercatoria: Applicability of Lex Mercatoria as Substantive Law in International Commercial Arbitration

The study addresses the controversy surrounding the existence and validity of the lex mercatoria as an autonomous legal system. The overall objective of the study is to evaluate whether the lex mercatoria has attained the status of an autonomous system of law. Traces of the law merchant derive from the early ages, a time when merchants began to traverse the world in search for new markets. This created a need to govern their businesses and conduct to avoid the interference of their affairs by sovereign authorities. The rules formulated by the merchants were codified into the laws of states giving rise to the oblivion of the law merchant. There has arisen over time a debate on the existence of a new lex mercatoria. The study evaluates the existence and viability of the new lex mercatoria by answering the following pertinent research questions: what are the sources of the new lex mercatoria; are the criticisms levelled against the lex mercatoria viable; has the lex mercatoria attained the status of an autonomous legal system and if not, what are the reasons behind its rejection? This study is limited to international commercial arbitration since it is through arbitration that the applicability of lex mercatoria as substantive law has been made possible. Recognition of state-less awards, the modernization of arbitration laws by African states, recognition by the European Union of the possibility of application of general principles of law reflect trends towards the acceptance of the autonomous nature of lex mercatoria

A system approach to improving maternal and child health care delivery in Kenyan communities and primary care facilities: baseline survey on maternal health

Background: Maternal, fetal and neonatal mortality are 10 to 100 fold higher in many low-income compared to high-income countries. Reasons for these discrepancies include limited antenatal care and delivery outside health facilities.Objectives: The study aimed at conducting a baseline survey to assess the current levels of maternal health indicators in six counties in Western Kenya.Methods: This was a cross sectional study conducted targeting women residing in Uasin-Gishu, ElgeyoMarakwet, TransNzoia, Bungoma, Busia and Kakamega counties who had given birth five years prior to the interview. Socio-demographic and maternal indicators were collected using forms adopted from KDHS 2009. Interviews were conducted in the homesteads between December 2015 and June 2016.Results: A total of 6257 women participated in the study, median age 27 years IQR 23-32. Majority of the women had post-primary level of education, were married and 40% were members of an income-generating activity. 56.8% were using modern family planning method, 49% attended WHO recommended four plus antenatal clinic visits and only 20% attended in the first trimester. Majority, 85% had their most recent delivery in a health facility.Conclusion: Findings suggest that women are not attending recommended four plus antenatal clinic visits and even those that attend are few are during the first trimester.Keywords: System approach, maternal and child health care, Kenyan communities

Prevalence and Factors Associated with Contraceptive Use Among Females Living with HIV at Moi Teaching and Referral Hospital, Eldoret, Kenya

Objective: To assess the prevalence of, and the factors associated with, contraceptive use among females living with HIV at Moi Teaching and Referral Hospital, Eldoret, Kenya. Methods: A cross-sectional study with a sample including a total of 375 females living with HIV aged 15–49 years undergoing follow-up. Data were collected using a semi-structured questionnaire. Bivariate and multivariate analysis was done to check for association and predictors of contraceptive use. Results: The contraceptive prevalence rate was 64%. Factors associated with contraceptive utilisation included parity (crude odds ratio [COR]: 2.33; 95% confidence interval [CI]: 1.22–4.45; P=0.010), marital status (COR: 1.75; 95% CI: 1.04–2.97; P=0.036), and availability of information on the side effects of the contraception methods (COR: 29.93; 95% CI: 14.26–70.58; P=0.001). Multivariate analysis showed a significant association between contraceptive use and whether information on the side effects of the current contraception method was provided (adjusted OR: 34.98; 95% CI: 16.72–83.33; P=0.001).The odds of meeting the contraceptive needs of females living with HIV was 34 times higher among females who had information on side effects of the contraceptives than their counterparts who had no information. Conclusions: The contraceptive prevalence rate was 64% among females living with HIV, higher than latest national value of 61%. Females living with HIV had a high unmet need for contraceptive use at 28.4%. Key factors associated with contraceptive utilisation included awareness of side effects

A system approach to improving maternal and child health care delivery in Kenyan communities and primary care facilities: baseline survey on maternal health

Background: Maternal, fetal and neonatal mortality are 10 to 100 fold higher in many low-income compared to high-income countries. Reasons for these discrepancies include limited antenatal care and delivery outside health facilities. Objectives: The study aimed at conducting a baseline survey to assess the current levels of maternal health indicators in six counties in Western Kenya. Methods: This was a cross sectional study conducted targeting women residing in Uasin-Gishu, ElgeyoMarakwet, TransNzoia, Bungoma, Busia and Kakamega counties who had given birth five years prior to the interview. Socio-demographic and maternal indicators were collected using forms adopted from KDHS 2009. Interviews were conducted in the homesteads between December 2015 and June 2016. Results: A total of 6257 women participated in the study, median age 27 years IQR 23-32. Majority of the women had post-primary level of education, were married and 40% were members of an income-generating activity. 56.8% were using modern family planning method, 49% attended WHO recommended four plus antenatal clinic visits and only 20% attended in the first trimester. Majority, 85% had their most recent delivery in a health facility. Conclusion: Findings suggest that women are not attending recommended four plus antenatal clinic visits and even those that attend are few are during the first trimester. DOI: https://dx.doi.org/10.4314/ahs.v19i2.6 Cite as: Mwangi A, Nangami M, Tabu J, Ayuku D, Were E, Fabian E. A system approach to improving maternal and child health care delivery in Kenyan communities and primary care facilities: Baseline Survey on Maternal Health. Afri Health Sci.2019;19(2): 1841-1848. https://dx.doi. org/10.4314/ahs.v19i2.

Integrating Prevention of Mother-to-Child Transmission of HIV Care into General Maternal Child Health Care in Western Kenya

Background: Health systems integration is becoming increasingly important as the global health community transitions from acute, disease-specific health programming to models of care built for chronic diseases, primarily designed to strengthen public-sector health systems. In many countries across sub-Saharan Africa, including Kenya, prevention of mother-to-child transmission of HIV (pMTCT) services are being integrated into the general maternal child health (MCH) clinics. The objective of this study was to evaluate the benefits and challenges for integration of care within a developing health system, through the lens of an evaluative framework. Methods: A framework adapted from the World Health Organization's six critical health systems functions was used to evaluate the integration of pMTCT services with general MCH clinics in western Kenya. Perspectives were collected from key stakeholders, including pMTCT and MCH program leadership and local health providers. The benefits and challenges of integration across each of the health system functions were evaluated to better understand this approach. Results: Key informants in leadership positions and MCH staff shared similar perspectives regarding benefits and challenges of integration. Benefits of integration included convenience for families through streamlining of services and reduced HIV stigma. Concerns and challenges included confidentiality issues related to HIV status, particularly in the context of high-volume, crowded clinical spaces. Conclusion and global health implications: The results from this study highlight areas that need to be addressed to maximize the effectiveness and clinical flow of the pMTCT-MCH integration model. The lessons learned from this integration may be applied to other settings in sub-Saharan Africa attempting to integrate HIV care into the broader public-sector health system

Evolution of fungal and non-fungal eukaryotic communities in response to thermophilic co-composting of various nitrogen-rich green feedstocks

Thermophilic composting is a promising soil and waste management approach involving diverse micro and macro-organisms, including eukaryotes. Due to sub-optimal amounts of nutrients in manure, supplemental feedstock materials such as Lantana camara, and Tithonia diversifolia twigs are used in composting. These materials have, however, been reported to have antimicrobial activity in in-vitro experiments. Furthermore, the phytochemical analysis has shown differences in their complexities, thus possibly requiring various periods to break down. Therefore, it is necessary to understand these materials’ influence on the biological and physical-chemical stability of compost. Most compost microbiome studies have been bacterial-centric, leaving out eukaryotes despite their critical role in the environment. Here, the influence of different green feedstock on the fungal and non-fungal eukaryotic community structure in a thermophilic compost environment was examined. Total community fungal and non-fungal eukaryotic DNA was recovered from triplicate compost samples of four experimental regimes. Sequencing for fungal ITS and non-fungal eukaryotes; 18S rDNA was done under the Illumina Miseq platform, and bioinformatics analysis was done using Divisive Amplicon Denoising Algorithm version 2 workflow in R version 4.1. Samples of mixed compost and composting day 84 recorded significantly (P<0.05) higher overall fungal populations, while Lantana-based compost and composting day 84 revealed the highest fungal community diversity. Non-fungal eukaryotic richness was significantly (P< 0.05) more abundant in Tithonia-based compost and composting day 21. The most diverse non-fungal eukaryotic biome was in the Tithonia-based compost and composting day 84. Sordariomycetes and Holozoa were the most contributors to the fungal and non-fungal community interactions in the compost environment, respectively. The findings of this study unravel the inherent influence of diverse composting materials and days on the eukaryotic community structure and compost’s biological and chemical stability

Trends Over Time for Adolescents Enrolling in HIV Care in Kenya, Tanzania, and Uganda From 2001–2014

Background: The data needed to understand the characteristics and outcomes, over time, of adolescents enrolling in HIV care in East Africa are limited. Setting: Six HIV care programs in Kenya, Tanzania, and Uganda. Methods: This retrospective cohort study included individuals enrolling in HIV care as younger adolescents (10–14 years) and older adolescents (15–19 years) from 2001–2014. Descriptive statistics were used to compare groups at enrollment and antiretroviral therapy (ART) initiation over time. The proportion of adolescents was compared with the total number of individuals aged 10 years and older enrolling over time. Competing-risk analysis was used to estimate 12-month attrition after enrollment/pre-ART initiation; post-ART attrition was estimated by Kaplan–Meier method. Results: A total of 6344 adolescents enrolled between 2001 and 2014. The proportion of adolescents enrolling among all individuals increased from 2.5% (2001–2004) to 3.9% (2013–2014, P < 0.0001). At enrollment, median CD4 counts in 2001–2004 compared with 2013–2014 increased for younger (188 vs. 379 cells/mm3, P < 0.0001) and older (225 vs. 427 cells/mm3, P < 0.0001) adolescents. At ART initiation, CD4 counts increased for younger (140 vs. 233 cells/mm3, P < 0.0001) and older (64 vs. 323 cells/mm3, P < 0.0001) adolescents. Twelve-month attrition also increased for all adolescents both after enrollment/pre-ART initiation (4.7% vs. 12.0%, P < 0.001) and post-ART initiation (18.7% vs. 31.2%, P < 0.001). Conclusions: Expanding HIV services and ART coverage was likely associated with earlier adolescent enrollment and ART initiation but also with higher attrition rates before and after ART initiation. Interventions are needed to promote retention in care among adolescents

Improving Phosphate Rock Use Efficiency In Organic Farming

Between 45 to 81% of the total phosphorus (P) fertilizer applied to soils in sub-Saharan Africa is absorbed in the soil, which among other factors reduce crop yield and contributes to high poverty in the region.  The objective of the study was to assess the effect of different phosphorus rock (PR) management on carrot yields, P recovery and use efficiency.  Different volumes (100, 200, 300, 400, and 500 mLs) of organic (lemon and pineapple) juices and water were used to dissolve 100 g of PR. The available P concentration in the solution was determined using a standard protocol. The solution with the high P concentration as well as powdered PR was each composted with manure and crop residues. Thereafter, a field experiment was set up on Humic andosols and Orthic acrisols to compare the effect of the dissolved PR applied directly with compost, to dissolved PR composted,  powder PR composted, powdered PR applied directly with compost, Triple supper phosphate applied directly with compost, compost and the soil alone (as a control). Our findings showed that lemon juice could release over 65% of the available P from PR and the combined application of the dissolved PR and compost at planting increased P recovery and use efficiency, and carrot yields on both soils as compared to the other treatments

Accelerating Progress Towards the 2030 Neglected Tropical Diseases Targets: How Can Quantitative Modeling Support Programmatic Decisions?

Over the past decade, considerable progress has been made in the control, elimination, and eradication of neglected tropical diseases (NTDs). Despite these advances, most NTD programs have recently experienced important setbacks; for example, NTD interventions were some of the most frequently and severely impacted by service disruptions due to the coronavirus disease 2019 (COVID-19) pandemic. Mathematical modeling can help inform selection of interventions to meet the targets set out in the NTD road map 2021-2030, and such studies should prioritize questions that are relevant for decision-makers, especially those designing, implementing, and evaluating national and subnational programs. In September 2022, the World Health Organization hosted a stakeholder meeting to identify such priority modeling questions across a range of NTDs and to consider how modeling could inform local decision making. Here, we summarize the outputs of the meeting, highlight common themes in the questions being asked, and discuss how quantitative modeling can support programmatic decisions that may accelerate progress towards the 2030 targets