Regionalism and Economic Integration in Africa: A Conceptual and Theoretical Perspective

A well-established strand of the literature on regionalism and economic integration has made clear that economic, geopolitical, and socio-cultural relationships across the globe, for which Africa is no exception, have been changing rapidly in the last few decades. African leaders have been embracing these concepts as vital elements of their development agenda and have engaged their countries in a number of integration arrangements. This study has investigated regionalism and economic integration in Africa from a conceptual and theoretical perspective. The study identified that (i) the rationalist’s theory of neorealism and neoliberalism, (ii) the social constructivism theory, and (iii) several theories of economic integration are very relevant in explaining the formation of regional and economic blocs in Africa. Theories of economic integration that focus on trade, economic interdependency, monetary, fiscal, and political policy coordination seem to be the main forces driving regionalism and economic integration on the continent. The study revealed transportation and mobility of factors of production, limited intra-African trade, multi-memberships, macroeconomic divergence, and conflicts as key factors hindering the success of regionalism and economic integration in Africa. Although regionalism and economic integration on the continent is plagued with these challenges, there are opportunities and possibilities in the power and energy sectors, the manufacturing sector, and in private-public partnerships that the continent can explore to accelerate Africa’s speed of regional and economic integration, crucial for economic growth and development

Unveiling the effect of income inequality on safe drinking water, sanitation and hygiene (WASH) : does financial inclusion matter?

Access to safe drinking water, sanitation, and hygiene (WASH) is crucial for disease prevention and improving general health outcomes. However, a significant number of people across the globe still lack access to safe drinking water and practice open defecation. Therefore, evidence-based research is needed to guide policymakers in improving WASH adoption and practice across the globe. In this study, we add to knowledge and policy by probing the role of income inequality and financial inclusion on access to improved WASH facilities using a comprehensive panel dataset from 119 countries between 2004 and 2020. We used the heteroskedasticity-based instrumental variable regression and the Driscoll-Kraay estimator to account for endogeneity and cross-sectional dependency inherent in panel data, respectively. Our preferred endogeneity and cross-sectional dependency-corrected results show that income inequality reduces access to safe WASH facilities. Our study demonstrates that financial inclusion significantly increases access to safe WASH facilities. Income inequality and financial inclusion have heterogeneous effects on access to safe WASH facilities across rural and urban settings, income groups, and geographical regions. Through our interaction and marginal effect analysis, we document that improvement in financial inclusion reduces the adverse effect of income inequality on safe WASH adoption and practices. These findings highlight that policies that strengthen financial inclusion services and further address income inequality would improve WASH adoption and practices. Considering the inhibiting and enhancing effects of income inequality and financial inclusion, respectively, governments could adopt social welfare policies to tackle the former and also put in measures to enhance financial development and inclusion to enhance the latter

Is foreign direct investment globalization‐induced or a myth? A tale of Africa

Foreign direct investment (FDI) provides many African countries an important source of capital inflow. Despite notable improvements in these capital-scarce countries' economic, political, and social conditions, foreign investors have not considered them viable host locations. Since FDI brings enormous spillovers to its host, some countries have recently institutionalized globalization as the catalyst for reversing the trend. Against this backdrop, we examine the FDI–globalization nexus across 47 African countries for the 1996–2016 period. Using the augmented mean group estimator, the results suggest that FDI in Africa is indeed globalization-induced. Moreover, we find this positive nexus to be driven by the economic dimension of globalization. Overall, we demonstrate the potential of globalization in stimulating an FDI boom in Africa

Re–examining Bhagwati hypothesis: the case of some selected countries in Sub-Saharan Africa

Bhagwati hypothesis opines that the overall impact of foreign direct investment (FDI) on economic growth is conditioned on countries’ level of integration with the international market. We test this hypothesis for some selected countries in sub-Saharan Africa (SSA). Does this hypothesis hold given our sample evidence? Yes! No! Maybe! We explain why. By invoking the sample splitting and threshold estimation technique, we find that the two measures of openness (trade openness and exports) mediate the FDI-economic growth relationship in three countries and this is an indication of complete Bhagwati hypothesis in these countries. Also, we find that, given the measure of openness, four countries exhibit incomplete Bhagwati hypothesis. Finally, we find no support for the Bhagwati hypothesis for most countries. Based on these findings, we argue that the validity of the Bhagwati hypothesis may be contingent on both country characteristics and the indicator of openness

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Trade and environmental pollution in Africa: accounting for consumption and territorial-based emissions

This paper employs a recently constructed consumption-based carbon dioxide emissions data in which emissions computations are made based on fossil fuel usage domestically, in addition to emissions emanating from imports minus exports. We contrast this measure with the commonly measured territory-based carbon dioxide emissions data and examine how trade performance (split into imports, exports, and total trade) impacts these two measures of carbon dioxide. We focus on 22 sub-Saharan African countries over the period 1995-2014. Employing the system generalized method of moments, we find trade to generally have positive effect on emissions. The results are consistent across the different measures of trade and carbon dioxide emissions. The results of the paper allow us to give some policy suggestions regarding carbon dioxide emissions in sub-Saharan Africa