The nature and extent of faith-based involvement in African pharmaceutical systems

Within the context of health system strengthening and pharmaceutical systems development goals, a population must have equitable access to quality affordable medicines and pharmaceutical supplies. The utilization of the private (for-profit and not-for-profit) pharmaceutical sector actors by the public to promote universal access to quality medicines and related commodities is an increasingly common practice in resource poor settings. Faith-based drug supply organizations (FB-DSOs), as a component of the private-not-for-profit (PNFP) sector, are increasingly involved in the supply of pharmaceuticals to complement public sector efforts in wider coverage of communities in Africa. However, their role in the pharmaceutical system in Africa is not well defined. This paper presents the results of a systematic review conducted to map out the organization of pharmaceutical systems and establish the role of faith-based health care providers in the pharmaceutical supply chain in Africa. For this study, a scoping review was first conducted to map the literature on pharmaceutical supply chains in low- and middle-income countries (LMICs), understand the challenges facing pharmaceutical supply chainsin LMICs and the role faith-based health care providers play in the pharmaceutical supply chain. After this, a qualitative systematic review was conducted across multiple electronic databases to identify documents that contain information on faith-based involvement in pharmaceutical supply chain in Africa. Citation tracking was used to identify further relevant articles. Included materials were analyzed using thematic narrative analysis and synthesized. The public pharmaceutical supply chain in Africa is faced with challenges including drug stock outs and irregular supplies, shortage of trained pharmacy personnel and lack of system for drug regulation and quality assurance. Faith-based health care providers involved in pharmaceutical supply chain do exist extensively as drug supply organizations or as a Christian Health Association with a pharmaceutical supply chain. They have been in existence in Africa for a very long time now contributing to the national pharmaceutical system in Africa. The review revealed that faith-based involvement in pharmaceutical chains tended to improve access to the general population and inserted additional pharmaceutical supplies into the national pharmaceutical system - which tended to strengthen the broader public private partnership between faith-based health providers and the public sector. This analysis confirmed that African pharmaceutical supply systems continue to face challenges. There is a major evidence gap relating to PNFP contribution to pharmaceutical systems - as is evidenced by this study on faith-based contributions to African pharmaceutical systems (which can be understood as a tracer for a broader concern). There is a particular lack of evidence about the national supply chain, and how faith-based PNFP engagement contribute or detract from the national pharmaceuticalsupply chain. FB-DSOs complement the public pharmaceutical system by improving access to medicines and related commodities in Africa

Medication Errors in Hospitals

In hospitals, the issue of medication errors poses a serious problem, often leading to substantial health complications and, in some cases, even deaths among hospitalized as well as discharged patients. This health challenge not only imposes a substantial financial burden on patients, insurance providers, and Federal/State governments but also contributes to elevated healthcare expenses, hindering the effective allocation of resources to address other healthcare issues. Understanding the triggers of medication errors in hospitals is critical in solving this problem. The purpose of this integrative review is to determine the causes/triggers of medication errors in hospitals. This review will highlight the conditions that providers and clinicians face, including the routine processes during prescription and medication administration to determine specific areas where discrepancies occur, which in turn, creates the inevitability of medication errors. The review will reveal that poor collaboration between healthcare providers and clinicians is a significant contributing factor to medication errors within hospital settings. Also, illegible handwritten orders, and in some cases, poor understanding of verbal orders in emergency situations are also reasons for wrong dosage medication errors. The review will also reveal an elevated incidence of medication errors among night shift nurses in comparison to those on day shifts, primarily due to burnout resulting from holding multiple jobs during the day, sometimes leading to difficulties in reaching healthcare providers at night. Furthermore, the review will provide applicable approaches that increase team collaboration during patient admission and discharge in order to decrease medication errors. Also, the review will encourage clinicians to repeat verbal orders for clarification and to confirm written orders before administering medications to reduce dosing errors. Finally, the review will show that collaboration through active listening, change of behaviors, and communication are critical in reducing medications errors in hospitals

Regional Economic Integration and Incomes Convergence: A Case Study of the Economic Community of West African States

With a view to taking advantage of the region’s economic potentials,  a group of  15  West African countries signed  a treaty  in  Lagos, Nigeria on 28th May , 1975,  leading to the establishment of the Economic Community of West African States ( ECOWAS ). The principal objective was to promote co-operation and integration in economic, political social and cultural activities in the fifteen West African States. This study, therefore, aim at assessing the extent to which regional integration in West Africa has promoted incomes convergence in the region. The study utilizes two approaches of measuring incomes convergence, namely, sigma and conditional Beta Convergence.  The results from the sigma convergence regression indicate no convergence in income per capita but rather growth in income per capita amongst ECOWAS member states. This is because; the coefficient of the trend variable is positive and significantly different from zero. From the Conditional Beta Convergence regression, the results show that the speed of incomes convergence for  ECOWAS member states is approximately 17% per annum, implying that any short-run shock that puts the economies of the sub-region into disequilibrium may take a longer period to attain the steady state . This thus calls for further action in accelerating the pace with which member states meet the ECOWAS convergence criteria . Keywords: regional integration,  incomes, convergence , West Africa, economies, criteri

Analyzing the Economic Consequences of an Epidemic Outbreak: Experience from the 2014 Ebola Outbreak in West Africa

The Ebola virus disease has been infection countries in Africa since its first emergence in Zaire in 1976. However, the 2014 Ebola outbreak in West Africa has been unanimously described as the World’s most devastating outbreak in history and the first ever witnessed in West Africa. The devastating nature of the 2014 Ebola epidemic made the international community becoming increasing worried as the disease continued to spread across borders. This stud therefore, aimed at evaluating the economic impact of the epidemic in West African countries affected by the outbreak. The study adopted an innovative methodology that scientifically captures the contemporaneous impact of the outbreak on key socioeconomic variables of interest. The results from the study revealed that in addition to the adverse impact of the Ebola outbreak on economic growth, commodity prices and government budget deficits, the isolation of countries hardest hit by the epidemic contributed significantly in worsening the socioeconomic conditions faced by these countries. By way of policy recommendations, the study noted the need to strengthen health care systems in the region, training of more health care workers, and avoidance of actions restriction the movement of persons and goods from epidemic affected areas and the need for regional coordination efforts for the effective combating of epidemic outbreaks in the future. Keywords:  Ebola, epidemic, outbreak, devastating, West African, health care, growt

Prosecuting Those Bearing \u27Greatest Responsibility\u27: The Lessons of the Special Court for Sierra Leone

This Article examines the controversial article 1(1) of the Statute of the Special Court for Sierra Leone (SCSL) giving that tribunal the competence “to prosecute those who bear the greatest responsibility” for serious international and domestic crimes committed during the latter part of the notoriously brutal Sierra Leonean conflict. The debate that arose during the SCSL trials was whether this bare statement constituted a jurisdictional requirement that the prosecution must prove beyond a reasonable doubt or merely a type of guideline for the exercise of prosecutorial discretion. The judges of the court split on the issue. This paper is the first to critically assess the reasons why the tribunal’s judges disagreed in the interpretation of this seemingly simple legal question. It then attempts to discern the common ground in the judicial reasoning, and argues that the ultimate conclusion that “greatest responsibility” implied that leaders as well as the worst killers may be prosecuted is a welcome jurisprudential contribution to our understanding of personal jurisdiction in international criminal law. The paper makes several contributions to the literature. First, it takes up and highlights a widely ignored but important legal question. Second, it demonstrates why the reasoning of the Appeals Chamber was results-oriented and wrong. Finally, it identifies the lessons of Sierra Leone and builds on them to offer preliminary recommendations on how the greatest responsibility conundrum can be avoided when drafting personal jurisdiction clauses for future ad hoc international penal tribunals

The Special Tribunal for Lebanon: A Defense Perspective

This Article analyzes the absence of organs tasked with guaranteeing the rights of the defense in international criminal law. It explains the historical origins of the problem, tracing it back to the genesis of modern prosecutions at the Nuremberg International Military Tribunal. It then explains how the organizational charts of the UN courts for the former Yugoslavia, Rwanda, and Sierra Leone omitted the defense and essentially treated it as a second class citizen before the eyes of the law. This sets the stage for the author to show why the creation of the first full-fledged defense organ in international criminal law by the UN-backed Special Tribunal for Lebanon is a welcome advance in the maturing of international penal tribunals from primitive to more civilized institutions. The Article argues that if the legal provision contained in the Lebanon Tribunal statute is matched with the independence and resources needed to help realize defendant rights, it will likely become one of the statute\u27s biggest legacies to international law

Approaches to Sea Level Rise: A Comparative View of Emerging Policy Responses by the African and the American Regions

It is a great privilege to be here with all of you tonight. Thank you very much to you, Professor Grossman, the moderator of this panel, and to all the organizers for inviting me to be part of this really important event. I hope this is the first of many such events concerning this really pressing issue for the international community: the issue of sea level rise which is already affecting peoples and States in many different regions of our world