India’s African Engagement

The April 2008 India-Africa Forum Summit not only marked the zenith of India-African cooperation following intensified cultural, political and economic interactions between India and African countries, but also the increased competition with China over access to Africa’s resources and markets. The author reviews India’s development cooperation with African economies. The exceptionally fast growth of big economies like China and India has resulted in a new-found interest in the economic and political consequences of this growth for the developed economies. Recently, traditional donors’ concern that ‘emerging’ donors were re-emerging on the development scene was addressed. This kicked off a quest among donor agencies, think tanks and researchers alike to identify and establish the doings of these ‘emerging’ donors. To date, however, China has received most attention while the doings of other donors like India, Brazil and South Africa have remained virtually invisible. This ARI describes India’s current engagement in Africa and analyses the reasons why India once again puts Africa high on its political agenda. It argues that the development cooperation and in particular the 2008 India-Africa summit is a way to brand India anew

From screening to postpartum follow-up – the determinants and barriers for gestational diabetes mellitus (GDM) services, a systematic review

Background Gestational diabetes mellitus (GDM) – a transitory form of diabetes first recognised during pregnancy complicates between < 1% and 28% of all pregnancies. GDM has important short and long-term health consequences for both the mother and her offspring. To prevent adverse pregnancy outcomes and to prevent or delay future onset of type 2 diabetes in mother and offspring, timely detection, optimum treatment, and preventive postpartum care and follow-up is necessary. However the area remains grossly under-prioritised. Methods To investigate determinants and barriers to GDM care from initial screening and diagnosis to prenatal treatment and postpartum follow-up, a PubMed database search to identify quantitative and qualitative studies on the subject was done in September 2012. Fifty-eight relevant studies were reviewed. Results Adherence to prevailing GDM screening guidelines and compliance to screening tests seems sub-optimal at best and arbitrary at worst, with no clear or consistent correlation to health care provider, health system or client characteristics. Studies indicate that most women express commitment and motivation for behaviour change to protect the health of their unborn baby, but compliance to recommended treatment and advice is fraught with challenges, and precious little is known about health system or societal factors that hinder compliance and what can be done to improve it. A number of barriers related to health care provider/system and client characteristics have been identified by qualitative studies. Immediately following a GDM pregnancy many women, when properly informed, desire and intend to maintain healthy lifestyles to prevent future diabetes, but find the effort challenging. Adherence to recommended postpartum screening and continued lifestyle modifications seems even lower. Here too, health care provider, health system and client related determinants and barriers were identified. Studies reveal that sense of self-efficacy and social support are key determinants. Conclusions The paper identifies and discusses determinants and barriers for GDM care, fully recognising that these are highly dependent on the context