Providing marketing information to smallholders in Zimbabwe: What can the state usefully do?

In recent decades, significant international assistance has been provided to assist the establishment of market information systems (MISs) in a range of developing countries, including many in Africa. However, experience with state-run MISs, looking to provide current price information to market participants, has not been encouraging. Volatile horticultural markets provide particular challenges for such MISs. Therefore, it is suggested that it might be more appropriate to provide other types of marketing information to inform the production and marketing decisions of smallholder producers. This paper reports on recent efforts by the national extension agency, Agritex, to provide such information to smallholder horticultural producers in two districts of north-eastern Zimbabwe. Drawing on an initial evaluation of this pilot programme, the paper suggests that: 1) in the Zimbabwe case, the extension service may provide a viable vehicle for dissemination of marketing information to smallholder (horticultural) producers; 2) information on new crops and market opportunities is valued more highly by farmers than information on current market prices; 3) such information should complement, not supplant, traditional production extension advice. The paper concludes by considering some of the issues pertaining to the continuation and expansion of the pilot programme.Marketing,

Screening for Ocular Surface Squamous Neoplasia (OSSN) by Slit-lamp Assisted Visual Inspection (SAVI) following a short course of mild topical steroid-test qualities

Introduction: Ocular surface squamous neoplasia (OSSN) is currently the commonest ocular malignancy affecting people of child bearing age and is associated with high morbidity and mortality rates in Zimbabwe. Early surgical intervention has been shown to mitigate the effects of OSSN amongst its victims, however this is hampered by limited histopathological services which should guide the extent of surgical excisions of these tumours. Purpose: The purpose of this study was to determine the accuracy of Slit-lamp Assisted Visual Inspection (SAVI) in diagnosing ocular surface squamous neoplasia with the hope of recommending a fall back tool that ophthalmologists / medical practitioners / ophthalmic nurses or optometrists can use in resource limited situations without readily accessible histopathological services when surgical intervention is contemplated. Method: This was part of a study which screened one hundred and nineteen (119) patients with conjunctival growths and recruited sixty seven (67) patients with ocular surface squamous neoplasia by visual inspection over a period of six months. All patients received a week’s course of topical fluorometholone 0.1% and had the lesions excised either completely or partially depending on size of tumour and histology performed on the tissues. The histology results were compared with the results by visual inspection to determine diagnostic accuracy. Outcome measures were specificity, sensitivity and predictive values. Results: Total number of patients with conjunctival growths screened by visual inspection was 119, with median age of 42 years and a range of 18 to 90 years and gender ratio of 1:1.9 in favour of females. There was no significant age difference between confirmed OSSN patients and non-OSSN (pterygia) and the p-value was 0.617. Sensitivity and specificity of visual inspection in diagnosing OSSN when compared to histology were 94.3% and 74.2% respectively, with a positive predictive value of 74.6%. Histology reports indicated that 24.5% of OSSN specimens seen actually arose from pterygia. Conclusions: Slit lamp assisted visual inspection (SAVI) is an accurate method of clinically diagnosing OSSN and can be recommended for use in resource limited settings with hard to access histopathological services

Lessons learnt and opportunities for growth and transformation during the Covid-19 era and beyond: experiences of Faculty of Medicine and Health Sciences, University of Zimbabwe

Zimbabwe, like the rest of the world, has been severely affected by the Covid-19 pandemic. Medical education, constrained by decades-long crises, was confronted by yet another crisis. This concept paper seeks to reflect on the lessons learnt by the University of Zimbabwe Faculty of Medicine and Health Sciences in executing its academic business. It looks at some of the gaps experienced in each of the service areas and the lessons learnt as a result. The authors also reflect on how far we can think creatively towards transforming medical education and training in the post-Covid era

Providing marketing information to smallholders in Zimbabwe: What can the state usefully do?

In recent decades, significant international assistance has been provided to assist the establishment of market information systems (MISs) in a range of developing countries, including many in Africa. However, experience with state-run MISs, looking to provide current price information to market participants, has not been encouraging. Volatile horticultural markets provide particular challenges for such MISs. Therefore, it is suggested that it might be more appropriate to provide other types of marketing information to inform the production and marketing decisions of smallholder producers. This paper reports on recent efforts by the national extension agency, Agritex, to provide such information to smallholder horticultural producers in two districts of north-eastern Zimbabwe. Drawing on an initial evaluation of this pilot programme, the paper suggests that: 1) in the Zimbabwe case, the extension service may provide a viable vehicle for dissemination of marketing information to smallholder (horticultural) producers; 2) information on new crops and market opportunities is valued more highly by farmers than information on current market prices; 3) such information should complement, not supplant, traditional production extension advice. The paper concludes by considering some of the issues pertaining to the continuation and expansion of the pilot programme

The Magpie Trial: A randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for children at 18 months

Objective: To assess the long-term effects of in utero exposure to magnesium sulphate for children whose mothers had pre-eclampsia. Design: Assessment at 18 months of age for children whose mothers were recruited to the Magpie Trial (recruitment 1998-2001 ISRCTN 86938761), which compared magnesium sulphate with placebo. Setting: Follow-up of children born at 125 centres in 19 countries across five continents. Population: A total of 6922 children were born to women randomised before delivery at follow-up centres. Of these, 2271 were not included for logistic reasons and 168 were excluded (101 at a centre where <20% were contacted, 40 whose death or disability was due to a problem at conception or embryogenesis and 27 whose parent/s opted out). Therefore, 4483 children were included in follow-up, of whom 3283 (73%) were contacted. Methods: Assessment by questionnaire, with interview and neurodevelopmental testing of selected children. Main outcome measures: Death or neurosensory disability at age of 18 months. Results: Of those allocated magnesium sulphate, 245/1635 (15.0%) were dead or had neurosensory disability at 18 months compared with 233/1648 (14.1%) allocated placebo (relative risk [RR] 1.06, 95% CI 0.90-1.25), and of survivors, 19/1409 (1.3%) had neurosensory disability at 18 months compared with 27/1442 (1.9%) (RR 0.72, 95% CI 0.40-1.29). There were no substantial differences in causes of death or in the risk of individual impairments or disabilities. Conclusions: The lower risk of eclampsia following prophylaxis with magnesium sulphate was not associated with a clear difference in the risk of death or disability for children at 18 months. © RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology.Articl