The Concept of Life Cycle and Sustainability of Microfinance Institutions – Literature Review

This article paper discusses how development stages (life cycle) and self-sustainability of microfinance institutions relates by reviewing different related literature. Growth stages of microfinance institution can be categorized in different standard measure. However some literature categorized growth stages of microfinance institutions as start-up stage, growing stage and mature stage. This study also presents indicators which may determine microfinance institution’s sustainability in relation to growth stages of development of microfinance institutions. Keywords: microfinance institutions, financial sustainability, development/ growth stages

Challenges faced by Dar-es-Salaam Stock Exchange Market in Tanzania

For the past three decades, stock exchanges in emerging markets have accounted for economic growth, revolution and acceleration of financial sector development. For instance in Africa, stock exchange markets have been established in many countries such as Tanzania, Rwanda, Kenya, Swaziland, Botswana, Ghana, Malawi, Zambia, and Uganda. Prior to 1989 there were just five stock markets in sub-Saharan Africa and three in North Africa. Today there are more than 20 stock exchange markets in Africa and have been one of the domestic financial liberalization programs of most African countries. The main factor towards the establishment of stock exchange markets in African countries during the past few decades is linked to some important factors for development of global financial market and economy. Despite of establishment of stock exchange markets in Eastern and Sub-Saharan countries still there are challenges which hinder the sustainable development of these markets. Dar-es-Salaam Stock Exchange (DSE) market in Tanzania is one of the emerging stock exchange markets facing challenges that hinder the efficiency, sustainable growth and development of the market. This paper is going to identify some of the challenges faced by Dar-es-Salaam Stock Exchange market in Tanzania. Keywords: stock exchange markets, emerging markets, capital markets, financial market

The Potential Effect of Using the Cockcroft-Gault Method on Tenofovir-Associated Renal Impairment Reports and on Clinical Decisions Regarding Tenofovir Use in Individual Patients: Implications for the Future

Introduction: In Namibia, the Cockcroft-Gault (C-G) method is recommended for monitoring renal function in HIV patients receiving tenofovir disoproxil fumarate (TDF)-containing combination antiretroviral therapy (cART). However, there are concerns with the potential over-reporting of TDF-associated renal impairment. Methods: Retrospective study comparing the renal function of patients receiving 2nd line cART with either C-G or Chronic Kidney Disease-Epidemiology (CKD-EPI) methods. Results: 71 patients were included. The majority (62%) received TDF-containing 1st line ART. All received 2nd-line cART containing TDF/ lamivudine (3TC)/ zidovudine (AZT) and LPV/r. Before switching to 2nd-line cART, 40.8% and 8.5% had abnormal eGFR according to C-G and CKD-EPI methods respectively. During 2nd-line cART, 47.9% and 7% of patients had abnormal eGFR by C-G and CKD-EPI methods, respectively, and 4.1% and 2.8% respectively experienced a decline in eGFR. There was a significant lack of agreement between the two methods. Conclusion: The C-G method has the potential to report more cases of TDF-associated renal impairment. Consequently, national guidelines in Namibia and other pertinent countries should be reviewed if this is the recommended method for monitoring renal function

Developing countries subcommittee of the clinical pharmacology division : The medicines utilization research in Africa (MURIA) group and IUOHAR co-organized a workshop in botswana for the promotion of rational use of medicines

The improper use of medicines is a major cause of poor therapeutic effect as well as adverse drug reactions, and has considerable financial consequences (1-4). In the present era of global economic recession, there is a need for the judicious use of resources to benefit all citizens in developing countries. Therefore, the promotion of the Rational Use of Medicines (RUM) should be a healthcare priority in African countries. Still, there is limited information available on how appropriately medicines are prescribed and used in Africa (5)

Knowledge Management the Pillar for Innovation and Sustainability

In this ever changing and challenging business landscape characterized by rapid and continuous technological advances the competitiveness and sustainability of any enterprise depends on knowledge management, efficiency, flexibility, innovativeness and timely response to changes to be in alignment with or superior to its rival in terms of time factor to significantly meet the market demands. The competitiveness of any enterprise depends on flexible and innovative management of its human resourc

Initiative to progress research on medicine utilization in Africa : formation of the Medicines Utilization Research in Africa group

This two day meeting brought together drug utilisation researchers from across Africa. The purpose was to share current drug utilisation (DU) research findings to further DU research across Africa including the development of a medicines utilisation research group. This led to the formation of the MURIA (Medicine Utilisation Research in Africa) Group, with a tentative vision and mission as well as the first planned research methodology training course and a symposium in Botswana later in the year. Future research projects were also planned including studies on drug utilisation of ARVs in Botswana and across Africa as well as ways to enhance the appropriate use of antibiotics and increase generic utilisation

Potential drug-drug interactions in paediatric outpatient prescriptions in Nigeria and implications for the future

BACKGROUND: Information regarding the incidence of drug-drug interactions (DDIs) and adverse drug events (ADEs) among paediatric patients in Nigeria is limited. METHODS: Prospective clinical audit among paediatric outpatients in four general hospitals in Nigeria over a 3-month period. Details of ADEs documented in case files was extracted. RESULTS: Among 1233 eligible patients, 208 (16.9%) received prescriptions with at least one potential DDI. Seven drug classes were implicated with antimalarial combination therapies predominating. Exposure mostly to a single potential DDI, commonly involved promethazine, artemether/lumefantrine, ciprofloxacin and artemether/lumefantrine. Exposure mostly to major and serious, and moderate and clinically significant, potential DDIs. Overall exposure similar across all age groups and across genders. A significant association was seen between severity of potential DDIs and age. Only 48 (23.1%) of these patients presented at follow-up clinics with only 15 reporting ADEs. CONCLUSION: There was exposure to potential DDIs in this population. However, potential DDIs were associated with only a few reported ADEs

Research activities to improve the utilization of antibiotics in Africa

There is a need to improve the rational use of antibiotics across continents including Africa. This has resulted in initiatives in Botswana including treatment guidelines and the instigation of Antibiotic Stewardship Programs (ASPs). The next steps involve a greater understanding of current antibiotic utilization and resistance patterns (AMR). This resulted in a 2-day meeting involving key stakeholders principally from Botswana to discuss key issues including AMR rates as well as ASPs in both the public and private sectors. Following this, the findings will be used to plan future studies across Africa including point prevalence studies. The findings will be presented in July 2016 at the next Medicines Utilization Research in Africa meeting will ideally serve as a basis for planning future pertinent interventional studies to enhance the rational use of antibiotics in Botswana and wider

The IUPHAR sub-committee on clinical pharmacology in developing countries and the medicines utilization research in Africa (MURIA) group co-organized the third training workshop on drug utilization research in Africa

The IUPHAR Sub-Committee on Clinical Pharmacology in developing countries continues to partner with The Medicines Utilization Research In Africa (MURIA) Group to advance Drug Utilization research (DUR) in Africa and promote sustainable rational uses of medicines (RUM) through training, workshops, networking and cross national research.1-6 The Third Annual MURIA Training Workshop and Symposium took place between 26 and 28 June, 2017 at The University of Windhoek, Namibia, with the theme ‘Medicines Utilization Research in Africa influencing patient care and policy.

Prescribing indicators at primary health care centers within the WHO African region: a systematic analysis (1995-2015)

Abstract Background Rational medicine use is essential to optimize quality of healthcare delivery and resource utilization. We aim to conduct a systematic review of changes in prescribing patterns in the WHO African region and comparison with WHO indicators in two time periods 1995–2005 and 2006–2015. Methods Systematic searches were conducted in PubMed, Scopus, Web of science, Africa-Wide Nipad, Africa Journals Online (AJOL), Google scholar and International Network for Rational Use of Drugs (INRUD) Bibliography databases to identify primary studies reporting prescribing indicators at primary healthcare centres (PHCs) in Africa. This was supplemented by a manual search of retrieved references. We assessed the quality of studies using a 14-point scoring system modified from the Downs and Black checklist with inclusions of recommendations in the WHO guidelines. Results Forty-three studies conducted in 11 African countries were included in the overall analysis. These studies presented prescribing indicators based on a total 141,323 patient encounters across 572 primary care facilities. The results of prescribing indicators were determined as follows; average number of medicines prescribed per patient encounter = 3.1 (IQR 2.3–4.8), percentage of medicines prescribed by generic name =68.0 % (IQR 55.4–80.3), Percentage of encounters with antibiotic prescribed =46.8 % (IQR 33.7–62.8), percentage of encounters with injection prescribed =25.0 % (IQR 18.7–39.5) and the percentage of medicines prescribed from essential medicines list =88.0 % (IQR 76.3–94.1). Prescribing indicators were generally worse in private compared with public facilities. Analysis of prescribing across two time points 1995–2005 and 2006–2015 showed no consistent trends. Conclusions Prescribing indicators for the African region deviate significantly from the WHO reference targets. Increased collaborative efforts are urgently needed to improve medicine prescribing practices in Africa with the aim of enhancing the optimal utilization of scarce resources and averting negative health consequences