Conceptualising Higher Education and the Public Good in Ghana, Kenya, Nigeria, and South Africa

Higher education has been the object of policy attention in sub-Saharan Africa in recent years. It has been seen as key to unlocking the potential of the youth bulge, responding to the demands of a growing middle class and to transforming commodities-based economies into knowledge societies (World Bank 2009; Cloete, Maassen & Bailey 2015; Chuks, 2017). Yet despite significant expansions of enrolment – including widening participation by women, major barriers to access exist, reflecting inequalities based on class, gender, geographical location, ethnicity, religion, language and disability (AAI 2015; Morley & Lugg 2009; Morley & Croft, 2011). There are quality challenges in relation to teaching and learning, research, and governance. While some comment on a ’renaissance in African higher education’ (Higgs, 2016), and others on the effects and framings of colonial epistemicides (Nyamnjoh, 2012) key questions abound about relevance and power relations highlighting the need to decolonise the curriculum, structure, organisation and cultures of universities. The student protests in South Africa from 2015 highlighted problems of access and funding, but these are not isolated events. They expose an unresolved colonial legacy in these higher education systems. These processes raise questions not only of the public good relevance of higher education - beyond the obvious advantages conferred on those who manage to go to these institutions – but also of how higher education and its relationship with society may be conceptualised given these contexts (Lebeau and Milla, 2008; Mamdani, 2017). An overarching question is who is defining the public good and how? While many of the above issues are global e.g. universities throughout Latin America, Australasia, Asia and Europe are involved in similar debates and protests, this paper explores the relationship between higher education and the public good in the sub- Saharan African context through a consideration of some connections and disconnections. There appear to be two distinct ways in which higher education and the public good have been conceptualised are discussed. Firstly, higher education can be portrayed as instrumental in shaping a version of the public good where its qualifications, knowledge production, innovation, development of the professional classes, and expertise are perceived to lead to particular manifestations of public good, delineated as economic, social, political or cultural (McMahon 2009; Stiglitz 1999). The key arguments that underpin this conceptual framing speak to different levels of the public good, whether individual and community levels or the provision of ‘global public goods’ (Marginson 2007; 2013; Menashy 2009). However, a contrasting set of arguments portray the relationship between higher education and the public good as an intrinsic one, where the intellectual, physical and cultural experiences enabled through higher education express and enact the public good e.g. prejudice reduction, democratisation, critical thinking, active citizenship (Singh 2001; Calhoun 2006; Leibowitz, 2013; Marginson, 2011; Locatelli, 2017). Important here are considerations of the historical conjuncture that shapes experiences of higher education at a particular time and what these may mean. In considering the connections and disjunctures between these two formulations and the way writings on higher education in contemporary Africa have engaged with this debate, the paper makes an argument for discussing the importance of processes that link instrumental and intrinsic visions of higher education and the public good. The analysis of these from a rigorous review of literature leads to a delineation of some different views of time, space and evaluation. The paper argues that these contestations need to be read contextually. Higher education in sub-Saharan Africa has moved through phases, from the establishment of flagship national universities in the post-independence period for state bureaucracy formation (Teferra, 2017), to the emergence of developmental universities with a commitment to indigenising knowledge and benefiting marginalised populations, through more recent tendencies towards the marketisation of public institutions and the significant growth of the private sector (Assié-Lumumba & CODESRIA 2006; ADEA & AAU 2004; Coleman 1986; Mamdani, 2007; McCowan 2016). Appreciating these contextual factors in shaping the role and functioning of higher education and thus its relationship to the public good is a central theme in our analysis. We suggest that mainstream conceptualisations of higher education and the public good are underpinned by particular understandings of the nature and form of higher education and how knowledge is acquired, developed and disseminated – orientations that may be very far from the reality of highly unequal, socially stratified, and politically complex societies within which higher education is deeply embedded. Thus a reconceptualisation of the public is required by these contexts and some challenge to conceptualisations of the private, given the strong obligations of individuals to extended families, and the sharing of the benefits of higher education amongst their communities of origin. The paper concludes with a consideration of what may be important in conceptualising higher education and the public good in the African context and the value of such thinking for broader debates on the role of higher education

Factors Associated with Short and Long Term Mobility and HIV Risk of Women Living in Fishing Communities Around Lake Victoria in Kenya, Tanzania, and Uganda: A Cross Sectional Survey.

Mobility is linked to negative HIV care continuum outcomes. We sought to understand factors associated with short and long term mobility among women in fishing communities in Kenya, Tanzania, and Uganda. From 2018 through 2019 we conducted a cross-sectional survey of women aged 15 years and above, randomly selected from a census of six fishing villages, around Lake Victoria. Data collected included: demographics, risky sexual behaviour on the most recent trip, and travel behaviour in the previous 4 months. Mobility was recorded as any overnight trip outside the participant's village. A two-level multinomial logistic regression model was used to determine the associated factors. A total of 901 participants were enrolled, of whom 645 (71.6%) reported travelling (53.4%; short and 18.2% long term trips). Five factors were associated with long term travel: age, travel purpose, frequency of travel, sexual behaviour while travelling, and destination. Trips made by women aged 46-75 years were less likely to be long term. Long term trips were more common if the trip was to visit, rather than to trade, and more common for women who reported one or two trips rather than three or more trips. Women who made long term trips were more likely to engage in unprotected sex while on a trip. Women who travelled to a regional town/district or another town/district were more likely to take long term trips. The factors associated with travel duration among women living in fishing communities could inform planning of future health care interventions in these communities

Food access and diet quality are associated with quality of life outcomes among HIV-infected individuals in Uganda.

BACKGROUND: Food insecurity is associated with poor nutritional and clinical outcomes among people living with HIV/AIDS. Few studies investigate the link between food insecurity, dietary diversity and health-related quality of life among people living with HIV/AIDS. OBJECTIVE: We investigated whether household food access and individual dietary diversity are associated with health-related quality of life among people living with HIV/AIDS in Uganda. METHODS: We surveyed 902 people living with HIV/AIDS and their households from two clinics in Northern Uganda. Health-related quality of life outcomes were assessed using the Medical Outcomes Study (MOS)-HIV Survey. We performed multivariate regressions to investigate the relationship between health-related quality of life, household food insecurity and individual dietary diversity. RESULTS: People living with HIV/AIDS from severe food insecurity households have mean mental health status scores that are 1.7 points lower (p<.001) and physical health status scores that are 1.5 points lower (p<.01). Individuals with high dietary diversity have mean mental health status scores that were 3.6 points higher (p<.001) and physical health status scores that were 2.8 points higher (p<.05). CONCLUSIONS: Food access and diet quality are associated with health-related quality of life and may be considered as part of comprehensive interventions designed to mitigate psychosocial consequences of HIV

United States Pharmacopeia (USP) Safety Review of Gamma-Aminobutyric Acid (GABA)

Gamma-amino butyric acid (GABA) is marketed in the U.S. as a dietary supplement. USP conducted a comprehensive safety evaluation of GABA by assessing clinical studies, adverse event information, and toxicology data. Clinical studies investigated the effect of pure GABA as a dietary supplement or as a natural constituent of fermented milk or soy matrices. Data showed no serious adverse events associated with GABA at intakes up to 18 g/d for 4 days and in longer studies at intakes of 120 mg/d for 12 weeks. Some studies showed that GABA was associated with a transient and moderate drop in blood pressure (&lt;10% change). No studies were available on effects of GABA during pregnancy and lactation, and no case reports or spontaneous adverse events associated with GABA were found. Chronic administration of GABA to rats and dogs at doses up to 1 g/kg/day showed no signs of toxicity. Because some studies showed that GABA was associated with decreases in blood pressure, it is conceivable that concurrent use of GABA with anti-hypertensive medications could increase risk of hypotension. Caution is advised for pregnant and lactating women since GABA can affect neurotransmitters and the endocrine system, i.e., increases in growth hormone and prolactin levels