Credit accessibility and rural development in the former Ciskei: an overview of Keiskammahoek

This study focuses on the issue of credit accessibility for the rural poor. Taking cognisance of the critical role played by innovative micro-lending mechanisms in the sphere of rural development, the study reaffirms the need to enhance access to financial services by rural communities. However, it also reveals the fact that there are numerous impediments to access to credit for the people living in parts of the Keiskammahoek District of the former Ciskei. Key among the impediments has been lack of awareness about the existence and the activities of micro-lending institutions. This has, in a large measure been blamed for many of the rural poor people's failure to approach such institutions for funding. As a result, the affected people's efforts to fully actualize themselves economically have to a certain extent been hampered. Consequently, as its core argument, this study views as crucial the need to tackle all the attendant impediments. It also suggests that as the first step, the government, NGOs as well as formal and informal lending institutions should endeavour to disseminate the requisite information on micro-financing and in enhancing the affected people's institutional capacity to effectively use credit obtained for commercially productive ventures. Without sorting out the basics first, credit extension even when easily availed may not have the desired impact. At worst, it may actually complicate the poverty situation as the people grapple with piling debts

The new initiative of the East African Cooperation : opportunities, challenges and prospects

The landmark inauguration of the East African Cooperation (EAC) on 14 March 1996 brought to the fore some key issues regarding regional economic integration in East Africa, particularly since it signalled the second attempt by Kenya, Uganda and Tanzania to form a regional economic bloc. The EAC's predecessor, the East African Community, had collapsed in 1977 in acrimonious circumstances. Prominent among the issues that led to the collapse of the East African Community was the perception of unequal gains from the integration scheme, with Uganda and Tanzania considering that disproportionate benefits were accruing to Kenya at their expense. With the new initiative, the question emerges as to whether the problems that caused the collapse of the Community will not beset the EAC and subject it to a similar fate. In an attempt to address this question, this study considers some of the theoretical issues relating to regional economic integration among countries at different levels of development, and attempts to provide an analysis of the new initiative of the EAC in the light of this theory and the history of the East African Community. The study also critically examines the objectives of the EAC and the integration strategy adopted by the three countries, and offers suggestions on the way forward. Among the arguments made in this thesis are that, contrary to the suggestions of orthodox static analysis, if the dynamic effects of integration are considered, then there may be important gains which may accrue to integrating states in the developing country context. It is also argued that different levels of development among integrating states need not necessarily be an impediment to economic integration. The study finds that, in spite of the enormous challenges facing the EAC, member states may be better off within the integration scheme than if they acted as individual units in a rapidly globalizing international system

Energy Recovery routes from Municipal Solid Waste, A case study of Arusha-Tanzania

A study of energy recovery from municipal solid waste was undertaken. The energy content of the solid waste is 12MJ/kg. The elemental composition shows that the municipal solid waste contains 50% and 5% of carbon and hydrogen respectively. The energy flow (exothermic and endothermic) and thermal degradation analysis were carried out using differential scanning calorimetry and thermo-gravimetric analyser respectively. Experiments were performed at heating rate of 10 K/min, 20 K/min, 30 K/min and 40 K/min in the nitrogen atmosphere at temperature between room temperature and 1273 K. The thermal degradation kinetic parameters values of activation energy (Ea) ranged from 205.9 to 260.6kJ/mol. It has been observed that municipal solid waste is less reactive to combustion as compared to coal and biomass, but its reactivity can be improved through pre-treating process so as to reduce noncombustible materials such as oxygen and ash content. Also pyrolysis and gasification can be used to convert MSW to liquid or gaseous fuel. Keywords: Municipal Solid Waste, Thermal behavior, Thermo gravimetric Analysis

Association mapping of stem rust race TTKSK resistance in US barley breeding germplasm

KEY MESSAGE: Loci conferring resistance to the highly virulent African stem rust race TTKSK were identified in advanced barley breeding germplasm and positioned to chromosomes 5H and 7H using an association mapping approach. ABSTRACT: African races of the stem rust pathogen (Puccinia graminis f. sp. tritici) are a serious threat to barley production worldwide because of their wide virulence. To discover and characterize resistance to African stem rust race TTKSK in US barley breeding germplasm, over 3,000 lines/cultivars were assessed for resistance at the seedling stage in the greenhouse and also the adult plant stage in the field in Kenya. Only 12 (0.3 %) and 64 (2.1 %) lines exhibited a resistance level comparable to the resistant control at the seedling and adult plant stage, respectively. To map quantitative trait loci (QTL) for resistance to race TTKSK, an association mapping approach was conducted, utilizing 3,072 single nucleotide polymorphism (SNP) markers. At the seedling stage, two neighboring SNP markers (0.8 cM apart) on chromosome 7H (11_21491 and 12_30528) were found significantly associated with resistance. The most significant one found was 12_30528; thus, the resistance QTL was named Rpg-qtl-7H-12_30528. At the adult plant stage, two SNP markers on chromosome 5H (11_11355 and 12_31427) were found significantly associated with resistance. This resistance QTL was named Rpg-qtl-5H-11_11355 for the most significant marker identified. Adult plant resistance is of paramount importance for stem rust. The marker associated with Rpg-qtl-5H-11_11355 for adult plant resistance explained only a small portion of the phenotypic variation (0.02); however, this QTL reduced disease severity up to 55.0 % under low disease pressure and up to 21.1 % under heavy disease pressure. SNP marker 11_11355 will be valuable for marker-assisted selection of adult plant stem rust resistance in barley breeding. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00122-014-2297-8) contains supplementary material, which is available to authorized users

Pay for performance: an analysis of the context of implementation in a pilot project in Tanzania.

BACKGROUND: Pay for performance schemes are increasingly being implemented in low income countries to improve health service coverage and quality. This paper describes the context within which a pay for performance programme was introduced in Tanzania and discusses the potential for pay for performance to address health system constraints to meeting targets. METHOD: 40 in-depth interviews and four focus group discussions were undertaken with health workers, and regional, district and facility managers. Data was collected on work environment characteristics and staff attitudes towards work in the first phase of the implementation of the pilot. A survey of 75 facilities and 101 health workers were carried out to examine facility resourcing, and health worker employment conditions and job satisfaction. RESULTS: Five contextual factors which affect the implementation of P4P were identified by health workers: salary and employment benefits; resource availability, including staff, medicines and functioning equipment; supervision; facility access to utilities; and community preferences. The results suggest that it is important to consider contextual issues when implementing pay for performance schemes in low income settings. It highlights the importance of basic infrastructures being in place, a minimum number of staff with appropriate education and skills as well as sufficient resources before implementing pay for performance. CONCLUSION: Health professionals working within a pay for performance scheme in Tanzania were concerned about challenges related to shortages of resources, limited supplies and unfavourable community preferences. The P4P scheme may provide the incentive and means to address certain constraints, in so far as they are within the control of providers and managers, however, other constraints will be harder to address

Routine delivery of artemisinin-based combination treatment at fixed health facilities reduces malaria prevalence in Tanzania: an observational study

BACKGROUND Artemisinin-based combination therapy (ACT) has been promoted as a means to reduce malaria transmission due to their ability to kill both asexual blood stages of malaria parasites, which sustain infections over long periods and the immature derived sexual stages responsible for infecting mosquitoes and onward transmission. Early studies reported a temporal association between ACT introduction and reduced malaria transmission in a number of ecological settings. However, these reports have come from areas with low to moderate malaria transmission, been confounded by the presence of other interventions or environmental changes that may have reduced malaria transmission, and have not included a comparison group without ACT. This report presents results from the first large-scale observational study to assess the impact of case management with ACT on population-level measures of malaria endemicity in an area with intense transmission where the benefits of effective infection clearance might be compromised by frequent and repeated re-infection. METHODS A pre-post observational study with a non-randomized comparison group was conducted at two sites in Tanzania. Both sites used sulphadoxine-pyrimethamine (SP) monotherapy as a first-line anti-malarial from mid-2001 through 2002. In 2003, the ACT, artesunate (AS) co-administered with SP (AS + SP), was introduced in all fixed health facilities in the intervention site, including both public and registered non-governmental facilities. Population-level prevalence of Plasmodium falciparum asexual parasitaemia and gametocytaemia were assessed using light microscopy from samples collected during representative household surveys in 2001, 2002, 2004, 2005 and 2006. FINDINGS Among 37,309 observations included in the analysis, annual asexual parasitaemia prevalence in persons of all ages ranged from 11% to 28% and gametocytaemia prevalence ranged from <1% to 2% between the two sites and across the five survey years. A multivariable logistic regression model was fitted to adjust for age, socioeconomic status, bed net use and rainfall. In the presence of consistently high coverage and efficacy of SP monotherapy and AS + SP in the comparison and intervention areas, the introduction of ACT in the intervention site was associated with a modest reduction in the adjusted asexual parasitaemia prevalence of 5 percentage-points or 23% (p < 0.0001) relative to the comparison site. Gametocytaemia prevalence did not differ significantly (p = 0.30). INTERPRETATION The introduction of ACT at fixed health facilities only modestly reduced asexual parasitaemia prevalence. ACT is effective for treatment of uncomplicated malaria and should have substantial public health impact on morbidity and mortality, but is unlikely to reduce malaria transmission substantially in much of sub-Saharan Africa where individuals are rapidly re-infected.Financial support for IMPACT-Tz came primarily from CDC, the U.S. Agency for International Development and the Wellcome Trust

In vitro antileishmanial activity and phytochemical analysis of Carissa edulis against Leishmania major

Background: However, there is need to carry out scientific studies in order to confirm the medicinal properties of many plants used traditionally. Carissa edulis Forskk. (Gentiales: Apocynaceae) used by local communities for the treatment of various diseases has showed antiviral, antibacterial and antiprotozoal properties although there are no studies demonstrating its antileishmanial activity. Objective: To investigate in vitro antileishmanial activity of extracts of Carissa edulis on promastigote and amastigote forms of Leishmania major. Methodology: Solvent extraction of the stem parts of C. edulis was performed using water, methanol, petroleum ether, dichloromethane and ethyl acetate. Minimum inhibitory concentration (MIC), anti-amastigote and nitric oxide production assays were carried out to demonstrate antileishmanial activity of C. edulis extracts against the two forms of L. major parasite species: promastigote and amastigote. The extracts were also screened for phytochemical constituents present. Cytotoxicity assay was then done to assess their safe use as herbal medicinal products. Results: The C. edulis petroleum ether extract showed the strongest antileishmanial activity against L. major promastigotes (MIC=625μg/ml) with the water, dichloromethane and ethyl acetate extracts recording the weakest activity (MIC=2500μg/ml). The successive methanol extract reduced the number L. major amastigotes by 88.29% compared to the negative control (RPMI). The water (13.37μM), petroleum ether (12.93μM) and successive methanol extracts (12.82μM) produced nitrite values lower than the standard drugs Pentostam® (14.35μM) and Amphotericin B (14.13μM). Discussion: All C. edulis extracts have potential antileishmanial activity against L. major. Preliminary phytochemical screening of these extracts showed presence of alkaloids, terpenoids, phenols, anthraquinones and saponins. These phytochemicals were previously reported to have antileishmanial activity. Therefore, the plant extracts could offer an opportunity to develop cheaper antileishmanial alternatives to the more expensive pentavalent antimonials. Key words: C. edulis, L. major, promastigote, amastigot

Are Tanzanian patients attending public facilities or private retailers more likely to adhere to artemisinin-based combination therapy?

BACKGROUND: Artemisinin combination therapy (ACT) is first-line treatment for malaria in most endemic countries and is increasingly available in the private sector. Most studies on ACT adherence have been conducted in the public sector, with minimal data from private retailers. METHODS: Parallel studies were conducted in Tanzania, in which patients obtaining artemether-lumefantrine (AL) at 40 randomly selected public health facilities and 37 accredited drug dispensing outlets (ADDOs) were visited at home and questioned about doses taken. The effect of sector on adherence, controlling for potential confounders was assessed using logistic regression with a random effect for outlet. RESULTS: Of 572 health facility patients and 450 ADDO patients, 74.5% (95% CI: 69.8, 78.8) and 69.8% (95% CI: 64.6, 74.5), respectively, completed treatment and 46.0% (95% CI: 40.9, 51.2) and 34.8% (95% CI: 30.1, 39.8) took each dose at the correct time ('timely completion'). ADDO patients were wealthier, more educated, older, sought care later in the day, and were less likely to test positive for malaria than health facility patients. Controlling for patient characteristics, the adjusted odds of completed treatment and of timely completion for ADDO patients were 0.65 (95% CI: 0.43, 1.00) and 0.69 (95% CI: 0.47, 1.01) times that of health facility patients. Higher socio-economic status was associated with both adherence measures. Higher education was associated with completed treatment (adjusted OR = 1.68, 95% CI: 1.20, 2.36); obtaining AL in the evening was associated with timely completion (adjusted OR = 0.35, 95% CI: 0.19, 0.64). Factors associated with adherence in each sector were examined separately. In both sectors, recalling correct instructions was positively associated with both adherence measures. In health facility patients, but not ADDO patients, taking the first dose of AL at the outlet was associated with timely completion (adjusted OR = 2.11, 95% CI: 1.46, 3.04). CONCLUSION: When controlling for patient characteristics, there was some evidence that the adjusted odds of adherence for ADDO patients was lower than that for public health facility patients. Better understanding is needed of which patient care aspects are most important for adherence, including the role of effective provision of advice

A Case-Control Study to Assess the Relationship between Poverty and Visual Impairment from Cataract in Kenya, the Philippines, and Bangladesh

Hannah Kuper and colleagues report a population-based case-control study conducted in three countries that found an association between poverty and visual impairment from cataract