The reality of climate change and Africa’s development agenda

Studies affirm that developing countries will be hardest it by the dynamics of climate change given that they have to contend with extreme poverty levels and waning levels of economic growth. Climate variability will impact on water resources, land, forests and ecosystems, all of which will threaten livelihoods and food security. In developing countries the effects of climate change will manifest as increased and deeper exposure to vulnerabilities, with the previously attained development gains being compromised. Together these factors will impact on the achievement of the MDGs. Although Africa contributes negligibly to Greenhouse Gas (GHG) emissions, it will be worst affected due to its geographical location, its dependence on climate-sensitive resources and its overall inherent limitations financially, institutionally and human resource wise. Although most of Africa will feel the adversity that climate change will engender, certain African countries are at greater risk than others given their vulnerability and their subdued development credentials. We use a number of proxy variables as indicators of countries sliding further down the development stakes due to increased risk from climate change expounded as decreases in income or economic growth or increased expenditure on food that will siphon off development funds. The paper will look at the impact of climate change in developing countries and in Africa as a whole, with an analysis of why certain African countries will be worse off from the after-effects of climate change. Lastly, policy options will be briefly touched on.Environmental Economics and Policy,

Open-Set Speaker Identification under Mismatch Conditions

Full text of this paper is not available in the UHRA.This paper presents investigations into the performance of open-set, text-independent speaker identification (OSTI-SI) under mismatched data conditions. The scope of the study includes attempts to reduce the adverse effects of such conditions through the introduction of a modified parallel model combination (PMC) method together with condition-adjusted T-Norm (CT-Norm) into the OSTI-SI framework. The experiments are conducted using examples of real world noise. Based on the outcomes, it is demonstrated that the above approach can lead to considerable improvements in the accuracy of open-set speaker identification operating under severely mismatched data conditions. The paper details the realisation of the modified PMC method and CT-Norm in the context of OSTI-SI, presents the experimental investigations and provides an analysis of the results.otherPeer reviewe

Resuscitating an ethical climate in the health system: The role of healthcare workers

South Africa boasts a proud tradition of healthcare professionals speaking out against injustice in line with the medical doctrine of beneficence (to do good) and maleficence (do no harm). There are many who play a part in making the health system better, including the state, managers, patients and healthcare workers (HCWs). This article looks at the role of HCWs beyond providing medical care to individual patients. HCWs often face a lack of resources enabling them to adequately provide care and treatment and respond to lifethreatening emergencies. As a result, they are forced to make difficult decisions when it comes to allocating those scarce resources. These decisions are not purely fiscal in nature, but also ethical. Deciding who to bump off a theatre list because there is no linen is a choice most HCWs did not imagine they would ever have to make. In order to circumvent a sense of hopelessness, HCWs need to empower and motivate themselves (and others) with knowledge of how to make things better

Donor gender does not affect liver transplantation outcome in children

The liver is recognized as a sex hormone-responsive organ. Gender-specific differences in liver function are known to exist. Recently, a higher failure rate for organs transplanted in adults from female donors to male recipients has been reported. This increased failure rate of livers obtained from adult females and transplanted into adult males is thought to occur, at least in part, as a result of intrinsic gender-specific differences in hepatocyte cell surface expression and to alterations in the hormonal milieu of the donor liver in the recipient. To determine whether the same graft-recipient gender-determined failure rates pertain in the pediatric liver transplant population, the outcome of 335 primary liver transplants performed in children at the University of Pittsburgh Medical Center was examined. No difference in transplant outcome was demonstrated in children based on the gender pairings between the donor and recipient whether or not variables such as the age, etiology of the liver disease, and the blood group of the recipient were included in the data analysis. Thus, in contrast, to the situation in adults, the gender of the donor does not influence the outcome of liver transplantation in children and should not be used as a criterion for donor selection. This difference between adults and children may be due, at least in part, to gender differences in hepatocyte phenotypic expression induced as a consequence of puberty. © 1990 Plenum Publishing Corporation

The Association between Maternal Mortality and Non-Medical factors in African Countries

The medical expertise to treat to complications arising from pregnancy and childbirth has not spared girls and women in developing countries from dying of such conditions. Developing countries account for the bulk of the global share of maternal deaths with complications of pregnancy and childbirth being the leading cause of death in young women aged between 15 and 49. Sub-Saharan Africa is responsible for nearly three-fifths of all global maternal deaths which have saddled it with notoriously high levels of maternal mortality ratios, a concern that has been red-flagged internationally and regionally. Most studies on maternal mortality in Africa have been confined to an examination of factors impinging on maternal mortality from both medical and socioeconomic standpoints for individual country’s based on survey data. Our study differs from others as it employs logistic regression to look at the association between non-medical factors and maternal mortality nationally for all African countries. Whilst the results from the logistic regression suggests that there is no statistically significant relationship between any of the variables and maternal mortality, the odds ratio for Human Development Index (HDI) and Gross National Income per capita (GNI) imply that African countries with low HDI are about three time more likely to have high maternal mortality compared to high HDI countries. Similarly, African countries with low GNI are about five times more likely to have high maternal mortality compared to high GNI countries

Monitoring, Evaluation and Accountability Against Corruption: A South African Case Study

The article is an empirical effort to research and analyse the dialectical relationship between public sector monitoring and evaluation relations, structures and processes with corruption and accountability. The case study is the Gauteng Department of Health that has been the subject of this research for the last two years as a part of a wider health-related project.Following a brief exposition of the concept of monitoring and evaluation that has been covered extensively in international and national literature, its relationship with accountability is explored. The existing legislative national and provincial legislature as well as the existing state rules and regulations are presented before the description of the project's research methods and design. This is a research project utilising a qualitative–based research design and framework consisting of thorough content analysis of primary and secondary sources including government official documents, newspaper articles and face-to-face interviews with a wide range of carefully selected public administrators, political figures and representatives of the public sector. The paper presents an analysis of corruption trends within the department as identified in the latest Auditor General's report, a corruption–ridden case and the wide-ranging responses of the interviewees. The latest evidence–based Corruption Index follows

Advocacy: Are we teaching it?

Background. Health advocacy has been identified as a key outcome competency in the undergraduate curriculum for a number of health professions by the Health Professions Council of South Africa (HPCSA) and the University of KwaZulu-Natal (UKZN), Durban, SA. Despite health advocacy and activism playing a strong role in the student body and civil society, there has been only limited engagement with the manner in which to teach health advocacy in the health professions literature.Objectives. To assess how the faculty in health professions programmes at UKZN understood health advocacy and how it was covered in the curriculum.Methods. Focus group discussions were held with faculty from undergraduate health professions programmes at the university regarding how health advocacy was understood and how it was being integrated into the current curriculum. A thematic analysis was performed on the transcripts of the focus groups.Results. A range of ways in which health advocacy was understood became apparent in the focus groups, with a few disciplines indicating that they do not cover health advocacy explicitly in the curriculum. Three main focus areas of health advocacy training were identified: for the profession (particularly in the smaller health professions groups); for services within the health system; and for patients or communities. The main points of departure for health advocacy were ethics and human rights and to a much lesser degree social justice. There was generally limited experience of how health advocacy could be taught as a skill and little consensus between the participating disciplines regarding the scope and content of health advocacy training. Advocacy itself was also seen as potentially risky, which could undermine the relationship between the university and the service platform. Similarly, the potential risk to whistle-blowers and the institutional culture in universities and public sector services were also seen as limitations.Conclusions. Ample opportunities were identified for the potential teaching of health advocacy in complex professional and public sector interactions. Dual loyalty was seen to be a key dilemma for how to approach advocacy as part of work-based learning, and linked to considerable risk to the institution, educators and students. The current review offers an exciting opportunity to define more clearly what the outcome competencies of health advocacy are, particularly in the context of transformative health professions education – and how these can be operationalised in the overall curriculum