Systematic Analysis of Factors Associated with Late Breast Cancer Screening in Women in Sub-Saharan Africa from 2014 to 2020

Research background: Breast cancer remains a major public health problem, with a high number of new cases and deaths each year. However, despite advances in research to improve this disease, there is a high rate of late detection, leading to diagnosis at an advanced stage and a reduced chance of survival. Objective: The aim of this study is to identify the factors associated with late detection of breast cancer in women in Sub-Saharan Africa from 2014 to 2020.Setting: This systematic review focuses on sub-Saharan Africa. Methods: We searched for articles in four databases (PubMed, Embase, Global-Health and CINAHL) between 2014 and 2020 and performed a narrative synthesis to organize and group the different factors associated with late breast cancer detection. Result: After reviewing 583 publications, 6 studies were selected, highlighting factors such as lack of awareness, knowledge gaps, difficulties in accessing health services and financial constraints associated with late breast cancer screening. The participants, who ranged in number from 20 to 1776, were mainly aged between 18 and 25, with a mean age of 25 years and 6 months. Conclusion: The analysis enabled us to identify various factors associated with late breast cancer screening. Collaboration between health professionals, community organizations and policy-makers is essential to foster an environment conducive to the prevention and early detection of breast cancer.

Hepatitis B Vaccination Coverage among University Students in Sub-Saharan Africa: Systematic Review and Meta Analysis

Introduction: Hepatitis B is an infectious disease that remains a real public health problem in Africa. Students represent a group at risk for this disease. The objective of this study was to estimate the hepatitis B vaccination coverage rate among students in sub-Saharan Africa. Methods: A systematic search of databases (PubMed, AJOL) and a manual search of Google Scholar was conducted to retrieve all published studies reporting hepatitis B vaccination coverage among students in sub-Saharan Africa. The pooled coverage rate was estimated with a 95% confidence interval (CI) in a random-effects meta-analysis. Results: A total of 35 studies were included and included 20,520 students. The mean age was 22.1 ± 5.1 years with a predominance of female sex (sex ratio F/M = 1.05). The vaccination coverage rate was 28.8% [95% CI: 22.9% - 34.7%]. Disaggregation allowed to estimate coverage rates of 29.8% [95% CI: 22.9% - 36.7%], 23.4% [95% CI: 9.4% - 37.4%] and 17.0% [95% CI: 14.4% - 19.5%] respectively in West Africa, East Africa and Central Africa. Conclusion: Less than a third of students in sub-Saharan Africa are protected against hepatitis B. However, the majority of this target group is at risk of infection. It would be relevant to screen and, if necessary, vaccinate all new students.

The Effects of Competence and Auditor Training on Fraud Detection Within Multinational Companies in Sub-Saharan Africa

The aim of this study is to examine the qualities that auditors engaged in detecting potential fraud within multinational corporations in Sub-Saharan Africa should possess.To achieve this goal,a quantitative approach was used to develop and test a research model based on three theories:agency theory,attribution theory,and cognitive dissonance theory.Responses from a panel of two hundred and nine(209)auditors who conducted a legal audit mission in a Sub-Saharan multinational were analyzed using SmartPLS 3.3.3 software.The results emphasize the crucial importance of auditors’competence and continuous training in fraud detection.However,professional skepticism and time pressure were found to be non-significant in this context.This conclusion provides essential insights for auditors,highlighting the key qualities needed to effectively address fraud detection within multinational corporations in Sub-Saharan Africa.

Barriers and Facilitators to Evidence-Based Practice among Physiotherapists Practicing in Sub-Saharan Africa

Background: Evidence-based practice (EBP) is vital for high-quality patient care, yet its implementation among physiotherapists in sub-Saharan Africa (SSA) faces significant challenges. This scoping review explores the barriers and facilitators of EBP in this region. Objectives: To identify barriers and facilitators of EBP at individual, organisational, and extra organisational levels among physiotherapists in SSA. Methods: A comprehensive literature search was conducted across PubMed, Sabinet, BioMed Central, and Google Scholar. Seven studies from Ghana, Nigeria, Cameroon, Benin, Kenya, Zimbabwe and South Africa met the inclusion criteria. Results: Key barriers at the practitioner level included lack of time, insufficient knowledge of EBP, limited access to information resources, and inadequate research skills. Facilitators comprised positive attitudes toward EBP and a desire for further knowledge. At the organisational level, resource unavailability emerged as a major barrier. Notably, no studies addressed extra organisational factors. Conclusion: This review highlights critical barriers and facilitators of EBP among SSA physiotherapists and emphasises the need for further research on extra organisational influences. Addressing systemic challenges is essential for enhancing physiotherapist engagement in EBP, ultimately improving patient care and outcomes in sub-Saharan Africa.

A Generic and Reliable Land Acquisition Protocol Implementation for Sub-Saharan Africa Countries

Land acquisition is subject of many frauds worldwide. In Africa countries, land acquisition frauds are a real curse. Main reasons of the high land acquisition frauds in Africa are a lack of a reliable land acquisition protocol implementation, no centralized information system that records land transactions and integrates all actors, lack of education about the acquisition protocol and lack of applied sanctions in case of frauds. As of sanctions, the issue is bound to the corruption plague in Africa. Authorities that are supposed to rule the laws are not well paid and are part of the corruption scheme. Most frequent frauds are multiple sales of the same land, falsified land title, false owner identification. In Africa, a land belongs generally to the first residents of the area. To claim ownership of a land, an owner should be recognized by the rural or city authorities. To achieve this recognition, he must obtain from those authorities an attribution letter. The author proposed a complete and reliable land acquisition protocol named ACLAP (Africa Countries Land Acquisition Protocol). The purpose of this paper is to explain the main components of the protocol implementation and show its efficiency when confronting fraud threats. In this paper, a Generic and Reliable Land Acquisition Protocol Implementation in Sub-Saharan Africa countries context is proposed. The platform keeps relevant land transaction information for administrators, managers, buyers, sellers, or for people consultation purpose. The application may be used in village, city, department, region, or country for land management decision making.

History, current status, and prospects of soybean production and research in sub-Saharan Africa

Soybean(Glycine max(L.) Merr.) is a non-native and non-staple crop in sub-Saharan Africa(SSA) with potential to be a commercial crop owing to its wide range of uses as food, feed,and industrial raw material. Soybean was first introduced to SSA by Chinese traders in the19 th century and was cultivated as an economic crop as early as 1903 in South Africa. In the past four decades, soybean cultivation area and production in SSA has increased exponentially, from about 20,000 ha and 13,000 t in the early 1970 s to 1,500,000 ha and2,300,000 t in 2016. Soybean yield has been stagnant in SSA for decades at about 1.1 t ha^(-1),much lower than the world average, representing one of the most challenging issues in the soybean industry in SSA. The low soybean yield in SSA can be attributed to the use of poorperforming varieties and to the limited application of fertilizers and rhizobial inoculants in soils with no history of soybean production. South Africa, Nigeria, Zambia, and Uganda are the leading soybean producers in SSA. Soybean research in SSA is conducted by international and national research institutions, including IITA, national soybean improvement programs, universities, and the private sector. Between 1970 and 2011, 195 soybean varieties were released by IITA, private breeders, and national soybean improvement programs in SSA. This paper reviews the history and current state of soybean production and of the utilization and adoption of tropical varieties in SSA, addresses the major soybean yield-limiting factors across the region, and discusses the potential of the soybean industry in SSA. It also highlights soybean improvement efforts and lessons learned from previous soybean improvement efforts and the current progress of some national soybean improvement programs in SSA. Opportunities for scaling up tropical soybean as a major crop across SSA countries are promising.

Achieving food and nutritional security through agroforestry: a case of Faidherbia albida in sub-Saharan Africa

Faidherbia albida is an ideal agroforestry tree commonly intercropped with annual crops like millet and groundnuts in the dry and densely populated areas of Africa. With its peculiar reverse phenology, it makes growth demands at a different time from that of crops. In addition, it deposits great amount of organic fertilizer on food crops. Leaves entering soils are comparable to fertilization of almost 50 t·ha^-1year^-1 of manure in dense stands of 50 large trees per ha. These nutrients help maximize agricultural production and reduce the need for a fallow period on poorer soils. Research has shown that millet grown under F. albida yielded 2.5 and 3.4 fold increases in grain and protein, respectively. Animals eat pods which contain mean amounts of crude protein of 20.63% and carbohydrate of 40.1% in seeds. Moreover, the continued existence ofF. albida in agroforestry parklands as in Ethiopia and Mali signifies the success of traditional conservation measures. Modem scientists have also developed much interest in the role of agroforestry in maintaining long-term biological balance between agriculture and livestock production systems. To ensure food security, which still remains a major challenge in sub-Saharan Africa, and concurrently minimize environmental degradation, promotion of agroforestry that specifically involves indigenous trees is crucial. We discuss the prospective role ofF. albida in alleviating poverty while simultaneously protecting the environment from factors associated with, for example, deforestation and loss of biodiversity. The overall aim is to promote wide-scale adoption ofF. albida as a valuable tree crop in farming systems, particularly in those areas where it remains unexploited.

Trade-offs and synergies of climate change adaptation strategies among smallholder farmers in sub-Saharan Africa:A systematic review

Climate change adaptation strategies provide a cushion for smallholder farmers,especially in subSaharan Africa against the risks posed by climate hazards such as droughts and floods.However,the decision-making process in climate adaptation is complex.To better understand the dynamics of the process,we strive to answer this question:what are the potential trade-offs and synergies related to decision-making and implementation of climate adaptation strategies among smallholder farmers in sub-Saharan Africa region?A systematic literature review methodology was used through the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)statement with the four-stage inclusion/exclusion criteria to identify the literature from selected databases(Scopus and Google Scholar).The climate adaptation strategies are organized into five broad categories(crop management,risk management,soil/land management,water management,and livestock management strategies).Evidence suggests that potential trade-offs may arise concerning added costs,additional labor requirements,and competition among objectives or available resources.The synergies,on the other hand,arise from implementing two or more adaptation strategies concurrently in respect of increased productivity,resilience,yield stability,sustainability,and environmental protection.Trade-offs and synergies may also differ among the various adaptation strategies with minimum/zero tillage,comparatively,presenting more tradeoffs.The development and promotion of low-cost adaptation strategies and complementary climate adaptation options that minimize the trade-offs and maximize the synergies are suggested.Skills and knowledge on proper implementation of climate change adaptation strategies are encouraged,especially at the local farm level.

Microgrids-as-a-Service for Rural Electrification in Sub-Saharan Africa

The majority of the population on the African continent is unable to access basic electricity services,this despite the abundance of renewable energy sources(RESs).The inability to adequately tap into these RESs has led to the continued dependence on non-renewable energy sources such as coal for electricity generation,and kerosene for cooking and lighting,the resulting use of which is poor health conditions.The use of Microgrids(MGs)is being extensively researched as a feasible means of tackling the challenge of electrification,especially in rural and remote areas.Recent times have seen an increasing number of research works focusing on Sub-Saharan Africa(SSA),which is one of the regions with the lowest electrification rates in the world.MGs provide the most suitable means to integrate RESs into the electricity generation process,paving the way towards clean energy for the African continent.This paper presents a review of recent literature on the usage of MG technology for rural electrification,with a specific focus on the applicability of MGs in the SSA context.The paper additionally presents the challenges and opportunities to date.Research findings indicate that SSA has already begun the transition towards clean energy via implementation of RES-based MGs.However,two resonating challenges in the literature are adequate support via policy,and proper planning of project implementation.These two major barriers are needed to be overcome in order to fully utilize MGs for rural electrification in SSA.The key methodology derived from this study is that any effort towards rural electrification requires a sufficient amount of investigation,incorporating both the technological and socio-economic aspects into a suitable design for the target location.

A Cost-Benefit Analysis of China＇s Trade Relations With Sub-Saharan Africa

Trade and economic relations between China and Africa have a protracted history and have developed incrementally over the course of time. Consequently, increasing numbers of Chinese businesses and entrepreneurs have sought partnerships with African companies with the aim of establishing strategic partnerships, collaborations, and joint ventures. In recent years, these Sino-African trading relations have been the subject of consistent debate and scrutiny, attracting positive and negative analyses from scholars and practitioners across disciplines. Some studies questioned China＇s motives in Africa＇s markets, and others viewed with suspicion the structure of Sino-Africa＇s bilateral trading engagements. Conducting an extensive literature survey of related sources and employing content analysis of recent and current data （2000-2009）, the paper examined institutional and academic publications pertaining to Sino-African relationship. It determines imbalance in the structure of Sino-African bilateral trade, negative impact on domestic economic development, and competitive disadvantage in African marketplaces. Policy implications of these findings were provided as well as recommendations for mutual trade benefits and global strategic investments

Interconnections between governance and socioeconomic conditions:Understanding the challenges in sub-Saharan Africa

Given that challenges on the issue of socioeconomic development faced by countries in sub-Saharan Africa(SSA)have been identified as critical to strengthening the inherent link between governance and socioeconomic conditions,this study examines the interconnections between governance and socioeconomic conditions in SSA.With a focus on 25 countries in SSA between 2005 and 2019,we conduct the analysis based on the Panel-Corrected Standard Error and System Generalized Method of Moments estimations and panel causality tests.The results show that SSA does not seem to have the means of effective governance to spur improved socioeconomic conditions.Moreover,the pervasiveness of institutional problems in many countries of SSA has been responsible for the poor socioeconomic conditions in the region.Likewise,governance quality and socioeconomic conditions are found to influence each other.An improvement in socioeconomic conditions could result in better governance quality.On the other hand,governance quality is viewed as a vital ingredient in achieving needed socioeconomic development outcomes.Thus,it is suggested that there is a need for countries in SSA to streamline governing systems toward engendering improved well-being.The introduction and implementation of transformative policies through effective governance are also necessary for ensuring critical structural changes and increasing social service provision.Overall,there should be a proactive identification of ineffective policies and procedures by policymakers to enhance meaningful impacts in the region.

Towards data-driven models for diverging emerging technologies for maternal,neonatal and child health services in Sub-Saharan Africa:a systematic review

Sub-Saharan Africa(SSA)has the highest maternal and under-five mortality rates in the world.The advent of the coronavirus disease 2019 exacerbated the region's problems by overwhelming the health systems and affecting access to healthcare through travel restrictions and rechanelling of resources towards the containment of the pandemic.The region failed to achieve the Millenium Development Goals on maternal and child mortalities,and is poised to fail to achieve the same goals in the Sustainable Development Goals.To improve on the maternal and child health outcomes,many SSA countries introduced digital technologies for educating pregnant and nurs-ing women,making doctors'appointments and sending reminders to mothers and expectant mothers,as well as capturing information about patients and their illnesses.However,the collected epidemiological data are not being utilised to inform patient care and improve on the quality,efficiency and access to maternal,neonatal and child health(MNCH)care.To the researchers'best knowledge,no review paper has been published that focuses on digital health for MNCH care in SSA and proposes data-driven approaches to the same.Therefore,this study sought to:(1)identify digital systems for MNCH in SSA;(2)identify the applicability and weaknesses of the dig-ital MNCH systems in SSA;and(3)propose a data-driven model for diverging emerging technologies into MNCH services in SSA to make better use of data to improve MNCH care coverage,efficiency and quality.The PRISMA methodology was used in this study.The study revealed that there are no data-driven models for monitoring pregnant women and under-five children in Sub-Saharan Africa,with the available digital health technologies mainly based on SMS and websites.Thus,the current digital health systems in SSA do not support real-time,ubiquitous,pervasive and data-driven healthcare.Their main applicability is in non-real-time pregnancy moni-toring,education and information dissemination.Unless new and more effective approaches are implemented,SSA might remain with the highest and unacceptable maternal and under-five mortality rates globally.The study proposes feasible emerging technologies that can be used to provide data-driven healthcare for MNCH in SSA,and the recommendations on how to make the transition successful as well as the lessons learn from other regions.

Carotid Web as a Cause of Ischemic Stroke in Sub-Saharan Africa: A Preliminary Monocentric Descriptive Study of 6 Cases Collected at the Fann Teaching Hospital (Senegal)

Introduction: Carotid web (CW), a rare and probably unknown arterial cause of ischemic stroke (IS), is commonly reported in young black patients, although most of the published cases resided in a non-African country. We describe the features of the first six Senegalese cases diagnosed at the Neurology Department of the Fann Teaching Hospital in Dakar. Patients and Method: It was a preliminary retrospective and prospective study conducted at the Neurology department of Fann teaching hospital (Dakar-Senegal). The symptomatic CW diagnosis was based on angioCT-scan of the neck arteries. The National Institute of Health Stroke Scale (NIHSS) and the modified-Rankin Scale (mRS) were used to assess the severity of the IS and the functional disability after the event, respectively. Results: CW was causing a left sylvian infarction in 4 patients. The mean age of the patients at the IS diagnosis was 41 ± 6 years with a sex ratio of 1. The mean time to diagnosis of CW was 13 months. Smoking (1/6), hypertension (1/6), and obesity (1/6) were the main vascular risk factors. The mean LDL cholesterol level was 1.52 g/L ± 0.49. The mean initial NIHSS was 15 ± 6 (8-22). Half of the patients had a severe infarction (NIHSS ≥ 15). For secondary prevention, half of the patients were treated with aspirin and the other half with acenocoumarol. After 18 months ± 17 of follow-up, the mean mRS score was 2 ± 1 (1-3). Conclusion: CW is an unknown cause of IS in young black patients. An early and appropriate multidisciplinary management could help to reduce the risk of recurrences.

Mass media exposure and its impact on malaria prevention behaviour among adult women in sub-Saharan Africa:results from malaria indicator surveys

Background:Mass media exposure plays a pivotal role in health communication and adoption of a healthy lifestyle.In this study,we aimed to measure the prevalence of malaria prevention behaviour among adult women in eight malariaendemic countries in sub-Saharan Africa(SSA),and assess the influence of mass media exposure in the adoption of those behaviours.Methods:For this study,we collected cross-sectional data on 46,822 women aged between 15 and 49 years from the Malaria Indicator Surveys(MIS)conducted in Burkina Faso,Ghana,Mali,Malawi,Kenya,Nigeria,Sierra Leone and Uganda.As the outcome variable,malaria prevention behaviour was proxied by the use of insecticide treated nets(ITNs)and uptake of antimalarial drugs in last pregnancy.Results:The overall prevalence of sleeping under ITN and that of taking antimalarial drug during the last pregnancy was respectively 67.9%(95%CI=66.6-69.2)and 72.8%(95%CI=71.3-74.2).However,there were disparities in the prevalence of using ITN and antimalarial drug use across the study countries.In the multivariable regression analysis,not receiving malaria related information from radio,poster/billboards,community events,and health workers were found to be significantly associated with reduction in the odds of using ITN the previous night.For the use of antimalarial drugs during last pregnancy,the odds were 23%[OR=0.773,95%CI=0.625-0.956]lower for those who did not receive malaria information on radio compared with those who received.Conclusions:These findings indicate a potentially important role of malaria information received through mass media on utilisation of ITN among women in SSA.More research is needed to explore the factors that limit the accessibility to malaria information through mass media.

(Re)assessing Climate-Smart Agriculture practices for sustainable food systems outcomes in sub-Saharan Africa:The case of Bono East Region,Ghana

This research paper assesses the reality of Climate-Smart Agriculture(CSA)practices’potential to promote the outcomes of sustainable food systems(SFS)within Ghana’s smallholding agriculture context.The study demon-strates that rural farmers generally perceive CSA’s contribution to‘food and nutrition security’and‘economic performance’as more important than CSA’s contribution to‘social equity’and‘environmental stewardship’.From a narrow perspective,the study demonstrates that farmers perceive CSA’s potential to‘prevent pest and disease outbreaks’and‘increase human capital information’as the most important contribution of CSA to SFS outcomes.In contrast,CSA’s potential to promote environmental stewardship is perceived as the least important among Ghana’s rural farmers.This enormity of displacement of smallholders’perceptions at large is motivated by de-mographic,socioeconomic and ecological factors.Moreso,the CSA for SFS outcomes narratives is driven by farmers’self-apprise,social networks and other local information dissemination agents.Furthermore,research findings suggest farmers’awareness of CSA practices and interventions is deficient owing to unmet training and information needs for approximately 82%of the CSA practices and interventions.This situation elucidates the dichotomy of CSA practices’narratives as tools for attaining food,nutrition security and economic performance to the detriment of critical issues such as increasing awareness and building farmers’capacity to engage with CSA practices while also managing socio-ecological trade-offs that emerge over time due to engagement with CSA.Critical(re)orientation is needed across the scale to drive CSA practices and interventions that confine cli-mate adaptation and food production practices within safe planetary boundaries without undermining social,economic,food and nutrition security needs.

Examination of the poverty-environmental degradation nexus in Sub-Saharan Africa

The relationship between environmental degradation and poverty has increasingly become the focus of national strategic decision-making in recent years.However,despite several theoretical explorations on the nexus,a dearth of empirical literature on the poverty-environmental degradation nexus,specifically on Sub-Saharan Africa(SSA),still exists.In this study,we investigated the poverty-environmental degradation nexus in SSA.We hypothesized that poverty is both a cause and effect of environmental degradation,and this relationship is explained as a vicious cycle.Unlike previous studies,we employed several alternative indicators of environmental degradation to examine the poverty-environmental degradation nexus in this study.We used data from 41 countries of SSA between 1996 and 2019 and employed the generalized method of moments(GMM)approach.The findings suggest a cyclical relationship between poverty and environmental degradation in SSA,which confirms that an increase in poverty leads to an increase in environmental degradation,especially in deforestation and PM2.5 emissions.Similarly,the increase in environmental degradation positively affects poverty in SSA.We also confirmed that exogenous conditioning factors such as population growth rate,education,industrialization,and income inequality,institutional quality indicators such as governance effectiveness,control of corruption,freedom ad civil liberty,and democracy,and endogenous factors including fossil fuel energy use,fuelwood energy use,household health expenditure,infant mortality rate,and agriculture productivity influence the nexus between poverty and environmental degradation.The findings on the relationship between poverty and environmental degradation in SSA are a testimonial evidence that both poverty and environmental degradation are significant issues in SSA.Hence,poverty alleviation policies in SSA should not lead to PM2.5 emissions and deforestation,which may as well force people into a poverty-environmental degradation trap.Instead,poverty reduction policies should simultaneously achieve environmental conservation.

Spatial spillover effects of official development assistance on environmental pressure in sub-Saharan African(SSA)countries

Impoverished sub-Saharan Africa(SSA)is under increasing environmental pressure from global environmental changes.It is now generally accepted in academic circles that economic development in SSA countries can cause environmental pressure in other countries.However,there is research gap on the impact of economic assistance on environmental pressure in SSA countries and whether economic assistance causes spatial spillovers of environ-mental pressure between SSA countries.To better understand the impact of economic assistance on environmental pressures in SSA,a dynamic spatial Dubin panel model was developed.It helped us explore the spatial spillover effects of economic assistance on environmental pressures in recipient countries based on the panel data from 34 SSA countries.The results show that economic assistance had a positive stimulating effect on environmen-tal pressures of recipient countries,which means that the degree of human disturbance to the environment has deepened.Due to the regional correlation effect,neighboring countries were saddled with environmental pres-sures from the target country.Moreover,environmental pressures have time inertia,which can easily produce a snowball effect.The decomposition of effects shows that the impact of economic assistance on environmental pressures is relatively minor.Environmental pressures have spillover effects,so to deal with diffuse risks,joint regional prevention and control policies should be developed.

Degree of financialization and energy efficiency in Sub-Saharan Africa: do institutions matter?

The United Nations Sustainable Development Goal 7 emphasizes the need for economies around the world to double their efforts in energy efficiency improvements.This is because improvements in energy efficiency can trigger economic growth and considered as one of the‘green’growth strategies due to its carbon free content.To this end,some empirical studies have investigated the nexus between economic growth and energy efficiency,but the effects of the latter on financial indicators have not been sufficiently studied in the literature,at least in developing economies like Africa.This study examines the effect of energy efficiency improvements on commercial bank profitability under different political regimes(i.e.,autocratic and democratic political regimes);something previous literature had neglected.The study uses panel data,consisting of 43 African countries and the simultaneous System Generalized Method of Moments.We found that energy efficiency improvement is more likely to induce higher bank profitability in political institutions with the characteristics of centralization of power compared with those with decentralization of power.Furthermore,for the banking sector,the findings suggest that energy utilization behavior of clients should be included in the loan or credit valuation process.For the government,the agenda of energy efficiency should be aggressively pursued while taking cognizance of creating a political environment that weans itself from a‘grandfathering’behavior.

Institutions as Tools of Public Policy： A Comparative Evaluation of South East Asian-Sub-Saharan African Post War Development

In general, it can be argued that institutional framework a country or region designs plays a significant role in crafting, applying or even success of public policy. Drawing lessons from how Asia exploited the developmental state＇s concept by designing institutions which targeted key public policy areas such as education, health, domestic savings, and rural development, or aligned infrastructures such as roads, transport and ports, to drive economic development. The paper explores how this approach can be applied in sub-Saharan Africa （or individual countries）. The objective is to extricate constant factors impacting development both in ahistorical and atemporal terms. The investigation is guided by the key question： whether quality of institutions and institutional analysis can help explain development failures in Africa？ Hence, on one part, it probes institutions, institution-making, public policy making and what uniquely the Asian developmental state did that can help illuminate institutional role in policymaking and application. In pursuing this objective, the paper is cognisant of the question by Brousseau et al. asked, regarding generalizability of institutional capabilities, ＂If growth-enhancing institutions are identified in a specific country, can other countries learn from and transplant these＂. The investigation concludes that in public policy and development strategy-making institutions do matter as they delimit or even help create possibilities necessary for development and its sustenance, and to a certain extent, they are the vital constant （factors） that explains development differentiations in different geographic spaces or time periods.

Front-of-pack labeling:a health literacy intervention to improve cardiovascular health in Sub-Saharan Africa

There is a surge in the burden of cardiovascular disease(CVD)in Sub-Saharan African(SSA)countries.Over the last 50 years there has been a rapid growth in the consumption of ultra-processed food products high in salt,fat,and glycemic load in SSA.There is overwhelming evidence linking UPFP consumption to an increased risk of coronary artery disease,cerebrovascular disease,overall CVD,and all-cause mortality.Front-of-pack labeling(FOPL)represents an important intervention to guide consumers towards healthier diets and ultimately contribute to the prevention of diet-related adverse health outcomes including CVD.This paper discusses the challenges in the development and implementation of FOPL systems in SSA,and proposes some key elements that would be critical for developing an effective FOPL system in SSA countries.