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Neoliberal policy, rural livelihoods, and urban food security in West Africa: a comparative study of The Gambia, Cote d'Ivoire, and Mali.

ABSTRACT: This study examines the impact of two decades of neoliberal policy reform on food production and household livelihood security in three West African countries. The rice sectors in The Gambia, Côte d'Ivoire, and Mali are scrutinized as well as cotton and its relationship to sorghum production in Mali. Although market reforms were intended to improve food production, the net result was an increasing reliance on imported rice. The vulnerability of the urban populations in The Gambia and Côte d'Ivoire became especially clear during the 2007-2008 global food crisis when world prices for rice spiked. Urban Mali was spared the worst of this crisis because the country produces more of its own rice and the poorest consumers shifted from rice to sorghum, a grain whose production increased steeply as cotton production collapsed. The findings are based on household and market surveys as well as on an analysis of national level production data.

SUBMITTER: Moseley WG

PROVIDER: S-EPMC2851933 | biostudies-literature | 2010 Mar

REPOSITORIES: biostudies-literature

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Neoliberal policy, rural livelihoods, and urban food security in West Africa: a comparative study of The Gambia, Cote d'Ivoire, and Mali.

Moseley William G WG Carney Judith J Becker Laurence L

Proceedings of the National Academy of Sciences of the United States of America 20100325 13

This study examines the impact of two decades of neoliberal policy reform on food production and household livelihood security in three West African countries. The rice sectors in The Gambia, Côte d'Ivoire, and Mali are scrutinized as well as cotton and its relationship to sorghum production in Mali. Although market reforms were intended to improve food production, the net result was an increasing reliance on imported rice. The vulnerability of the urban populations in The Gambia and Côte d'Ivoi ...[more]

PMID: 20339079

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Project description:BackgroundSchistosomiasis is a water-based disease transmitted by trematodes belonging to the genus Schistosoma. The aim of this study was to assess the relationship between the prevalence of schistosomiasis and access to water, sanitation and hygiene (WASH) and environmental and socioeconomic factors in the city of Korhogo, northern Côte d'Ivoire.MethodsA cross-sectional study including 728 randomly selected households was conducted in Korhogo in March 2015. The heads of the households were interviewed about access to WASH and environmental and socioeconomic factors. All children abed between 5 and 15 years living in the households were selected to provide stool and urine samples for parasitological diagnosis of Schistosoma mansoni and Schistosoma haematobium infection. The relationship between infection with S. mansoni and potential risk factors was analysed by a mixed logistic regression model with 'household' as a random factor. Likelihood ratio tests were used to identify factors that were significantly associated with a Schistosoma spp. infection.ResultsThe overall prevalence of schistosomiasis among school-aged children in Korhogo was 1.9% (45/2341) composed of 0.3% (3/1248) S. haematobium and 3.5% (42/1202) S. mansoni. Due to the low prevalence of S. haematobium infection, risk factor analysis was limited to S. mansoni. Boys were 7.8 times more likely to be infected with S. mansoni than girls. Children between 10 and 15 years of age were 3.8 times more likely to be infected than their younger counterparts aged 5-10 years. Moreover, living in a house further away from a water access point (odds ratio [OR] = 0.29, 95% confidence interval [CI]: 0.13-0.70) and abstaining from swimming in open freshwater bodies (OR = 0.16, 95% CI: 0.04-0.56) were significantly associated with decreased odds of S. mansoni infection. The socioeconomic status did not appear to influence the prevalence of S. mansoni.ConclusionsA strategy to reduce the incidence of schistosomiasis should focus on health education to change the behaviour of populations at risk and encourage communities to improve sanitation and infrastructure in order to reduce contact with surface water.

Project description:BackgroundThe ATLAS programme aims to promote and implement HIV self-testing (HIVST) in three West African countries: Côte d'Ivoire, Mali, and Senegal. During 2019-2021, in close collaboration with the national AIDS implementing partners and communities, ATLAS plans to distribute 500,000 HIVST kits through eight delivery channels, combining facility-based, community-based strategies, primary and secondary distribution of HIVST. Considering the characteristics of West African HIV epidemics, the targets of the ATLAS programme are hard-to-reach populations: key populations (female sex workers, men who have sex with men, and drug users), their clients or sexual partners, partners of people living with HIV and patients diagnosed with sexually transmitted infections and their partners. The ATLAS programme includes research support implementation to generate evidence for HIVST scale-up in West Africa. The main objective is to describe, analyse and understand the social, health, epidemiological effects and cost-effectiveness of HIVST introduction in Côte d'Ivoire, Mali and Senegal to improve the overall HIV testing strategy (accessibility, efficacy, ethics).MethodsATLAS research is organised into five multidisciplinary workpackages (WPs): Key Populations WP: qualitative surveys (individual in-depth interviews, focus group discussions) conducted with key actors, key populations, and HIVST users. Index testing WP: ethnographic observation of three HIV care services introducing HIVST for partner testing. Coupons survey WP: an anonymous telephone survey of HIVST users. Cost study WP: incremental economic cost analysis of each delivery model using a top-down costing with programmatic data, complemented by a bottom-up costing of a representative sample of HIVST distribution sites, and a time-motion study for health professionals providing HIVST. Modelling WP: Adaptation, parameterisation and calibration of a dynamic compartmental model that considers the varied populations targeted by the ATLAS programme and the different testing modalities and strategies.DiscussionATLAS is the first comprehensive study on HIV self-testing in West Africa. The ATLAS programme focuses particularly on the secondary distribution of HIVST. This protocol was approved by three national ethic committees and the WHO's Ethical Research Committee.

Project description:IntroductionHIV self-testing (HIVST) is a promising strategy to improve diagnosis coverage among key populations (KP). The ATLAS (Auto Test VIH, Libre d'Accéder à la connaissance de son Statut) programme implemented HIVST in three West African countries, distributing over 380,000 kits up between 2019 and 2021, focussing on community-led distribution by KP to their peers and subsequent secondary distribution to their partners and clients. We aim to evaluate the cost-effectiveness of community-led HIVST in Côte d'Ivoire, Mali and Senegal.MethodsAn HIV transmission dynamics model was adapted and calibrated to country-specific epidemiological data and used to predict the impact of HIVST. We considered the distribution of HIVST among two KP-female sex workers (FSW), and men who have sex with men (MSM)-and their sexual partners and clients. We compared the cost-effectiveness of two scenarios against a counterfactual without HIVST over a 20-year horizon (2019-2039). The ATLAS-only scenario mimicked the 2-year implemented ATLAS programme, whereas the ATLAS-scale-up scenario achieved 95% coverage of HIVST distribution among FSW and MSM by 2025 onwards. The primary outcome is the number of disability-adjusted life-years (DALY) averted. Scenarios were compared using incremental cost-effectiveness ratios (ICERs). Costing was performed using a healthcare provider's perspective. Costs were discounted at 4%, converted to $USD 2022 and estimated using a cost-function to accommodate economies of scale.ResultsThe ATLAS-only scenario was highly cost-effective over 20 years, even at low willingness-to-pay thresholds. The median ICERs were $126 ($88-$210) per DALY averted in Côte d'Ivoire, $92 ($88-$210) in Mali and 27$ ($88-$210) in Senegal. Scaling-up the ATLAS programme would also be cost-effective, and substantial epidemiological impacts would be achieved. The ICERs for the scale-up scenario were $199 ($122-$338) per DALY averted in Côte d'Ivoire, $224 ($118-$415) in Mali and $61 ($18-$128) in Senegal.ConclusionsBoth the implemented and the potential scale-up of community-led HIVST programmes in West Africa, where KP are important to overall transmission dynamics, have the potential to be highly cost-effective, as compared to a scenario without HIVST. These findings support the scale-up of community-led HIVST to reach populations that otherwise may not access conventional testing services.

Project description:BackgroundPopulations of vultures in Africa have experienced a rapid decline over recent decades, with some species suffering losses of more than 90%. Various forms of human pressures have been identified as the causes of this decline. However, very little is known about the complex interaction between cultural practises, traditional medicine and the vultures' natural environment. The purpose of this study was to analyse human pressures on vultures in relation with cultural attitudes such as their demand for magico-traditional medicine in Côte d'Ivoire, around the Comoé National Park (CNP), one of the last major refuges of these organisms in West Africa.MethodsEleven surrounding villages were visited to carry out ethno-ornithology surveys. One hundred and ten people were interviewed, at a rate of ten people per village, using a semi-structured questionnaire and informal discussions.ResultsThe findings showed that vultures are still being seen both in and around the CNP. The most common species indicated to be observed and indicated by the interviewees were the Hooded Vulture (Necrosyrtes monachus) and the White-headed Vulture (Trigonoceps occipitalis). Nevertheless, 98.2% of the interviewees indicated having observed a decrease in the abundance of vultures over the last few years in the study area, as well as a decline in the number of sightings of these organisms. Interviewees attributed this scarcity of vultures to (1) the limited availability of food resources, (2) pesticide and tobacco poisoning, (3) hunting, (4) rapid population growth, (5) annual bushfires and (6) habitat loss. The uses of the vulture or parts of vultures by the populations surrounding the CNP (traditional medicine, mystic practises, consumption as food, cultural heritage) were also highlighted as real threats to these organisms. And the vulture parts commonly used in this area are: feathers, legs, head, heart, stomach, brain and excrement. The Hooded Vulture (Necrosyrtes monachus) appears to be the most sought-after species and the most widely used for these practises in the study area.ConclusionAppropriate conservation and communication initiatives are required to ensure the survival of these raptors, crucial for ecosystem well-being, while also ensuring a respect of cultural practises.

Dataset Information

Neoliberal policy, rural livelihoods, and urban food security in West Africa: a comparative study of The Gambia, Cote d'Ivoire, and Mali.

Publications

Neoliberal policy, rural livelihoods, and urban food security in West Africa: a comparative study of The Gambia, Cote d'Ivoire, and Mali.

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