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Orientation The article examines the impact of mobile money adoption and regional financial integration in sub-Saharan Africa. Research purpose The study sought to uncover the relationship between mobile money adoption and cross-border remittances as a de facto measure of regional integration. Motivation for the study The extent to which differences in mobile money penetration rates across sub-Saharan Africa influence cross-border remittances remains a grey area that necessitates empirical investigation. Research approach, design and method A quantitative research method was adopted and the study examined aggregated quarterly data obtained from 41 countries making up the four regions of sub-Saharan Africa. The study applied the dynamic ordinary least squares and fully modified ordinary least squares approaches as the estimation techniques. Main findings Mobile money adoption has positively impacted cross-border remittances and improved de facto regional financial links in sub-Saharan Africa. The study's findings also support the view that better governance through control of corruption and political stability removes dependence on remittances. Practical/managerial implications There is a need to integrate mobile money and other cross-border remittance platforms to improve access to financial services for migrants and harness their savings into the mainstream economy. Contributions/value-add The study adds to the body of knowledge by showing that higher mobile money penetration rates have regional integration benefits.

This study explores the financial liberalization and economic growth debate from a Zimbabwean context. It employs two measures of financial liberalisation, foreign assets and liabilities, and a dummy variable based on liberalisation or repression policies implemented from 1980 to 2023 alongside other macroeconomic variables. The study uses two OLS models alongside the Toda-Yamamoto approach to assess Granger causality between the variables. The findings show that financial liberalisation, as measured by the flow of foreign assets and liabilities, negatively impacts economic growth and that there is Granger causality from the flow of foreign assets and liabilities to GDP. The financial liberalisation dummy had a positive and statistically significant impact on economic growth, while the Toda-Yamamoto tests showed no relationship. The study highlights the need to carefully consider liberalisation policies’ nature, timing, and causality effects when formulating and implementing financial liberalisation policy.

This study examined the fintech systems used by savings and credit cooperative institutions in South Africa. The study objectives included assessing fintech systems used by savings and credit cooperative institutions, services dependent on these technologies, and the benefits and implications of adopting these fintech systems. The research design utilised a qualitative paradigm, with sampling delimited by the combined application of convenience and purposive methods. This process yielded a sample of twelve participants from six distinct South African organisations, from whom primary data was acquired via semi-structured, mixed-mode interviews (online and in-person). The findings revealed significant variations in fintech adoption across the savings and credit cooperatives. While some institutions used advanced cloud-based platforms and customised digital solutions, others remained dependent on traditional, manual methods. The services dependent on technological systems included fund distribution, member onboarding, accounting procedures, contribution collection, loan provision, and administration. The main benefits of fintech adoption included improved efficiency, enhanced service delivery, and better financial management. The study recommended training to improve employees’ digital skills while at the same time designing fintech systems with intuitive interfaces, clear instructions, and multilingual support to accommodate diverse users.

Inadequate transportation infrastructure is a significant obstacle to any economy’s growth and development potential. A primary challenge to sustainable delivery is finance. Concerns about the efficacy of innovative mechanisms for financing infrastructure investments, primarily through public-private partnerships (PPPs), abound in the literature and practice. Few studies focus on the critical success factors (CSFs) for PPPs transport projects in emerging markets. This study aims to identify the taxonomy and manifestations of CSFs associated with executing PPP-based transportation projects in developing countries. The study collected and analysed data using a questionnaire and in-depth interviews using a mixed-methods sequential explanatory investigation among built environment professionals, including general contractors, consultants and government agencies. Findings indicated that good governance, the project’s technical feasibility, the commitment of the public and private partners, appropriate risk allocation and sharing and experience were the most critical success factors. Multivariate techniques using factor analysis identified four principal components: partnership and procurement, economic and governance technical factors and political and social factors. The study contributes to the body of knowledge using mixed methods within an underexplored context: developing countries. The findings could be extended further using more robust statistical techniques. The localisation conditions for the effective delivery of transportation projects should be considered.

The study aimed to evaluate tobacco use, attitudes, knowledge, and perceptions about tobacco control policies and smoking cessation counseling among dental students in Morocco. This cross-sectional study was conducted at the Dentistry Faculty of the Mohammed VI University of Health Sciences of Casablanca, using the Global Health Professions Student Survey (GHPSS) tool. Participants completed a self-administered survey questionnaire, including information on socio-demographic characteristics, tobacco use, exposure to secondhand smoke, attitudes, behavior and cessation, curriculum, and training. A total of 426 dental students were included in the study. Over 15% of the participants were current smokers, and 31.2% had tried smoking at least once. About 29.3% reported having been exposed to secondhand smoke in family settings and 49.5% in other environments. The majority of the students had felt that health professionals were role models for their patients. However, only 20% had felt they had received formal training in smoking cessation approaches. More than 70% of smokers had tried to quit smoking in the past year; however, only 41.7% reported having received help or advice. It is crucial that education and public health officials join efforts to plan and carry out programs aimed at training dental students in evidence-based cessation counseling methods, in order to change their own smoking behavior and assist their future patients. Improving dental school curriculums with regard to tobacco use prevention and cessation is also a powerful means of alleviating the national burden of cancer.

Background Binding and neutralising anti-Spike antibodies play a key role in immune defence against SARS-CoV-2 infection. Since it is known that antibodies wane with time and new immune-evasive variants are emerging, we aimed to assess the dynamics of anti-Spike antibodies in an African adult population with prior SARS-CoV-2 infection and to determine the effect of subsequent COVID-19 vaccination. Methods Using a prospective cohort design, we recruited adults with prior laboratory-confirmed mild/moderate COVID-19 in Blantyre, Malawi, and followed them up for 270 days ( n  = 52). A subset of whom subsequently received a single dose of the AstraZeneca COVID-19 vaccine (ChAdOx nCov-19) ( n  = 12). We measured the serum concentrations of anti-Spike and receptor-binding domain (RBD) IgG antibodies using a Luminex-based assay. Anti-RBD antibody cross-reactivity across SARS-CoV-2 variants of concern (VOC) was measured using a haemagglutination test. A pseudovirus neutralisation assay was used to measure neutralisation titres across VOCs. Ordinary or repeated measures one-way ANOVA was used to compare log10 transformed data, with p value adjusted for multiple comparison using Šídák's or Holm-Šídák's test. Results We show that neutralising antibodies wane within 6 months post mild/moderate SARS-CoV-2 infection (30–60 days vs. 210–270 days; Log ID 50 6.8 vs. 5.3, p  = 0.0093). High levels of binding anti-Spike or anti-RBD antibodies in convalescent serum were associated with potent neutralisation activity against the homologous infecting strain ( p  < 0.0001). A single dose of the AstraZeneca COVID-19 vaccine following mild/moderate SARS-CoV-2 infection induced a 2 to 3-fold increase in anti-Spike and -RBD IgG levels 30 days post-vaccination (both, p  < 0.0001). The anti-RBD IgG antibodies from these vaccinated individuals were broadly cross-reactive against multiple VOCs and had neutralisation potency against original D614G, beta, and delta variants. Conclusions These findings show that the AstraZeneca COVID-19 vaccine is an effective booster for waning cross-variant antibody immunity after initial priming with SARS-CoV-2 infection. The potency of hybrid immunity and its potential to maximise the benefits of COVID-19 vaccines needs to be taken into consideration when formulating vaccination policies in sub-Saharan Africa, where there is still limited access to vaccine doses.

Background Mineworkers in Southern Africa have the highest rates of tuberculosis (TB) among working populations in the world (The World Bank, Benefits and costs associated with reducing tuberculosis among Southern Africa’s mineworkers, 2014), making mineworkers a key population for TB program efforts. The current evaluation aimed to characterize mineworkers and former (ex-) mineworkers, and assess knowledge, attitudes and practices related to TB and HIV care among mineworkers and healthcare workers (HCWs) in Zambia. Methods A mixed-methods evaluation of current and former (ex-) mineworkers and HCWs was conducted in the Copperbelt and North-Western provinces, Zambia. Knowledge, attitudes and practices (KAPs) related to TB care and policies were assessed using a structured survey. Focus Group Discussions (FGDs) were conducted with current and ex-mineworkers to understand perceptions, practices, and barriers related to accessing healthcare for TB. Results Overall, 2,792 mineworkers and 94 HCWs completed the KAP survey, and 206 (171 current, 71 ex-) mineworkers participated in FGDs. Mineworkers and ex-mineworkers were knowledgeable about TB symptoms (cough; 94%), transmission (81.7%) and treatment (99.2%). Yet, barriers to seeking care were evident with 30% of mineworkers experiencing cough, and 19% reporting 2 or more TB symptoms at the time of the survey. The majority of mineworkers (70.9%) were aware of policies barring persons from working after a diagnosis of TB, and themes from FGDs and HCW comments ( n  = 32/62; 51.6%) recognized fear of job loss as a critical barrier to providing timely screening and appropriate care for TB among mineworkers. The majority (76.9%) of mineworkers indicated they would not disclose their TB status to their supervisor, but would be willing to share their diagnosis with their spouse (73.8%). Conclusion Fear of job loss, driven by governmental policy and mistrust in mining companies, is a major barrier to healthcare access for TB among mineworkers in Zambia. As a result of these findings, the government policy prohibiting persons from working in the mines following TB disease is being repealed. However, major reforms are urgently needed to mitigate TB among mineworkers, including ensuring the rights of mineworkers and their communities to healthy living and working environments, improved social responsibility of mining companies, and facilitating choice and access to affordable, timely, and high-quality healthcare services.

Background The protective effect of insecticide-treated bed nets against individual-level malaria transmission is well known, however community-level effects are less understood. Protective effects from community-level bed net use against malaria transmission have been observed in clinical trials, however, the relationship is less clear outside of a controlled research setting. The objective of this research was to investigate the effect of community-level bed net use against malaria transmission outside of a bed net clinical trial setting in Lilongwe, Malawi following national efforts to scale-up ownership of long-lasting, insecticide-treated bed nets. Methods An annual, cross-sectional, household-randomized, malaria transmission intensity survey was conducted in Lilongwe, Malawi (2011–2013). Health, demographic, and geographic-location data were collected. Participant blood samples were tested for Plasmodium falciparum presence. The percentage of people sleeping under a bed net within 400-m and 1-km radii of all participants was measured. Mixed effects logistic regression models were used to measure the relationship between malaria prevalence and surrounding bed net coverage. Each year, 800 people were enrolled (400 <5 years; 200 5–19 years; 200 ≥20 years; total n = 2400). Results From 2011 to 2013, malaria prevalence declined from 12.9 to 5.6%, while bed net use increased from 53.8 to 78.6%. For every 1% increase in community bed net coverage, malaria prevalence decreased among children under 5 years old [adjusted odds ratio: 0.98 (0.96, 1.00)]. Similar effects were observed in participants 5–19 years [unadjusted odds ratio: 0.98 (0.97, 1.00)]; the effect was attenuated after adjusting for individual-level bed net use. Community coverage was not associated with malaria prevalence among adults ≥20 years. Supplemental analyses identified more pronounced indirect protective effects from community-level bed net use against malaria transmission among children under 5 years who were sleeping under a bed net [adjusted odds ratio: 0.97 (0.94, 0.99)], compared to children who were not sleeping under a bed net [adjusted odds ratio: 0.99 (0.97, 1.01)]. Conclusions Malawi’s efforts to scale up ownership of long-lasting, insecticide-treated bed nets are effective in increasing reported use. Increased community-level bed net coverage appears to provide additional protection against malaria transmission beyond individual use in a real-world context.