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This title explores the issues on intra-household income management and economic benefits of livestock markets to women, focusing on how types of markets, the types of products and women's participation in markets influence their access to livestock income. The book further analyses the role of livestock ownership, especially women's ownership of livestock, in influencing household food security though increasing household dietary diversity and food adequacy.

This paper uses firm-level data worldwide to investigate productivity gaps between female and male-managed companies in developing and developed countries and compare the outcomes obtained for different regions in the world. The main aim is to shed some light on the debate around the existence of performance differences when females participate in managerial activities. The main results indicate that it is crucial to distinguish between female management and female ownership and the confluence between both. We find that when the firms have a top female manager and ownership is exclusively male, firms show higher average labor productivity. We argue that firms owned by males belong to male-dominated corporate culture and would only select a female manager if she is more competent than potential male candidates. These results are very heterogeneous among regions, of which South Saharan Africa, East Asia, and South Asia are driving the main results.

A joint effort led by the African Development Bank and the World Bank, 'Leveraging Migration for Africa' is the first comprehensive publication on harnessing migration, remittances, and other diaspora resources for the development of Africa. It comes at a time when countries in Africa and elsewhere are grappling with difficult choices on how to manage migration.Policy makers can help leverage the contributions of migrants to the development of Africa, reduceremittance costs, improve the efficiency of remittance markets in both origin and destination countries, and address the needs of the origin countries without restricting the emigration of high-skilled professionals. Innovative financing mechanisms such as issuance of diaspora bonds and securitization of future remittance flows can help finance big-ticket projects, such as railways, roads, power plants, and institutions of higher learning that will, step by step, help to transform Africa. This volume contributes to a greater understanding of migration and its potential role in Africa?s development.

Sub-Saharan Africa (SSA) has one of the highest levels of perinatal mortality globally. However, there are sub-regional and country-specific disparities in its distribution. The aim of this study was to undertake a meta-analysis of demographic and health surveys to quantify perinatal mortality rate within sub-Saharan Africa and to depict sub-regional and country-specific differences. This study used cross-sectional data from the most recent demographic and health surveys (2010-2016) conducted in 21 sub-Saharan African countries. The countries were grouped into four sub-regions (Eastern Africa, Western Africa, Southern Africa and Central Africa), and a meta-analysis was conducted to estimate perinatal mortality rate within each of the sub-regions. Significant heterogeneity was detected among the various surveys (I2 > 50%), hence a random effect model was used. Sensitivity analysis was also performed to examine the effects of outliers. Perinatal mortality was defined as pregnancy losses occurring after seven completed months of gestation (stillbirths) and deaths to live births within the first seven days of life (early neonatal deaths). The pooled estimate for perinatal mortality rate per 1000 births across 21 countries in the four sub-regions of SSA was 34.7 (95% CI: 32.6, 36.8). Eastern Africa reported 34.5 (95% CI: 32.2, 36.8), with the highest rate observed in Tanzania [39.5 (95% CI: 35.8, 43.4)]. Western Africa reported 35.7 (95% CI: 32.2, 39.3), with the highest rate observed in Nigeria [40.9 (95% CI: 38.3, 43.2)]. Southern Africa reported 30.3 (95% CI: 26.5, 34.0), with the highest rate observed in Lesotho [49.6 (95% CI: 42.3, 57.8)]. Central Africa reported 30.7 (95% CI: 28.0, 33.3), with the highest rate observed in Equatorial Guinea [37.3 (95% CI: 30.5, 45.1)]. To reduce mortality in the perinatal period, interventions should focus on improving access to high quality antenatal and postnatal care, as well as strengthening health care systems within countries in sub-Saharan Africa.

Using the World Bank Enterprise Survey data, we analyze performance gaps between male-and female-owned companies in three regions—Eastern Europe and Central Asia (ECA), Latin America (LA), and Sub-Saharan Africa (SSA). Among our findings are significant gender gaps between male-and femaleowned companies in terms of firm size, but much smaller gaps in terms of firm efficiency and growth (except in LA). Part of the reason women run smaller firms is that they tend to concentrate in sectors in which firms are smaller and less efficient (in ECA and SSA). By contrast, we find no evidence of gender discrimination in access to formal finance in any of the three regions, although in ECA women are less likely than men to seek formal finance. Finally, while female entrepreneurs receive smaller loans than their male counterparts, the returns from each dollar they receive is no lower in terms of overall sales revenue.

► 1 in 10 women worldwide carries an HPV infection at any point in time. ► 610,000 incident cancers per annum are attributable to HPV infection globally. ► 80.6% of HPV associated cancers occur in less developed regions of the world. ► Cervix is the predominant HPV-associated cancer with 530,000 incident cases p.a. ► Genital warts are caused by HPV with an annual incidence of 0.1 to 0.2%. The worldwide prevalence of infection with human papillomavirus (HPV) in women without cervical abnormalities is 11–12% with higher rates in sub-Saharan Africa (24%), Eastern Europe (21%) and Latin America (16%). The two most prevalent types are HPV16 (3.2%) and HPV18 (1.4%). Prevalence increases in women with cervical pathology in proportion to the severity of the lesion reaching around 90% in women with grade 3 cervical intraepithelial neoplasia and invasive cancer. HPV infection has been identified as a definite human carcinogen for six types of cancer: cervix, penis, vulva, vagina, anus and oropharynx (including the base of the tongue and tonsils). Estimates of the incidence of these cancers for 2008 due to HPV infection have been calculated globally. Of the estimated 12.7 million cancers occurring in 2008, 610,000 (Population Attributable Fraction [PAF]=4.8%) could be attributed to HPV infection. The PAF varies substantially by geographic region and level of development, increasing to 6.9% in less developed regions of the world, 14.2% in sub-Saharan Africa and 15.5% in India, compared with 2.1% in more developed regions, 1.6% in Northern America and 1.2% in Australia/New Zealand. Cervical cancer, for which the PAF is estimated to be 100%, accounted for 530,000 (86.9%) of the HPV attributable cases with the other five cancer types accounting for the residual 80,000 cancers. Cervical cancer is the third most common female malignancy and shows a strong association with level of development, rates being at least four-fold higher in countries defined within the low ranking of the Human Development Index (HDI) compared with those in the very high category. Similar disparities are evident for 5-year survival—less than 20% in low HDI countries and more than 65% in very high countries. There are five-fold or greater differences in incidence between world regions. In those countries for which reliable temporal data are available, incidence rates appear to be consistently declining by approximately 2% per annum. There is, however, a lack of information from low HDI countries where screening is less likely to have been successfully implemented. Estimates of the projected incidence of cervical cancer in 2030, based solely on demographic factors, indicate a 2% increase in the global burden of cervical cancer, i.e., in balance with the current rate of decline. Due to the relative small numbers involved, it is difficult to discern temporal trends for the other cancers associated with HPV infection. Genital warts represent a sexually transmitted benign condition caused by HPV infection, especially HPV6 and HPV11. Reliable surveillance figures are difficult to obtain but data from developed countries indicate an annual incidence of 0.1 to 0.2% with a peak occurring at teenage and young adult ages. This article forms part of a special supplement entitled “Comprehensive Control of HPV Infections and Related Diseases” Vaccine Volume 30, Supplement 5, 2012.

Background Intimate partner violence (IPV) is a widespread yet often unrecognized problem that affects millions of women worldwide. It is prevalent among marginalized individuals, such as women living with HIV. However, there is a dearth of available evidence concerning this matter among women living with HIV in East Africa. Objective We systematically reviewed and analyzed the existing evidence on the prevalence of IPV and its associated factors among women living with HIV in East Africa. Methods We included all primary cross-sectional studies published before 20th June/2024. PubMed, HINARI, Web of Science, African Journal Online, ScienceDirect, and Google Scholar were searched. To appraise the included studies, the Joanna Briggs Institute checklist was used. We used the I 2 test to determine the heterogeneity of the included studies. Publication bias was assessed using funnel plot and Egger’s test. Lastly, the IPV among women living with HIV and its associated factors were presented using pooled proportion and odds ratio with a 95% confidence interval. Results Eighteen cross-sectional studies involving 11,168 individuals were included. The pooled prevalence of intimate partner violence among women living with HIV in East Africa was 54.6% (95% CI, 44.1-65.1%). The odds of IPV among women living with HIV in East Africa were high for those with low monthly income (OR: 2.96, 95% CI: 1.32–6.68), alcohol-drinking partners (OR: 2.24, 95% CI: 1.54–3.28), multiple sexual partners (OR: 2.29, 95% CI: 1.52–3.43), experiences of controlling behavior by an intimate partner (OR: 4.65, 95% CI: 2.79–7.73), and favorable attitudes towards wife-beating (OR: 2.56, 95% CI: 1.87–3.51). Conclusion In East Africa, the prevalence of IPV among women living with HIV was found to be high. As a result, it is crucial to implement focused and targeted interventions that promote behavioral change. Also, the findings emphasize the necessity of establishing and organizing support networks to address IPV among women living with HIV. Trial registration Registered in PROSPERO with ID: CRD42024565464.

Introduction Iodine deficiency disorders (IDDs) are a significant global public health issue that affects the physical and mental development of every age group, with children and nursing mothers being the most vulnerable. Approximately 50 million of approximately 2 billion people with iodine deficiency (ID) globally exhibit clinical symptoms. Identifying iodine levels using various techniques is important when considering treatment choices. Screening programs and early ID diagnostics are crucial for the follow-up of pregnant women, especially in iodine-deficient nations. There have been calls for universal salt iodization programs, but only approximately 71% of people have access to them. The problem is more common in developing nations; however, there is a shortage of literature on the individual-, family-, and community-level factors influencing iodized salt use in East Africa. This study aimed to investigate individual- and community-level factors of household iodized salt usage in East Africa. Methods Using Stata 17, this study used the most recent demographic and health survey datasets from twelve East African countries. The survey included a weighted sample of 154,980 households. To assess factors related to iodized salt use in the region, bivariable and multivariable multilevel logistic regressions were used. P values less than or equal to 0.2, and < 0.05 were used in the binary regression, and to deem variables statistically significant in the final model respectively. Results About 87.73% (95% CI = 87.56,87.89) households have utilized iodized household salt. Secondary and above education (AOR = 1.23, 95% CI = 1.17–1.30), household heads with ages of 25–35 years, 36–45 years (AOR = 1.20, 95% CI = 1.12,1.28), 36–45 years (AOR = 1.16, 95% CI = 1.09,1.24), and more than 45 years (AOR = 1.18, 95% CI = 1.11,1.25), lower and middle wealth (AOR = 0.89, 95% CI = 0.76,0.89) and (AOR = 0.97, 95% CI = 0.81,0.93), media exposure (AOR = 1.10, 95% CI = 1.07–1.14), female household leaders (AOR = 1.08, 95% CI = 1.04–1.12), access to improved drinking water and better toilet facility (AOR = 2.26, 95% CI = 2.18–2.35) and (AOR = 1.50, 95% CI = 1.44,1.56), larger than five family members (AOR = 0.96, 95% CI = 0.93–0.99), high community level wealth (AOR = 1.54, 95% CI = 1.27–1.87), and low community education(AOR = 0.40, 95% CI = 0.33,0.49) were statistically associated with utilization of iodized household salt in East Africa respectively. Conclusion In East Africa, household salt iodization is moderately good. To expand the use of iodized salt in the region, access to improved drinking water and toilet facilities, participating family leaders, using the opportunity of family planning services, media sources, and the improvement of the community’s socioeconomic level are all needed.

Pregnancy termination remains a complex and sensitive issue with approximately 45% of abortions worldwide being unsafe, and 97% of abortions occurring in developing countries. Unsafe pregnancy terminations have implications for women’s reproductive health. This research aims to compare black box models in their prediction of pregnancy termination among reproductive-aged women and identify factors associated with pregnancy termination using explainable artificial intelligence (XAI) methods. We used comprehensive secondary data on reproductive-aged women’s demographic and socioeconomic data from the Demographic Health Survey (DHS) from six countries in East Africa in the analysis. This study implemented five black box ML models, Bagging classifier, Random Forest, Extreme Gradient Boosting (XGB) Classifier, CatBoost Classifier, and Extra Trees Classifier on a dataset with 338,904 instances and 18 features. Additionally, SHAP, Eli5, and LIME XAI techniques were used to determine features associated with pregnancy termination and Statistical analysis were employed to understand the distribution of pregnancy termination. The results demonstrated that machine learning algorithms were able to predict pregnancy termination on DHS data with an overall accuracy ranging from 79.4 to 85.6%. The ML classifier random forest achieved the highest result, with an accuracy of 85.6%. Based on the results of the XAI tool, the most contributing factors for pregnancy termination are wealth index, current working experience, and source of drinking water, sex of household, education level, and marital status. The outcomes of this study using random forest is expected to significantly contribute to the field of reproductive healthcare in East Africa and can assist healthcare providers in identifying individuals’ countries at greater risk of pregnancy termination, allowing for targeted interventions and support.

Introduction Cervical cancer is the most common malignant tumor among women. It is the main cause of death among women in sub-Saharan African countries. Particularly, the incidence and mortality rates are highest in East Africa. Even though the burden of human papilloma virus-related cervical cancer is high in East Africa, there is no conclusive evidence about the prevalence of human papilloma virus vaccine uptake and its predictors. Objective To assess the pooled prevalence of human papilloma virus vaccine uptake and its determinants in East Africa. Method Eligible articles were searched on PubMed, Embase, Scopus, Cochrane Library, Google Scholar, and Google. Those articles incorporating the outcome of interest, both analytical and descriptive study designs, and published or unpublished articles at any time were included. Keywords and Medical Subjects Heading terms or synonyms of human papilloma virus vaccine and Boolean operators were used to retrieve the articles. To assure the quality of articles, Joana Brigg’s Institute critical appraisal checklist for cross-sectional studies was used. Sensitivity analysis was conducted to assess the heterogeneity among the studies, and a random effect model was used to analyze the pooled effect size. Result A total of 29 articles were included, and the pooled prevalence of HPV vaccine uptake in East Africa was 35% (95% CI: 26–45%). Good knowledge (OR = 1.6, 95%CI; 1.43–1.8), positive attitude (OR = 2.54, 95% CI; 2.13–3.03), ever heard about HPV vaccine (OR = 1.41, 95% CI; 1.03–1.94), mother educational status above college (OR = 1.84, 95%CI; 1.03–3.31), middle wealth index (OR = 1.33, 95%CI; 1.04–1.7), ≥ 9 family size (OR = 0.76, 95%CI; 0.68–0.98), availability of promotion (OR = 2.53, 95%CI: 1.51–4.26), availability of adequate vaccine (OR = 4.84, 95%CI; 2.9–8.08), outreach vaccination practice (OR = 1.47, 95%CI; 1.02–2.12) and family support (OR = 4.3, 95% CI; 2.98–6.21) were the significant factors for the uptake of human papilloma virus vaccine. Conclusion As compared to the global strategic plan, the pooled prevalence of HPV vaccine uptake in east Africa was low. The uptake of the HPV vaccine was higher among adolescents than youths. Knowledge about the HPV vaccine, attitude towards the HPV vaccine, ever hearing about the HPV vaccine, residence, mother’s educational status, mother’s occupational status, wealth index, and family size were the significant determinants of HPV vaccine uptake. Therefore, we recommend focusing on awareness creation and behavioral change to expand the uptake of vaccines in East Africa.