Background. One way to achieve universal health coverage (UHC) in low- and middle-income countries (LMIC) is the implementation of health insurance schemes. A robust and up to date overview of... Show moreBackground. One way to achieve universal health coverage (UHC) in low- and middle-income countries (LMIC) is the implementation of health insurance schemes. A robust and up to date overview of empirical evidence assessing and substantiating health equity impact of health insurance schemes among specific vulnerable populations in LMICs beyond the more common parameters, such as income level, is lacking. We fill this gap by conducting a systematic review of how social inclusion affects access to equitable health financing arrangements in LMIC. Methods. We searched 11 databases to identify peer-reviewed studies published in English between January 1995 and January 2018 that addressed the enrolment and impact of health insurance in LMIC for the following vulnerable groups: female-headed households, children with special needs, older adults, youth, ethnic minorities, migrants, and those with a disability or chronic illness. We assessed health insurance enrolment patterns of these population groups and its impact on health care utilization, financial protection, health outcomes and quality of care. Results.The comprehensive database search resulted in 44 studies, in which chronically ill were mostly reported (67%), followed by older adults (33%). Scarce and inconsistent evidence is available for individuals with disabilities, female-headed households, ethnic minorities and displaced populations, and no studies were yielded reporting on youth or children with special needs. Enrolment rates seemed higher among chronically ill and mixed or insufficient results are observed for the other groups. Most studies reporting on health care utilization found an increase in health care utilization for insured individuals with a disability or chronic illness and older adults. In general, health insurance schemes seemed to prevent catastrophic health expenditures to a certain extent. However, reimbursements rates were very low and vulnerable individuals had increased out of pocket payments. Conclusion. Despite a sizeable literature published on health insurance, there is a dearth of good quality evidence, especially on equity and the inclusion of specific vulnerable groups in LMIC. Evidence should be strengthened within health care reform to achieve UHC, by redefining and assessing vulnerability as a multidimensional process and the investigation of mechanisms that are more context specific. Show less
.Responses to the article: "Struggling to be a “happy self”?: psychotherapy and the medicalization of unhappiness in Uganda" written byJulia Vorhölter.
This paper presents the results of a short-term research project conducted in 2017/2018 on the various ways in which migration and land dynamics in West Africa are intertwined. Contrary to much... Show moreThis paper presents the results of a short-term research project conducted in 2017/2018 on the various ways in which migration and land dynamics in West Africa are intertwined. Contrary to much conventional (policy) thinking in the European Union (EU) today, our point of departure is not that migration is the problem to be solved – nor that (access to) land is the straightforward means to discouraging migration. Drawing on local case studies in four West African countries, this research aims to shed light on the various relationships between migration and land, and to analyze to what extent they may contribute to or obstruct (local) inclusive and sustainable development in Mali, Senegal, Burkina Faso, and Benin. In doing so, we aim to offer food for thought concerning possible ways for making the connection between migration and land more fruitful and productive for as many people as possible, especially in relation to the opportunities and constraints facing different categories of West African youth. Show less
Intensified and competing claims over land are crucial to understanding current urban transformations in Africa. This paper aims to highlight the role of transnational migrants in urban land... Show moreIntensified and competing claims over land are crucial to understanding current urban transformations in Africa. This paper aims to highlight the role of transnational migrants in urban land investments and claim making on urban land. While the relationship between urbanization in Africa and migration has long been a focus of research and policy, attention had mainly focused on the intertwinement between rising urbanization and the in flux of rural migrants, internally displaced people (IDPs) and refugees struggling to survive and gain access to urban space and services. More recently, the African city has gained a more positive image as a consequence of Africa's economic boom and has come to be seen as a pillar of development, rather than a place of chaos and poverty. In this 'urban turn' in development thinking and concomitant technocratic and infrastructural policy approaches, the link between urbanization and migration has been largely overlooked. We argue, however, that transnational migrants in particular are an important category in claim-making processes over urban land and real estate and add to these in specific ways. Using case studies in Khartoum and Dakar, we investigate the ways in which transnational migrants contribute to speculation, rising land values and processes of socio-spatial inclusion and exclusion. Rather than making a comparative analysis, we use two concrete cases to gain an empirical understanding of the processes associated with these diaspora investments, including the question of whether these transnational migrants can be considered as contributing to urban 'land grabs' or not. Show less
[Abstract in English]. This article investigates the possibility of long-term causation in the political history of the Central African Republic. It does so by looking at the biography of... Show more[Abstract in English]. This article investigates the possibility of long-term causation in the political history of the Central African Republic. It does so by looking at the biography of Barthélémy Boganda (1910-1959). It argues that the upheavals of European colonisation at the beginning of the twentieth century – as experienced by Boganda as a child – exercised an enduring influence on his persona and remained relevant for his life and work throughout the later part of the colonial era. Second, the article investigates the persistent relevance of cultural repertoires as ingrained in the religious cosmologies in the region in pre-colonial times for the nature of Boganda’s political leadership. It argues that his charisma was articulated through the behavioural repertoires of the trickster archetype, as described in the pedagogical warnings of pre-colonial regional cosmologies. This betrays the continued relevance of pre-colonial notions of political legitimacy as marked by folly, which is an essential element in the trickster figure. While warning against essentialist interpretations of Central African culture, the article concludes that research into political anthropology could reveal how styles of political deportment among Central African leaders (from politicians to warlords) are possibly fed by older (unhelpfully called ‘pre-colonial’) notions of cunning and brutality, which undergird deeper representations of violence and power.[Abstract in French]. Cet article examine la possibilité de causalités de longue durée dans l’histoire politique de la République centrafricaine. Il s’y attèle à travers une étude biographique de Barthélémy Boganda (1910-1959). Il soutient que les bouleversements induits par la colonisation européenne au début du XXe siècle – tels que vécus par Boganda enfant – ont exercé une influence durable sur sa personnalité et ont continué à avoir un impact sur sa vie et son travail tout au long des dernières années de l’époque coloniale. L’article examine également le fait que les répertoires culturels enracinés dans les cosmologies religieuses de la région depuis l’époque précoloniale sont restés pertinents pour la nature du leadership politique de Boganda. Il soutient que son charisme s’exprimait à travers des répertoires de comportement liés à l’archétype du décepteur ou fripon, tels que décrits dans les admonitions pédagogiques des cosmologies régionales précoloniales. De ce fait, on constate que les notions précoloniales de légitimité politique marquées par la folie, qui sont un élément central de la figure du décepteur, sont restées d’actualité. Tout en mettant en garde contre toute interprétation essentialiste des cultures centrafricaines, l’article conclut que les recherches sur l’anthropologie politique peuvent mettre au jour la manières dont les modes de conduite politique observables chez les leaders centrafricains (des politiciens aux chefs de guerre) pourraient être nourris par des notions anciennes (qualifiées de façon peu idoine de « précoloniales ») de ruse et de brutalité, qui sous-tendent des représentations plus profondes de violence et de pouvoir. Show less
Nature conservation in southern Africa has always been characterised by an interplay between Capital, specific understandings of Morality, and forms of Militarism, that are all dependent upon the... Show moreNature conservation in southern Africa has always been characterised by an interplay between Capital, specific understandings of Morality, and forms of Militarism, that are all dependent upon the shared subservience and marginalization of animals and certain groups of people in society. Although the subjectivity of people has been rendered visible in earlier publications on histories of conservation in southern Africa, the subjectivity of animals is hardly ever seriously considered or explicitly dealt with. In this edited volume the subjectivity and sentience of animals is explicitly included. The contributors argue that the shared human and animal marginalisation and agency in nature conservation in southern Africa (and beyond) could and should be further explored under the label of `sentient conservation'. Contributors are Malcolm Draper, Vupenyu Dzingirai, Jan-Bart Gewald, Michael Glover, Paul Hebinck, Tarito Kamuti, Lindiwe Mangwanya, Albert Manhamo, Dhoya Snijders, Marja Spierenburg, Sandra Swart, Harry Wels. Show less
This volume in honour of Stephen Ellis is a follow-up to the public presentation of his book on the history of organised crime in Nigeria This Present Darkness (Hurst, 2016) at the University of... Show moreThis volume in honour of Stephen Ellis is a follow-up to the public presentation of his book on the history of organised crime in Nigeria This Present Darkness (Hurst, 2016) at the University of Lagos, Nigeria on 28 October 2016. In addition to four papers, and a book review presented at this colloquium, other contributions about crime in Nigeria have been added, written by Nigerian authors. In July 2015 Stephen died, and he has worked on This Present Darkness almost to his last moments, as a senior researcher of the African Studies Centre in Leiden. This book also contains a tribute to his life and work written by his wife and scholar Gerrie ter Haar. Show less
This article provides a review of the latest status and policy framework for wind energy in Africa. In addition, it takes a close look at Kenya, which is one of the most successful African... Show moreThis article provides a review of the latest status and policy framework for wind energy in Africa. In addition, it takes a close look at Kenya, which is one of the most successful African countries in terms of attracting renewable energy (RE) investments, including the largest wind farm on the continent. Globally, wind energy development needs strong government policy. Following numerous bilateral and multilateral efforts, by 2016, the majority of African countries had defined RE supporting policies, with nearly half also having defined their wind energy targets. However, the review of such policies on the continent as a whole, as well as a closer examination of the situation in Kenya, indicate that established supportive policies and fiscal incentives remain important for the development of wind energy on the African continent but are not the decisive factors. It also suggests that international private participation in energy generation and renewable/wind energy expansion in Africa is critical and expected to increase. Consequently, it may be challenging to ensure that African countries capitalise on their inherent advantage in terms of clean energy during their energy transition processes. Show less
Enrolment in both primary and secondary schools has risen substantially over the years, but secondary and tertiary enrolment remains low. The primary student population increased from just under 4... Show moreEnrolment in both primary and secondary schools has risen substantially over the years, but secondary and tertiary enrolment remains low. The primary student population increased from just under 4 million students in 1970 to more than 26 million students in 2013.Similarly, at the secondary level, student numbers increased from a base of approximately 360,000 students in 1970 to 12.5 million students in 2013. Likewise, the tertiary sector recorded an appreciable increase in the numbers of institutions, variety of courses and enrolled students in the same period. Despite these increases, only about half of all primary students continue to the secondary level, and less than 15 percent eventually make it to tertiary level. The seeming lack of employment opportunities and other problems identified in the tertiary sector has contributed to a substantial increase in the number of Nigerian students undertaking tertiary education abroad, with the United Kingdom and the United States emerging as the top two destinations.Unemployment is high, particularly among youth and higher educated students. Despite Nigeria’s natural resource wealth, many Nigerians appear to have been left behind, primarily because of the shortage of employment opportunities. Unemployment is highest among youth and among those with post-secondary education. Agriculture still has the largest share of employment. Trade emerged as the second most important employment sector providing jobs for Nigerians. Though manufacturing ranks third on the list, the proportion employed in this sector has shrunk to half of what it used to be in the preceding decade. One interesting sector is Information and Communication: while providing less than 1% of all jobs, it contributes more to Nigeria’s GDP than manufacturing, due to its high value added.Nigeria is an important area of origin, destination, and transit of migrants in Africa. It is Africa’s most populous country, and a country of high migration turnover. The high immigration rate (1.2 million in 2017) is accompanied by an even higher rate of emigration of Nigerians (1.3 million in 2017), resulting in a negative net migration rate. The Nigerian Government formally adopted a National Policy on Migration and its Implementation Plan in May 2015. This occurred in the backdrop of a growing recognition of the strong links between migration and potentially immense national development benefits for the country. For instance, Central Bank of Nigeria (CBN) stated that the inflow of remittances to Nigeria increased dramatically from $2.3 billion in 2004 to $22 billion in 2018; The US, followed by the UK and Cameroon are the top three destinations of Nigerian migrants. In mainland Western Europe, the Netherlands ranks as the fifth destination behind Germany, Italy, Spain and Austria. Noteworthy is the large ‘brain drain’ of Nigeria-trained medical students and health workers as well as academics who appear to be fleeing Nigeria’s struggling tertiary education landscape and unstable labour market prospects. Thousands of them are now gainfully employed in medical jobs abroad, and they tend to prefer the US and the UK to the Netherlands. Show less
