At the beginning of the twentieth century, Christianity was predominantly a white Euro-American religion with 83 percent of all Christians living in the Global North. Today, it is a global religion... Show moreAt the beginning of the twentieth century, Christianity was predominantly a white Euro-American religion with 83 percent of all Christians living in the Global North. Today, it is a global religion where over two-thirds of the world’s Christians are non-Westerners, who live in the Global South. Christianity is on the rise in Latin America, Asia and especially Africa: a trend that is predicted to continue in the second half of the twenty-first century. I will explore explanations for the appeal of Christianity, and Pentecostalism in particular, for contemporary Africans. Pentecostalism is a form of Christianity that is predominantly popular in those African countries with the fastest population growth. Alongside Catholicism, it is the most rapidly growing religion on the African continent. Show less
In African neurological practice, muscle disorders are either underdiagnosed or underrepresented. This may in part be due to the large burden of other more common neurological disorders. In this... Show moreIn African neurological practice, muscle disorders are either underdiagnosed or underrepresented. This may in part be due to the large burden of other more common neurological disorders. In this report we describe the first Tanzanian patient with genetically confirmed Becker muscular dystrophy. His phenotype and genotype were compatible with elsewhere in the world. Remarkably, this patient reported his progressive weakness of the legs with difficulty in walking only after a fall. We demonstrate that muscular dystrophies occur in sub-Saharan Africa. Neurologists must however be aware that patients are likely to delay seeking medical care for muscle disorders. (C) 2019 Elsevier B.V. All rights reserved. Show less
Africa is a continent of considerable cultural diversity. This diversity does not necessarily run in parallel to the national boundaries that were created in Africa in the colonial period. However,... Show moreAfrica is a continent of considerable cultural diversity. This diversity does not necessarily run in parallel to the national boundaries that were created in Africa in the colonial period. However, decades of nation building in Africa must have made their mark. Is it possible nowadays to distinguish national cultures in Africa, or are the traditional ethnolinguistic distinctions more important? This article uses an approach developed in cross-cultural psychology to examine these questions. In 2012, Minkov and Hofstede published an article in this journal analyzing World Values Survey data from seven countries in Sub-Saharan Africa at the level of subnational administrative regions. They argued that national culture is also a meaningful concept in this region. This study reexamines the matter. It uses an innovative approach, looking at ethnolinguistic groups instead of at administrative regions and using the much more extensive Afrobarometer survey data set. It finds that although the Minkov/Hofstede study still has merit, the picture is more nuanced in several important ways. There is not one pattern that adequately describes the situation in the whole of Africa. Show less
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
