An Overview of the Performance of the East African Economies since 1985: Implications for the New Initiative on East African Co-operation

Kimemia, Peter

doi:10.4314/asr.v4i1.23177

Cited by 7 publications

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“…Finally, it has been suggested that a cost-effectiveness ratio less than double the annual income per capita might be an acceptable threshold value for most governments deciding which intervention to fund [ 22 ]. The findings from this study fall well below the average annual per capita income of US$120 for Tanzania [ 23 ]. “Thresholds,” however, are only a guide to decision-makers.…”

Section: Discussionmentioning

confidence: 56%

Cost-Effectiveness Study of Three Antimalarial Drug Combinations in Tanzania

et al. 2006

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BackgroundAs a result of rising levels of drug resistance to conventional monotherapy, the World Health Organization (WHO) and other international organisations have recommended that malaria endemic countries move to combination therapy, ideally with artemisinin-based combinations (ACTs). Cost is a major barrier to deployment. There is little evidence from field trials on the cost-effectiveness of these new combinations.Methods and FindingsAn economic evaluation of drug combinations was designed around a randomised effectiveness trial of combinations recommended by the WHO, used to treat Tanzanian children with non-severe slide-proven malaria. Drug combinations were: amodiaquine (AQ), AQ with sulfadoxine-pyrimethamine (AQ+SP), AQ with artesunate (AQ+AS), and artemether-lumefantrine (AL) in a six-dose regimen. Effectiveness was measured in terms of resource savings and cases of malaria averted (based on parasitological failure rates at days 14 and 28). All costs to providers and to patients and their families were estimated and uncertain variables were subjected to univariate sensitivity analysis. Incremental analysis comparing each combination to monotherapy (AQ) revealed that from a societal perspective AL was most cost-effective at day 14. At day 28 the difference between AL and AQ+AS was negligible; both resulted in a gross savings of approximately US$1.70 or a net saving of US$22.40 per case averted. Varying the accuracy of diagnosis and the subsistence wage rate used to value unpaid work had a significant effect on the number of cases averted and on programme costs, respectively, but this did not change the finding that AL and AQ+AS dominate monotherapy.ConclusionsIn an area of high drug resistance, there is evidence that AL and AQ+AS are the most cost-effective drugs despite being the most expensive, because they are significantly more effective than other options and therefore reduce the need for further treatment. This is not necessarily the case in parts of Africa where recrudescence following SP and AQ treatment (and their combination) is lower so that the relative advantage of ACTs is smaller, or where diagnostic services are not accurate and as a result much of the drug goes to those who do not have malaria.

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Section: Discussionmentioning

confidence: 56%

Cost-Effectiveness Study of Three Antimalarial Drug Combinations in Tanzania

et al. 2006

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“…First, capital expenditure on parastatal shipping companies was heavily reduced and, in some cases such as Mozambique, outright privatization took place [4,5]. Even if they managed to stay in state hands, strict controls on expenditure by international financial institutions, such as the world Bank and the IMF, invariably had deleterious effects [6,7]. Again, new exigencies of profitability intensified competition between national railways companies, affecting the direction in which goods were routed and, hence, choices of ports for transhipment [8].…”

Section: Deregulation Ports and Shipping In East Africamentioning

confidence: 99%

Tanzanian coastal and inland ports and shipping: crises and policy options

Wood

2004

Maritime Policy & Management

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This paper explores the current state of coastal and inland shipping in Tanzania. It provides an overview of the state of ports and shipping in Tanzania, and the reasons underlying the present crisis of competitiveness in terms of both global pressures and national and regional dynamics. Problems of competitiveness are at least partially due to under-investment, management failures, skills shortfalls and difficulties in interfacing with the railway network. Less easy to resolve structural problems include the great imbalance between imports and exports, heightened regional competition and ongoing political instability in the Great Lakes region.

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“…The latter are moulded not only by external pressures, but also by quasi-independent action by indigenous elites, and the effects of durable pre-capitalist networks (Hyden, 1983(Hyden, , 1998. In much of tropical Africa, local firms lack access to a range of sources of capital, forcing a reliance on reinvestment and personal networks (Kimemia, 2000). Meanwhile, extended peasant-based networks of support permeate employment practices, allowing for a certain continuity, but limiting recruitment options and constraining innovation (c.f.…”

Section: Regional Realities and The Persistence Of National Modelsmentioning

confidence: 99%

International Homogenization or the Persistence of National Practices?

Webster

Wood

Brookes

2006

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This paper is the first systematic attempt to provide an overview of industrial relations practices at firm level in Mozambique. Through a nationwide survey of firms, the paper assesses the extent to which specific sets of practices are associated with particular regions, and/or sectors, and explores the relationship between IR practice and national institutional realities. The survey revealed that informalism and autocratic managerialism characterize the practice of employment relations. But it would be mistaken to assume a convergence towards a global systematic archetype of low wage/low skill/low security of tenure set of practices. Instead, the authors conclude, contemporary Mozambique employment relations are an example of external market pressures being channelled and moulded by the persistence of national level realities that stretch back to the colonial era. In the absence of effective institutional mechanisms, familiar conventions are likely to persist because people know how these work in practice.

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An Overview of the Performance of the East African Economies since 1985: Implications for the New Initiative on East African Co-operation

Abstract: Abstract

Cited by 7 publications

References 0 publications

Cost-Effectiveness Study of Three Antimalarial Drug Combinations in Tanzania

Cost-Effectiveness Study of Three Antimalarial Drug Combinations in Tanzania

Tanzanian coastal and inland ports and shipping: crises and policy options

International Homogenization or the Persistence of National Practices?

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