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Item Is equity meaningfully incorporated into pandemic preparedness and response? A scoping review and critical analysis of Ebola andCOVID-19 outbreak responses in Uganda 2019-2023(Taylor and Francis Group, 2025-12-31) Redondo G; Murray L; Bromhead C; Makumbi ISocietal inequities produce vulnerabilities that infectious disease can exploit. Current approaches to pandemic prevention, detection and response are led by the International Health Regulations IHR and the Global Health Security Agenda. However, to contain the spread of infectious diseases, localised action to address systemic inequities must be considered. The purpose of this scoping review and equity analysis is to 1) Synthesise the available information on Uganda’s Ebola Virus Disease (EVD) and COVID-19 preparedness and outbreak responses between 2019 and 2023, and 2) Critique if and how Uganda’s Ministry of Health incorporated concepts of health equity in its EVD and COVID-19 interventions, while building national capacity to identify and prevent public health emergencies. This scoping review and critical analysis was conducted following the five-stage process defined by Levac et al. After identification and screening, the scoping review was based on six preparedness and response plans, three after-action reviews, and 20 grey literature and peer-reviewed articles. The findings revealed that the EVD and COVID-19 preparedness and response plans in Uganda show the country’s commitment and readiness for early detection and response to infectious disease outbreaks. However, further examination of the plans reveals missed opportunities to address systemic inequities. The ongoing mpox outbreak, declared a PHEIC by WHO on July 23, 2022, with significant impacts in African countries including Uganda, further underscores the need for a paradigm shift in managing infectious disease outbreaks. Such a shift may be similar to that experienced by the field of disaster risk reduction, which underwent a significant transformation at the Sendai Conference in 2015 towards a more holistic and proactive approach that addresses underlying systemic issues and focuses on building resilience. The exclusive focus on biomedical strategies to manage infectious diseases fails to address the social aspects of transmission, the local perceptions of illness, and community vulnerabilities often associated with social and historical perspectives. The social determinants of health disparities should be incorporated into pandemic planning and response. This will contribute to fostering equitable health outcomes and resilience in the face of the multifaceted challenges posed by future pandemics and environmental changes.Item Mental health conceptualisations and perspectives on mental health services of Black Sub-Saharan African migrants and refugees in Aotearoa New Zealand : a doctoral thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Manawatu Campus, New Zealand(Massey University, 2025-08-22) Musakwa, MichelleThe number of African migrants and refugees is increasing in Aotearoa-New Zealand (A-NZ). However, there is still limited understanding regarding the mental health experiences of Black Sub-Saharan Africans. Without adequate knowledge of the experiences of this population, it is difficult for mental health professionals to provide culturally appropriate services. As such, it is prudent to develop an understanding of the way this population conceptualises, experiences, and manages mental health and mental distress. This study explores how Black Sub-Saharan Africans in A-NZ conceptualise and manage mental health and their perspectives on mental health services in A-NZ. A qualitative approach was employed, with data collected through nine semi-structured individual interviews and two focus groups (each with four Black Sub-Saharan African women). Individual interview data were analysed using Interpretative Phenomenological Analysis, highlighting the role of identity in mental health conceptualisation and the intergenerational and gender differences that exist. Focus group data were analysed through Reflexive Thematic Analysis and key themes identified included barriers to accessing services and participants’ preferences regarding mental health services. Overall, this study found that culture and identity play a critical role in how Black Sub-Saharan Africans perceive mental health. These factors also influence people's experiences with mental health services. Understanding the cultural nuances of Black Sub-Saharans in A-NZ can help mental health clinicians develop an ethos of engagement that promotes better quality of care.Item Incorporating hydrology into climate suitability models changes projections of malaria transmission in Africa.(Springer Nature Limited, 2020-08-28) Smith MW; Willis T; Alfieri L; James WHM; Trigg MA; Yamazaki D; Hardy AJ; Bisselink B; De Roo A; Macklin MG; Thomas CJContinental-scale models of malaria climate suitability typically couple well-established temperature-response models with basic estimates of vector habitat availability using rainfall as a proxy. Here we show that across continental Africa, the estimated geographic range of climatic suitability for malaria transmission is more sensitive to the precipitation threshold than the thermal response curve applied. To address this problem we use downscaled daily climate predictions from seven GCMs to run a continental-scale hydrological model for a process-based representation of mosquito breeding habitat availability. A more complex pattern of malaria suitability emerges as water is routed through drainage networks and river corridors serve as year-round transmission foci. The estimated hydro-climatically suitable area for stable malaria transmission is smaller than previous models suggest and shows only a very small increase in state-of-the-art future climate scenarios. However, bigger geographical shifts are observed than with most rainfall threshold models and the pattern of that shift is very different when using a hydrological model to estimate surface water availability for vector breeding.Item Ectoparasite and bacterial population genetics and community structure indicate extent of bat movement across an island chain.(Cambridge University Press, 2024-05-24) McKee CD; Peel AJ; Hayman DTS; Suu-Ire R; Ntiamoa-Baidu Y; Cunningham AA; Wood JLN; Webb CT; Kosoy MYFew studies have examined the genetic population structure of vector-borne microparasites in wildlife, making it unclear how much these systems can reveal about the movement of their associated hosts. This study examined the complex host-vector-microbe interactions in a system of bats, wingless ectoparasitic bat flies (Nycteribiidae), vector-borne microparasitic bacteria (Bartonella), and bacterial endosymbionts of flies (Enterobacterales) across an island chain in the Gulf of Guinea, West Africa. Limited population structure was found in bat flies and Enterobacterales symbionts compared to that of their hosts. Significant isolation by distance was observed in the dissimilarity of Bartonella communities detected in flies from sampled populations of Eidolon helvum bats. These patterns indicate that, while genetic dispersal of bats between islands is limited, some nonreproductive movements may lead to the dispersal of ectoparasites and associated microbes. This study deepens our knowledge of the phylogeography of African fruit bats, their ectoparasites, and associated bacteria. The results presented could inform models of pathogen transmission in these bat populations and increase our theoretical understanding of community ecology in host-microbe systems.Item Dysphagia management in community/home settings: A scoping review investigating practices in Africa.(Taylor & Francis Group, 2024-02-21) Jayes M; Madima V; Marshall J; Pillay MPURPOSE: Little is known about how people living with dysphagia in rural, socioeconomically impoverished contexts in Africa are supported and manage their disability. This scoping review sought to map and synthesise evidence relating to the management of dysphagia in adults in community/home settings in Africa as a starting point for a broader study on this topic. METHOD: A multifaceted search strategy involved searches of electronic databases and grey literature, hand searches, ancestry searches, and consultation with expert advisors. Records were screened by two blinded researchers. Characteristics of included studies were summarised, and their findings synthesised using the Framework approach. RESULT: Six studies were included, relating to services for people with dysphagia secondary to various aetiologies. No grey literature was identified that provided service delivery descriptions or practice guidance. This limited evidence suggests little professional support is available to people living with dysphagia in the community. Individuals and carers use a range of strategies, including choosing different food and drink items and modifying how food is chewed and swallowed. CONCLUSION: Further research is required to understand current practice in managing dysphagia in the community in Africa, and the needs and priorities of community members who experience dysphagia and their carers.Item Prevalence of unmet health care need in older adults in 83 countries: measuring progressing towards universal health coverage in the context of global population ageing.(BioMed Central Ltd, 2023-09-15) Kowal P; Corso B; Anindya K; Andrade FCD; Giang TL; Guitierrez MTC; Pothisiri W; Quashie NT; Reina HAR; Rosenberg M; Towers A; Vicerra PMM; Minicuci N; Ng N; Byles JCurrent measures for monitoring progress towards universal health coverage (UHC) do not adequately account for populations that do not have the same level of access to quality care services and/or financial protection to cover health expenses for when care is accessed. This gap in accounting for unmet health care needs may contribute to underutilization of needed services or widening inequalities. Asking people whether or not their needs for health care have been met, as part of a household survey, is a pragmatic way of capturing this information. This analysis examined responses to self-reported questions about unmet need asked as part of 17 health, social and economic surveys conducted between 2001 and 2019, representing 83 low-, middle- and high-income countries. Noting the large variation in questions and response categories, the results point to low levels (less than 2%) of unmet need reported in adults aged 60+ years in countries like Andorra, Qatar, Republic of Korea, Slovenia, Thailand and Viet Nam to rates of over 50% in Georgia, Haiti, Morocco, Rwanda, and Zimbabwe. While unique, these estimates are likely underestimates, and do not begin to address issues of poor quality of care as a barrier or contributing to unmet need in those who were able to access care. Monitoring progress towards UHC will need to incorporate estimates of unmet need if we are to reach universality and reduce health inequalities in older populations.Item Ecology of infectious diseases in wild bats : a dissertation presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Veterinary Sciences at Massey University, New Zealand(Massey University, 2019) Hranac, Carter ReedEmerging infectious diseases present significant threats to the health of humans and wildlife. The ecology of emerging infectious diseases is a data hungry field in a world of rare events. Bats are both the source of human pathogens globally and the victims of a novel fungal pathogen causing continent-wide population declines in North America. By using the principals of iterative model design and model guided field work I leverage the mechanistic relationships between seasonally limiting biotic and abiotic factors of wild bats to understand spatio-temporal disease emergence dynamics from and within bat populations. I first use a novel ecological niche modeling technique to relate the seasonal availability of resources to predict African bat birthing events. I then use these model results to test hypotheses that Ebola virus disease (EVD) transmission to humans and non-reservoir animal hosts are related to the birthing events of bats through the use of a spatiotemporal Poisson point process model. The results suggest EVD emergence in Africa may be driven in part by the pattern of births among bats, especially fruit bats. Further, the identified temporal lag terms between bat birthing terms and EVD emergence are consistent with hypothesized viral dynamics in bat populations. Out of sample testing on the two most recent EVD outbreaks in the Democratic Republic of the Congo reveal a high predictive model performance and suggest the existence of both strong regional seasonality and locations persistently at risk of EVD outbreaks in humans and susceptible wildlife. Finally, I model North American winter duration and incorporate spatial variation in host traits related to body mass and composition to update survival estimates for hibernating Myotis lucifugus infected with Pseudogymnoascus destructans, the causative agent of the emerging disease white- nose syndrome (WNS) killing bats in Eastern North American populations. Results indicate that hibernating M. lucifugus in the West are likely to suffer populations declines similar to those observed in the East. All my findings will require further ground-truthing to validate the results, yet demonstrate the predictive power of identified mechanistic relationships on complex infectious disease systems.Item Threads from the past : a genetic study of African ethnic groups and human origins : a thesis presented in partial filfulment of the requirements for the degree of Doctor of Philosophy in Biological Science, Biological Anthropology at Massey University(Massey University, 1996) Watson, Elizabeth EvelynMitochondrial DNA (mtDNA) provides an efficient tool for investigating human pre-history and evolution. In this thesis Hypervariable I sequences from 241 individuals representing nine diverse African ethnic groups arc presented, and analysed together with published sequences. Each ethnic group studied represents a different combination of geography (East and West Africa), linguistic phylum (Niger-Kordofanian, Nilo-Saharan, and Afroasiatic), and subsistence mode (agricultural and pastoral). The African mtDNA dataset is expanded considerably by the addition of these samples. Questions concerning human evolution and human pre-history are readdressed. These samples demonstrate a higher diversity in Africa than previously reported. An ethnic group such as the Turkana has a higher mitochondrial diversity than the rest of the world combined. There is some evidence of regionalism, in that some of the clusters are specific to West or East Africa; however, there is also sharing of lineages across Africa suggesting substantial migration and admixture both in the past and more recent times. In Africa, the !Kung being the exception, the mtDNA from one ethnic group does not show a common unique ancestor, rather the ethnic groups are composites of several mtDNA types, with distinct origins and population histories. Combined analysis with Median networks and pairwise distance methods, demonstrate that within Africa approximately 60,000 years ago, there was a phenomenal expansion of one cluster, which was associated with the people who subsequently moved out of Africa. Almost all non-African populations are derived from this cluster. The Out of Africa hypothesis is supported, but there may have been more than one expansion of modern humans out of Africa. Further sampling in Asia and Australia is crucial to conclude the Multiregional-Out of Africa debate.Item New Zealand's response to the crises in Africa : a thesis submitted for the degree of Doctor of Philosophy, Massey University, Albany, Auckland, New Zealand(Massey University, 1996) Chile, Love MngoholThe thesis seeks to explain the motivation for New Zealand's response to the sociopolitical and economic crises in Africa. New Zealand's response is conceptualised to include 'foreign aid' as well as the non-traditional forms of international assistance such as peacekeeping and monitoring, political and moral support on issues such as apartheid. Qualitative research methodology is used to critically examine both the official bilateral response and the response of the non governmental organisations (NGOs). In the context of existing theory, New Zealand's response to the crises in Africa has significant elements of both the functional utility approach (McKinley and Little 1977) and the conventionalist framework (Gordenker 1976). Official policy espouses both, although the balance between the pursuit of foreign policy interests and altruistic response to the crises is difficult to attain. The thesis concludes that while New Zealand's political and moral response was an important factor in the resolution of the crisis of apartheid, the overall official response to the socioeconomic and developmental crises is ineffective. Development partnership between New Zealand NGOs and local NGOs and communities in Africa has been a more effective response to the developmental crises. International development partnership with African countries and communities based on longer term commitment to processes which enhance sustainable socioeconomic progress and social justice is recommended as a strategy for maximising the effectiveness of international response to the crises in Africa.Item The value of discretion in Africa: Evidence from acquired intangible assets under IFRS 3(World Scientific Publishing Company, 2020-06) Tunyi A; Ehalaiye D; Gyapong E; Ntim C; Chaney, PKThis paper examines the value of managerial discretion in financial reporting by exploring the value relevance of intangible assets acquired in business combinations (AIA) before and after the 2008 International Financial Reporting Standard (IFRS) 3 amendment. The 2008 IFRS 3 amendment gave managers the discretion to recognize previously unrecognized intangibles in the target firm, hence, we posit that if managerial discretion improves the quality of financial reporting, we should observe an increase in the value relevance of AIA after the amendment. Our empirical analysis is based on a dataset of 603 mergers announced between 2004 and 2016, across seven African countries. Consistent with our main hypothesis, we find that the value relevance of AIA, predominantly acquired goodwill (AGW), increased after the amendment, suggesting that managerial discretion improves the quality of financial information. Our results further show that the value of discretion is moderated by the underlying institutional quality, with the value relevance of AIA being greater in high-quality institutional contexts. Our findings are robust to alternative measures of AIA, alternative models for testing value relevance, and various controls for endogeneity. Overall, our findings have important implications for accounting standard-setters, governments, investors, and practitioners.