Brastorne Connects the Unconnected in Africa

Digital inclusion is not universal and a growing digital divide is excluding entire segments of our society from the potentially limitless benefits.

In Africa, 650 million of the continent's one billion people own mobile phones, but the majority lack meaningful digital access.  About 760 million people are unconnected in Africa. 

Economic realities are driving this digital divide. Africans use feature phones in large numbers, leaving only a few people who have both smartphones and the data plans required to be online. 

Yet more and more aspects of modern life have moved online - access to information, economic opportunities, and how we interact with our social circles are all reliant on access to the internet. 

Access to this near-limitless online world leads to empowerment for those with ready access. When they have a smartphone, digital access comes at a crippling cost. 

One gigabyte of mobile data costs an average of $6.44 in Africa, which is equivalent to a week's wages for the majority of the continent's rural poor. There are many efforts globally to promote digital inclusion, but Africa is still left behind. 

Brastorne acknowledges these realities and has implemented disruptive solutions to dissolve the barriers to digital inclusion in Africa. Using existing infrastructure, standard telco networks, Brastorne’s technology turns the continent's ubiquitous feature phones into internet portals for less than $0.05 per day. 

For these feature phone users, Brastorne's solutions provide an experience similar to that of a smartphone mobile app. This is accomplished through a suite of technology solutions including USSD, IVR, or Voice to promote digital inclusion through Brastorne’s applications Mpotsa, mAgri and Vuka.

Mpotsa, which translates to "ask me how?" in English, is a two-way telephone-based question/answer platform that aims to provide users with information on almost anything. It provides information to users by acting as a Google-like service that uses the user-friendly technology of Voice/IVR. 

Farmers use mAgri to access advisory services, wikipedia, weather/pest alerts, crop prices, and financial services, as well as trade, chat, and email in their native language. 

Vuka facilitates and accelerates convenient communication through USSD, allowing users to chat, send in-person messages, or broadcast messages on both low-end phones and smartphones. 

These solutions empower numerous communities that rely on feature phones by giving them access to essential information such as employment opportunities, health advice, and legal services.

Through Brastorne’s flagship product Smallholder Farmers experience increased access to communications and Women Smallholder Farmers see increased Crop Yield and increased revenue. 

In 2021, 36 000 farmers gained access to information, markets, & communication in Botswana through mAgri. 

Furthermore Brastorne users realized 85% Monthly Savings in costs of information and communication access compared to alternatives (data bundles, physical travel costs etc), which can cost $15+/month. 

Brastorne users in total have realized $3.4 million total annual savings across all 60,000 subscribers in 2021. 

These savings can now be put to use to improve their farm, feed their families, or buy much-needed personal items. 

Brastorne’s information access service Mpotsa has brought the power of the internet to new users, giving them increased access to information, medical treatment, COVID vaccinations, and access to jobs. 

The service is a literal lifeline with an estimated 60% of Mpotsa subscribers who cannot otherwise afford digital information. 

In 2021, Mpotsa connected 25,231 total youth, over 15,000 of whom would otherwise have remained unconnected. This resulted in $60,554 total information access cost savings. 

With its mission of connecting 760 million Africans who lack meaningful access to today's digital world, Brastorne plans to expand its solutions to 19 different African countries. 

Brastorne is currently operational in Botswana, the Democratic Republic of the Congo, and most recently Cameroon (https://bit.ly/3VBXhNM), having launched in October through partnerships with mobile network providers such as Orange. 

It plans to address the realities of Africa's lack of connectivity by enabling digital inclusion and its dividends through mAgri and Vuka.

No need for more benchmarking trips to pass Uganda National Health Insurance

By Esther Nakkazi

Each year parliament allocates 3billion Uganda shillings or USD $ 800,000 to the National Health Insurance Scheme (NHIS).

Uganda urgently needs an NHIS. It should be universal, fair, with only one pool, said Fredrick Makaire, the Executive Director, Save for Health an NGO that coordinates community health insurance schemes across the country.

After many years since it was first proposed, the Uganda NHIS is not operational although discussions about how it should be implemented are on going in Parliament and among stakeholders.

One of the activities for which the UGX 3 billion allocated is spent is the benchmarking exercise by members of parliament. This involves travel to different countries.

Twenty years since talks about starting the Uganda NIHS started divisions on whether the benchmarking is even relevant anymore are raising eyebrows.

Stakeholders are divided on the way forward. While some think the exercise is not relevant arguing that if the funds for benchmarking were to be saved they would have jump started Uganda’s NIHS by now others say ‘seeing is believing’ so the new members of Parliament need a physical assessment to support it.

Makaire says there’s no need for fresh benchmarking as there’s already enough data gathered over the last fifteen years.

Joel Ssebikali Yoweri, the Vice Chairperson of the health committee in parliament says the new members of parliament on the health committee who are 32 out of the 36 team need to get proof of how NIH systems work. 

Next month, for the fourth round of benchmarking 36 members of parliamentary health committee will visit Rwanda in December and proceed to Kenya and Tanzania in early 2023, participants attending the 6th National Community Health Financing two-day conference held in Kampala heard.

Previously, MPs visited Rwanda, Namibia, Ghana and France to benchmark for the bill that was passed by parliament in 2021.

However, the Bill was rejected by president Museveni who refused to accent to it.

The bill has been in parliament for four terms. The assessment is that there is zero political will to pass it. At some point it even disappeared and could not be tabled.

“It becomes embarrassing, as politicians we get ashamed when we talk about it. We have wasted government money because we benchmarked all over the world that money was wasted, efforts were futile and time,” said Ssebikali.

He advised stakeholders to start engaging smaller groups individually. “If we finish smaller groups without achieving this we shall be ashamed.” Financing healthcare in Uganda remains a nightmare. Maybe times Ugandans who go to hospitals come out poorer.

At least 1.5 million Ugandans are pushed down the poverty line because of health care expenditure. This was even more so amplified during the Covid-19 pandemic.

As well about 40 percent Ugandan households use out of pocket expenses to finance health care. The World health Organisation (WHO) recommends 15 percent out of pocket expenditure. 

At the East African Community level only Uganda and South Sudan lack an NHIS. Uganda has only 30.9 percent health coverage compared to Rwanda at 95 percent.

Now the Bill is back at the Ministry of Health for review. Dr. Charles Olaro, the Director curative Services in the Ministry of Health, says returning the Bill back to the Ministry of Health has enabled them to consult - engaging members of parliament, private sector and they have managed to get a consensus and a ‘win-win’ situation’ for most of the items that were not accepted. 

He noted that they are ensuring that everything that missed in the 2021 bill including the fate of community health schemes and private providers are well catered for in the new document.

Leticia Nakimuli Irumba, the Board chairperson, Save for Health Uganda says if the country puts all its resources in one pool we shall achieve universal health Insurance coverage.

“We are glad that we back and counting to advocate for the bill. We are sure that an opportune time we shall have the Bill signed.”

Ends

Africa food cooling technology to be expanded

The African Centre of Excellence for Sustainable Cooling and Cold-chain (ACES) has announced at COP 27 that it will work with global cold chain provider Carrier to help advance cooling development and training in Africa.

“Turning food loss into nutritionally available food is essential for Africa’s sustainable development, as well as building the food systems that are used to feed people in times of uncertainty," said Toby Peters, Centre for Sustainable Cooling Director and Professor of Cold Economy, University of Birmingham and Heriot-Watt University.

Global leaders have recently agreed that the only way to overcome food insecurity is by working together to create innovative partnerships within the global community,” 

Carrier will collaborate in the development of the ACES cold-chain centre in Kigali, Rwanda - providing capacity building for farmers and refrigeration technicians, skills development for students and supply chain professionals, and demonstration of best-in-class sustainable cooling technology.

More than 475 million tons of the world’s food can be saved annually with effective refrigeration, and more than 50% of all perishable food loss could be avoided by using cold chain technology.

The University of Birmingham plays a leading role in ACES, which is developed with the Governments of UK and Rwanda and UN Environment Programme at the University of Rwanda.

Additionally, progress continues on the collaboration between Carrier, WFP and other leading companies to build a world-class Transport Training Centre in Accra, Ghana, aimed at enhancing transport and logistics capacities across West Africa. 

The centres are expected to inject new expertise into local transport markets, equipping them to deliver goods more efficiently throughout their respective regions.

 “We’re pleased to partner with ACES and WFP to make a meaningful difference across Africa, as the potential benefits of these collective efforts are far reaching and can positively impact the cold chain from farmers and manufacturers to consumers with wide-reaching benefits,” said Tim White, President, Refrigeration, Carrier. 

The University of Birmingham and the Indian State of Haryana recently signed a Memorandum of Understanding (MoU) to develop a Haryana Centre of Excellence on crop post-harvest management and sustainable cold chain.

The agreement builds on ACES and will conduct state-of-the-art applied research and provide capacity building and training, an innovation and business hub and technology testing/demonstration centre. 

It will connect experts, investors, agri-food business, farmer cooperatives, and energy or logistics providers to deliver sustainable cooling. 

It also follows an MoU signed earlier this year with the Indian State of Telangana for a Telangana Centre of Excellence. The UK and UN Environment technical assistance programme is funded by DEFRA.

Carrier is a leading global provider of healthy, safe, sustainable and intelligent building and cold chain solutions. 

ACES’ partnership will support Carrier’s focus on expanding the cold chain – improving health outcomes and reducing hunger, food insecurity and carbon emissions. 

ACES is being highlighted at COP27 through a series of side-events. Professor Peters will be presenting at the Clean Heating and Cooling Forum on Monday, 14 November. 

The event will explore policy, technology, and models needed across both the sustainable cooling and clean heat challenges.

As outgoing COP 26 President, the Rt. Hon. Alok Sharma MP, said when he visited ACES during CHOGM: “ACES is a demonstration of how we can work together, to help tackle rising emissions and keep alive the goal of limiting average global temperature rises. Cooling and refrigeration are the fastest-growing source of greenhouse gas emissions in the world, especially in developing countries. But this challenge gives us the opportunity to develop innovative, energy efficient technologies of the future.”

Orange Launches first 5G commercially in Botswana

Orange Botswana is the first Orange affiliate to launch 5G, with a coverage of 30% of the population, including greater Gaborone and Francistown. Other cities will follow in early 2023.

It follows the launch of Botswana’s first Orange Digital Centre this morning, which will help bridge the digital divide and prepare Batswana youth for employment in a blossoming digital ecosystem.

This 5G launch will further support innovation and digital inclusion in the country, putting Botswana at the forefront of 5G in Africa and is closely aligned with the government’s ambition to leverage Fourth Industrial Revolution (4IR) innovation towards transforming Botswana into a knowledge-based economy, leaving no-one behind.

Orange Botswana is the first Orange (www.Orange.com) affiliate in Africa to launch 5G commercially. New healthcare, education and security services will be enabled in the country by the 5G technology.

5G, with its ultra-high speed and low latency, will support new disruptive services such as e-health, connected vehicles, connected cities, real-time gaming, smart homes and learning through VR and augmented reality. 

It offers a new world of possibilities to companies, innovators and society at large.

Orange Botswana has partnered with MRI Botswana to create a “Connected Ambulance” project that will allow Doctors to guide Paramedics through life saving procedures on their way to hospitals. 

This telemedicine intervention will change lives and would not have been possible without 5G. Orange Botswana is looking forward to collaborating with government and enterprises to implement 5G-based use cases.

Orange Botswana introduces new 5G fixed broadband services and mobile data bundles. The offers are available for residential customers, small and medium enterprises and include value added services.

The fixed offers are available from15Mbps for Prepaid and from 20Mbps for Postpaid with a monthly rental from BWP 699 (€53 per month). The subscription of Prepaid offers is accessible through Orange Yame App, USSD and Card to Wallet.

In other countries, regulation boards still have not officially initiated the 5G licenses attribution process although many of them, such as in Cote d’Ivoire showed a clear will to make the 5G spectrum available in 2023.

Meanwhile, Orange is collaborating with several regulatory bodies to help build a 5G deployment roadmap while testing the technology and developing use cases that fit with the local populations’ need.

Africa: Of 23 countries studied only two-thirds publish data on bid opportunities

By Esther Nakkazi

Although one-third of government spending is done through public contracting, most African governments do not publish the information needed to track public spending on procurement, according to a regional analysis of 23 African countries conducted by the Open Contracting Partnership (OCP).

According to OCP research, while nearly all African nations analysed (91%) publish at least some information online, only two-thirds publish data on bid opportunities (65%) and 57%, publish data on who is awarded contracts.

“Over the last few years across Africa, many governments have struggled to procure, build, and institutionalise electronic government procurement systems despite tens of millions of dollars in headline Public Financial Management reforms from donors,” says Edwin Muhumuza, Head of Africa at Open Contracting Partnership.

The data is based on Fulfilling the promise of e-procurement reforms in Africa, OCP's latest comparative study on e-procurement in Africa provides guidance for making digital public procurement reforms more efficient, fair and transparent across the continent.

There is also the issue of how governments publish their procurement data. 

Only five African countries, Cameroon, Kenya, Nigeria, Sierra Leone, Uganda, publish data in machine-readable formats, dramatically limiting how the information can be used to ensure that public contracts benefit society as intended.

The analysis is based on the Global Data Barometer, an independent study of the quality and use of open data worldwide.Nigeria stands alone as the only country that publishes some data across the full procurement cycle including planning, tender, award, and implementation.

Transparency in public contracting is important because it is the main way governments hire companies to deliver vital goods, public services and infrastructure to citizens.

Bad procurement policies mean run-down roads, under-resourced schools and non-existing healthcare centers, and quite often, elements of state capture.

Transforming manual and often paper-based public procurement to electronic government procurement systems can make government more efficient, fair and transparent.

“Public procurement has a reputation as being bureaucratic, inefficient and wasteful,” says Muhumuza. 

“But doing it better is possible. And it’s critical if we want to make sure that government spending improves the lives of people. Our new report provides specific guidance and tools for governments implementing reforms and builds on best practices from the region.”

The report provides eight key recommendations in addition to practical tools built on the latest research by experts around the world as well as insights from practitioners in five countries – Ethiopia, Nigeria, Rwanda, Uganda, and Zambia.

National and county governments in five countries are publishing open contracting data, including Ghana, Kenya, Nigeria, Uganda and Zambia. Five more places have committed to open contracting reforms including Sierra Leone, South Africa, Tunisia, and the city of Tangier in Morocco.

"It will be important to build a coalition of change, comprising stakeholders from various parts of government as well as non-government champions, to overpower blockers so that enough winners accrue from the new system that ‘escape velocity’ be achieved, and the system is actually appreciated and used," says Muhumuza.

A procurement ecosystem has grown in Africa in the last decade. Investigative journalists such as Nigeria’s Dataphyte, civil society organizations such as the Uganda-based Africa Freedom of Information Centre (AFIC), and prominent anti-corruption campaigns in Kenya and South Africa have shown how public procurement data can be used to track money going into vital projects such as primary health care centers, schools and public works. This kind of civic monitoring ensures better value.

“Those leading e-procurement reforms need to engage civic actors, service beneficiaries and business stakeholders to build a coalition. A program of change needs to be designed and built ‘with them’ and not ‘for them’,” says Muhumuza, the author of the study.

New app will cut the cost of sending money from Europe to Uganda by a quarter

By Esther Nakkazi 

A new app  will just make the cost of sending money through mobile channels from Europe to Uganda four times cheaper.

The app, ‘PostalPay’ will enable people located in the EU to send remittances in a cheaper, but also faster and safer way from their mobile phones.

It was created through a joint effort by Inpay, the UN’s International Fund for Agricultural Development (IFAD), a cross-border payments company, and its subsidiary company Eurogiro, a global postal cross-border payments networkand Eurogiro in collaboration with PostBank Uganda and Posta Uganda.

“By using our cross-border payment technology, we are cutting the total costs of remittances to 2.5 per cent, helping migrant workers get a fairer service and helping us in our mission of democratizing payments in every corner of the world,"said Thomas Jul, CEO of Inpay and Eurogiro.

"We are incredibly grateful for the cooperation with IFAD, the EU and our partners in Uganda in this joint project. We look forward to working with local members of the Ugandan community in the Netherlands and Sweden to further support app uptake,” said Jul. 

In 2021, the remittance flows to Uganda (US$1.08 billion) represented almost 3 per cent of national GDP. Uganda ranks in the top 10 of remittance recipient countries of sub-Saharan Africa. 

Currently, money can take days to be delivered and costs exceed 10 per cent of the amount sent, including the foreign exchange margin, adding unnecessary strain and cost on migrant workers and family members back home.

Money can either be instantly transferred to a PostBank bank account or received as a cash pick-up in multiple Posta Uganda and PostBank Uganda locations. 

“PostBank and Posta Uganda wide outreach through their branches makes picking up cash far more convenient for recipients in Uganda; we also believe that the trusted name of the Post and Bank will help foster market adoption,” added Jul.

 

IFAD’s EUR 369,000 grant will support the launch of ‘PostalPay’ in Sweden and the Netherlands, two European countries with an established Ugandan diaspora.

The IFAD contribution is part of the PRIME Africa Programme, co-financed by the European Union with the additional support from the Government of Luxembourg. Inpay and Eurogiro are jointly contributing EUR 172,000 to co-finance this venture over the next 18 months.

 

“We are delighted to work with Inpay and Eurogiro to promote financial inclusion in marginal rural areas. Facilitating people's access to savings and credit will help them to participate in the rural economy and improve their livelihoods. Inpay technology provides low-cost and secure cross border payments and Eurogiro’s access to the global postal network makes it a valuable partner,” said Pedro de Vasconcelos, Manager of the Financing Facility for Remittances at IFAD.

“These remittances are a lifeline for rural people. However, the cost of sending money to Uganda is still far above the SDG target 10.c of reducing the cost of migrants’ remittances to less than 3 per cent by 2030. Mobile channels offer a great opportunity to achieve this goal,” added De Vasconcelos.

The partnership builds upon a previous IFAD grant to Postbank Uganda (PBU) and Posta Uganda between 2017 and 2020. 

IFAD support helped extend financial services, including remittances, to rural and refugee communities, and supported the refurbishment of 30 post offices, opened new mobile branches, and procured mobile cash management vans in rural areas.

Grey expands virtual international banking to East Africa

Grey (https://Grey.co), a fintech has raised $2 million in seed funding. The service offered by Grey enables its customers to have virtual international bank accounts for free and enjoy a seamless foreign payment process.

Grey was started by two Nigerians to simplify sending and receiving foreign payments for Africans in 2021 to empower people to live a location-independent lifestyle.

“I believe that the least of your worries as a freelancer, remote worker, or digital nomad should be sending or receiving payments, so we’ve made it easy. We like to say that we’re on a mission to make international payments as easy as sending an email," CEO of Grey, Idorenyin Obong, says. 

"We want to do impactful work to improve how Africa as a continent interacts with money across its borders. I am delighted that we’ve acquired an extensive and fiercely loyal user base.”

On Grey, you can create a foreign USD, GBP, and EUR bank account for free, send money to the UK and Europe, and receive payments from over 88 countries. The company also offers conversion directly to your local currency so that you can spend it easily on the app. 

Grey allows users to receive foreign payments in their preferred foreign currency and withdraw directly to mobile money or their local bank account.

In addition to the funding announcement, Grey also announced Its expansion into East Africa, starting with Kenya, and partnerships with payments giant Cellulant and ed-tech leader Moringa. Travelling to Kenya is much easier with Grey (https://bit.ly/3Q5bCyY) because you can pay vendors directly to M-pesa. 

For example, suppose you’re a traveller on a trip to Nairobi. In that case, you can convert any supported currencies to Kenyan Shillings and pay for services directly to M-Pesa, or other mobile money accounts. 

Grey is the easiest way to send money abroad and between African countries. The company plans to expand into more East African countries in the coming months. It has included support for Ugandan Shillings on the app, bringing the total number of supported currencies to six. 

This addition means that Grey customers in Nigeria and Kenya can send money to mobile money accounts in Uganda.

“Sending money worldwide is not just an individual problem; it affects African businesses too. Over the last two months, we’ve onboarded several African businesses to our private beta. Honestly, when I listen to the feedback about how much we’ve simplified a previously complex process, it pushes us to do more,” COO Femi Aghedo says, 

Grey’s seed funding round included participation from Y Combinator, Soma Capital, Heirloom Fund, True Culture Fund, angel investors Alan Rutledge, Samvit Ramadurgam, Karthik Ramakrishnan, and other high-profile investors. 

According to the CEO, Idorenyin Obong, with this new round of capital, they plan to launch into new markets and extend their product suite to include not just remittances but also person-to-person and business-to-business payments so every African can enjoy seamless cross-border payments with low fees.

Grey’s services are available in Kenya and Nigeria via the Grey website (https://Grey.co), Play Store (https://bit.ly/3Q0zcfY), and App store (https://link.grey.co/iOSapp).

Zambians can make payments through Tingg digital payment platform

Zambia has signed a partnership agreement with leading fashion retailer LC Waikiki, which will enable customers to make payments from all LC Waikiki stores across Zambia through the Tingg digital payment platform.

As the ways consumers can pay for goods continue to evolve, LC Waikiki customers will now be able to make payments seamlessly via mobile money in all their branches in Zambia. 

This partnership reflects the growing synergies between retailers and payment solution providers across Africa, in serving a growing consumer base that is now preferring digital payment methods. 

Although there was a growing acceptance of digital payment methods before COVID-19, the pandemic served to accelerate this adoption.

“As a result of the government's efforts to eliminate cash handling by promoting contactless payments as a safer and more effective option post-COVID-19, we are seeing an increase in digital payments in Zambia. Additionally, more consumers are expressing a desire to use cash much less. The Zambian government, through regulators, continues to reaffirm this, as mobile money wallets are now more than ever a common way to store money,” says Cellulant Zambia Country Manager, Mr Gilbert Lungu.

“Tingg by Cellulant (www.tingg.africa) is an easy to use, versatile and exciting service which has guaranteed advanced security and is password-protected,” he added.

Millions of people on the African continent have adopted digital payment platforms largely owing to COVID-19. The requirement for contactless methods of making transactions transformed what was previously a nice-to-have into a necessity. 

For instance, the Nigerian Inter-Bank Settlement System reported that in Q1 2021, electronic payments increased by 88% year over year in Nigeria, the continent's largest economy. The total amount of payments was $155 billion USD. Mobile payments increased by 189% while POS collections increased by 48%, showing that consumers are increasingly adopting digital channels for transactions.

LC Waikiki Country Manager Mrs Sevda Bilen stated that using mobile money to pay for clothes and other accessories is going to be a huge advantage for the company in Zambia: “LC Waikiki Zambia customers now have a wider choice of payment methods. True to our mission that offers fashion at affordable prices in line with the belief that “everyone deserves to dress well”, every one of our clientele can now seamlessly pay at any of our stores through Tingg. Consistently providing convenience for our clientele is something we strive to achieve daily.”

She further said “As our business grows in Zambia, we are constantly looking for opportunities to add value to our customer's experience of the LC Waikiki brand. The strategic partnership with Tingg by Cellulant represents our commitment to the Zambian market and we will continue to explore additional opportunities with the company.”

A mobile money platform is non-cash which allows customers to make payments and other transactions quickly and easily. It has been widely adopted by corporate, government and individual customers to purchase airtime, Person-2-Person cash transfers and utility bill Payments.

LC Waikiki has more than 1200 stores in 56 countries with almost 60,000 employees and a brand range that includes clothes and accessories for men, women and children of all ages, including babies, style-aware individuals and families. 

The brand accompanies itself with a distinctive methodology – high-quality clothes at great value. From close-fitting, stylish knitwear for men, to fashionable shoes and slippers for young girls, LC Waikiki has exactly what you need, when you need it.

Cellulant payments company integrates digital payments in 35 countries for more than 1000 retailers to unlock opportunities for millions of customers.

www.Cellulant.io

Think of Uganda Private HealthCare Providers as Partners

Grace Kiwanuka Ssali, the Executive Director of Uganda Healthcare Federation (UHF) an umbrella body for private health providers wants Uganda private healthcare providers to be treated as a partners and not profit centres. 

But this will require a mindset shift perception by the public, development partners and the government. 

Speaking to Health Journalists Network members during a boot camp held in Kampala,  Kiwanuka Ssali,  said the private health sector providers need more support from development partners and the government. 

"I know that development partners say we are putting money into government and supporting Private-not-for-profits (PNFPS) but it is not as easy as saying ... I am going to support these three people the rest of you will figure it out," Kiwanuka told HEJNU journalists. 

"We need to shift the perception about the private sector health providers to be partners and not profit centres." 

Kiwanuka said the private sector health providers are waiting for the government to allow them to officially offer COVID-19 vaccination services. 

Right now the a pilot project to do this was started in Kampala, because it a unique district in terms of healthcare - 98 percent of the healthcare facilities are privately owned. 

The Uganda private health providers resolved to dialogue with the government and have the Ministry of Health (MOH) draft a policy that’s now in very early stages to allow private health providers officially offer COVID-19 vaccination when it became practically impossible to do it on their own.

At the height of the pandemic, Kiwanuka says members of the Federation went directly to COVID-19 vaccine manufacturers with proposals but they needed up to US$500,000 to make the smallest acceptable import order because companies were prioritizing the COVAX facility. The providers couldn’t afford this. 

While a number of private facilities are now offering vaccine services, according to the federation, these are being offered in a pilot mode. The accredited facilities went through a tight verification process where they gave priority to those that had been engaging in routine immunization prior to the pandemic and those that had the equipment and expressed capacity to arrest the adverse reactions from the vaccine in a timely manner case they happen.

Noteworthy, MOH had early last year drafted guidelines for private pharmacies and importers of pharmaceutical products to start dealing in vaccines, a move that was immediately shot down by critics including public health experts who expressed worries about fakes infiltrating the market.

Now, Kiwanuka says over the last two years, they have been in back and forth meetings with the policymakers to ensure that they are engaged early to participate in health emergencies. 

For her, it’s now clear that government cannot handle it on its own with lessons taken from COVID-19 interventions where they were overwhelmed when private hospitals started filling with critical COVID-19 patients and yet they were not involved in the preparations.

Because of this, she says all the solutions so far reached with the government on vaccine provision so far are not feasible for private providers. For instance, MOH had allowed them to use the National Medical Stores (NMS) to manage the vaccines logistics for them.

 

Insecurity heightens spread of Tuberculosis in Karamoja region

 A bad cough that lasts 3 weeks or longer, pain in the chest, coughing up blood or sputum (phlegm from deep inside the lungs) are some of the symptoms of Tuberculosis. 

In Napak district, Karamoja region coughing loudly and persistently without stopping resulted in a bullet shot for a TB patient and death. 

Now, patients suffering from Tuberculosis in Karamoja, one of the high burden regions with a TB prevalence rate ten times higher than the national average, are scared and want to run away from their villages due to insecurity and their TB treatment is being interrupted. 

The Karamoja region is also home to the U.S. government's Accelerated Control of TB in Karamoja program or PACT Karamoja supported by the United States Agency for International Development (USAID) launched 2018. 

USAID's PACT Karamoja program is a $7.5 million agreement (2020-2025) that aims to address the Karamoja Region’s high TB prevalence and low treatment success rates by supporting locally generated solutions to mobilize health facilities, village health teams, and community members for accelerated screening, testing, identification, and successful treatment and prevention of TB.

Paul Losiru was in his hut sleeping at night and he started coughing because he is a TB patient but on medication. Outside the “Manyatta” were he resided cattle rustlers were passing by and they heard him coughing persistently. 

They ordered him to get out of his house because his coughing and the noise irritated the warriors and alerted the security.

‘’I had them saying that each time we pass by your home, you are seriously coughing, it’s like you are cursing us or if not you are signalling to the security that we are around. This is intolorable. I immediately heard gunshots,’’ Daniel Kedi his neighbour narrated.  

This is terrible because the Karamoja region in North Eastern Uganda is one of the high burden regions with a TB prevalence rate ten times higher than the national average. The treatment success rate in the Karamoja region was below 50% until an emergency response was declared in 2019. 

TB is the world's deadliest infectious disease, infecting about 10 million people and killing 1.5 million globally each year. Uganda is among the 30 high burden TB and HIV countries in the world. 

As dangerous as TB is, it is treatable and curable but in Uganda TB disease still causes illness in about 90,000 Ugandans annually including 1,500 people who get infected with drug-resistant TB. And in Uganda, about 15,600 people died from TB in Uganda in 2019.

In 2019, of the estimated 1,500 drug-resistant TB (DR-TB) cases, only 559 were diagnosed and notified to the National TB and Leprosy Program (NTLP) 

After killing Losiru, the warriors picked his phone and they used it to call the relatives inquiring about the mood of people since the incident happened. Now TB patients in Karamoja are scared of what will happen to them too. 

Maria Nakoru, a TB patient and a resident of Iriiri trading center, says coughing is a must for TB patients and there’s nothing they can do to stop it. They are turning to God for protection.

Its not only the warriors that are scaring TB patients in Karamoja but patients are also grappling with a food crisis and yet the medicines require them to feed well. She fears that if insecurity is not addressed in the region, time will come when they will be slaughtered like chicken. 

Losiru and Nakoru both live in Napak district, which records a high number of Tuberculosis cases ranging between 500 and 600 annually. 

James Lemukol the district Health Officer Napak says that the TB patients are now traumatized because the insecurity is affecting their treatment cycle. Lemukol said when patients fail to follow the treatment series, they are at increased risks of morbidity, drug resistance, transmission and mortality.

However, without security even with the USAID Accelerated Control of TB project home based in the district, the prevalence will increase and success rate will continue to decline. 

An Integrated approach of cervical cancer and Schistosomiasis treatment and care present opportunities towards elimination

By Esther Nakkazi

Initiating an integrated approach for cervical cancer and Female Genital Schistosomiasis (FGS) for affected women and girls presents an opportunity towards the World Health Organization (WHO) elimination target over the next decade.

The WHO targets to eliminate transmission of cervical cancer by 2030 and its policy brief on deworming adolescent girls and women of reproductive age aims to control schistosomiasis in the same time frame. 

Dr Tedros Adhanom Ghebreyesus, Director-General, WHO, has stated that “FGS is a silent and neglected epidemic, affecting the same people who carry a disproportionate global burden of HIV and cervical cancer”.

Now, scientists say there is an increased probability to achieve the WHO target by 2030 if an integrated approach for FGS and cervical cancer into routine sexual and reproductive health care services where affected women and girls most likely seek prevention, treatment and care is implemented.

“We want to support, develop and implement worldwide evidence based initiatives to improve on three spheres; first HPV and cervical cancer prevention. 

Secondly, FGS diagnosis and patient information and thirdly, quality of treatment which has to be tailored to the needs through research and policy initiatives,” says Eyrun Flörecke Kjetland a professor at Oslo University Hospital.

Scientists led by Dr Julie Jacobson, a global health leader who serves as Managing Partner for the global health non-profit Bridges to Development published in January in the Nature Reproductive Health Journal  says the skills necessary for FGS management is a critical step to prepare for proper diagnosis and treatment of women and girls in sub-Saharan Africa by trained health professionals. 

The suggested competencies can now serve as the foundation to create educative tools and curricula to better train health care workers on the prevention, diagnosis, and management of FGS, says the research.

Kjetland says right now there is an enormous thrust in the cervical cancer community to push forward to eliminate it is an opportunity for FGS to piggyback as the little sister in the system on a disease (FGS) that is life threatening with less much less funding, much less push. “It’s an excellent opportunity to try to wedge our way in and join with the big systems program.”

FGS is a chronic disease caused by parasitic worms, schistosomes, transmitted by contact with infested fresh water. An estimated 56 million women may have FGS in Africa, but almost none are diagnosed or treated. 

FGS like cervical cancer can be life threatening and life altering. They are both dangerous conditions for sexual reproductive health in endemic areas. They both cause physical pain and discomfort to women who also have to contend with stigma and isolation.

FGS as a common gynaecological lesion could be confused to be cancer or an STI. “When we looked at the implications of FGS on HPV and HIV, we found an association between the high risk of HPV which causes cancer and the FGS lesions,” says Kjetland.

“To me the most dangerous situation would be that you are misdiagnosing something as cervical cancer when it is genital schistosomiasis, removing parts of the cervix, unnecessarily creating problems for the women, fertility wise and vice versa as well,” says Kjetland.

As the overlap of the incidence of cervical cancer and the prevalence of schistosomiasis presents itself in Africa, coupling the two diseases using an integrated approach through opportunities in screening, early treatment and awareness creation would maximise cost effectiveness from limited resources available, says Teresa Norris a sexual health specialist and HPV expert, the founder and president of HPV global action.

Scientists also have an opportunity through a screening method that can be used for both diseases, the Automated Visual Evaluation (AVE), a deep learning computer application.

A typical country programme would first target HPV and cervical cancer prevention by combining screening simultaneously girls aged nine to 14 and then screening and treatment for women 25 to 45 years, scientists say.

“We would first of all do screening for cervical cancer lesions using AVE while simultaneously screening for FGS lesions using this same tool and then providing treatment,” said Norris.

Secondly, the program can look at the country wide HPV vaccination programs that run through GAVI while simultaneously providing Praziquantel through GAVI to supplement the mass Drug Administration programs. Many GAVI countries also have an objective of eliminating Schistosomiasis transmission.

The scientists say they need to consider the country’s specific resources, needs and attitudes to ensure this will work.“This will give us an opportunity to be mapping for FGS and cervical cancer via a pilot project proof of concept studies in Africa in several places,” says Norris. “These initiatives in individual countries will be able to assess the accessibility and feasibility and then we can move towards scaling it up for population control in many African countries.”

Both diseases also require early treatment for better outcomes. “The diagnosis and management strategies for the two need to be hand in hand. For the young girls we know that this can be prevented if you treat it early, so they don’t have to walk into their first sexual intercourses with damaged genitals,” says Kjetland.

Cervical cancer and FGS also need more awareness creation among populations, academics and professionals. But more work is required for FGS which is hardly known. “Currently, no women are diagnosed with FGS or informed that they have this disease and FGS is not mentioned in any prevention programs,” says Kjetland.

“To many of us, learning about the prominence of FGS is new for us and then also further to that is adding that opportunity to have a deworming strategy in a lot of our projects is something that’s new in our in our community,” says Norris.

Sierra Leone has managed to make remarkable progress to control Schistosomiasis. “And the most important lesson I think we’ve learned over the last 10 years certainly is the power of integration,”says Mary Hodges, Adjunct professor, Njala University, Sierra Leone.

“Transitioning from mass campaigns for preschoolers into an integrated service delivery that included family planning for their caregivers, was a real success. And going forward, I would recommend that further integration channels for adolescents, women of reproductive age, should take a careful look at the opportunities to ride on,” says Hodges.

Kakuuto Health Centre IV alarming birth deliveries

 You have got to give it up for women in Kyotera district. The fertility rate is over the top. At Kakuuto Health Centre IV in Kyotera district baby deliveries are about six per day which now averages 180 deliveries per month.

In 2020 the population of Kyotera district was recorded to be 261,000 people. With the current additions you can do the maths. The issues may be lack of access to contraception or boredom – I don’t know.

The health officers at Kakuuto HCIV say they are overwhelmed. A health centre IV is a mini hospital with wards for men, women, and children and should be able to admit patients. It should have a senior medical officer and another doctor as well as a theatre for carrying out emergency operations.

At Kakuuto HCIV, they have an acute shortage of beds now. Of the 6 baby deliveries done everyday at least two are caesarian, which takes away time and resources for other pregnancy or antenatal related cases that are not delivering babies.

Dr. Aloysious Musoke, the Medical Officer in charge of Kakuuto HCIV, said they have a 15-bed capacity which is not enough for the increasing number of patients at the maternity ward. As a result, Musoke says they are forced to improvise with mattresses so that the patients can get maternity care from the floor.

A non-governmental organisation Brick By Brick Uganda, through its Babies And Mothers Alive (BAMA) project, built a neonatal unit to save premature babies in the congested ward but this is not enough.

Due to increased numbers, Dr. Musoke further noted that the insufficient drug supply at the health center is also worsening the situation since the drugs run out of stock before the next cycle. 

He explains that this nature of the health center is meant to be supplied drugs worth over Ugx30, 000,000 but the National Medical Stores provides drugs worth Ugx11,000,000 which is not enough considering the performance of the Health center and the numbers of patients.

Kate Nalwadda, a caregiver of a caesarian patient, says they do not have space to sleep in because the floor is being occupied by the expecting mothers.

Edward Muwanga, the Kyotera District Health Officer, he is aware of the challenge and he attributed it to lack of financial resources to purchase more beds for the maternity and other wards at the health centre.

Agnes Namusiitwa, the Kakuuto Female Councilor, and Kyotera LC5 Vice-chairperson, says that different patients and caregivers have expressed the same concern on different occasions but there is nothing to do in the meantime but to improvise. She adds that they are still lobbying some beds from good Samaritans and Non-governmental Organisations.

Frog limbs regrown - research study

US scientists have regrown the legs of frogs after a brief drug treatment, marking a significant advance for regenerative medicine.

The team at Tufts University, in collaboration with colleagues at Harvard University,  both Massachusetts, used a combination of five drugs applied in a wearable silicone cap that was placed over the stump of the frog leg, that previously had been amputated.

Each drug had a different purpose, including reducing inflammation, promoting growth of blood vessels and muscle, and stopping scar tissue.

The findings, in Science Advances, showed that after an 18-month period of regrowth, frogs restored a functional leg able to respond to stimuli such as touch.

“The fact that it required only a brief exposure to the drugs to set in motion a months-long regeneration process suggests that frogs and perhaps other animals may have dormant regenerative capabilities that can be triggered into action,” said Nirosha Murugan, first author of the paper.

Source: EARA News Digest

Gene-environment interactions that drives autism evidence revealed for the first time

Scientists have provided the first evidence of the close interactions between genes and the environment in the social dysfunctions typical of autistic disorders.

For the first time a team from the University of Geneva (UNIGE), Switzerland, within the framework of the Synapsy National Centre of Competence in Research, has deciphered how a change in cell environment triggers the onset of autistic symptoms in mice with a genetic vulnerability. 

While a link between the inflammatory process and autism was suspected, an imbalance in the expression of a series of genes caused by a massive inflammation — resulting from an immune response to the administration of a pharmacological product —leads to the hyperexcitability of neurons of the reward system" says a press release from the University of Geneva (UNIGE), Switzerland.

The results of the research are published this month in the journal Molecular Psychiatry.

The research team led by Camilla Bellone, a professor in the Department of Basic Neurosciences at the UNIGE Faculty of Medicine and director of the Synapsy National Centre of Competence in Research, had already demonstrated the role of the reward system in the social interaction deficit in autistic mice. 

Indeed, the motivation that drives individuals to interact with their peers is closely linked to the reward system, through the activation of the neuronal networks that make it up. 

But what are the cellular and molecular mechanisms at the origin of the deficits in social interaction? To understand this process and thus decipher how the symptoms appear, the scientists studied so-called heterozygous mice, i.e. mice carrying a deletion of only one of the two copies of the SHANK3 gene, but not showing social behavioural disorders. With 1-2% of all autism cases, this is indeed one of the most common monogenic causes of the disease.

“Humans carry a mutation in only one of the two copies of SHANK3, a gene that is essential for the functioning of synapses and communication between neurons,” points out Camilla Bellone. 

“In animal models of the disease, however, mutation of a single copy of SHANK3 only slightly affects the behaviour of mice, which explains why the behavioural phenotypes observed are not homogeneous”.

The role of neuronal hyperexcitability

The researchers first inhibited the expression of SHANK3 in the neural networks of the reward system in order to identify the other genes whose expression was modified. Several genes related to the inflammatory system were detected, including one of them, Trpv4, which is also involved in the functioning of communication channels between neurons. 

“By inducing massive inflammation, we observed an overexpression of Trpv4, which then led to a neuronal hyperexcitability concomitant to the onset of social avoidance behaviours that our mice did not exhibit until now,” stresses Camilla Bellone. Moreover, by inhibiting Trpv4, the scientists were able to
restore normal social behaviour.

“This provides evidence that autistic disorders are indeed the result of an interaction between a genetic susceptibility and an external trigger - in this case, massive inflammation. Neuronal hyperexcitability disrupts communication channels, thereby altering the brain circuits governing social behaviour.”

This would also explain why the same genetic predisposition can lead, depending on the environmental factors encountered and the type of inflammation they trigger, to a diversity of symptoms of equally variable severity.

Irreversible damage during development?

In this study, the inflammation was induced in adult animals. The resulting deficit in social behaviour was not only reversible, but also disappeared naturally after a few days. “We now need to replicate our research during the critical phases of neurodevelopment — i.e. during gestation and immediately after birth — in order to observe the impact of hyperexcitability on the developing neural networks.

This could damage the construction of neural networks beyond repairs,” says Camilla Bellone. This study constitutes a proof-of-principle of a direct causality between inflammation and the appearance of behavioural symptoms in the presence of genetic vulnerability, and highlights the importance of environmental factors, which have been largely underestimated until now. 

It also highlights the fact that the understanding of the mechanisms behind autistic disorders still needs to be refined in order to intervene effectively. Indeed, depending on the gene-environment interactions and inflammatory mechanisms specific to each patient, it would be possible to identify a treatment that would correspond exactly to the cellular and molecular modification at stake in the brain circuits.

People with autism spectrum disorders all have characteristic behavioural difficulties. Nevertheless, the important heterogeneity of their symptoms remains one of the major questions for scientists and physicians.

DOI: 10.1038/s41380-021-01427-0

Uganda Polio mass vaccination roll out: vaccine carriers, cults and health workers

About 270 health workers were trained to roll out the vaccination against Polio for six days in Arua City.

The Wild Polio 2 virus was detected from two samples last year at two sewage treatment sites. This type of polio can lead to permanent paralysis or even death in some cases.

Uganda was named free of Wild Polio 2 virus in 2015 and it was removed from the routine immunization schedule in 2016. As such the country doesn't store vaccines for it anymore. 

As a result the government through the Ministry of Health decided to roll out mass vaccination for children below five years targeting to vaccinate at least 8.7 million children, countrywide scheduled three days.

7.2 million children were targeted to be vaccinated by Monday 17, leaving a deficit of 1.5 million children yet to receive the vaccine. But due to limited vaccine carriers the Ministry of Health extended the date for the mass polio vaccination to Wednesday, 19th.

Vaccine carriers are insulated containers where vaccines are kept cold during transportation.

In Arua, City Health officials extended days for Polio vaccination over a shortage of vaccine carriers forcing health officials to conduct the campaign in two phases from Monday up to Wednesday.

According to Peter Aziku the Deputy Health Officer Arua City, they needed 890 cold boxes but they received 469. 

Aziku said they have decided to divide the health staff into two with the first one starting vaccination in the areas of Pajulu, Adumi, and Ayivuni all in Ayivu West while the second group of health workers will resume on Monday in the areas of Arua Hill, Oli Division, Oluko Dadamu, Manibe, and Aroi.

Pader district had a target of 50,777 children under five to be vaccinated but only 45,780 received the vaccine.

Justine Ocen the LCV Vice-Chairperson, said that the district received fewer vaccines because the Ministry of Health relied on the district report about the target population, yet the figure is now different. 

Ocen said the district is liaising with other neighboring districts to get vaccines and vaccinate the remaining children.

In Mukono district, the lack of medical workers stalled the polio vaccination campaign. The district dispatched 108 medical workers to carry out the exercise in the entire district with each parish receiving one medical worker. Mukono district target was to vaccinate 147, 000 children. 

Sarah Nassaka, a health worker said that during the previous mass vaccination exercises, four medical workers were allocated to Bagala zone but this time round only one was assigned for the polio vaccination.

Stephen Mulindwa, the District Health Officer-DHO advised parents with busy schedules to take their children to the district general hospital and health center IVs where were designated immunization centers and enough staff.

The issue of lack of vaccine carriers:

As the government rolled out the national mass polio vaccination, vaccine carriers stalled the process. The exercise which was slated to commence on Thursday January 13th, 2022, and end on Sunday, 16th January was extended for three more days. 

According to a Ministry of health survey carried out prior to commencement of the exercise only 24,000 cold chain carriers were available in the country. Hence, about 56,000 out of the 80,000 teams deployed to conduct the polio vaccination exercise nationwide didn’t get carriers to safely carry the vaccines. 

The ministry then used a staggered approach, where vaccination teams shared the carriers. Dr. Immaculate Ampaire, the deputy program manager of the Uganda National Expanded Programme on Immunization (UNEPI) said the campaign exposed the need of investing in door-to-door cold storage equipment. 

"When it comes to other cold storage equipment we are okay but we do not have enough vaccine carriers. In this ongoing campaign, we had a shortfall of over 50,000 and that is why districts were asked to do passed implementation," Ampaire said.

Extension of the campaign was a necessity and the Ministry of Health also halted COVID-19 vaccination from taking place to free up cold chain boxes that would otherwise have been used to store COVID-19 vaccines. 

The Health Ministry Spokesperson, Emmanuel Ainebyoona, said that the ministry is in the long term working towards increasing the capacity of cold chain storage equipment in the country. Recently the health ministry received equipment worth US$ 8.3million. 

Using the sub-country approach: 

As a means to reach all the children the government changed to a sub-county approach from the district approach. The door to door also consists of teams visiting each household and school which will achieve the target of reaching every child. 

On Friday, Luwero district embarked on the door-to-door immunization campaign against polio among children aged five years and below.  The district targeted to immunize 106,000 children within six days and 65 centers were gazetted to coordinate the campaign.

The health workers kicked off by immunizing children in daycare and nursery schools before they move door to do together with LCI Chairpersons.

According to preliminary data released by the immunization program, Busoga has emerged as the best performing region in this campaign with 484,809 children vaccinated followed by South Central with 450,260 children. 

Ampaire attributes Busoga's excellent performance to a change in the models used. Figures from the health ministry show that the region normally scores less than 50 percent vaccine coverage on average when it comes to routine immunization. 

“This time around we had a plan that catered for all parishes. We used village teams to move from one village to another and parish to parish. This helped us plan for all hard-to-reach areas like mountains, islands, and even some cities," she said.

"We are urging parents and school administrators to go and get children under five vaccinated. This vaccine was removed from the routine immunization schedule. We got resources from the Global Polio Eradication Initiative to carry out this campaign and parents must take up this opportunity," Ampaire said.

The health officials have also involved the cultural, religious, and local council leaders in addition to the VHTs to popularize the vaccination campaign. 

Hellen Alimo a Village Health Team-VHT Officer in Luwero said parents responded positively to the exercise although there was a challenge of inadequate health workers.

Ismail Tuku the Prime Minister of Lugbara Cultural Institution said the government should consider sharing polio vaccines with the Neighboring DRC and South Sudan because of the eminent polio risk in these countries.

Cult culture inhibit uptake of polio vaccines;

Luwero district health officials are facing a challenge to reach children of cult members that are against any form of immunization. Over 50 children could be affected.

When Luwero district embarked on the door-to-door immunization campaign, parents of children who belong to the Abajiri Christian cult in Luwero rejected it.  The families are spread at villages of Kakoola, Makokonyigo, Kikandwa, and Nakasejjere village in Kamira sub-county.

Local Leaders say the cult believes that the immunization campaign is satanic and a plan to enforce the new world order.

Abdullatif Serugo the LCI Chairman of Makokonyigo village said that during the registration of families whose children are eligible for immunization, 10 families that follow the cult in his area indicated that they won’t participate in the campaign and hence refused to volunteer any information.

He said that in the past parents have been arrested and jailed for rejecting government programs but this has not deterred their beliefs.

Ronald Mulumba the LCI Chairman of Nakasejjere village said that whenever cult followers learn about such campaigns, the children are hidden in makeshift houses in the swamps until the exercise ends.

Ponsiano Kabaale the LC 1 Chairperson of Kakoola village said he was secretly gathering information about the total number of children in the families and they intend to round them for immunization during their prayers on Saturday.

The Chairpersons have since asked the District Leadership to take up the matter and force the parents to surrender the children for immunization.

Doctor Innocent Nkonwa the Luwero District Health Officer said they were privy to information on the existence of the group and they intend to use security personnel to ensure they access children for immunization.

Erastus Kibirango the LCV Chairperson of Luwero said they would visit the villages to persuade and sensitize communities to participate in the campaign.

Sheikh Ramadhan Mulindwa the Chairperson of Inter-Religious Council in Luwero district said that immunization is not against religious faiths and parents should embrace it. It's believed that the followers of the cult have also shunned COVID 19 vaccination exercise.

In 2014, more than 300 followers of Abajiri cult in Luwero and Nakasongola districts fled their homes to evade arrest after rejecting the national population and housing census.

In 2010, the same cult followers were arrested and jailed for blocking their children from attending school but their attitude didn’t change. It is believed that they're over 500 followers of Bajiri cult in Luwero and Nakasongola districts. 

Polio hit Uganda hard in 1983 and left many children who are now aged 30 years plus maimed with its scars. Since then vaccines have been rolled out to eliminate the disease. 

Uganda had already excluded the vaccines for Wild Polio 2 virus from its immunization routine programs in 2016, following the WHO declaration in 2006 that Uganda was Polio free since it had not reported a case of polio for a decade. But porous borders continue to derail these efforts.    

 

Instead of coercing, nudges prove their effectiveness

Our choices are not only determined by our ability to reason, but are also influenced by certain biases such as our emotions, our memories, the opinions of others or the configuration of our environment.

This is based on a  theory termed as  «nudging» developed by American economist Richard Thaler in the late 2000s. Focusing on these elements can therefore be more effective in getting us to change certain behaviours than a ban or an awareness-raising campaign.

In the behavioral sciences, researchers call this a modification of the 'choice architecture'. This is done, for example, when in a company cafeteria the healthiest dishes are deliberately placed at the top of the menu to encourage customers to select the option that is most beneficial to their health, without infringing on their freedom to choose. 

As a result, this type of intervention is attracting increasing interest from both the scientific community and public authorities.

Over 450 strategies analyzed
Despite the growing popularity of nudges, their performances had not yet been studied in their entirety. By performing a meta-analysis (a statistical approach aimed at synthesizing the results of numerous studies), a research team from the University of Geneva (UNIGE) has succeeded in demonstrating the effectiveness of “nudges” and identifying the areas in which they are most relevant. 

"We have collected more than 200 scientific articles published over the last 15 years on the subject, which represent more than 450 ‘nudge’ strategies," says Stéphanie Mertens, the study’s first author and a researcher at the Consumer Decision and Sustainable Behavior Laboratory of the Department of Psychology in the Faculty of Psychology and Educational Sciences at the UNIGE.

Inciting instead of coercing, «nudges» prove their effectiveness

A team from the UNIGE demonstrates that certain soft incentive techniques, known as «nudges», are effective in getting people to change their behaviour. To get through challenges such as the pandemic or the climate change, citizens must change their habits and behaviors. 

But how can this be achieved without resorting to coercive measures? The answer to this question may be the «nudges» that have been gaining popularity over the last decade. By making small changes in our environment, these interventions aim to encourage changes in our behaviour, while preserving our freedom of choice. 

From adding informative labels to reorganising the food offer in a cafeteria, the overall effectiveness of these interventions has now been demonstrated by a scientific team from the University of Geneva (UNIGE). 

Their results can be found in the Proceedings of the National Academy of Sciences of the United States of America. To carry out this study, the researchers classified the nudges described in this scientific literature into three groups: «information», «structure» and «assistance». 

In the first set, they grouped interventions whose objective is to inform individuals in order to motivate them to make certain choices, such as the «nutri-score» labels found on certain food products. In the second set, they grouped techniques that deal with the structure of an environment. This is the example (cited above) of highlighting certain meals in a cafeteria menu.

In the third set, they classified nudges involving a form of commitment, as in the case of a person who stops smoking and informs those around him or her. When informed, the people around him or her take on the function of a 'safeguard' in the choice architecture of the abstinent smoker.

Highly effective for food choices

The scientific team concluded that all three groups of nudges are effective. They note, however, that the techniques in the second group («structure») are the most effective. 

"Within these groups, we also compared different areas of application, such as health, finances or energy consumption. In the end, we found that nudges work best in the area of food", explains Tobias Brosch, Director of the Consumer Decision and Sustainable Behavior Laboratory. 

Tobias Brosch and his team have also observed disparities in the quality of the studies produced on the subject over the years. "It is imperative that the overall study quality increases because of the impact that nudges can have on the daily lives of citizens," he explains. 

All of the synthesized data is now available to researchers. But this study is also intended to become a reference document for policymakers who wish to implement these new practices. 

"However, it is important to bear in mind that nudges are powerful tools, as our research shows. Nudges must therefore be used wisely and within the framework of democratic and transparent processes," concludes the researcher.

ends

World Mobile plans to launch balloons across Africa to connect hundreds of millions of people

World Mobile, the first mobile network built on blockchain and run by the people has partnered with Altaeros, developers of the world’s first autonomous aerostats, to connect the unconnected. 

World Mobile and Altaeros have united to bring internet to unconnected areas in Africa,  leading to mass digital inclusion.  

Through this partnership, Altaeros and World Mobile will provide low-altitude aerostats (tethered balloon platforms) with a coverage area of approximately 8,000 km^2 each, forming part of World Mobile Dynamic Network. 

World Mobile plans to launch these balloons across Africa to connect hundreds of millions of people. Several aerostats will launch in Zanzibar anchoring the network and delivering connectivity near to 100% of the island. 

Each aerostat will connect hundreds of thousands of subscribers and each subscriber on the network will create a blockchain wallet. World Mobile will be deploying thousands of aerostats across the continent.

The aerostat system consists of a helium-filled envelope and stabilising fins. The unique 3-tethered architecture limits the aerostat's movement in the air (pitch, roll and yaw), which is essential in stabilizing telco coverage so connectivity doesn't drop in and out. 

The aerostat is attached to a movable mooring platform with built-in software that adjusts the balloon's position depending on wind conditions. The onboard communication system, using beam forming technology (a technique that focuses a wireless signal towards a specific receiving device) will allow 3G, 4G and 5G handsets to connect directly and will also connect WM AirNodes in the vicinity via traditional and alternative spectrums.

“We’re on a journey to bring modern infrastructure to billions of un-served and under-served people around the world. We’re driven by a belief that business and technical innovation are the keys to creating a positive, scalable impact. World Mobile is the perfect partner to work with to deliver our vision as they strive to connect the unconnected, everywhere,” says Altaeros CEO/CTO Ben Glass.

“World Mobile is on a mission to connect the unconnected and build the first mobile network powered and run by the people. Working with leading tech partners who share our values will make us stronger, says World Mobile Founder and CEO Micky Watkins.

World Mobile is the first mobile network powered and run by the people. Their fearless commitment to community, the environment, and technology will help them go where no telecom has gone before. 

By joining forces with their users, they’ll connect billions of unconnected people worldwide—allowing everyone the freedom to explore the world. 

Altaeros is on a mission is to help bring connectivity to those who need it most. Founded at MIT in 2010, Altaeros is focused on developing and deploying innovative real-world infrastructure solutions to bring affordable services anywhere needed, helping businesses and communities access the basic building blocks to allow for prosperity. 

Altaeros is headquartered in Somerville, MA.