Contextual factors in premature non-communicable disease mortality in selected African countries within the sustainable development goals framework: the implication of voice and accountability

Sustainable Development Goal number 3, target 4 (SDG 3.4), seeks a 30% reduction in premature Non-Communicable Diseases (NCDs) mortality from 2015 levels by 2030. Africa United Nations (UN) Member States continue to experience increasing NCD mortality significantly, with the highest proportion of diabetes mortality among the working-age group. Past efforts to address this burden have been centered primarily on individual risk modifications evident by the NCDs Cluster Program at the World Health Organization (WHO) Africa Regional Office. To achieve a progressive reduction, a comprehensive premature NCD reduction approach which includes a consideration of contexts within which premature NCD, such diabetes mortality arises is necessary. The aim was to examine the relationship between contextual factors and diabetes-related deaths as premature NCD mortality and to enable an improved contextualized evidence-based approach to premature NCD mortality reduction. Country-level data was retrieved for post SDG initiative years (2016-2019) from multiple publicly available data sources for 32 selected Africa UN Member States in the International Diabetes Federation (IDF) East and West Africa Region. Multiple linear regression was employed to examine the relationship between diabetes-related deaths in individuals 20-79 years and contextual factors identified within the SDG framework. Weighted data analysis showed that voice and accountability as a contextual factor explained approximately 47% variability in diabetes-related deaths across the selected Africa UN Member Sates in IDF East and West Region (n=32). Civil society engagement is vital to develop effective premature NCD mortality reduction policies, and strategies and stakeholders' accountabilities are necessary to ensure adherence to obligations.

Corrupção governamental e difusão do acesso à Internet: evidências globais / Corrupción gubernamental y difusión del acceso a Internet: evidencias globales / Government corruption and Internet access diffusion: global evidence

Resumo Este artigo investiga as relações entre difusão da internet, voz e accountability, dimensão cultural, corrupção e eficácia governamental, por meio de análise entre países realizada com 117 nações no período de 2000 a 2014. Adotando a técnica de Análise Robusta de Caminho para a análise de dados, conclui-se que, independentemente dos efeitos das variáveis de controle, a difusão da internet promove menores níveis de corrupção governamental, uma relação que ocorre direta e indiretamente via mediação de voz e accountability, que, por sua vez, apresenta forte correlação com a corrupção governamental. A título de contribuição teórica, reforça-se a compreensão de que a internet constitui uma importante ferramenta de combate à corrupção, além de evidenciar o papel moderador da dimensão cultural na relação entre voz e accountability e corrupção governamental e, sobretudo, de incorporar a eficácia governamental ao modelo teórico.

Resumen Este artículo investiga las relaciones entre difusión de Internet, voz, rendición de cuentas, dimensión cultural, corrupción y efectividad gubernamental mediante el análisis de 117 países, de 2000 a 2014. Usando el Robust Path Analysis como técnica de análisis de datos, se concluye que, independientemente de los efectos de las variables de control, la difusión de Internet promueve niveles más bajos de corrupción gubernamental, relación que ocurren directa e indirectamente a través de la mediación vocal y la rendición de cuentas, lo que a su vez presenta una fuerte correlación con la corrupción gubernamental. Como aportación teórica, se refuerza la idea de que Internet es una herramienta importante en la lucha contra la corrupción, además de evidenciar el papel moderador de la dimensión cultural en la relación entre la voz, la rendición de cuentas y la corrupción gubernamental y, sobre todo, incorporar la eficacia gubernamental al modelo teórico.

Abstract The relationship between Internet diffusion, voice and accountability, cultural dimension, corruption, and government effectiveness was investigated through a cross-country analysis of 117 countries from 2000 to 2014. Using Robust Path Analysis as a data analysis technique, it is concluded that, regardless of the effects of control variables, the diffusion of the Internet promotes lower levels of government corruption, occurring directly and indirectly through voice mediation and accountability, which, in turn, presents a strong direct relationship with government corruption. The focus on theoretical contribution reinforces the idea that the Internet is an important tool in the fight against corruption, as well as highlighting the role of cultural dimension, the relationship between voice and responsibility and government corruption, and, above all, incorporating government action into the theoretical model.