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Risk management and financial performance: empirical evidence from the Nigerian banking industry
(2025) Elisha, Douglas Enahoro; Alhassan, Abdul Latif
The banking industry is an important sector of any economy because banks are primarily tasked with the intermediation role of channeling funds from the deficit unit to the surplus unit through deposit mobilization and the creation of risk assets (Loans and Advances). This intermediation process is fraught with inherent risks, including credit, operational, liquidity, and solvency risks. In ensuring that banks function efficiently, they are obligated to manage these risks to ensure the creation of value for shareholders and other stakeholders. Risk management is critical to the Nigerian banking industry's system architecture. This dissertation sought to examine the relationship between risk management practices, proxied by its various components, including solvency risk (CAR), liquidity risk (LDR), credit risk (NPL), operational risk, and profitability. The study employed a sample of 12 banks, representing 97.0% of the banking industry's total assets over 11 years, from 2012 to 2022. The random and fixed effect panel technique was employed in estimating the static panel model to examine the impact of risk management on the performance of banks. The regression analysis results indicate a strong adverse effect of credit and operational risks on return on assets, suggesting that higher returns on assets are associated with lower loan loss provisions and operational losses. This indicates the importance of asset quality and risk management practices in banks' delivery of quality financial performance. On the contrary, capital ratio and liquidity risks positively affect returns on assets and equity. The study revealed a negative coefficient for banks' ages and profitability, indicating that older banks tend to have lower profitability, primarily due to Nigeria's rapidly evolving banking landscape, creating discriminating advantages for the new-generation banks. However, ownership type does not exhibit statistically significant coefficients with banks' profitability, suggesting that their direct impact on bank profitability may be limited in the context of the variables considered in the analysis Based on the findings, banks are encouraged to design data-driven policies on the capital adequacy ratios with the twin objectives of meeting the regulatory hurdle of 15% and pursuing loan book expansion. This will support the growth of the overall economy when credits are channeled to the productive sectors of the economy; moreover, expanded loan books will create interest income that ultimately enhances the profitability of banks. The study also demonstrated that banks are susceptible to time decay. Older banks underperform newer banks; therefore, banks must undertake frequent periodic analyses of their processes, strategies, and supporting infrastructure to adapt to the changing environment and landscape. Based on the findings, banks are encouraged to design data-driven policies on the capital adequacy ratios with the twin objectives of meeting the regulatory hurdle of 15% and pursuing loan book expansion. This will support the growth of the overall economy when credits are channeled to the productive sectors of the economy; moreover, expanded loan books will create interest income that ultimately enhances the profitability of banks. The study also demonstrated that banks are susceptible to time decay. Older banks underperform newer banks; therefore, banks must undertake frequent periodic analyses of their processes, strategies, and supporting infrastructure to adapt to the changing environment and landscape.
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Open Access
LSTM prediction capability on the South African JSE Top 40 of historical and live data
(2025) Elhag, Mohsen; Ndlovu, Godfrey
This study evaluates the efficacy of Long Short-Term Memory (LSTM) models in stock price forecasting using data from the South African FTSE/JSE Top 40 index, a domain yet to be extensively explored, particularly in real-time data analysis. Addressing the gap in existing research, this study assesses LSTM model predictive capability in the South African stock market on historical data and its adaptability to the dynamic, real-time stock market environment over the period from January 2001 to January 2024. Various LSTM models were trained with different configurations, and the results show that a single-layer LSTM model performs better than its multilayer counterpart in processing historical data, in terms of the mean absolute error (MAE), the root mean square error (RMSE), Mean Absolute Percentage Error (MAPE) and the R-squared. However, when applied to real-time data, the accuracy of the single-layer model diminishes, underscoring the challenges posed by the dynamic and unpredictable nature of live stock market conditions. The findings contribute to the field of financial forecasting by demonstrating the strengths and limitations of the LSTM model in the context of the South African stock market. While showcasing significant potential in historical data analysis, performing on par with previous studies, the study underscores the need for further development of the model for real-time forecasting. Future research directions include extending the testing period, integrating diverse data sets, and exploring a combination of LSTM with other forecasting methodologies.
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Open Access
Difficulties and challenges in implementing screening for lung cancer in high-risk group patients in the respiratory clinic at Groote Schuur Hospital
(2025) Emhemed, Mohamed; Van Zyl-Smit, Richard
Introduction: Lung cancer is the leading cause of cancer related deaths in South Africa. The high prevalence of cigarette smoking in our population continues to contribute to the high burden of lung cancer. Screening high risk groups with annual low dose computed tomography (LDCT) has demonstrated the potential benefit of being able to identify individuals with early-stage disease and offer potential curative therapy from this deadly disease. Objective: To determine the barriers and challenges of implementing lung cancer screening in a group of high-risk patients with underling Chronic Obstructive Pulmonary Disease (COPD). Methods: We retrospectively analysed patient records of COPD patients attending the respiratory clinic at Groote Schuur Hospital, Cape Town in the year 2022. Eligibility for lung cancer screening included formal diagnosis of COPD, age 55-74 years, at least 30 pack year history of smoking or stopped smoking within the past 15 years, no history of lung cancer, good general health, fitness for surgery and patients' willingness to undergo further invasive investigations and treatment. Fitness for surgery was objectively determined by a modified Medical Research Council (mMRC) score less than 3 and FEV1 greater than one litre. Results: 116 patients with COPD were screened for eligibility for lung cancer screening. The mean (SD) age was 62.84(10.4) years and 56.1% were male. 44 (37.9%) patients were current smokers, 68 (58.6) were ex-smokers and 4 (3.5%) never smoked. Hypertension (46.6%) was the most common medical comorbidity, followed by previous tuberculosis (19.0%) and diabetes (7.8%). 16 (13.8%) patients were potentially eligible for lung cancer screening. 47 patients had a FEV1 < 1L, 54 participants had a mMRC of 3 and above and 38 patients were excluded because of age. Conclusion: Common clinical factors which made patients ineligible for lung cancer screening in our study are age and poor surgical candidates based on mMRC class and low FEV1. Tertiary service severe/multimorbid COPD clinics provide few patients for lung cancer screening, community-based service may provide a better yield of patients for active lung cancer screening.
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Open Access
Clinico-epidemiological profile of cardiac admissions at a district level hospital in South Africa: a cohort study
(2025) Engelbrecht, Lillian Lize; van der Schyff, Nasief; Engel, Mark
Background Nineteen percent of all deaths during 2016 in South Africa (SA), were due to cardiovascular disease. Despite this notable burden, research describing cardiac admissions at the district level is limited and thus, area-specific studies are warranted to provide a perspective on SA's unique population of rich genetic, geographic, social, and cultural diversity. The aim of this study was to describe the epidemiological and clinical characteristics, associated risk factors and outcomes of cardiac patients admitted to a district level hospital in SA, in order to fill the void within currently available literature. Methods We conducted a retrospective records review of all patients admitted to Victoria Hospital Wynberg with a primary cardiac diagnosis, between 1 September 2020 to 30 November 2020. Data were transcribed onto a bespoke data collection form and captured into the Victoria Internal Medicine Research Initiative (VIMRI) electronic registry. The study was approved by UCT HREC (048/2022), the Western Cape Government and Victoria Hospital Board. Results Our cohort consisted of 218 patients (52.8% male) with a mean age (SD) of 60 years (±14.6), and an age range from 22 to 95 years. Acute decompensated heart failure, together with acute coronary syndrome, were responsible for 87.4% of all admissions. The mean length (SD) of stay was 4 days (±3.5 days). Most prevalent risk factors among admitted patients included hypertension (76%), cigarette smoking (55%) and diabetes (42.7%). Amongst diabetics, 27.3% were considered to have acceptable diabetic control (HbA1c £7%). Most frequently reported precipitants for hospital admission were prior inadequate therapy, discontinuing chronic medication, uncontrolled hypertension, disease progression, and ongoing substance use. Twenty-one percent of the cohort were transferred to cardiology for further management and specialist intervention. The inpatient mortality rate was 9.2%, and one-year mortality rate was 18.8%. Readmission within six months was reported amongst 30.8% of our cohort. Discussion and Conclusion Our study provides important insight into the clinico-epidemiological profile of cardiac admissions at a public district level hospital in SA. We report notable rates of morbidity, readmission, and mortality together with a high prevalence of well-known cardiovascular risk factors of hypertension, diabetes mellitus and cigarette smoking. While the in-hospital and one-year mortality rates are notable, but not too unexpected when compared to available data, we nevertheless recommend programmes focused on improving adherence to treatment and optimization of heart failure therapy at a primary care level, as means to reduce rates of poor adherence, suboptimal anti-failure therapy and poor glycaemic control observed in our cohort.
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Open Access
The effect of mobile messaging-based health interventions on non-communicable disease health risks and behaviours
(2025) Emeran, Aminah; Lambert, Estelle; Kroff, Jacolene
Introduction: The prevalence of non-communicable diseases (NCDs) has increased rapidly, with NCDs being a leading cause of death globally. Despite the high mortality rate, NCDs are preventable and can be managed through addressing modifiable risk factors such as obesity and physical inactivity. Many public health interventions have aimed to reduce NCD risk factors, through supporting various lifestyle modifications. These interventions include Mobile Health (mHealth) interventions, which involve the use of mobile technology to provide health care and support to patients remotely. Community-based programmes may benefit from the use of mHealth interventions, due to the potential of these interventions for scalability and cost effectiveness. Aim: The aim of this thesis was to develop, implement and evaluate a pilot mHealth intervention that delivered automated, one-way WhatsApp messages for the promotion of healthy behaviour changes, as part of a pre-existing community health programme, Western Cape on Wellness (WoW!). Prior to the implementation of the pilot intervention, formative research was conducted, which included i) performing a systematic review and meta-analysis to better understand existing mHealth literature relevant to the pilot study, and ii) conducting a prospective descriptive study that aimed to determine the baseline health status, health goals, and health barriers of the population in which the intervention would be piloted. Methods: A mixed method approach was used. First a systematic review and meta analysis was performed by searching for relevant literature on PubMed, Scopus, and Web of Science databases. Eligibility included pre-post intervention studies using one way mobile messaging for health behaviour change. A random effects model was used for meta-analysis and standardised mean difference for effect size. Thereafter, a prospective, descriptive study was performed by administering an online health questionnaire to recruited WoW! members. Lastly, a quasi-experimental two-arm intervention was piloted on the participants recruited in the descriptive study. The intervention involved a WhatsApp bot that was programmed to send biweekly messages that were tailored to the intervention participants' pre-selected health goals and health barriers, using the COM-B model (Capability, Opportunity, Motivation Behaviour). The control condition included regular, non-tailored WhatsApp messages. After 12 weeks of messages, participants were prompted to complete a follow-up health assessment. Results: The systematic review and meta-analysis (n=43) found that unidirectional mobile messaging had minimal but significant effects on physical activity (d+: 0.14, 95% CI: 0.05 to 0.23, p=0.003, I2=65%), and no effect on weight loss (d+: 0.04, 95% CI: −0.02 to 0.10, p=0.21, I 2=29%). The descriptive study (n=95) observed a high prevalence of obesity (52%) and insufficient physical activity (70%) in the target population. The most frequently selected health goal by participants was to achieve a healthy weight (55%) which correlated to the high levels of obesity and physical inactivity. Upon the completion of the pilot intervention, only 26% of the 95 participants completed the follow-up post intervention. Although no significant changes were observed post intervention, most participants in the intervention group who completed the evaluation found the intervention acceptable. Discussion: The results of our systematic review and meta-analysis are similar to our findings in the feasibility pilot. In both, we showed that unidirectional, tailored mobile messaging had little to no effect on NCD risk factors, including physical activity and weight-related outcomes. These results suggest that messaging alone is not sufficient to elicit lifestyle changes to reduce the burden of NCDs and the associated risk factors. However, due to the small sample size, the study may have been underpowered to detect any significant changes. Future studies should consider using other intervention components, in addition to mobile messages, such as interactive texting, phone calls or in-person group sessions to potentially improve intervention effectiveness. Conclusion: Although mobile health has shown some potential in managing NCD risk factors, using unidirectional messaging alone may not be sufficient as a standalone intervention. More research using messaging in conjunction with other intervention components may be needed to realise the scalable potential of mHealth for NCD management in South Africa.