UNFPA  United Nations Population Fund [to 8 March 2014]
http://www.unfpa.org/public/

06 March 2014 – Statement
International Women’s Day: Progress for Women and Girls is Progress for All
As we commemorate International Women’s Day and celebrate the many achievements of women and girls, we should also remember that for far too many, the ability to live a healthy, productive life free from violence, to fully enjoy their rights, remains an aspiration. So today is also a time to recommit ourselves to delivering once and for all on the promise of gender equality, women’s empowerment and sexual and reproductive health and rights for all women and girls everywhere. more

04 March 2014 – Dispatch
“Sexual and Reproductive Health is a Fundamental Human Right”: UNFPA Executive Director Addresses Human Rights Council
UNITED NATIONS, Geneva – Dr. Babatunde Osotimehin addressed the 25th Regular Session of the Human Rights Council where he emphasized that sexual and reproductive health is a fundamental human right and that empowering women and girls is one of the most reliable pathways to improved well-being for all. more

FAO Food & Agriculture Organization [to 8 March 2014]
http://www.fao.org/home/en/

Closing the gender gap in agriculture  
7 March 2014, Rome – Tomorrow will mark International Women’s day, and with that, high-level experts from the UN and partner organizations met today at FAO Headquarters in Rome to discuss the theme “Closing the gender gap in agriculture”. Women play a remarkably strong role in Agriculture while facing an equally remarkable array of challenges. In this dialogue – jointly organized by the Food and Agriculture Organization (FAO), the International Fund for Agricultural Development (IFAD), the World Food Programme (WFP), the International Development Law Organization (IDLO), the International Food Policy Research Institute (IFPRI) and the World Farmers’ (…)

FAO Food Price Index  
6 March 2014, Rome – Weather-related trends and increased demand came into play as the FAO Food Price Index registered its sharpest increase since mid-2012, averaging 208.1 points in February 2014. The new level was 5.2 points, or 2.6 percent, above a slightly revised index for January, but was still 2.1 percent lower than last year at the same time. The figures were released amid news reports of spikes in wheat and corn prices in response to recent developments in Ukraine, but the February increase in the Index cannot be attributed to those events. Changing conditions in Ukraine and Russia, (…)

Zimbabwe: smallholder farmers receive support  
6 March 2014, Harare – The European Union (EU) has given $19 million USD to help smallholder farmers in communal and old resettlement areas of Zimbabwe. The funds, channelled through the Food and Agriculture Organization of the United Nations (FAO), will enable smallholder farmers to receive support through two programs: Irrigation Support and livestock assistance. According to FAO, the programmes will be rolled out over a 48 month period, with the goal of sustainably increasing production and productivity in the targeted areas, as well as, assisting smallholders to engage in commercial agriculture through integrated farming approaches.

UNESCO  [to 8 March 2014]
http://www.unesco.org/new/en/media-services/for-the-press/all-news//

7 Mar 2014 – HOPE calls for a Sustainable Development Goal on the Ocean

7 Mar 2014 – Feedback sought for UNESCO’s research on the Internet

6 Mar 2014 – Gender equality – a breakthrough strategy for sustainable development

6 Mar 2014 – UNWTO, UNODC and UNESCO launch anti-trafficking campaign

6 Mar 2014 – Report Details Troubling Toll of Gender-Based Violence in Asia-Pacific Schools

6 Mar 2014 – Launch of the global campaign against illegal trafficking in tourism

6 Mar 2014 – UNESCO and partners launch Women Make the News 2014

5 Mar 2014 – Just 30% of the world’s researchers are women. What’s the situation in your country?

UNCTAD  [to 8 March 2014]
http://unctad.org/en/Pages/Home.aspx

UNCTAD-ITC Partnership on Trade faciliation
Jointly issued by UNCTAD and ITC
Geneva, Switzerland, (04 March 2014)
The United Nations Conference on Trade and Development (UNCTAD) and the International Trade Centre (ITC) are joining forces to assist developing countries in the implementation of the recent WTO Trade Facilitation Agreement. The two agencies have today signed a Memorandum of Understanding reaffirming this collaboration.
‘The Trade Facilitation Agreement is a real opportunity for developing countries, but only if they can put its provisions into practice,’ said Arancha González, ITC’s Executive Director.
‘The two agencies complement each other very well and can offer meaningful support to developing countries together, ‘said UNCTAD Secretary-General Mukhisa Kituyi. UNCTAD already has a successful programme in building institutional capacity around effective trade facilitation, while ITC has experience in building the capacity of the private sector and increasing their export competitiveness’, he added.
The programme which the agencies will develop will focus particularly on Least Developed Countries…

CBD (Convention of Biological Diversity) [to 8 March 2014]
http://www.cbd.int/

South Sudan becomes 194th Party to Convention on Biological Diversity
Montreal, 7 March 2014 – South Sudan deposited its instrument of accession to the Convention on Biological Diversity (CBD) on 17 February 2014, thus becoming the 194th Party to the global treaty on biodiversity and sustainable development. With this accession, the CBD will enter into force for South Sudan on 18 May 2014.

Iraq to become 167th Party to the Cartagena Protocol on Biosafety
Montreal, 7 March 2014 – Iraq deposited its instrument of accession to the Cartagena Protocol on Biosafety to the Convention on Biological Diversity on 3 March 2014 and will become the 167th Party to the Cartagena Protocol on 1 June 2014.

USAID [to 8 March 2014]
http://www.usaid.gov/

Administrator Shah Delivers Remarks at the US-ASEAN Business Council
USAID to Release Women’s Lives and Challenges Report
March 7, 2014
Today the U.S. Agency for International Development (USAID) and the Demographic and Health Surveys Program released Women’s Lives and Challenges: Equality and Empowerment since 2000, a report that assesses gains in women’s status and gender equality worldwide.
Women’s Lives and Challenges: Equality and Empowerment since 2000

Launch of US-ASEAN Business Alliance for Competitive SMEs
March 4, 2014
The U.S. Agency for International Development (USAID) and US-ASEAN Business Council signed a Memorandum of Understanding (MOU) today to create the US-ASEAN Business Alliance for Competitive Small and Medium Sized Enterprises (SMEs). The MOU was signed by USAID Administrator Rajiv Shah, Council President Alexander Feldman, and Procter & Gamble Vice President Carolyn Brehm as the representative of the Council’s ASEAN committee.

DFID  [to 8 March 2014]
https://www.gov.uk/government/organisations/department-for-international-development

The Coca-Cola company and the UK government strengthen girls’ education and economic opportunities in Nigeria
7 March 2014
DFID Press release

Greening: it’s time to break the silence on early and forced marriage
5 March 2014
DFID Press release

OECD  [to 8 March 2014]
http://www.oecd.org/

7-March-2014
New approach needed to boost strong and sustainable tourism growth, says OECD
Governments should recognise tourism’s role as an essential driver of jobs and growth and boost their support for the sector. The industry today accounts for 4.7% of GDP and 6.0% of employment in the developed world, according to a new OECD report.

World Trade Organisation [to 8 March 2014]
http://www.wto.org/english/news_e/news13_e/news13_e.htm

6 March 2014
ENHANCED INTEGRATED FRAMEWORK
New UNCTAD-EIF report says improved trade policies in fish sectors could address gender inequalities
The expansion of the fisheries sector could help lift Gambians from poverty, in particular women, a new UNCTAD-EIF report has found, concluding that the inclusion of gender considerations in trade policy is a useful way to achieve greater prosperity for all. The case study warns that without built-in gender perspectives, the promotion of fish exports in The Gambia could in some cases actually worsen inequality between men and women…

American Journal of Tropical Medicine and Hygiene
March 2014; 90 (3)
http://www.ajtmh.org/content/current

Importance of Cholera and Other Etiologies of Acute Diarrhea in Post-Earthquake Port-au-Prince, Haiti
Macarthur Charles, Glavdia G. Delva, Jethro Boutin, Karine Severe, Mireille Peck, Marie Marcelle abou, Peter F. Wright, and Jean W. Pape
Am J Trop Med Hyg 2014 90:511-517; Published online January 20, 2014, doi:10.4269/ajtmh.13-0514
Abstract

Pre-Travel Preparation of US Travelers Going Abroad to Provide Humanitarian Service, Global TravEpiNet 2009–2011
Rhett J. Stoney, Emily S. Jentes, Mark J. Sotir, Phyllis Kozarsky, Sowmya R. Rao, Regina C. LaRocque, Edward T. Ryan, and the Global TravEpiNet Consortium
Am J Trop Med Hyg 2014 90:553-559; Published online January 20, 2014, doi:10.4269/ajtmh.13-0479
Abstract

Effects of Malnutrition on Children’s Immunity to Bacterial Antigens in Northern Senegal
Lobna Gaayeb, Jean B. Sarr, Cecile Cames, Claire Pinçon, Jean-Baptiste Hanon, Mamadou O. Ndiath, Modou Seck, Fabien Herbert, Andre B. Sagna, Anne-Marie Schacht, Franck Remoue,
Gilles Riveau, and Emmanuel Hermann
Am J Trop Med Hyg 2014 90:566-573; Published online January 20, 2014, doi:10.4269/ajtmh.12-0657
Abstract

BMC Public Health
(Accessed 8 March 2014)
http://www.biomedcentral.com/bmcpublichealth/content

Research article
Factors associated with non-utilization of child immunization in Pakistan: evidence from the Demographic and Health Survey 2006-07
Ayesha Siddiqa Bugvi, Rahla Rahat, Rubeena Zakar, Muhammad Zakria Zakar, Florian Fischer, Muazzam Nasrullah and Riffat Manawar
Author Affiliations
BMC Public Health 2014, 14:232  doi:10.1186/1471-2458-14-232
Published: 6 March 2014
http://www.biomedcentral.com/1471-2458/14/232/abstract

Abstract (provisional)
Background
The proportion of incompletely immunized children in Pakistan varies from 37-58%, and this has recently resulted in outbreaks of measles and polio. The aim of this paper is to determine the factors associated with incomplete immunization among children aged 12-23?months in Pakistan.

Methods
Secondary analysis was conducted on nationally representative cross-sectional survey data from the Pakistan Demographic and Health Survey, 2006-07. The analysis was limited to ever-married mothers who had delivered their last child during the 23?months immediately preceding the survey (n?=?2,435). `Complete immunization? was defined as the child having received twelve doses of five vaccines, and `incomplete immunization? was defined if he/she had missed at least one of these twelve doses. The association between child immunization status and determinants of non-utilization of vaccines was assessed by calculating unadjusted and adjusted odds ratios (AOR) with 95% confidence intervals using a multivariable binary logistic regression.

Results
The findings of this research showed that nearly 66% of children were incompletely immunized against seven preventable childhood diseases. The likelihood of incomplete immunization was significantly associated with the father’s occupation as a manual worker (AOR = 1.47; 95% CI: 1.10-1.97), lack of access to information (AOR = 1.35; 95% CI: 1.09-1.66), non-use of antenatal care (AOR = 1.33; 95% CI: 1.07-1.66), children born in Baluchistan region (AOR = 1.74; 95% CI: 1.12-2.70) and delivery at home (AOR = 1.39; 95% CI: 1.14-1.69).

Conclusions
Despite governmental efforts to increase rates of immunization against childhood diseases, the proportion of incompletely immunized children in Pakistan is still high. Targeted interventions are needed to increase the immunization rates in Pakistan. These interventions need to concentrate on people with low socioeconomic and educational status in order to improve their knowledge of this topic.

BMC Public Health
(Accessed 8 March 2014)
http://www.biomedcentral.com/bmcpublichealth/content

Research article
From the parents’ perspective: a user-satisfaction survey of immunization services in Guatemala
Lissette Barrera, Silas Pierson Trumbo, Pamela Bravo-Alcántara, Martha Velandia-González and M Carolina Danovaro-Holliday
Author Affiliations
BMC Public Health 2014, 14:231  doi:10.1186/1471-2458-14-231
Published: 6 March 2014
http://www.biomedcentral.com/1471-2458/14/231/abstract

Abstract (provisional)
Background
Immunization coverage levels in Guatemala have increased over the last two decades, but national targets of >=95% have yet to be reached. To determine factors related to undervaccination, Guatemala’s National Immunization Program conducted a user-satisfaction survey of parents and guardians of children aged 0-5 years. Variables evaluated included parental immunization attitudes, preferences, and practices; the impact of immunization campaigns and marketing strategies; and factors inhibiting immunization.

Methods
Based on administrative coverage levels and socio-demographic indicators in Guatemala’s 22 geographical departments, five were designated as low-coverage and five as high-coverage areas. Overall, 1194 parents and guardians of children aged 0-5 years were interviewed in these 10 departments. We compared indicators between low- and high-coverage areas and identified risk factors associated with undervaccination.

Results
Of the 1593 children studied, 29 (1.8%) were determined to be unvaccinated, 458 (28.8%) undervaccinated, and 1106 (69.4%) fully vaccinated. In low-coverage areas, children of less educated (no education: RR = 1.49, p = 0.01; primary or less: 1.39, p = 0.009), older (aged >39 years: RR =1.31, p = 0.05), and single (RR = 1.32, p = 0.03) parents were more likely to have incomplete vaccination schedules. Similarly, factors associated with undervaccination in high-coverage areas included the caregiver’s lack of education (none: RR = 1.72, p = 0.0007; primary or less: RR = 1.30, p = 0.05) and single marital status (RR = 1.36, p = 0.03), as well as the child’s birth order (second: RR = 1.68, p = 0.003). Although users generally approved of immunization services, problems in service quality were identified. According to participants, topics such as the risk of adverse events (47.4%) and next vaccination appointments (32.3%) were inconsistently communicated to parents. Additionally, 179 (15.0%) participants reported the inability to vaccinate their child on at least one occasion. Compared to high-coverage areas, participants in low-coverage areas reported poorer service, longer wait times, and greater distances to health centers. In high-coverage areas, participants reported less knowledge about the availability of services.

Conclusions
Generally, immunization barriers in Guatemala are related to problems in accessing and attaining high-quality immunization services rather than to a population that does not adequately value vaccination. We provide recommendations to aid the country in maintaining its achievements and addressing new challenges.

BMC Public Health
(Accessed 8 March 2014)
http://www.biomedcentral.com/bmcpublichealth/content

Research article
Vaccination coverage of children aged 12-23 months in Gaziantep, Turkey: comparative results of two studies carried out by lot quality technique: what changed after family medicine?
Birgul Ozcirpici, Neriman Aydin, Ferhat Coskun, Hakan Tuzun and Servet Ozgur
Author Affiliations
BMC Public Health 2014, 14:217  doi:10.1186/1471-2458-14-217
Published: 3 March 2014
http://www.biomedcentral.com/1471-2458/14/217/abstract

Abstract (provisional)
Background
Health care systems in many countries are changing for a variety of reasons. Monitoring of community-based services, especially vaccination coverage, is important during transition periods to ensure program effectiveness. In 2005, Turkey began a transformation from a “socialization of health services” system to a “family medicine” system. The family medicine system was implemented in the city of Gaziantep, in December, 2010.

Methods
Two descriptive, cross-sectional studies were conducted in Gaziantep city center; the first study was before the transition to the family medicine system and the second study was one year after the transition. The Lot Quality Technique methodology was used to determine the quality of vaccination services. The population studied was children aged 12-23 months. Data from the two studies were compared in terms of vaccination coverage and lot service quality to determine whether there were any changes in these parameters after the transition to a family service system.

Results
A total of 93.7% of children in Gaziantep were fully vaccinated before the transition. Vaccination rates decreased significantly to 84.0% (p <0.005) after the family medicine system was implemented. The number of unacceptable vaccine lots increased from 5 lots before the transition to 21 lots after the establishment of the family medicine system.

Cocclusions
The number of first doses of vaccine given was higher after family medicine was implemented; however, the numbers of second, third, and booster doses, and the number of children fully vaccinated were lower than before transition. Acceptable and unacceptable lots were not the same before and after the transition. Different health care personnel were employed at the lots after family medicine was implemented. This result suggests that individual characteristics of the health care personnel working in a geographic area are as important as the socioeconomic and cultural characteristics of the community.

Disaster Medicine and Public Health Preparedness
http://journals.cambridge.org/action/displayIssue?jid=DMP&tab=currentissue
2014 Feb 27:1-7. [Epub ahead of print]

Editorial
Conversations in Disaster Medicine and Public Health: The Profession
Frederick M. Burkle Jr
Harvard Humanitarian Initiative, Harvard University and Harvard School of Public Health, Cambridge, Massachusetts, and Woodrow Wilson International Center for Scholars, Washington, DC.
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9187305&fulltextType=ED&fileId=S1935789314000111
Abstract
Using historical and research examples of disaster and crisis science, I argue here for the professionalization of disaster medicine and public health as a unique and essential discipline in support of global public health security. Questions about clinical competencies of providers and reports of unacceptable practices and the limited scope of guidelines for foreign medical teams have persisted for years. The professionalization movement endorses a standard route to certification through the completion of a competency-based curriculum, demonstrating competency through examination or experience to produce a learning and development portfolio, document competency through the acquisition of experience and added training, and develop professional associations. These programs devise certification criteria for entry, mid-level, and higher level candidates who serve in domestic and global humanitarian crises.

Health Policy and Planning
Volume 29 Issue 2 March 2014
http://heapol.oxfordjournals.org/content/current

Impact of user fees on maternal health service utilization and related health outcomes: a systematic review
Susie Dzakpasu1, Timothy Powell-Jackson2 and Oona M.R. Campbell1
Author Affiliations
1Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK and 2Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
Accepted December 21, 2012.
http://heapol.oxfordjournals.org/content/29/2/137.abstract

Abstract
Objective
To assess the evidence of the impact of user fees on maternal health service utilization and related health outcomes in low- and middle-income countries, as well as their impact on inequalities in these outcomes.

Methods
Studies were identified by modifying a search strategy from a related systematic review. Primary studies of any design were included if they reported the effect of fee changes on maternal health service utilization, related health outcomes and inequalities in these outcomes. For each study, data were systematically extracted and a quality assessment conducted. Due to the heterogeneity of study methods, results were examined narratively.

Findings
Twenty studies were included. Designs and analytic approaches comprised: two interrupted time series, eight repeated cross-sectional, nine before-and-after without comparison groups and one before-and-after in three groups. Overall, the quality of studies was poor. Few studies addressed potential sources of bias, such as secular trends over time, and even basic tests of statistical significance were often not reported. Consistency in the direction of effects provided some evidence of an increase in facility delivery in particular after fees were removed, as well as possible increases in the number of managed delivery complications. There was little evidence of the effect on health outcomes or inequality in accessing care and, where available, the direction of effect varied.

Conclusion
Despite the global momentum to abolish user fees for maternal and child health services, robust evidence quantifying impact remains scant. Improved methods for evaluating and reporting on these interventions are recommended, including better descriptions of the interventions and context, looking at a range of outcome measures, and adopting robust analytical methods that allow for adjustment of underlying and seasonal trends, reporting immediate as well as longer-term (e.g. at 6 months and 1 year) effects and using comparison groups where possible.

Health Policy and Planning
Volume 29 Issue 2 March 2014
http://heapol.oxfordjournals.org/content/current

Estimates of performance in the rate of decline of under-five mortality for 113 low- and middle-income countries, 1970–2010
Stéphane Verguet and Dean T. Jamison
Author Affiliations
Department of Global Health, University of Washington, Seattle, WA, USA
Accepted December 21, 2012.
http://heapol.oxfordjournals.org/content/29/2/151.abstract

Abstract
Background
Measuring country performance in health has focused on assessing predicted vs observed levels of outcomes, an indicator that varies slowly over time. An alternative is to measure performance in terms of the rate of change in how a selected outcome compares to what would be expected given contextual determinants. Rates of change in health indicators can prove more sensitive than levels to changes in social, intersectoral or health policy context. It is thus similar to the growth rate of gross domestic product in the economic context. We assess performance in the rate of change (decline) of under-five mortality for 113 low- and middle-income countries.

Methods
For 1970–2010, we study the evolution in rates of decline of under-five mortality. For each decade, we define performance as the average of the difference between the observed rate of decline and a rate of decline predicted by a model controlling for the contextual factors of income, female education levels, decade and geographical location.

Results
In the 1970s, the top performer in the rate of decline of under-five mortality was Costa Rica. In the 2000s, the top performer was Turkey. Overall, performance in rates of decline correlated little with performance in levels of under-five mortality. A major transition in performance between decades suggests a change in underlying determinants and we report the magnitude of these transitions. For example, heavily AIDS impacted countries, such as Botswana, experienced major drops in performance between the 1980s and the 1990s and some, including Botswana, experienced major compensatory improvements between the 1990s and the 2000s.

Conclusions
Rate-based measures of country performance in health provide a starting point for assessments of the importance of health system, social and intersectoral determinants of performance.

Health Policy and Planning
Volume 29 Issue 2 March 2014
http://heapol.oxfordjournals.org/content/current

Achieving comprehensive childhood immunization: an analysis of obstacles and opportunities in The Gambia
Sarah Payne1, John Townend3, Momodou Jasseh3, Yamundow Lowe Jallow4 and Beate Kampmann2,3
Author Affiliations
1School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK, 2Department of Paediatrics, St Mary’s Campus, Imperial College of Science, Technology & Medicine, Norfolk Place, London W2 1PG, UK, 3MRC-Unit, Atlantic Road, Fajara, The Gambia, West Africa and 4Ministry of Health and Social Welfare Government of The Gambia, The Quadrangle Banjul, The Gambia
Accepted January 11, 2013.
http://heapol.oxfordjournals.org/content/29/2/193.abstract

Abstract
Introduction
Immunization is a vital component in the drive to decrease global childhood mortality, yet challenges remain in ensuring wide coverage of immunization and full immunization, particularly in low- and middle-income countries. This study assessed immunization coverage and the determinants of immunization in a semi-rural area in The Gambia.

Methods
Data were drawn from the Farafenni Health and Demographic Surveillance System. Children born within the surveillance area between January 2000 and December 2010 were included. Main outcomes assessed included measles, BCG and DTP vaccination status and full immunization by 12 months of age as reported on child healthcards. Predictor variables were evaluated based on a literature review and included gender, ethnicity, area of residence, household wealth and mother’s age.

Results
Of the 7363 children included in the study, immunization coverage was 73% (CI 72–74) for measles, 86% (CI 86–87) for BCG, 79% (CI 78–80) for three doses of DTP and 52% (CI 51–53) for full immunization. Coverage was significantly associated with area of residence and ethnicity, with children in urban areas and of Mandinka ethnicity being least likely to be fully immunized.

Conclusions
Despite high levels of coverage of many individual vaccines, delivery of vaccinations later in the schedule and achieving high coverage of full immunization remain challenges, even in a country with a committed childhood immunization programme, such as The Gambia. Our data indicate areas for targeted interventions by the national Expanded Programme of Immunization.

Journal of International Development
March 2014  Volume 26, Issue 2  Pages 155–302
http://onlinelibrary.wiley.com/doi/10.1002/jid.v26.1/issuetoc

Review Article
GENDER INEQUALITY AND ECONOMIC GROWTH: A CRITICAL REVIEW
David Cuberes1,*, Marc Teignier2
Article first published online: 29 NOV 2013
DOI: 10.1002/jid.2983
http://onlinelibrary.wiley.com/doi/10.1002/jid.2983/abstract

Abstract
The link between gender inequality and economic growth is a topic that is of growing interest, both in the academic literature and the policy arena. In this paper, we survey the literature that analyses this relationship from a macroeconomic perspective. We argue that that the existing theories provide a wide range of mechanisms through which these two variables may affect each other but also that more work needs to be carried out to obtain quantitative predictions out of these models. In the empirical arena, we note the lack of connection between most studies and the existing theories described earlier. In both cases, we propose approaches to alleviate these problems.

The Lancet  
Mar 08, 2014   Volume 383  Number 9920  p845 – 926
http://www.thelancet.com/journals/lancet/issue/current

Editorial
An inspired change—stopping sexual violence against women
The Lancet
Preview |
International Women’s Day, this year themed Inspiring Change, falls on March 8. For more than a century, this event has marked women’s achievements in a world where the sexes are far from equal in many countries. In promoting the education, health, and success of women, the Day has addressed the distressing but key topic of violence against women more than once.

The Milbank Quarterly
A Multidisciplinary Journal of Population Health and Health Policy
March 2014  Volume 92, Issue 1  Pages 1–166
http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1468-0009/currentissue

Review Article
Social Media and Internet-Based Data in Global Systems for Public Health Surveillance: A Systematic Review
EDWARD VELASCO1, TUMACHA AGHENEZA1, KERSTIN DENECKE2, GÖRAN KIRCHNER1, TIM ECKMANNS1
Article first published online: 6 MAR 2014
DOI: 10.1111/1468-0009.12038
http://onlinelibrary.wiley.com/doi/10.1111/1468-0009.12038/abstract

Abstract
Context
The exchange of health information on the Internet has been heralded as an opportunity to improve public health surveillance. In a field that has traditionally relied on an established system of mandatory and voluntary reporting of known infectious diseases by doctors and laboratories to governmental agencies, innovations in social media and so-called user-generated information could lead to faster recognition of cases of infectious disease. More direct access to such data could enable surveillance epidemiologists to detect potential public health threats such as rare, new diseases or early-level warnings for epidemics. But how useful are data from social media and the Internet, and what is the potential to enhance surveillance? The challenges of using these emerging surveillance systems for infectious disease epidemiology, including the specific resources needed, technical requirements, and acceptability to public health practitioners and policymakers, have wide-reaching implications for public health surveillance in the 21st century.

Methods
This article divides public health surveillance into indicator-based surveillance and event-based surveillance and provides an overview of each. We did an exhaustive review of published articles indexed in the databases PubMed, Scopus, and Scirus between 1990 and 2011 covering contemporary event-based systems for infectious disease surveillance.

Findings
Our literature review uncovered no event-based surveillance systems currently used in national surveillance programs. While much has been done to develop event-based surveillance, the existing systems have limitations. Accordingly, there is a need for further development of automated technologies that monitor health-related information on the Internet, especially to handle large amounts of data and to prevent information overload. The dissemination to health authorities of new information about health events is not always efficient and could be improved. No comprehensive evaluations show whether event-based surveillance systems have been integrated into actual epidemiological work during real-time health events.

Conclusions
The acceptability of data from the Internet and social media as a regular part of public health surveillance programs varies and is related to a circular challenge: the willingness to integrate is rooted in a lack of effectiveness studies, yet such effectiveness can be proved only through a structured evaluation of integrated systems. Issues related to changing technical and social paradigms in both individual perceptions of and interactions with personal health data, as well as social media and other data from the Internet, must be further addressed before such information can be integrated into official surveillance systems.