MacArthur Foundation [to 23 May 2015]
http://www.macfound.org/

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Publication
Assessing the Costs of Jails
Published May 21, 2015
Hidden costs make jails far more expensive than previously understood, according to a report by the Vera Institute of Justice. The report shows that while the U.S. Department of Justice estimated that local communities spent $22.2 billion on jails in 2011, that figure fails to take into account significant costs such as employee benefits and inmate medical care that may not be included in jail budgets. The report was supported by MacArthur through the Safety and Justice Challenge, which seeks to reduce over-incarceration by changing the way America thinks about and uses jails.

Pew Charitable Trusts [to 23 May 2015]
http://www.pewtrusts.org/en/about/news-room/press-releases

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Press Releases
Pew: Clean Energy Investment Shifting to Developing Nations
May 19, 2015
Investment in and deployment of electricity infrastructure is shifting from the industrialized economies of the Northern Hemisphere to the developing economies collectively known as the “global south” and from fossil fuels toward clean energy, according to research released today by The Pew Charitable Trusts.

The report, Power Shifts—Emerging Clean Energy Markets, examines clean energy investment and deployment trends in developing countries. The report finds that 100 nations outside of the Group of 20 and the Organization for Economic Cooperation and Development attracted a total of $62 billion in clean energy investment from 2009 to 2013, much of it in a relatively small number of countries. In fact, almost half (45 percent) of the total five-year investment, $27.9 billion, occurred in 10 markets, where clean energy capacity grew by 91 percent, three times faster than any other supply option, over the five years…

Robert Wood Johnson Foundation [to 23 May 2015]
http://www.rwjf.org/en/about-rwjf/newsroom/news-releases.html

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RWJF Commits $25 Million to Broaden Health Research
Three programs will offer innovative research opportunities.
May 19, 2015
Princeton, N.J.—The Robert Wood Johnson Foundation (RWJF) today announced an initial $25 million commitment over the next three years to fund innovative research on policies, laws, system interventions, and community dynamics that improve health and well-being, with emphasis on sectors not typically associated with health, such as transportation and housing.

The research grants will support RWJF’s vision, released in 2014, to work with others to build a national Culture of Health in which everyone has the opportunity to live their healthiest life possible.

“For decades, we have supported a research agenda that supports evidence-based approaches to solve some of the most complex health issues facing America, but we want to go even deeper to address root causes of inequitable health outcomes and possible solutions based in creative collaboration across sectors and disciplines,” said Alonzo Plough, PhD, MPH, chief science officer and vice president of Research, Evaluation and Learning at RWJF. “This funding will support analyses of the impact of innovative programs and policies on overall health and well-being. We will explore topics that extend beyond the traditional understanding of health as just the absence of illness, to a broader understanding of well-being that is influenced by a range of factors affecting communities, the environment, and other social and economic determinants of health.”

Research projects will be solicited that examine the factors necessary to building a Culture of Health by identifying problems and finding evidence for what works. RWJF hopes to identify analytic methods that will help determine if the consequences of specific actions, both interventions and policy changes, actually improve population health, well-being, and equity.

Three expert organizations will lead new research programs:
:: Evidence for Action, led by a team at the University of California, San Francisco, will support investigator-initiated research that spans the full range of topics and methodologies needed to build an evidence base for a Culture of Health.

:: Policies for Action, based at Temple University, will specifically explore how policies, laws and regulations in both the public and private sectors can support a Culture of Health. This new project builds on the work and insights of the Temple team’s six years of experience with its Public Health Law Research program, an RWJF grantee.

:: Systems for Action, at the University of Kentucky, will specifically explore ways to better align and integrate public health delivery and financing systems with health care, social services, and other community systems, incorporating the Kentucky team’s experience running RWJF’s National Coordinating Center for Public Health Services and Systems Research.

RWJF officials said the roughly $25 million in new research funding adds to robust research and evaluation funding available through its current areas of focus, including reducing childhood obesity; expanding access to affordable, high-quality health coverage; increasing value of U.S. health care; and others. In addition to working with researchers who focus on traditional approaches to health research, RWJF is seeking new relationships with experts in fields not traditionally associated with health and building a broader capacity in population health science…

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 23 May 2015)

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Research article
Does a voucher program improve reproductive health service delivery and access in Kenya?
Rebecca Njuki, Timothy Abuya, James Kimani, Lucy Kanya, Allan Korongo, Collins Mukanya, Piet Bracke, Ben Bellows, Charlotte Warren BMC Health Services Research 2015, 15:206 (23 May 2015)
Abstract (provisional)
Background
Current assessments on Output-Based Aid (OBA) programs have paid limited attention to the experiences and perceptions of the healthcare providers and facility managers. This study examines the knowledge, attitudes, and experiences of healthcare providers and facility managers in the Kenya reproductive health output-based approach voucher program.
Methods
A total of 69 in-depth interviews with healthcare providers and facility managers in 30 voucher accredited facilities were conducted. The study hypothesized that a voucher program would be associated with improvements in reproductive health service provision. Data were transcribed and analyzed by adopting a thematic framework analysis approach. A combination of inductive and deductive analysis was conducted based on previous research and project documents. Results
Facility managers and providers viewed the RH-OBA program as a feasible system for increasing service utilization and improving quality of care. Perceived benefits of the program included stimulation of competition between facilities and capital investment in most facilities. Awareness of family planning (FP) and gender-based violence (GBV) recovery services voucher, however, remained lower than the maternal health voucher service. Relations between the voucher management agency and accredited facilities as well as existing health systems challenges affect program functions.
Conclusions
Public and private sector healthcare providers and facility managers perceive value in the voucher program as a healthcare financing model. They recognize that it has the potential to significantly increase demand for reproductive health services, improve quality of care and reduce inequities in the use of reproductive health services. To improve program functioning going forward, there is need to ensure the benefit package and criteria for beneficiary identification are well understood and that the public facilities are permitted greater autonomy to utilize revenue generated from the voucher program.

BMC Research Notes
(Accessed 23 May 2015)
http://www.biomedcentral.com/bmcresnotes/content

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Research article
Culturally appropriate methodology in obtaining a representative sample of South Australian Aboriginal adults for a cross-sectional population health study: challenges and resolutions
Tania Marin, Anne Taylor, Eleonora Grande, Jodie Avery, Graeme Tucker, Kim Morey BMC Research Notes 2015, 8:200 (19 May 2015)
Abstract (provisional)
Background
The considerably lower average life expectancy of Aboriginal and Torres Strait Islander Australians, compared with non-Aboriginal and non-Torres Strait Islander Australians, has been widely reported. Prevalence data for chronic disease and health risk factors are needed to provide evidence based estimates for Australian Aboriginal and Torres Strait Islanders population health planning. Representative surveys for these populations are difficult due to complex methodology. The focus of this paper is to describe in detail the methodological challenges and resolutions of a representative South Australian Aboriginal population-based health survey.
Methods
Using a stratified multi-stage sampling methodology based on the Australian Bureau of Statistics 2006 Census with culturally appropriate and epidemiological rigorous methods, 11,428 randomly selected dwellings were approached from a total of 209 census collection districts. All persons eligible for the survey identified as Aboriginal and/or Torres Strait Islander and were selected from dwellings identified as having one or more Aboriginal person(s) living there at the time of the survey.
Results
Overall, the 399 interviews from an eligible sample of 691 SA Aboriginal adults yielded a response rate of 57.7%. These face-to-face interviews were conducted by ten interviewers retained from a total of 27 trained Aboriginal interviewers. Challenges were found in three main areas: identification and recruitment of participants; interviewer recruitment and retainment; and using appropriate engagement with communities. These challenges were resolved, or at least mainly overcome, by following local protocols with communities and their representatives, and reaching agreement on the process of research for Aboriginal people.
Conclusions
Obtaining a representative sample of Aboriginal participants in a culturally appropriate way was methodologically challenging and required high levels of commitment and resources. Adhering to these principles has resulted in a rich and unique data set that provides an overview of the self-reported health status for Aboriginal people living in South Australia. This process provides some important principles to be followed when engaging with Aboriginal people and their communities for the purpose of health research.

Forum for Development Studies
Volume 42, Issue 2, 2015
http://www.tandfonline.com/toc/sfds20/current

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The Impact of ‘Women’s Empowerment in Agriculture’ on Household Vulnerability to Food Insecurity in the KwaZulu-Natal Province
Stanley Sharaunga, Maxwell Mudhara & Ayalneh Bogale
pages 195-223
Free access
DOI:10.1080/08039410.2014.997792
Abstract
It is argued that empowering women in smallholder agriculture is very crucial in reducing vulnerability to food insecurity among rural households. This study contributes to this literature by adapting the vulnerability as expected poverty approach to determine which dimensions of ‘women’s empowerment in agriculture’ reduces household’s vulnerability to food insecurity based on cross-section data collected from 300 randomly selected primary female heads-of-households in Msinga rural areas of KwaZulu-Natal. It was found that empowering women in socio-cultural aspects that creates hindrances in agriculture reduces the probability of their households being vulnerable to food insecurity. Surprisingly, access to irrigation and improved water-use security did not significantly influence household vulnerability to food insecurity. However, other forms of women’s empowerment including economic agency and physical capital empowerment were found to reduce the likelihood of a household being vulnerable to food insecurity. Women with high levels of financial capital empowerment invested less in other capital assets and were more vulnerable to food insecurity in the future. In addition to women’s empowerment, demographic characteristics of a household influence its vulnerability status. A household’s vulnerability to food insecurity reduces as the husband’s income increases but increases with increased dependency ratio. It was concluded that empowerment in agriculture alone is not a panacea to reduce household vulnerability to food insecurity. Efforts should be made to improve physical assets that determine the off-farm income earning and agricultural production capacity of households.
NGO Effectiveness: Evidence from the Field of Child Labour in El Salvador

Forum for Development Studies
Volume 42, Issue 2, 2015
http://www.tandfonline.com/toc/sfds20/current

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NGO Effectiveness: Evidence from the Field of Child Labour in El Salvador
Ivica Petrikova
pages 225-244
DOI:10.1080/08039410.2015.1010567
Abstract
This article examines the impact that relations among three non-governmental organisations (NGOs) working with child labourers in El Salvador have on the effectiveness of the NGO’s development assistance. Each of the organisations has chosen a different approach to child labour – one of them views it as an inevitable consequence of poverty that cannot be addressed separately from other developmental problems, while another one regards it a violation of children’s human rights in need of imminent eradication. The third organisation falls somewhere in between, promoting child-labour bans in theory but not fully enforcing them in practice. The three NGOs neither collaborate nor communicate with each other. As a result, the overall effect of their work is hindered by a small scale of projects, high transaction costs, potential duplication, and contradicting strategies to addressing child labour. Some of these shortcomings could be improved via intensifying organisations’ mutual coordination. However, more communication on its own would likely not lead to greater coherence in the approach to addressing child labour on the national level, as it appears that the NGOs devise their strategies and projects on the basis of their donors’ preferences rather than on the basis of their beneficiaries’ needs. I conclude with the observation that in order to increase their effectiveness, NGOs working in child labour, and in other divisive development topics, should be in closer coordination not only with each other but also with the governments of the countries where they work.

Journal of Global Infectious Diseases (JGID)
April-June 2015 Volume 7 | Issue 2 Page Nos. 53-94
http://www.jgid.org/currentissue.asp?sabs=n

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State of the globe: Ebola outbreak in the western world: Are we really ready?
Miguel Reina-Ortiz1, Ismael Hoare1, Vinita Sharma2, Ricardo Izurieta1
1 Department of Global Health, College of Public Health, University of South Florida, Florida, USA
2 Department of Community and Family Health, College of Public Health, University of South Florida, Florida, USA
Excerpt
…In summary, if we are to prevent an Ebola outbreak to ever occur in the Western World, we would need to consider the additional following steps: Educate the population to avoid overflowing of healthcare services, but at the same time to recognize early symptoms properly; implement triage units or sentinel posts closer to the most vulnerable populations (if and when needed); care for the uninsured; educate and train healthcare workers; establish sterilizing units directly under the command of Health Departments; and recruit and train staff and volunteers. We deem the prospects of an Ebola outbreak to occur in the US and the Western World still very low; however, we believe it is important to address the weaknesses in our healthcare systems to be better prepared for such a challenge should it occur.

Journal of Health Care for the Poor and Underserved (JHCPU)
Volume 26, Number 2, May 2015 Supplement
https://muse.jhu.edu/journals/journal_of_health_care_for_the_poor_and_underserved/toc/hpu.26.2A.html
SUPPLEMENT FOCUS: Shining the Light on Asian American, Native Hawaiian, and Pacific Islander Health

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Introduction: Shining the Light on Asian American, Native Hawaiian, and Pacific Islander Health
Winston Tseng, Simona C. Kwon
Author’s Note: In liieu of an abstract, here is a brief excerpt of the content:
The United States’s diverse Asian American and Native Hawaiian and Pacific Islander (AA and NHPI) populations have grown faster than those of any other racial/ethnic group over the past three decades.* , Out of the shadows and into the light, the health and health care issues faced by our AA and NHPI communities across the U.S., its territories, and freely associated states matter more and more to the vitality and future of the nation.

In 2015, we mark the 30th anniversary of the Heckler Report, the seminal Report of the Secretary’s Task Force on Black and Minority Health documenting national health inequities by race and ethnicity, which led to the establishment of the Office of Minority Health by Congress in 1986. Notably, the report concluded that Asian/Pacific Islanders in aggregrate were healthier than any other racial group in the U.S. In this supplement, Ponce and colleagues– Ko Chin and Caballero* present a community perspective on the leadership of Assistant Secretary for Health, Dr. Howard Koh, and his work in shepherding new national health equity initiatives, including the Patient Protection and Affordable Care Act of 2010, the reauthorization of the Office of Minority Health (OMH), the creation of the first national U.S. Department of Health and Human Services (HHS) Plan for Asian American, Native Hawaiian, and Pacific Islander Health, and the new HHS data standards for race, ethnicity, sex, primary language, and disability status from Section 4302 of the Affordable Care Act (ACA)., In addition, the National Standards for Culturally and Linguistically Appropriate Service in Health and Health Care were updated in 2013 to provide a comprehensive framework of health and health care organizations for the delivery of culturally respectful and linguistically responsive care and services to all. We honor the heroes and transformative ideas that have worked to advance AA and NHPI health equity.

Asian American and NHPI advocates, researchers, and community leaders have also made tremendous strides in building local and regional community coalitions to document health disparities and advance health equity on behalf of our diverse communities over the past decades., In this supplement, Trinh-Shevrin and colleagues
Authors across the articles by Huang, Islam, is to focus on addressing NHPI health conditions and health care services. This work ahead of us must start with recognizing the effects of structural racism, federal policies, and U.S. occupation on NHPI health, if it is to address racial justice and restore the agency and civil rights of NHPI indigenous communities across Hawaii, the Pacific Islands, and the continental U.S.

The health equity goals of the HHS Action Plan to Reduce Racial and Ethnic Health Disparities, National Stakeholder Strategy for Achieving Health Equity and Healthy People 2020 offer an opportunity for strengthening public-private partnerships between government and communities to document further the structural health inequities disfavoring AA and NHPI populations., The new HHS data standards that examine granular ethnicity and primary languages, as they are implemented across national surveys (e.g., National Health and Nutrition Examination Survey, National Health Interview Survey, Behavioral Risk Factors Surveillance System, Youth Risk Behavioral Surveillance System) and administrative health data systems (e.g., Medicare, Medicaid, Medical Expenditure Panel Survey, Physician Quality Reporting Initiative, and Uniform Data System) and reported through Healthy People 2020 and other public health dissemination venues, will allow us to track and monitor many key health issues facing AA and NHPI populations for the first time at a national level.

The National Stakeholder Strategy for Achieving Health Equity defines health equity as the “attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities.”24[page 9] The definition of disparities by HHS and the Healthy People program has changed over time; initially the term disparities was understood as denoting disparities by race and ethnicity and focused on health behaviors and conditions. The conception of disparities in Healthy People 2020 is much broader today and includes health disparities by race and ethnicity, gender, sexual orientation, disability status, and geography as well as an examination of other…

Journal of the Pediatric Infectious Diseases Society (JPIDS)
Volume 4 Issue 2 June 2015
http://jpids.oxfordjournals.org/content/current

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Challenges in the Surveillance of Invasive Pneumococcal Disease in the Postvaccination Era
Kattia Camacho-Badilla1, Luiza H. Falleiros-Arlant2, José Brea3 and María L. Avila-Aguero1
Author Affiliations
1Pediatric Infectious Diseases Service, Hospital Nacional de Niños, “Dr. Carlos Sáenz Herrera”, San José, Costa Rica
2Pediatrics, Facultade de Medicina da Universidade de Santos, Sao Paulo, Brazil
3Pediatrics, Centro Universitario Médico del Este, Santo Domingo, Dominican Republic
Accepted April 6, 2015.
Excerpt
Worldwide, meningitis and pneumonia are the leading cause of morbidity and mortality in children. Invasive pneumococcal disease (IPD) is the leading cause of vaccine-preventable deaths, accounting for 11% of deaths in children <5 years globally in the pre-pneumococcal conjugate vaccine (PCV) era [1], and it causes significant disease burden in Latin America (LA) and the Caribbean.

According to data published by the Pan American Health Organization (PAHO) in July 2014, 25 countries from LA and the Caribbean have introduced PCVs in their immunization schedules. Bolivia is the latest country that has introduced the 13-PCV in their national immunization program. The First Latin American Meeting of Pneumococcus: Epidemiology and Impact of Pneumococcal Conjugate Vaccines was held in San José, Costa Rica in August 2014 given the importance of analyzing the data of the post-PCVs era and its impact since their introduction in different countries…

Nonprofit and Voluntary Sector Quarterly
June 2015; 44 (3)
http://nvs.sagepub.com/content/current

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Two Approaches to Nonprofit Financial Ratios and the Implications for Managerial Incentives
Adam Eckerd1
1Virginia Tech, Alexandria, USA
Abstract
Nonprofits compete in donation markets for resources and are expected to report on the financial stewardship of the organization. Without a clear comparative signal to differentiate organizations in this resource market, simple financial ratios have been used as proxy measures of relative organizational efficiency. Two conceptual models can be applied to the use of these ratios: first, as dichotomous conformance thresholds that identify poor performers who are unable to meet some minimum standard, or second, as directly comparable scales of performance where more optimized ratios can be used to distinguish the best performers. These two different conceptual models imply two different managerial approaches and potential organizational outcomes. This research assesses the extent to which nonprofits that are evaluated by an external evaluator appear to use the ratios as thresholds to pass or as scales to optimize.

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Anatomy of the Nonprofit Starvation Cycle
An Analysis of Falling Overhead Ratios in the Nonprofit Sector
Jesse D. Lecy1, Elizabeth A. M. Searing1
1Georgia State University, Atlanta, USA
Abstract
The nonprofit starvation cycle is a debilitating trend of under-investment in organizational infrastructure that is fed by potentially misleading financial reporting and donor expectations of increasingly low overhead expenses. Since its original reporting in 2004, the phenomenon has been referenced several times, but seldom explored empirically. This study uses 25 years of nonprofit data to examine the existence, duration, and mechanics behind the nonprofit starvation cycle. Our results show a definite downward trend in reported overhead costs, reflecting a deep cut in administrative expenses partially offset by an increase in fundraising expenses. The organization’s size is instrumental to its behavior, with a sharp rise in reported overhead occurring when revenues equal $100,000, but diminishing at $550,000. Finally, the brunt of the cuts have fallen on nonexecutive staff wages and professional fees, which heightens the concern of potentially ill effects derived from a fixation on overhead cost reduction.

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International Nonprofit Collaboration – Examining the Role of Homophily
Yannick C. Atouba1 Michelle Shumate2
1Rutgers, the State University of New Jersey, New Brunswick, USA
2Northwestern University, Evanston, IL, USA
Abstract
The importance and popularity of interorganizational collaboration among nongovernmental organizations (NGOs) have grown considerably in recent years. Despite these growths, however, not much is known about why NGOs network the way they do or why NGO networks are structured the way they are. Using homophily theory and exponential random graph modeling, this study examines the patterns of interorganizational collaborative ties among infectious diseases international NGOs (INGOs) in 2007 (n = 94). The results suggest that these NGOs are more likely to collaborate when they have the same status, when they have similar (closer) founding dates, when they are headquartered in the same global hemisphere (north/south), when they have common funding partners, and when they are headquartered in the same geographic regions. Overall, the findings from this study suggest that various sources of homophily inform partner selection among infectious disease INGOs.

PLOS Currents: Disasters
[Accessed 23 May 2015]
http://currents.plos.org/disasters/

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The Duration of an Exposure Response Gradient between Incident Obstructive Airways Disease and Work at the World Trade Center Site: 2001-2011
May 20, 2015 · Research article
Background: Adverse respiratory effects of World Trade Center (WTC) exposure have been widely documented, but the length of time that exposure remains associated with disease is uncertain. We estimate the incidence of new cases of physician-diagnosed obstructive airway disease (OAD) as a function of time since 9/11/2001 in WTC-exposed firefighters.
Methods: Exposure was categorized by first WTC arrival time: high (9/11/2001 AM); moderate (9/11/2001 PM or 9/12/2001); or low (9/13-24/2001). We modeled relative rates (RR) and 95% confidence intervals (CI) of OAD incidence by exposure over the first 10 years post-9/11/2001, estimating the time(s) of change in the RR with change point models. We further examined the relationship between self-reported lower respiratory symptoms and physician diagnoses.
Results: Change points were observed at 15 and 84 months post-9/11/2001, with relative incidence rates for the high versus low exposure group of 4.02 (95% CI 2.62-6.16) prior to 15 months, 1.90 (95% CI 1.49-2.44) from months 16 to 84, and 1.20 (95% CI 0.92-1.56) thereafter. Incidence in all exposure groups increased after the WTC health program began to offer free coverage of OAD medications in month 63. Self-reported lower respiratory symptoms in the first 15 months had 80.6% sensitivity, but only 35.9% specificity, for eventual OAD diagnoses.
Conclusions: New OAD diagnoses are associated with WTC exposure for at least seven years. Some portion of the extended duration of that association may be due to delayed diagnoses. Nevertheless, our results support recognizing OAD among rescue workers as WTC-related even when diagnosed years after exposure.

PLoS One
[Accessed 23 May 2015]
http://www.plosone.org/

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Research Article
Effective Coverage and Systems Effectiveness for Malaria Case Management in Sub-Saharan African Countries
Katya Galactionova, Fabrizio Tediosi, Don de Savigny, Thomas Smith , Marcel Tanner
Published: May 22, 2015
DOI: 10.1371/journal.pone.0127818
Abstract
Scale-up of malaria preventive and control interventions over the last decade resulted in substantial declines in mortality and morbidity from the disease in sub-Saharan Africa and many other parts of the world. Sustaining these gains will depend on the health system performance. Treatment provides individual benefits by curing infection and preventing progression to severe disease as well as community-level benefits by reducing the infectious reservoir and averting emergence and spread of drug resistance. However many patients with malaria do not access care, providers do not comply with treatment guidelines, and hence, patients do not necessarily receive the correct regimen. Even when the correct regimen is administered some patients will not adhere and others will be treated with counterfeit or substandard medication leading to treatment failures and spread of drug resistance. We apply systems effectiveness concepts that explicitly consider implications of health system factors such as treatment seeking, provider compliance, adherence, and quality of medication to estimate treatment outcomes for malaria case management. We compile data for these indicators to derive estimates of effective coverage for 43 high-burden Sub-Saharan African countries. Parameters are populated from the Demographic and Health Surveys and other published sources. We assess the relative importance of these factors on the level of effective coverage and consider variation in these health systems indicators across countries. Our findings suggest that effective coverage for malaria case management ranges from 8% to 72% in the region. Different factors account for health system inefficiencies in different countries. Significant losses in effectiveness of treatment are estimated in all countries. The patterns of inter-country variation suggest that these are system failures that are amenable to change. Identifying the reasons for the poor health system performance and intervening to tackle them become key priority areas for malaria control and elimination policies in the region

The Lancet
May 23, 2015 Volume 385 Number 9982 p2015-2120
http://www.thelancet.com/journals/lancet/issue/current

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Editorial
Strengthening clinical research in children and young people
The Lancet
DOI: http://dx.doi.org/10.1016/S0140-6736(15)60974-6
Summary
“The time has come to protect children and young people through research not from research”, said Bobbie Farsides, Professor of Bioethics at Brighton and Sussex Medical School and Chair of the Working Party for the Nuffield Council on Bioethics, which published its report Children and clinical research: ethical issues on May 14. “It will always be easier to say ‘no’ to research with children on the grounds that it’s too difficult, but we should challenge the idea that it is acceptable to continue to offer health care to children without seeking to improve the evidence base for many of the treatments provided”, added Farsides. [Download the report]

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Articles
Socioeconomic inequalities in adolescent health 2002–2010: a time-series analysis of 34 countries participating in the Health Behaviour in School-aged Children study
Dr Frank J Elgar, PhD, Timo-Kolja Pförtner, PhD, Irene Moor, MSc, Bart De Clercq, MSc, Gonneke W J M Stevens, PhD, Candace Currie, PhD
Published Online
DOI: http://dx.doi.org/10.1016/S0140-6736(14)61460-4
Summary
Background
Information about trends in adolescent health inequalities is scarce, especially at an international level. We examined secular trends in socioeconomic inequality in five domains of adolescent health and the association of socioeconomic inequality with national wealth and income inequality.
Methods
We undertook a time-series analysis of data from the Health Behaviour in School-aged Children study, in which cross-sectional surveys were done in 34 North American and European countries in 2002, 2006, and 2010 (pooled n 492 788). We used individual data for socioeconomic status (Health Behaviour in School-aged Children Family Affluence Scale) and health (days of physical activity per week, body-mass index Z score [zBMI], frequency of psychological and physical symptoms on 0–5 scale, and life satisfaction scored 0–10 on the Cantril ladder) to examine trends in health and socioeconomic inequalities in health. We also investigated whether international differences in health and health inequalities were associated with per person income and income inequality.
Findings
From 2002 to 2010, average levels of physical activity (3·90 to 4·08 days per week; p<0·0001), body mass (zBMI −0·08 to 0·03; p<0·0001), and physical symptoms (3·06 to 3·20, p<0·0001), and life satisfaction (7·58 to 7·61; p=0·0034) slightly increased. Inequalities between socioeconomic groups increased in physical activity (−0·79 to −0·83 days per week difference between most and least affluent groups; p=0·0008), zBMI (0·15 to 0·18; p<0·0001), and psychological (0·58 to 0·67; p=0·0360) and physical (0·21 to 0·26; p=0·0018) symptoms. Only in life satisfaction did health inequality fall during this period (−0·98 to −0·95; p=0·0198). Internationally, the higher the per person income, the better and more equal health was in terms of physical activity (0·06 days per SD increase in income; p<0·0001), psychological symptoms (−0·09; p<0·0001), and life satisfaction (0·08; p<0·0001). However, higher income inequality uniquely related to fewer days of physical activity (−0·05 days; p=0·0295), higher zBMI (0·06; p<0·0001), more psychological (0·18; p<0·0001) and physical (0·16; p<0·0001) symptoms, and larger health inequalities between socioeconomic groups in psychological (0·13; p=0·0080) and physical (0·07; p=0·0022) symptoms, and life satisfaction (−0·10; p=0·0092).
Interpretation
Socioeconomic inequality has increased in many domains of adolescent health. These trends coincide with unequal distribution of income between rich and poor people. Widening gaps in adolescent health could predict future inequalities in adult health and need urgent policy action.
Funding
Canadian Institutes of Health Research.

Science
22 May 2015 vol 348, issue 6237, pages 833-940
http://www.sciencemag.org/current.dtl

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Report
Encouraging sanitation investment in the developing world: A cluster-randomized trial
Raymond Guiteras1, James Levinsohn2, Ahmed Mushfiq Mobarak2,*
Author Affiliations
1Department of Economics, University of Maryland, College Park, MD 20742, USA.
2School of Management, Yale University, New Haven, CT 06520, USA.
Abstract
Poor sanitation contributes to morbidity and mortality in the developing world, but there is disagreement on what policies can increase sanitation coverage. To measure the effects of alternative policies on investment in hygienic latrines, we assigned 380 communities in rural Bangladesh to different marketing treatments—community motivation and information; subsidies; a supply-side market access intervention; and a control—in a cluster-randomized trial. Community motivation alone did not increase hygienic latrine ownership (+1.6 percentage points, P = 0.43), nor did the supply-side intervention (+0.3 percentage points, P = 0.90). Subsidies to the majority of the landless poor increased ownership among subsidized households (+22.0 percentage points, P < 0.001) and their unsubsidized neighbors (+8.5 percentage points, P = 0.001), which suggests that investment decisions are interlinked across neighbors. Subsidies also reduced open defecation by 14 percentage points (P < 0.001).

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
__________________________________________________
Week ending 16 May 2015

This weekly digest is intended to aggregate and distill key content from a broad spectrum of practice domains and organization types including key agencies/IGOs, NGOs, governments, academic and research institutions, consortia and collaborations, foundations, and commercial organizations. We also monitor a spectrum of peer-reviewed journals and general media channels. The Sentinel’s geographic scope is global/regional but selected country-level content is included. We recognize that this spectrum/scope yields an indicative and not an exhaustive product. Comments and suggestions should be directed to:

David R. Curry
Editor &
Founding Managing Director
GE2P2 – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

pdf verion: The Sentinel_ week ending 16 May 2015

blog edition: comprised of the 35+ entries to be posted below on 17 May 2015

Migration

Managing migration better in all aspects: A European Agenda on Migration
European Commission – Press release
Brussels, 13 May 2015

Today, the European Commission presented a European Agenda on Migration outlining the immediate measures that will be taken in order to respond to the crisis situation in the Mediterranean as well as the steps to be taken in the coming years to better manage migration in all its aspects.

The plight of thousands of migrants putting their lives in peril to cross the Mediterranean has shocked and it has become clear that no Member State can or should be left alone to address huge migratory pressures. This Agenda sets out a European response, combining internal and external policies, making best use of EU agencies and tools, and involving all actors: Member States, EU institutions, International Organisations, civil society, local authorities and third countries….

Immediate Action
There is political consensus in the European Parliament and the European Council following the recent tragedies in the Mediterranean to mobilise all efforts and tools at our disposal to take immediate action to prevent more people from dying at sea. Today the Commission has set out the concrete and immediate actions it will take, including:
:: Tripling the capacities and assets for the Frontex joint operations Triton and Poseidon in 2015 and 2016. An amending budget for 2015 was adopted today to secure the necessary funds – a total of €89 million, including €57 million in AMIF and €5 million in ISF emergency funding for frontline Member States – and the new Triton Operational Plan will be presented by the end of May;

:: Proposing the first ever activation of the emergency mechanism to help Member states confronted with a sudden influx of migrants under Article 78(3) TFEU. By the end of May, the Commission will propose a temporary distribution mechanism for persons in clear need of international protection within the EU. A proposal for a permanent EU system for relocation in emergency situations of mass influxes will follow by the end of 2015;

:: Proposing, by the end of May, an EU-wide resettlement scheme to offer 20,000 places distributed in all Member States to displaced persons in clear need of international protection in Europe with a dedicated extra funding of €50 million for 2015 and 2016;

:: Working on a possible Common Security and Defence Policy (CSDP) operation in the Mediterranean to dismantle traffickers’ networks and fight smuggling of people, in accordance with international law.

The Way Forward: Four pillars to manage migration better
The migration crisis in the Mediterranean has put the spotlight on immediate needs. But it has also revealed that our collective EU migration policy has fallen short. Looking forward, the European Agenda on Migration develops President Juncker’s Political Guidelines into a set of mutually coherent and reinforcing initiatives, based around four pillars, to manage migration better in all its aspects (see also Annex).

The four pillars of the new Agenda on Migration are:
:: Reducing the incentives for irregular migration, notably by seconding European migration liaison officers to EU Delegations in key third countries; amending the Frontex legal basis to strengthen its role on return; a new action plan with measures that aim to transform people smuggling into high risk, low return criminal activity and addressing the root causes through development cooperation and humanitarian assistance;

:: Border management – saving lives and securing external borders, notably by strengthening the role and capacity of Frontex; helping strengthen the capacity of third countries to manage their borders; pooling further, where necessary, certain coast guard functions at EU level;

:: Europe’s duty to protect: a strong common asylum policy: The priority is to ensure a full and coherent implementation of the Common European Asylum System, notably by promoting systematic identification and fingerprinting and with efforts to reduce its abuses by strengthening the Safe Country of Origin provisions of the Asylum Procedure Directive; evaluating and possibly revising the Dublin Regulation in 2016;

:: A new policy on legal migration: The focus is on maintaining a Europe in demographic decline as an attractive destination for migrants, notably by modernising and overhauling the Blue Card scheme, by reprioritising our integration policies, and by maximising the benefits of migration policy to individuals and countries of origin, including by facilitating cheaper, faster and safer remittance transfers.

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UNHCR hails today’s EU proposed Agenda on Migration as breakthrough, urges speedy adoption
15 May 2015
Press Releases, 13 May 2015
UNHCR applauds the European Commission’s proposals, announced earlier today, for dealing with the thousands of refugees and migrants arriving in Europe via the Mediterranean.

The proposals include strengthened measures to save lives at sea, and improved mechanisms for allowing legal entry into the EU for people fleeing war, and providing for a fair redistribution of refugees. They also contain measures to address some of the factors that are driving people into the hands of smugglers, including the desperate conditions many refugees face in countries of first-asylum and transit…

…”The EU’s proposals represent a great breakthrough in terms of managing refugee flows and migration,” said Volker Türk, UNHCR’s Assistant High Commissioner for Protection. “It is now enormously important, and vital for the urgent purpose of saving lives, that these proposals be embraced quickly and fully implemented.”
More details on UNHCR’s response to the EU proposals can be found here: http://www.unhcr.org/55537b166.html

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UNHCR alarmed at reports of boat pushbacks in South-east Asia
Press Releases, 13 May 2015
The UN refugee agency is extremely alarmed at reports suggesting that Indonesia and Malaysia may have pushed back boats carrying vulnerable people from Myanmar and Bangladesh.

On Monday the Indonesian navy stated that it had escorted a boat out to sea, although it is not clear if this represents a change in the government’s policy. Yesterday Malaysia’s Maritime Enforcement Agency announced that it would not let foreign ships dock unless they are unseaworthy and sinking.
As conflicts and persecution force more and more people to seek safety beyond international borders, UNHCR has been emphasizing the importance of saving lives on the high seas.

“The first priority is to save lives. Instead of competing to avoid responsibility, it is key for States to share the responsibility to disembark these people immediately,” said Volker Türk, UNHCR’s Assistant High Commissioner for Protection.

“Sea crossings are a symptom of desperation as people are left with no other choice but to risk their lives,” Mr Türk said. He reiterated the agency’s global call for legal alternatives to access protection and safety, “Nobody should have to put their lives into the hands of ruthless smugglers.”…

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Migrants: “EU’s resettlement proposal is a good start but remains woefully inadequate” – UN expert
Office of the United Nations High Commissioner for Human Rights
GENEVA (15 May 2015) – The United Nations Special Rapporteur on the human rights of migrants, François Crépeau, expressed both hope and disappointment at the new European Agenda on Migration unveiled by the European Commission for dealing with Europe’s migration crisis.

“The EU’s resettlement proposal is good in principle but woefully inadequate in its scale,” the human rights expert said. The plan includes quotas for the resettlement of refugees, an initiative that Mr. Crépeau has been calling for since September 2014.

“The number of resettlement places initially envisaged seems utterly insufficient,” he stressed. “20.000 places in the EU regional block is not an adequate response to the current crisis which in 2014 saw over 200,000 irregular migrants – a majority of whom were asylum seekers – arrived in Europe by boat.”

The Special Rapporteur recalled that over 60,000 irregular migrants-many of whom are aslyum seekers- have already been rescued this year. “For a continental union of over 500 million inhabitants, 20,000 persons represent 0.004% of its population,” he stressed.

The EU also proposed a relocation plan for the asylum seekers who enter the common territory in order to relief frontline States. “It is good that a mandatory EU-wide relocation system, with an appropriate distribution key, will be presented for adoption by all EU member states,” he said. “However, such a system must be based on the wishes of the asylum seekers, an increase in mobility throughout the common EU territory, and on numbers of relocated asylum seekers that actually match the number of arrivals.”…

Humanitarian assistance from non-state donors: Latest trends
Global Humanitarian Assistance (GHA)
Briefing Paper
Author: Chloe Stirk
May 2015 :: 20 pages
Pdf: http://www.globalhumanitarianassistance.org/wp-content/uploads/2015/05/Private-Funding-2015_May2015.pdf
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Report Synopsis
Humanitarian needs around the world continue to increase but traditional funding from governments and institutional donors is not keeping pace. As part of efforts to leverage new and alternative forms of assistance, aid agencies continue to look to a diverse and growing range of funding sources to fill the gap.

Humanitarian assistance from non-state donors is playing a growing role in supporting the international humanitarian response but it remains under-reported. This report looks at the role non-state donors play in the provision of humanitarian assistance – measuring funding from individuals, trusts and foundations, and companies and corporations – and assesses where the money comes from, who raises it, and where it is spent. The research draws on a broad set of data sourced directly from humanitarian agencies and covers the period from 2009 to 2013. Private assistance continues to be an important source of funding for humanitarian crises.

The number, scale and severity of humanitarian crises are outstripping resources. While international humanitarian assistance continues to increase, reaching record levels in 2013 (US$21.8 billion), it is still not enough to fully meet needs. Non-state or private donors have long played an important role in supporting the international humanitarian response, and there is currently significant attention being paid to further building the role of these actors.

The report finds that the volume of private humanitarian assistance given has grown from US$5 billion in 2012 to US$5.4 billion in 2013. However, from 2012 to 2013 the proportion of total international humanitarian assistance from private donors fell from 27% to 25%.

Individuals provide the majority of private funding
Individuals continue to contribute the overwhelming majority of private funding, providing an estimated 72% (US$3.9 billion) of the total in 2013. Individuals have long been major donors of humanitarian funding, providing an estimated 19% of the total international humanitarian response between 2009 and 2013. One potentially significant area of charitable giving from individuals that has received less attention in discussions around the current humanitarian financing crisis is faith-based giving, and Islamic social finance in particular.

NGOs are the largest recipients of private humanitarian assistance, but UN agencies and the International Red Cross Red Crescent movement are receiving an increasing proportion
Non-governmental organisations continue to receive by far the largest proportion of private assistance, raising an estimated US$ 4.7 billion in 2013 and US$22.7 billion in the five years between 2009 and 2013. However, from 2012 to 2013 the proportion of total private humanitarian assistance received by UN agencies rose from 5% to 9% and from 3% to 4% for the International Red Cross Red Crescent movement.

Different expenditure patterns exist between government and private funding
Our data shows different expenditure patterns between government and private funding for different countries. For example, in 2013 Haiti was the third largest recipient of private funding but was only the 17th largest recipient of government funding. On the other hand, the occupied Palestinian territory was the 3rd largest recipient of bilateral government funding in 2013, but was only the 33rd largest recipient of funding from private donors.

As our 2014 report Humanitarian assistance from non-state donors: what is it worth? also showed, while all crises are dependent on donor governments for the majority of humanitarian funding, rapid-onset natural disasters tend to attract a greater proportion of funding from private donors than chronic and conflict-related crises.

Private donors are diversifying the range of assistance they provide
Private donors, in particular the private sector, are diversifying the type of support they offer beyond merely financial assistance to include new and innovative forms of in-kind assistance.
In 2013 private companies and corporations provided an estimated US$385.4 million in humanitarian funding. Many private sector actors are now moving beyond a direct donorship role towards a ‘corporate partnership’ approach, providing a range of skills and resources, the financial value of which is often unknown.

The need for timely and comprehensive data
Funding from private donors is currently under-reported and there is little information, data or research available on it. Due to this widespread lack of transparency, it is difficult to judge precisely how much is available, where it comes from, who is spending it, on what, or where.

As the profile, scale and diversity of private contributions to humanitarian assistance grows, so does the importance of being able to track all sources of available funding in order to coordinate the design and delivery of a comprehensive response. Improved and standardised reporting of all forms of assistance – cash and in-kind, private and government funding – will help to ensure the transparency, accountability and effective coordination of humanitarian assistance in this new and continually changing landscape.

Global Partnership for Social Accountability Continues to Grow, with New Contributions from Dominican Republic, Ford Foundation
World Bank
PRESS RELEASE
WASHINGTON, May 13, 2015—The Dominican Republic has become the first country in the global South to join the group of donors who are funding the Global Partnership for Social Accountability (GPSA), a program launched by the World Bank Group in 2012 to strengthen public-sector performance and meet governance challenges in developing countries.

The Government of the Dominican Republic has joined such GPSA donors as the Ford Foundation, the Open Society Foundations and the Aga Khan Foundation USA, in a reflection of the government’s commitment to create stronger social accountability mechanisms and to pursue governance reforms as a means to end poverty.

The GPSA is already active in the Dominican Republic, supporting a $730,000 project by Intermon Oxfam working to coordinate and scale up social accountability processes aimed at improving budget accountability in the education, agriculture, water and sanitation, and public housing sectors. Using locally driven social accountability processes that target issues and problems in specific sectors of the economy and society, the project aims to generate evidence-based and continuous feedback to be used by national authorities focusing on budget priorities and service delivery…

…In addition, the Ford Foundation has announced a new contribution of US$1 million thereby renewing its commitment of support to the program. In 2012, after the World Bank’s initial investment of $20 million, the Ford Foundation made a commitment to the GPSA Trust Fund of $3 million. To date, the funds have been allocated toward GPSA’s grants portfolio, as well as toward the knowledge and capacity-building components of the GPSA…

…44 countries have now opted into the GPSA to date. To see all the countries where the GPSA’s funding component operates, visit Where We Operate. In these countries, the GPSA is launching its 3rd Call for Proposals on May 13, 2015. Civil society organizations from these countries wishing to apply, should consult the GPSA website.

About the GPSA
Launched in 2012 with a $20 million commitment from the World Bank Group, the GPSA is currently supporting 23 social accountability projects in 17 countries, helping civil society and governments work together to solve critical governance challenges and strengthen public-sector performance. Governments of 44 countries have now joined the program, which allows civil society organization in those countries to gain access to GPSA grants. In addition, the GPSA has developed an extensive knowledge and learning agenda. GPSA grantees and other stakeholders in the field are supported by a strong capacity-building program to enhance the implementation of projects that promote social accountability. The GPSA’s network of partners includes over 250 organizations from civil society, foundations, private sector, academia and think tanks, as well as multilateral and bilateral institutions.

Expanding Opportunities for the Next Generation, Early Childhood Development in the Middle East and North Africa – Directions in development; human development
World Bank Group
May 07, 2015 :: 343 pages
Authors: El-Kogali, Safaa El Tayeb; Krafft, Caroline Gould;
Pdf:
http://documents.worldbank.org/curated/en/2015/01/23811898/expanding-opportunities-next-generation-early-childhood-development-middle-east-north-africa
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The report fills a critical research gap by providing the first comprehensive analysis of the state of early childhood development (ECD) in the Middle East and North Africa (MENA).

Abstract
Early childhood is the most important stage of human development. In the Middle East and North Africa (MENA), there is little research and inadequate investment in this crucial stage of life. This book assesses the state of early childhood development (ECD) in MENA from before birth through age five, examining multiple dimensions of early development including health, nutrition, socio-emotional development, early learning, and early work. The book begins with a discussion of the importance of ECD as a critical foundation for later development, and also as a stage of life when inequality and social exclusion begin. ECD in MENA is set in a global context, and then countries within MENA are compared, with chapters on ECD in Algeria, Djibouti, Egypt, Iraq, Jordan, Lebanon, Libya, Morocco, Syria, Tunisia, West Bank and Gaza, and Yemen. As well as illustrating the state of ECD, the chapters assess risk and protective factors for early development and the extent of inequality in early childhood. A discussion of policies and programs that can enhance ECD illustrates how inequality and shortfalls in early development can be effectively addressed. This book will be of interest to anyone interested in the state of human development and inequality in MENA.

Contents Overview
The first chapter offers an overview of the evidence that the period from before birth to age five is the most important stage of human development. This period is especially crucial as deficits at this early stage tend to be irreversible and to perpetuate cycles of poverty and inequality. The many dimensions of healthy ECD, from proper healthcare and nutrition to early development activities, are identified along with the range of related indicators used to measure the state of ECD in the region.

Chapter 2 offers a comparison with other regions of the world, for a better understanding of the state of ECD in MENA,. The twelve countries of the region are also compared, to establish benchmarks and identify country-specific deficits in ECD. The chapter includes an analysis of the factors that influence ECD, as there is significant inequality of access to key development activities even in the region’s more developed countries.

Chapter 3 shows that economic growth alone will not address the many shortfalls in the region’s ECD. Targeted interventions are needed. The chapter provides a way forward with a number of approaches from around the world that have been implemented successfully and which would benefit children in MENA.

Country analyses:
:: Algeria which has achieved good immunization rates but has high rates of stunting due to malnutrition, and where a child’s social and economic background influences the chances of healthy development.
:: Djibouti where prenatal and delivery care is now almost universal but child mortality rates are still high and less than one third of children are fully immunized by the age of one.
:: Egypt where stunting is a major and persistent problem and disadvantaged children are the least likely to benefit from early schooling, although immunization rates have reached 92%.
:: Iraq where only half of children are receiving regular prenatal care, less than two-thirds are fully immunized and access to key development activities is closely related to social and economic background.
:: Jordan which has achieved near universal coverage for prenatal and neonatal care, and while rates for stunting are low there is large variation in nutrition status, with a child from the poorest segment of society seven times as likely to be stunted as a child from the richest.
:: Lebanon which has also achieved near universal coverage for prenatal and neonatal care but where only half of all children are fully immunized by age one and poorer children are more likely to be stunted.
:: Libya before the current crisis, where 87% of all children were fully immunized but only half had access to iodized salt, essential for cognitive development, and more than one fifth were stunted.
:: Morocco where 90% of children are fully immunized but almost one third are stunted and deaths in the first month and year of life are above regional averages, with the poorest children facing greater risk of death.
:: Syria before the current crisis, where 96% of births were assisted by a skilled attendant but only 78% of one-year-olds were fully immunized and over one quarter of all children were stunted.
:: Tunisia which has achieved near universal prenatal and delivery care and early mortality has fallen below regional averages, but children in rural areas have one third the chance of urban children to attend early education and 22% of children aged 5 are engaged in child labor.
:: West Bank and Gaza which has achieved near universal coverage for prenatal and delivery care but stunting remains a persistent problem and there are large differences in access to early care and education between advantaged and disadvantaged children.
:: Yemen before the current crisis where less than half of all births received prenatal care and children were more than twice as likely to die before their first birthday (7%) as they were to attend early childhood education (3%).