MSF/Médecins Sans Frontières [to 12 September 2015]
http://www.doctorswithoutborders.org/news-stories/press/press-releases

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The 2015 Lasker-Bloomberg Public Service Award:
Médecins Sans Frontières (Doctors Without Borders) for Sustained and Effective Frontline Responses to the Recent Ebola Outbreak in Africa
The 2015 Lasker~Bloomberg Public Service Award honors Médecins Sans Frontières (Doctors Without Borders), established in 1971, for bold leadership in responding to the recent Ebola outbreak in Africa, and for sustained and effective frontline responses to health emergencies.

Since the beginning of the most recent Ebola outbreak in West Africa in March 2014, more than 11,000 people lost their lives, including hundreds of health workers. MSF leaders realized quickly the devastating magnitude of the outbreak and sprang into action. The organization sent experts, built hospitals, imported necessary supplies, and set up systems to receive and treat patients. For many months, MSF was alone in its work. When other international organizations later began stepping up, MSF provided guidelines and trained many of their personnel.

Throughout the Ebola crisis, MSF led a call for governments and international organizations to provide trained medical personnel and set up a system for disaster response. In May, the World Health Organization and its constituent countries announced that it would create a $100M fund that will support an international rapid response system for future outbreaks.

Since its inception, MSF has tackled the world’s most overwhelming disasters that affect our planet’s most marginalized people, and its activities during the last 18 months have demonstrated its exceptional perseverance and effectiveness.

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Press release
Syria: Daily Bombings Made August One of the Bloodiest Months in East Ghouta
September 11, 2015
Makeshift hospitals near Damascus overwhelmed by mass casualities; 2 million people now under siege

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Press release
Jordan: Reconstructive Surgery Hospital for War Victims Opens in Amman
September 08, 2015
AMMAN, JORDAN—Doctors Without Borders/Médecins Sans Frontières (MSF) officially opened a newly upgraded reconstructive surgery hospital today in Amman to provide improved treatment to war-wounded patients from across the region.

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Press release
Global Health Community Walks Away from Snakebite Crisis as Antivenom Runs Out
September 07, 2015
BASEL—Tens of thousands of people will continue to die of snakebite unnecessarily unless the global health community takes action to ensure treatment and antivenom is made available, said the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) ahead of a symposium on this issue in Basel, Switzerland, this week.

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Field news
MSF Assists Hundreds of Refugees in Roszke, Hungary
September 11, 2015
Thousands of refugees, mostly from Syria, are arriving to Roszke, on the Serbia-Hungary border. They are both physically and psychologically exhausted after a long and dangerous journey by sea and road across several countries, says Doctors Without Borders/Médecins Sans Frontières. Some 2,000 people are crossing over the border daily.

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Field news
Greece: Closure of Captain Elias Camp Leaves Refugees Even More Vulnerable
September 11, 2015
Yesterday, September 10, saw the immediate closure of the Captain Elias camp on Kos Island, a makeshift building where authorities have been directing refugees to stay while awaiting their registration papers.

OXFAM [to 12 September 2015]
http://www.oxfam.org/en/pressroom/pressreleases

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Increasing inequality plunging millions more Europeans into poverty
9 September 2015
Poverty and inequality in Europe have reached shocking levels, according to a new Oxfam report.

Between 2009 and 2013, the number of Europeans living without enough money to heat their homes or cope with unforeseen expenses, known as “severe material deprivation”, rose by 7.5 million to 50 million people. These are among the 123 million people(1) – almost a quarter of the EU’s population – at risk of living in poverty, while the continent is home to 342 billionaires. ‘A Europe for the Many, Not the Few’ report findings confirm and add to research done by the IMF and others on how rising inequality is making the fight against poverty harder to win. As part of its global campaign against inequality, Oxfam works on tackling poverty across Europe.

The Oxfam report, which reveals the extent of inequality across the continent by analyzing data on poverty and wealth, is accompanied by a league table. Both are being published ahead of an informal meeting of European Finance Ministers on 11 and 12 September…

Norwegian Refugee Council [to 12 September 2015]
http://www.nrc.no/

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Press release
“Unworthy refugee response in Greece”
11. September 2015
“Today we are too often prevented from providing effective assistance to refugees arriving in Greece. All European countries have the responsibility to treat refugees according to international standards, and national political challenges are no excuse. Faced with the urgent humanitarian challenge, international humanitarian actors must be allowed to provide assistance” says Benedicte Giæver, Director of the Emergency Deployment Department of the Norwegian Refugee Council (NRC).

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Refugee crisis: NRC’s response
07. september 2015
An increasing number of desperate refugees are seeking safety in Europe – many of them fleeing the brutal war in Syria. NRC is working to assist refugees in Europe, as well as in Syria and the neighbouring countries

Partners In Health [to 12 September 2015]
http://www.pih.org/blog

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Sep 10, 2015
“Guardian Angels” for Pregnant Women with HIV
Socios En Salud (SES), Partners In Health’s sister organization in Peru, understands the challenges pregnant women living with HIV face. SES launched a unique yearlong pilot program in which peer counselors—all of whom are HIV-positive themselves—contact expectant mothers and help them access the clinical and social services they need. Most importantly though, they are friends to women who feel completely alone following their diagnosis.

PATH [to 12 September 2015]
http://www.path.org/news/index.php

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Announcement
PATH joins leading global health organizations in calling for inclusion of research and development indicators in Sustainable Development Goal framework
Posted September 8, 2015.
As global leaders are set to adopt the Sustainable Development Goals (SDGs) later this month, PATH joined a group of leading global health organizations in commissioning a report that calls for the United Nations (UN) and its Member States to strengthen the SDG health targets by including indicators to measure global health research and development (R&D) progress. The report—Measuring global health R&D for the post-2015 development agenda—includes a short list of recommended global health R&D indicators for inclusion in the global and national SDG monitoring frameworks.

From the partner announcement:
The report underscores the critical link between global health R&D and achieving the SDGs. It notes that the SDGs include ambitious targets for reducing child and maternal deaths and ending the epidemics of HIV/AIDS, tuberculosis, malaria, and neglected tropical diseases, but existing global strategies that align with these targets clearly acknowledge they cannot be achieved without the development and delivery of new and improved drugs, vaccines, diagnostics, and other health tools. While the SDGs include a means of implementation target (target 3.b) to support R&D for vaccines and medicines for diseases primarily impacting developing countries, none of the official UN indicator proposals include any indicators to measure progress on the global health R&D needed to meet this and other health targets.

To fill this gap and ensure the SDGs generate the innovations needed to reach the health targets, the report proposes three indicators to measure global health R&D for inclusion in the SDG global monitoring framework, as well as five additional indicators countries are encouraged to include in their national monitoring frameworks if appropriate for their circumstances. These indicators were recommended based on an extensive landscaping and consultative process to identify health R&D indicators and further analysis to refine this list based on feasibility, level of community endorsement, appropriateness, and cross-cutting potential.

The report was prepared by Policy Cures and commissioned by the Council on Health Research for Development (COHRED), the Foundation for Innovative New Diagnostics (FIND), the Global Health Technologies Coalition (GHTC), the International AIDS Vaccine Initiative (IAVI), the Medicines for Malaria Venture (MMV), PATH, and the TB Alliance to inform stakeholders of the importance of including robust indicators for global health R&D and advise on the most suitable indicators for inclusion.

Plan International [to 12 September 2015]
http://plan-international.org/about-plan/resources/media-centre

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Press releases
Europe must act together to save refugee children
11 September 2015
European leaders must urgently agree a comprehensive and united response to the arrival of thousands of refugees in European countries. In particular strenuous efforts must be made by all states across Europe to directly ensure refugee children and their families receive appropriate treatment, including food, shelter, sanitation, education, psychosocial support and protection from abuse…

SOS-Kinderdorf International [to 12 September 2015]
http://www.sos-childrensvillages.org/about-sos/press/press-releases
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A global response to refugee crisis
11.09.2015 – SOS Children’s Villages International is continuing to respond in every possible way to the global humanitarian crisis of refugees and displaced people. Emergency response activities are underway in the Middle East and across Europe, bringing much needed relief to refugee children and their families.

CONCORD [to 12 September 2015]
European NGO confederation for relief and development
http://www.concordeurope.org/news-room

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The best and worst of Europe: CONCORD, Social Platform, EPAM statement on humanitarian crisis
(Brussels, 11/09/2015) In the face of the current humanitarian crisis affecting people fleeing war, persecution and poverty, EPAM, Social Platform and CONCORD Europe – the three largest coalitions of European NGOs working on development, social rights, asylum and migration – have come together to call on Member State governments and ministers to create a more welcoming Europe.

The Elders [to 12 September 2015]
http://theelders.org/news-media

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Press release 7 September 2015
A stronger UN: The Elders hold high-level talks in Liechtenstein
As the UN celebrates its 70th year, three Elders travelled to Liechtenstein to participate in high-level discussions on strengthening the organisation with a distinguished and diverse group of experts

Vaduz – The Elders met in Liechtenstein on 5-6 September at the invitation of Foreign Minister Aurelia Frick to discuss proposals on strengthening the United Nations in its 70th anniversary year to ensure it remains “fit for purpose”.

Gro Harlem Brundtland, Deputy Chair of The Elders, led the delegation together with Lakhdar Brahimi and Martti Ahtisaari, and held wide-ranging discussions with ministers from Liechtenstein and other UN states, including several UN Permanent Representatives and former officials.

The discussions follow the launch of The Elders’ “Stronger UN” initiative at the Munich Security Conference in February 2015, which calls for four fundamental changes to the way the organisation operates: enlargement of the UN Security Council, a new agreement on UNSC veto restraint to prevent mass atrocities, a transparent and accountable mechanism to elect the new UN Secretary-General, and greater involvement of civil society in UN processes and decision-making…

Muslim Charities Forum [to 12 September 2015]
https://www.muslimcharitiesforum.org.uk/media/news
[An umbrella organisation for Muslim-led international NGOs based in the UK. It was set up in 2007 and works to support its members through advocacy, training and research, by bringing charities together. Our members have a collective income of £150,000,000 and work in 71 countries.]

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Muslim Charities Forum Statement on the European Refugee Crisis
9th September 2015
More than 2000 refugees have drowned, losing their lives in a desperate attempt to reach Europe. Many of those victims have been women and children. Thousands more are stranded in southern and eastern Europe, desperate to build new lives after witnessing the horrors of war tear apart the fabric of their societies and homes.

So far, various European countries such as Germany, Sweden, & France have opened up their borders to allow in some of the refugees that have made it to the shores of Europe.

We welcome Prime Minister David Cameron’s pledge to allow in 20,000 refuges over the next five years but are dismayed at the comparatively low number in relation to some of our European neighbours. We are also disappointed by the fact that these refugees will only come from the camps neighbouring Syria. Whilst we commend all efforts to help those currently in the Middle East, the UK has a moral obligation to help the refugees that have made it to Europe, and to take its fair share of those refugees in a collective effort with others on the continent who are bearing the brunt of the crisis.

Though the focus has been on the Syrian refugees, we must not forget that many are also fleeing conflict, poverty and abuse from Iraq, Afghanistan, Eritrea, Nigeria, Somalia and other countries and need our help and compassion as well.

We ask that this government reconsider the number of refugees it will take in as well as shorten the time span to two years instead of five. We need immediate action now as this is a crisis situation. The UK needs to take a leadership role in this crisis due to its unique positioning in Europe and history in the region.

We also call upon our members to work together with local councils to support and resettle those that will be coming in, as well as coordinate their efforts with other NGOs who are already engaged with emergency relief in places like Calais, Greece, Macedonia and Hungary.

ODI [to 12 September 2015]
http://www.odi.org/media

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How does Nepal’s Child Grant work for Dalit children and their families?
Research reports and studies | September 2015 | Jessica Hagen-Zanker, Richard Mallett and Anita Ghimire
This study examines the delivery and impact of Nepal’s Child Grant to identify implementation barriers and recommend ways to improve effectiveness.

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Nepal’s Child Grant: how is it working for Dalit families?
Briefing papers | September 2015 | Jessica Hagen-Zanker and Richard Mallett
This briefing paper uses two case studies from Bajura and Saptari to identify issues with the current Child Grant programme in Nepal and provides recommendations for ways to improve its effectiveness.

BMGF – Gates Foundation [to 12 September 2015]
http://www.gatesfoundation.org/Media-Center/Press-Releases

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SEPTEMBER 09, 2015
Bill & Melinda Gates Foundation Opens 16th Round of Grand Challenges Explorations
Seeking great ideas for understanding antimicrobial resistance, improving newborn gut health, measuring digital financial services, and other global health and development priorities.

Clinton Foundation [to 12 September 2015]
https://www.clintonfoundation.org/press-releases-and-statements

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Press Release
No Ceilings Commemorates 20th Anniversary of Beijing Platform with Digital Awareness Campaign
8 Sept 2015Press Release
Campaign includes media partnership with MTV’s “Look Different” campaign to challenge bias and inspire action for a “No Ceilings generation”
Today, No Ceilings: The Full Participation Project, an initiative of the Clinton Foundation, launched a social media awareness effort to educate young Americans on the progress that has been made for girls and women worldwide, and gaps to full participation that still remain. This campaign will mark the 20th anniversary of the UN Fourth World Conference on Women and the Beijing Platform for Action, a turning point in the global agenda for gender equality…

HHMI – Howard Hughes Medical Institute [to 12 September 2015]
https://www.hhmi.org/news

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Research [ September 8, 2015 ]
Stephen Elledge Receives Albert Lasker Basic Medical Research Award
HHMI Investigator Stephen Elledge of Brigham and Women’s Hospital shares the 2015 Albert Lasker Basic Medical Research Award with Evelyn Witkin of Rutgers University.

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Science Education [ September 8, 2015 ]
WildCam Gorongosa: Help Tag Animal Selfies to Support Conservation in Africa
HHMI and the Zooniverse launch WildCam Gorongosa, a new citizen science project.

MacArthur Foundation [to 12 September 2015]
http://www.macfound.org/

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Publication
September 9, 2015
A Landscape Evaluation of Oil Governance in Uganda and Kenya
…A key output of the study was the creation of a framework to monitor and evaluate both the impact of the oil sector on the environmental and socioeconomic livelihoods of people. It is available in the report available for download and includes an analysis of the robustness of existing data that the Foundation and others might track, or work to improve, in order to better understand the pace and kind of changes taking place. The report also contains specific recommendations related to Uganda and Kenya made by UNEP-WCMC.
Download the complete evaluation

Gordon and Betty Moore Foundation [to 12 September 2015]
https://www.moore.org/newsroom/press-releases

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Fourth wheat gene is key to flowering and climate adaptation
September 4, 2015
In the game of wheat genetics, Jorge Dubcovsky’s laboratory at UC Davis has hit a grand slam, unveiling for the fourth time in a dozen years a gene that governs wheat vernalization, the biological process requiring cold temperatures to trigger flower formation.

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 12 September 2015)

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Research article
Maternal health care use among married women in Hossaina, Ethiopia
Zeleke Dutamo, Nega Assefa, Gudina Egata BMC Health Services Research 2015, 15:365 (10 September 2015)
Abstract
Background
Pregnancy and child birth are natural process of continuity of life. For many it is a normal process, for some it puts life at risk impending complications. Provision of skilled care for all women before, during, and after childbirth is a key in saving women’s life and ensuring delivery of healthy baby. Maternal health service drop-out through the course of pregnancy is widely claimed, yet by how much it is dropped is not known. The main aim of this study was to identify the use of maternal health service over the course of pregnancy and child birth in a comprehensive manner.
Methods
A community based cross-sectional quantitative study on 623 women supported by qualitative inquiry was conducted Hossaian town, South Ethiopia during January 1–31, 2014. A structured questionnaire was used to generate the quantitative data and 4 Focus Group Discussions (FGD) were carried out to support the finding. Multiple logistic regression was used to control the effect of confounding. Odds ratios with 95 % CI used to display the result of analysis. Data generated from the FGD was analyzed using thematic analysis.
Results
The study revealed that 87.6 % of women attended at least one antenatal care (ANC). Among 546 women who attended ANC, 61.3 % of the women made their first visit during second and third trimester of pregnancy and 49 % had less than four antenatal visits. The study also revealed that 62.6 % of deliveries were assisted by skilled attendants and 51.4 % of the women received at least one postnatal check-up. Parity, pregnancy intention and awareness on danger signs of pregnancy during pregnancy were significantly associated (p < 0.05) with ANC usage. Skilled delivery attendance was significantly associated with some socio-demographic, economic and obstetric factors. Average family monthly income, awareness on obstetric danger signs of pregnancy during recent pregnancy, and frequency of ANC were positive predictors of Postnatal Care (PNC) utilization.
Conclusions
Though use of maternal health care services is relatively higher, however, it is not adequate. Engaging women in their own reproductive health affairs, strengthening maternal health care, increasing community awareness about obstetric danger signs during pregnancy and child birth, and telling the benefit of family planning should be major targets for intervention.

BMC Medical Ethics
http://www.biomedcentral.com/bmcmedethics/content
(Accessed 12 September 2015)

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Debate
Informed consent in paediatric critical care research – a South African perspective
Brenda Morrow, Andrew Argent, Sharon Kling BMC Medical Ethics 2015, 16:62 (9 September 2015)
Abstract
Background
Medical care of critically ill and injured infants and children globally should be based on best research evidence to ensure safe, efficacious treatment. In South Africa and other low and middle-income countries, research is needed to optimise care and ensure rational, equitable allocation of scare paediatric critical care resources.
Ethical oversight is essential for safe, appropriate research conduct. Informed consent by the parent or legal guardian is usually required for child research participation, but obtaining consent may be challenging in paediatric critical care research. Local regulations may also impede important research if overly restrictive.
By narratively synthesising and contextualising the results of a comprehensive literature review, this paper describes ethical principles and regulations; potential barriers to obtaining prospective informed consent; and consent options in the context of paediatric critical care research in South Africa.
Discussion
Voluntary prospective informed consent from a parent or legal guardian is a statutory requirement for child research participation in South Africa. However, parents of critically ill or injured children might be incapable of or unwilling to provide the level of consent required to uphold the ethical principle of autonomy. In emergency care research it may not be practical to obtain consent when urgent action is required. Therapeutic misconceptions and sociocultural and language issues are also barriers to obtaining valid consent.
Alternative consent options for paediatric critical care research include a waiver or deferred consent for minimal risk and/or emergency research, whilst prospective informed consent is appropriate for randomised trials of novel therapies or devices.
Summary
We propose that parents or legal guardians of critically ill or injured children should only be approached to consent for their child’s participation in clinical research when it is ethically justifiable and in the best interests of both child participant and parent. Where appropriate, alternatives to prospective informed consent should be considered to ensure that important paediatric critical care research can be undertaken in South Africa, whilst being cognisant of research risk. This document could provide a basis for debate on consent options in paediatric critical care research and contribute to efforts to advocate for South African law reform.

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Debate
Obligations of low income countries in ensuring equity in global health financing
John Barugahare, Reidar Lie BMC Medical Ethics 2015, 16:59 (8 September 2015)
Abstract
Background
Despite common recognition of joint responsibility for global health by all countries particularly to ensure justice in global health, current discussions of countries’ obligations for global health largely ignore obligations of developing countries. This is especially the case with regards to obligations relating to health financing. Bearing in mind that it is not possible to achieve justice in global health without achieving equity in health financing at both domestic and global levels, our aim is to show how fulfilling the obligation we propose will make it easy to achieve equity in health financing at both domestic and international levels.
Discussion
Achieving equity in global health financing is a crucial step towards achieving justice in global health. Our general view is that current discussions on global health equity largely ignore obligations of Low Income Country (LIC) governments and we recommend that these obligations should be mainstreamed in current discussions. While we recognise that various obligations need to be fulfilled in order to ultimately achieve justice in global health, for lack of space we prioritise obligations for health financing. Basing on the evidence that in most LICs health is not given priority in annual budget allocations, we propose that LIC governments should bear an obligation to allocate a certain minimum percent of their annual domestic budget resources to health, while they await external resources to supplement domestic ones. We recommend and demonstrate a mechanism for coordinating this obligation so that if the resulting obligations are fulfilled by both LIC and HIC governments it will be easy to achieve equity in global health financing.
Summary
Although achieving justice in global health will depend on fulfilment of different categories of obligations, ensuring inter- and intra-country equity in health financing is pivotal. This can be achieved by requiring all LIC governments to allocate a certain optimal per cent of their domestic budget resources to health while they await external resources to top up in order to cover the whole cost of the minimum health opportunities for LIC citizens.

BMC Pregnancy and Childbirth
http://www.biomedcentral.com/bmcpregnancychildbirth/content
(Accessed 12 September 2015)

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Research article
Reasons for home delivery and use of traditional birth attendants in rural Zambia: a qualitative study
Cephas Sialubanje, Karlijn Massar, Davidson Hamer, Robert Ruiter BMC Pregnancy and Childbirth 2015, 15:216 (11 September 2015)
Abstract
Background
Despite the policy change stopping traditional birth attendants (TBAs) from conducting deliveries at home and encouraging all women to give birth at the clinic under skilled care, many women still give birth at home and TBAs are essential providers of obstetric care in rural Zambia. The main reasons for pregnant women’s preference for TBAs are not well understood. This qualitative study aimed to identify reasons motivating women to giving birth at home and seek the help of TBAs. This knowledge is important for the design of public health interventions focusing on promoting facility-based skilled birth attendance in Zambia.
Methods
We conducted ten focus group discussions (n = 100) with women of reproductive age (15–45 years) in five health centre catchment areas with the lowest institutional delivery rates in the district. In addition, a total of 30 in-depth interviews were conducted comprising 5 TBAs, 4 headmen, 4 husbands, 4 mothers, 4 neighbourhood health committee (NHC) members, 4 community health workers (CHWs) and 5 nurses. Perspectives on TBAs, the decision-making process regarding home delivery and use of TBAs, and reasons for preference of TBAs and their services were explored.
Results
Our findings show that women’s lack of decision- making autonomy regarding child birth, dependence on the husband and other family members for the final decision, and various physical and socioeconomic barriers including long distances, lack of money for transport and the requirement to bring baby clothes and food while staying at the clinic, prevented them from delivering at a clinic. In addition, socio-cultural norms regarding childbirth, negative attitude towards the quality of services provided at the clinic, made most women deliver at home. Moreover, most women had a positive attitude towards TBAs and perceived them to be respectful, skilled, friendly, trustworthy, and available when they needed them.
Conclusion
Our findings suggest a need to empower women with decision-making skills regarding childbirth and to lower barriers that prevent them from going to the health facility in time. There is also need to improve the quality of existing facility-based delivery services and to strengthen linkages between TBAs and the formal health system.

BMC Public Health
http://www.biomedcentral.com/bmcpublichealth/content
(Accessed 12 September 2015)

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Research article
Implementation of an HPV vaccination program in Eldoret, Kenya: results from a qualitative assessment by key stakeholders
Heleen Vermandere, Violet Naanyu, Olivier Degomme, Kristien Michielsen BMC Public Health 2015, 15:875 (10 September 2015)
Abstract
Background
Cervical cancer strikes hard in low-resource regions yet primary prevention is still rare. Pilot projects have however showed that Human Papillomavirus (HPV) vaccination programs can attain high uptake. Nevertheless, a study accompanying a vaccination demonstration project in Eldoret, Kenya, revealed less encouraging outcomes: uptake during an initial phase targeting ten schools (i.e., 4000 eligible girls), was low and more schools had to be included to reach the proposed number of 3000 vaccinated girls. The previously conducted study also revealed that many mothers had not received promotional information which had to reach them through schools: teachers were sensitized by health staff and asked to invite students and parents for HPV vaccination in the referral hospital. In this qualitative study, we investigate factors that hampered promotion and vaccine uptake.
Methods
Focus group discussions (FGD) with teachers (4) and fathers (3) were organized to assess awareness and attitudes towards the vaccination program, cervical cancer and the HPV vaccine, as well as a FGD with the vaccinators (1) to discuss the course of the program and potential improvements. Discussions were recorded, transcribed, translated, and analyzed using thematic analysis In addition, a meeting with the program coordinator was set up to reflect upon the program and the results of the FGD, and to formulate recommendations for future programs.
Results
Cervical cancer was poorly understood by fathers and teachers and mainly linked with nonconforming sexual behavior and modern lifestyle. Few had heard about the vaccination opportunity: feeling uncomfortable to discuss cervical cancer and not considering it as important had hampered information flow. Teachers requested more support from health staff to address unexpected questions from parents. Non-uptake was also the result of distrust towards new vaccines. Schools entering the program in the second phase reacted faster: they were better organized, e.g., in terms of transport, while the community was already more familiarized with the vaccine.
Conclusions
Close collaboration between teachers and health staff is crucial to obtain high HPV vaccine uptake among schoolgirls. Promotional messages should, besides providing correct information, tackle misbeliefs, address stigma and stress the priority to vaccinate all, regardless of lifestyle. Monitoring activities and continuous communication could allow for detection of rumors and unequal uptake in the community.

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Debate
Strategies to increase demand for maternal health services in resource-limited settings: challenges to be addressed
Khalifa Elmusharaf, Elaine Byrne, Diarmuid O’Donovan BMC Public Health 2015, 15:870 (8 September 2015)
Abstract
Background
Universal health access will not be achieved unless women are cared for in their own communities and are empowered to take decisions about their own health in a supportive environment. This will only be achieved by community-based demand side interventions for maternal health access. In this review article, we highlight three common strategies to increase demand-side barriers to maternal healthcare access and identify the main challenges that still need to be addressed for these strategies to be effective.
Discussion
Common demand side strategies can be grouped into three categories:(i) Financial incentives/subsidies; (ii) Enhancing patient transfer, and; (iii) Community involvement. The main challenges in assessing the effectiveness or efficacy of these interventions or strategies are the lack of quality evidence on their outcome and impact and interventions not integrated into existing health or community systems. However, what is highlighted in this review and overlooked in most of the published literature on this topic is the lack of knowledge about the context in which these strategies are to be implemented.
Summary
We suggest three challenges that need to be addressed to create a supportive environment in which these demand-side strategies can effectively improve access to maternal health services. These include: addressing decision-making norms, engaging in intergenerational dialogue, and designing contextually appropriate communication strategies.

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Research article
Women’s position and attitudes towards female genital mutilation in Egypt: A secondary analysis of the Egypt demographic and health surveys, 1995-2014
Ronan Van Rossem, Dominique Meekers, Anastasia Gage BMC Public Health 2015, 15:874 (10 September 2015
Abstract
Background
Female genital mutilation (FGM) is still widespread in Egyptian society. It is strongly entrenched in local tradition and culture and has a strong link to the position of women. To eradicate the practice a major attitudinal change is a required for which an improvement in the social position of women is a prerequisite. This study examines the relationship between Egyptian women’s social positions and their attitudes towards FGM, and investigates whether the spread of anti-FGM attitudes is related to the observed improvements in the position of women over time.
Methods
Changes in attitudes towards FGM are tracked using data from the Egypt Demographic and Health Surveys from 1995 to 2014. Multilevel logistic regressions are used to estimate 1) the effects of indicators of a woman’s social position on her attitude towards FGM, and 2) whether these effects change over time.
Results
Literate, better educated and employed women are more likely to oppose FGM. Initially growing opposition to FGM was related to the expansion of women’s education, but lately opposition to FGM also seems to have spread to other segments of Egyptian society.
Conclusions
The improvement of women’s social position has certainly contributed to the spread of anti-FGM attitudes in Egyptian society. Better educated and less traditional women were at the heart of this change, and formed the basis from where anti-FGM sentiment has spread over wider segments of Egyptian society.