Tropical Medicine & International Health
November 2016 Volume 21, Issue 11 Pages 1347–1488, E1–E1
http://onlinelibrary.wiley.com/doi/10.1111/tmi.2016.21.issue-11/issuetoc

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Reviews
Pregnancy and childbirth after repair of obstetric fistula in sub-Saharan Africa: Scoping Review (pages 1348–1365)
Alexandre Delamou, Bettina Utz, Therese Delvaux, Abdoul Habib Beavogui, Asm Shahabuddin, Akoi Koivogui, Alain Levêque, Wei-Hong Zhang and Vincent De Brouwere
Version of Record online: 6 SEP 2016 | DOI: 10.1111/tmi.12771
Abstract
Objective
To synthesise the evidence on pregnancy and childbirth after repair of obstetric fistula in sub-Saharan Africa and to identify the existing knowledge gaps.
Methods
A scoping review of studies reporting on pregnancy and childbirth in women who underwent repair for obstetric fistula in sub-Saharan Africa was conducted. We searched relevant articles published between 1 January 1970 and 31 March 2016, without methodological or language restrictions, in electronic databases, general Internet sources and grey literature.
Results
A total of 16 studies were included in the narrative synthesis. The findings indicate that many women in sub-Saharan Africa still desire to become pregnant after the repair of their obstetric fistula. The overall proportion of pregnancies after repair estimated in 11 studies was 17.4% (ranging from 2.5% to 40%). Among the 459 deliveries for which the mode of delivery was reported, 208 women (45.3%) delivered by elective caesarean section (CS), 176 women (38.4%) by emergency CS and 75 women (16.3%) by vaginal delivery. Recurrence of fistula was a common maternal complication in included studies while abortions/miscarriage, stillbirths and neonatal deaths were frequent foetal consequences. Vaginal delivery and emergency C-section were associated with increased risk of stillbirth, recurrence of the fistula or even maternal death.
Conclusion
Women who get pregnant after repair of obstetric fistula carry a high risk for pregnancy complications. However, the current evidence does not provide precise estimates of the incidence of pregnancy and pregnancy outcomes post-repair. Therefore, studies clearly assessing these outcomes with the appropriate study designs are needed.

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Scoping review: strategies of providing care for children with chronic health conditions in low- and middle-income countries (pages 1366–1388)
Hamish Graham, Mariam Tokhi and Trevor Duke
Version of Record online: 16 SEP 2016 | DOI: 10.1111/tmi.12774

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Measuring domestic water use: a systematic review of methodologies that measure unmetered water use in low-income settings (pages 1389–1402)
Charlotte C. Tamason, Sophia Bessias, Adriana Villada, Suhella M. Tulsiani, Jeroen H. J. Ensink, Emily S. Gurley and Peter Kjær Mackie Jensen
Version of Record online: 30 AUG 2016 | DOI: 10.1111/tmi.12769

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Systematic review of evidence on the effectiveness of safe child faeces disposal interventions (pages 1403–1419)
Tomohiko Morita, Samuel Godfrey and Christine Marie George
Version of Record online: 16 SEP 2016 | DOI: 10.1111/tmi.12773

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Assessing the impact of defining a global priority research agenda to address HIV-associated tuberculosis (pages 1420–1427)
Anna Odone, Alberto Matteelli, Valentina Chiesa, Paola Cella, Antonio Ferrari, Federica Pezzetti, Carlo Signorelli and Haileyesus Getahun
Version of Record online: 31 AUG 2016 | DOI: 10.1111/tmi.12768

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Occupational hazards of traditional healers: repeated unprotected blood exposures risk infectious disease transmission (pages 1476–1480)
Carolyn M. Audet, José Salato, Meridith Blevins, Wilson Silva, Lázaro González-Calvo, Sten H. Vermund and Felisbela Gaspar
Version of Record online: 16 SEP 2016 | DOI: 10.1111/tmi.12775

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Original Research Papers
Rotavirus vaccines contribute towards universal health coverage in a mixed public–private healthcare system (pages 1458–1467)
Tharani Loganathan, Mark Jit, Raymond Hutubessy, Chiu-Wan Ng, Way-Seah Lee and Stéphane Verguet
Version of Record online: 24 AUG 2016 | DOI: 10.1111/tmi.12766
Abstract
Objectives
To evaluate rotavirus vaccination in Malaysia from the household’s perspective. The extended cost-effectiveness analysis (ECEA) framework quantifies the broader value of universal vaccination starting with non-health benefits such as financial risk protection and equity. These dimensions better enable decision-makers to evaluate policy on the public finance of health programmes.
Methods
The incidence, health service utilisation and household expenditure related to rotavirus gastroenteritis according to national income quintiles were obtained from local data sources. Multiple birth cohorts were distributed into income quintiles and followed from birth over the first five years of life in a multicohort, static model.
Results
We found that the rich pay more out of pocket (OOP) than the poor, as the rich use more expensive private care. OOP payments among the poorest although small are high as a proportion of household income. Rotavirus vaccination results in substantial reduction in rotavirus episodes and expenditure and provides financial risk protection to all income groups. Poverty reduction benefits are concentrated amongst the poorest two income quintiles.
Conclusion
We propose that universal vaccination complements health financing reforms in strengthening Universal Health Coverage (UHC). ECEA provides an important tool to understand the implications of vaccination for UHC, beyond traditional considerations of economic efficiency.