BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 20 February 2016)

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Research article
Evaluating a complex model designed to increase access to high quality primary mental health care for under-served groups: a multi-method study
Christopher Dowrick, Peter Bower, Carolyn Chew-Graham, Karina Lovell, Suzanne Edwards, Jonathan Lamb, Katie Bristow, Mark Gabbay, Heather Burroughs, Susan Beatty, Waquas Waheed, Mark Hann and Linda Gask
BMC Health Services Research 2016 16:58
Published on: 17 February 2016
Abstract
Background
Many people with mental distress are disadvantaged because care is not available or does not address their needs. In order to increase access to high quality primary mental health care for under-served groups, we created a model of care with three discrete elements: community engagement, primary care training and tailored wellbeing interventions. We have previously demonstrated the individual impact of each element of the model. Here we assess the effectiveness of the combined model in increasing access to and improving the quality of primary mental health care. We test the assumptions that access to the wellbeing interventions is increased by the presence of community engagement and primary care training; and that quality of primary mental health care is increased by the presence of community engagement and the wellbeing interventions.
Methods
We implemented the model in four under-served localities in North-West England, focusing on older people and minority ethnic populations. Using a quasi-experimental design with no-intervention comparators, we gathered a combination of quantitative and qualitative information. Quantitative information, including referral and recruitment rates for the wellbeing interventions, and practice referrals to mental health services, was analysed descriptively. Qualitative information derived from interview and focus group responses to topic guides from more than 110 participants. Framework analysis was used to generate findings from the qualitative data.
Results
Access to the wellbeing interventions was associated with the presence of the community engagement and the primary care training elements. Referrals to the wellbeing interventions were associated with community engagement, while recruitment was associated with primary care training. Qualitative data suggested that the mechanisms underlying these associations were increased awareness and sense of agency. The quality of primary mental health care was enhanced by information gained from our community mapping activities, and by the offer of access to the wellbeing interventions. There were variable benefits from health practitioner participation in community consultative groups. We also found that participation in the wellbeing interventions led to increased community engagement.
Conclusions
We explored the interactions between elements of a multilevel intervention and identified important associations and underlying mechanisms. Further research is needed to test the generalisability of the model.
Trial registration
Current Controlled Trials, reference ISRCTN68572159. Registered 25 February 2013.

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Research article
Maternal mental health in primary care in five low- and middle-income countries: a situational analysis
Emily C. Baron, Charlotte Hanlon, Sumaya Mall, Simone Honikman, Erica Breuer, Tasneem Kathree, Nagendra P. Luitel, Juliet Nakku, Crick Lund, Girmay Medhin, Vikram Patel, Inge Petersen, Sanjay Shrivastava and Mark Tomlinson
BMC Health Services Research 2016 16:53
Published on: 16 February 2016
Abstract
Background
The integration of maternal mental health into primary health care has been advocated to reduce the mental health treatment gap in low- and middle-income countries (LMICs). This study reports findings of a cross-country situation analysis on maternal mental health and services available in five LMICs, to inform the development of integrated maternal mental health services integrated into primary health care.
Methods
The situation analysis was conducted in five districts in Ethiopia, India, Nepal, South Africa and Uganda, as part of the Programme for Improving Mental Health Care (PRIME). The analysis reports secondary data on the prevalence and impact of priority maternal mental disorders (perinatal depression, alcohol use disorders during pregnancy and puerperal psychosis), existing policies, plans and services for maternal mental health, and other relevant contextual factors, such as explanatory models for mental illness.
Results
Limited data were available at the district level, although generalizable data from other sites was identified in most cases. Community and facility-based prevalences ranged widely across PRIME countries for perinatal depression (3–50 %) and alcohol consumption during pregnancy (5–51 %). Maternal mental health was included in mental health policies in South Africa, India and Ethiopia, and a mental health care plan was in the process of being implemented in South Africa. No district reported dedicated maternal mental health services, but referrals to specialised care in psychiatric units or general hospitals were possible. No information was available on coverage for maternal mental health care. Challenges to the provision of maternal mental health care included; limited evidence on feasible detection and treatment strategies for maternal mental disorders, lack of mental health specialists in the public health sector, lack of prescribing guidelines for pregnant and breastfeeding women, and stigmatising attitudes among primary health care staff and the community.
Conclusions
It is difficult to anticipate demand for mental health care at district level in the five countries, given the lack of evidence on the prevalence and treatment coverage of women with maternal mental disorders. Limited evidence on effective psychosocial interventions was also noted, and must be addressed for mental health programmes, such as PRIME, to implement feasible and effective services.

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 20 February 2016)

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Research article
Factors influencing completion of multi-dose vaccine schedules in adolescents: a systematic review
K. E. Gallagher, E. Kadokura, L. O. Eckert, S. Miyake, S. Mounier-Jack, M. Aldea, D. A. Ross and D. Watson-Jones
BMC Public Health 2016 16:172
Published on: 19 February 2016
Abstract
Background
Completion of multiple dose vaccine schedules is crucial to ensure a protective immune response, and maximise vaccine cost-effectiveness. While barriers and facilitators to vaccine uptake have recently been reviewed, there is no comprehensive review of factors influencing subsequent adherence or completion, which is key to achieving vaccine effectiveness. This study identifies and summarises the literature on factors affecting completion of multi-dose vaccine schedules by adolescents.
Methods
Ten online databases and four websites were searched (February 2014). Studies with analysis of factors predicting completion of multi-dose vaccines were included. Study participants within 9–19 years of age were included in the review. The defined outcome was completion of the vaccine series within 1 year among those who received the first dose.
Results
Overall, 6159 abstracts were screened, and 502 full texts were reviewed. Sixty one studies were eligible for this review. All except two were set in high-income countries. Included studies evaluated human papillomavirus vaccine, hepatitis A, hepatitis B, and varicella vaccines. Reported vaccine completion rates, among those who initiated vaccination, ranged from 27 % to over 90 %. Minority racial or ethnic groups and inadequate health insurance coverage were risk factors for low completion, irrespective of initiation rates. Parental healthcare seeking behaviour was positively associated with completion. Vaccine delivery in schools was associated with higher completion than delivery in the community or health facilities. Gender, prior healthcare use and socio-economic status rarely remained significant risks or protective factors in multivariate analysis.
Conclusions
Almost all studies investigating factors affecting completion have been carried out in developed countries and investigate a limited range of variables. Increased understanding of barriers to completion in adolescents will be invaluable to future new vaccine introductions and the further development of an adolescent health platform.
PROSPERO reg# CRD42014006765.

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Research article
Reducing routine vaccination dropout rates: evaluating two interventions in three Kenyan districts, 2014
Adam Haji, S. Lowther, Z. Ngan’ga, Z. Gura, C. Tabu, H. Sandhu and Wences Arvelo
BMC Public Health 2016 16:152
Published on: 16 February 2016
Abstract
Background
Globally, vaccine preventable diseases are responsible for nearly 20 % of deaths annually among children <5 years old. Worldwide, many children dropout from the vaccination program, are vaccinated late, or incompletely vaccinated. We evaluated the impact of text messaging and sticker reminders to reduce dropouts from the vaccination program.
Methods
The evaluation was conducted in three selected districts in Kenya: Machakos, Langata and Njoro. Three health facilities were selected in each district, and randomly allocated to send text messages or provide stickers reminding parents to bring their children for second and third dose of pentavalent vaccine, or to the control group (routine reminder) with next appointment date indicated on the well-child booklet. Children aged <12 months presenting for their first dose of pentavalent vaccine were enrolled. A dropout was defined as not returning for vaccination ≥2 weeks after scheduled date for third dose of pentavalent vaccine. We calculated dropout rate as a percentage of the difference between first and third pentavalent dose.
Results
We enrolled 1,116 children; 372 in each intervention and 372 controls between February and October 2014. Median age was 45 days old (range: 31–99 days), and 574 (51 %) were male. There were 136 (12 %) dropouts. Thirteen (4 %) children dropped out among those who received text messages, 60 (16 %) among who received sticker reminders, and 63 (17 %) among the controls. Having a caregiver with below secondary education [Odds Ratio (OR) 1.8, 95 % Confidence Interval (CI) 1.1–3.2], and residing >5 km from health facility (OR 1.6, CI 1.0–2.7) were associated with higher odds of dropping out. Those who received text messages were less likely to drop out compared to controls (OR 0.2, CI 0.04–0.8). There was no statistical difference between those who received stickers and controls (OR 0.9, CI 0.5–1.6).
Conclusion
Text message reminders can reduce vaccination dropout rates in Kenya. We recommend the extended implementation of text message reminders in routine vaccination services.

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Research article
The first mile: community experience of outbreak control during an Ebola outbreak in Luwero District, Uganda
A major challenge to outbreak control lies in early detection of viral haemorrhagic fevers (VHFs) in local community contexts during the critical initial stages of an epidemic, when risk of spreading is its highest…
Daniel H. de Vries, Jude T. Rwemisisi, Laban K. Musinguzi, Turinawe E. Benoni, Denis Muhangi, Marije de Groot, David Kaawa-Mafigiri and Robert Pool
BMC Public Health 2016 16:161
Published on: 16 February 2016

BMC Cost Effectiveness and Resource Allocation
http://resource-allocation.biomedcentral.com/
(Accessed 20 February 2016)

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Research
The economic burden of childhood pneumococcal diseases in The Gambia
Effua Usuf, Grant Mackenzie, Sana Sambou, Deborah Atherly and Chutima Suraratdecha
Published on: 17 February 2016
Abstract
Background
Streptococcus pneumoniae is a common cause of child death. However, the economic burden of pneumococcal disease in low-income countries is poorly described. We aimed to estimate from a societal perspective, the costs incurred by health providers and families of children with pneumococcal diseases.
Methods
We recruited children less than 5 years of age with outpatient pneumonia, inpatient pneumonia, pneumococcal sepsis and bacterial meningitis at facilities in rural and urban Gambia. We collected provider costs, out of pocket costs and productivity loss for the families of children. For each disease diagnostic category, costs were collected before, during, and for 1 week after discharge from hospital or outpatient visit.
Results
A total of 340 children were enrolled; 100 outpatient pneumonia, 175 inpatient pneumonia 36 pneumococcal sepsis, and 29 bacterial meningitis cases. The mean provider costs per patient for treating outpatient pneumonia, inpatient pneumonia, pneumococcal sepsis and meningitis were US$8, US$64, US$87 and US$124 respectively and the mean out of pocket costs per patient were US$6, US$31, US$44 and US$34 respectively. The economic burden of outpatient pneumonia, inpatient pneumonia, pneumococcal sepsis and meningitis increased to US$15, US$109, US$144 and US$170 respectively when family members’ time loss from work was taken into account.
Conclusion
The economic burden of pneumococcal disease in The Gambia is substantial, costs to families was approximately one-third to a half of the provider costs, and accounted for up to 30 % of total societal costs. The introduction of pneumococcal conjugate vaccine has the potential to significantly reduce this economic burden in this society.

British Medical Journal
20 February 2016 (vol 352, issue 8045)
http://www.bmj.com/content/352/8045

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Research Update
Publication and reporting of clinical trial results: cross sectional analysis across academic medical centers
BMJ 2016; 352 :i637 (Published 17 February 2016)
Abstract
Objective
To determine rates of publication and reporting of results within two years for all completed clinical trials registered in ClinicalTrials.gov across leading academic medical centers in the United States.
Design
Cross sectional analysis.
Setting
Academic medical centers in the United States.
Participants
Academic medical centers with 40 or more completed interventional trials registered on ClinicalTrials.gov.
Methods
Using the Aggregate Analysis of ClinicalTrials.gov database and manual review, we identified all interventional clinical trials registered on ClinicalTrials.gov with a primary completion date between October 2007 and September 2010 and with a lead investigator affiliated with an academic medical center.
Main outcome measures
The proportion of trials that disseminated results, defined as publication or reporting of results on ClinicalTrials.gov, overall and within 24 months of study completion.
Results
We identified 4347 interventional clinical trials across 51 academic medical centers. Among the trials, 1005 (23%) enrolled more than 100 patients, 1216 (28%) were double blind, and 2169 (50%) were phase II through IV. Overall, academic medical centers disseminated results for 2892 (66%) trials, with 1560 (35.9%) achieving this within 24 months of study completion. The proportion of clinical trials with results disseminated within 24 months of study completion ranged from 16.2% (6/37) to 55.3% (57/103) across academic medical centers. The proportion of clinical trials published within 24 months of study completion ranged from 10.8% (4/37) to 40.3% (31/77) across academic medical centers, whereas results reporting on ClinicalTrials.gov ranged from 1.6% (2/122) to 40.7% (72/177).
Conclusions
Despite the ethical mandate and expressed values and mission of academic institutions, there is poor performance and noticeable variation in the dissemination of clinical trial results across leading academic medical centers.

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 20 February 2016]

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Research
The 10 largest public and philanthropic funders of health research in the world: what they fund and how they distribute their funds
Roderik F. Viergever and Thom C. C. Hendriks
Published on: 18 February 2016
Abstract
Background
Little is known about who the main public and philanthropic funders of health research are globally, what they fund and how they decide what gets funded. This study aims to identify the 10 largest public and philanthropic health research funding organizations in the world, to report on what they fund, and on how they distribute their funds.
Methods
The world’s key health research funding organizations were identified through a search strategy aimed at identifying different types of funding organizations. Organizations were ranked by their reported total annual health research expenditures. For the 10 largest funding organizations, data were collected on (1) funding amounts allocated towards 20 health areas, and (2) schemes employed for distributing funding (intramural/extramural, project/‘people’/organizational and targeted/untargeted funding). Data collection consisted of a review of reports and websites and interviews with representatives of funding organizations. Data collection was challenging; data were often not reported or reported using different classification systems.
Results
Overall, 55 key health research funding organizations were identified. The 10 largest funding organizations together funded research for $37.1 billion, constituting 40% of all public and philanthropic health research spending globally. The largest funder was the United States National Institutes of Health ($26.1 billion), followed by the European Commission ($3.7 billion), and the United Kingdom Medical Research Council ($1.3 billion). The largest philanthropic funder was the Wellcome Trust ($909.1 million), the largest funder of health research through official development assistance was USAID ($186.4 million), and the largest multilateral funder was the World Health Organization ($135.0 million). Funding distribution mechanisms and funding patterns varied substantially between the 10 largest funders.
Conclusions
There is a need for increased transparency about who the main funders of health research are globally, what they fund and how they decide on what gets funded, and for improving the evidence base for various funding models. Data on organizations’ funding patterns and funding distribution mechanisms are often not available, and when they are, they are reported using different classification systems. To start increasing transparency in health research funding, we have established http://www.healthresearchfunders.org that lists health research funding organizations worldwide and their health research expenditures.

Journal of Epidemiology & Community Health
March 2016, Volume 70, Issue 3
http://jech.bmj.com/content/current

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Editorial
Methods to estimate maternal mortality: a global perspective
Serena Donati, Alice Maraschini, Marta Buoncristiano, the Regional Maternal Mortality Working Group
Author Affiliations
National Centre for Epidemiology, Surveillance, and Health Promotion—Istituto Superiore di Sanità, Italian National Institute of Health, Rome Italy
Extract
The maternal mortality ratio (MMR) is globally a reproductive health core indicator, and the death of a woman, while pregnant or within 42 days of termination of pregnancy, is always, anywhere and anyway, a tragedy for the entire community. Reducing the MMR is one of the Millennium Development Goals and the UN Global strategy for women’s and children’s health mobilised multiple resources and commitments to accelerate this objective.1 However MMR estimates and accurate identification of the causes of maternal death are still a complex and difficult challenge. In most developing country settings, owing to the lack of complete and accurate civil registration systems, MMR estimates are based on data from a variety of alternative sources including censuses, household surveys, reproductive age mortality studies and verbal autopsies.2 The WHO classified 183 countries/territories according to the availability and quality of maternal mortality data: 67 countries (covering 17% of births) having complete civil registration data with good attribution of causes of death, 96 countries (covering 81% of births) having incomplete civil registration and/or other types of maternal mortality data and 20 countries (covering 2% of births) lacking national data on maternal mortality. For the last two categories, a regression model has been developed to estimate maternal mortality figures.3 The Demographic and Health Surveys Program4 uses the sisterhood method for Maternal Mortality estimations. This method remains the major source of empirical data on maternal mortality in developing countries, although it presents notable limitations.

Journal of Epidemiology & Community Health
March 2016, Volume 70, Issue 3
http://jech.bmj.com/content/current

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Ebola, jobs and economic activity in Liberia
Jeremy Bowles, Jonas Hjort, Timothy Melvin, Eric Werker
J Epidemiol Community Health 2016;70:271-277 Published Online First: 5 October 2015 doi:10.1136/jech-2015-205959
Abstract
Background
The 2014 Ebola virus disease (EVD) outbreak in the neighbouring West African countries of Guinea, Liberia and Sierra Leone represents the most significant setback to the region’s development in over a decade. This study provides evidence on the extent to which economic activity declined and jobs disappeared in Liberia during the outbreak.
Methods
To estimate how the level of activity and number of jobs in a given set of firms changed during the outbreak, we use a unique panel data set of registered firms surveyed by the business-development non-profit organisation, Building Markets. We also compare the change in economic activity during the outbreak, across regions of the country that had more versus fewer Ebola cases in a difference-in-differences approach.
Findings
We find a large decrease in economic activity and jobs in all of Liberia during the Ebola outbreak, and an especially large decline in Monrovia. Outside of Monrovia, the restaurants, and food and beverages sectors have suffered the most among the surveyed sectors, and in Monrovia, the construction and restaurant sectors have shed the most employees, while the food and beverages sectors experienced the largest drop in new contracts. We find little association between the incidence of Ebola cases and declines in economic activity outside of Monrovia.
Conclusions
If the large decline in economic activity that occurred during the Ebola outbreak persists, a focus on economic recovery may need to be added to the efforts to rebuild and support the healthcare system in order for Liberia to regain its footing.

Journal of Epidemiology & Community Health
March 2016, Volume 70, Issue 3
http://jech.bmj.com/content/current

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Immunisation coverage in rural–urban migrant children in low and middle-income countries (LMICs): a systematic review and meta-analysis
Abiyemi Benita Awoh, Emma Plugge
J Epidemiol Community Health 2016;70:305-311 Published Online First: 7 September 2015 doi:10.1136/jech-2015-205652
Abstract
Background
The majority of children who die from vaccine-preventable diseases (VPDs) live in low-income and-middle-income countries (LMICs). With the rapid urbanisation and rural–urban migration ongoing in LMICs, available research suggests that migration status might be a determinant of immunisation coverage in LMICs, with rural–urban migrant (RUM) children being less likely to be immunised.
Objectives
To examine and synthesise the data on immunisation coverage in RUM children in LMICs and to compare coverage in these children with non-migrant children.
Methods A multiple database search of published and unpublished literature on immunisation coverage for the routine Expanded Programme on Immunisation (EPI) vaccines in RUM children aged 5 years and below was conducted. Following a staged exclusion process, studies that met the inclusion criteria were assessed for quality and data extracted for meta-analysis.
Results
Eleven studies from three countries (China, India and Nigeria) were included in the review. There was substantial statistical heterogeneity between the studies, thus no summary estimate was reported for the meta-analysis. Data synthesis from the studies showed that the proportion of fully immunised RUM children was lower than the WHO bench-mark of 90% at the national level. RUMs were also less likely to be fully immunised than the urban-non-migrants and general population. For the individual EPI vaccines, all but two studies showed lower immunisation coverage in RUMs compared with the general population using national coverage estimates.
Conclusions
This review indicates that there is an association between rural–urban migration and immunisation coverage in LMICs with RUMs being less likely to be fully immunised than the urban non-migrants and the general population. Specific efforts to improve immunisation coverage in this subpopulation of urban residents will not only reduce morbidity and mortality from VPDs in migrants but will also reduce health inequity and the risk of infectious disease outbreaks in wider society.

The Lancet
Feb 20, 2016 Volume 387 Number 10020 p717-816
http://www.thelancet.com/journals/lancet/issue/current

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Editorial
An ambitious agenda for humanity
The Lancet
As highlighted in today’s Lancet, protracted conflicts continue to harm human health and wellbeing. In Yemen, 21 million of 24 million people are now in need of humanitarian assistance and 15 million lack access to health care (see World Report). In Syria, despite a recent ceasefire agreement, fighting looks set to continue into its sixth year. A letter in this issue draws attention to the plight of the 1 million Syrian children who have been orphaned by the war.

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Comment
Zika virus and microcephaly: why is this situation a PHEIC?
David L Heymann, Abraham Hodgson, Amadou Alpha Sall, David O Freedman, J Erin Staples, Fernando Althabe, Kalpana Baruah, Ghazala Mahmud, Nyoman Kandun, Pedro F C Vasconcelos, Silvia Bino, K U MenonPublished Online: 10 February 2016
Summary
When the Director-General of WHO declared, on Feb 1, 2016, that recently reported clusters of microcephaly and other neurological disorders are a Public Health Emergency of International Concern (PHEIC),1 it was on the advice of an Emergency Committee of the International Health Regulations and of other experts whom she had previously consulted. We are the members of the Emergency Committee, and we were identified by the Director-General from rosters of experts that had been submitted by WHO Member States.

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Health Policy
Moving towards universal health coverage: lessons from 11 country studies
Michael R Reich, Joseph Harris, Naoki Ikegami, Akiko Maeda, Cheryl Cashin, Edson C Araujo, Keizo Takemi, Timothy G Evans
Summary
In recent years, many countries have adopted universal health coverage (UHC) as a national aspiration. In response to increasing demand for a systematic assessment of global experiences with UHC, the Government of Japan and the World Bank collaborated on a 2-year multicountry research programme to analyse the processes of moving towards UHC. The programme included 11 countries (Bangladesh, Brazil, Ethiopia, France, Ghana, Indonesia, Japan, Peru, Thailand, Turkey, and Vietnam), representing diverse geographical, economic, and historical contexts. The study identified common challenges and opportunities and useful insights for how to move towards UHC. The study showed that UHC is a complex process, fraught with challenges, many possible pathways, and various pitfalls—but is also feasible and achievable. Movement towards UHC is a long-term policy engagement that needs both technical knowledge and political know-how. Technical solutions need to be accompanied by pragmatic and innovative strategies that address the national political economy context.

New England Journal of Medicine
February 18, 2016 Vol. 374 No. 7
http://www.nejm.org/toc/nejm/medical-journal

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Perspective
Zika Virus in the Americas — Yet Another Arbovirus Threat
A.S. Fauci and D.M. Morens
[Extract; Free full text]
The explosive pandemic of Zika virus infection occurring throughout South America, Central America, and the Caribbean and potentially threatening the United States is the most recent of four unexpected arrivals of important arthropod-borne viral diseases in the Western Hemisphere over the past 20 years. It follows dengue, which entered this hemisphere stealthily over decades and then more aggressively in the 1990s; West Nile virus, which emerged in 1999; and chikungunya, which emerged in 2013. Are the successive migrations of these viruses unrelated, or do they reflect important new patterns of disease emergence? Furthermore, are there secondary health consequences of this arbovirus pandemic that set it apart from others?..

Original Articles
Clinical Management of Ebola Virus Disease in the United States and Europe
T.M. Uyeki and Others

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 20 February 2016)

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Essay
The Health Care Consequences Of Australian Immigration Policies
John-Paul Sanggaran, Bridget Haire, Deborah Zion
Essay | published 16 Feb 2016 | PLOS Medicine
10.1371/journal.pmed.1001960
Summary Points
:: In Australia, immigration policy is to incarcerate those seeking asylum in order to deter others from coming.
:: Within this environment, health care providers frequently experience “dual loyalty” conflict, whereby they cannot serve the interests of both their patients and their employers.
:: The ratification of the Optional Protocol to the Convention Against Torture (OPCAT) would allow for domestic and international monitoring of places of detention, which would serve to ameliorate some of the most problematic aspects of the detention system, including the undemocratic lack of transparency.
:: This would assist in resolving the “dual loyalty” conflict that health care workers must contend with in the current situation.

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 20 February 2016)

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Research Article
Concerted Efforts to Control or Eliminate Neglected Tropical Diseases: How Much Health Will Be Gained?
Sake J. de Vlas, Wilma A. Stolk, Epke A. le Rutte, Jan A. C. Hontelez, Roel Bakker, David J. Blok, Rui Cai, Tanja A. J. Houweling, Margarete C. Kulik, Edeltraud J. Lenk, Marianne Luyendijk, Suzette M. Matthijsse, William K. Redekop, Inge Wagenaar, Julie Jacobson, Nico J. D. Nagelkerke, Jan H. Richardus
Research Article | published 18 Feb 2016 | PLOS Neglected Tropical Diseases
10.1371/journal.pntd.0004386
Abstract
Background
The London Declaration (2012) was formulated to support and focus the control and elimination of ten neglected tropical diseases (NTDs), with targets for 2020 as formulated by the WHO Roadmap. Five NTDs (lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths and trachoma) are to be controlled by preventive chemotherapy (PCT), and four (Chagas’ disease, human African trypanosomiasis, leprosy and visceral leishmaniasis) by innovative and intensified disease management (IDM). Guinea worm, virtually eradicated, is not considered here. We aim to estimate the global health impact of meeting these targets in terms of averted morbidity, mortality, and disability adjusted life years (DALYs).
Methods
The Global Burden of Disease (GBD) 2010 study provides prevalence and burden estimates for all nine NTDs in 1990 and 2010, by country, age and sex, which were taken as the basis for our calculations. Estimates for other years were obtained by interpolating between 1990 (or the start-year of large-scale control efforts) and 2010, and further extrapolating until 2030, such that the 2020 targets were met. The NTD disease manifestations considered in the GBD study were analyzed as either reversible or irreversible. Health impacts were assessed by comparing the results of achieving the targets with the counterfactual, construed as the health burden had the 1990 (or 2010 if higher) situation continued unabated.
Principle Findings/Conclusions
Our calculations show that meeting the targets will lead to about 600 million averted DALYs in the period 2011–2030, nearly equally distributed between PCT and IDM-NTDs, with the health gain amongst PCT-NTDs mostly (96%) due to averted disability and amongst IDM-NTDs largely (95%) from averted mortality. These health gains include about 150 million averted irreversible disease manifestations (e.g. blindness) and 5 million averted deaths. Control of soil-transmitted helminths accounts for one third of all averted DALYs. We conclude that the projected health impact of the London Declaration justifies the required efforts.
Author Summary
Neglected tropical diseases (NTDs) are a group of infectious diseases that occur mostly in poor, warm countries. NTDs are caused by various bacteria and parasites, such as worms. They can either be cured or prevented through drugs and other interventions, such as control of insects that spread the infection. The London Declaration is a statement by various organizations, including the World Health Organization (WHO) and pharmaceutical companies that donate the necessary drugs. The declaration endorses targets for disease reductions by 2020, as recently formulated in the WHO Roadmap, to be achieved by rigorous application of available interventions. We explore how much health can be gained if these targets are indeed achieved. We estimate that in such case 5 million deaths can be averted before 2030 and also that huge reductions in ill-health and disability can be realized. Over the period 2011–2030, a total health gain would be accomplished of about 600 million disability adjusted life years (DALYs) averted. DALYs are a measure of disease burden, consisting of life years lost and years lived with disability. This enormous health gain seems to justify similar investments as for e.g. HIV or malaria control.

PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/
(Accessed 20 February 2016)

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Social Sciences – Economic Sciences – Social Sciences – Sustainability Science:
The effect of rights-based fisheries management on risk taking and fishing safety
Lisa Pfeiffer and Trevor Gratz
PNAS 2016 ; published ahead of print February 16, 2016, doi:10.1073/pnas.1509456113
Significance
Commercial fishing is a dangerous occupation despite decades of regulatory initiatives aimed at making it safer. We posit that the individual allocation of fishing quota can improve safety by solving many of the problems associated with the competitive race to fish, which manifest themselves in risky behavior such as fishing in poor weather. We present a previously unidentified approach to evaluation: estimating the change in the propensity to start a fishing trip in poor weather conditions as a result of the management change. We chronicle a revolution in risk-taking behavior by fishermen (a 79% decrease in the annual average rate of fishing on high wind days) that is due to the change in economic incentives provided by rights-based management.
Abstract
Commercial fishing is a dangerous occupation despite decades of regulatory initiatives aimed at making it safer. We posit that rights-based fisheries management (the individual allocation of fishing quota to vessels or fishing entities, also called catch shares) can improve safety by solving many of the problems associated with the competitive race to fish experienced in fisheries around the world. The competitive nature of such fisheries results in risky behavior such as fishing in poor weather, overloading vessels with fishing gear, and neglecting maintenance. Although not necessarily intended to address safety issues, catch shares eliminate many of the economic incentives to fish as rapidly as possible. We develop a dataset and methods to empirically evaluate the effects of the adoption of catch shares management on a particularly risky type of behavior: the propensity to fish in stormy weather. After catch shares was implemented in an economically important US West Coast fishery, a fisherman’s probability of taking a fishing trip in high wind conditions decreased by 82% compared with only 31% in the former race to fish fishery. Overall, catch shares caused the average annual rate of fishing on high wind days to decrease by 79%. These results are evidence that institutional changes can significantly reduce individual, voluntary risk exposure and result in safer fisheries.

Reproductive Health
http://www.reproductive-health-journal.com/content
[Accessed 20 February 2016]

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Research
The neonatal mortality and its determinants in rural communities of Eastern Uganda
Rornald M. Kananura, Moses Tetui, Aloysius Mutebi, John N. Bua, Peter Waiswa, Suzanne N. Kiwanuka, Elizabeth Ekirapa-Kiracho and Fredrick Makumbi
Published on: 16 February 2016
Abstract
Background
In Uganda, neonatal mortality rate (NMR) remains high at 27 deaths per 1000 live births. There is paucity of data on factors associated with NMR in rural communities in Uganda. The objective of this study was to determine NMR as well as factors associated with neonatal mortality in the rural communities of three districts from eastern Uganda.
Methods
Data from a baseline survey of a maternal and newborn intervention in the districts of Pallisa, Kibuku and Kamuli, Eastern Uganda was analyzed. A total of 2237 women who had delivered in the last 12 months irrespective of birth outcome were interviewed in the survey. The primary outcome for this paper was neonatal mortality. The risk ratio (RR) was used to determine the factors associated with neonatal mortality using log – binomial model.
Results
The neonatal mortality was found to be 34 per 1000 live births (95 % CI = 27.1–42.8); Kamuli 31.9, Pallisa 36.5 and Kibuku 30.8. Factors associated with increased neonatal deaths were parity of 5+ (adj. RR =2.53, 95 % CI =1.14–5.65) relative to parity of 4 and below, newborn low birth weight (adj. RR = 3.10, 95 % CI = 1.47–6.56) and presence of newborn danger signs (adj. RR = 2.42, 95 % CI = 1.04–5.62). Factors associated with lower risk of neonatal death were, home visits by community health workers’ (CHW) (adj. RR =0.13, 95 % CI = 0.02–0.91), and attendance of at least 4 antenatal visits (adj. RR = 0.65, 95 % CI = 0.43–0.98).
Conclusions
Neonatal mortality in rural communities is higher than the national average. The use of CHW’s to mobilize and sensitize households on appropriate maternal and newborn care practices could play a key role in reducing neonatal mortality.

Science
19 February 2016 Vol 351, Issue 6275
http://www.sciencemag.org/current.dtl

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Perspectives
Beyond Ebola
By Janet Currie, Bryan Grenfell, Jeremy Farrar
Science19 Feb 2016 : 815-816
[Free full text]
Summary
On 14 January 2016, Liberia was declared Ebola-free. A new case was identified shortly after the announcement, but it is nevertheless clear that the West African epidemic has moved on to a more hopeful phase. What lessons can be drawn from the Ebola crisis to help the international community to prepare for and respond to the next global epidemic? This question is particularly pertinent given the recent declaration of the Zika virus as a public health emergency.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
__________________________________________________
Week ending 13 February 2016

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 version: The Sentinel_ week ending 13 February 2016

blog edition: comprised of the 35+ entries  for this edition posted below

News Release
Hilton Foundation Mourns Loss of Hilton Prize Director Judy M. Miller
Renowned nonprofit executive passes away in Los Angeles at the age of 77
LOS ANGELES, Feb. 11, 2016 /PRNewswire-USNewswire/ — Philanthropist and activist Judy M. Miller, passed away on February 8, 2016 at her home in Los Angeles of natural causes. She was 77. Judy was known throughout the nonprofit community as a tireless advocate for vulnerable and disadvantaged people around the world. She served as Vice President and Director of the Conrad N. Hilton Humanitarian Prize for 18 years, after a remarkable four-decade career in communications and marketing.

“Judy was a beloved member of our Foundation family and will be greatly missed,” said Peter Laugharn, President and CEO at the Conrad N. Hilton Foundation. “We are very proud of her many accomplishments and will miss her dedication to discovering and advocating for nonprofit organizations that have made extraordinary advances in relieving human suffering.”…

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Chronicle pf Philanthropy
February 12, 2016
Appreciation: Judy Miller’s Leadership Made Hilton Prize Rigorous and Rewarding
By Tom Watson
Last fall at the Waldorf Astoria in New York, I watched as Judy Miller worked the room. The venerable Park Avenue pile was packed with philanthropic luminaries and social-sector leaders celebrating the 20th anniversary of the Hilton Humanitarian Prize, the world’s largest philanthropic award, of which she was the longtime director. Former laureates told stories of challenge and redemption and impact as the Conrad N. Hilton Foundation justly marked one of the great philanthropic success stories in glamorous fashion.

Indefatigable, personally generous, insatiably curious, and possessed of the unmistakable glow that comes from organizing people and resources for the betterment of society, Judy was a true force in the world of American philanthropy. She didn’t have her name on the front door, she rarely stepped into the spotlight, and she worked the inside game. But she made a path that made a difference.

Her death Monday at age 77 shocked and saddened the huge network of nonprofit leaders and change-makers long accustomed to her stoic presence and quiet leadership. This was a person who logged millions of miles visiting nonprofit programs around the world in the service of making the Hilton Prize the most rigorous (and rewarding) of program achievements. Judy delighted in stories of exotic and occasionally dangerous travel, and she took pride in just how hard it was to win a Hilton Prize.

Her record of service to philanthropy lives on in the Hilton laureates, a group that includes nonprofits that have been more innovative and had more impact than most others on the planet…

World Humanitarian Summit
https://www.worldhumanitariansummit.org/
23-24 May 2016 :: Istanbul, Turkey

General Assembly: Briefing by the Secretary-General of the United Nations on the occasion of the launch of his report for the World Humanitarian Summit (Informal meeting of the plenary)
9 Feb 2016 – [Video: 1:58:51]

Stephen O’Brien (OCHA) on the launch of the Secretary-General’s report for the World Humanitarian Summit (WHS) – Press Conference
9 Feb 2016 – [Video: 41:52]
Mr. Stephen O’Brien, Under-Secretary-General for Humanitarian Affairs, briefed reporters on the launch of the Secretary-General’s report for the World Humanitarian Summit (WHS).

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One Humanity: Shared Responsibility
Report of the Secretary-General for the World Humanitarian Summit
Advance unedited copy :: 64 pages
General Assembly
Seventieth session
Item 73 (a)
Strengthening of the coordination of humanitarian and disaster relief assistance of the United Nations, including special economic assistance: strengthening of the coordination of emergency humanitarian assistance of the United Nations
Pdf: http://reliefweb.int/sites/reliefweb.int/files/resources/Secretary-General%27s%20Report%20for%20WHS%202016%20%28Advance%20Unedited%20Draft%29.pdf

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AGENDA FOR HUMANITY – Annex to the Report of the Secretary-General for the World Humanitarian Summit
The World Humanitarian Summit must be a turning point in the way we address the challenges facing our common humanity. The community of “we the peoples”—Governments, local communities, private sector, international organizations and aid providers, and the thousands of committed and compassionate indi¬viduals assisting in crises and disasters every day—will only succeed if we work with a unified sense of purpose to end crises and suffering. The Summit must lead to genuine change in the way we deliver as-sistance and reduce risk and vulnerability; in our commitment to respecting, promoting and implementing international law; in the progress we make in reaching those furthest left behind; in the way we commit to collective outcomes and based on comparative advantage; in the way we resolve to reduce the fragmenta¬tion of international assistance into unmanageable numbers of projects and activities; and in the greater investments we make to prevent and resolve conflicts and human suffering.

We must build on the commitments made in the 2030 Agenda for Sustainable Development by seizing the opportunity of this Summit to prevent and end suffering more decisively, and with more capacity, resolve and resources. We need to commit to working together collectively and coherently across political, cultural, religious and institutional divides. We need to inspire faith in national, regional and international solidarity and our willingness and capacity to prioritize humanity in our decision-making. Most importantly, we need to recognize people’s rights to live in safety, dignity and with the prospects to thrive as agents of their own destinies. Acting upon our individual and collective responsibilities must be our global commitment.

To this end, I urge you to commit to taking forward this Agenda for Humanity and use it as a framework for action, change and mutual accountability. I urge all stakeholders at the Summit to commit to implementing concrete initiatives aimed at making the Agenda a reality. Given the urgency of protecting and improving people’s lives, and ending suffering experienced by millions today, we must commit to making immediate progress in implementing the Agenda over the next three years, measuring further progress thereafter. My report to the 71st session of the General Assembly on the outcomes of the Summit will reflect further on this and make recommendations on how to best implement and monitor the necessary strategic shifts and actions to make a decisive difference for people today and tomorrow.

Change will require a steady and determined effort to do better and overcome the structures and arrange¬ments that we have been used to for decades. It will require a new and creative spirit of collaboration at all levels and openness to new and diverse partnerships. And it will require recognition that we must do far better in accepting our responsibilities for humanity, by ensuring an international order based on sol¬idarity and collaboration – with people at its centre.

Today the values of the United Nations and the vision of humanity that we have agreed upon in its Char¬ter and key instruments such as the Universal Declaration of Human Rights, the humanitarian principles agreed upon by the Red Cross and Red Crescent Movement and reaffirmed by General Assembly resolu¬tion 46/182, the Millennium Declaration and most recently the 2030 Agenda for Sustainable Development, is needed more than ever. Humanity is not just a moral imperative but also a strategic necessity. We must therefore act upon our individual and shared responsibilities. And we must start by making the strategic, operational and policy shifts identified in this Agenda for Humanity a reality, with a heightened sense of urgency and resolve.

Pdf [14 pages]: http://reliefweb.int/sites/reliefweb.int/files/resources/Agenda%20for%20Humanity.pdf

UNODC Chief describes risk of 10,000 missing migrant children as “unacceptable”
09/02/2016 –
Executive Director of the UN Office on Drugs and Crime (UNODC) says in speech on human trafficking that we have the tools to fight this crime, but greater cooperation needed among those countries facing human trafficking

New York/Vienna, 9 February 2016 – Reacting to a Europol warning that up to 10,000 unaccompanied migrant children travelling to Europe were missing, UNODC Executive Director, Yury Fedotov, said today that this situation was “clearly unacceptable, and international action is urgently needed”.

Mr. Fedotov was speaking at an event in New York on human trafficking and the eradication of modern-day slavery through Sustainable Development, organized by the Belarus government, the Group of Friends United against Human Trafficking and UNODC. Other speakers included the President of the UN General Assembly, Mogens Lykketoft, and UN Secretary-General, Ban Ki-moon.

The UNODC chief said solutions lay in fostering greater action and cooperation among every country affected by human trafficking. He underscored the importance of the UN Convention against Transnational Organized Crime and its protocol against human trafficking and stressed that it provided the necessary tools for action.

But the problem, said Mr. Fedotov, is that many countries are not using these laws. He quoted UNODC research that four in 10 countries reported having less than 10 yearly convictions, with nearly 15 per cent having no convictions at all.

He also indicated that the share of children being trafficked was rising with the number of detected child victims now representing nearly one-third of all detected trafficking victims in the world.

Discussing a strategy to counter the traffickers, Mr. Fedotov said the Global Plan of Action to Combat Trafficking in Persons offered a suitable plan, but funding was also needed.

He said the UN Voluntary Trust Fund for Victims of Trafficking in Persons needed the strong support of countries. The Trust Fund has already supported 30 NGO projects, in 26 countries around the world, with grants worth US$ 1.75 million.

Read the Executive Director’s full speech at the event.

International Day against the Use of Child Soldiers: Child Soldiers are Boys and Girls We Failed to Protect
SRSG/CAAC :: Office of the Special Representative of the Secretary-General for Children and Armed Conflict
12 Feb 2016
New York – As we mark the International Day against the Use of Child Soldiers, tens of thousands of boys and girls are associated with armed forces and groups in conflicts in over 20 countries around the world.

“Again this year, the multiplication of conflicts and the brutality of tactics of war have made children extremely vulnerable to recruitment and use,” said Leila Zerrougui, the Special Representative of the Secretary-General for Children and Armed Conflict.

In the most recent Annual report of the Secretary-General on children and armed conflict, 56 of the 57 parties to conflict identified for grave violations against children are named because they are recruiting and using child soldiers.

Children are sent to the frontlines as combatants, but many are also used in functions that put their lives in danger such as cooks, porters, spies and informants. During their association with armed groups or forces, children are exposed to high levels of violence. They are witnesses, victims or forced to commit acts of brutality. In addition, a majority of girls, but also boys, are victims of rape and sexual violence. When they are captured or arrested for alleged association with armed groups, too often, children are not treated primarily as victims and denied the protection guaranteed by international norms and standards of juvenile justice.

“Children who are released or escape often have a hard time finding their place in society, or can even be rejected by their communities. We must make it our common responsibility to ensure sufficient resources are available for reintegration to provide psychosocial support as well as education and vocational training. This is crucial to their future and to build peaceful societies,” said Leila Zerrougui.

…The Optional Protocol to the Convention on the Rights of the Child on the involvement of children in armed conflict, now ratified by 162 state parties, has played a crucial role to bring about this consensus. Leila Zerrougui invites all Member States who have not yet ratified the Optional protocol to do so as soon as possible.

“I invite everyone to start thinking about child soldiers as boys and girls we collectively failed to protect,” said Leila Zerrougui. “We have an opportunity to end the recruitment and use of children in conflict. It is now our common responsibility to ask for urgent action to end grave violations against children and to dedicate the necessary attention and resources to reach our objective.”

Additional information on the recruitment and use of children:
In Afghanistan, there is progress to end the recruitment and use of children in national security forces, but children continue to be recruited by armed groups such as the Taliban.

In the Central African Republic, children continue to be subjected to grave violations by all parties to the conflict. The UN has documented several thousand children recruited and used by armed groups since the beginning of the conflict. Children have been used in many ways. They have been sent to the frontlines as combatants, as informants or porters. Girls have been used for sexual purposes.

In the Democratic Republic of the Congo, there is steady progress in the implementation of the Action Plan signed with the United Nations to end the recruitment and use of children by the national security forces. Despite this positive development, children continued to be recruited and used by armed groups, most notably in eastern DR Congo. It is estimated that the ranks of some armed groups are composed of about 30% of children.

In Iraq and Syria, with the proliferation of armed groups and advances by ISIL, children remain vulnerable to recruitment. Reports have been received of armed groups targeting children as young as seven years of age, and forcibly recruiting children through coercion of family members and abductions.

In South Sudan, children continue to suffer the consequences of a brutal conflict and most of the progress previously achieved to protect them has been erased. We now see high levels of recruitment and use and call on all parties to take tangible action to honour their commitment to protect children.

In Yemen, the recruitment and use of children by all parties to the conflict has become widespread since the escalation of conflict in March 2015.

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11 Feb 2016
Colombia: UN Special Representative for Children and Armed Conflict Welcomes FARC-EP’s Decision to End Child Recruitment
New York – The Special Representative of the Secretary-General for Children and Armed Conflict, Leila Zerrougui, welcomes yesterday’s confirmation by the Fuerzas Armadas Revolucionarias de Colombia-Ejército del Pueblo (FARC-EP) that they will stop the recruitment and use of children under 18…