Health Affairs
June 2015; Volume 34, Issue 6
http://content.healthaffairs.org/content/current

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PEPFAR Funding Associated With An Increase In Employment Among Males in Ten Sub-Saharan African Countries
Zachary Wagner 1 , Jeremy Barofsky 2 and Neeraj Sood 3
Author Affiliations
1Zachary Wagner (zwagner@berkeley.edu) is a doctoral student in health economics at the University of California, Berkeley.
2Jeremy Barofsky is the Okun-Model Fellow at the Brookings Institution, in Washington, D.C.
3Neeraj Sood is an associate professor of health economics and director of research at the Leonard D. Schaeffer Center for Health Policy and Economics at the University of Southern California, in Los Angeles.
Abstract
The President’s Emergency Plan for AIDS Relief (PEPFAR) has provided billions of US tax dollars to expand HIV treatment, care, and prevention programs in sub-Saharan Africa. This investment has generated significant health gains, but much less is known about PEPFAR’s population-level economic effects. We used a difference-in-differences approach to compare employment trends between ten countries that received a large amount of PEPFAR funding (focus countries) and eleven countries that received little or no funding (control countries). We found that PEPFAR was associated with a 13 percent differential increase in employment among males in focus countries, compared to control countries. However, we observed no change in employment among females. In addition, we found that increasing PEPFAR per capita funding by $100 was associated with a 9.1-percentage-point increase in employment among males. This rise in employment generates economic benefits equal to half of PEPFAR’s cost. These findings suggest that PEPFAR’s economic impact should be taken into account when making aid allocation decisions.

Health Policy and Planning
July 2015 30 (6)
http://heapol.oxfordjournals.org/content/current

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The use of counting beads to improve the classification of fast breathing in low-resource settings: a multi-country review
Aaltje Camielle Noordam1,13,*, Yolanda Barberá Laínez2, Salim Sadruddin3, Pabla Maria van Heck4,14, Alex Opio Chono5,15, Geoffrey Larry Acaye6,16, Victor Lara7, Agnes Nanyonjo8,9, Charles Ocan10,17 and Karin Källander11,12
Author Affiliations
1Health Section, United Nations Children Fund (UNICEF), Three United Nations Plaza, New York, NY 10017, USA, 2International Rescue Committee (IRC), 122 East 42nd Street, New York, NY 10168, USA, 3Save the Children, 501 Kings Highway East, Suite 400, Fairfield CT 06825, USA, 4UNICEF Supply Division, Oceanvej 10-12, 2100 København Ø, Denemarken, 5International Rescue Committee (IRC), Plot 7 Lower East Naguru Road, P.O. Box 24672, Kampala, Uganda, 6UNICEF Tamale Field Office, Norrip Building Complex, Bolgatanga Road, P.O. Box 1098, Tamale, Ghana, 7Population Service International (PSI), Whitefield Place, School Lane, Westlands, P.O. Box 14355-00800, Nairobi, Kenya, 8Malaria Consortium, Plot 25, Upper Naguru East road, P.O Box 8045, Kampala, Uganda, 9Department of Public Health Sciences, Karolinska Institutet, 17177 Stockholm, Sweden, 10Save the Children, 501 Kings Highway East, Suite 400, Fairfield CT 06825, USA, 11Malaria Consortium, plot 25, Upper Naguru East road, P.O Box 8045, Kampala, Uganda and 12Department of Public Health Sciences, Karolinska Institutet, 17177 Stockholm, Sweden
Abstract
To decrease child mortality due to common but life-threatening illnesses, community health workers (CHWs) are trained to assess, classify and treat sick children. For pneumonia, CHWs are trained to count the respiratory rate of a child with cough and/or difficulty breathing, and determine whether the child has fast breathing or not based on how the child’s breath count relates to age-specific respiratory rate cut-off points. International organizations training CHWs to classify fast breathing realized that many of them faced challenges counting and determining how the respiratory rate relates to age-specific cut-off points. Counting beads were designed to overcome these challenges. This article presents findings from different studies on the utility of these beads, in conjunction with a timer, as a tool to improve classification of fast breathing. Studies conducted by the International Rescue Committee and Save the Children among illiterate CHWs assessed the effectiveness of counting beads to improve both counting and classifying respiratory rate against age-specific cut-off points. These studies found that the use of counting beads enabled and improved the assessment and classification of fast breathing. However, a Malaria Consortium study found that the use of counting beads decreased the accuracy of counting breaths among literate CHWs. Qualitative findings from these studies and two additional studies by UNICEF suggest that the design of the beads is crucial: beads should move comfortably, and a separate bead string, with colour coding, is required for the age groups with different cut-off thresholds—eliminating more complicated calculations. Further research, using standardized protocols and gold standard comparisons, is needed to understand the accuracy of beads in comparison to other tools used for classifying pneumonia, which CHWs benefit most from each different tool (i.e. disaggregating data by levels of literacy and numeracy) and what the impact is on improving appropriate treatment for pneumonia.

Health Policy and Planning
July 2015 30 (6)
http://heapol.oxfordjournals.org/content/current

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Ten best resources on conditional cash transfers
Caroline Marshall* and Peter S Hill
Author Affiliations
School of Population Health, University of Queensland, QLD 4006, Australia
Abstract
The world’s economy is in a fragile state. Although cautiously recovering from a global recession, unemployment rates and poverty levels remain high. At the same time, food and fuel crises have resulted in skyrocketing commodity costs, straining household budgets even further than before. In the wake of these financial pressure points, there has been increased focus on social safety net programmes. More recently, Brazil’s ‘Bolsa Familia’ conditional cash transfer (CCT) programme has celebrated its tenth-year anniversary, renewing focus on this particular aspect of social transfer programmes. This essay examines one particular aspect of these social safety net programmes: CCTs. CCT programmes are useful social programmes that have had demonstrable effects on many different populations. However, they are not a ‘magic bullet’ against poverty, and their image has suffered from unreasonable expectations of their impacts. This 10 best list is an ideal starting point from which a potential user can begin to understand CCTs. There remain significant gaps in the literature behind CCTs, with a particular need for much more research on emerging areas such as impacts on gender, long-term school and health outcomes, methods for increasing efficiency and adapting conditionalities within cultural contexts, among others. However, this list can function as a starting point from which the reader can gain an understanding and appreciation for what we believe to be one of the most innovative social programmes for addressing poverty worldwide.

Health Policy and Planning
July 2015 30 (6)
http://heapol.oxfordjournals.org/content/current

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Highlighting the evidence gap: how cost-effective are interventions to improve early childhood nutrition and development?
Neha Batura1,*, Zelee Hill1, Hassan Haghparast-Bidgoli1, Raghu Lingam2, Timothy Colbourn1,
Sungwook Kim1, Siham Sikander3, Anni-Maria Pulkki-Brannstrom1,4, Atif Rahman5, Betty Kirkwood6 and Jolene Skordis-Worrall1,7,8
Author Affiliations
1Institute for Global Health, University College London, London WC1N 1EH, UK, 2Maternal and Child Health Intervention Research Group, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK, 3Human Development Research Foundation, Islamabad 44000, Pakistan, 4Epidemiology and Global Health, Umeä University, 90187 Umeå, Sweden, 5Institute of Psychology, Health & Society, Child Mental Health Unit, University of Liverpool, Liverpool L69 3BX, UK, 6Department of Population Health and Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK, 7Health Economics and Systems Group, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK and 8Health Economics Unit, University of Cape Town, Observatory 7925, South Africa
Abstract
There is growing evidence of the effectiveness of early childhood interventions to improve the growth and development of children. Although, historically, nutrition and stimulation interventions may have been delivered separately, they are increasingly being tested as a package of early childhood interventions that synergistically improve outcomes over the life course. However, implementation at scale is seldom possible without first considering the relative cost and cost-effectiveness of these interventions. An evidence gap in this area may deter large-scale implementation, particularly in low- and middle-income countries. We conduct a literature review to establish what is known about the cost-effectiveness of early childhood nutrition and development interventions. A set of predefined search terms and exclusion criteria standardized the search across five databases. The search identified 15 relevant articles. Of these, nine were from studies set in high-income countries and six in low- and middle-income countries. The articles either calculated the cost-effectiveness of nutrition-specific interventions (n = 8) aimed at improving child growth, or parenting interventions (stimulation) to improve early childhood development (n = 7). No articles estimated the cost-effectiveness of combined interventions. Comparing results within nutrition or stimulation interventions, or between nutrition and stimulation interventions was largely prevented by the variety of outcome measures used in these analyses. This article highlights the need for further evidence relevant to low- and middle-income countries. To facilitate comparison of cost-effectiveness between studies, and between contexts where appropriate, a move towards a common outcome measure such as the cost per disability-adjusted life years averted is advocated. Finally, given the increasing number of combined nutrition and stimulation interventions being tested, there is a significant need for evidence of cost-effectiveness for combined programmes. This too would be facilitated by the use of a common outcome measure able to pool the impact of both nutrition and stimulation activities.

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 20 June 2015]

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Research
Introduction of male circumcision for HIV prevention in Uganda: analysis of the policy process
Walter Odoch, Kenneth Kabali, Racheal Ankunda, Joseph Zulu, Moses Tetui Health Research Policy and Systems 2015, 13:31 (20 June 2015)

Human Service Organizations Management, Leadership & Governance
Volume 39, Issue 3, 2015
http://www.tandfonline.com/toc/wasw21/current

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Examining the Impact of Job Burnout on the Health and Well-Being of Human Service Workers: A Systematic Review and Synthesis
Erica Leeanne Lizano
pages 167-181
DOI:10.1080/23303131.2015.1014122
Abstract
This systematic review synthesizes findings from 19 empirical studies published between 1970 and 2014 that examine the relationship between job burnout and affective, psychological, physiological, and behavioral well-being among human service workers. Study findings point to the detrimental impact of job burnout on the well-being of workers. Studies in this area of research continue to use the Maslach Burnout Inventory as the primary measure of burnout, are largely cross-sectional in design, and focus mostly on affective well-being as an outcome. A discussion on the impact of study findings for human service workforce management and future research is presented.

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Voluntary Turnover in Nonprofit Human Service Organizations: The Impact of High Performance Work Practices
DOI:10.1080/23303131.2015.1031416
Sally Coleman Seldena* & Jessica E. Sowab
pages 182-207
Abstract
Voluntary turnover in nonprofits can present a significant cost, reducing the performance of a nonprofit and challenging its sustainability over time. This study examines voluntary turnover in a sample of human service (HS) nonprofit organizations in eight states, exploring the relationship between the implementation of high performance work practices (HPWP) and voluntary turnover. The findings demonstrate that certain HPWPs, including onboarding, leadership development, compensation, and employee relations, are associated with lower voluntary turnover. The results suggest that human service nonprofits seeking to improve retention should invest more time and resources in developing employees as future leaders and cultivating a positive working environment.

Global Health: Science and Practice (GHSP)
June 2015 | Volume 3 | Issue 2
http://www.ghspjournal.org/content/current

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COMMENTARIES
Leveraging the Power of Knowledge Management to Transform Global Health and Development
Good knowledge is essential to prevent disease and improve health. Knowledge management (KM) provides a systematic process and tools to promote access to and use of knowledge among health and development practitioners to improve health and development outcomes. KM tools range from publications and resources (briefs, articles, job aids) and products and services (websites, eLearning courses, mobile applications), to training and events (workshops, webinars, meetings) and approaches and techniques (peer assists, coaching, after-action reviews, knowledge cafés).
Tara M Sullivan, Rupali J Limaye, Vanessa Mitchell, Margaret D’Adamo, Zachary Baquet
Glob Health Sci Pract 2015;3(2):150-162. First published online April 27, 2015. http://dx.doi.org/10.9745/GHSP-D-14-00228

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How Can We Better Evaluate Complex Global Health Initiatives? Reflections From the January 2014 Institute of Medicine Workshop
An IOM workshop on evaluation design drew on recent evaluations of 4 complex initiatives (PEPFAR; the Global Fund to Fight AIDS, TB and Malaria; the President’s Malaria Initiative; and the Affordable Medicines Facility-malaria). Key components for good evaluations: (1) a robust theory of change to understand how and why programs should work; (2) use of multiple analytic methods; and (3) triangulation of evidence to validate and deepen understanding of results as well as synthesis of findings to identify lessons for scale-up or broader application.
Sangeeta Mookherji, Kate Meck
Glob Health Sci Pract 2015;3(2):174-179. First published online May 20, 2015. http://dx.doi.org/10.9745/GHSP-D-14-00184

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Establishing and Scaling-Up Clinical Social Franchise Networks: Lessons Learned From Marie Stopes International and Population Services International
Sarah Thurstona, Nirali M Chakrabortyb, Brendan Hayesc, Anna Mackayc, Pierre Moonb
Family planning social franchising has succeeded in countries with an active private sector serving low- and middle-income clients, with services provided mostly by mid-level providers, such as nurses and midwives. Key support for social franchising includes: clinical training and supportive supervision, help building sustainable businesses, marketing and demand creation, and mechanisms to make services affordable for clients. The forward agenda includes selectively introducing other priority health services, improving cost-effectiveness of the model, and promoting sustainability and health systems integration.
Abstract
In many low- and middle-income countries, a majority of people seek health care from the private sector. However, fragmentation, poor economies of scale, inadequate financing, political opposition, a bias toward curative services, and weak regulatory and quality control systems pose serious challenges for the private sector. Social franchising addresses a number of these challenges by organizing small, independent health care businesses into quality-assured networks. Global franchisors Marie Stopes International (MSI) and Population Services International (PSI) have rapidly scaled their family planning social franchising programs in recent years, jointly delivering over 10.8 million couple-years of protection (CYPs) in 2014—up 26% from 8.6 million CYPs just 1 year prior. Drawing on experience across MSI’s 17 and PSI’s 25 social franchise networks across Africa, Asia, and Latin America and the Caribbean, this article documents the organizations’ operational approaches, challenges faced, and solutions implemented. The organizations provide intensive capacity building and support for private-sector providers, including clinical training, branding, monitoring quality of franchised services, and commodity support. In addition, franchising programs engage providers and clients through behavior change communication (BCC) and demand generation activities to raise awareness and to attract clients, and they implement initiatives to ensure services are affordable for the lowest-income clients. Social franchise programs offer the private sector a collective platform to better engage government in health policy advocacy and for integrating into new public health care financing and procurement mechanisms. The future of social franchising will require developing approaches to scale-up and sustain the model cost-effectively, selectively integrating other health services into the franchise package, and being responsive to evolving health care financing approaches with the potential to contribute to universal health coverage

Health Policy and Planning
July 2015 30 (6)
http://heapol.oxfordjournals.org/content/current

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Applying lessons learned from the USAID family planning graduation experience to the GAVI graduation process
Angela K Shen*,1,2, Marguerite M Farrell3, Mary F Vandenbroucke4, Elizabeth Fox5 and Ariel Pablos-Mendez1
Author Affiliations
1Bureau for Global Health, US Agency for International Development, Washington, DC, USA, 2US Department of Health and Human Services, Washington, DC, USA, 3Office of Population and Reproductive Health, US Agency for International Development, Washington, DC, USA, 4Office of Country Support, US Agency for International Development, Washington, DC, USA and 5Office of Health Infectious Disease and Nutrition, US Agency for International Development, Washington, DC, USA
Abstract
As low income countries experience economic transition, characterized by rapid economic growth and increased government spending potential in health, they have increased fiscal space to support and sustain more of their own health programmes, decreasing need for donor development assistance. Phase out of external funds should be systematic and efforts towards this end should concentrate on government commitments towards country ownership and self-sustainability. The 2006 US Agency for International Development (USAID) family planning (FP) graduation strategy is one such example of a systematic phase-out approach. Triggers for graduation were based on pre-determined criteria and programme indicators. In 2011 the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunizations) which primarily supports financing of new vaccines, established a graduation policy process. Countries whose gross national income per capita exceeds $1570 incrementally increase their co-financing of new vaccines over a 5-year period until they are no longer eligible to apply for new GAVI funding, although previously awarded support will continue. This article compares and contrasts the USAID and GAVI processes to apply lessons learned from the USAID FP graduation experience to the GAVI process. The findings of the review are 3-fold: (1) FP graduation plans served an important purpose by focusing on strategic needs across six graduation plan foci, facilitating graduation with pre-determined financial and technical benchmarks, (2) USAID sought to assure contraceptive security prior to graduation, phasing out of contraceptive donations first before phasing out from technical assistance in other programme areas and (3) USAID sought to sustain political support to assure financing of products and programmes continue after graduation. Improving sustainability more broadly beyond vaccine financing provides a more comprehensive approach to graduation. The USAID FP experience provides a window into understanding one approach to graduation from donor assistance. The process itself—involving transparent country-level partners well in advance of graduation—appears a valuable lesson towards success.

Health Policy and Planning
July 2015 30 (6)
http://heapol.oxfordjournals.org/content/current

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Ten best resources on conditional cash transfers
Caroline Marshall* and Peter S Hill
Author Affiliations
School of Population Health, University of Queensland, QLD 4006, Australia
Abstract
The world’s economy is in a fragile state. Although cautiously recovering from a global recession, unemployment rates and poverty levels remain high. At the same time, food and fuel crises have resulted in skyrocketing commodity costs, straining household budgets even further than before. In the wake of these financial pressure points, there has been increased focus on social safety net programmes. More recently, Brazil’s ‘Bolsa Familia’ conditional cash transfer (CCT) programme has celebrated its tenth-year anniversary, renewing focus on this particular aspect of social transfer programmes. This essay examines one particular aspect of these social safety net programmes: CCTs. CCT programmes are useful social programmes that have had demonstrable effects on many different populations. However, they are not a ‘magic bullet’ against poverty, and their image has suffered from unreasonable expectations of their impacts. This 10 best list is an ideal starting point from which a potential user can begin to understand CCTs. There remain significant gaps in the literature behind CCTs, with a particular need for much more research on emerging areas such as impacts on gender, long-term school and health outcomes, methods for increasing efficiency and adapting conditionalities within cultural contexts, among others. However, this list can function as a starting point from which the reader can gain an understanding and appreciation for what we believe to be one of the most innovative social programmes for addressing poverty worldwide.

JAMA
June 16, 2015, Vol 313, No. 23
http://jama.jamanetwork.com/issue.aspx

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Scientific Discovery and the Future of Medicine
Science, Medicine, and Society: A View From the Wellcome Trust
Jeremy Farrar, FRS, FRCP, FMedSci, OBE

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Editorial | June 16, 2015
Development Assistance for Health Potential Contribution to the Post-2015 Agenda
Andy Haines, MD, MB, BS1
Author Affiliations
JAMA. 2015;313(23):2328-2330. doi:10.1001/jama.2015.5790.
Despite economic growth in low-income countries, the internal resources available to some governments will be inadequate to support the delivery of health care to their populations for years to come.1 Approximately 150 million people worldwide experience catastrophic expenditure annually to cover out-of-pocket payments for health.1 Despite substantial progress, 6.6 million children who were younger than 5 years died in 2012 and a quarter of all children younger than 5 years were stunted (having an inadequate height or length for age).2 Almost 300 000 women died in 2013 of causes related to pregnancy and childbirth.2 Against this background, the study by Dieleman and colleagues3 in this issue of JAMA makes a substantial contribution to the current understanding of the flow of development assistance for health (DAH) and how these resources can contribute to the achievement of international health goals…

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Special Communication | June 16, 2015
Sources and Focus of Health Development Assistance, 1990–2014
Joseph L. Dieleman, PhD1; Casey Graves, BA1; Elizabeth Johnson, BA1; Tara Templin, BA1; Maxwell Birger, BS1; Hannah Hamavid, BA1; Michael Freeman, MPH2; Katherine Leach-Kemon, MPH1; Lavanya Singh, BS1; Annie Haakenstad, MA1; Christopher J. L. Murray, MD1
Author Affiliations
JAMA. 2015;313(23):2359-2368. doi:10.1001/jama.2015.5825
Abstract
Importance
The governments of high-income countries and private organizations provide billions of dollars to developing countries for health. This type of development assistance can have a critical role in ensuring that life-saving health interventions reach populations in need.
Objectives
To identify the amount of development assistance that countries and organizations provided for health and to determine the health areas that received these funds.
Evidence Review Budget, revenue, and expenditure data on the primary agencies and organizations (n = 38) that provided resources to developing countries (n = 146-183, depending on the year) for health from 1990 through 2014 were collected. For each channel (the international agency or organization that directed the resources toward the implementing institution or government), the source and recipient of the development assistance were determined and redundant accounting of the same dollar, which occurs when channels transfer funds among each other, was removed. This research derived the flow of resources from source to intermediary channel to recipient. Development assistance for health (DAH) was divided into 11 mutually exclusive health focus areas, such that every dollar of development assistance was assigned only 1 health focus area.
Findings
Since 1990, $458.0 billion of development assistance has been provided to maintain or improve health in developing countries. The largest source of funding was the US government, which provided $143.1 billion between 1990 and 2014, including $12.4 billion in 2014. Of resources that originated with the US government, 70.6% were provided through US government agencies, and 41.0% were allocated for human immunodeficiency virus (HIV)/AIDS. The second largest source of development assistance for health was private philanthropic donors, including the Bill and Melinda Gates Foundation and other private foundations, which provided $69.9 billion between 1990 and 2014, including $6.2 billion in 2014. These resources were provided primarily through private foundations and nongovernmental organizations and were allocated for a diverse set of health focus areas. Since 1990, 28.0% of all DAH was allocated for maternal health and newborn and child health; 23.2% for HIV/AIDS, 4.3% for malaria, 2.8% for tuberculosis, and 1.5% for noncommunicable diseases. Between 2000 and 2010, DAH increased 11.3% annually. However, since 2010, total DAH has not increased as substantially.
Conclusions and Relevance
Funding for health in developing countries has increased substantially since 1990, with a focus on HIV/AIDS, maternal health, and newborn and child health. Funding from the US government has played a substantial role in this expansion. Funding for noncommunicable diseases has been limited. Understanding how funding patterns have changed across time and the priorities of sources of international funding across distinct channels, recipients, and health focus areas may help identify where funding gaps persist and where cost-effective interventions could save lives.

Journal of Immigrant & Refugee Studies
Volume 13, Issue 2, 2015
http://www.tandfonline.com/toc/wimm20/current#.VQS0KOFnBhW

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Special Issue: Implementing Human Rights: Civil Society and Migration Policies
NGOs and Health Services for Irregular Immigrants in Italy: When the Protection of Human Rights Challenges the Laws
Maurizio Ambrosini
pages 116-134
DOI:10.1080/15562948.2015.1017631
Published online: 17 Jun 2015

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The Integration of Forced Migrants Into the Italian Labor Market
Livia Elisa Ortensi
pages 179-199
DOI:10.1080/15562948.2014.907952
Published online: 17 Jun 2015

The Lancet
Jun 20, 2015 Volume 385 Number 9986 p2433-2546
http://www.thelancet.com/journals/lancet/issue/current

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Editorial
The G7 and global health: inaction or incisive leadership?
The Lancet
DOI: http://dx.doi.org/10.1016/S0140-6736(15)61121-7
Preview
“They came, they met, and nothing happened.” So was the conclusion of James Rubin, former US Assistant Secretary of State. A harsh, but many might say fair, statement about the recent G7 meeting held in Germany. A few days before the start of the Summit, UN Secretary General Ban Ki-moon set the scene for leaders: “When they meet at the Schloss Elmau Summit in Germany on June 7–8, G7 leaders can show they are serious about seizing the moment and protecting people and the planet.” He was right to suggest that as the international community prepares to adopt a new sustainable development agenda in New York in September, together with a new climate treaty in Paris in December, G7 countries have “a special responsibility to lead”.

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Comment
Capacity for science in sub-Saharan Africa
Alison Elliott, Barbara Nerima, Bernard Bagaya, Andrew Kambugu, Moses Joloba, Stephen Cose, Guiseppe Pantaleo, Maria Yazdanbakhsh, David Mabey, David Dunne, Ashley Moffett, Eli Katunguka Rwakishaya, Pontiano Kaleebu, Edward Katongole Mbidde
DOI: http://dx.doi.org/10.1016/S0140-6736(15)61111-4
Preview
During the past decade there has been an increase in funding for research capacity building in Africa. Two major European programmes are at a turning point: the Wellcome Trust’s African Institutions Initiative is about to end, while their new initiative, DELTAS Africa,1 will be launched later this year. The European Union’s Seventh Framework Programme (FP7) is ending, superseded by Horizon 2020,2 with the transition of some research areas that are important to Africa into the expanded second phase of the European and Developing Countries Clinical Trials Partnership.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 20 June 2015)

.Collection Review
HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs
David Wilson
Published: June 16, 2015
DOI: 10.1371/journal.pmed.1001808
Featured in PLOS Collections
Abstract
There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection “Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers” highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i) HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii) national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii) comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 20 June 2015)

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Policy Forum
Maximizing the Impact of Training Initiatives for Health Professionals in Low-Income Countries: Frameworks, Challenges, and Best Practices
Corrado Cancedda, Paul E. Farmer, Vanessa Kerry, Tej Nuthulaganti, Kirstin W. Scott, Eric Goosby, Agnes Binagwaho
June 16, 2015
DOI: 10.1371/journal.pmed.1001840
Summary Points
:: Historically, the impact of many health professional training initiatives in low-income countries has been limited by narrow focus on a small set of diseases, inefficient utilization of donor funding, inadequate scale up, insufficient emphasis on the acquisition of practical skills, poor alignment with local priorities, and lack of coordination.
:: Fortunately, several innovative training initiatives have emerged over the past five years in sub-Saharan Africa. This articles focuses on four initiatives funded by the United States government: the Medical Education Training Partnership Initiative (MEPI), the Nursing Training Partnership Initiative (NEPI), the Rwanda Human Resources for Health Program (HRH Program), and the Global Health Service Partnership (GHSP).
:: The best practices adopted by these initiatives are: alignment to local priorities, country ownership, competency-based training, institutional capacity building, and the establishment of long-lasting partnerships with international stakeholders,
:: Based on these best practices, we outline a framework for health professional training initiatives that can help better address the health workforce shortage in low-income countries.

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 20 June 2015)

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Research Article
Acceptability and Willingness-to-Pay for a Hypothetical Ebola Virus Vaccine in Nigeria
Maduka Donatus Ughasoro, Dorothy Omono Esangbedo, Beckie Nnenna Tagbo, Ijeoma Chigozie Mejeha
Published: June 15, 2015
DOI: 10.1371/journal.pntd.0003838
Abstract
Background
Ebola virus disease is a highly virulent and transmissible disease. The largest recorded fatality from Ebola virus disease epidemic is ongoing in a few countries in West Africa, and this poses a health risk to the entire population of the world because arresting the transmission has been challenging. Vaccination is considered a key intervention that is capable of arresting further spread of the disease and preventing future outbreak. However, no vaccine has yet been approved for public use, although various recombinant vaccines are undergoing trials and approval for public use is imminent. Therefore, this study aimed to determine the acceptability of and willingness-to-pay for Ebola virus vaccine by the public.
Methods
The study was a community-based cross-sectional qualitative and quantitative interventional study conducted in two communities, each in two states in Nigeria. An interviewer-administered questionnaire was used to collect information on respondents’ knowledge of the Ebola virus, the ways to prevent the disease, and their preventive practices, as well as their acceptability of and willingness-to-pay for a hypothetical vaccine against Ebola virus disease. The association between acceptability of the vaccine and other independent variables were evaluated using multivariate regression analysis.
Results
Ebola virus disease was considered to be a very serious disease by 38.5% of the 582 respondents (224/582), prior to receiving health education on Ebola virus and its vaccine. Eighty percent (80%) accepted to be vaccinated with Ebola vaccine. However, among those that accepted to be vaccinated, most would only accept after observing the outcome on others who have received the vaccine. More than 87.5% was willing to pay for the vaccine, although 55.2% was of the opinion that the vaccine should be provided free of charge.
Conclusion
The level of acceptability of Ebola virus vaccine among respondents was impressive (though conditional), as well as their willingness to pay for it if the vaccine is not publicly funded. In order to achieve a high uptake of the vaccine, information and education on the vaccine should be extensively shared with the public prior to the introduction of the vaccine, and the vaccine should be provided free of charge by government.
Author Summary
Ebola virus disease (EVD) is highly virulent and transmissible. The transmission is mostly by direct contact with an infected person or indirectly through contact with material contaminated with the secretions or body fluids of an infected person. Currently there is no vaccine or drug for EVD. Maintaining good personal and environmental hygiene remains the only control strategy, and its implementation was a challenge in West Africa countries. Ebola virus vaccine (EVV) is being developed and may soon be deployed; thus a need to evaluate factors that can improve or discourage the uptake of the vaccine when it becomes approved for public administration. This study highlights the acceptability and willingness-to-pay for EVV. Majority of the respondents were willing to accept the vaccine and pay for it if it is not publicly funded. Of interest was that among those that accepted to be vaccinated, most would only accept to do so after they had observed the outcome on others that had received the vaccine. There is need for early dissemination of correct information and education on EVV to the populace so as to prevent any misinformation and misperception about the vaccine. This will improve universal coverage with the vaccine when deployed.

Sustainability
Volume 7, Issue 5 (May 2015), Pages 4783-6335
http://www.mdpi.com/2071-1050/7/4

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Article: Assessing Child Development: A Critical Review and the Sustainable Child Development Index (SCDI)
by Ya-Ju Chang, Laura Schneider and Matthias Finkbeiner
Sustainability 2015, 7(5), 4973-4996; doi:10.3390/su7054973
Received: 26 January 2015 / Revised: 13 April 2015 / Accepted: 21 April 2015 / Published: 24 April 2015
Abstract:
Children are an important stakeholder group for sustainable development, as they represent the interface between current and future generations. A comprehensive assessment of child development (CD) in the context of sustainable development is still missing. In this paper, as a first step, a literature review is conducted to identify relevant aspects and gaps related to the assessment of CD. The main issues of CD are categorized into seven themes: health, education, safety, economic status, relationships, participation, and newly proposed environmental aspects. The corresponding subthemes and criteria are classified accordingly (e.g., nutrition, child mortality, immunization, etc., are assigned to the theme health). However, gaps in current studies, such as the heterogeneous classification of relevant aspects, regional and societal bias in addressing certain aspects, the limited number of subthemes, and criteria and the missing inclusion of environmental aspects impede the assessment of sustainable child development. To address the existing gaps, a comprehensive framework, the Sustainable Child Development Index (SCDI), is proposed. The SCDI is based on sustainable development as the core value, considers relevant aspects of CD with regard to newly-proposed environmental aspects and includes 26 aspects on an outcome and 37 indicators on a context level to tackle the heterogeneous classifications and interdependencies of relevant aspects. The proposed index intends to strengthen the stakeholder perspective of children in sustainability assessment.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
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Week ending 13 June 2015

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

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Editor &
Founding Managing Director
GE2P2 – Center for Governance, Evidence, Ethics, Policy, Practice
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pdf version: The Sentinel_ week ending 13 June 2015

blog edition: comprised of the 35+ entries to be posted below on 14 June 2015

earlier pdf editions archived here

Annual Report of the Secretary-General on children and armed conflict
UN General Assembly / Security Council
A/69/926–S/2015/409
5 June 2015 :: 51 pages
http://www.un.org/ga/search/view_doc.asp?symbol=A/69/926&Lang=E&Area=UNDOC

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[Excerpt]
II. Addressing the impact of armed conflict on children
A. Trends and developments
5. There were unprecedented challenges in 2014 with regard to the protection of tens of millions of children growing up in situations affected by conflict. In particular, children in several countries affected by major crises, namely, the Central African Republic, Iraq, Israel/State of Palestine, Nigeria, South Sudan and the Syrian Arab Republic, were exposed to the most egregious violations. This added to existing violations against children in protracted conflicts, such as in Afghanistan, the Democratic Republic of the Congo and Somalia. Most recently, the security situation in Yemen deteriorated further with reports, in April 2015, of significant numbers of child casualties.
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B. Abductions as an increasing trend
6. Mass abductions of civilians, including children, have become an increasingly prevalent feature of conflict in many situations described in the present report. The abduction of children had primarily been a precursor to other violations, such as killing and maiming, recruitment and use, or sexual violence. In many instances, abducted children were also arbitrarily detained by Governments and armed groups. While these trends continued in 2014, armed groups abducted children in greater numbers and increasingly used abductions as a tactic to terrorize or target particular ethnic groups or religious communities.
7. In Iraq and the Syrian Arab Republic, over one thousand girls and boys were abducted by the Islamic State of Iraq and the Levant (ISIL). In one incident in the Syrian Arab Republic, ISIL abducted approximately 150 young boys on their way home from having taken school exams in Aleppo. They were released from captivity after a few months, during which they were physically abused, indoctrinated and made to observe violent practices. Towards the end of the year, ISIL issued a document justifying its sexual slavery of Yezidi girls abducted in Iraq. In Nigeria, Boko Haram abducted hundreds of women and girls in major attacks in Chibok and across the country’s north-eastern region. Video statements released by Boko Haram indicated that the abductions were in retaliation against the Government for the detention of relatives and served as punishment for schoolchildren attending Western-style schools.
8. The information contained in the present report demonstrates that the increase in the frequency and scale of abductions has resulted in greater protection needs for children. The children require safe release, family tracing, medical, psychological and legal assistance…

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Press Release
Abductions of children pose alarming new trend: Secretary-General’s Annual Report on Children and Armed Conflict
11 Jun 2015
New York – Mass abductions of children and other civilians have become increasingly prevalent in many of the 23 conflict situations of 2014 that are highlighted in the Annual Report of the Secretary-General on children and armed conflict, released today.

“Abductions have emerged as a rising and alarming trend that are being used in many new ways, including as a tactic to terrorize or target particular ethnic groups or religious communities,” said the Secretary-General’s Special Representative for Children and Armed Conflict, Leila Zerrougui.

“The sharp rise in abductions highlights the need for us to elevate our focus on this violation as we seek to strengthen the tools we have that are aimed at protecting children during armed conflict.”…

World Report on Child Labour 2015: Paving the way to decent work for young people
International Programme on the Elimination of Child Labour (IPEC)
10 June 2015 :: 112 pages
978‐92‐2‐129689‐8[ISBN]
http://www.ilo.org/ipecinfo/product/download.do?type=document&id=26977

The second volume of the ILO World Report on Child Labour series highlights the close linkages between child labour and good youth employment outcomes, and the consequent need for common policy approaches to addressing challenges arising in countries where both child labour and youth unemployment prevail.
:: Download the Report
:: Download the Executive Summary
Abstract
The Report presents empirical evidence of how child labour combined with limited education can lead to increased youth vulnerability and greater difficulties in transiting to good jobs. This evidence includes results from the ILO School-to-Work Transition Survey (SWTS) programme, an unprecedented data collection effort allowing the analysis of the trajectories followed by youth to enter the world of work in a total of 28 low- and middle-income countries around the world. The Report also reviews evidence of how the child labour-youth employment link can operate in the opposite direction, i.e., of how the difficulties faced by youth in the labour market can make personal investment in education less attractive as an alternative to child labour earlier in the lifecycle.

Hazardous work among adolescents aged 15 to 17 years is a third focus of the Report. Individuals in this critical age group, who are above the minimum working age in most countries but at the same time are still legally children, overlap the child labour and youth employment fields. Evidence is presented indicating that an alarming share of working adolescents aged 15 to 17 years are in hazardous work and therefore are child labourers.

Taken together, the evidence presented in the Report makes a strong case that the challenge of finding decent work during youth cannot be separated from the challenge of eliminating child labour earlier in the life cycle. Eliminating child labour, in other words, is a key policy goal in itself and a necessary starting point for achieving decent work for all.

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Press Release
World Day Against Child Labour 2015
New ILO study points to the long-term impact of child labour
New ILO report shows the need for coherent policies tackling child labour and the lack of decent jobs for youth together.

News | Geneva/Dhaka | 11 June 2015
Around 20 to 30 per cent of children in low income countries complete their schooling and enter the labour market by the age of 15, says a new International Labour Organization (ILO) report prepared for World Day against Child Labour. Most of these children were in child labour before.

The World Report on Child Labour 2015: Paving the way to decent work for young people shows that young persons who were burdened by work as children are consistently more likely to have to settle for unpaid family jobs and are more likely to be in low paying jobs.

“Our new report shows the need for a coherent policy approach that tackles child labour and the lack of decent jobs for youth together. Keeping children in school and receiving a good education until at least the minimum age of employment will determine the whole life of a child. It is the only way for a child to acquire the basic knowledge and skills needed for further learning, and for her or his future working life,” ILO Director-General Guy Ryder said.

To take up this challenge, 2014 Nobel Peace Prize co-Laureate Kailash Satyarthi who will address the ILO’s International Labour Conference on 11 June , calls for a change of mindsets: “When we consider our biological children, we think that they are born to become doctors, engineers, and professors – the whole world is for them. But when we talk about other children, we think, ok, they are poor children, let them work, we will slowly help them. Let us consider all children our children.”

Main findings
The report addresses the twin challenges of eliminating child labour and ensuring decent work for young people. Based on a 12 country survey, it examines the future careers of former child labourers and early school leavers.

The main findings of the report are that:
:: Prior involvement in child labour is associated with lower educational attainment, and later in life with jobs that fail to meet basic decent work criteria;
:: Early school leavers are less likely to secure stable jobs and are at greater risk of remaining outside the world of work altogether;
:: A high share of 15-17 year olds in many countries are in jobs that have been classified as hazardous or worst forms of child labour; and
:: Those in hazardous work are more likely to have left school early before reaching the legal minimum age of employment.

The report recommends early interventions to get children out of child labour and into school as well as measures to facilitate the transition from school to decent work opportunities for young people.

Particular attention should be given to the 47.5 million young people aged 15-17 in hazardous work and the special vulnerabilities of girls and young women.

“National policies should be directed towards removing children and young people from hazardous jobs and, of course, towards removing the hazards in the workplace,” Ryder said.

The ILO’s most recent estimate is that 168 million children are in child labour, with 120 million of them aged 5-14. The report underscores the critical importance of intervening early in the life cycle against child labour…