The Lancet
Apr 25, 2015 Volume 385 Number 9978 p1591-1696 e38-e44
http://www.thelancet.com/journals/lancet/issue/current

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Editorial
Vaccines: a step change in malaria prevention?
The Lancet
According to WHO’s 2014 World Malaria Report there were an estimated 198 million cases of malaria worldwide in 2013, occurring in around half of the world’s countries. These infections resulted in some 584 000 deaths, principally associated with Plasmodium falciparum infection, of which 90% occurred in equatorial Africa. Most distressingly, malaria mortality is concentrated in children, with about 453 000 deaths of children aged younger than 5 years in 2013, the vast majority in African countries.

The Lancet
Apr 25, 2015 Volume 385 Number 9978 p1591-1696 e38-e44
http://www.thelancet.com/journals/lancet/issue/current
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Comment
Research priorities to address violence against women and girls
Marleen Temmerman
Published Online: 20 November 2014
DOI: http://dx.doi.org/10.1016/S0140-6736(14)61840-7
Violence against women and girls is increasingly visible on the global health and development agenda—both as a matter of social justice and equality for women and as a public health priority. After many years of dedicated efforts, more is known about the epidemiology of some forms of violence against women, and knowledge is increasing about what works to prevent and respond to such violence. However, as this Lancet Series on violence against women and girls1–5 highlights, in terms of research and evidence this is still an emerging field.

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Series
Prevention of violence against women and girls: lessons from practice
Lori Michau, MA, Jessica Horn, MSc, Amy Bank, BA, Mallika Dutt, JD, Cathy Zimmerman, PhD
Published Online: 20 November 2014
DOI: http://dx.doi.org/10.1016/S0140-6736(14)61797-9
Summary
This Series paper describes programming to prevent violence against women and girls, and emphasises the importance of systematic, sustained programming across the social ecology (ie, the delicate equilibrium of interacting social, institutional, cultural, and political contexts of people’s lives) to transform gender-power inequalities. Effective prevention policy and programming is founded on five core principles: first, analysis and actions to prevent violence across the social ecology (individual, interpersonal, community, and societal); second, intervention designs based on an intersectional gender-power analysis; third, theory-informed models developed on the basis of evidence; fourth, sustained investment in multisector interventions; and finally, aspirational programming that promotes personal and collective thought, and enables activism on women’s and girls’ rights to violence-free lives. Prevention programming of the future will depend on all of us having a vision of, and a commitment to, gender equality to make violence-free lives for women and girls a reality.

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Series
Addressing violence against women: a call to action
Dr Claudia García-Moreno, MD, Cathy Zimmerman, PhD, Alison Morris-Gehring, PhD, Lori Heise, PhD, Avni Amin, PhD, Naeemah Abrahams, PhD, Oswaldo Montoya, MA, Padma Bhate-eosthali, SW, Nduku Kilonzo, PhD, Prof Charlotte Watts, PhD
Published Online: 20 November 2014
DOI: http://dx.doi.org/10.1016/S0140-6736(14)61830-4
Summary
Violence against women and girls is prevalent worldwide but historically has been overlooked and condoned. Growing international recognition of these violations creates opportunities for elimination, although solutions will not be quick or easy. Governments need to address the political, social, and economic structures that subordinate women, and implement national plans and make budget commitments to invest in actions by multiple sectors to prevent and respond to abuse. Emphasis on prevention is crucial. Community and group interventions involving women and men can shift discriminatory social norms to reduce the risk of violence. Education and empowerment of women are fundamental. Health workers should be trained to identify and support survivors and strategies to address violence should be integrated into services for child health, maternal, sexual, and reproductive health, mental health, HIV, and alcohol or substance abuse. Research to learn how to respond to violence must be strengthened. The elimination of violence against women and girls is central to equitable and sustainable social and economic development and must be prioritised in the agenda for development after 2015.

The Lancet Global Health
May 2015 Volume 3 Number 5 e240-e296
http://www.thelancet.com/journals/langlo/issue/current
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Comment
Burden of obstetric fistula: from measurement to action
Saifuddin Ahmed, Özge Tunçalp
Open Access
DOI: http://dx.doi.org/10.1016/S2214-109X(15)70105-1
For every maternal death, an additional 20–30 women develop serious pregnancy-related complications. Among all maternal morbidities, obstetric fistula is one of the most devastating. It is caused by injury during childbirth, resulting in an abnormal opening between the vagina and the bladder (vesicovaginal fistula) or rectum (rectovaginal fistula), leading to continuous urinary or fecal incontinence. Obstructed labour is the most common cause of vesicovaginal fistula in low-income countries.1 Worldwide, an estimated 2–3 million women have obstetric fistula,1 almost exclusively in sub-Saharan Africa and south Asia.
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Articles
Prevalence of symptoms of vaginal fistula in 19 sub-Saharan Africa countries: a meta-analysis of national household survey data
Mathieu Maheu-Giroux, ScD, Véronique Filippi, PhD, Sékou Samadoulougou, PhD, Marcia C Castro, PhD, Nathalie Maulet, MPH, Prof Nicolas Meda, MD, Dr Fati Kirakoya-Samadoulougou, PhD
Open Access
DOI: http://dx.doi.org/10.1016/S2214-109X(14)70348-1
Summary
Background
Vaginal fistula is a serious medical disorder characterised by an abnormal opening between the vagina and the bladder or rectum, which results in continuous leakage of urine or stool. The burden of this disorder in sub-Saharan Africa is uncertain. We estimated the lifetime and point prevalence of symptoms of vaginal fistula in this region using national household surveys based on self-report of symptoms.
Methods
We considered all Demographic and Health Surveys (DHS) and Multiple Indicators Cluster Surveys (MICS) from sub-Saharan Africa and included data for women of reproductive age (15–49 years). We estimated lifetime prevalence and point prevalence of vaginal fistula with use of Bayesian hierarchical meta-analysis.
Findings
We included 19 surveys in our analysis, including 262 100 respondents. Lifetime prevalence was 3•0 cases (95% credible interval 1•3–5•5) per 1000 women of reproductive age. After imputation of missing data, point prevalence was 1•0 case (0•3–2•4) per 1000 women of reproductive age. Ethiopia had the largest number of women who presently have symptoms of vaginal fistula.
Interpretation
This study is the first to estimate the burden of vaginal fistula in 19 sub-Saharan Africa countries using nationally representative survey data. Point prevalence was slightly lower than previously estimated but these earlier estimates are within the prevalence’s credible intervals. Although vaginal fistula is relatively rare, it is still too common in sub-Saharan Africa.
Funding
None.

The Lancet Global Health
May 2015 Volume 3 Number 5 e240-e296
http://www.thelancet.com/journals/langlo/issue/current

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Comment
Governing the UN Sustainable Development Goals: interactions, infrastructures, and institutions
Jeff Waage, Christopher Yap, Sarah Bell, Caren Levy, Georgina Mace, Tom Pegram, Elaine nterhalter, Niheer Dasandi, David Hudson, Richard Kock, Susannah Mayhew, Colin Marx, Nigel Poole
Published Online: 29 March 2015
Open Access
DOI: http://dx.doi.org/10.1016/S2214-109X(15)70112-9
Summary
Three of the eight Millennium Development Goals (MDGs) concerned health. There is only one health goal in 17 proposed Sustainable Development Goals (SDGs). Critiques of the MDGs included missed opportunities to realise positive interactions between goals.1 Here we report on an interdisciplinary analytical review of the SDG process, in which experts in different SDG areas identified potential interactions through a series of interdisciplinary workshops. This process generated a framework that reveals potential conflicts and synergies between goals, and how their interactions might be governed.

The Lancet Global Health
May 2015 Volume 3 Number 5 e240-e296
http://www.thelancet.com/journals/langlo/issue/current

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Articles
Health gains and financial risk protection afforded by public financing of selected interventions in Ethiopia: an extended cost-effectiveness analysis
Dr Stéphane Verguet, PhD, Zachary D Olson, MA, Joseph B Babigumira, PhD, Dawit Desalegn, MD, Kjell Arne Johansson, PhD, Margaret E Kruk, MD, Carol E Levin, PhD, Rachel A Nugent, PhD, Clint Pecenka, PhD, Mark G Shrime, MD, Solomon Tessema Memirie, MD, David A Watkins, MD, Prof Dean T Jamison, PhD
Open Access
DOI: http://dx.doi.org/10.1016/S2214-109X(14)70346-8
Summary
Background
The way in which a government chooses to finance a health intervention can affect the uptake of health interventions and consequently the extent of health gains. In addition to health gains, some policies such as public finance can insure against catastrophic health expenditures. We aimed to evaluate the health and financial risk protection benefits of selected interventions that could be publicly financed by the government of Ethiopia.
Methods
We used extended cost-effectiveness analysis to assess the health gains (deaths averted) and financial risk protection afforded (cases of poverty averted) by a bundle of nine (among many other) interventions that the Government of Ethiopia aims to make universally available. These nine interventions were measles vaccination, rotavirus vaccination, pneumococcal conjugate vaccination, diarrhoea treatment, malaria treatment, pneumonia treatment, caesarean section surgery, hypertension treatment, and tuberculosis treatment.
Findings
Our analysis shows that, per dollar spent by the Ethiopian Government, the interventions that avert the most deaths are measles vaccination (367 deaths averted per $100 000 spent), pneumococcal conjugate vaccination (170 deaths averted per $100 000 spent), and caesarean section surgery (141 deaths averted per $100 000 spent). The interventions that avert the most cases of poverty are caesarean section surgery (98 cases averted per $100 000 spent), tuberculosis treatment (96 cases averted per $100 000 spent), and hypertension treatment (84 cases averted per $100 000 spent).
Interpretation
Our approach incorporates financial risk protection into the economic evaluation of health interventions and therefore provides information about the efficiency of attainment of both major objectives of a health system: improved health and financial risk protection. One intervention might rank higher on one or both metrics than another, which shows how intervention choice—the selection of a pathway to universal health coverage—might involve weighing up of sometimes competing objectives. This understanding can help policy makers to select interventions to target specific policy goals (ie, improved health or financial risk protection). It is especially relevant for the design and sequencing of universal health coverage to meet the needs of poor populations.
Funding
Bill & Melinda Gates Foundation.

Maternal and Child Health Journal
Volume 19, Issue 5, May 2015
http://link.springer.com/journal/10995/19/5/page/1

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Review Paper
Use of Text Messaging for Maternal and Infant Health: A Systematic Review of the Literature
Elisabeth Poorman, Julie Gazmararian, Ruth M. Parker, Baiyu Yang, Lisa Elon
Abstract
Text messaging is an increasingly popular communication tool in health interventions, but has been little studied in maternal and infant health. This literature review evaluates studies of text messaging that may be applied to the promotion of maternal and infant health. Articles from peer-reviewed journals published before June 2012 were included if they were experimental or quasi-experimental studies of behaviors endorsed either by the American College of Obstetrics and Gynecology, the American Pediatrics Association, or the United States Preventive Services Task Force; included reproductive age women (12–50 years) or infants up to 2 years of age; and were available in English. Qualitative studies of text messaging specific to pregnant women were also included. Studies were compared and contrasted by key variables, including: design, time-period, study population, and results. Forty-eight articles were included, 30 of which were randomized controlled trials. Interventions vary greatly in effectiveness and soundness of methodology, but collectively indicate that there is a wide range of preventative behaviors that text message interventions can effectively promote, including smoking cessation, diabetes control, appointment reminders, medication adherence, weight loss, and vaccine uptake. Common methodological issues include not accounting for attention affect and not aligning text message content to measured outcomes. Those interventions that are based on an established theory of behavior change and use motivational as opposed to informational language are more likely to be successful. Building on the growing body of evidence for text message interventions reviewed here, as well as the growing popularity of text messaging as a medium, researchers should be able to use this technology to engage difficult to reach populations.

Nature
Volume 520 Number 7548 pp407-578 23 April 2015
http://www.nature.com/nature/current_issue.html
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Editorials
Highway to health
Africa has an ambitious and welcome plan for a continent-wide centre for disease control — but if the agency is to live up to its promise, it will need substantially better resources.
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Comment
Policy: Five priorities for the UN Sustainable Development Goals
Restructure data-gathering and evaluation networks to address climate change, energy, food, health and water provision, say Yonglong Lu and colleagues.

PLOS Currents: Disasters
[Accessed 25 April 2015]
http://currents.plos.org/disasters/

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Revitalising Evidence-based Policy for the Sendai Framework for Disaster Risk Reduction 2015-2030: Lessons from Existing International Science Partnerships
April 23, 2015 • Research article
The convergence of agreements on disaster risk reduction (DRR), development finance, sustainable development and climate change in 2015 presents a unique opportunity for coherence across these inter-related policy areas. At the same time, demand is growing for a more prominent and effective role for science and technology in providing evidence for policy, with the international community recognising that successful disaster risk reduction (DRR) depends on it. Reflecting this ambition, science is included as a core aspect of the Sendai Framework for Disaster Risk Reduction 2015-2030, although the ways in which this will be implemented in practice is still unclear. This paper aims to inform the implementation of international science coordination for DRR by examining a number of existing international science partnerships used across other relevant areas of policy to understand best practice, options for coordination and lessons identified. In the field of DRR, the science-policy interface needs to be strengthened in line with the best practice described in this review. An enhanced UNISDR Scientific and Technical Advisory Group will be given the mandate for to enhance the evidence base for DRR and mobilise science and technical work in coordination with a broad range of stakeholders. The structure and function of an enhanced STAG must be as open, as inclusive and as participatory as possible in order to build trust in new and existing institutions at local, national, regional and global levels. The challenge for the international community is to facilitate evidence-based policy making by formally recognising the links between DRR, development finance, sustainable development and climate change in the upcoming post-2015 agreements.

PLoS Currents: Outbreaks
http://currents.plos.org/outbreaks/
(Accessed 25 April 2015)

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Understanding the Emergence of Ebola Virus Disease in Sierra Leone: Stalking the Virus in the Threatening Wake of Emergence
April 20, 2015 • Research
Since Ebola Virus Disease (EVD) was first identified in 1976 in what is now the Democratic Republic of Congo, and despite the numerous outbreaks recorded to date, rarely has an epidemic origin been identified. Indeed, among the twenty-one most documented EVD outbreaks in Africa, an index case has been identified four times, and hypothesized in only two other instances. The initial steps of emergence and spread of a virus are critical in the development of a potential outbreak and need to be thoroughly dissected and understood in order to improve on preventative strategies. In the current West African outbreak of EVD, a unique index case has been identified, pinpointing the geographical origin of the epidemic in Guinea. Herein, we provide an accounting of events that serve as the footprint of EVD emergence in Sierra Leone and a road map for risk mitigation fueled by lessons learned.

PLoS Medicine
(Accessed 25 April 2015)
http://www.plosmedicine.org/

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Research Priorities to Improve the Management of Acute Malnutrition in Infants Aged Less Than Six Months (MAMI)
Chloe Angood, Marie McGrath, Sagar Mehta, Martha Mwangome, Mary Lung’aho, Dominique Roberfroid, Abigail Perry, Caroline Wilkinson, Anne-Dominique Israel, Cecile Bizouerne, Rukhsana Haider, Andrew Seal, James A. Berkley, Marko Kerac, MAMI Working Group Collaborators Guidelines and Guidance | published 21 Apr 2015 | PLOS Medicine 10.1371/journal.pmed.1001812
Summary Points
:: Worldwide, 8.5 million infants aged less than 6 months (<6m) are acutely malnourished. For the first time, 2013 WHO Malnutrition Guidelines describe their treatment, but on the basis of “very low quality” evidence, per WHO. More and better research is urgently needed.
:: To prioritise the many possible research questions on infant <6m malnutrition, we used the systematic, transparent, well-established Child Health and Nutrition Research Initiative (CHNRI) approach. Sixty-four experts scored 60 research questions on the basis of their answerability, likelihood of intervention efficacy, effectiveness, deliverability, sustainability, impact on disease burden, and impact on equity.
:: “How should infant <6m SAM be defined?” was the top-scoring research question; that this and other basic questions are still needed highlights paucity of evidence on this topic.
:: Other leading questions reflect interest in public health/community-focused models of care, e.g., “What are priority components of a package of outpatient care?” These questions are important to inform new outpatient strategies now recommended by WHO.
:: Most of our questions received high-priority scores reflecting a great need for a wide variety of evidence. Several major global initiatives such as the “Scaling Up Nutrition Movement” and “Generation Nutrition” would benefit from better evidence. Our results show clear ways forward for future research investments.

Qualitative Health Research
May 2015; 25 (5)
http://qhr.sagepub.com/content/current

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Trauma Systems in Kenya
A Qualitative Analysis at the District Level
Hadley K. H. Wesson1,2, Kent A. Stevens1,3, Abdulgafoor M. Bachani1, Stephen Mogere4
Daniel Akungah5. Jackim Nyamari5, John Masasabi Wekesa6, Adnan A. Hyder1
1Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
2Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
3Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
4Roless Media Management Institute, Nairobi, Kenya
5Kenyatta University, Nairobi, Kenya
6Ministry of Medical Services, Nairobi, Kenya
Abstract
Injury is a leading cause of death and disability in low- and middle-income countries. Kenya has a particularly high burden of injuries, accounting for 88.4 deaths per 100,000 population. Despite recent attempts to prioritize injury prevention in Kenya, trauma care systems have not been assessed. We assessed perceptions of formal and informal district-level trauma systems through 25 qualitative semi-structured interviews and 16 focus group discussions with Ministry of Health officials, district hospital administrators, health care providers, police, and community members. We used the principles of theoretical analysis to identify common themes of prehospital and hospital trauma care. We found prehospital care relied primarily on “good Samaritans” and police. We described hospital care in terms of human resources, infrastructure, and definitive care. The interviewers repeatedly emphasized the lack of hospital infrastructure. We showed the need to develop prehospital care systems and strengthen hospital trauma care services.

Social Science & Medicine
Volume 132, Pages 1-286 (May 2015)
http://www.sciencedirect.com/science/journal/02779536/132

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Review articles
Anchoring contextual analysis in health policy and systems research: A narrative review of contextual factors influencing health committees in low and middle income countries
Review Article
Pages 159-167
Asha George, Kerry Scott, Surekha Garimella, Shinjini Mondal, Rajani Ved, Kabir Sheikh
Abstract
Health committees, councils or boards (HCs) mediate between communities and health services in many health systems. Despite their widespread prevalence, HC functions vary due to their diversity and complexity, not least because of their context specific nature. We undertook a narrative review to better understand the contextual features relevant to HCs, drawing from Scopus and the internet. We found 390 English language articles from journals and grey literature since 1996 on health committees, councils and boards. After screening with inclusion and exclusion criteria, we focused on 44 articles. Through an iterative process of exploring previous attempts at understanding context in health policy and systems research (HPSR) and the HC literature, we developed a conceptual framework that delineates these contextual factors into four overlapping spheres (community, health facilities, health administration, society) with cross-cutting issues (awareness, trust, benefits, resources, legal mandates, capacity-building, the role of political parties, non-governmental organizations, markets, media, social movements and inequalities). While many attempts at describing context in HPSR result in empty arenas, generic lists or amorphous detail, we suggest anchoring an understanding of context to a conceptual framework specific to the phenomena of interest. By doing so, our review distinguishes between contextual elements that are relatively well understood and those that are not. In addition, our review found that contextual elements are dynamic and porous in nature, influencing HCs but also being influenced by them due to the permeability of HCs. While reforms focus on tangible HC inputs and outputs (training, guidelines, number of meetings held), our review of contextual factors highlights the dynamic relationships and broader structural elements that facilitate and/or hinder the role of health committees in health systems. Such an understanding of context points to its contingent and malleable nature, links it to theorizing in HPSR, and clarifies areas for investigation and action.

Social Science & Medicine
Volume 132, Pages 1-286 (May 2015)
http://www.sciencedirect.com/science/journal/02779536/132

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Patient access to health care and medicines across low-income countries
Original Research Article
Pages 21-27
Divya Srivastava, Alistair McGuire
Abstract
This study explores the issue of demand for health care and medicines in low-income country settings. Using the World Health Survey, multivariate analysis of cross-sectional household data from 35 low-income countries found that when ill, patient demand for health care to visit a clinic or hospital is inelastic ranging from −0.19 to 0.11. The main determinants of health seeking behaviour include having insurance, having a chronic condition, high household expenditure, and marital status. Women, the educated and those living in urban settings are more likely to seek care in a clinic. These findings suggest low-income patients will experience access problems, raising important policy implications to improve access to health care and medicines in these settings.

Social Science & Medicine
Volume 132, Pages 1-286 (May 2015)
http://www.sciencedirect.com/science/journal/02779536/132

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The traditional healer in obstetric care: A persistent wasted opportunity in maternal health
Original Research Article
Pages 59-66
Raymond Akawire Aborigo, Pascale Allotey, Daniel D. Reidpath
Abstract
Traditional medical systems in low income countries remain the first line service of choice, particularly for rural communities. Although the role of traditional birth attendants (TBAs) is recognised in many primary health care systems in low income countries, other types of traditional practitioners have had less traction. We explored the role played by traditional healers in northern Ghana in managing pregnancy-related complications and examined their relevance to current initiatives to reduce maternal morbidity and mortality. A grounded theory qualitative approach was employed. Twenty focus group discussions were conducted with TBAs and 19 in-depth interviews with traditional healers with expertise in managing obstetric complications. Traditional healers are extensively consulted to manage obstetric complications within their communities. Their clientele includes families who for either reasons of access or traditional beliefs, will not use modern health care providers, or those who shop across multiple health systems. The traditional practitioners claim expertise in a range of complications that are related to witchcraft and other culturally defined syndromes; conditions for which modern health care providers are believed to lack expertise. Most healers expressed a willingness to work with the formal health services because they had unique knowledge, skills and the trust of the community. However this would require a stronger acknowledgement and integration within safe motherhood programs.

Sustainability
Volume 7, Issue 4 (April 2015), Pages 3515-4782
http://www.mdpi.com/2071-1050/7/4

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Editorial: Interdisciplinary Approaches and Methods for Sustainable Transformation and Innovation
by Sangkyun Kim
Sustainability 2015, 7(4), 3977-3983; doi:10.3390/su7043977
Received: 24 March 2015 / Revised: 26 March 2015 / Accepted: 1 April 2015 / Published: 3 April 2015
Abstract:
To increase the likelihood of success and sustainability, organizations must fundamentally reposition themselves and try to change current processes or create new products and services. One of the most effective approaches to find a solution for transformation and innovation is to learn from other domains where a solution for similar problems is already available. This paper briefly introduces the definition of and approaches to convergence of academic disciplines and industries, and overviews several representative convergence cases focusing on gamification for sustainable education, environments, and business managements.

Sustainability
Volume 7, Issue 4 (April 2015), Pages 3515-4782
http://www.mdpi.com/2071-1050/7/4

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Article: Delivering a Multi-Functional and Resilient Urban Forest
by James D. Hale, Thomas A. M. Pugh, Jon P. Sadler, Christopher T. Boyko, Julie Brown, Silvio Caputo, Maria Caserio, Richard Coles, Raziyeh Farmani, Chantal Hales, Russell Horsey, Dexter V. L. Hunt, Joanne M. Leach, Christopher D. F. Rogers and A. Rob MacKenzie
Sustainability 2015, 7(4), 4600-4624; doi:10.3390/su7044600
Received: 9 March 2015 / Revised: 4 April 2015 / Accepted: 8 April 2015 / Published: 17 April 2015
Abstract:
Tree planting is widely advocated and applied in urban areas, with large-scale projects underway in cities globally. Numerous potential benefits are used to justify these planting campaigns. However, reports of poor tree survival raise questions about the ability of such projects to deliver on their promises over the long-term. Each potential benefit requires different supporting conditions—relating not only to the type and placement of the tree, but also to the broader urban system within which it is embedded. This set of supporting conditions may not always be mutually compatible and may not persist for the lifetime of the tree. Here, we demonstrate a systems-based approach that makes these dependencies, synergies, and tensions more explicit, allowing them to be used to test the decadal-scale resilience of urban street trees. Our analysis highlights social, environmental, and economic assumptions that are implicit within planting projects; notably that high levels of maintenance and public support for urban street trees will persist throughout their natural lifespan, and that the surrounding built form will remain largely unchanged. Whilst the vulnerability of each benefit may be highly context specific, we identify approaches that address some typical weaknesses, making a functional, resilient, urban forest more attainable.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
__________________________________________________
Week ending 18 April 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, consortiums and collaborations, foundations, and commercial organizations. We also monitor a spectrum of peer-reviewed journals and general media channels. The Sentinel’s geographic scope is global/regional but selected country-level content is included. We recognize that this spectrum/scope yields an indicative and not an exhaustive product. Comments and suggestions should be directed to:

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

pdf verion: The Sentinel_ week ending 18 April 2015

blog edition: comprised of the 35+ entries to be posted below on 19 April 2015

CHARTING A NEW COURSE – Overcoming the stalemate in Gaza
JOINT AGENCY BRIEFING PAPER
13 APRIL 2015 :: 30 pages
Pdf: https://www.oxfam.org/en/research/charting-new-course-overcoming-stalemate-gaza
Overview
In 2014, after unprecedented destruction and suffering in Gaza, international donors pledged $3.5bn and a change in approach. Six months later, reconstruction and recovery have barely begun, there has been no accountability for violations of international law, and Gaza remains cut off from the West Bank. This paper outlines an achievable course of action to address the root causes of the recurrent conflict and put international engagement with Gaza on the right course.

Report signatories include:
ActionAidAlianzapor la Solidaridad
American Friends Service Committee (AFSC)
Asamblea de Cooperaciónpor la Paz (ACPP)
CARE International
CCFD-Terre Solidaire
CCP Japan
Christian Aid
Church of Sweden
Council for Arab-British Understanding
Cooperazione per lo SviluppodeiPaesiEmergenti (COSPE)
DanChurchAid (DCA)
Diakonia
GVC
Handicap International
Heinrich Böll Foundation
HelpAge International
Horyzon – Swiss Youth Development Organization
Japan International Volunteer Center (JVC)
KinderUSA
Medical Aid for Palestinians (Map – UK)
Medicos del Mundo MDM-Spain
Médecins du Monde France
Médecins du Monde Switzerland
Medicos del Mundo MDM-Spain
medico international
medico international schweiz
Mennonite Central Committee
Norwegian Church Aid (NCA)
Norwegian People’s Aid (NPA)
Norwegian Refugee Council (NRC)
Overseas
Oxfam
Première Urgence – Aide MédicaleInternationale
Quaker Council for European Affairs
Rebuilding Alliance
Save the Children
Secours Islamique France
Secours Catholique – Caritas France
Terre des hommes Foundation
Terre des Hommes Italy
The Carter Center
The Kvinna till Kvinna Foundation
The Lutheran World Federation
The Swedish Organization for Individual Relief/ IM – Swedish Development Partner (SOIR)
United Civilians for Peace, Netherlands

SUMMARY
Operation Protective Edge – the codename used by Israel for the 51 day military operation1 and the associated conflict between Israel, Hamas and other Palestinian armed groups – has inflicted unprecedented destruction and human suffering in Gaza.2 This was the third such major military operation in six years, further complicating recovery for a civilian population sealed off by a blockade and separated economically, socially and politically from Palestinians in the West Bank. Shortly after Israel and Palestinian armed groups agreed to a temporary ceasefire, donors from around the world gathered in Cairo to pledge $3.5bn for the reconstruction of Gaza. Six months later, there has been no accountability to address violations of international law, only 26.8 percent of the money has been released, reconstruction and recovery have barely begun, and people in Gaza remain in dire straits.

This paper outlines an achievable course of action that, if implemented, could make significant progress in addressing the root causes of the recurrent conflict and towards the realization of a just, durable peace that would benefit Israelis and Palestinians alike. By directly addressing the different actors that have distinct responsibilities towards Gaza – from Israel and the international community to the Palestinian Authority and Hamas – the signatories to this report outline what each party can and must do to end the conflict and ensure Palestinians in Gaza can realize their rights. It is time for these actors to work together effectively to change the course for Gaza before it is too late.

The main recommendations of this report are:
:: Ending the cycle of violence
All parties should immediately resume negotiations for a long-term ceasefire that addresses the need for sustainable reconstruction, tackles the root causes of the conflict and can deliver long-lasting security for both Israelis and Palestinians. Negotiations should include all concerned parties, particularly women, in keeping with UN Security Council Resolution 1325.

Both the Government of Israel and Palestinian armed groups, including Hamas, must abide by international humanitarian and human rights law in the conduct of hostilities.

The international community must demand an end to violations of international law, and push for greater accountability of all parties, including guarantees of non-repetition.3

:: Committing to principled assistance, reconstruction and recovery
States should comply with their third state responsibilities not to aid or assist rights violations with respect to companies that contribute to such violations. This should include, where appropriate, adopting clear guidance to national companies, including state-owned companies, and pension and investment funds, to ensure that they undertake adequate due diligence and to ensure they do not support companies whose actions support violations of international law.4

Palestinian political actors must prioritize reconstruction as a humanitarian imperative. International donors should work with the Palestinian Government of National Consensus to take a holistic approach to reconstruction in Gaza, initially through the development of ministerial action plans for early recovery efforts, adequate and sustainable housing, and large-scale infrastructure.

Egypt should also fulfil its third state obligations under international humanitarian law to facilitate the provision of humanitarian assistance.5

Donors should make good on the pledges made at the Cairo Conference and move forward with reconstruction and recovery projects for Gaza. Given the devastation of the economy in Gaza, donor funding should wholly subsidize construction materials, prioritizing the most vulnerable.

As an immediate measure, funding and technical support should be made available to enable people to buy the necessary materials and labour to complete housing repairs.

:: Making the necessary shift: Ending the blockade and the separation between Gaza and the West Bank
Israel must lift the blockade and open all crossings into and out of Gaza; priority should be given for the unimpeded entry and exit of goods, as a necessary prerequisite to meet humanitarian needs and to ensure sustainable economic recovery and development.

Israel must allow free movement of Palestinians across the occupied Palestinian territory, in line with their obligations as an occupying power, with individual restrictions on movement placed only in exceptional cases of legitimate security concern, as defined by international humanitarian law.

The international community, in particular the Quartet of the US, the EU, Russia and the UN, should propose a time-bound plan to support an end to the blockade, which can be implemented and monitored through relevant UN mechanisms.

The international community should promptly develop a common response to the government of Israel if immediate progress is not made to lift the blockade.

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Press Release
World not delivering on Gaza reconstruction promises, new report warns
Published:
13 April 2015

Singapore and the United Nations Co-Host Forum to Discuss Enhancing Civil-Military Coordination in Humanitarian Efforts
Report from UN Office for the Coordination of Humanitarian Affairs

Singapore, Bangkok 13 April 2015) The Ministry of Defence of Singapore and the United Nations Office for the Coordination of Humanitarian Affairs (UN OCHA) are co-hosting the World Humanitarian Summit (WHS) Global Forum on Humanitarian Civil-Military Coordination at the Changi Command and Control Centre in Singapore from 13 to 15 April 2015. The Global Forum will help to shape the discussions and agenda for the World Humanitarian Summit to be held in Istanbul in May 2016.

The WHS Global Forum seeks to develop recommendations to improve the effectiveness and efficiency of civil-military coordination in disaster relief responses at the national, regional and international levels. More than 100 policy makers and operational experts from UN agencies, regional organisations and non-governmental organisations (NGOs), as well as defence establishments and national disaster management authorities from more than 25 countries are attending the three-day forum…

…Putting people at the centre drives humanitarian response and depends on the many parts coming together including coordination with the military. “Humanitarian civil-military coordination plays a vital role in the exchange of data, information and knowledge among multiple stakeholders. Military participation is equally critical for successfully establishing a shared situational awareness,” commented Ambassador Toni Frisch, the Chair of the Global Consultative Group on Civil Military Coordination.

The United Nations Assistant Secretary-General Kyung-wha Kang urged participants to engage in “a productive debate on how to make civil-military coordination work better in both natural disaster response operations and when providing humanitarian assistance in complex emergencies.”…

New fund aims to unlock $1 billion for children’s nutrition
WASHINGTON D.C., 16 April 2015 – The Power of Nutrition, a new independent fund launched today, will help millions of children reach their full potential. Backed by leading organisations from private philanthropy and international development, the partnership aims to unlock one billion dollars to tackle child undernutrition in some of the world’s poorest countries.

The Power of Nutrition will save lives and help millions of children escape from the effects of malnutrition. It will help countries build healthy and prosperous communities. It launches with arrangements in place to unlock the first $200 million from high profile backers such as the Children’s Investment Fund Foundation, UBS Optimus Foundation, the UK’s Department for International Development, UNICEF, and the World Bank Group. It opens to new private and public investors today.

Unlocking children’s potential
Without the right nutrients, health services and care within the first 1,000 days of life, a child’s brain and body fail to develop properly. Unlike hunger, these effects are largely invisible and essentially irreversible. Undernutrition is the underlying cause of 45 per cent of all under five mortality – or nearly three million deaths every year. Undernutrition leaves nearly four in ten children in Sub-Saharan Africa and South Asia with underdeveloped brains and bodies. As a result, these children have lower IQs and are more likely to drop out of school. As adults, they are a third less likely to escape poverty.

The problem does not stop there. As undernourished girls grow into undernourished mothers, who give birth to undernourished children. This creates a vicious cycle that holds back the growth of future generations.

Money raised by the Power of Nutrition will finance large-scale, high-impact nutrition programmes to help break this cycle. Evidence shows that with the right nutrients and care early on in life, a child’s brain and body are able to develop to their full potential, improving their health, education and future livelihoods. It is an investment in children, families and communities that lasts and lasts.

Multiplying funds for nutrition
For the first time, a combination of private and public finances will support country-led programmes that target child undernutrition at scale. The Power of Nutrition will act as a catalyst to multiply the financial resources going into this area, through a combination of grants, government funding and International Development Association (IDA) financing,

The fund has developed an innovative matching offer that guarantees that every dollar in private funding is multiplied up to six times with new financing secured from other funders. Governments seeking financial support for their national nutrition programmes will also be able to multiply their resources through the fund.

The Power of Nutrition opens to new private and public investors today. It launches with arrangements in place to unlock the first $200m of financing. Contributions include $55m from the Children’s Investment Fund Foundation, up to £32m ($47m) from the UK Department of International Development, and up to Swiss Francs 25m ($26m) from the UBS Optimus Foundation.

These resources will be channelled through a new World Bank Group (WBG) trust fund for nutrition and through a UNICEF matched-funding mechanism. The new WBG trust fund of at least $55m will leverage at least another $100m from the IDA, the WBG’s fund for the poorest. The new agreement with UNICEF provides an opportunity for donors to fund UNICEF through a matched-funding mechanism dedicated to ending child undernutrition.