UNFPA United Nations Population Fund [to 24 May 2014]

UNFPA United Nations Population Fund [to 24 May 2014]
http://www.unfpa.org/public/

UNFPA News
23 May 2014 – Dispatch
In Nepal, fight against obstetric fistula marches on
DHARAN, Nepal – Dhani Devi Mukhiya remembers the days when her relatives shunned her in public and her husband threatened to bring home another wife. For some of the villagers in her community in Nepal, the obstetric fistula that she lived with for seven years was ‘punishment for a sin’ she had committed in her ‘previous life’. more

22 May 2014 – Dispatch
A new lease on life for women living with obstetric fistula in Afghanistan
KABUL, Afghanistan – “I was 15 years old when I got married, and my husband was 22. My sister-in-law saw me at one of my relative’s wedding and made all the arrangements for her brother to have me,” Sharifa recalls. Forty years later, she describes this as the start of a life derailed by obstetric fistula. more

22 May 2014 – Statement
Statement on the International Day to End Obstetric Fistula
UNITED NATIONS, New York – The theme of this year’s International Day to End Obstetric Fistula, “Tracking Fistula – Transforming Lives,” reflects an important step forward in eradicating this preventable condition, which affects an estimated two million women and girls in developing countries. more

21 May 2014 – Dispatch
Holding out a hand: Youth-to-youth initiative making a difference in Mongolia
ZAVKHAN PROVINCE, Mongolia – “Y-Peer saved my life. For that, I am so thankful,” says Oyuka, recalling a time when she contemplated suicide. That was before Enkhbat, an educator with the youth peer education programme Y-Peer, reached out to her and saved her life. more

19 May 2014 – Dispatch
In South Sudan, 200,000 pregnant women may need urgent care
UNITED NATIONS, New York – Amid escalating conflict, some 30,000 women in South Sudan are at risk of dying in childbirth, according to estimates by UNFPA, and 200,000 pregnant women will be in need of urgent care before the end of the year. more

19 May 2014 – Statement
Providing Support for the Chibok Girls and their Families
UNITED NATIONS, New York – UNFPA will be leading a coalition of partners to provide health and psychosocial services to the young girls who were kidnapped from their school in Chibok, Nigeria, as soon as they are returned to their families. more

UNESCO [to 24 May 2014]

UNESCO [to 24 May 2014]
http://en.unesco.org/

24 May 2014
:: Director-General Participates in the UN Rule of Law Coordination and Resource Group

23 May 2014
:: Media organizations of Central America issue Recommendations for Post-2015 Development Agenda in the region
:: UNESCO Director-General confirms US$100,000 contribution for the Museum of Islamic Art in Cairo

22 May 2014
:: Agriculture: Focus of Africa Week at UNESCO
:: IFAP adopts recommendations and elects new Chairperson and Bureau to guide its work
:: Joining together to celebrate safer and more resilient schools and communities (UNESCO Press, Hanoi)

21 May 2014
:: Director-General Presents Vision of Post-2015 to G77 in New York
:: Director-General concerned about the impact of the floods in South-East Europe

FAO Food & Agriculture Organization [to 24 May 2014]

FAO Food & Agriculture Organization [to 24 May 2014]
http://www.fao.org/home/en/

FAO and OIE boost collaboration on animal health
The Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE) today pledged to step up their existing collaboration to control animal disease, ensure the safety of food from animal origin and promote safe trade.
25-05-2014

MERS Coronavirus: Stepped up research into role of camels and other animals urged
Expert meeting in Oman leads to guidance on investigating transmission routes and stemming spread of the disease.
23-05-2014

FAO responds to devastating flooding in the Balkans
In response to recent devastating floods affecting Bosnia and Herzegovina, Serbia as well as Croatia, FAO is assessing the potentially extensive damage to livestock, crops and rural infrastructure. The Serbian government has already indicated that agriculture is among the hardest hit sectors.
23-05-2014

FAO urges global commitment to tackle world’s nutrition challenges
FAO Director-General José Graziano da Silva today called on countries to put nutrition high on their national and international agendas, and to take a lead role in the upcoming Second International Conference on Nutrition (ICN2).
21-05-2014

South Sudan facing risk of famine
South Sudan is at a risk of famine unless humanitarian assistance is provided now, FAO Deputy Director-General for Operations Dan Gustafson told a humanitarian pledging conference for the country in Oslo.
21-05-2014

Report highlights growing role of fish in feeding the world
More people than ever before rely on fisheries and aquaculture for food and as a source of income, but harmful practices and poor management threaten the sector’s sustainability, says a new FAO report published today.
19-05-2014

USAID [to 24 May 2014]

USAID [to 24 May 2014]
http://www.usaid.gov/

Press Releases
USAID Pledges to Improve Nutrition for Millions of Children and Mothers with New Approach
May 22, 2014
The U.S. Agency for International Development (USAID) announced today a new effort to reduce the number of chronically malnourished or stunted children by at least 2 million over the next five years and hold global acute malnutrition below the agreed emergency threshold of 15 percent in places with humanitarian crises, like South Sudan and the Central African Republic. Overall, the new 360-degree approach unveiled today by National Security Advisor Susan Rice and USAID Administrator Rajiv Shah will cut the rate of stunting by 20 percent in places where USAID works.

U.S. Pledges Additional Humanitarian Assistance to South Sudan
May 20, 2014
The United States today announced nearly $300 million in humanitarian assistance to help the people of South Sudan who have been placed at risk by the conflict that began last December. The additional funding was announced at the Humanitarian Pledging Conference for South Sudan in Oslo, Norway where we joined more than 40 other countries in pledging support to help those displaced inside the country, as well as those who have fled to neighboring countries.

USAID Administrator to Provide Keynote Remarks at the Chicago Council Global Food Symposium
May 19, 2014
MEDIA ADVISORY
On THURSDAY, MAY 22, U.S. Agency for International Development (USAID) Administrator Rajiv Shah will give remarks during the luncheon program at the Chicago Council Global Food Symposium 2014 in Washington, D.C. The topic of Administrator Shah’s remarks is, “Tackling Extreme Poverty at the Roots: A New Model of Development.” The Hon. Dan Glickman, former Secretary of Agriculture, will introduce Administrator Shah. Following Shah’s remarks, the Administrator will join Dr. Agnes Kalibata, Minister of Agriculture and Animal Resources for the Republic of Rwanda, in a discussion moderated by Roger Thurow, Senior Fellow, The Chicago Council on Global Affairs.

USAID, Texas A&M Invest $5 Million to Combat Coffee Rust Crisis
May 19, 2014
Plant Disease Threatens Production and Jobs for Millions in Latin America & the Caribbean
The U.S. Agency for International Development (USAID) today announced a $5 million partnership with Texas A&M University’s World Coffee Research to eliminate coffee rust, a plant disease that has caused more than $1 billion in economic damage across Latin America and the Caribbean since 2012 and seriously threatens the livelihoods and food security of those who make their living in the coffee industry, especially small farmers.

Feed the Future Initiative Reduces Hunger and Poverty for Millions, Boosts Incomes and Nutrition around the World
May 19, 2014
U.S. Agency for International Development (USAID) Administrator Rajiv Shah announced today that President Obama’s Feed the Future initiative has reached nearly 7 million smallholder farmers and helped to save 12.5 million children from the threat of hunger, poverty, and malnutrition in just the last year alone.

USAID Unveils Results for President Obama’s Feed the Future Initiative to Reduce Global Hunger and Poverty
May 19, 2014
Plant Disease Threatens Production and Jobs for Millions in Latin America & the Caribbean
Global leaders today praised President Obama’s Feed the Future initiative for reaching nearly 7 million smallholder farmers and helping to save 12.5 million children from the threat of hunger, poverty, and malnutrition in just the last year alone.

World Bank [to 24 May 2014]

World Bank [to 24 May 2014]
http://www.worldbank.org/en/news/all

May 23, 2014
Africa Water Week in Senegal: Placing Water at the Heart of the Post 2015 Development Agenda
“Water’s centrality to development is no longer debatable – a fact that has been proven throughout history. And yet, water’s social, economic and environmental value is often overlooked … The Africa Water Week is therefore a call to action and positions us to creatively think and act and win,” said Hon. Sarah Reng Ochekpe, AMCOW Interim President and Nigeria’s Minister for Water Resources, during her welcome statement ahead of the May 26th conference opening. Dakar’s Fifth Africa Water Week (dubbed aww-5) has ambitious plans to advance Africa’s core water agenda. It seeks to place a spotlight on water and serve as a platform for improving understanding of why managing resources wisely is key for the post-2015 development framework…

May 20, 2014
Op-Ed: Powering Science and Technology for Africa’s Economic Transformation
As Africans move to cities in ever-growing strength, we must also address unprecedented rates of urbanization and new needs for housing, infrastructure, and agricultural productivity to feed urban residents as well as increase food security in rural areas. On the environment front, Africa, which has contributed the least to climate change, is bearing its disproportionate impact in terms of droughts, floods, rising sea levels which in turn bring economic losses and hardship. At the same time, these challenges also bring opportunities for joint research that would benefit scientists across the world as well in Africa. There is scope for similar research collaboration between African and foreign scientists in medicine and biodiversity, irrigation, engineering, mining and other fields. But here is the challenge. We will only achieve these exciting research coalitions in Africa if we correct a longstanding imbalance in our education systems…

BMC Health Services Research (Accessed 24 May 2014)

BMC Health Services Research
(Accessed 24 May 2014)
http://www.biomedcentral.com/bmchealthservres/content

Research article
Health-service performance of TB treatment for indigenous and non-indigenous populations in Brazil: a cross-sectional study
Everton Ferreira Lemos, Aline Mara Alves, Giovana de Oliveira, Marcella Paranhos Rodrigues, Natália Daiane Martins, Julio Croda
BMC Health Services Research 2014, 14:237 (23 May 2014)
Abstract | Provisional PDF

Research article
Developing attributes and attribute-levels for a discrete choice experiment on micro health insurance in rural Malawi
Gilbert Abotisem Abiiro, Gerald Leppert, Grace Bongololo Mbera, Paul J Robyn, Manuela De Allegri
BMC Health Services Research 2014, 14:235 (22 May 2014)
Abstract | Provisional PDF

Research article
Gaps in universal health coverage in Malawi: A qualitative study in rural communities
Gilbert Abotisem Abiiro, Grace Bongololo Mbera, Manuela De Allegri
BMC Health Services Research 2014, 14:234 (22 May 2014)
Abstract | Provisional PDF

Knowledge and attitudes of spanish adolescent girls towards human papillomavirus infection: where to intervene to improve vaccination coverage

BMC Public Health
(Accessed 24 May 2014)
http://www.biomedcentral.com/bmcpublichealth/content

Research article
“Knowledge and attitudes of spanish adolescent girls towards human papillomavirus infection: where to intervene to improve vaccination coverage”
Pedro Navarro-Illana, Javier Diez-Domingo, Esther Navarro-Illana, José Tuells, Sara Alemán and Joan Puig-Barberá
Author Affiliations
BMC Public Health 2014, 14:490 doi:10.1186/1471-2458-14-490
Published: 22 May 2014
Abstract (provisional)
Background
HPV vaccine coverage is far from ideal in Valencia, Spain, and this could be partially related to the low knowledge about the disease and the vaccine, therefore we assessed these, as well as the attitude towards vaccination in adolescent girls, and tried to identify independently associated factors that could potentially be modified by an intervention in order to increase vaccine coverage.
Methods
A cross sectional study was conducted in a random selection of schools of the Spanish region of Valencia. We asked mothers of 1278 girls, who should have been vaccinated in the 2011 campaign, for informed consent. Those that accepted their daughters’ participation, a questionnaire regarding the Knowledge of HPV infection and vaccine was passed to the girls in the school.
Results
833 mothers (65.1%) accepted participation. All their daughters’ responded the questionnaire. Of those, 89.9% had heard about HPV and they associated it to cervical cancer. Only 14% related it to other problems like genital warts. The knowledge score of the girls who had heard about HPV was 6.1/10. Knowledge was unrelated to the number of contacts with the health system (Pediatrician or nurse), and positively correlated with the discussions with classmates about the vaccine. Adolescents Spanish in origin or with an older sister vaccinated, had higher punctuation. 67% of the girls thought that the vaccine prevented cancer, and 22.6% felt that although prevented cancer the vaccine had important safety problems. 6.4% of the girls rejected the vaccine for safety problems or for not considering themselves at risk of infection. 71.5% of the girls had received at least one vaccine dose. Vaccinated girls scored higher knowledge (p = 0.05).
Conclusion
Knowledge about HPV infection and vaccine was fair in adolescents of Valencia, and is independent to the number of contacts with the health system, it is however correlated to the conversations about the vaccine with their peers and the vaccination status. An action to improve HPV knowledge through health providers might increase vaccine coverage in the adolescents.

Neonatal survival in complex humanitarian emergencies: setting an evidence-based research agenda

Conflict and Health
http://www.conflictandhealth.com/
[Accessed 24 May 2014]

Research
Neonatal survival in complex humanitarian emergencies: setting an evidence-based research agenda
Diane F Morof, Kate Kerber, Barbara Tomczyk, Joy Lawn, Curtis Blanton, Samira Sami and Ribka Amsalu
Author Affiliations
Conflict and Health 2014, 8:8 doi:10.1186/1752-1505-8-8
Published: 20 May 2014
Abstract (provisional)
Background
Over 40% of all deaths among children under 5 are neonatal deaths (0-28 days), and this proportion is increasing. In 2012, 2.9 million newborns died, with 99% occurring in low- and middle-income countries. Many of the countries with the highest neonatal mortality rates globally are currently or have recently been affected by complex humanitarian emergencies. Despite the global burden of neonatal morbidity and mortality and risks inherent in complex emergency situations, research investments are not commensurate to burden and little is known about the epidemiology or best practices for neonatal survival in these settings.
Methods
We used the Child Health and Nutrition Research Initiative (CHNRI) methodology to prioritize research questions on neonatal health in complex humanitarian emergencies. Experts evaluated 35 questions using four criteria (answerability, feasibility, relevance, equity) with three subcomponents per criterion. Using SAS 9.2, a research prioritization score (RPS) and average expert agreement score (AEA) were calculated for each question.
Results
Twenty-eight experts evaluated all 35 questions. RPS ranged from 0.846 to 0.679 and the AEA ranged from 0.667 to 0.411. The top ten research priorities covered a range of issues but generally fell into two categories- epidemiologic and programmatic components of neonatal health. The highest ranked question in this survey was “What strategies are effective in increasing demand for, and use of skilled attendance?”
Conclusions
In this study, a diverse group of experts used the CHRNI methodology to systematically identify and determine research priorities for neonatal health and survival in complex humanitarian emergencies. The priorities included the need to better understand the magnitude of the disease burden and interventions to improve neonatal health in complex humanitarian emergencies. The findings from this study will provide guidance to researchers and program implementers in neonatal and complex humanitarian fields to engage on the research priorities needed to save lives most at risk.

International Journal of Disaster Risk Reduction – Volume 9, In Progress (September 2014)

International Journal of Disaster Risk Reduction
Volume 9, In Progress (September 2014)
http://www.sciencedirect.com/science/journal/22124209/9

Multipurpose uses of cyclone shelters: Quest for shelter sustainability and community development
Original Research Article
Pages 1-11
Mohammed Ziaul Haider, Md. Firoz Ahmed
Abstract
This study tries to identify multipurpose uses of cyclone shelters at Morelgonj and Sarankhola upazila under Bagerhat district of Bangladesh for the quest of shelter sustainability and surrounding community development. Focus Group Discussion (FGD), questionnaire survey and consultation with stakeholders are executed to accomplish the study. The findings demonstrate that people of the shelter catchment areas prefer to consider the shelter as a service providing center instead of a production center. This study finds that decorator service, van rent service with garage and repair facilities, and venue for meeting/training hold the top-three positions, respectively among various alternatives for economic development of the people living in the shelter catchment areas. The quantitative analysis results indicate that a better road infrastructure and access to electricity encourage cyclone shelter-centric space rent related activities, whereas, access to electricity and road infrastructure discourage ‘Shelter Management Committee’ initiated business and production activities in a cyclone shelter, respectively. The study results indicate that shelter-wise yearly income may vary from 400 to 2000 US$ during 2013–2015. The study also finds that exploring cyclone shelter-centric income generating activities solely from a business motive may hamper the prime objective of the shelter – providing shelter to disaster affected people. Therefore, exploring income generating activities through multipurpose uses of cyclone shelters need to be done carefully.

Revisiting the concept of development, disaster and safety management: The Quranic perspective
Review Article
Pages 26-37
Azizan Ramli, Mazlin Mokhtar, Badhrulhisham Abdul Aziz
Abstract
Economic development is accompanied by the use of an increasingly complex technology, especially in the process of industrialization. The technological threats will cause an unpredictable event such as industrial accident or even the worst scenario, industrial disaster. Thus, the purpose of this paper is to provide an overview linking the literature on how Islam views the objective of development as well as the industrial disaster and safety management system. To our knowledge, most of the studies with regard to disaster and safety management are technical and administrative oriented. The angle of spirituality and religiosity is always being disassociated, especially with what commonly is regarded as worldly affairs. In this paper we tried to discuss what Islam says about industrial disaster and safety of industrial activities and how it relates to Allah׳s commandment. We also highlighted the story about disasters from the Quran in brief and drawn the lessons learned. The risk assessment process relating to safety matter was also discussed alongside the priority (-awlawiyyat) and comparison (-muqaranah) approach. The sources of information are academic articles and books, religion texts, and internet websites. To this end, in order to incorporate the spiritual approach into the industrial disaster and safety management system, the tripartite concepts of vicegerency (-al-istikhlaf), cooperation for righteousness (-al-ta’awun) and consultation (-shura) are introduced.

Implementing a web-based decision support system for disaster logistics: A case study of an evacuation location assessment for Indonesia
Original Research Article
Pages 38-47
Rika Ampuh Hadiguna, Insannul Kamil, Azalika Delati, Richard Reed
Abstract
Decision support systems have increasingly played a critical role in disaster logistics. This study outlines the processes required to build an effective and reliable decision support system to assess the feasibility of public facilities during an evacuation after a disaster has occurred. The purpose of this study is to build a model of a web-aided decision support system to assess the extent to which public facilities can be used as evacuation centers for the victims of an earthquake and/or tsunami. An outcome from this research is an innovative system with direct web-based accessibility, involves many decision-makers and employs multiple criteria and inputs. Even though the system has been specifically designed for evacuation scenarios in Indonesia, the system can be used for disaster scenarios in other countries as well. There are several stages in this study where the first stage identifies and selects attributes, assembles a comprehensive computer application, and employs object-oriented programming (OOP), verification and validation of the system. The role of information systems and decision support systems are critical when informing decision-makers about evacuation location alternatives and to assess their feasibility immediately after a disaster occurs. The results from this study confirm that this system can provide critical and timely insights into complex evacuation scenarios. An additional benefit of this system is the user-friendly web-based application ensuring data access from any global location with internet access.

Who you train matters: Identifying combined effects of financial education on migrant households

Journal of Development Economics
Volume 109, In Progress (July 2014)
http://www.sciencedirect.com/science/journal/03043878/109

Who you train matters: Identifying combined effects of financial education on migrant households
Original Research Article
Pages 39-55
Yoko Doi, David McKenzie, Bilal Zia
Abstract
There has long been a concern among policymakers that too much of remittances are consumed and too little saved, limiting the development impact of migration. Financial literacy programs have become an increasingly popular way to try and address this issue, but to date there is no evidence that they are effective in inducing savings among remittance-receiving households, nor is it clear whether such programs are best targeted at the migrant, the remittance receiver, or both. We conducted a randomized experiment in Indonesia which allocated female migrants and their families to a control group, a migrant-only training group, a family member-only training group, and a training group in which both the migrant and a family member were trained. Three rounds of follow-up surveys are then used to measure impacts on the financial knowledge, behaviors, and remittance and savings outcomes of the remaining household. We find that training both the migrant and family member together has large and significant impacts on knowledge, behaviors, and savings. Training the family member alone has some positive, but smaller effects, while training only the migrant leads to no impacts on the remaining family members. The results show that financial education can have large effects when provided at a teachable moment, but that this impact varies greatly with who receives training.

The Lancet Global Health – Jun 2014, Volume 2, Number 6

The Lancet Global Health
Jun 2014 Volume 2 Number 6 e301 – 363
http://www.thelancet.com/journals/langlo/issue/current

Detention, denial, and death: migration hazards for refugee children
Mina Fazel, Unni Karunakara, Elizabeth A Newnham
Preview |
Organised violence, persecution, and community instability cause millions of children to flee their native countries every year. About 7•6 million people were newly displaced by conflict or persecution in 20121 (the highest number in a decade), of which approximately half were younger than 18 years. Regions prone to disaster and adversity often have disproportionately young populations, and thus larger numbers of children and adolescents are now moving across country borders, with or without their families.

Global causes of maternal death: a WHO systematic analysis
Dr Lale Say MD a, Doris Chou MD a, Alison Gemmill MPH a b, Özge Tunçalp MD a, Ann-Beth Moller MSc a, Jane Daniels PhD c, A Metin Gülmezoglu MD a, Marleen Temmerman MD a, Leontine Alkema PhD d
Summary
Background
Data for the causes of maternal deaths are needed to inform policies to improve maternal health. We developed and analysed global, regional, and subregional estimates of the causes of maternal death during 2003—09, with a novel method, updating the previous WHO systematic review.
Methods
We searched specialised and general bibliographic databases for articles published between between Jan 1, 2003, and Dec 31, 2012, for research data, with no language restrictions, and the WHO mortality database for vital registration data. On the basis of prespecified inclusion criteria, we analysed causes of maternal death from datasets. We aggregated country level estimates to report estimates of causes of death by Millennium Development Goal regions and worldwide, for main and subcauses of death categories with a Bayesian hierarchical model.
Findings
We identified 23 eligible studies (published 2003—12). We included 417 datasets from 115 countries comprising 60 799 deaths in the analysis. About 73% (1 771 000 of 2 443 000) of all maternal deaths between 2003 and 2009 were due to direct obstetric causes and deaths due to indirect causes accounted for 27•5% (672 000, 95% UI 19•7—37•5) of all deaths. Haemorrhage accounted for 27•1% (661 000, 19•9—36•2), hypertensive disorders 14•0% (343 000, 11•1—17•4), and sepsis 10•7% (261 000, 5•9—18•6) of maternal deaths. The rest of deaths were due to abortion (7•9% [193 000], 4•7—13•2), embolism (3•2% [78 000], 1•8—5•5), and all other direct causes of death (9•6% [235 000], 6•5—14•3). Regional estimates varied substantially.
Interpretation
Between 2003 and 2009, haemorrhage, hypertensive disorders, and sepsis were responsible for more than half of maternal deaths worldwide. More than a quarter of deaths were attributable to indirect causes. These analyses should inform the prioritisation of health policies, programmes, and funding to reduce maternal deaths at regional and global levels. Further efforts are needed to improve the availability and quality of data related to maternal mortality.
Funding
USAID, the US Fund for UNICEF through a grant from the Bill & Melinda Gates Foundation to CHERG, and The UNDP/UNFPA/UNICEF/WHO/The World Bank Special Programme of Research, Development, and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research.

Editorial
Cost-effectiveness and classification
Zoë Mullan a
This week the global health cynosure has been the World Health Assembly (WHA) in Geneva. On the agenda we’ve seen action plans galore: from tuberculosis control to disability to neonatal health. There have been follow-up reports on vaccination, non-communicable diseases, and nutrition. But one thing that hasn’t so far made it onto a WHA agenda is surgery. Conservative estimates dating back to 2006 put the global burden of surgically treatable disorders at 11%, and many such conditions—eg, road-traffic injuries and cancer—are rising. Why the neglect?
WHO established the Global Initiative for Emergency and Essential Surgical Care in 2005 with the aim of engendering collaboration between “health professionals, professional societies, academic institutions, non-governmental organisations, and health authorities interested in improving surgical care in LMICs”. The forum has met biennially since 2005, but strategic outputs have been difficult to identify. Similarly, the 2008 World Health Report recognised surgery as an essential spoke in the health-system wheel, with primary care as the hub. Yet calls made back in 2010 for a “World Health Assembly amendment confirming the critical role of emergency and essential surgery within the health system” have still not borne fruit.
The Lancet’s forthcoming Commission on Global Surgery aims to push the agenda forward. One of its key aims is to identify barriers to universal access to safe, affordable, high-quality surgical care, and to clarify the role of all stakeholders in attaining this goal. As well as the Commission report, which is due early next year, a number of research papers will come out of the project, and The Lancet Global Health publishes one such paper this month.
Tiffany Chao and colleagues explore one of the potential barriers to the adequate provision of surgical care in low-income countries and to its visibility on the global health agenda—its supposed high cost. In their systematic review, Chao and colleagues assessed 26 previous studies of the cost-effectiveness of a range of essential surgical procedures across 24 countries. Standardised cost-effectiveness ratios were calculated in 2012 US dollars per disability-adjusted life-year (DALY) averted, and median values were found to be $13•78 for adult male circumcision; $47•74 for cleft lip and palate repair; $82•32 for general surgery; $108•74 for hydrocephalus repair; $136•00 for ophthalmic surgery (cataract, trichiasis, and trachoma); $315•12 for caesarean deliveries; and $381•15 for orthopaedic surgery. Rather than relying on these figures in isolation, or applying WHO’s standard measures of what is “cost-effective” (one-to-three times greater than a country’s gross domestic product [GDP] per head) and “very cost-effective” (less than a country’s GDP per head), Chao and colleagues go a step further and compare these ratios against those for interventions with existing donor and government support—ie, vaccines of the Expanded Program on Immunization, bednets, BCG vaccinations, and HIV treatment. All the median values for the surgical procedures studied were well within the cost range of these accepted interventions, nicely showing that surgery is a valuable addition to the toolbox of global health policy and practice.
Maternal deaths have also been in the headlines over recent weeks, with WHO and the Institute for Health Metrics and Evaluation (IHME) both releasing new estimates for 2013. While methods differed, and it is instructive to have these alternative measurements, the number of women estimated to have died in 2013 during pregnancy or shortly after childbirth were remarkably similar: 289 000 according to WHO and 293 000 according to IHME. The findings on why mothers die, however, were not so consistent. WHO’s analysis of the causes of maternal death are published in The Lancet Global Health this month, and put indirect causes such as diabetes, malaria, HIV, and obesity on a par with haemorrhage as the major causes of maternal mortality (around 27% of deaths each), with hypertension (14%) and sepsis (11%) the next most important contributors. The IHME findings indicate that indirect causes only accounted for around 10% of deaths, with hypertension at 12% and sepsis 9%. Abortion and “other direct causes” accounted for the most deaths according to IHME (around 17% each), with haemorrhage at around 14%. The Lancet Global Health paper includes a useful panel that unpicks some of the common problems encountered when classifying cause of maternal death, which undoubtedly account for some of these differences. The main policy recommendation, then, is for data collection to be improved. Any death in pregnancy is a tragedy and ought to be recorded with the utmost care.

Comment
Essential surgery is cost effective in resource-poor countries
Elliot Marseille, Saam Morshed
Preview | Full Text | PDF
In this issue of The Lancet Global Health, Tiffany Chao and colleagues present a systematic, comprehensive, and critical assessment of published estimates of the cost-effectiveness of essential surgery,1 and thus make an important contribution to the published work on the economics of global health interventions. Their headline finding is that a wide range of surgical interventions are cost effective across a wide range of settings in low-income and middle-income countries, and are competitive with other accepted and broadly implemented interventions.

Cost-effectiveness of surgery and its policy implications for global health: a systematic review and analysis
Dr Tiffany E Chao MD a b, Ketan Sharma MD a c, Morgan Mandigo MSc a d e, Lars Hagander MD a f g, Stephen C Resch PhD h, Thomas G Weiser MD i, John G Meara MD a c d
Summary
Background
The perception of surgery as expensive and complex might be a barrier to its widespread acceptance in global health efforts. We did a systematic review and analysis of cost-effectiveness studies that assess surgical interventions in low-income and middle-income countries to help quantify the potential value of surgery.
Methods
We searched Medline for all relevant articles published between Jan 1, 1996 and Jan 31, 2013, and searched the reference lists of retrieved articles. We converted all results to 2012 US$. We extracted cost-effectiveness ratios (CERs) and appraised economic assessments for their methodological quality using the 10-point Drummond checklist.
Findings
Of the 584 identified studies, 26 met full inclusion criteria. Together, these studies gave 121 independent CERs in seven categories of surgical interventions. The median CER of circumcision ($13•78 per disability-adjusted life year [DALY]) was similar to that of standard vaccinations ($12•96—25•93 per DALY) and bednets for malaria prevention ($6•48—22•04 per DALY). Median CERs of cleft lip or palate repair ($47•74 per DALY), general surgery ($82•32 per DALY), hydrocephalus surgery ($108•74 per DALY), and ophthalmic surgery ($136 per DALY) were similar to that of the BCG vaccine ($51•86—220•39 per DALY). Median CERs of caesarean sections ($315•12 per DALY) and orthopaedic surgery ($381•15 per DALY) are more favourable than those of medical treatment for ischaemic heart disease ($500•41—706•54 per DALY) and HIV treatment with multidrug antiretroviral therapy ($453•74—648•20 per DALY).
Interpretation
Our findings suggest that many essential surgical interventions are cost-effective or very cost-effective in resource-poor countries. Quantification of the economic value of surgery provides a strong argument for the expansion of global surgery’s role in the global health movement. However, economic value should not be the only argument for resource allocation—other organisational, ethical, and political arguments can also be made for its inclusion.
Funding
Massachusetts General Hospital Department of Surgery, Boston Children’s Hospital, and Stanford University Department of Surgery

The rise and fall of malaria in a west African rural community, Dielmo, Senegal, from 1990 to 2012: a 22 year longitudinal study

The Lancet Infectious Diseases
Jun 2014 Volume 14 Number 6 p441 – 532
http://www.thelancet.com/journals/laninf/issue/current

Comment
In for the long haul: 20 years of malaria surveillance
Chris Drakeley, Jo Lines
The past 20 years have seen many changes in malaria control. In most countries where malaria is endemic, first-line treatment has switched several times as drug resistance has developed, moving from chloroquine through to artemisinin-based combination therapies. In the past decade, thanks to increased funding through the Global Fund to Fight AIDS, Tuberculosis and Malaria, coverage of long-lasting insecticide-treated nets (LLINs) has massively expanded. These efforts have led to a substantial reduction in the incidence of malaria mortality,1 with a cumulative total of about 3•3 million deaths prevented since 2001, according to the 2013 World Malaria Report.

The rise and fall of malaria in a west African rural community, Dielmo, Senegal, from 1990 to 2012: a 22 year longitudinal study
Dr Jean-François Trape MD a, Adama Tall MD b, Cheikh Sokhna PhD a, Alioune Badara Ly MD c, Nafissatou Diagne PhD a, Ousmane Ndiath PhD a, Catherine Mazenot PhD a, Vincent Richard MD b, Abdoulaye Badiane BSc b, Fambaye Dieye-Ba BSc a, Joseph Faye BSc b, Gora Ndiaye a, Fatoumata Diene Sarr MD b, Clémentine Roucher PhD a, Charles Bouganali a, Hubert Bassène BSc a, Aissatou Touré-Baldé PhD d, Christian Roussilhon PhD d e, Ronald Perraut PhD d e, Prof André Spiegel MD b, Jean-Louis Sarthou PhD d, Prof Luiz Pereira da Silva e, Odile Mercereau-Puijalon PhD e, Pierre Druilhe MD e, Prof Christophe Rogier MD b f
Summary
Background
A better understanding of the effect of malaria control interventions on vector and parasite populations, acquired immunity, and burden of the disease is needed to guide strategies to eliminate malaria from highly endemic areas. We monitored and analysed the changes in malaria epidemiology in a village community in Senegal, west Africa, over 22 years.
Methods
Between 1990 and 2012, we did a prospective longitudinal study of the inhabitants of Dielmo, Senegal, to identify all episodes of fever and investigate the relation between malaria host, vector, and parasite. Our study included daily medical surveillance with systematic parasite detection in individuals with fever. We measured parasite prevalence four times a year with cross-sectional surveys. We monitored malaria transmission monthly with night collection of mosquitoes. Malaria treatment changed over the years, from quinine (1990—94), to chloroquine (1995—2003), amodiaquine plus sulfadoxine-pyrimethamine (2003—06), and finally artesunate plus amodiaquine (2006—12). Insecticide-treated nets (ITNs) were introduced in 2008.
Findings
We monitored 776 villagers aged 0—101 years for 2 378 150 person-days of follow-up. Entomological inoculation rate ranged from 142•5 infected bites per person per year in 1990 to 482•6 in 2000, and 7•6 in 2012. Parasite prevalence in children declined from 87% in 1990 to 0•3 % in 2012. In adults, it declined from 58% to 0•3%. We recorded 23 546 fever episodes during the study, including 8243 clinical attacks caused by Plasmodium falciparum, 290 by Plasmodium malariae, and 219 by Plasmodium ovale. Three deaths were directly attributable to malaria, and two to severe adverse events of antimalarial drugs. The incidence of malaria attacks ranged from 1•50 attacks per person-year in 1990 to 2•63 in 2000, and to only 0•046 in 2012. The greatest changes were associated with the replacement of chloroquine and the introduction of ITNs.
Interpretation
Malaria control policies combining prompt treatment of clinical attacks and deployment of ITNs can nearly eliminate parasite carriage and greatly reduce the burden of malaria in populations exposed to intense perennial malaria transmission. The choice of drugs seems crucial. Rapid decline of clinical immunity allows rapid detection and treatment of novel infections and thus has a key role in sustaining effectiveness of combining artemisinin-based combination therapy and ITNs despite increasing pyrethroid resistance.
Funding
Pasteur Institutes of Dakar and Paris, Institut de Recherche pour le Développement, and French Ministry of Cooperation.

Predominance of Norovirus and Sapovirus in Nicaragua after Implementation of Universal Rotavirus Vaccination

PLoS One
[Accessed 24 May 2014]
http://www.plosone.org/

Predominance of Norovirus and Sapovirus in Nicaragua after Implementation of Universal Rotavirus Vaccination
Filemón Bucardo, Yaoska Reyes, Lennart Svensson, Johan Nordgren
Research Article | published 21 May 2014 | PLOS ONE 10.1371/journal.pone.0098201
Abstract
Background
Despite significant reduction of rotavirus (RV) infections following implementation of RotaTeq vaccination in Nicaragua, a large burden of patients with diarrhea persists.
Methods
We conducted a community- and hospital-based study of the burden of RV, norovirus (NV) and sapovirus (SV) infections as cause of sporadic acute gastroenteritis (GE) among 330 children ≤ 5 years of age between September 2009 and October 2010 in two major cities of Nicaragua with a RotaTeq coverage rate of 95%.
Results
We found that NV, SV and RV infections altogether accounted for 45% of cases of GE. Notably, NV was found in 24% (79/330) of the children, followed by SV (17%, 57/330) and RV (8%, 25/330). The detection rate in the hospital setting was 27%, 15% and 14% for NV, SV and RV respectively, whereas in the community setting the detection rate of RV was < 1%. Among each of the investigated viruses one particular genogroup or genotype was dominant; GII.4 (82%) for NV, GI (46%) for SV and G1P[8] (64%) in RV. These variants were also found in higher proportions in the hospital setting compared to the community setting. The GII.4.2006 Minerva strain circulating globally since 2006 was the most common among genotyped NV in this study, with the GII.4-2010 New Orleans emerging in 2010.
Conclusions
This study shows that NV has become the leading viral cause of gastroenteritis at hospital and community settings in Nicaragua after implementation of RV vaccination.

Science – 23 May 2014, vol 344, issue 6186 [The Science of Inequality]

Science
23 May 2014 vol 344, issue 6186, pages 773-936
http://www.sciencemag.org/current.dtl

Introduction to Special Issue
The Science of Inequality: What the numbers tell us
Gilbert Chin, Elizabeth Culotta
Author Affiliations
Gilbert Chin is a senior editor for Science and Elizabeth Culotta is a deputy news editor for Science.

In 2011, the wrath of the 99% kindled Occupy movements around the world. The protests petered out, but in their wake an international conversation about inequality has arisen, with tens of thousands of speeches, articles, and blogs engaging everyone from President Barack Obama on down. Ideology and emotion drive much of the debate. But increasingly, the discussion is sustained by a tide of new data on the gulf between rich and poor.

This special issue uses these fresh waves of data to explore the origins, impact, and future of inequality around the world. Archaeological and ethnographic data are revealing how inequality got its start in our ancestors (see pp. 822 and 824). New surveys of emerging economies offer more reliable estimates of people’s incomes and how they change as countries develop (see p. 832). And in the past decade in developed capitalist nations, intensive effort and interdisciplinary collaborations have produced large data sets, including the compilation of a century of income data and two centuries of wealth data into the World Top Incomes Database (WTID) (see p. 826 and Piketty and Saez, p. 838).

It is only a slight exaggeration to liken the potential usefulness of this and other big data sets to the enormous benefits of the Human Genome Project. Researchers now have larger sample sizes and more parameters to work with, and they are also better able to detect patterns in the flood of data. Collecting data, organizing it, developing methods of analysis, extracting causal inferences, formulating hypotheses—all of this is the stuff of science and is more possible with economic data than ever before. Even physicists have jumped into the game, arguing that physical laws may help explain why inequality seems so intractable (see p. 828).
In the United States, the new information suggests a wide rift between top and bottom. Tax data from the WTID suggest that today the top 1% control nearly 20% of U.S. income, up from about 8% in the 1970s. But inequality is increasing within the 99%, too, as a consequence of a growing premium on college and postgraduate education: The fates of the tech-savvy worker at Google and the blue-collar employee at General Motors have been decoupled (see Autor, p. 843). According to surveys by the Census Bureau, in 2012 the richest 20% of Americans enjoyed more than 50% of the nation’s total income, up from 43% in 1967. The middle 20%—the actual middle class—received only about 14% of all income, and the poorest got a mere 3% (see p. 820).

Flip to a world map, and America’s inequality, despite reaching levels last seen in the Gilded Age, turns out to be far from extreme. Many nations, especially emerging economies, have even larger chasms between the super-rich and the poor. One widely used metric, the Gini coefficient, estimates inequality as an index between 0—at which point everyone has exactly equal incomes—to 1, in which a single person takes all the income and the rest get nothing. The U.S. Gini, at 0.40 in 2010, seems relatively high compared with, for example, Japan at 0.32. But South Africa is a sky-high 0.7.

Many assume that governments in emerging economies have chosen to favor growth even at the cost of inequality on the grounds that “a rising tide lifts all boats.” But evidence that this trade-off is necessary is sparse, and recent data show that policies to reduce inequality need not stymie growth (see Ravallion, p. 851).

What of those at the bottom? Research has established a base of knowledge about the harmful effects of disadvantageous circumstances on education and health. These influences can begin early in life, even prenatally (see Aizer and Currie, p. 856). But researchers are still exploring whether the stress of being low-ranked itself adds to the poor’s burden, causing illness and even early death (see p. 829). In addition, psychological mechanisms may spur a negative feedback loop in which poor individuals behave in ways that help keep them poor (see Haushofer and Fehr, p. 862).

Harsh as life can be for those at the bottom, the opportunity to move up the ladder can compensate. Newly available data from taxes and other records promise to yield insights into intergenerational mobility, in which children advance from their parents’ socioeconomic status. But so far, researchers have a relatively limited view of how and why people move into different social, as well as economic, classes (see p. 836 and http://scim.ag/sci_inequality; also see Corak, p. 812).
Few would deny that excessive inequality can be unhealthy for societies and economies, but the new data don’t pinpoint a desirable level. They do show that the forces that foster inequality—from the patchy distribution of resources among ancient hunter-gatherers to the sheer earning power of capital today—are many and potent. It is up to society to decide whether, and how, to restrain them (see p. 783).

[Selected articles from special issue]
Review
Income inequality in the developing world
Martin Ravallion
Author Affiliations
Department of Economics, Georgetown University, Washington, DC 20057, and National Bureau of Economic Research, Cambridge, MA 02138, USA.
Abstract
Should income inequality be of concern in developing countries? New data reveal less income inequality in the developing world than 30 years ago. However, this is due to falling inequality between countries. Average inequality within developing countries has been slowly rising, though staying fairly flat since 2000. As a rule, higher rates of growth in average incomes have not put upward pressure on inequality within countries. Growth has generally helped reduce the incidence of absolute poverty, but less so in more unequal countries. High inequality also threatens to stall future progress against poverty by attenuating growth prospects. Perceptions of rising absolute gaps in living standards between the rich and the poor in growing economies are also consistent with the evidence.

Review
On the psychology of poverty
Johannes Haushofer1,2,3,4,*, Ernst Fehr3,*
Author Affiliations
1Abdul Latif Jameel Poverty Action Lab, Massachusetts Institute of Technology, 30 Wadsworth Street, Cambridge, MA 02142, USA.
2Program in Economics, History, and Politics, Harvard University, Cambridge, MA 02138, USA.
3Department of Economics, University of Zürich, Blümlisalpstrasse 10, Zürich 8006, Switzerland.
4Department of Psychology and Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ 08544, USA.
Abstract
Poverty remains one of the most pressing problems facing the world; the mechanisms through which poverty arises and perpetuates itself, however, are not well understood. Here, we examine the evidence for the hypothesis that poverty may have particular psychological consequences that can lead to economic behaviors that make it difficult to escape poverty. The evidence indicates that poverty causes stress and negative affective states which in turn may lead to short-sighted and risk-averse decision-making, possibly by limiting attention and favoring habitual behaviors at the expense of goal-directed ones. Together, these relationships may constitute a feedback loop that contributes to the perpetuation of poverty. We conclude by pointing toward specific gaps in our knowledge and outlining poverty alleviation programs that this mechanism suggests.

Are public–private partnerships a healthy option? A systematic literature review

Social Science & Medicine
Volume 113, In Progress (July 2014)

Are public–private partnerships a healthy option? A systematic literature review
Original Research Article
Pages 110-119
Jens K. Roehrich, Michael A. Lewis, Gerard George
Abstract
Governments around the world, but especially in Europe, have increasingly used private sector involvement in developing, financing and providing public health infrastructure and service delivery through public–private partnerships (PPPs). Reasons for this uptake are manifold ranging from rising expenditures for refurbishing, maintaining and operating public assets, and increasing constraints on government budgets stifle, seeking innovation through private sector acumen and aiming for better risk management. Although PPPs have attracted practitioner and academic interest over the last two decades, there has been no attempt to integrate the general and health management literature to provide a holistic view of PPPs in healthcare delivery. This study analyzes over 1400 publications from a wide range of disciplines over a 20-year time period. We find that despite the scale and significance of the phenomenon, there is relatively limited conceptualization and in-depth empirical investigation. Based on bibliographic and content analyses, we synthesize formerly dispersed research perspectives into a comprehensive multi-dimensional framework of public-private partnerships. In so doing, we provide new directions for further research and practice.

Using Technology to Shift Education Paradigms in Low-Resource Environments

Stability: International Journal of Security & Development
http://www.stabilityjournal.org/articles
[accessed 24 May 2014]
Using Technology to Shift Education Paradigms in Low-Resource Environments
Elizabeth Calhoun, Nathaniel Calhoun
Abstract
As innovative and exponential technologies make their way into development projects and humanitarian aid interventions, pioneers are just starting to codify and publish their best practices, for example UNICEF’s Child-Friendly Technology Framework. Code Innovation designed and lead the Connecting Classrooms project over seven years, bringing technology and education innovations to secondary school students, out-of-school youth and young adults in eleven countries around sub-Saharan Africa. The majority of participants had never experienced being connected to the Internet and there were numerous and ongoing challenges. Using collaborative teaching methodologies and a group learning approach, the program brought young people and their teachers or adult facilitators through a blended learning curriculum around key issues of shared global concern. This paper seeks to expand on lessons learned from the program to make recommendations for others to get the greatest leverage out of technology-supported education initiatives. As there is relatively little research published around multi-year technology for education projects in developing countries to date, this article strives to offer some best practices and lessons learned that will guide similar initiatives in the future.

From Google Scholar+ [to 24 May 2014]

From Google Scholar+ [to 24 May 2014]
Selected content from beyond the journals and sources covered above, aggregated from a range of Google Scholar monitoring algorithms and other monitoring strategies.

Information and communication technologies for disaster risk management in the Caribbean
Robert Crane Williams, Atiba Phillips
United Nations – ECLAS ISSN 1727-9917
February 2014
Abstract
This paper examines the role of information and communications technologies (ICTs) for disaster risk management (DRM) with a specific focus on the Caribbean. The study included the review of literature and case studies, as well the administration of a survey instrument that collected the feedback of 13 regional national DRM agencies.
Analysis of the survey suggests that while subregional disaster management agencies have fairly good access to technology infrastructure and enjoy an information sharing culture, challenges exist with regard to the information governance frameworks as well as the capacity and availability of human capital with regard to ICT. The study findings indicate that the regional DRM sector would do well to:
:: Deepen connections with policy makers and other communities of practice
:: Modernize ICT Infrastructure for DRM
:: Consider a subregional e-strategy for DRM
:: Improve ICT governance
:: Urgently develop programmes of ICT human capacity development.

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
Research Article
The psychological impact of a dual-disaster caused by earthquakes and radioactive contamination in Ichinoseki after the great East Japan earthquake
Tomihisa Niitsu, Kota Takaoka, Saho Uemura, Akiko Kono, Akihiko Saito, Norito Kawakami, Michiko Nakazato and Eiji Shimizu
Published: 20 May 2014
doi:10.1186/1756-0500-7-307
Abstract
Background
The psychological impact of dual-disasters (earthquakes and a nuclear accident), on affected
communities is unknown. This study investigated the impact of a dual-disaster (earthquakes
and radioactive contamination) on the prevalence of psychological distress in a landlocked
city within the Tohoku area, Japan.
Methods
A cross-sectional mail-in survey with a random sample of inhabitants from Ichinoseki city
was conducted eleven months after the disasters, and data from 902 respondents were
analyzed by logistic regression models, with multiple imputation methodology. The K6 was
used to determine psychological distress.
Results
The estimated prevalence of psychological distress was 48.0 percent. House damage due to
earthquakes and anxiety about radioactive contamination were significantly associated with
psychological distress (p < 0.05), while an interactive effect between house damage and
anxiety about radioactive contamination was not significant. Being female, middle-to-low
educational status and unemployed were additional risk factors for psychological distress.
Conclusions
This dual-disaster was associated with a moderate prevalence of psychological distress in the
area. The impact of the earthquake and radioactive contamination appeared additive.

Social Science & Medicine
Available online 14 May 2014
Disaster Medicine: Genealogy of a Concept
Cécile Stephanie Stehrenberger, Svenja Goltermann
Highlights
:: Humanitarian and disaster medicine developed along entangled but different paths.
:: Disaster medicine emerged and was developed in the context of industrialization and the Cold War.
:: Some of humanitarian medicine’s present issues date back to early 20th Century disaster medicine.
:: Throughout its history, the political character of disaster medicine has been both affirmed and denied.
:: Disaster medicine was heavily contested as “war medicine”.
Abstract
This paper evaluates disaster medicine from a historical perspective that facilitates the understanding of its present. Today, disaster medicine and humanitarian medicine are inextricably linked and the terms are sometimes used synonymously. An in-depth analysis of an extensive body of concrete empirical cases from various sources (i.e. archival records) reveals, however, that they have not always been the same. A genealogical, history-of-knowledge approach demonstrates that the concept of disaster medicine emerged in the early 20th century in Switzerland in the context of industrialization. Even though it gained important impetus during the First World War, the concept was informed by the experiences of forensic physicians in technological disasters such as mining explosions. The Cold War constituted the historical constellation in which disaster medicine was developed in West Germany during the 1960s and 1970s in a way that was paradigmatic for other Western European countries. At the same time, it was contested there in an unusual, historically unique way. Although focusing on a Western European context, this paper explores how medical interventions in disasters were international events and how the practice of disaster medicine was developed and “trained” through being applied in the Global South. It demonstrates the historicity of disaster medicine’s political character and of the controversies generated by its involvement in civil and military operations. Throughout the 20th century, the political nature and military involvement of disaster medicine resulted in a number of ethical and practical issues, which are similar to the challenges facing humanitarian medicine today. The exploration of disaster medicine’s past can therefore open up critical interventions in humanitarian medicine’s present.

Disaster Prevention and Management
Vol. 23 Iss: 3, pp.214 – 221
http://www.emeraldinsight.com/journals.htm?issn=0965-3562&volume=23&issue=3
Rights and obligations in international humanitarian assistance
George Kent, (Department of Political Science, University of Hawai‘i, Honolulu, Hawai‘i, USA)
DOI: 10.1108/DPM-07-2013-0122
Abstract
Purpose – The purpose of this paper is to propose a framework for understanding the rights and obligations of different parties in relation to international humanitarian assistance.
Design/methodology/approach – Past discourse on rights and obligations of the parties in various types of humanitarian emergencies is critically reviewed. Various moral and legal principles are used to assess that discourse.
Findings – Many governments emphasize their right to provide international humanitarian assistance, but appear reluctant to acknowledge any obligation to provide such assistance. Claims regarding the right to provide assistance under some conditions should be accompanied by acknowledgment of obligations to provide assistance under some conditions.
Originality/value – This analysis encourages national governments and international agencies to go beyond asserting their rights to assist to also recognize obligations to assist under some conditions

Journal of Health Care for the Poor and Underserved (JHCPU)
Volume 25, Number 2, May 2014
http://muse.jhu.edu/journals/journal_of_health_care_for_the_poor_and_underserved/toc/hpu.25.2.html
Cervical Cancer and HPV: Knowledge, Attitudes, Beliefs, and Behaviors among Women Living in Guatemala
Amy Petrocy, Mira L. Katz
Abstract:
This study was conducted to explore knowledge, attitudes, and beliefs about cervical cancer, cervical cancer screening, human papillomavirus (HPV), and acceptance of the HPV vaccine. A purposive sample of 40 women was interviewed during August 2012. Fisher’s exact test was used to evaluate differences among rural and urban women, and open-ended questions were coded independently by two individuals (Cohen’s kappa coefficient of 0.816). Among the 22 rural and 18 urban women, there was limited knowledge about cervical cancer, screening, HPV, and the HPV vaccine. Cervical cancer was described in language related to gender, science, severity, or associated with having children, a uterus, or menstruation. All rural and most urban participants were interested in the HPV vaccine for themselves and their daughters. Limited awareness and knowledge about cervical cancer and HPV was common among Guatemalan women, highlighting the need for additional information prior to developing cancer prevention educational materials and programs.

Human Rights Quarterly
Volume 36, Number 2, May 2014
http://muse.jhu.edu/journals/human_rights_quarterly/toc/hrq.36.2.html
Book Review: Reshaping the Idea of Humanitarian Intervention: Norms, Causal Stories, and the Use of Force
Courtney Hillebrecht
Excerpt
With an ongoing human tragedy unfolding in Syria and the international community unable and unwilling to respond, Carrie Booth Walling’s All Necessary Measures reminds us that in international politics, power is “no longer simply about whose military can win but also about whose story can win.” That is, the narratives that shape our understanding of the causes and possible solutions of mass violence inherently shape our willingness to act. In this carefully researched and well-reasoned book, Walling argues that scholars and practitioners must take norms seriously, even in the arena of power politics.
All Necessary Measures considers how the United Nations Security Council (UNSC) began to entertain questions about human rights and then, how principled arguments for human rights led to humanitarian intervention. It contrasts examples of successful humanitarian intervention with those instances of mass atrocity in which the UNSC either refused or failed to act. By comparing these cases, the author convincingly demonstrates that principled ideas and arguments intersect with and change states’ interests. It also makes a secondary but no less important argument about the intersection of norms, arguing that human rights exist alongside other norms, particularly state sovereignty, and that these norms are constantly co-evolving. All Necessary Measures ultimately points to an emerging synthesis of sovereignty and human rights.
The book adds to the expansive literature on humanitarian intervention by showing that in order to understand when and why states engage in humanitarian intervention, we need to pay particular attention to the narratives states are telling about the use of force and how these narratives and the principled arguments that undergird them can alter states’ material interests. Much of the literature on humanitarian intervention focuses on the legitimacy of the idea of humanitarian intervention and the domestic and international hurdles in overcoming collective action problems related to intervention. Many, if not most, of these analyses regard states’ material interests as fixed. Walling reminds us that these interests are not fixed and are instead at least partially socially constructed.
All Necessary Measures puts forth a theory of causal stories. This theory emphasizes the discourse of human rights and humanitarianism used at the UNSC and suggests that the types of stories member states tell influences the decision to authorize force. Through content analysis of UNSC texts, the author identifies three types of causal stories. The first, the intentional causal story, characterizes conflicts as one-sided and premeditated, describing human rights abuses as “systematic, targeted, deliberate.” In intentional causal stories, there is a clear victim and a clear perpetrator, thus resulting in an impulse to punish the perpetrators and protect the victims. The main principles at play are justice and international law.
The second type of causal story, the inadvertent causal story, paints conflict as being two-sided. Civilian casualties are to be expected, but this type of story depicts these casualties as unintended and indiscriminate. Walling calls this a narrative of moral equivalency, meaning that there are multiple parties involved and the conflict often earns the label of civil war or ethnic conflict. The main principles at play are neutrality, sovereign equality, and domestic noninterference, while the main outcomes are framed in terms of providing assistance and protection or conducting observations.
Finally, the third type of causal story is the complex causal story, in which a combination of macro-level factors results in a complicated and tragic scenario that is, almost by definition, unsolvable. The main principles in these narratives are state sovereignty, stability, and the status quo, and the resulting policy outcomes involve reporting, documentation, condemnations, and appeals, but no other action.
This tripartite scale provides a unique lens through which to look at how UNSC members promote humanitarian intervention and understand the narratives they rely on to justify their action or inaction. Perhaps the two most compelling components of these narratives are the degree to which there is a clear perpetrator and the degree to which humanitarian intervention can actually solve the crisis at hand. The two are, not surprisingly, related. That is, in situations that are described as complex, with large, structural contributing factors, there is no one to clearly blame and the prognosis for humanitarian intervention is grim. Further, failing to identify…

Book: Social Innovation and Impact in Nonprofit Leadership
Tine Hansen-Turton, Nicholas Torres, M.E.D
Springer Publishing Company, May 28, 2014 304 pages
Overview
This timely textbook, reflecting the trends and developments in the nonprofit sector over the past decade, encompasses the core competencies required to lead nonprofit organizations through social innovation and impact during the 21st century. It fills a knowledge gap for leaders, managers, practitioners, students, faculty members, and providers in this rapidly growing field by providing a comprehensive framework for how to run and manage nonprofits. This includes all of the tools needed to affect social change through ethical business practices, management and leadership business strategies, social marketing, and policy analysis across government, nonprofits, and philanthropy.

Seven Steps to Assisting the People of South Sudan: Statement by Non Governmental Organisations (NGOs) – 12 May 2014

Seven Steps to Assisting the People of South Sudan: Statement by Non Governmental Organisations (NGOs)
12 May 2014
Excerpt
On 20 May 2014, the international community will convene in Oslo, Norway, to discuss how to address the humanitarian crisis in South Sudan. In just under five months since fighting erupted, the situation in South Sudan has deteriorated severely, causing 1.3 million people to flee from their homes, including an estimated 300,000 to neighbouring countries. Over 4 million people, including over 2.5 million children, are extremely vulnerable to food insecurity, as people have been displaced from their sources of survival. This crisis is worsening on a daily basis. Humanitarian actors have warned that by the end of this year half of all South Sudanese citizens could experience forced displacement (within the country or as a refugee), severe food insecurity, and/or threats to their protection.

The undersigned non-governmental organisations (NGOs) call on the UN member states and others to urgently focus on clear and immediate actions to provide assistance to the people of South Sudan and to rally national, regional and international support to this end. Furthermore, an inclusive and viable political framework for ending conflict is critical. As such, we call for the following seven steps in order to provide coherent assistance to the people of South Sudan.

1) Timely funding of the humanitarian response is critical to saving countless lives, preventing further suffering in the coming months, and supporting resilience to further shocks…
2) Protection of and respect for humanitarian staff, installations and operations is vital to allow the delivery of this assistance…
3) In South Sudan political and financial support to the Government of South Sudan has, until now, been generally quite high, but support to the humanitarian needs of the people has sometimes wavered… At this time, given the humanitarian impacts of the recent crisis, there is an imperative to protect the lives and security of all communities in South Sudan without delay…
4) Providing financial assistance cannot be an excuse for inaction or inertia at the political level. The people of South Sudan require a viable, inclusive and transparent mediation and political process….
5) In addition to an inclusive mediation and political process to address this crisis, other measures need to be taken to immediately protect the people of South Sudan. The upcoming renewal of the UN Mission in South Sudan (UNMISS) mandate – which current circumstances dictate be brought forward without delay – provides an opportunity to increase emphasis on the protection of civilians, and to provide greater clarity and resourcing for the UNMISS..
6) UNMISS alone cannot protect the people of South Sudan in the face of the extraordinary violence being levied against them by the multiple armed groups in South Sudan. Engaging with clear and direct drivers of the conflict is imperative…
7) Finally, but importantly, accountability for the violence should be a critical component in any eventual political settlement and peace effort. Building towards justice and reconciliation in South Sudan should be the genuine aim of the international community, requiring sustained diplomatic efforts and political will.

[Sixty NGOs were listed as signing the Statement including BRAC, Handicap International, International Rescue Committee (IRC), and Women for Women International]

Beyond expectations: 40 years of EPI (Expanded Programme on Immunization)

Beyond expectations: 40 years of EPI (Expanded Programme on Immunization)
Margaret Chan
Director General, World Health Organization
The Lancet
Volume 383, Issue 9930, Pages 1697 – 1698, 17 May 2014
doi:10.1016/S0140-6736(14)60751-0

[Excerpt; Editor’s text bolding]
The Expanded Programme on Immunization (EPI) was established by the World Health Assembly in 1974 at a time of great optimism for public health. The imminent certification for the eradication of smallpox was taken as proof of the power of vaccines, delivered in well-managed programmes, to permanently improve the world.1

When EPI was established, only about 5% of the world’s children were protected from six diseases (polio, diphtheria, tuberculosis, pertussis, measles, and tetanus) targeted by four vaccines. Today, that figure is 83%, with some low-income countries reaching 99% immunisation coverage.2 The number of public health vaccines being used for universal protection has more than doubled since 1974. Almost all countries include vaccines against hepatitis B and Haemophilus influenzae type b in addition to the original six diseases, and quality-assured vaccines are used in 97% of all countries.3 Today, WHO estimates that immunisation programmes save the lives of 2•5 million people each year and protect many millions more from illness and disability.4 With the certification of WHO’s South-East Asia Region as polio-free, 80% of the world’s population now lives in a country where polio has been eradicated.5

What accounts for this success? Does EPI offer lessons of broader relevance as the world prepares for the post-2015 era? EPI had some advantages from the outset. The prevention of childhood deaths has great public and political appeal, and that helped create momentum within individual countries and the international community to support immunisation programmes. Vaccines are scheduled interventions that can be delivered even in the absence of well functioning health systems, and even in places where capacities are weak and skilled health workers are scarce. The costs of the initial six EPI antigens against polio, diphtheria, tuberculosis, pertussis, measles, and tetanus were low.

But EPI’s success must be attributed to more than these advantages. During the past four decades, EPI has encouraged new models of international cooperation, found new sources of funding, and stimulated innovation in technology and the operational performance of national immunisation programmes.3 EPI has also pioneered improvements in surveillance and monitoring as a contribution to accountability for results.3 Fundamental public health capacities have also been strengthened; as just one example, there are nearly 700 laboratories, in 164 countries, accredited by WHO to undertake laboratory-based surveillance for measles and other vaccine-preventable epidemic-prone diseases.6…

…I see many signs that this desire to aim ever higher, with ambitious yet feasible goals, such as exceeding the Millennium Development Goal for reducing childhood mortality, eliminating a number of the neglected tropical diseases, and reducing tuberculosis deaths by 75%, will characterise the post-2015 era for public health. The future of global health can benefit from the pioneering work done by EPI in many respects—for example, finding new ways to secure and increase funding, fostering cooperation between multiple partners to work together with shared yet flexible strategies, stimulating industry innovation, and promoting country ownership through the streamlining of programmatic demands. Above all, EPI carved out pathways and strategies to achieve universal access to immunisation services. This legacy provides guidance for reforms that move health systems towards universal coverage, another worthy ambition for the future…