UNFPA United Nations Population Fund [to 10 May 2014]
http://www.unfpa.org/public/

09 May 2014 – Dispatch
The colour purple, changing the future of Afghan mothers
KABUL, Afghanistan – Purple is the colour that midwifery students proudly wear in a small but revolutionary school in the busy Afghan capital, Kabul. In a country where a woman dies every two hours from pregnancy-related complications, midwives play a key role in promoting safe motherhood and delivering healthy babies. They embody the difference between life and death. more

07 May 2014 – Dispatch
Caught in crisis, South Sudanese women learn to plan their families
JUBA, South Sudan – Teresa Aruoth never knew she could use family planning to help space the births of her children. Married in her teenage years, she counts herself lucky to have remained healthy in a country where one in seven mothers dies in childbirth. But the ongoing crisis in South Sudan has made the need to provide women with family planning services even more urgent. more

06 May 2014 – Dispatch
Maternal deaths continue to fall, new data show
UNITED NATIONS, New York – New data from the United Nations reveal that maternal deaths have declined by 45 per cent since 1990. Some 523,000 deaths occurred from complications in pregnancy or childbirth in 1990; in 2013, that number was 289,000. Despite this progress, most countries are not on track to meet the Millennium Development Goal target on maternal mortality. more

06 May 2014 – Press Release
United Nations agencies report steady progress in saving mothers’ lives
GENEVA / NEW YORK – New United Nations data show a 45 per cent reduction in maternal deaths since 1990. An estimated 289 000 women died in 2013 due to complications in pregnancy and childbirth, down from 523 000 in 1990. more

05 May 2014 – Statement
Statement for the International Day of the Midwife
Globally, in the past two decades, maternal death has declined by nearly half. In the same period, skilled birth attendance has increased by 15 per cent, with two out of three deliveries worldwide now attended by a skilled health professional. With just over 600 days left until the Millennium Development Goals (MDGs) deadline, concerted efforts are required to scale up cost-effective interventions in educating midwives and other professionals with midwifery skills. more

05 May 2014 – Dispatch
“Life Starts in the Hands of a Midwife”
UNITED NATIONS, New York – Every two minutes, a woman dies in pregnancy or childbirth, according to UN estimates, adding up to nearly 290,000 maternal deaths each year. Nearly 3 million newborns die each year as well. Most of these deaths are entirely preventable: Prenatal care and the presence of a skilled attendant at birth – services provided by midwives – could avert as many as 3.6 million deaths a year. The International Day of the Midwife, on 5 May, commemorates the work of midwives around the world. more

UNESCO [to 10 May 2014]
http://en.unesco.org/

9 May 2014
:: Syria: the Director General condemns new destruction at the World Heritage site of the Old City of Aleppo
:: Mangrove ecosystems for nature protection and food productivity
:: Vocational pedagogy: What it is, why it matters and how to put it into practice
7 May 2014
:: New project to support youth education in Northern Mali
6 May 2014
:: UNESCO conference urges UN to include free expression in post-2015 development goals
:: United Nations General Assembly underscores culture as key to the Post-2015 Development Agenda

FAO Food & Agriculture Organization [to 10 May 2014]
http://www.fao.org/home/en/

A third of South Sudanese now severely food insecure due to ongoing conflict
Urgent action required to prevent famine
10-05-2014

Governments in Latin America and Caribbean agree on solid measures to eradicate hunger
Countries of Latin America and the Caribbean have advanced a robust agenda aimed at achieving the eradication of hunger in the region, during a major FAO meeting which concluded today in Santiago, Chile.
9-05-2014

Six months after disaster, Philippine farmers bring in the harvest
Tens of thousands of farmers are bringing in their first rice harvest just six months after one of the worst typhoons to ever hit the Philippines left their fields in tatters and their livelihoods at risk, FAO announced today.
7-05-2014

Joint action needed to tackle massive global food losses
Tackling the world’s massive food loss problem is a key to reducing hunger and poverty, but governments and companies must step up their collaboration on the issue, an international congress on food losses and waste heard today.
7-05-2014

UNCTAD [to 10 May 2014]
http://unctad.org/en/Pages/Home.aspx

UNCTAD places trade at the heart of sustainable development agenda beyond 2015
UNCTAD’s Trade and Development Commission held a debate on the role of international trade in the post-2015 development agenda on the first day of its sixth session on 5 May
Geneva, Switzerland, (08 May 2014)
The sixth session of the Trade and Development Commission included an informal meeting in the afternoon of its first day to consider “The Role of International Trade in the Post-2015 Development Agenda”.
With the form of the sustainable development goals (SDGs) that will replace the Millennium Development Goals (MDGs) currently under discussion, UNCTAD is making a contribution to integrating economic development and related global economic issues into the UN-led agenda beyond 2015.
The idea that economic growth can lift people out of poverty and form the basis of an aspiration for improving lives underpinned the MDGs – but the topic of trade was confined to Goal 8 (to “develop a global partnership for development”). Trade was mainly referred to as a matter of market access and tariff reduction, and in just three of 16 indicators used to track Goal 8.
However, UNCTAD’s work has shown that international trade should be mainstreamed as an “enabler” for achieving a broad range of social, economic and environmental development goals through promoting inclusive and sustainable economic growth. Exactly how this idea will be integrated across the SDGs, and what targets will be used to measure the outcomes of such goals as gender equality, for example, is currently a matter for consideration.
As part of UNCTAD’s ongoing contribution to the formulation of the SDGs, the Third Geneva Dialogue, to take place during UNCTAD’s fiftieth anniversary events held in Geneva from 16 to 20 June, takes as its theme “Trade as a means of implementation of sustainable development”.
One commitment supported by UNCTAD is the eradication of extreme poverty. UNCTAD has backed this aim since the first United Nations Conference on Trade and Development (UNCTAD I) was held in 1964.
“The States participating in the Conference are determined… to find ways by which the human and material resources of the world may be harnessed for the abolition of poverty everywhere,” read the Final Act of the UNCTAD I, which was held in Geneva…

WIPO (World Intellectual Property Organization) [to 10 May 2014]
http://www.wipo.int/portal/en/index.html

Francis Gurry Appointed for Second Term as WIPO Director General
The member states of the World Intellectual Property Organization (WIPO) appointed Francis Gurry by acclamation on May 8, 2014, to a second six-year term of office as Director General of the Organization.
May 8, 2014 PR/2014/759

USAID [to 10 May 2014]
http://www.usaid.gov/

Press Releases
Statement From USAID Administrator Rajiv Shah on the Passage of the Electrify Africa Act of 2014
May 9, 2014
USAID is pleased with the Electrify Africa Act of 2014 passed today by the House of Representatives with strong bipartisan support. We thank Chairman of the House Foreign Affairs Committee Ed Royce, Ranking Member Eliot Engel, Chairman of the Subcommittee on Africa Chris Smith, and Ranking Member of the Subcommittee on Africa Karen Bass for their leadership on H.R. 2548, and look forward to working with the Senate on complementary legislation.

Global Fight Against Neglected Tropical Diseases Reaches 465 Million People
May 8, 2014
1 Billion Treatments Delivered to the World’s Poorest
The U.S. Agency for International Development (USAID) today celebrates its support of the delivery of 1 billion Neglected Tropical Disease (NTD) treatments that are helping more than 465 million people in 25 countries in some of the world’s poorest populations.

NBA and USAID Join to Launch ‘Live, Learn and Play’ Program in Senegal
May 7, 2014
The National Basketball Association (NBA) and the U.S. Agency for International Development (USAID) today launched Live, Learn and Play, a new partnership that will include a comprehensive basketball-based youth development program aimed at using the values of the game including leadership, character and teamwork to promote youth development and citizenship in 20 schools in Senegal.

New research highlights progress in HIV prevention in Eastern and Southern Africa
May 6, 2014
Studies show successes with high quality voluntary medical male circumcision
U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development (USAID), the U.S. Centers for Disease Control and Prevention (CDC), the U.S. Department of Defense (DoD), and the Bill and Melinda Gates Foundation, funded research studies released today in PLOS ONE and PLOS Medicine. These studies provide evidence that safe, high quality voluntary medical male circumcision (VMMC) services performed by trained healthcare professionals in low resource settings can be implemented and sustained at scale and has the potential to significantly prevent new HIV infections in adolescent and adult men.

USAID Administrator Shah Travels to Nigeria for World Economic Forum
May 5, 2014
Focus on Innovations in Global Food Security and Energy
U.S. Agency for International Development (USAID) Administrator Rajiv Shah will travel to Abuja, Nigeria, May 6-9 to attend the 24th World Economic Forum (WEF) on Africa, “Forging Inclusive Growth, Creating Jobs.” WEF will bring together more than 1,000 leaders from across politics, business, and civil society, including 11 African heads of state and government, to focus on development and economic opportunity throughout Africa. Administrator Shah’s participation in WEF events will focus on strengthening food security, ensuring greater access to reliable energy, and raising awareness on the U.S. Government’s effort to support peace and bring an end to violence in South Sudan.

USAID Announces Grants to Nine Universities in Field of Democracy, Human Rights, and Governance
May 5, 2014
Today, USAID announced the launch of nine innovative partnership grants with U.S. universities in the field of democracy, human rights and governance (DRG). The grants will produce cutting-edge research, including findings and recommendations for USAID’s Center of Excellence on Democracy, Human Rights and Governance (DRG Center).

DFID [to 10 May 2014]
https://www.gov.uk/government/organisations/department-for-international-development

UK calls for action on child and early forced marriage in Mozambique
9 May 2014 DFID Press release

UK supports economic development in Mozambique
8 May 2014 DFID Press release

ECHO [to 10 May 2014]
http://ec.europa.eu/echo/index_en.htm

Six months after Haiyan: EU humanitarian aid in full swing in affected areas
08/05/2014 – – Today marks the six-month anniversary since Typhoon Haiyan/ Yolanda hit the Philippines, killing thousands and displacing millions, as one of the strongest tropical cyclones every recorded.

EU steps up efforts to help refugees fleeing violence in Central African Republic
06/05/2014 – The EU is increasing its life-saving assistance to refugees of the Central African crisis by €6 million. The new funding tops the previous €4 million aid to Central African refugees since the country’s crisis escalated last December.

ODI [to 10 May 2014]
http://www.odi.org.uk/

6 May 2014
China shale gas bonanza will hit poorest countries – report
A massive increase in shale gas production in China is projected to mean the superpower will import 40% less gas – with a big impact on some of the world’s poorest countries.

OECD [to 10 May 2014]
http://www.oecd.org/

7 May 2014
OECD Ministers reinforce commitment to building resilient economies and inclusive societies
OECD ministers today closed two days of discussions aimed at building resilient economies and inclusive societies. Chaired by Japan, the OECD’s Annual Meeting at Ministerial Level saw the launch or reinforcement of a number of major projects such as the OECD Southeast Asia Programme and the New Approaches to Economic Challenges initiative.

7 May 2014
OECD countries commit to work towards a climate deal for 2015
The OECD’s 34 member countries today affirmed their common resolve to work towards a deal on combating climate change at the COP21 talks in Paris in 2015. OECD accession countries Colombia and Latvia joined the statement issued at the Organisation’s annual Ministerial Council Meeting, attended by finance, economy, trade and other ministers.

5 May 2014
Countries must improve resilience to disasters or face mounting costs, OECD says
Smarter planning for natural and man-made disasters that increases collaboration between countries and encourages households and businesses to take more responsibility would improve resilience and reduce future economic losses, a new OECD report says.

World Trade Organisation [to 10 May 2014]
http://www.wto.org/english/news_e/news13_e/news13_e.htm

Azevêdo to push for trade role in future sustainable development goals
Director-General Roberto Azevêdo, in opening the WTO “Geneva Week” on 5 May 2014 for non-resident missions and observers, said that “trade has played a central role in lifting millions of people out of poverty in recent years”. He said that he would work “to ensure that the power of trade to support sustainable development is recognized” in the current discussions on the post-2015 development agenda.
> Speech

The Sphere Project [to 10 May 2014]
http://www.sphereproject.org/news/

UNICEF to offer Sphere elearning course to staff
09 May 2014 | Sphere Project
The United Nations Children’s Fund (UNICEF) will integrate the Sphere Handbook in Action e-learning course into its new learning platform.
As of next month, UNICEF staff across the world will be able to take the Sphere course on humanitarian principles and standards within their own online learning platform. The course will be available in English, Arabic, French and Spanish…

American Journal of Public Health
Volume 104, Issue 5 (May 2014)
http://ajph.aphapublications.org/toc/ajph/current

Noncommunicable Diseases and Human Rights: A Promising Synergy
Sofia Gruskin, JD, MIA, Laura Ferguson, PhD, MSc, MA, Daniel Tarantola, MD, and Robert Beaglehole, DSc
Sofia Gruskin and Laura Ferguson are with the Program on Global Health and Human Rights, Institute for Global Health, University of Southern California, Los Angeles. Daniel Tarantola is a global health consultant, Ferney-Voltaire, France. Robert Beaglehole is an emeritus professor, University of Auckland, Auckland, New Zealand.
Abstract
Noncommunicable diseases (NCDs) have finally emerged onto the global health and development agenda. Despite the increasingly important role human rights play in other areas of global health, their contribution to NCD prevention and control remains nascent.
The recently adopted Global Action Plan for the Prevention and Control of NCDs 2013–2020 is an important step forward, but the lack of concrete attention to human rights is a missed opportunity.
With practical implications for policy development, priority setting, and strategic design, human rights offer a logical, robust set of norms and standards; define the legal obligations of governments; and provide accountability mechanisms that can be used to enhance current approaches to NCD prevention and control. Harnessing the power of human rights can strengthen action for NCDs at the local, national, and global levels.

American Journal of Tropical Medicine and Hygiene
May 2014; 90 (5)
http://www.ajtmh.org/content/current

Special Section on Neglected Parasitic Infections
Neglected Parasitic Infections in the United States: Needs and Opportunities
Monica E. Parise*, Peter J. Hotez and Laurence Slutsker
Author Affiliations
Division of Parasitic Diseases and Malaria, Center for Global Health, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas
Initial text
Parasitic infections are a major global health burden. The impact of debilitating diseases caused by parasites is greatest among those who struggle to meet their daily basic needs and access basic health care services in low-income countries. However, persons who have or are at risk for parasitic infections are present in every income and social strata, and residents of the United States and other developed nations are not unaffected. For some persons living in the United States, these parasitic infections are acquired in their own immediate environment; for example, exposure to feces from domestic dogs or cats puts children at risk for toxocariasis and toxoplasmosis. For others, chronic parasitic infections acquired years ago in other areas of the world can manifest with severe illness later in life, such as neurocysticercosis leading to adult–onset epilepsy or Chagas disease leading to severe cardiomyopathy requiring heart transplant. We know much less than we should about the health and economic burden and impact of parasitic diseases in developed countries, including the United States (Table 1).1
This issue of the American Journal of Tropical Medicine and Hygiene features brief reviews of five parasitic infections that remain a significant health problem in the United States: Chagas disease, cysticercosis, toxocariasis, toxoplasmosis, and trichomoniasis.2–6 These five diseases, which are among those that Centers for Disease Control and Prevention (CDC) refers to as neglected parasitic infections (NPIs) in the United States, have different epidemiologic profiles and modes of transmission and require tailored prevention and control strategies…

Early Phase Clinical Trials with Human Immunodeficiency Virus-1 and Malaria Vectored Vaccines in The Gambia: Frontline Challenges in Study Design and Implementation
Muhammed O. Afolabi*, Jane U. Adetifa, Egeruan B. Imoukhuede, Nicola K. Viebig, Beate Kampmann and Kalifa Bojang
Author Affiliations
Vaccinology Theme, Medical Research Council Unit, The Gambia; The Jenner Institute, University of Oxford, United Kingdom; European Vaccine Initiative, Germany; Disease Control and Elimination Theme, Medical Research Council Unit, The Gambia Abstract.
Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and malaria are among the most important infectious diseases in developing countries. Existing control strategies are unlikely to curtail these diseases in the absence of efficacious vaccines. Testing of HIV and malaria vaccines candidates start with early phase trials that are increasingly being conducted in developing countries where the burden of the diseases is high. Unique challenges, which affect planning and implementation of vaccine trials according to internationally accepted standards have thus been identified. In this review, we highlight specific challenges encountered during two early phase trials of novel HIV-1 and malaria vectored vaccine candidates conducted in The Gambia and how some of these issues were pragmatically addressed. We hope our experience will be useful for key study personnel involved in day-to-day running of similar clinical trials. It may also guide future design and implementation of vaccine trials in resource-constrained settings.

BMC Health Services Research
(Accessed 10 May 2014)
http://www.biomedcentral.com/bmchealthservres/content

Research article
Improvements in pandemic preparedness in 8 Central American countries, 2008 – 2012
Lucinda EA Johnson, Wilfrido Clará, Manoj Gambhir, Rafael Chacón- Fuentes, Carlos Marín-Correa, Jorge Jara, Percy Minaya, David Rodríguez, Natalia Blanco, Naomi Iihoshi, Maribel Orozco, Carmen Lange, Sergio Vinicio Pérez, Nydia Amador, Marc-Alain Widdowson, Ann C Moen and Eduardo Azziz-Baumgartner
Author Affiliations
BMC Health Services Research 2014, 14:209 doi:10.1186/1472-6963-14-209
Published: 9 May 2014
Abstract (provisional)
Background
In view of ongoing pandemic threats such as the recent human cases of novel avian influenza A(H7N9) in China, it is important that all countries continue their preparedness efforts. Since 2006, Central American countries have received donor funding and technical assistance from the U.S. Centers for Disease Control and Prevention (CDC) to build and improve their capacity for influenza surveillance and pandemic preparedness. Our objective was to measure changes in pandemic preparedness in this region, and explore factors associated with these changes, using evaluations conducted between 2008 and 2012.
Methods
Eight Central American countries scored their pandemic preparedness across 12 capabilities in 2008, 2010 and 2012, using a standardized tool developed by CDC. Scores were calculated by country and capability and compared between evaluation years using the Student’s t-test and Wilcoxon Rank Sum test, respectively. Virological data reported to WHO were used to assess changes in testing capacity between evaluation years. Linear regression was used to examine associations between scores, donor funding, technical assistance and WHO reporting.
Results
All countries improved their pandemic preparedness between 2008 and 2012 and seven made statistically significant gains (p < 0.05). Increases in median scores were observed for all 12 capabilities over the same period and were statistically significant for eight of these (p < 0.05): country planning, communications, routine influenza surveillance, national respiratory disease surveillance, outbreak response, resources for containment, community interventions and health sector response. We found a positive association between preparedness scores and cumulative funding between 2006 and 2011 (R2 = 0.5, p < 0.01). The number of specimens reported to WHO from participating countries increased significantly from 5,551 (2008) to 18,172 (2012) (p < 0.01).
Conclusions
Central America has made significant improvements in influenza pandemic preparedness between 2008 and 2012. U.S. donor funding and technical assistance provided to the region is likely to have contributed to the improvements we observed, although information on other sources of funding and support was unavailable to study. Gains are also likely the result of countries’ response to the 2009 influenza pandemic. Further research is required to determine the degree to which pandemic improvements are sustainable.

Conflict and Health
http://www.conflictandhealth.com/
[Accessed 10 May 2014]

Research
Need for a gender-sensitive human security framework: results of a quantitative study of human security and sexual violence in Djohong District, Cameroon
Open Access
Parmar PK, Agrawal P, Goyal R, Scott J and Greenough PG Conflict and Health 2014, 8:6 (7 May 2014)
Abstract (provisional)
Background
Human security shifts traditional concepts of security from interstate conflict and the absence of war to the security of the individual. Broad definitions of human security include livelihoods and food security, health, psychosocial well-being, enjoyment of civil and political rights and freedom from oppression, and personal safety, in addition to absence of conflict.
Methods
In March 2010, we undertook a population-based health and livelihood study of female refugees from conflict-affected Central African Republic living in Djohong District, Cameroon and their female counterparts within the Cameroonian host community. Embedded within the survey instrument were indicators of human security derived from the Leaning-Arie model that defined three domains of psychosocial stability suggesting individuals and communities are most stable when their core attachments to home, community and the future are intact.
Results
While the female refugee human security outcomes describe a population successfully assimilated and thriving in their new environments based on these three domains, the ability of human security indicators to predict the presence or absence of lifetime and six-month sexual violence was inadequate. Using receiver operating characteristic (ROC) analysis, the study demonstrates that common human security indicators do not uncover either lifetime or recent prevalence of sexual violence.
Conclusions
These data suggest that current gender-blind approaches of describing human security are missing serious threats to the safety of one half of the population and that efforts to develop robust human security indicators should include those that specifically measure violence against women.

Research
After abduction: exploring access to reintegration programs and mental health status among young female abductees in Northern Uganda
Muldoon KA, Muzaaya G, Betancourt TS, Ajok M, Akello M, Petruf Z, Nguyen P, Baines EK et al. Conflict and Health 2014, 8:5 (7 May 2014)
Abstract (provisional)
Background
Reintegration programs are commonly offered to former combatants and abductees to acquire civilian status and support services to reintegrate into post-conflict society. Among a group of young female abductees in northern Uganda, this study examined access to post-abduction reintegration programming and tested for between group differences in mental health status among young women who had accessed reintegration programming compared to those who self-reintegrated.
Methods
This cross-sectional study analysed interviews from 129 young women who had previously been abducted by the Lords Resistance Army (LRA). Data was collected between June 2011-January 2012. Interviews collected information on abduction-related experiences including age and year of abduction, manner of departure, and reintegration status. Participants were coded as ‘reintegrated’ if they reported >=1 of the following reintegration programs: traditional cleansing ceremony, received an amnesty certificate, reinsertion package, or had gone to a reception centre.
A t-test was used to measure mean differences in depression and anxiety measured by the Acholi Psychosocial Assessment Instrument (APAI) to determine if abductees who participated in a reintegration program had different mental status from those who self-reintegrated.
Results
From 129 young abductees, 56 (43.4%) had participated in a reintegration program. Participants had been abducted between 1988-2010 for an average length of one year, the median age of abduction was 13 years (IQR:11-14) with escaping (76.6%), being released (15.6%), and rescued (7.0%) being the most common manner of departure from the LRA. Traditional cleansing ceremonies (67.8%) were the most commonly accessed support followed by receiving amnesty (37.5%), going to a reception centre (28.6%) or receiving a reinsertion package (12.5%). Between group comparisons indicated that the mental health status of abductees who accessed >=1 reintegration program were not significantly different from those who self-reintegrated (p > 0.05).
Conclusions
Over 40% of female abductees in this sample had accessed a reintegration program, however significant differences in mental health were not observed between those who accessed a reintegration program and those who self-reintegrated. The successful reintegration of combatants and abductees into their recipient community is a complex process and these results support the need for gender-specific services and ongoing evaluation of reintegration programming.

Health Policy and Planning
Volume 29 Issue 3 May 2014
http://heapol.oxfordjournals.org/content/current

Sustainability of recurrent expenditure on public social welfare programmes: expenditure analysis of the free maternal care programme of the Ghana National Health Insurance Scheme
Emmanuel Ankrah Odame1,*, Patricia Akweongo2, Ben Yankah3, Francis Asenso-Boadi3 and Irene Agyepong2
Author Affiliations
1Public Health Unit, Ridge Regional Hospital, Ghana Health Service, Box 473, Accra, Ghana, 2School of Public Health, University of Ghana, Box LG13, Legon-Accra, Ghana and 3National Health Insurance Authority, No. 36-6th Avenue, Ridge Residential Area, Private Mail Bag Ministries, Accra, Ghana
Accepted February 28, 2013.
Abstract
Objective: Sustainability of public social welfare programmes has long been of concern in development circles. An important aspect of sustainability is the ability to sustain the recurrent financial costs of programmes. A free maternal care programme (FMCP) was launched under the Ghana National Health Insurance Scheme (NHIS) in 2008 with a start-up grant from the British Government. This article examines claims expenditure under the programme and the implications for the financial sustainability of the programme, and the lessons for donor and public financing of social welfare programmes.
Methods: Records of reimbursement claims for services and medicines by women benefitting from the policy in participating facilities in one sub-metropolis in Ghana were analysed to gain an understanding of the expenditure on this programme at facility level. National level financial inflow and outflow (expenditure) data of the NHIS, related to implementation of this policy for 2008 and 2009, were reviewed to put the facility-based data in the national perspective.
Findings: A total of US$936 450.94 was spent in 2009 by the scheme on FMCP in the sub-metropolis. The NHIS expenditure on the programme for the entire country in 2009 was US$49.25 million, exceeding the British grant of US$10.00 million given for that year. Subsequently, the programme has been entirely financed by the National Health Insurance Fund. The rapidly increasing, recurrent demands on this fund from the maternal delivery exemption programme—without a commensurate growth on the amounts generated annually—is an increasing threat to the sustainability of the fund.
Conclusions: Provision of donor start-up funding for programmes with high recurrent expenditures, under the expectation that government will take over and sustain the programme, must be accompanied by clear long-term analysis and planning as to how government will sustain the programme.

10 best resources on … mixed methods research in health systems
Sachiko Ozawa1,* and Krit Pongpirul1,2,3,4
Author Affiliations
1Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA, 2Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, 3Thailand Research Center for Health Services System, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand and 4Chula Clinical Research Center (ChulaCRC), Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Pathumwan, Bangkok 10600, Thailand
Accepted March 8, 2013.
Abstract
Mixed methods research has become increasingly popular in health systems. Qualitative approaches are often used to explain quantitative results and help to develop interventions or survey instruments. Mixed methods research is especially important in low- and middle-income country (LMIC) settings, where understanding social, economic and cultural contexts are essential to assess health systems performance. To provide researchers and programme managers with a guide to mixed methods research in health systems, we review the best resources with a focus on LMICs. We selected 10 best resources (eight peer-reviewed articles and two textbooks) based on their importance and frequency of use (number of citations), comprehensiveness of content, usefulness to readers and relevance to health systems research in resource-limited contexts. We start with an overview on mixed methods research and discuss resources that are useful for a better understanding of the design and conduct of mixed methods research. To illustrate its practical applications, we provide examples from various countries (China, Vietnam, Kenya, Tanzania, Zambia and India) across different health topics (tuberculosis, malaria, HIV testing and healthcare costs). We conclude with some toolkits which suggest what to do when mixed methods findings conflict and provide guidelines for evaluating the quality of mixed methods research.

Integrating family planning messages into immunization services: a cluster-randomized trial in Ghana and Zambia
Gwyneth Vance1,*, Barbara Janowitz1, Mario Chen1, Brooke Boyer1, Prisca Kasonde1, Gloria Asare2, Beatrice Kafulubiti3 and John Stanback1
Author Affiliations
1FHI 360 – Program Sciences, Durham, NC, USA, 2Ghana Health Service, Accra, Ghana and 3Zambia Ministry of Health, Kabwe, Zambia
Accepted March 15, 2013.
Abstract
Objective To determine whether integrating family planning (FP) messages and referrals into facility-based, child immunization services increase contraceptive uptake in the 9- to 12-month post-partum period.
Methods A cluster-randomized trial was used to test an intervention where vaccinators were trained to provide individualized FP messages and referrals to women presenting their child for immunization services. In each of 2 countries, Ghana and Zambia, 10 public sector health facilities were randomized to control or intervention groups. Shortly after the introduction of the intervention, exit interviews were conducted with women 9–12 months postpartum to assess contraceptive use and related factors before and after the introduction of the intervention. In total, there were 8892 participants (Control Group Ghana, 1634; Intervention Group Ghana, 1129; Control Group Zambia, 3751; Intervention Group Zambia, 2468). Intervention effects were evaluated using logistic mixed models that accounted for clustering in data. In addition, in-depth interviews were conducted with vaccinators, and a process assessment was completed mid-way through the implementation of the intervention.
Results In both countries, there was no significant effect on non-condom FP method use (Zambia, P = 0.56 and Ghana, P = 0.86). Reported referrals to FP services did not improve nor did women’s knowledge of factors related to return of fecundity. Some providers reported having made modifications to the intervention; they generally provided FP information in group talks and not individually as they had been trained to do.
Conclusion Rigorous evidence of the success of integrated immunization services in resource poor settings remains weak.

Journal of Infectious Diseases
Volume 209 Issue 11 June 1, 2014
http://jid.oxfordjournals.org/content/current

Protecting the Family to Protect the Child: Vaccination Strategy Guided by RSV Transmission Dynamics
Barney S. Graham
Author Affiliations – Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
Respiratory syncytial virus (RSV) is the most important respiratory pathogen of childhood and also contributes to substantial morbidity and mortality in the elderly. It was recently estimated that as a single infectious agent, RSV is second only to malaria as a cause of death in children between 1 month and 1 year of age [1]. In addition, the global impact as an adult pathogen has a comparable level of morbidity and mortality as influenza in the frail elderly [2, 3]. Further demonstration that RSV is a ubiquitous global pathogen is now reported in the prospective family cohort study performed by Munywoki et al and reported in this issue of the Journal of Infectious Diseases [4]. More than 80% of households with children experienced an RSV infection within the 6-month surveillance period, and RSV was detected in 64% of study infants (defined as <1 year of age). In about 50% of households, more than one person was infected, and repeat infections in the same individual from homologous or heterologous RSV subtypes within the same season were documented. Thus, transmission within family units is common, and natural infection with RSV, especially in very young infants, does not provide solid immunity against reinfection. These data that were collected in rural Kenya are consistent with another household study performed more than 40 years ago in Rochester, New York, that reported 2 months of surveillance data [5]. Although it would be useful to have more data from different geographic and climatic settings, the congruity of these 2 studies suggests the likelihood that these results are a realistic reflection of how RSV is transmitted within family units globally. Importantly, the current study was prospective, employed active …

The Source of Respiratory Syncytial Virus Infection In Infants: A Household Cohort Study In Rural Kenya
Patrick K. Munywoki1, Dorothy C. Koech1, Charles N. Agoti1, Clement Lewa1, Patricia A. Cane2, Graham F. Medley2 and D. J. Nokes1,2
Author Affiliations
1KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
2School of Life Sciences and WIDER, University of Warwick, Coventry, United Kingdom

Community Circulation Patterns of Oral Polio Vaccine Serotypes 1, 2, and 3 After Mexican National Immunization Weeks
Stephanie B. Troy1,a, Leticia Ferreyra-Reyes2,a, ChunHong Huang3, Clea Sarnquist3, Sergio Canizales-Quintero2, Christine Nelson1, Renata Báez-Saldaña2, Marisa Holubar3, Elizabeth erreira-Guerrero2, Lourdes García-García2 and Yvonne A. Maldonado3
Author Affiliations
1Eastern Virginia Medical School, Norfolk, Virginia
2Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
3Stanford University School of Medicine, Stanford, California
Abstract
Background With wild poliovirus nearing eradication, preventing circulating vaccine-derived poliovirus (cVDPV) by understanding oral polio vaccine (OPV) community circulation is increasingly important. Mexico, where OPV is given only during biannual national immunization weeks (NIWs) but where children receive inactivated polio vaccine (IPV) as part of their primary regimen, provides a natural setting to study OPV community circulation.
Methods In total, 216 children and household contacts in Veracruz, Mexico, were enrolled, and monthly stool samples and questionnaires collected for 1 year; 2501 stool samples underwent RNA extraction, reverse transcription, and real-time polymerase chain reaction (PCR) to detect OPV serotypes 1, 2, and 3.
Results OPV was detected up to 7 months after an NIW, but not at 8 months. In total, 35% of samples collected from children vaccinated the prior month, but only 4% of other samples, contained OPV. Although each serotype was detected in similar proportions among OPV strains shed as a result of direct vaccination, 87% of OPV acquired through community spread was serotype 2 (P < .0001).
Conclusion Serotype 2 circulates longer and is transmitted more readily than serotypes 1 or 3 after NIWs in a Mexican community primarily vaccinated with IPV. This may be part of the reason why most isolated cVDPV has been serotype 2.

Journal of International Development
May 2014 Volume 26, Issue 4 Pages 409–566
http://onlinelibrary.wiley.com/doi/10.1002/jid.v26.3/issuetoc

Research Article
BRAZILIAN LAND TENURE CONFLICTS: A SPATIAL ANALYSIS
Carlos Pestana Barros1, João Ricardo Faria2,* and Ari Francisco de Araujo Jr.3
Abstract
This paper analyses land occupation involving landless peasants in Brazil for the period 2000–2008. It is the first study to be undertaken at the national level, with a contemporary data span, using spatial analysis. Land occupation in Brazil is a state-based phenomenon and mainly a political issue. Our results show that land occupation grows with left-wing political violence and left-wing government’s support through public agencies. The view that land invasion is caused by poverty does not apply to the Brazilian case.

Research Article
SELF-HELP GROUPS AND EMPOWERMENT OF WOMEN: SELF-SELECTION, OR ACTUAL BENEFITS?
Zakir Husain1,*, Diganta Mukerjee2 and Mousumi Dutta3
Abstract
Researchers argue that programmes promoting SHGs often attract women already active in the public domain (‘self-selection effect’), excluding those most in need of assistance. This exaggerates estimates of the effects of the programme (‘programme effects’). This paper attempts to test the significance of the programme effect of SHGs by comparing empowerment levels of newly inducted and older members of SHGs, based on a survey conducted in six municipalities in West Bengal, India. Results indicate that programme effects operated only to reduce tolerance of domestic violence and enhance status of members within the household.

Research Article
MAKING POVERTY INTO A FINANCIAL PROBLEM: FROM GLOBAL POVERTY LINES TO KIVA.ORG
Anke F. Schwittay*
Abstract
This paper presents the financialization of poverty as a conceptual addition to the literature on microfinance. It argues that for microfinance to be seen as a solution to poverty alleviation, poverty has been made into a financial problem. This is exemplified by the World Bank’s global poverty line and leads to the constitution of poor people as financial subjects. In addition, thinking of poverty in financial terms enables Northern publics’ engagement with poverty. Recent initiatives like Live Below the Line and Kiva.org are presented as examples of how poverty is made manageable for Northern supporters of microfinance.

Journal of Public Health Policy
Volume 35, Issue 2 (May 2014)
http://www.palgrave-journals.com/jphp/journal/v35/n2/index.html

Editorial
Lessons from cholera in Haiti
6 March 2014
Anthony Robbins, Co-Editor
[Full text]
Following the cholera outbreak in Haiti is a little like recapitulating the history of public health. The earliest public health interventions that protected lives were really very simple to understand, if not to implement: keeping food and drinking water clean, reducing crowding in housing, and managing disposal of human waste. Almost two centuries ago, reformers in Europe, then in North America, found that these measures to combat filth were effective. Thus, health improved even before vaccines and antibiotics arrived.

Late in the nineteenth century came scientific knowledge of causal agents, making it possible to blame carriers, often the very same people who lived with filth. The focus for interventions shifted from communities to individuals, from cleaning up environments and creating infrastructure to vaccines and antibiotics.

Where does Haiti fit in this picture? The country has always lacked clean water and proper sewers and then the earthquake of 2010 further damaged the already scant infrastructure. An outbreak in Haiti awaited only the introduction of a communicable pathogen, in this case Vibrio cholerae, rather like a parched landscape awaiting a lit match.

What followed was an outbreak that has taken over 8000 lives and infected almost 700 000 more Haitians. How did cholera get to Haiti? In the old days, the health authorities might have found the physical source, like the Broad Street pump, but today, more could be learned. Genetic typing made it possible to recognize that the strain of cholera afflicting Haiti came from Asia, most likely brought to the island by Nepalese soldiers working with the United Nations emergency response for the earthquake.

Very interesting, a triumph for laboratory methods that typed the pathogen! But how cholera got to Haiti offered little help in ending the outbreak or preventing future ones once the disease was spreading. The source didn’t much matter. Haiti’s abysmal sanitation infrastructure meant that Vibrio cholerae introduced from almost any source could have caused an epidemic. To their credit, the Haitian Ministry of Health and the National Directorate for Water Supply and Sanitation, understood how to control and prevent cholera. As stated in 2011 by the United Nations’ Independent Panel. To prevent the spread of cholera, the United Nations and the Government of Haiti should prioritize investment in piped, treated drinking water supplies and improved sanitation throughout Haiti. Until such time as water supply and sanitation infrastructure is established:
:: Programs to treat water at the household or community level with chlorine or other effective systems, hand washing with soap, and safe disposal of fecal waste should be developed and/or expanded; and,
:: Safe drinking water supplies should continue to be delivered and fecal waste should be collected and safely disposed of in areas of high population density, such as the spontaneous settlement camps.

As far as we can see, the key lesson from Haiti is that populations around the world that live without potable water and proper management of human fecal waste remain vulnerable. The fact that there had been no cholera in Haiti for over 100 years should have been no comfort – especially to those in public health who (should) know that protection depends on infrastructure.

In 1991, Dr Robert Knouss, who was serving as the Deputy Director General of the Pan American Health Organization, appeared before a committee of the US Congress to testify about the cholera epidemic in Peru. ‘What would it cost to eliminate cholera in the Americas?’ he was asked. He had not prepared for just that question, but his answer was quick if not precise: ‘$25 billion. Enough to build modern drinking water and sewage systems for every major city in the region that lacks one today’. (The number would be far larger in today’s dollars.)

We urge the United Nations and programs that contribute money to build infrastructure to learn a lesson from Haiti and think as the late Dr Knouss did. Invest now before you can be ‘surprised’ by an epidemic of cholera or other waterborne disease from any source.