BMC Health Services Research
(Accessed 22 March 2014)
http://www.biomedcentral.com/bmchealthservres/content

Research article  
The long walk to universal health coverage: patterns of inequities in the use of primary healthcare services in Enugu, Southeast Nigeria
Ijeoma L Okoronkwo, Obinna E Onwujekwe, Francis O Ani BMC Health Services Research 2014, 14:132 (21 March 2014)

Abstract | Provisional PDF
Background
Knowledge and understanding of health service usage are necessary for health resource allocation, planning and monitoring the achievement of universal coverage (UHC). There is limited information on patterns of utilization among adult users of primary health care (PHC) services. Lack of understanding of current and past utilization patterns of health services often hinders the improvement of future Primary Health Care (PHC) delivery in the remote areas of developing countries. This paper presents new knowledge on the patterns of utilization of PHC services among adults in Enugu metropolis southeast Nigeria.

Methods
A cross-sectional study was conducted in 15 PHC facilities of Enugu North Local Government Area (LGA) from June to July 2012. A total of 360 consenting adult users aged 18 years and above were consecutively recruited as they attended the health facilities. An interviewer-administered questionnaire was used to collect data from the respondents. A modified Likert scale questionnaire was used to analyze data on patterns of utilization. Utilization of PHC services was compared by gender, socio-economic status (SES) and level of education.

Results
Out of the 360 respondents, (46.9%) utilized PHC services regularly. The components of PHC mostly utilized by respondents were immunization with a mean score of 3.05, treatment of common ailments (2.99) and maternal and child health (2.64). The least poor SES group utilized PHC services the most while the very poor and poor SES groups used PHC services least. There were statistically significant relationships between utilization of PHC services and gender (p = 0.0084), level of education (p = 0.0366) and income (p = 0.0001).

Conclusions
Most adult users in this study did not utilize the health facilities regularly and there were gender, educational and SES inequities in the use of PHC services. These inequities will negate the achievement of universal health coverage with PHC services and should be remedied using appropriate interventions.

BMC Health Services Research
(Accessed 22 March 2014)
http://www.biomedcentral.com/bmchealthservres/content

Research article  
Community participation to design rural primary healthcare services
Jane Farmer, Amy Nimegeer BMC Health Services Research 2014, 14:130 (21 March 2014)

Abstract | Provisional PDF
Background
This paper explores how community participation can be used in designing rural primary healthcare services by describing a study of Scottish communities. Community participation is extolled in healthcare policy as useful in planning services and is understood as particularly relevant in rural settings, partly due to high social capital. Literature describes many community participation methods, but lacks discussion of outcomes relevant to health system reconfiguration. There is a spectrum of ideas in the literature on how to design services, from top-down standard models to contextual plans arising from population health planning that incorporates community participation. This paper addresses an evidence gap about the outcomes of using community participation in (re)designing rural community health services.

Methods
Community-based participatory action research was applied in four Scottish case study communities in 2008-10. Data were collected from four workshops held in each community (total 16) and attended by community members. Workshops were intended to produce hypothetical designs for future service provision. Themes, rankings and selections from workshops are presented.

Results
Community members identified consistent health priorities, including local practitioners, emergency triage, anticipatory care, wellbeing improvement and health volunteering. Communities designed different service models to address health priorities. One community did not design a service model and another replicated the current model despite initial enthusiasm for innovation.

Conclusions
Communities differ in their receptiveness to engaging in innovative service design, but some will create new models that fit in a given budget. Design diversity indicates that context influences local healthcare planning, suggesting community participation impacts on design outcomes, but standard service models maybe useful as part of the evidence in community participation discussions.

BMC Public Health
(Accessed 22 March 2014)
http://www.biomedcentral.com/bmcpublichealth/content

Study protocol  
Effectiveness of a smart phone app on improving immunization of children in rural Sichuan Province, China: study protocol for a paired cluster randomized controlled trial
Li Chen, Wei Wang, Xiaozhen Du, Xiuqin Rao, Michelle van Velthoven, Ruikan Yang, Lin Zhang, Jeanne Koepsell, Ye Li, Qiong Wu, Yanfeng Zhang BMC Public Health 2014, 14:262 (20 March 2014)
Abstract |

Background
Although good progress has been achieved in expanding immunization of children in China, disparities exist across different provinces. Information gaps both from the service supply and demand sides hinder timely vaccination of children in rural areas. The rapid development of mobile health technology (mHealth) provides unprecedented opportunities for improving health services and reaching underserved populations. However, there is a lack of literature that rigorously evaluates the impact of mHealth interventions on immunization coverage as well as the usability and feasibility of smart phone applications (apps). This study aims to assess the effectiveness of a smart phone-based app (Expanded Program on Immunization app, or EPI app) on improving the coverage of children’s immunization.

Methods/Design
This cluster randomized trial will take place in Xuanhan County, Sichuan Province, China. Functionalities of the app include the following: to make appointments automatically, record and update children’s immunization information, generate a list of children who missed their vaccination appointments, and send health education information to village doctors. After pairing, 36 villages will be randomly allocated to the intervention arm (n = 18) and control arm (n = 18). The village doctors in the intervention arm will use the app while the village doctors in the control arm will record and manage immunization in the usual way in their catchment areas. A household survey will be used at baseline and at endline (8 months of implementation). The primary outcome is full-dose coverage and the secondary outcome is immunization coverage of the five vaccines that are included in the national Expanded Program on Immunization program as well as Hib vaccine, Rotavirus vaccine and Pneumococcal conjugate vaccine. Multidimensional evaluation of the app will also be conducted to assess usability and feasibility.

Discussion
This study is the first to evaluate the effectiveness of a smart phone app for child immunization in rural China. This study will contribute to the knowledge about the usability and feasibility of a smart phone app for managing immunization in rural China and to similar populations in different settings.

Global Public Health
Volume 9, Issue 3, 2014
http://www.tandfonline.com/toc/rgph20/current#.Uq0DgeKy-F9

Political commitment to tuberculosis control in Ghana
Joshua Amo-Adjei
pages 299-311
DOI:10.1080/17441692.2014.880500
Published online: 13 Feb 2014

Abstract
As part of expanding and sustaining tuberculosis (TB) control, the Stop TB Partnership of the World Health Organization initiative has called for strong political commitment to TB control, particularly in developing countries. Framing political commitment within the theoretical imperatives of the political economy of health, this study explores the existing and the expected dimensions of political commitment to TB control in Ghana. Semi-structured in-depth interviews were conducted with 29 purposively selected staff members of the Ghana Health Service and some political officeholders. In addition, the study analysed laws, policies and regulations relevant to TB control. Four dimensions of political commitment emerged from the interviews: provision of adequate resources (financial, human and infrastructural); political authorities’ participation in advocacy for TB; laws and policies’ promulgation and social protection interventions. Particularly in respect to financial resources, donors such as the Global Fund to Fight AIDS, Tuberculosis and Malaria presently give more than 60% of the working budget of the programme. The documentary review showed that laws, policies and regulations existed that were relevant to TB control, albeit they were not clearly linked.

Global Public Health
Volume 9, Issue 3, 2014
http://www.tandfonline.com/toc/rgph20/current#.Uq0DgeKy-F9

Old-age pensions and population health: A global and cross-national perspective
Ola Sjöberg
pages 271-285

Abstract
Social security schemes can reduce poverty risk and increase resources available for individuals and families, and these schemes may therefore have an important role to play in population health in both high- and middle-income countries. This article analyses the linkage between effective coverage of old-age pension schemes and life expectancy in a sample of 93 high- and middle-income countries at the end of the twenty-first century. The analyses support the notion that social security schemes, and especially programmes with a universal approach, may have positive effects on population health, even after taking into account the effect of levels of economic development, income inequality and essential characteristics of health care systems. This article also demonstrates that there is no evident relationship between levels of economic development and social security legislation: historically, late industrialisers were often first in introducing major social security schemes, and today there is no clear cross-national relationship between levels of economic development and the proportion of the population covered by old-age pension schemes.

Journal of Immigrant and Minority Health
Volume 16, Issue 2, April 2014
http://link.springer.com/journal/10903/16/2/page/1

Pathways to Understand Help-Seeking Behaviors Among Haitians
Billie Schwartz, Darren Bernal, Lauren Smith, Guerda Nicolas
http://link.springer.com/article/10.1007/s10903-012-9751-y

Abstract
The earthquake in Haiti led to an outpouring of outreach from groups of the Haitian international community as well as to residents of the island. Thus, an understanding of the help-seeking behavior patterns of this group is necessary to make meaning of their receptivity of assistance in a time of need. This paper summarizes help-seeking behavior patterns of 150 Haitian immigrants residing in the US. The results indicate that, overall, this sample was more likely to go to their family for assistance, regardless of the nature of the problem. In contrast, they were least likely to go to professionals for help, even when in need of emotional assistance. Given the increased rate of Haitians living outside of Haiti and around the world, a more comprehensive understanding of their mental health needs, coping patterns, and barriers to seeking help from mental health professionals is warranted.

Journal of Sustainable Development
Vol 7, No 2 (2014)
http://www.ccsenet.org/journal/index.php/jsd/issue/current

Design trade-offs for sustainability in humanitarian markets: The case of off-grid energy
Brita Fladvad Nielsen
http://www.ccsenet.org/journal/index.php/jsd/article/view/32723

Abstract
Contextual challenges and conflicting interests within the humanitarian market prevent a satisfactory impact of energy-generating technology introduction in humanitarian relief settings. Interviews with product design enterprises and humanitarian customers reveal that the current lack of follow-up and end-of-life overview prevents the information flow and cooperation necessary to increase the performance of products in field. This affects the trust between customer and enterprise and more importantly prevents technical performance in field due to lack of contextual insight about end-user and resource availability. Six design trade-offs represent dilemmas that designers must make in order to balance short term objectives and long term, triple bottom line, sustainable development goals within their off-grid energy designs.

The Lancet  
Mar 22, 2014  Volume 383  Number 9922  p1013 – 1098
http://www.thelancet.com/journals/lancet/issue/current

Editorial
A new brand for tuberculosis
The Lancet
Preview |
The Lancet received an interesting email last week—an invitation to participate in the research stage of a new Stop TB Partnership initiative to build a brand for tuberculosis from Siegel+Gale, a London-based branding agency who have been commissioned to undertake the work. The aim of the project is to develop an iconic and lasting identity for tuberculosis. The goal is to create a brand that will raise the profile of the disease, influence high-level decision makers, attract necessary resources, and amplify the voice of the tuberculosis community.

Comment
World TB Day 2014: finding the missing 3 million
Nick Herbert, Andrew George, Baroness Masham of Ilton, Virendra Sharma, Matt Oliver, Aaron Oxley, Mario Raviglione, Alimuddin I Zumla
Preview |
On April 23, 1993, WHO declared tuberculosis a global health emergency.1 Tuberculosis is now about to come of age as a global emergency—April, 2014 marks the 21st anniversary of that declaration. Arata Kochi, manager of WHO’s tuberculosis programme in 1993, aptly called the disease “a forgotten epidemic” and “humanity’s greatest killer”. Tuberculosis might no longer be humanity’s deadliest disease in terms of annual deaths but, 21 years after the declaration, it remains a serious and substantial threat to the health of people worldwide, causing 1·3 million unnecessary deaths every year.

Special Report
Breaking the cycle: drought and hunger in Kenya
Sam Loewenberg
Preview |
Aid to Kenya responds to the country’s recurrent food crises but it fails to address the underlying infrastructure problems that could prevent such emergencies. Sam Loewenberg reports.

Viewpoint
Addressing invisibility, inferiority, and powerlessness to achieve gains in maternal health for ultra-poor women
Zubia Mumtaz, Sarah Salway, Afshan Bhatti, Lynn McIntyre
Preview |
Despite a continued stated commitment to social justice and equity—the guiding spirit of the Millennium Declaration in 20001—concerns have arisen that this focus has often been diluted in efforts to translate the Millennium Development Goals (MDGs) into actions.2 Nowhere is this more apparent than in relation to MDG 5. Analyses of national survey data and local programme assessments show that policy directives and interventions often fail to reach the poorest women within local populations. In Pakistan, for example, a ten-district intervention aimed at upgrading health facilities while simultaneously increasing demand through behavioural change resulted in a rise in institutional deliveries in the highest wealth quintile (from 62% to 74%), but no change in the poorest (remaining at roughly 18%).

PLOS Currents: Disasters
http://currents.plos.org/disasters/

The Prevalence of Sexual Violence among Female Refugees in Complex Humanitarian Emergencies: a Systematic Review and Meta-analysis
Alexander Vu, Atif Adam, Andrea Wirtz, Kiemanh Pham, Leonard Rubenstein, Nancy Glass
Chris Beyrer, Sonal Singh

Abstract
Importance: Refugees and internally displaced persons are highly vulnerable to sexual violence during conflict and subsequent displacement. However, accurate estimates of the prevalence of sexual violence among in these populations remain uncertain.

Objective: Our objective was to estimate the prevalence of sexual violence among refugees and displaced persons in complex humanitarian emergencies.

Data Source: We conducted systematic review of relevant literature in multiple databases (EMBASE, CINAHL, and MEDLINE) through February 2013 to identify studies. We also reviewed reference lists of included articles to identify any missing sources.

Study Selection: Inclusion criteria required identification of sexual violence among refugees and internally displaced persons or those displaced by conflict in complex humanitarian settings. Studies were excluded if they did not provide female sexual violence prevalence, or that included only single case reports, anecdotes, and those that focused on displacement associated with natural disasters. After a review of 1175 citations 19 unique studies were selected.

Data Extraction: Two reviewers worked independently to identify final selection and a third reviewer adjudicated any differences. Descriptive and quantitative information was extracted; prevalence estimates were synthesized. Heterogeneity was assessed using I2.

Main Outcomes: The main outcome of interest was sexual violence among female refugees and internally displaced persons in complex humanitarian settings.

Results: The prevalence of sexual violence was estimated at 21.4% (95% CI, 14.9-28.7; I2=98.3%), using a random effects model. Statistical heterogeneity was noted with studies using probability sampling designs reporting lower prevalence of sexual violence (21.0%, 95% CI, 13.2-30.1; I2=98.6%), compared to lower quality studies (21.7%, 95% CI, 11.5-34.2; I2=97.4%). We could not rule out the presence of publication bias.

Conclusions: The findings suggest that approximately one in five refugees or displaced women in complex humanitarian settings experienced sexual violence. However, this is likely an underestimation of the true prevalence given the multiple existing barriers associated with disclosure. The long-term health and social consequences of sexual violence for women and their families necessitate strategies to improve identification of survivors of sexual violence and increase prevention and response interventions in these complex settings.

PLOS Currents: Disasters
http://currents.plos.org/disasters/

The Gender Analysis Tools Applied in Natural Disasters Management: A Systematic Literature Review
Sanaz Sohrabizadeh, Sogand Tourani, Hamid Reza Khankeh

Abstract
Background: Although natural disasters have caused considerable damages around the world, and gender analysis can improve community disaster preparedness or mitigation, there is little research about the gendered analytical tools and methods in communities exposed to natural disasters and hazards. These tools evaluate gender vulnerability and capacity in pre-disaster and post-disaster phases of the disaster management cycle.

Objectives: Identifying the analytical gender tools and the strengths and limitations of them as well as determining gender analysis studies which had emphasized on the importance of using gender analysis in disasters.

Methods: The literature search was conducted in June 2013 using PubMed, Web of Sciences, ProQuest Research Library, World Health Organization Library, Gender and Disaster Network (GDN) archive. All articles, guidelines, fact sheets and other materials that provided an analytical framework for a gender analysis approach in disasters were included and the non-English documents as well as gender studies of non-disasters area were excluded. Analysis of the included studies was done separately by descriptive and thematic analyses.

Results: A total of 207 documents were retrieved, of which only nine references were included. Of these, 45% were in form of checklist, 33% case study report, and the remaining 22% were article. All selected papers were published within the period 1994-2012.

Conclusions: A focus on women’s vulnerability in the related research and the lack of valid and reliable gender analysis tools were considerable issues identified by the literature review. Although non-English literatures with English abstract were included in the study, the possible exclusion of non-English ones was found as the limitation of this study.

PLoS Neglected Tropical Diseases
February 2014
http://www.plosntds.org/article/browseIssue.action

Yellow Fever Outbreaks in Unvaccinated Populations, Brazil, 2008–2009
Alessandro Pecego Martins Romano, Zouraide Guerra Antunes Costa, Daniel Garkauskas Ramos, Maria Auxiliadora Andrade, Valéria de Sá Jayme, Marco Antônio Barreto de Almeida, Kátia Campomar Vettorello, Melissa Mascheretti, Brendan Flannery
Research Article | published 13 Mar 2014 | PLOS Neglected Tropical Diseases 10.1371/journal.pntd.0002740
http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0002740

Abstract
Due to the risk of severe vaccine-associated adverse events, yellow fever vaccination in Brazil is only recommended in areas considered at risk for disease. From September 2008 through June 2009, two outbreaks of yellow fever in previously unvaccinated populations resulted in 21 confirmed cases with 9 deaths (case-fatality, 43%) in the southern state of Rio Grande do Sul and 28 cases with 11 deaths (39%) in Sao Paulo state. Epizootic deaths of non-human primates were reported before and during the outbreak. Over 5.5 million doses of yellow fever vaccine were administered in the two most affected states. Vaccine-associated adverse events were associated with six deaths due to acute viscerotropic disease (0.8 deaths per million doses administered) and 45 cases of acute neurotropic disease (5.6 per million doses administered). Yellow fever vaccine recommendations were revised to include areas in Brazil previously not considered at risk for yellow fever.

Author Summary
Yellow fever is a viral hemorrhagic disease transmitted by mosquitos, endemic in tropical regions of Africa and South America. Large urban outbreaks of yellow fever have been eliminated in the Americas, where most yellow fever cases result from human exposure to jungle or forested environments. Vaccination is effective but carries a risk of potentially fatal adverse events in a small number of vaccinees. In a large country such as Brazil, vaccination is recommended only in areas where there is a risk of exposure to yellow fever virus. We describe two outbreaks of yellow fever in areas without yellow fever vaccine recommendations. Numerous epizootics, or die-offs of non-human primates, were reported from areas with human cases. In response to the outbreaks and epizootic activity, over five million doses of vaccine were administered in previously unvaccinated populations, resulting in vaccine associated adverse events, six of which were fatal. The outbreaks resulted in expansion of areas with yellow fever vaccine recommendations, and highlight the need for safer yellow fever vaccines.

PNAS – Proceedings of the National Academy of Sciences of the United States
of America
http://www.pnas.org/content/early/
(Accessed 22 March 2014)

The reputational and social network benefits of prosociality in an Andean community
Henry F. Lyle IIIa,1 and Eric A. Smitha,b
Author Affiliations
Edited by H. Russell Bernard, University of Florida, Gainesville, FL, and approved February 6, 2014 (received for review October 2, 2013)
http://www.pnas.org/content/early/2014/03/12/1318372111.abstract

Significance
Scientists have long debated how group cooperation can be maintained. From many standard evolutionary and economic perspectives, the best decision for an individual is to engage in free riding on the cooperation of others (i.e., share in the benefits but pay no costs). Such free riding, however, reduces the collective benefits of group cooperation and can unravel cooperation. Some propose that this “tragedy of the commons” can be solved if cooperators are compensated with reputational benefits. Our research in an Andean community found that cooperative households have better reputations for various qualities and have larger support networks, with the latter associated with healthier households. This finding supports the argument that positive reputations gained by cooperators can solve the tragedy of the commons.

Abstract
Several theories have emerged to explain how group cooperation (collective action) can arise and be maintained in the face of incentives to engage in free riding. Explanations focusing on reputational benefits and partner choice have particular promise for cases in which punishment is absent or insufficient to deter free riding. In indigenous communities of highland Peru, collective action is pervasive and provides critical benefits. Participation in collective action is unequal across households, but all households share its benefits. Importantly, investment in collective action involves considerable time, energy, and risk. Differential participation in collective action can convey information about qualities of fellow community members that are not easily observable otherwise, such as cooperative intent, knowledge, work ethic, skill, and/or physical vitality. Conveying such information may enhance access to adaptive support networks. Interview and observational data collected in a Peruvian highland community indicate that persons who contributed more to collective action had greater reputations as reliable, hard workers with regard to collective action and also were considered the most respected, influential, and generous people in the community. Additionally, household heads with greater reputations had more social support partners (measured as network in degree centrality), and households with larger support networks experienced fewer illness symptoms.

Public Health Ethics
Volume 7 Issue 1 April 2014
http://phe.oxfordjournals.org/content/current

Recruiting and Educating Participants for Enrollment in HIV-Vaccine Research: Ethical Implications of the Results of an Empirical Investigation
Sibusiso Sifunda*
HIV, AIDS, STIs & TB (HAST), Human Sciences Research Council, Pretoria, South Africa
Priscilla Reddy
Population Health, Health Systems & Innovation (PHHSI), Human Sciences Research Council, Cape Town, South Africa
Nasheen Naidoo
Health Promotion Research and Development Unit, Medical Research Council, Cape Town
Shamagonam James
Health Promotion Research and Development Unit, Medical Research Council, Cape Town
David Buchanan
Author Affiliations
School of Public Health and Health Sciences, University of Massachusetts at Amherst and Director of the Institute for Global Health
http://phe.oxfordjournals.org/content/7/1/78.abstract

Abstract
The study reports on the results of an empirical investigation of the education and recruitment processes used in HIV vaccine trials conducted in South Africa. Interviews were conducted with 21 key informants involved in HIV vaccine research in South Africa and three focus groups of community advisory board members. Data analysis identified seven major themes on the relationship between education and recruitment: the process of recruitment, the combined dual role of educators and recruiters, conflicts perceived by field staff, pressure to achieve recruitment targets, problems in achieving comprehension, accountability and education as capacity building. The results raise ethical concerns about the adequacy of current informed consent processes in these settings. The study findings bear directly on current debates about issues of exploitation and the scope of moral responsibilities of researchers and funding agencies to assure that HIV clinical prevention research is conducted ethically.

Public Health Ethics
Volume 7 Issue 1 April 2014
http://phe.oxfordjournals.org/content/current

Ethical Challenges in Implementation Research
Ruth Macklin*
Author Affiliations
Department of Epidemiology & Population Health, Albert Einstein College of Medicine
http://phe.oxfordjournals.org/content/7/1/86.abstract

Abstract
Implementation research is increasingly common in developing countries as a way of studying the introduction to the population of health interventions that have been proven to be effective elsewhere. Implementation studies are often conducted as cluster randomized trials, a design that raises ethical and conceptual questions different from those in conventional randomized controlled trials. It is often unclear who the subjects of the research are, informed consent may be difficult or impossible to obtain and controversy surrounds the use of comparison clusters that provide substandard care to the population where the research is carried out. An examination of protocols for this type of research reveals uncertainty on the part of researchers themselves about whom or what they are studying and from whom (if anyone) informed consent is required.

Risk Analysis
March 2014  Volume 34, Issue 3  Pages 399–598
http://onlinelibrary.wiley.com/doi/10.1111/risa.2014.34.issue-2/issuetoc

Original Research Article
Toward Disaster-Resilient Cities: Characterizing Resilience of Infrastructure Systems with Expert Judgments
Stephanie E. Chang*, Timothy McDaniels, Jana Fox, Rajan Dhariwal and Holly Longstaff
Article first published online: 23 OCT 2013
DOI: 10.1111/risa.12133
http://onlinelibrary.wiley.com/doi/10.1111/risa.12133/abstract

Abstract
Resilient infrastructure systems are essential for cities to withstand and rapidly recover from natural and human-induced disasters, yet electric power, transportation, and other infrastructures are highly vulnerable and interdependent. New approaches for characterizing the resilience of sets of infrastructure systems are urgently needed, at community and regional scales. This article develops a practical approach for analysts to characterize a community’s infrastructure vulnerability and resilience in disasters. It addresses key challenges of incomplete incentives, partial information, and few opportunities for learning. The approach is demonstrated for Metro Vancouver, Canada, in the context of earthquake and flood risk. The methodological approach is practical and focuses on potential disruptions to infrastructure services. In spirit, it resembles probability elicitation with multiple experts; however, it elicits disruption and recovery over time, rather than uncertainties regarding system function at a given point in time. It develops information on regional infrastructure risk and engages infrastructure organizations in the process. Information sharing, iteration, and learning among the participants provide the basis for more informed estimates of infrastructure system robustness and recovery that incorporate the potential for interdependent failures after an extreme event. Results demonstrate the vital importance of cross-sectoral communication to develop shared understanding of regional infrastructure disruption in disasters. For Vancouver, specific results indicate that in a hypothetical M7.3 earthquake, virtually all infrastructures would suffer severe disruption of service in the immediate aftermath, with many experiencing moderate disruption two weeks afterward. Electric power, land transportation, and telecommunications are identified as core infrastructure sectors.

Sustainability
Volume 6, Issue 3 (March 2014), Pages 1107-
http://www.mdpi.com/2071-1050/6/2

Factors Influencing Household Food Security in West Africa: The Case of Southern Niger
by Seydou Zakari, Liu Ying and Baohui Song
Sustainability 2014, 6(3), 1191-1202; doi:10.3390/su6031191
Received: 10 January 2014; in revised form: 31 January 2014 / Accepted: 11 February 2014 / Published: 5 March 2014

Abstract
Food insecurity is a major challenge for Niger and for many African countries. The purpose of this study is to investigate the factors affecting household food security in Niger. Based on survey data covering 500 households, drought, high food prices, poverty, soil infertility, disease and insect attacks are reported by the respondents to be the main causes of food insecurity. The empirical results from logistic regression revealed that the gender of the head of household, diseases and pests, labor supply, flooding, poverty, access to market, the distance away from the main road and food aid are significant factors influencing the odds ratio of a household having enough daily rations. Another important finding is that female headed households are more vulnerable to food insecurity compared to male headed households. The findings of this study provide evidence that food insecurity continues to affect the Nigerien population.

Intellectual and Developmental Disabilities
February 2014, Vol. 52, No. 1, pp. 49-59.
Practice
Peer-Mentored Preparedness (PM-Prep): A New Disaster Preparedness Program for Adults Living Independently in the Community
David Paul Eisenman , Alicia Bazzano , Deborah Koniak-Griffin , Chi-hong Tseng , Mary-Ann Lewis , Kerry Lamb , and Danise Lehrer
doi: http://dx.doi.org/10.1352/1934-9556-52.1.49

Abstract
The authors studied a health promotion program called PM-Prep (Peer-Mentored Prep), which was designed to improve disaster preparedness among adults living independently in the community. PM-Prep consists of four 2-hour classes co-taught by a health educator and peer-mentors. Adults were randomly assigned to an experimental arm or a wait-list control arm. Earthquake safety knowledge and preparedness supplies were assessed prior to the intervention and at 1 month after the intervention (N  =  82). Adults in the experimental arm significantly increased preparedness by 19 percentage points, from 56% to 75% completed (p < .0001), and improved their knowledge by 8 percentage points, from 79% to 87% correct (p  =  .001). This is the first peer-mentored, targeted, and tailored disaster preparedness program tested with this population.

Book: Culture, Indigenous Knowledge and Development in Africa: Reviving Interconnections for Sustainable Development
Mawere, Munyaradzi
Langaa RPCIG, Mar 16, 2014 – Social Science – 184 pages

The continent of Africa is richly endowed with diverse cultures, a body of indigenous knowledge and technologies. These bodies of knowledge and technologies that are indeed embodied in the diverse African cultures are as old as humankind. From time immemorial, they have been used to solve socio-economic, political, health, and environmental problems, and to respond to the development needs of Africans. Yet with the advent of colonialism and Western scientism, these African cultures, knowledges, and technologies have been despised and relegated to the periphery, to the detriment of the self-reliant development of Africans. It is out of this observation and realisation that this book was born. The book is an exploration of the practical problems resulting from Africa’s encounter with Euro-colonialism, a reflection of the nexus between indigenous knowledge, culture, and development, and indeed a call for the revival and reinstitution of indigenous knowledge, not as a challenge to Western science, but a complementary form of knowledge necessary to steer and promote sustainable development in Africa and beyond.

An Ethical Framework for the development and review of health research proposals involving humanitarian contexts

David R. Curry, Ronald J. Waldman, Arthur L. Caplan
Enhancing Learning and Research for Humanitarian Assistance (ELRHA): R2HC Programme –
Department for International Development (DFID) and the Wellcome Trust

Abstract
The authors propose an ethical framework to 1) guide development of research designs and protocols intended for implementation in humanitarian crises and complex emergency contexts to help ensure their ethical viability, and 2) support ethical review of such protocols by independent ethical review bodies (REBs, IRBs), funders, and other organizations of interest, and 3) serve general educational purposes and enhance public understanding of the issues involved in and ethical principles guiding research in such settings. The framework is designed as a tool – offering a practical and easily implementable approach in which key ethical principles are considered in a clustered, hierarchical order. Implementation and assessment of the utility of this approach by researchers and by REBs/IRBs considering research protocols involving humanitarian crisis setting will guide further refinement of this ethical framework.

Conference Paper: Ethics in Humanitarian Assistance for Host Communities
Aung Zaw Win (Total E&P) | Swe Swe Win (Total E&P Myanmar)
SPE-168388-MS
SPE International Conference on Health, Safety, and Environment, 17-19 March 2014, Long Beach, California, USA
Society of Petroleum Engineers
DOI: http://dx.doi.org/10.2118/168388-MS

Abstract
Since 1995, Total has been involved in gas production activities in southern Myanmar as operator of the Yadana consortium. Besides its industrial activities, the company is also running a socio-economic program covering 33 villages, several of them located near the seashore. In 2012, one of these villages suffered from coastal erosion, resulting in the destruction of 12 houses by strong waves.

In order to prevent further damage during the following monsoon, local authorities decided to relocate the whole village up in the orchards on the hill at the back of the village. They planned to ask some orchard owners to donate portions of land, and to use laborers from the community for moving the houses. They also requested O&G companies operating in the area (Total E&P Myanmar (TEPM) among others) to assist with heavy machines and manpower for leveling the ground planned for relocation.

When it received the request, TEPM found itself in a dilemma. Putting safety on top of its priorities, and committed by its Ethics Charter to support local communities, the company was willing to get involved in a project aimed at protecting villagers against natural hazards. On the other hand, displacement of a community is a sensitive matter that can lead to violation of human rights (forced relocation, seizure of land, compulsory labor) that the same Ethics Charter commits to promote. The question appeared particularly difficult to handle after the TEPM socio-economic team witnessed on the ground that some villagers were not convinced by this plan, while some others did not fully understand what was about to happen. Therefore, before accepting the request from local authorities, the company had to take proper steps to ensure it would not be taken into a process where the rights of the villagers to live in a safe place would come into conflict with their other fundamental rights.

The contribution presents the different steps and the exhaustive dialogue initiated by the company between the multiple stakeholders to ensure that this project could and would be handled in full respect of villagers’ rights, and whether the company would be involved or not.