DHS Further Analysis Reports No. 90 - In Rwanda, between 2005 and 2010, there have been radical declines in the desired number of children, actual fertility, and child mortality along with a large increase in contraceptive prevalence. This study reviews trends in some of these measures. Multivariate... analyses evaluate the relative importance for
the desired number of children of years of schooling, wealth, urban residence, media exposure, child mortality, and attitudes toward gender equality. Variations in reproductive preferences, the total fertility rate, and unmet need for family planning are mapped for the 30 districts of Rwanda. The explanations for the rapid changes in reproductive attitudes and behavior are clearly related to the concerns of the country, the rapid rate of population growth, and its implications for economic development and reproductive health.
more
The use of the World Health Organization Health System Performance Assessment Framework
This brief highlights the urgency of addressing gender inequalities across the Rio Conventions, provides examples of where progress has been made, and identifies clear entry points for addressing gender equality considerations across the Conventions. It makes recommendations for actions to accelerat...e the synergistic implementation of the gender provisions and action plans of the Conventions.
more
This study identifies barriers and provides recommendations to improve asthma care in children across sub-Saharan Africa, where qualitative data is lacking despite high rates.
Objectives Our study aimed to systematically review the literature and synthesise findings on potential associations of built environment characteristics with type 2 diabetes (T2D) in Asia.
Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
more
A global Pandemic, Preparedness and Response (RRR) architecture
These guidelines have been compiled for education ministries or other educational leaders (including development partners, non-governmental or private organizations working with schools or directly with caregivers) who want to adapt and adopt resources to support the marginalized caregivers of child...ren with disabilities.
The guidance presented in this document was developed by a team of international and national experts following a proof-of-concept pilot4 of the resources in two countries. The work was carried out between February 2021 and January 2022. The pilots demonstrated that principles and activities described in the resources could be carried out, in practical terms, in line with existing government programmes supporting the implementation of disability-inclusive education.
more
This report, which involved input from across WaterAid, in particular from the Programme Support Unit (PSU) of WaterAid UK, includes case studies from a variety of countries, including Bangladesh, Burkina Faso, Eswatini, Ethiopia, Ghana, India and Nepal, each demonstrating what must be done now to i...mprove WASH services and address current challenges, in order to increase community resilience to climate change.
more
PlosOne Published: July 14, 2021
https://doi.org/10.1371/journal.pone.0254339
The discourse on climate change and migration has shifted from labelling migration merely as a consequence of climate impacts, to describing it as a form of human adaptation. This article explores the adaptation framing of the climate change and migration nexus and highlights its shortcomings and ad...vantages. While for some groups, under certain circumstances migration can be an effective form of adaptation, for others it leads to increased vulnerabilities and a poverty spiral, reducing their adaptive apacities. Non-economic losses connected to a change of place further challenge the notion of successful adaptation. Even when migration improves the situation of a household, it may conceal the lack of action on climate change adaptation from national governments or the international community. Given the growing body of evidence on the diverse circumstances and outcomes of migration
in the context of climate change, we distinguish between reactive and proactive migration and argue for a precise differentiation in the academic debate
more
Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This s...tudy aimed to test both interventions in low-income and middle-income countries.
more
PlosOne January 20, 2021
https://doi.org/10.1371/journal.pone.0241899
Antibiotic fixed dose combinations (FDCs) can have clinical advantages such as improving effectiveness and adherence to therapy. However, high use of potentially inappropriate FDCs has been reported, with implications for antim...icrobial resistance (AMR) and toxicity.
more
The early prevention project “Strong together!” supports refugee parents and their young children (0–4 years) in Berlin, Germany. It aims to mitigate the transmission of trauma to the generation born in exile. For refugee families who have only recently arrived in Germany, the COVID‐19 pande...mic poses a particularly great challenge. Not only are they confronted with numerous challenges in respect to rebuilding their lives in Germany after fleeing war and persecution, but are also vulnerable to conscious and unconscious anxieties, fantasies, and conflicts evoked by the pandemic and the threat it poses to their lives. This was observed in the context of the mother–child groups of “Strong together!”
more
Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such
communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now ...COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
more
High levels of storage iron may increase malaria susceptibility. This risk has not been investigated in semi-immune adolescents. We investigated whether baseline iron status of nonpregnant adolescent girls living in a high malaria transmission area in Burkina Faso affected malaria risk during the fo...llowing rainy season. For this prospective study, we analysed data from an interim safety survey, conducted six months into a randomised iron supplementation trial. We used logistic regression to model the risk of P. falciparum infection prevalence by microscopy, the pre-specified interim safety outcome, in relation to iron status, nutritional indicators and menarche assessed at recruitment.
more
The outbreak of COVID-19 comes with unpredictable primary and secondary impacts on vulnerable and food-insecure populations across the world. Mortality and morbidity appear to be most acute for elderly people, and those with underlying health conditions. At the same time, the widely anti...cipated economic downturn could have a more devastating effect on the world’s poor than the virus itself
more
School health programmes have been demonstrated to be the most cost-effective way to influence health behaviours in young people. The purpose of this two-part handbook is to support schools as they seek to implement interventions aimed at reducing the main modifiable risk behaviours f...or noncommunicable diseases (NCDs) . The background provided in this Introduction handbook and the approaches and advice outlined in the Practical application handbook focuses on providing young people with the knowledge, attitudes, beliefs and life skills necessary for making informed decisions, and creating a healthy school environment that can reduce the risk of NCDs
more
School health programmes are the most cost-effective way to influence health behaviours in young people. The purpose of this two-part handbook is to support schools as they seek to implement interventions in order to reduce the main modifiable risk behaviours for noncommunicable disea...ses. This Practical application handbook provides advice to schools on providing young people with the knowledge, attitudes, beliefs and life skills necessary for making informed decisions, and creating a healthy school environment that can reduce the risk of NCDs
more