Filter
3179
Text search:
malaria
cases
Featured
305
1080
Language
3070
88
46
24
23
16
9
5
2
2
2
2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Document type
1792
584
356
159
121
60
46
29
14
9
5
3
1
Countries
161
159
126
111
107
104
85
76
73
69
65
60
58
56
55
52
49
48
44
43
39
37
37
31
30
28
27
26
25
25
24
23
22
21
19
18
17
17
17
15
14
14
13
12
10
9
8
7
7
7
7
7
7
6
6
6
6
5
5
5
5
5
5
4
4
4
4
4
4
4
4
3
3
3
3
3
3
3
3
3
3
2
2
2
2
2
2
2
2
2
2
2
2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Authors & Publishers
386
166
103
77
74
61
57
53
45
34
22
20
20
20
17
16
16
15
15
15
15
14
14
13
12
12
12
12
11
11
11
10
10
10
10
9
9
9
9
9
9
9
8
8
8
8
8
8
8
8
8
7
7
7
7
7
7
7
7
7
7
7
7
7
6
6
6
6
6
6
6
6
6
6
6
6
6
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Publication Years
807
2025
326
21
Category
1497
210
175
170
162
67
43
Toolboxes
173
173
163
156
120
106
93
87
73
69
69
64
62
49
47
45
40
33
21
20
18
17
14
5
4
2
1
Ebola Synthesis Reference Document
Powell, Steve and others
International Federation of Red Cross and Red Crescent Societies (IFRC)
(2017)
C1
A survey of prevention, testing and treatment policies and practices
The duration of breastfeeding and support from health services to improve feeding practices among mothers living with HIV
This operational guidance, developed by WHO, UNICEF and ENN, outlines the duration of breastfeeding and support from health services to improve infant feeding practices amon ... g mothers living with HIV. It is intended to be used to complement emergency and sectoral guidelines on health, nutrition and HIV, including specifically infant feeding, prevention of mother-to-child transmission of HIV and paediatric antiretroviral treatment. more
This operational guidance, developed by WHO, UNICEF and ENN, outlines the duration of breastfeeding and support from health services to improve infant feeding practices amon ... g mothers living with HIV. It is intended to be used to complement emergency and sectoral guidelines on health, nutrition and HIV, including specifically infant feeding, prevention of mother-to-child transmission of HIV and paediatric antiretroviral treatment. more
no cover page / publication year available
The process to develop this "National Traditional Medicine Policy" included a detailed situational analysis of traditional medicine in Liberia and a desk review of relevant documents and the regional policy framework on the alignment of WAHO countries ... policy harmonization. more
The process to develop this "National Traditional Medicine Policy" included a detailed situational analysis of traditional medicine in Liberia and a desk review of relevant documents and the regional policy framework on the alignment of WAHO countries ... policy harmonization. more
Pathways to progress: a multi-level approach to strengthening health systems
Samuels, F., Amaya, A.B., Rodríguez Pose, R. and Balabanova, D.
Overseas Development Institute
(2014)
C1
Findings on maternal and child health in Nepal, Mozambique and
Rwanda, and neglected tropical diseases in Cambodia and Sierra Leone | This report synthesises findings from five country case studies from the health dimension of this project, which focus on maternal and child health (MCH) (Mozambique
...
,Nepal, Rwanda) and neglected tropical diseases (NTDs)(Cambodia, Sierra Leone). MCH was selected given its centrality in two of the Millennium Development Goals (MDGs) and its ability to act as a proxy for strengthened health systems. NTDs, while until recently relatively neglected in global policy debates, are now attracting more interest, not least because they are viewed as diseases of the poor whose treatment could positively impact on most of the other MDGs.
more
The Kabeho Mwana project (2006–2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda’s 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In p
...
roject districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems. The iCCM model implemented by Kabeho Mwana resulted in greater improvements in care-seeking than those seen in the rest of the country. Intensive monitoring, collaborative supervision, community mobilization, and CHW PSGs contributed to this success. The PSGs were a unique contribution of the project, playing a critical role in improving care-seeking in project districts. Effective implementation of iCCM should therefore include CHW management and social support mechanisms. Finally, re-analysis of national survey data improved evaluation findings by providing impact estimates.
more
The objective of the evaluation is to understand whether the CHW program has achieved its intended objectives, thus contributing to the overarching objectives defined in the HSSP III of improving the health status of the population by “Ensuring universal accessibility of quality health services fo
...
r all Rwandans”.
This evaluation has focused on CHWs, who are selected, trained and deployed by the MoH to deliver a defined set of tasks at community level. CHWs are the central element of the Community Health Policy and of the community health strategy plan (CHSP) of the MoH.
more
The purpose of the situation assessment was to execute a situation analysis for Autism and Neurodevelopment Disorder (NDD) in Bangladesh. The situation assessment covers the following areas: a review of the scale and prevalence of NDD with trends of the disorder in the recent past in Bangladesh (see
...
page 17); estimation of likely disease burden in the near future (see page 27); assessment of the social response to NDD in Bangladesh (see page 67); overview of the support and services required by persons with NDD (see page 79); an inventory of service providers working with NDD in Bangladesh (see page 85); an assessment of the adequacy of the existing services and support available for addressing NDD in country (see page 97); an overview of the role and preparedness of MOHFW and other stakeholders in addressing NDD in Bangladesh (see page 108); recommendations for monitoring, supervision and reporting mechanisms for NDD services at the national level (see page 167); and recommended key activities that should be undertaken by the Health and other relevant ministries in the short and medium term (see page 167).
more
This booklet presents key messages for action, summarized from a set of chapters on different environmental health issues, available at www.who.int/ ceh/publications/healthyenvironmentsforhealthychildren. The work is a result of an on-going partnership between WHO, UNEP and UNICEF in the area of chi
...
ldren’s environmental health, and seeks to update the 2002 joint publication “Children in the New Millennium: Environmental Impact on Health.”
more
World Relief published a new report revealing the immense impact of COVID-19 on the world's poor. This report is one of the most comprehensive of its kind, corresponding to the two-year anniversary of when the World Health Organization declared COVID-19 to be a global pandemic.
The uneven distribution of HIV risks and burdens across populations is a well-substantiated fact, though seldom publicly acknowledged. Gay men and other men who have sex with men, people who inject drugs, sex workers, and transgender women are 24, 24, 13.5, and 49 times more likely to acquire HIV,
...
respectively, than other reproductive aged adults (15 years old and older). Globally, new infections among these key populations account for 45% of all new HIV infections. This figure is likely to be an underestimate, given the intense stigma associated with disclosing and reporting acquisition risks for HIV among gay men, people who use drugs, sex workers, and transgender people. In addition, HIV epidemics in the majority of low- and middle-income countries (90 of 120) have concentrated epidemics among key populations. In countries with more broadly generalized epidemics, risks are still not evenly distributed and key populations still shoulder disease burden that is markedly disproportionate.
more
The purpose of the PAS III is to guide Pakistan’s overall national response for HIV and AIDS through 2020, through focused interventions with set targets, costs, roles and responsibilities. The successful implementation of PAS III involves multiple stakeholders to achieve priority outcomes outline
...
d in the Strategy. The Strategy focuses on allocating limited resources to scale up high-impact, high-value interventions such as HTC and treatment to reduce AIDS related deaths and new HIV infections. Priorities in the PAS III have been identified to ensure maximum impact in reducing new infections, especially among key populations, improving treatment uptake and retention, and improving the quality of life of people living with HIV and AIDS in the context of limited financial and human resources.
more
The provision of safe and efficacious blood and blood components for transfusion or manufacturing use involves a number of processes, from the selection of blood donors and the collection, processing and testing of blood donations to the testing of patient samples, the issue of compatible blood and
...
its administration to the patient. There is a risk of error in each process in this “transfusion chain” and a failure at any of these stages can have serious implications for the recipients of blood and blood products. Thus, while blood transfusion can be life-saving, there are associated risks, particularly the transmission of bloodborne infections.
Screening for transfusion-transmissible infections (TTIs) to exclude blood donations at risk of transmitting infection from donors to recipients is a critical part of the process of ensuring that transfusion is as safe as possible. Effective screening for evidence of the presence of the most common and dangerous TTIs can reduce the risk of transmission to very low levels. more
Screening for transfusion-transmissible infections (TTIs) to exclude blood donations at risk of transmitting infection from donors to recipients is a critical part of the process of ensuring that transfusion is as safe as possible. Effective screening for evidence of the presence of the most common and dangerous TTIs can reduce the risk of transmission to very low levels. more
- Twenty-two joint integrated rapid response mechanism (IRRM) missions were conducted in 11 counties and reached 305,887 people including 65,432 children under 5 years of age.
- UNICEF’s Integrated Community Mobilization Network reached 345,219 households (total population 2.1 million) advoca ... ting for child rights focused on child survival, birth notification, education and protection. Three million people have been reached with advocacy and life-saving messages through radio and community engagement activities, including activities focused on youth and faith leaders.
- On 27 June, discussions between President Salva Kiir and former First Vice President Riek Machar in Khartoum culminated in agreement to a permanent ceasefire and the opening of humanitarian corridors, effective 30 June. more
- UNICEF’s Integrated Community Mobilization Network reached 345,219 households (total population 2.1 million) advoca ... ting for child rights focused on child survival, birth notification, education and protection. Three million people have been reached with advocacy and life-saving messages through radio and community engagement activities, including activities focused on youth and faith leaders.
- On 27 June, discussions between President Salva Kiir and former First Vice President Riek Machar in Khartoum culminated in agreement to a permanent ceasefire and the opening of humanitarian corridors, effective 30 June. more
Submitted to the US Agency for International Development by the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. Arlington, VA: Management Sciences for Health. Submitted to the United Nations Children’s Fund by JSI, Arlington, VA: JSI Research & Training Institute, Inc.
...
This guide will assist program managers, service providers, and technical experts when conducting a quantification of commodity needs for the 13 reproductive, maternal, newborn, and child health commodities prioritized by the UN Commission on Life-Saving Commodities for Women and Children. This quantification supplement should be used with the main guide—Quantification of Health Commodities: A Guide to Forecasting and Supply Planning for Procurement. * This supplement describes the steps in forecasting consumption of these supplies when consumption and service data are not available; after which, to complete the quantification, the users should refer to the main quantification guide for the supply planning step.
more
The USAID | DELIVER PROJECT, Task Order 4, developed this guide for quantifying health commodities; it will assist technical advisors, program managers, warehouse managers, procurement officers, and service providers in (1) estimating the total commodity needs and costs for successful implementation
...
of national health program strategies and goals, (2) identifying the funding needs and gaps for procuring the required commodities, and (3) planning procurements and shipment delivery schedules to ensure a sustained and effective supply of health commodities.
The step-by-step approach to quantification presented in this guide is complemented by a set of product-specific companion pieces that include detailed instructions for forecasting consumption of antiretroviral drugs, HIV test kits, antimalarial drugs, and laboratory supplies.
more
Improving medicines access and use for child health: a guide to developing interventions
Ross-Degnan, D., Vialle-Valentin, C., and Briggs, J.
USAID, SIAPS (Systems for Improved Access to Pharmaceuticals and Services)
(2015)
C1
Submitted to the US Agency for International Development by the
Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program.
This manual provides a framework to identify problems and design interventions to improve access to and use of medicines for children. It is a resource for
...
both health policy makers and health system managers and presents a structured approach to the steps introduced in the framework in the context of child health.
more
Women and Health Initiative Working Paper No. 1. Women and Health Initiative
Improving maternal health in the context of the sub-Saharan African HIV epidemic requires greater understanding of the relationships between HIV disease and maternal morbidity and mortality, integrated and effective resp ... onses by the health system, and a social context which promotes quality care and encourages use of MCH and HIV services. Advancing the proposed research agenda will make an invaluable contribution by generating needed evidence for policy and practice that improves the maternal health of women who are living with HIV, as well as those who are not. Bringing together maternal health and HIV researchers, policy-makers and program implementers to reduce HIV-related maternal morbidity and mortality and improve the HIV response for women represents an opportunity and a challenge. more
Improving maternal health in the context of the sub-Saharan African HIV epidemic requires greater understanding of the relationships between HIV disease and maternal morbidity and mortality, integrated and effective resp ... onses by the health system, and a social context which promotes quality care and encourages use of MCH and HIV services. Advancing the proposed research agenda will make an invaluable contribution by generating needed evidence for policy and practice that improves the maternal health of women who are living with HIV, as well as those who are not. Bringing together maternal health and HIV researchers, policy-makers and program implementers to reduce HIV-related maternal morbidity and mortality and improve the HIV response for women represents an opportunity and a challenge. more