Bulletin of the World Health Organization
Volume 93, Number 9, September 2015, 589-664
http://www.who.int/bulletin/volumes/93/9/en/

EDITORIALS
Maximizing the impact of community-based practitioners in the quest for universal health coverage
James Campbell, Kesetebirhan Admasu, Agnes Soucat & Sheila Tlou
doi: 10.2471/BLT.15.162198
Monitoring inequality: an emerging priority for health post-2015
Ahmad Reza Hosseinpoor, Nicole Bergen & Veronica Magar
doi: 10.2471/BLT.15.162081

Research
Cost–effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya
Barbara McPake, Ijeoma Edoka, Sophie Witter, Karina Kielmann, Miriam Taegtmeyer, Marjolein Dieleman, Kelsey Vaughan, Elvis Gama, Maryse Kok, Daniel Datiko, Lillian Otiso, Rukhsana Ahmed, Neil Squires, Chutima Suraratdecha & Giorgio Cometto
Abstract
Objective
To assess the cost–effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya.
Methods
Incremental cost–effectiveness ratios for the three programmes were estimated from a government perspective. Cost data were collected for 2012. Life years gained were estimated based on coverage of reproductive, maternal, neonatal and child health services. For Ethiopia and Kenya, estimates of coverage before and after the implementation of the programme were obtained from empirical studies. For Indonesia, coverage of health service interventions was estimated from routine data. We used the Lives Saved Tool to estimate the number of lives saved from changes in reproductive, maternal, neonatal and child health-service coverage. Gross domestic product per capita was used as the reference willingness-to-pay threshold value.
Findings
The estimated incremental cost per life year gained was 82 international dollars ($)in Kenya, $999 in Ethiopia and $3396 in Indonesia. The results were most sensitive to uncertainty in the estimates of life-years gained. Based on the results of probabilistic sensitivity analysis, there was greater than 80% certainty that each programme was cost-effective.
Conclusion
Community-based approaches are likely to be cost-effective for delivery of some essential health interventions where community-based practitioners operate within an integrated team supported by the health system. Community-based practitioners may be most appropriate in rural poor communities that have limited access to more qualified health professionals. Further research is required to understand which programmatic design features are critical to effectiveness.

Systematic Reviews
Data collection tools for maternal and child health in humanitarian emergencies: a systematic review
Thidar Pyone, Fiona Dickinson, Robbie Kerr, Cynthia Boschi-Pinto, Matthews Mathai & Nynke van den Broek
Abstract
Objective
To describe tools used for the assessment of maternal and child health issues in humanitarian emergency settings.
Methods
We systematically searched MEDLINE, Web of Knowledge and POPLINE databases for studies published between January 2000 and June 2014. We also searched the websites of organizations active in humanitarian emergencies. We included studies reporting the development or use of data collection tools concerning the health of women and children in humanitarian emergencies. We used narrative synthesis to summarize the studies.
Findings
We identified 100 studies: 80 reported on conflict situations and 20 followed natural disasters. Most studies (76/100) focused on the health status of the affected population while 24 focused on the availability and coverage of health services. Of 17 different data collection tools identified, 14 focused on sexual and reproductive health, nine concerned maternal, newborn and child health and four were used to collect information on sexual or gender-based violence. Sixty-nine studies were done for monitoring and evaluation purposes, 18 for advocacy, seven for operational research and six for needs assessment.
Conclusion
Practical and effective means of data collection are needed to inform life-saving actions in humanitarian emergencies. There are a wide variety of tools available, not all of which have been used in the field. A simplified, standardized tool should be developed for assessment of health issues in the early stages of humanitarian emergencies. A cluster approach is recommended, in partnership with operational researchers and humanitarian agencies, coordinated by the World Health Organization.

Achieving universal health coverage
Joseph Wong
doi: 10.2471/BLT.14.149070