Innovative approaches for improving maternal and newborn health – A landscape analysis

BMC Pregnancy and Childbirth
(Accessed 19 December 2015)

Research article
Innovative approaches for improving maternal and newborn health – A landscape analysis
Essential interventions can improve maternal and newborn health (MNH) outcomes in low- and middle-income countries, but their implementation has been challenging.
Karsten Lunze, Ariel Higgins-Steele, Aline Simen-Kapeu, Linda Vesel, Julia Kim and Kim Dickson
BMC Pregnancy and Childbirth 2015 15:337
Published on: 17 December 2015

BMC Public Health (Accessed 19 December 2015)

BMC Public Health
(Accessed 19 December 2015)

Research article
Implementation of a national school-based Human Papillomavirus (HPV) vaccine campaign in Fiji: knowledge, vaccine acceptability and information needs of parents
S. F. La Vincente, D. Mielnik, K. Jenkins, F. Bingwor, L. Volavola, H. Marshall, P. Druavesi, F. M. Russell, K. Lokuge and E. K. Mulholland
BMC Public Health 2015 15:1257
Published on: 18 December 2015
In 2008 Fiji implemented a nationwide Human Papillomavirus (HPV) vaccine campaign targeting all girls aged 9–12 years through the existing school-based immunisation program. Parents of vaccine-eligible girls were asked to provide written consent for vaccination. The purpose of this study was to describe parents’ knowledge, experiences and satisfaction with the campaign, the extent to which information needs for vaccine decision-making were met, and what factors were associated with vaccine consent.
Following vaccine introduction, a cross-sectional telephone survey was conducted with parents of vaccine-eligible girls from randomly selected schools, stratified by educational district. Factors related to vaccine consent were explored using Generalised Estimating Equations.
There were 560 vaccine-eligible girls attending the participating 19 schools at the time of the campaign. Among these, 313 parents could be contacted, with 293 agreeing to participate (93.6 %). Almost 80 % of participants reported having consented to HPV vaccination (230/293, 78.5 %). Reported knowledge of cervical cancer and HPV prior to the campaign was very low. Most respondents reported that they were satisfied with their access to information to make an informed decision about HPV vaccination (196/293, 66.9 %). and this was very strongly associated with provision of consent. Despite their young age, the vaccine-eligible girls were often involved in the discussion and decision-making. Most consenting parents were satisfied with the campaign and their decision to vaccinate, with almost 90 % indicating they would consent to future HPV vaccination. However, negative media reports about the vaccine campaign created confusion and concern. Local health staff were cited as a trusted source of information to guide decision-making. Just over half of the participants who withheld consent cited vaccine safety fears as the primary reason (23/44, 52.3 %).
This is the first reported experience of HPV introduction in a Pacific Island nation. In a challenging environment with limited community knowledge of HPV and cervical cancer, media controversy and a short lead-time for community education, Fiji has implemented an HPV vaccine campaign that was largely acceptable to the community and achieved a high level of participation. Community sensitisation and education is critical and should include a focus on the local health workforce and the vaccine target group.


Research article
Challenges to the surveillance of non-communicable diseases – a review of selected approaches
The rising global burden of non-communicable diseases (NCDs) necessitates the institutionalization of surveillance systems to track trends and evaluate interventions. However, NCD surveillance capacities var …
Mareike Kroll, Revati K Phalkey and Frauke Kraas
BMC Public Health 2015 15:1243
Published on: 16 December 2015

MERS-CoV geography and ecology in the Middle East: analyses of reported camel exposures and a preliminary risk map

BMC Research Notes
(Accessed 19 December 2015)

Research article
MERS-CoV geography and ecology in the Middle East: analyses of reported camel exposures and a preliminary risk map
Middle Eastern respiratory syndrome coronavirus (MERS-CoV) has spread rapidly across much of the Middle East, but no quantitative mapping of transmission risk has been developed to date.
Tarian Reeves, Abdallah M. Samy and A. Townsend Peterson
BMC Research Notes 2015 8:801
Published on: 18 December 2015

Responding to the needs of refugees

British Medical Journal
19 December 2015 (vol 351, issue 8038)

Editorials Christmas 2015
Responding to the needs of refugees
BMJ 2015; 351 doi: (Published 16 December 2015) Cite this as: BMJ 2015;351:h6731
Frank Arnold, convenor, anti-torture initiative1, Cornelius Katona, lead23, Juliet Cohen, head of doctors4, Lucy Jones, UK programme manager5, David McCoy, director16
Author affiliations
Knowledge of and skills in human rights medicine will be needed
At the time of writing it is unclear how many people will eventually receive refuge in Britain from encampments in countries surrounding Syria through the UN vulnerable persons relocation scheme. The government’s current commitment to receive a maximum of 20 000 over five years, if delivered at a constant rate, would result in 4000 arrivals a year.1 It is also unclear when they will arrive and what financial and other arrangements are being made for local councils to support them. But even if the UK maintains its decision to opt out of the EU refugee sharing scheme, the number of asylum seekers reaching the UK by other routes may increase, given that more than half a million people seeking protection arrived in Europe by sea in 2015.

Whatever the numbers, many will have high levels of complex physical, psychological, social, and legal needs arising from their experiences in their countries of origin or during their often prolonged and dangerous journeys. This is particularly the case for people admitted under the UN relocation scheme, which emphasises vulnerability and damage as primary selection criteria.2

These health needs will interact with each other and with wider social needs (housing, schooling, linguistic, and cultural support) to produce challenges that exceed the experience of most UK clinicians. The issues that the responsible practices and hospitals will need to address are many and complex but largely predictable (box). The current crisis must be met by a plan to train and support clinicians to assist this vulnerable group. Such a plan would also benefit the many traumatised, tortured, and ill refugees, asylum seekers, and undocumented migrants who are already in the country.

Common interacting medical needs of refugees
:: Post-traumatic stress disorder and other mental health problems resulting from trauma
:: Consequences of torture such as damage to feet from repeated blunt trauma or brachial plexus damage after suspension by hyper-extended arms
:: Screening for sexually transmitted diseases (if rape revealed)
:: Traumatic war injuries
Social and legal
:: Adequate interpreting
:: Access to primary and secondary care and difficulties of negotiating exemption from overseas visitors charging regulations
:: Protection from subsequent unsafe repatriation or redress may require careful documentation of medical evidence of human rights abuses, including photographs or clinical notes of physical or psychological damage on arrival

So what needs to happen? Government departments should make use of standard handheld records of medical information gleaned during selection for relocation and ensure that the data follow the patients to their new practitioners. The European Union is developing such a record.3 For people who require secondary care the Home Office should provide immigration status documents and circulate them with advice to relevant officers to prevent inappropriate attempts to charge user fees. The entitlements of migrants to care are complex, but survivors of torture and other human rights abuses do not have to pay under the current regulations.4 And unless a general practice has a policy requiring all new registrants to supply documents, to do so for migrants only would constitute impermissible discrimination.5

As health professionals, we are occupationally and morally required to offer the highest standard of healthcare to all patients, including survivors of human rights abuses who arrive on these shores.6 But clinicians need to be trained and supported to help this vulnerable group. The knowledge and skills in human rights medicine and psychology developed by a relatively small number of specialist health professionals within the NHS and third sector organisations needs to be harnessed and used wisely to enable this to happen. These organisations include Freedom from Torture (, the Helen Bamber Foundation (, and Doctors of the World ( The Royal Society of Medicine is hosting training sessions organised by Medact on clinical aspects of torture and trauma. Public Health England, which has a helpful Migrant Health Guide,7 the royal colleges, the BMA, and other health professional bodies can also facilitate relevant educational initiatives. Close collaboration between the statutory and charity sectors will be crucial.

The voice and mandate of health professionals also needs to be used to prevent xenophobia and tackle the root causes of the refugee crisis. We should make good use of the expressions of goodwill and solidarity from much of the UK population towards those who need help and highlight the past and potential long term economic and social contributions that such refugees have and can make in the UK. We should also seek to educate and engage the UK health community about the need to promote peace and human security, particularly in north Africa and the Middle East. The refugee crisis will not be resolved otherwise.

Clinical Infectious Diseases (CID) – Volume 62 Issue 1 January 1, 2016

Clinical Infectious Diseases (CID)
Volume 62 Issue 1 January 1, 2016

The Use of Ebola Convalescent Plasma to Treat Ebola Virus Disease in Resource-Constrained Settings: A Perspective From the Field
Johan van Griensven, Anja De Weiggheleire, Alexandre Delamou, Peter G. Smith, Tansy Edwards, Philippe Vandekerckhove, Elhadj Ibrahima Bah, Robert Colebunders, Isola Herve, Catherine Lazaygues, Nyankoye Haba, and Lutgarde Lynen
Clin Infect Dis. (2016) 62 (1): 69-74 doi:10.1093/cid/civ680
Clinical evaluation of convalescent plasma (CP) as Ebola treatment in the current outbreak was prioritized by the World Health Organization. Although no efficacy data are available, current field experience supports the safety, acceptability, and feasibility of CP as Ebola treatment.


Prevalence and Persistence of Varicella Antibodies in Previously Immunized Children and Youth With Perinatal HIV-1 Infection
Murli U. Purswani, Brad Karalius, Tzy-Jyun Yao, D. Scott Schmid, Sandra K. Burchett, George K. Siberry, Kunjal Patel, Russell B. Van Dyke, and Ram Yogev for the Pediatric HIV/AIDS Cohort Study (PHACS)
Clin Infect Dis. (2016) 62 (1): 106-114 doi:10.1093/cid/civ734
Long-term persistence of varicella antibodies was strongly associated with administration of 2 varicella vaccines in perinatally human immunodeficiency virus–infected children. Vaccination after ≥3 months of combination antiretroviral therapy and duration of such therapy were also determinants of vaccine immunogenicity

Assessment of the MSF triage system, separating patients into different wards pending Ebola virus laboratory confirmation, Kailahun, Sierra Leone, July to September 2014

Volume 20, Issue 50, 17 December 2015

Research Articles
Assessment of the MSF triage system, separating patients into different wards pending Ebola virus laboratory confirmation, Kailahun, Sierra Leone, July to September 2014
by F Vogt, G Fitzpatrick, G Patten, R van den Bergh, K Stinson, L Pandolfi, J Squire, T Decroo, H Declerck, M Van Herp

Global Health: Science and Practice (GHSP) – December 2015

Global Health: Science and Practice (GHSP)
December 2015 | Volume 3 | Issue 4

Behavior Change Fast and Slow: Changing Multiple Key Behaviors a Long-Term Proposition?
An intensive radio campaign in rural areas of Burkina Faso addressed multiple key behaviors to reduce child mortality, using a randomized cluster design. After 20 months, despite innovative approaches and high reported listenership, only modest reported change in behavior was found, mainly related to care seeking rather than habitual behavior such as hand washing. Various methodologic difficulties may have obscured a true greater impact. Analysis of the intervention after its full 35-month duration may reveal more impact, including on actual child mortality. Improving a number of key behaviors is essential to child survival efforts, and much of it may require strong and sustained efforts.
Glob Health Sci Pract 2015;3(4):521-524. First published online November 3, 2015.


Original Articles
The Saturation+ Approach to Behavior Change: Case Study of a Child Survival Radio Campaign in Burkina Faso
This randomized radio campaign focused on the 3 principles of the Saturation+ approach to behavior change: (1) saturation (high exposure to messages), (2) science (basing design on data and modeling), and (3) creative storytelling. Locally developed short spots and longer dramas targeted multiple child survival-related behaviors and were delivered entirely by local radio stations. Innovative partnerships with radio stations provided free airtime in return for training, equipment, and investment in solar power.
Joanna Murray, Pieter Remes, Rita Ilboudo, Mireille Belem, Souleymane Salouka, Will Snell,
Cathryn Wood, Matthew Lavoie, Laurent Deboise, Roy Head
Glob Health Sci Pract 2015;3(4):544-556. First published online November 3, 2015.


Monitoring and Evaluating the Transition of Large-Scale Programs in Global Health
Monitoring and evaluating large-scale global health program transitions can strengthen accountability, facilitate stakeholder engagement, and promote learning about the transition process and how best to manage it. We propose a conceptual framework with 4 main domains relevant to transitions—leadership, financing, programming, and service delivery—along with guiding questions and illustrative indicators to guide users through key aspects of monitoring and evaluating transition. We argue that monitoring and evaluating transitions can bring conceptual clarity to the transition process, provide a mechanism for accountability, facilitate engagement with local stakeholders, and inform the management of transition through learning.
James Bao, Daniela C Rodriguez, Ligia Paina, Sachiko Ozawa, Sara Bennett
Glob Health Sci Pract 2015;3(4):591-605.


Introduction of Mobile Health Tools to Support Ebola Surveillance and Contact Tracing in Guinea
An informatics system consisting of a mobile health application and business intelligence software was used for collecting and analyzing Ebola contact tracing data. This system offered potential to improve data access and quality to support evidence-based decision making for the Ebola response in Guinea. Implementation challenges included software limitations, technical literacy of users, coordination among partners, government capacity for data utilization, and data privacy concerns.
Jilian A Sacks, Elizabeth Zehe, Cindil Redick, Alhoussaine Bah, Kai Cowger, Mamady Camara,
Aboubacar Diallo, Abdel Nasser Iro Gigo, Ranu S Dhillon, Anne Liu
Glob Health Sci Pract 2015;3(4):646-659. First published online November 12, 2015.