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BMJ Global Health

Lindsay Stark, Khudejha Asghar, Ilana Seff, Gary Yu, Teame Tesfay Gessesse, Leora Ward, Asham Assazenew Baysa, Amy Neiman, Kathryn L Falb
Introduction: Interpersonal violence is a critical public health concern in humanitarian contexts, but evidence of effective violence prevention programmes targeting adolescent girls is lacking. We investigated the efficacy of a life skills and safe spaces programme to reduce adolescent girls' experiences of interpersonal violence in a refugee setting. Methods: In this two-arm, single-blinded, cluster randomised controlled trial, we recruited 919 Sudanese and South Sudanese girls ages 13-19 years residing in refugee camps in Ethiopia...
2018: BMJ Global Health
Lindsay Stark, Ilana Seff, Khudejha Asghar, Danielle Roth, Theresita Bakamore, Mairi MacRae, Cecile Fanton D'Andon, Kathryn L Falb
Introduction: Parenting programmes are increasingly popular for reducing children's exposure to interpersonal violence in low/middle-income countries, but there is limited evidence on their effectiveness. We investigated the incremental impact of adding a caregiver component to a life skills programme for adolescent girls, assessing girls' exposure to violence (sexual and others) and caregivers' gender attitudes and parenting behaviours. Methods: In this two-arm, single-blinded, cluster randomised controlled trial, we recruited 869 adolescent girls aged 10-14 and 764 caregivers in South Kivu, Democratic Republic of Congo...
2018: BMJ Global Health
Ajibola Awotiwon, Charlie Sword, Tracy Eastman, Christy Joy Ras, Prince Ana, Ruth Vania Cornick, Lara Fairall, Eric Bateman, Audry Dube, Robyn Curran, Inemesit Udoekwere, Unyime-Obong Essien, Okorie Assem, Theresa Sylvester Edu, Hajia Binta Ismail, Olalekan Olugbenga Olubajo, Joseph Ana
Nigeria, in its quest to strengthen its primary healthcare system, is faced with a number of challenges including a shortage of clinicians and skills. Methods are being sought to better equip primary healthcare clinicians for the clinical demands that they face. Using a mentorship model between developers in South Africa and Nigerian clinicians, the Practical Approach to Care Kit (PACK) for adult patients, a health systems strengthening programme, has been localised and piloted in 51 primary healthcare facilities in three Nigerian states...
2018: BMJ Global Health
Sandy Picken, Juliet Hannington, Lara Fairall, Tanya Doherty, Eric Bateman, Mark Richards, Camilla Wattrus, Ruth Cornick
Pioneering strategies like WHO's Integrated Management of Childhood Illness (IMCI) have resulted in substantial progress in addressing infant and child mortality. However, large inequalities exist in access to and the quality of care provided in different regions of the world. In many low-income and middle-income countries, childhood mortality remains a major concern, and the needs of children present a large burden upon primary care services. The capacity of services and quality of care offered require greater support to address these needs and extend integrated curative and preventive care, specifically, for the well child, the child with a long-term health need and the child older than 5 years, not currently included in IMCI...
2018: BMJ Global Health
Jamie Murdoch, Robyn Curran, Max Bachmann, Eric Bateman, Ruth Vania Cornick, Tanya Doherty, Sandra Claire Picken, Makhosazana Lungile Simelane, Lara Fairall
Background: Despite significant reductions in mortality, preventable and treatable conditions remain the leading causes of death in children under five within South Africa. The WHO's Integrated Management of Childhood Illness (IMCI) programme has been widely implemented to address the most common causes of mortality in children under five. Although effective, limitations in IMCI scope and adherence have emerged. The Practical Approach to Care Kit (PACK) Child guide has been developed to expand on IMCI and address these limitations...
2018: BMJ Global Health
Tim Colbourn, Audrey Prost, Nadine Seward
No abstract text is available yet for this article.
2018: BMJ Global Health
Phuong Hong Nguyen, Samuel Scott, Rasmi Avula, Lan Mai Tran, Purnima Menon
Introduction: India carries the largest burden of anaemia globally. Progress to reduce anaemia has been slow despite substantial economic growth and 50 years of programmatic efforts. Identification of the factors that contribute to anaemia reductions is needed to accelerate progress. We examined changes in haemoglobin (Hb) and anaemia among women and children in India from 2006 to 2016 and identified drivers of changes in these outcomes over time. Methods: We used two rounds of National Family Health Survey data collected in 2005-2006 and 2015-2016 (n=245 346 children 6-59 months; 37 165 pregnant women (PW) 15-49 years; 760 460 non-pregnant women (NPW) 15-49 years)...
2018: BMJ Global Health
Lucy C Okell, Lisa Malene Reiter, Lene Sandø Ebbe, Vito Baraka, Donal Bisanzio, Oliver J Watson, Adam Bennett, Robert Verity, Peter Gething, Cally Roper, Michael Alifrangis
Artemether-lumefantrine (AL) and artesunate-amodiaquine (AS-AQ) are the most commonly used artemisinin-based combination therapies (ACT) for treatment of Plasmodium falciparum in Africa. Both treatments remain efficacious, but single nucleotide polymorphisms (SNPs) in the Plasmodium falciparum multidrug resistance 1 ( Pfmdr1 ) gene may compromise sensitivity. AL and AS-AQ exert opposing selective pressures: parasites with genotype 86Y, Y184 and 1246Y are partially resistant to AS-AQ treatment, while N86, 184 F and D1246 are favoured by AL treatment...
2018: BMJ Global Health
Eduardo J Gómez, Fernanda Aguilar Perez, Deisy Ventura
By early-2016, the international community began to pressure Brazil for a stronger policy response to Zika. In contrast to what was seen in the past, however, these international pressures did not elicit such a response. In this article, we explore why this was the case, reviewing the government's policy response and the broader political and economic context shaping this response. The authors used single case study analysis and qualitative sources, such as books, journal articles, and government policy reports to support their empirical claims...
2018: BMJ Global Health
Valéry Ridde, Abena Asomaning Antwi, Bruno Boidin, Benjamin Chemouni, Fatoumata Hane, Laurence Touré
No abstract text is available yet for this article.
2018: BMJ Global Health
Kirk Emerson
Multisectoral governance, one of many terms used to describe collaborative, cross-boundary approaches to solving complex public problems, is being applied broadly in several policy arenas, most notably in environmental and natural resource management, but increasingly in public health in multiple settings and scales around the globe. This paper explores how to transfer knowledge about collaborative governance to challenging public health settings found in low-income and moderate-income countries (LMICs). This paper presents a general background on collaborative governance, summarises some relevant empirical findings on the performance of collaborative governance and lays out some of the challenges and considerations for thinking about improving collaborative public health governance in LMICs...
2018: BMJ Global Health
Ruth Cornick, Sandy Picken, Camilla Wattrus, Ajibola Awotiwon, Emma Carkeek, Juliet Hannington, Pearl Spiller, Eric Bateman, Tanya Doherty, Merrick Zwarenstein, Lara Fairall
For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work...
2018: BMJ Global Health
Sara Bennett, Douglas Glandon, Kumanan Rasanathan
Multisectoral action is key to addressing many pressing global health challenges and critical for achieving the Sustainable Development Goals, but to-date, understanding about how best to promote and support multisectoral action for health is relatively limited. The challenges to multisectoral action may be more acute in low-income and middle-income countries (LMICs) where institutions are frequently weak, and fragmentation, even within the health sector, can undermine coordination. We apply the lens of governance to understand challenges to multisectoral action...
2018: BMJ Global Health
Y-Ling Chi, Mohamed Gad, Sebastian Bauhoff, Kalipso Chalkidou, Itamar Megiddo, Francis Ruiz, Peter Smith
No abstract text is available yet for this article.
2018: BMJ Global Health
Yan Chai, Arijit Nandi, Jody Heymann
Introduction: Among all barriers to breastfeeding, the need to work has been cited as one of the top reasons for not breastfeeding overall and for early weaning among mothers who seek to breastfeed. We aimed to examine whether extending the duration of paid maternity leave available to new mothers affected early initiation of breastfeeding, exclusive breastfeeding under 6  months and breastfeeding duration in low-income and middle-income countries (LMICs). Methods: We merged longitudinal data measuring national maternity leave policies with information on breastfeeding related to 992 419 live births occurring between 1996 and 2014 in 38 LMICs that participated in the Demographic and Health Surveys...
2018: BMJ Global Health
Albert Picado, Israel Cruz, Maël Redard-Jacot, Alejandro G Schijman, Faustino Torrico, Sergio Sosa-Estani, Zachary Katz, Joseph Mathu Ndung'u
It is estimated that between 8000 and 15 000 Trypanosoma cruzi infected babies are born every year to infected mothers in Chagas disease endemic countries. Currently, poor access to and performance of the current diagnostic algorithm, based on microscopy at birth and serology at 8-12 months after delivery, is one of the barriers to congenital Chagas disease (CCD) control. Detection of parasite DNA using molecular diagnostic tools could be an alternative or complement to current diagnostic methods, but its implementation in endemic regions remains limited...
2018: BMJ Global Health
Patrick K Moonan, Sreenivas A Nair, Reshu Agarwal, Vineet K Chadha, Puneet K Dewan, Umesh D Gupta, Christine S Ho, Timothy H Holtz, Ajay M Kumar, Nishant Kumar, Prahlad Kumar, Susan A Maloney, Sundari R Mase, John E Oeltmann, C N Paramasivan, Malik M Parmar, Kiran K Rade, Ranjani Ramachandran, Raghuram Rao, Virendra S Salhorta, Rohit Sarin, Sanjay Sarin, Kuldeep S Sachdeva, Sriram Selvaraju, Rupak Singla, Diya Surie, Jamhoih Tonsing, Srikanth P Tripathy, Sunil D Khaparde
The End TB Strategy envisions a world free of tuberculosis-zero deaths, disease and suffering due to tuberculosis by 2035. This requires reducing the global tuberculosis incidence from >1250 cases per million people to <100 cases per million people within the next two decades. Expanding testing and treatment of tuberculosis infection is critical to achieving this goal. In high-burden countries, like India, the implementation of tuberculosis preventive treatment (TPT) remains a low priority. In this analysis article, we explore potential challenges and solutions of implementing TPT in India...
2018: BMJ Global Health
J Damascene Kabakambira, Rafeal L Baker, Sara M Briker, Amber B Courville, Lilian S Mabundo, Christopher W DuBose, Stephanie T Chung, Robert H Eckel, Anne E Sumner
Background: To lower the risk of diabetes and heart disease in Africa, identification of African-centred thresholds for inexpensive biomarkers of insulin resistance (IR) is essential. The waist circumference (WC) thresholds that predicts IR in African men and women have not been established, but investigations recently conducted in Africa using indirect measures of IR suggest IR is predicted by WC of 80-95 cm in men and 90-99 cm in women. These WC cannot be used for guidelines until validated by direct measurements of IR and visceral adipose tissue (VAT)...
2018: BMJ Global Health
Churnrurtai Kanchanachitra, Viroj Tangcharoensathien, Walaiporn Patcharanarumol, Tipicha Posayanonda
Introduction: Interest in multisectoral governance for health has grown in recent years in response to the limitations of government-centric policy formulation and implementation. This study describes multisectoral governance associated with policy formulation and implementation of a total ban on chrysotile asbestos in Thailand. Methods: Qualitative methods were applied, including analysis of related literature and media, and in-depth interviews with key informants...
2018: BMJ Global Health
Jesse B Bump
This paper addresses the need for conceptual and analytic clarity on nutrition governance, an essential underpinning of more effective approaches for undernutrition, the 'single greatest constraint to global development' and obesity, which already accounts for 4% of the world's disease burden and is growing rapidly. The governance of nutrition, which is essential to designing and implementing policies to realise the right to food, is among the most important and most defining duties of society. But research and action on nutrition governance are hampered by the absence of conceptual rigour, even as the continuing very high burden of undernutrition and the rapid rise in obesity highlight the need for such structures...
2018: BMJ Global Health
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