Midwifery curricula inclusion of sexual and reproductive health in crisis settings in the Democratic Republic of Congo.

Aim: This discussion paper aims to argue for the inclusion of the Minimum Initial Service Package (MISP) for sexual and reproductive health in crisis settings in all midwifery curricula.

Background: The Democratic Republic of Congo continues to experience long-standing humanitarian crises that have affected the population's health, especially in relation to sexual violence and other sexual and reproductive health issues. The MISP was established in 1996 to meet the most vital sexual and reproductive health needs of crisis-affected populations and has become an international minimum standard in humanitarian response.

Anatomical variants of the celiac trunk.

Aim Of The Study: Determine the anatomical variants of the celiac trunk and describe it in its modal form using a scanner.

Patients: In total, 200 patients were included in this study.

Material And Methods: The study was carried out using a multi-detector scanner (SIEMENS Somatom Emotion Excel Edition, 16 bars).

Multiple variations of collateral branches of the abdominal aorta associated with pyelic duplication: A case report.

Purpose: We describe a rare case of anatomical variation of the collaterals of the abdominal aorta associated with a duplication of the pyelic.

Material And Method: A 51-year-old patient in whom an abdominal CT scan was performed as part of the exploration of a cystic left renal mass objectified on ultrasound.

Results: A celiomesenteric trunk with two left renal arteries and a duplication of the left pyelon were found.

[Economic hardship and fallout on households of the management of hydrocephalus in Benin].

Objectives: The socioeconomic profile of households and families of children attending hospital for hydrocephalus were documented and analysed. Main costs related to diagnosis and care were reviewed. The emotional fallout and social well-being of families were also analysed.

Diversity and divergence: the dynamic burden of poor maternal health.

Maternal health is a big issue and is central to sustainable development. Each year, about 210 million women become pregnant and about 140 million newborn babies are delivered-the sheer scale of maternal health alone makes maternal well being and survival vital concerns. In this Series paper, we adopt primarily a numerical lens to illuminate patterns and trends in outcomes, but recognise that understanding of poor maternal health also warrants other perspectives, such as human rights.

Effectiveness of demand generation interventions on use of modern contraceptives in low- and middle-income countries.

Objectives: To synthesise evidence on the implementation, costs and cost-effectiveness of demand generation interventions and their effectiveness in improving uptake of modern contraception methods.

Methods: A Cochrane systematic review was conducted. Searches were performed in electronic databases (MEDLINE, EMBASE) and the grey literature.

Contraceptive use and distribution of high-risk births in Nigeria: a sub-national analysis.

Background: Family planning expansion has been identified as an impetus to harnessing Nigeria's demographic dividend. However, there is a need for data to address pockets of inequality and to better understand cultural and social factors affecting contraceptive use and health benefits. This paper contributes to addressing these needs by providing evidence on the trends and sub-national patterns of modern contraceptive prevalence in Nigeria and the association between contraceptive use and high-risk births in Nigeria.

Patterns and trends of postpartum family planning in Ethiopia, Malawi, and Nigeria: evidence of missed opportunities for integration.

Background: The first 12 months following childbirth are a period when a subsequent pregnancy holds the greatest risk for mother and baby, but also when there are numerous contacts with the healthcare system for postnatal care for mother and baby (immunisation, nutrition, etc.). The benefits and importance of postpartum family planning are well documented.

Patterns and trends of contraceptive use among sexually active adolescents in Burkina Faso, Ethiopia, and Nigeria: evidence from cross-sectional studies.

Background: The benefits of universal access to voluntary contraception have been widely documented in terms of maternal and newborn survival, women's empowerment, and human capital. Given population dynamics, the choices and opportunities adolescents have in terms of access to sexual and reproductive health information and services could significantly affect the burden of diseases and nations' human capital.

Objectives: The objectives of this paper are to assess the patterns and trends of modern contraception use among sexually active adolescents by socio-economic characteristics and by birth spacing and parity; to explore predictors of use of modern contraception in relation to the health system; and to discuss implications of the findings for family planning policy and programmes.

Trends and patterns of modern contraceptive use and relationships with high-risk births and child mortality in Burkina Faso.

Background: In sub-Saharan Africa, few studies have stressed the importance of spatial heterogeneity analysis in modern contraceptive use and the relationships with high-risk births.

Objective: This paper aims to analyse the association between modern contraceptive use, distribution of birth risk, and under-five child mortality at both national and regional levels in Burkina Faso.

Design: The last three Demographic and Health Surveys - conducted in Burkina Faso in 1998, 2003, and 2010 - enabled descriptions of differentials, trends, and associations between modern contraceptive use, total fertility rates (TFR), and factors associated with high-risk births and under-five child mortality.

Meeting demand for family planning within a generation: prospects and implications at country level.

Background: In order to track progress towards the target of universal access to sexual and reproductive health care services of the post-2015 Sustainable Development Goals (SDGs), a measure (demand for family planning satisfied with modern contraceptive methods) and a benchmark (at least 75% by 2030 in all countries) have been recommended.

Objectives: The goal of this study was to assess the prospects of reaching the benchmark at the country level. Such information can facilitate strategic planning, including resource allocation at global and country levels.

Trends in contraceptive use and distribution of births with demographic risk factors in Ethiopia: a sub-national analysis.

Background: Evidence shows that family planning contributes to the decline in child mortality by decreasing the proportions of births that are considered high risk. The main objective of the present analysis was to examine the trends in use of modern contraceptives and their relationship with total fertility rate (TFR) and distribution of births by demographic risk factors as defined by mother's age, birth interval, and birth order at the sub-national level in Ethiopia.

Design: Analyses used data from three Demographic and Health Surveys in Ethiopia (2000, 2005, and 2011), which are nationally representative data collected through questionnaire-based interviews from women 15-49 using a stratified, two-stage cluster sampling.

Protocol for a systematic review on the effect of demand generation interventions on uptake and use of modern contraceptives in LMIC.

Background: Despite a global increase in contraception use, its prevalence remains low in low- and middle-income countries. One strategy to improve uptake and use of contraception, as an essential complement to policies and supply-side interventions, is demand generation. Demand generation interventions have reportedly produced positive effects on uptake and use of family planning services, but the evidence base remains poorly documented.

From joint thinking to joint action: a call to action on improving water, sanitation, and hygiene for maternal and newborn health.

Yael Velleman and colleagues argue for stronger integration between the water, sanitation, and hygiene (WASH) and maternal and newborn health sectors. Please see later in the article for the Editors' Summary.

Readiness of district and regional hospitals in Burkina Faso to provide caesarean section and blood transfusion services: a cross-sectional study.

Background: Health centres and hospitals play a crucial role in reducing maternal mortality and morbidity by offering respectively Basic Emergency Obstetric and Newborn Care (BEmONC) and Comprehensive Emergency Obstetric and Newborn Care (CEmONC). The readiness of hospitals to provide CEmONC depends on the availability of qualified human resources, infrastructure like surgical theatres, and supplies like drugs and blood for transfusion. We assessed the readiness of district and regional hospitals in Burkina Faso to provide two key CEmONC functions, namely caesarean section and blood transfusion.

Exploring the effects of task shifting for HIV through a systems thinking lens: the case of Burkina Faso.

Background: While the impact of task shifting on quality of care and clinical outcomes has been demonstrated in several studies, evidence on its impact on the health system as a whole is limited. This study has two main objectives. The first is to conceptualize the wider range of effects of task shifting through a systems thinking lens.

Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring.

Objective: Verbal autopsy (VA) is a systematic approach for determining causes of death (CoD) in populations without routine medical certification. It has mainly been used in research contexts and involved relatively lengthy interviews. Our objective here is to describe the process used to shorten, simplify, and standardise the VA process to make it feasible for application on a larger scale such as in routine civil registration and vital statistics (CRVS) systems.

Towards elimination of maternal deaths: maternal deaths surveillance and response.

Current methods for estimating maternal mortality lack precision, and are not suitable for monitoring progress in the short run. In addition, national maternal mortality ratios (MMRs) alone do not provide useful information on where the greatest burden of mortality is located, who is concerned, what are the causes, and more importantly what sub-national variations occur. This paper discusses a maternal death surveillance and response (MDSR) system.

Prevalence of neurocysticercosis among people with epilepsy in rural areas of Burkina Faso.

Purpose: To estimate the lifetime prevalence of neurocysticercosis (NCC)-associated epilepsy and the proportion of NCC among people with epilepsy in three Burkina Faso villages.

Methods: Three villages were selected to represent three types of pig-rearing methods: (1) Batondo, where pigs are left to roam; (2) Pabré, where pigs are mostly tethered or penned; and (3) Nyonyogo, where the majority of residents are Muslim and few pigs are raised. In Batondo and Nyonyogo, all concessions (a group of several households) were included.

Assessing effectiveness of a community based health insurance in rural Burkina Faso.

Background: Financial barriers are a recognized major bottleneck of access and use of health services. The aim of this study was to assess effectiveness of a community based health insurance (CBHI) scheme on utilization of health services as well as on mortality and morbidity.

Methods: Data were collected from April to December 2007 from the Nouna's Demographic Surveillance System on overall mortality, utilization of health services, household characteristics, distance to health facilities, membership in the Nouna CBHI.

Increasing skilled birth attendance through midwifery workforce management.

Policy makers and development partners struggle to help find solutions to the high rates of maternal and newborn mortality in many low and middle income countries. Increasing access to midwives and health workers skilled in midwifery can help to alleviate the situation. We aim to contribute to the debate on strategies to increase access to skilled birth attendance by sharing our views, illustrated with as yet unpublished case stories that were recognized with Awards of Excellence at the Second Global Forum on Human Resources for Health, 2011, held in Bangkok, Thailand.

Strengthening standardised interpretation of verbal autopsy data: the new InterVA-4 tool.

Background: Verbal autopsy (VA) is the only available approach for determining the cause of many deaths, where routine certification is not in place. Therefore, it is important to use standards and methods for VA that maximise efficiency, consistency and comparability. The World Health Organization (WHO) has led the development of the 2012 WHO VA instrument as a new standard, intended both as a research tool and for routine registration of deaths.

Applying the net-benefit framework for analyzing and presenting cost-effectiveness analysis of a maternal and newborn health intervention.

Background: Coverage of maternal and newborn health (MNH) interventions is often influenced by important determinants and decision makers are often concerned with equity issues. The net-benefit framework developed and applied alongside clinical trials and in pharmacoeconomics offers the potential for exploring how cost-effectiveness of MNH interventions varies at the margin by important covariates as well as for handling uncertainties around the ICER estimate.

Aim: We applied the net-benefit framework to analyze cost-effectiveness of the Skilled Care Initiative and assessed relative advantages over a standard computation of incremental cost effectiveness ratios.

Applying the net-benefit framework for assessing cost-effectiveness of interventions towards universal health coverage.

In assessing the cost-effectiveness of an intervention, the interpretation and handling of uncertainties of the traditional summary measure, the Incremental Cost Effectiveness Ratio (ICER), can be problematic. This is particularly the case with strategies towards universal health coverage in which the decision makers are typically concerned with coverage and equity issues. We explored the feasibility and relative advantages of the net-benefit framework (NBF) (compared to the more traditional Incremental Cost-Effectiveness Ratio, ICER) in presenting results of cost-effectiveness analysis of a community based health insurance (CBHI) scheme in Nouna, a rural district of Burkina Faso.

The West Africa Field Epidemiology and Laboratory Training Program, a strategy to improve disease surveillance and epidemic control in West Africa.

The West Africa Field Epidemiology and Laboratory Training Program (WA-FELTP) which was established in September 2007, is an inter-country, competency-based, in-service and post -graduate training program in applied epidemiology and public health that builds the capacity to strengthen the surveillance and response system as well as epidemic control in the French-speaking countries where they are implemented. The overall purpose is to provide epidemiological and public health laboratory services to the public health systems at national, provincial, district and local levels. The program includes four countries: Burkina Faso, Mali, Niger, and Togo with an overarching goal to progressively cover all French speaking countries in West Africa through a phased-in approach.