Subnational trends and inequalities of under-immunisation and zero-dose among children aged 12-23 months in Uganda: a national population-based cross-sectional study.

Objective: Despite the Global Vaccine Action Plan's goal of at least 90% vaccine coverage for all children, Uganda has made limited progress in vaccination over the past decade. The objective of this study was to examine the subnational trends in the prevalence and inequalities in under-immunisation and zero-dose among children aged 12-23 months in Uganda.

Study Design: A retrospective national cross-sectional study.

Harmonizing Data Visualizations on Child Health and Well-Being to Strengthen Advocacy and Monitoring Efforts.

Data visualization tools on child health have improved data accessibility but caused confusion over indicator data sources and which tools to use for specific purposes. We propose principles for generating future tools that can effectively trigger action and accountability for children everywhere.

Advocacy for Better Integration and Use of Child Health Indicators for Global Monitoring.

Making better use of harmonized indicators to monitor child health and well-being at the global level will avoid duplicative monitoring and evaluation exercises, improve evidence-based programming, and preserve resources that can be used to improve the quality of national data collection platforms.

Measurement of Mental Health Among Adolescents at the Population Level: A Multicountry Protocol for Adaptation and Validation of Mental Health Measures.

Purpose: Mental disorders are among the leading causes of disability among adolescents aged 10-19 years. However, data on prevalence of mental health conditions are extremely sparse across low- and middle-income countries, even though most adolescents live in these settings. This data gap is further exacerbated because few brief instruments for adolescent mental health are validated in these settings, making population-level measurement of adolescent mental health especially cumbersome to carry out.

Validation of the Kriol and Belizean English Adaptation of the Revised Children's Anxiety and Depression Scale for Use With Adolescents in Belize.

Purpose: To validate a culturally-adapted Kriol and Belizean English version of the Revised Children's Anxiety and Depression Scale (RCADS) through comparison with clinical diagnoses made using the Kiddie Schedule of Affective Disorders and Schizophrenia.

Methods: Participants comprised of 256 adolescents aged 10-14 years and 15-19 years, who completed the adapted RCADS (10 depression items, 12 anxiety items) in one-on-one interviews, followed by a diagnostic assessment using Kiddie Schedule of Affective Disorders and Schizophrenia administered by trained clinicians. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratios, area under the curve (AUC), and Youden's Index were calculated for RCADS cutoffs and scores on the total scale and anxiety and depression subscales.

Translation and Adaptation of the Revised Children's Anxiety and Depression Scale: A Qualitative Study in Belize.

Background: Adapting data collection instruments using transcultural translation and adaptation processes is essential to ensure that respondents comprehend the items and the original meaning is retained across languages and contexts. This approach is central to UNICEF's efforts to expand the use of standard data collection tools across settings and close the global data gap on adolescent mental health.

Methods: We conducted transcultural translation and adaptation processes in Belize using the Revised Children's Anxiety and Depression Scale (RCADS).

Toward a Demand-Driven, Collaborative Data Agenda for Adolescent Mental Health.

Purpose: Existing datasets and research in the field of adolescent mental health do not always meet the needs of practitioners, policymakers, and program implementers, particularly in the context of vulnerable populations. Here, we introduce a collaborative, demand-driven methodology for the development of a strategic adolescent mental health research agenda. Ultimately, this agenda aims to guide future data sharing and collection efforts that meet the most pressing data needs of key stakeholders.

A rapid systematic review and evidence synthesis of effective coverage measures and cascades for childbirth, newborn and child health in low- and middle-income countries.

Background: Effective coverage measures aim to estimate the proportion of a population in need of a service that received a positive health outcome. In 2020, the Effective Coverage Think Tank Group recommended using a 'coverage cascade' for maternal, newborn, child and adolescent health and nutrition (MNCAHN), which organises components of effective coverage in a stepwise fashion, with each step accounting for different aspects of quality of care (QoC), applied at the population level. The cascade outlines six steps that increase the likelihood that the population in need experience the intended health benefit: 1) the population in need (target population) who contact a health service; 2) that has the inputs available to deliver the service; 3) who receive the health service; 4) according to quality standards; 5) and adhere to prescribed medication(s) or health workers instructions; and 6) experience the expected health outcome.

Basic maternal health care coverage among adolescents in 22 sub-Saharan African countries with high adolescent birth rate.

Background: In the sub-Saharan Africa region, the adolescent birth rate is the highest in the world, estimated at 100.5 births per 1000 women aged 15 to 19 years, and 2.4 times greater than the global average.

Reducing unnecessary caesarean sections: scoping review of financial and regulatory interventions.

Background: Caesarean sections (CS) are increasing worldwide. Financial incentives and related regulatory and legislative factors are important determinants of CS rates. This scoping review examines the evidence base of financial, regulatory and legislative interventions intended to reduce CS rates.

Countdown to 2015: a decade of tracking progress for maternal, newborn, and child survival.

Conceived in 2003 and born in 2005 with the launch of its first report and country profiles, the Countdown to 2015 for Maternal, Newborn, and Child Survival has reached its originally proposed lifespan. Major reductions in the deaths of mothers and children have occurred since Countdown's inception, even though most of the 75 priority countries failed to achieve Millennium Development Goals 4 and 5. The coverage of life-saving interventions tracked in Countdown increased steadily over time, but wide inequalities persist between and within countries.

The post-2015 agenda: staying the course in maternal and child survival.

In this article, we draw on available evidence from Countdown to 2015 and other sources to make the case for keeping women and children at the heart of the next development agenda that will replace the Millennium Development Goal (MDG) framework after 2015. We provide a status update on global progress in achieving MDGs 4 and 5, reduce child mortality and improve maternal health, respectively--showing that although considerable mortality reductions have been achieved, many more women's and children's lives can be saved every day through available, cost effective interventions. We describe key underlying determinants of poor maternal and child health outcomes and the need for well-coordinated, comprehensive approaches for addressing them such as introducing a combination of nutrition specific and sensitive interventions to reduce pervasive malnutrition, targeting interventions to the underserved to reduce inequities in access to care, and increasing women's social status through improved access to education and income-earning opportunities.

Countdown to 2015 and beyond: fulfilling the health agenda for women and children.

The end of 2015 will signal the end of the Millennium Development Goal era, when the world can take stock of what has been achieved. The Countdown to 2015 for Maternal, Newborn, and Child Survival (Countdown) has focused its 2014 report on how much has been achieved in intervention coverage in these groups, and on how best to sustain, focus, and intensify efforts to progress for this and future generations. Our 2014 results show unfinished business in achievement of high, sustained, and equitable coverage of essential interventions.

Odon device: a promising tool to facilitate vaginal delivery and increase access to emergency care.

The last innovation in operative vaginal delivery happened centuries ago with the invention of the forceps and the vacuum extractor. The World Health Organization Odon Device Research Group recently published a protocol for a feasibility and safety study for a new device (Odon device) which aims to revolutionize assisted vaginal delivery. This editorial discusses the device and its pathway to global use.

A common evaluation framework for the African Health Initiative.

Background: The African Health Initiative includes highly diverse partnerships in five countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia), each of which is working to improve population health by strengthening health systems and to evaluate the results. One aim of the Initiative is to generate cross-site learning that can inform implementation in the five partnerships during the project period and identify lessons that may be generalizable to other countries in the region. Collaborators in the Initiative developed a common evaluation framework as a basis for this cross-site learning.

Measuring coverage in MNCH: challenges and opportunities in the selection of coverage indicators for global monitoring.

Global monitoring of intervention coverage is a cornerstone of international efforts to improve reproductive, maternal, newborn, and child health. In this review, we examine the process and implications of selecting a core set of coverage indicators for global monitoring, using as examples the processes used by the Countdown to 2015 for Maternal, Newborn and Child Survival and the Commission on Accountability for Women's and Children's Health. We describe how the generation of data for global monitoring involves five iterative steps: development of standard indicator definitions and measurement approaches to ensure comparability across countries; collection of high-quality data at the country level; compilation of country data at the global level; organization of global databases; and rounds of data quality checking.

The special programme of research in human reproduction: forty years of activities to achieve reproductive health for all.

The Special Programme of Research in Human Reproduction (HRP), co-sponsored by the UNDP, UNFPA, WHO, and the World Bank, is celebrating 40 years of activities with an expansion of its mandate and new co-sponsors. When it began, in 1972, the main focus was on evaluating the acceptability, effectiveness, and safety of existing fertility-regulating methods, as well as developing new, improved modalities for family planning. In 1994, HRP not only made major contributions to the Plan of Action of the International Conference on Population and Development (ICPD); it also broadened its scope of work to include other aspects of health dealing with sexuality and reproduction, adding a specific perspective on gender issues and human rights.

From safe motherhood, newborn, and child survival partnerships to the continuum of care and accountability: moving fast forward to 2015.

The present paper provides an overview of the Safe Motherhood Initiative, Healthy Newborn Partnership, and Child Survival Partnership and their eventual merge into the Partnership for Maternal, Newborn and Child Health (PMNCH) in 2005. The promise and past successes of the PMNCH are highlighted, with a particular focus on the PMNCH's partner-centric approach showing the importance of collaboration for progress. The aims of the strategic framework for 2012-2015 are presented within the context of the Global Strategy for Women's and Children's Health, launched in 2010, and growing political momentum to achieve Millennium Development Goals 4 and 5 (reduce child mortality and improve maternal health, respectively).

Restoring dignity: social reintegration after obstetric fistula repair in Ukerewe, Tanzania.

This study explores barriers and facilitating factors women experience re-integrating into society after treatment of an obstetric fistula in rural Tanzania. A total of 71 women were interviewed in the Mwanza region of Tanzania, including a community control group. The majority of the women who received successful surgical repairs reported that, over time, they were able to resume many of the social and economic activities they engaged in prior to the development of a fistula.

The World Health Organization policy on global women's health: new frontiers.

This article reviews formal and informal mechanisms through which the World Health Organization (WHO) is promoting policies for the advancement of women's health. Specific attention is given to select examples of innovative strategies the WHO has adopted in recent years to increase political commitment to women's and children's health and influence the development of policies supportive of country efforts to achieve Millennium Development Goals 4 (MDG4) and MDG 5 (to reduce child mortality and improve maternal health, respectively).