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Adolescents are disproportionately affected in humanitarian and fragile settings, where they will often find themselves in high-risk situations and may be forced to take on adult roles within their families and communities. They are also more likely to have poor well-being outcomes related to disrupted or no access to optimum nutrition, health services and protection, as well as opportunities for education, training, and employment. Our paper aims to provide an overview of current interventions focusing on adolescent well-being and to provide a set of policy and programmatic recommendations to prevent long-term consequences of crisis and conflict on adolescents’ lives. According to the UN H6+ Technical Working Group on Adolescent Health and Well-beings’ framework for adolescent well-being, this article analyses adolescents’ backgrounds and interventions oriented to them within humanitarian and fragile settings. In this sense, we refer to five domains that include: good health and optimum nutrition; connectedness, positive values and contribution to society; safety and a supportive environment; learning, competence, education, skills and employability; and agency and resilience.

INTRODUCTION: In its recent World Report on Vision, the WHO called for an updated approach to monitor eye health as part of universal health coverage (UHC). This project sought to develop a consensus among eye health experts from all world regions to produce a menu of indicators for countries to monitor eye health within UHC. METHODS: We reviewed the literature to create a long-list of indicators aligned to the conceptual framework for monitoring outlined in WHO's World Report on Vision. We recruited a panel of 72 global eye health experts (40% women) to participate in a two-round, online prioritisation exercise. Two-hundred indicators were presented in Round 1 and participants prioritised each on a 4-point Likert scale. The highest-ranked 95 were presented in Round 2 and were (1) scored against four criteria (feasible, actionable, reliable and internationally comparable) and (2) ranked according to their suitability as a 'core' indicator for collection by all countries. The top 30 indicators ranked by these two parameters were then used as the basis for the steering group to develop a final menu. RESULTS: The menu consists of 22 indicators, including 7 core indicators, that represent important concepts in eye health for 2020 and beyond, and are considered feasible, actionable, reliable and internationally comparable. CONCLUSION: We believe this list can inform the development of new national eye health monitoring frameworks, monitor progress on key challenges to eye health and be considered in broader UHC monitoring indices at national and international levels.

Armed conflict disproportionately affects the morbidity, mortality, and wellbeing of women, newborns, children, and adolescents. Our study presents insights from a collection of ten country case studies aiming to assess the provision of sexual, reproductive, maternal, newborn, child, and adolescent health and nutrition interventions in ten conflict-affected settings in Afghanistan, Colombia, Democratic Republic of the Congo, Mali, Nigeria, Pakistan, Somalia, South Sudan, Syria, and Yemen. We found that despite large variations in contexts and decision making processes, antenatal care, basic emergency obstetric and newborn care, comprehensive emergency obstetric and newborn care, immunisation, treatment of common childhood illnesses, infant and young child feeding, and malnutrition treatment and screening were prioritised in these ten conflict settings. Many lifesaving women's and children's health (WCH) services, including the majority of reproductive, newborn, and adolescent health services, are not reported as being delivered in the ten conflict settings, and interventions to address stillbirths are absent. International donors remain the primary drivers of influencing the what, where, and how of implementing WCH interventions. Interpretation of WCH outcomes in conflict settings are particularly context-dependent given the myriad of complex factors that constitute conflict and their interactions. Moreover, the comprehensiveness and quality of data remain limited in conflict settings. The dynamic nature of modern conflict and the expanding role of non-state armed groups in large geographic areas pose new challenges to delivering WCH services. However, the humanitarian system is creative and pluralistic and has developed some novel solutions to bring lifesaving WCH services closer to populations using new modes of delivery. These solutions, when rigorously evaluated, can represent concrete response to current implementation challenges to modern armed conflicts.

Additional file 3. Completed CONSORT checklist.

Additional file 1. Definition of primary and secondary outcomes.

This policy brief aims to promote a holistic mindset about the COVID-19 pandemic by 1) applying a complexity lens to understand its drivers, nature, and impact, 2) proposing actions to build resilient societies to pandemics, and 3) deriving principles to govern complex systemic crises. Building resilience to prevent, react to, and recover from systemic shocks need to become a core element of how societies are governed. This requires an integrated approach between health, social, economic, environmental, and institutional systems. The brief has been developed by a team of researchers coming from both the natural and social sciences.1 Reviewed by a group of policy actors,2 the brief aims to foster a dialogue between academic institutions and policymakers.

Additional file 1: Supplementary Table A: Research Question Generation Survey (Print Screens of Online Survey). Supplementary Table B: Top Research Priority Questions Solicited (n = 280). Supplementary Table C. Distribution of RPS scores per dimension for the top TEN CHNRI research priority questions per SRMNCAH domain. Supplementary Table D. Members, Institutional Affiliations and Terms of Reference of the Technical Advisory Group.

Additional file 2. Definition of other reported outcomes.

Additional file 7. Primary and secondary outcomes (secondary analyses, excluding “contaminated” control districts).

Additional file 4. Actual roll-out of the IeDA intervention with step dates and number (N) of children aged 2–59 months observed at each step in each district.

Additional file 5. Comparison of HCWs’ performance with and without use of IMCI paper-forms in the control arm. (DOCX 18 kb)

Additional file 1: Supplementary Table 1. Search terms for systematic review.

Additional file 2: Supplementary Material 1. Interview Guide. Supplementary Material 2. Table 1. Quality criteria for reporting qualitative research (COREQ) and Table 1. Domains, items, description, information in the study.

Additional file 2: Supplementary Table 2. PRISMA Checklist.

Background An estimated 70.8 million people are forcibly displaced worldwide, 75% of whom are women and children. Prioritizing a global research agenda to inform guidance, service delivery, access to and quality of services is essential to improve the survival and health of women, children and adolescents in humanitarian settings. Method A mixed-methods design was adapted from the Child Health and Nutrition Research Initiative (CHNRI) methodology to solicit priority research questions across the sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) domains in humanitarian settings. The first step (CHNRI) involved data collection and scoring of perceived priority questions, using a web-based survey over two rounds (first, to generate the questions and secondly, to score them). Over 1000 stakeholders from across the globe were approached; 177 took part in the first survey and 69 took part in the second. These research questions were prioritized by generating a research prioritization score (RPP) across four dimensions: answerability, program feasibility, public health relevance and equity. A Delphi process of 29 experts followed, where the 50 scored and prioritized CHRNI research questions were shortlisted. The top five questions from the CHNRI scored list for each SRMNCAH domain were voted on, rendering a final list per domain. Results A total of 280 questions were generated. Generated questions covered sexual and reproductive health (SRH) (n = 90, 32.1%), maternal health (n = 75, 26.8%), newborn health (n = 42, 15.0%), child health (n = 43, 15.4%), and non-SRH aspects of adolescent health (n = 31, 11.1%). A shortlist of the top ten prioritized questions for each domain were generated on the basis of the computed RPPs. During the Delphi process, the prioritized questions, based on the CHNRI process, were further refined. Five questions from the shortlist of each of the SRMNCAH domain were formulated, resulting in 25 priority questions across SRMNCAH. For example, one of the prioritized SRH shortlisted and prioritized research question included: “What are effective strategies to implement good quality comprehensive contraceptive services (long-acting, short-acting and EC) for women and girls in humanitarian settings?” Conclusion Data needs, effective intervention strategies and approaches, as well as greater efficiency and quality during delivery of care in humanitarian settings were prioritized. The findings from this research provide guidance for researchers, program implementers, as well as donor agencies on SRMNCAH research priorities in humanitarian settings. A global research agenda could save the lives of those who are at greatest risk and vulnerability as well as increase opportunities for translation and innovation for SRMNCAH in humanitarian settings.

Additional file 6. Agreement between HCWs and validation nurses’ children measurements. 6b: Agreement between HCWs and validation nurses’ RDT results and caretakers’ answers.

Additional file 3. Key informant interview guide.

Additional file 1. Desk review findings.

Additional file 3. Network level metrics grouped by PHCU. Description of data: Table with numeric data (whole numbers and decimals) reflecting values of the following network level metrics for each PHCU: degree centrality, out degree, in degree, density and number of ties. Theses metrics are presented for each of the following networks: all, all advice seeking, all advice giving, all antenatal care, all maternity care, all postnatal care and all newborn care

Additional file 4. List of RMNCAH&N indicators used to build Map 1.

Additional file 5. Cadre with the highest in degree centrality value by network. Description of data: Table with numeric data (whole numbers) reflecting number of networks where each cadre has the highest in degree centrality.

Additional file 1. Community based Newborn Care Framework. Description of data: graphic detailing the “4 C”‘s and the “9 Components” of Community based Newborn Care

Additional file 4. Actor-level metrics within each PHCU and network type: Cadre of actor with highest value. Description of data: Table with numeric data (whole numbers) of actor-level network metrics reflecting cadre of actor with highest value within that PHCU.

Additional file 2. Desk review search strategy and inclusion criteria.

Additional file 2. Social Network Analysis Network Metric Definitions and Formulas. Description of data: Table with text describing the actor and network level SNA metrics’ definitions, calculations and pathway to their output in UCINET

Additional file 1. BRANCH Country Case Study Common Protocol.