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The use of Electronic Health Records by healthcare providers has proved to be critical to achieving the triple aim of improved healthcare quality, increased efficiency as well as healthcare cost reduction. However, indiscriminate adoption and use of any technology like the EHR is also known to be prone to being counterproductive and a waste of resources. This paper seeks to extract the lessons from the experiences of the U.S in their adoption and use of the EHR technology as a guiding strategy or blueprint for Nigeria in its quest to encourage the use of the technology in its healthcare facilities for the benefit of its citizens. The paper concluded that for Nigeria to maximally benefit from the EHR technology, the country must encourage universal and meaningful use of the technology through appropriate legislation, incentives, standardized and certified solutions, health information exchange campaign and continuous monitoring of the progress of the process towards achieving the desired outcome. These lessons from the experiences of the U.S in their use of EHR promise to be the sure pathway to the successful adoption and use of the technology in Nigeria. [ABSTRACT FROM AUTHOR]

COVID‐19, caused by a novel coronavirus named SARS‐CoV‐2, was identified in December 2019, in Wuhan, China. It was first confirmed in sub‐Saharan Africa in Nigeria on 27 February 2020 and has since spread quickly to all sub‐Saharan African countries, causing more than 111,309 confirmed cases and 2,498 deaths as of 03 June 2020. The lessons learned during the recent Ebola virus disease (EVD) outbreaks in some sub‐Saharan African countries were expected to shape and influence the region's responses to COVID‐19 pandemic. However, some of the challenges associated with the management of the EVD outbreaks persist and create obstacles for the effective management of the COVID‐19 pandemic. This article describes the commonalities between the EVD epidemics and COVID‐19 pandemic, with a view to draw on lessons learned to effectively tackle the ongoing pandemic. Key successes, failures and lessons learned from previous EVD outbreaks are discussed. Recommendations on how these lessons can be translated to strengthen the COVID‐19 response in sub‐Saharan Africa are provided. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caused by a novel virus SARS-CoV-2 has swept the world, leaving behind a trail of free-falling economy, misery and death. The most vulnerable are the hardest hit—the elderly, those with chronic noncommunicable diseases and the poor and marginalised in society. The experience of various countries in handling the pandemic has shown that robustness of health system with surge capacity is critical to take the pandemic head-on. In the process important lessons for health systems have emerged. Countries with political leaders who led with a principled approach, while adopting an early and comprehensive strategy to contain the virus, have done better. Vulnerable populations should not be left to be further marginalised. To deal with the 'infodemic', communities should be engaged early. For successful handling of future challenges investment in public health is a must. National readiness and response capacity for epidemic control and disease surveillance need to be strengthened, leveraging modern technology. Institutional capacity building, pooling resources and harnessing innovations through partnerships would be key for mounting effective response now and in the future. [ABSTRACT FROM AUTHOR]

Objective: To describe the context, challenges and responses to COVID-19 public health measures for medical education in psychiatry, with an emphasis on sharing strategies for ongoing COVID-19 challenges. Conclusion: The rapidity of COVID-19 public health measures instituted in Australia required swift action for medical education to address lockdowns of student clinical placements. The responses included a transition to interim online learning followed by a return to truncated clinical placements renegotiated to conform to public health measures. Adjustment of formative and summative assessment has been necessary. However, further contingencies may emerge depending upon the overall progress of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Quotations yield the greatest insight from the fewest words. In addition to the wisdom and guidance quotations provide, teachers effectively use quotations in displays, presentations, speeches, research, writing prompts, classroom lessons, and discussions. Students employ quotations for speeches, classroom assignments, as sources of inspiration and guidance, and as support for essays—particularly those required for entrance to college. Considering the fast-paced, media culture in which today's students thrive, adolescents in a hurry embrace a quotation ranging from five to six words to three or four sentences. As a change of pace from textbook passages, short stories, poems, and novels, teachers find it refreshing to use quotations to stimulate thought and focus on the development of communication, thinking, and social skills. Although the lesson strategies outlined in this article use sample quotations most appropriately used in English classes, other subject area teachers, librarians, counselors, and administrators will also find value in many of the strategies. [ABSTRACT FROM AUTHOR]

The article analyses and synthesises the sustainable development important lessons and capacities of Quezon City, a highly-dynamic urban city in the Philippines, from the narratives and discourses of the City Planning and Development Officials. Conducting an elite and expert interview with the city planning and development officials, the paper document and highlight the city's vital best practices and capacities as a result of its technical expertise and specialised knowledge as supported and reinforced by the Comprehensive Development Plan 2017–2020 it helped to craft as evidence-based public policy coming straight from a city planner and developer views and perspectives on sustainable development. Utilising an integrative review approach, the article also critically examines some current literature frameworks and methods on sustainable development associated with Asia as an added dimension and contribution to sustainable development literature. Consequently, the article revealed and highlighted important sustainable development governance lessons that can contribute in shaping the future sustainable development agenda and its potential impact and contribution to the Philippines and Asia in terms of research, theory, and praxis, such as land banking, identification of manufacturing growth centres, revitalisation of manufacturing industry, and the promotion of Gender-Fair programmes and policies. [ABSTRACT FROM AUTHOR]

Previous studies have pointed to the benefits of involving students' everyday life experiences in lessons and in contextualizing the science content to enhance learning and positive attitudes toward school science. However, most of these investigations have been conducted as intervention studies. By contrast, the present study explored how teachers, in authentic situations and without interventions, related the school science context to other contexts. We analyzed a total of 490 min of lesson introductions in Swedish Grade 9 classes. The results revealed that teachers employed contextualization at the intersection of science content and the everyday life context, the school context, and the language context. Furthermore, it appeared that contextualization was created in the moment, as a way of explicating the scientific content. Compared to intervention studies, the present study shows that occasions of contextualization are rare. It is possible to conclude that the use of contextualization in science learning situations could be viewed as a teacher competence and must be explicit in teacher education and professional development to achieve the benefits of enhanced student interest and learning shown in the mentioned intervention studies. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic has involved nations and incapacitated the health systems globally. The pandemic preparedness has been tested with immense losses. Universal health coverage is needed more than ever to recuperate from the effects of the current pandemic. Post pandemic, many lessons need to be learnt especially for developing economies like India where public healthcare system is grossly inadequate to take care of health needs of citizens. World Health Organization's framework of six health system building blocks was utilized to study the lessons learnt and actionable points in the post pandemic period. Participation in Global Health Security Alliance has to be stepped up with involvement in Joint external evaluation and development of epidemiological core capacities. National Health Security Action Plan needs to drafted and available for health emergences. Ayushman Bharat scheme should incorporate elements to address surge capacity at the time of health emergencies and measures to deliver care at the time of pandemic. Technology through telemedicine, m-health, and digital platforms or apps should contribute to trainings, supervision, and facilitation of healthcare delivery at remote locations. Open data sharing policies should be developed for the practice of evidence-based public health. Public healthcare system and health manpower trained in epidemiology should be given a boost to have system readiness to respond in case of future pandemics. [ABSTRACT FROM AUTHOR]

Background: Aim of this intervention study was to evaluate whether availability of standing desks in classrooms may reduce sitting time and enhance standing and stepping time during lessons and breaks. Further, we evaluated if differences in standing desk use differed by physical fitness (PF) levels of children.Methods: To assess sitting, standing and stepping during a typical school week in 3rd grade primary school children (N = 52), activPAL monitors were used at baseline: T0, 1st follow-up: T1 and 2nd follow-up: T2. At baseline, PF was measured using the standing long jump and the 6-min jog-walk to assign children as having low PF (LPF) or high PF (HPF). Standing desks were assigned randomly to intervention and control groups at T1 (group 1) and T2 (group 2) with a cross-over design. Changes of sitting, standing and stepping were analyzed to investigate intervention effects at follow-up, using linear mixed models.Results: At baseline, children spent about 60 and 30% of time sitting during lessons and breaks, respectively. After installing standing desks (T1), significantly lower proportions of sitting were observed in the intervention group 1 [−13.1%, 95%-CI: (−20.5; −5.72)] and the control group 2 [−9.78%, 95%-CI: (−17.3; −2.28)]. Compared to the baseline measurement (T0), lower proportions of sitting were particularly expressed during school breaks in group 1 and 2 after intervention in T1 [group 1: −10.3%, 95%-CI: (−16.4; −4.25)] or in T2 [group 2: −8.59%, 95%-CI: (−15.2; −1.94)]. In general, children with higher physical fitness were less sedentary and more active, but intervention effects did not differ by fitness levels.Conclusion: Standing desks provide an opportunity to reduce sedentary time during lessons and breaks at school in primary school children, but do not directly increase PA of high intensity such as stepping. Future studies should consider potential bandwagon effects caused by structural interventions.

Background: Evaluators are cognisant of the need to determine the effects of an intervention within its context. Objectives: In education evaluations, there was a gap in context-specific assessment tools to determine the status of school functionality with the ultimate aim of examining whether there is a relationship between school functionality context and teaching and learning outcomes. To meet evaluation standards, evaluators must ensure that evaluation tools and data are accurately measuring the indicators and variables. The focus of the article is on lessons learned from a tool validation process. These are shared to guide evaluators in similar settings. Method: Khulisa Management Services (Khulisa) has conducted research and evaluations in South African schools since 1993. In 2011, Khulisa developed a school functionality tool based on local and international literature, engagement with key stakeholders, and through a series of implementation phases over various evaluations. The tool identifies high functional, functional, stagnant but functional and dysfunctional schools. The authors of this article undertook a reflection process to evaluate the evidence gathered to support the meaningfulness, usefulness and appropriateness of the tool properties. Results: Lessons from the validation process include the need to build time and resources for validation from the beginning, validating a tool over time and across evaluations adds value, training of data collectors is critical, and analysis is important towards establishing the consistency and reliability of a tool. Conclusion: While reliability analysis and the validation process are ongoing, preliminary results show that the tool has potential to document context appropriately.

Die Digitalisierung ist eine der großen Herausforderungen des 21. Jahrhunderts. Auch die Institution Schule ist hiervon betroffen. Der Digital- Pakt Schule zwischen Bund und Ländern soll helfen, diese Aufgabe zu bewältigen, indem er digitale Medien zur Verfügung stellt. Das Problem liegt aus pädagogischer Sicht darin, dass im Unterricht zwischen der Lernmethode und der Lerntechnik durchaus unterschieden werden kann. Digitale Medien sind dem Bereich der Lerntechniken zuzuordnen. Lerntechniken sind für den Lernprozess zwar notwendige, aber keine hinreichenden Bedingungen.

Abstract Initially, the optimal degree of anemia correction in patients with chronic kidney disease by erythropoiesis-stimulating agents (ESAs) relied mainly on the results of observational studies. Many of these studies supported full anemia correction. Subsequently, randomized controlled trials of small sample size examined intermediate outcomes, but only trials with hard outcomes could settle this issue convincingly. In contrast to expectations based on epidemiological studies, the randomized controlled trials of large sample size performed in patients with chronic kidney disease in the last two decades have convincingly shown that full anemia correction, as compared to partial anemia correction, is associated with increased risk of adverse events and mortality and that the increased risk outweighs potential benefit. Although transfusion needs decrease and quality of life increases with actively raised hemoglobin levels in severely anemic patients with chronic kidney disease, any benefit of increasing hemoglobin levels above 11.5 g/dL is at best unclear at present. As some of these patients may experience improvement in physical and mental health and overall well-being above this level, individualization of therapy may be chosen in those who are prepared to accept the associated risks. Future, adequately powered, and blinded randomized controlled trials of anemia treatment using patient-reported outcomes as primary rather than secondary endpoints are needed to answer the question of the optimal hemoglobin target as regards the quality of life.

Wissenschaftspropädeutik gilt neben einer vertieften Allgemeinbildung und Studierfähigkeit als wesentliches Element der Bildung in der Oberstufe. Forschendes Lernen könnte für Schüler*innen eine Möglichkeit darstellen, um im Unterricht eine „Bildung durch Wissenschaft“ zu erfahren. Bisher gibt es nur wenige Untersuchungen, die systematisch die Gelingensbedingungen und das Potenzial von Forschendem Lernen untersuchen, insbesondere, wenn man diesen Befund auf Schüler*innenforschung bezieht oder sogar auf partizipative Schüler*innenforschung im Bereich der Schulentwicklung ausweitet. Im Rahmen des Forschungs- und Entwicklungsprojektes (FEP) „Forschendes Lernen in der Oberstufe“ (FLidO) am Oberstufen-Kolleg erfolgt ein systematischer Ansatz zur Etablierung und Beforschung von Strukturen für Forschendes Lernen allgemein sowie insbesondere von partizipativen Forschungsstrukturen. Im Rahmen dieses Beitrages werden zunächst die Begriffe „Forschendes Lernen“ und „Partizipative Ak-tionsforschung“ theoretisch hergeleitet, der Forschungsstand dargestellt und die Grundkonzeption des Projektes beschrieben. Es werden die Arbeitsdefinition zum Forschenden Lernen im Projekt, die Leitideen für die konkrete Umsetzung des Forschenden Lernens in den verschiedenen Kontexten und exemplarisch zwei der fünf Kontexte, innerhalb derer Forschendes Lernen am Oberstufen-Kolleg Bielefeld implementiert wurde, vorgestellt. In addition to advanced general education and the ability to study, science propaedeutics (‘Wissenschaftspropädeutik’) is an essential element of upper secondary education. Research-based learning could be a way to enable students to pursue their education within the scope of science. So far, there are only a few studies that systematically analyze the prerequisites for success and the potential of research-based learning, especially if one refers to students’ research or even extends it to participatory students’ research in the field of school development. The research and development project “Research-based Learning in Upper Secondary Education” at the Oberstufen-Kolleg follows a systematic approach to set up structures for research-based learning in general, as well as participatory research structures are pursued. In this paper, the terms “research-based learning” and “participatory action research” will be derived theoretically, the state of research on this topic will be presented, and the conceptual framework of the project will be described. The working definition of research-based learning in the project, the guiding ideas for the concrete implementation of research-based learning in the various contexts and two examples of research-based learning implemented at the Oberstufen-Kolleg Bielefeld are presented.

The article presents the text of the authors' report at the plenary session of the XX Congress of Pediatricians of Russia (dated February 16, 2018) dedicated to the centenary of the Soviet state mother and child welfare system. The features of its formation and development were described. The most important achievements in the field of child health care were outlined. Attention is focused on the personalities of the first facilitators of pediatric healthcare in Soviet Russia. Authors summarise the findings resulting from the history of the Soviet pediatric service.

Abstract Background We use the example of the Gojjam Lymphoedema Best Practice Trial (GoLBeT), a pragmatic trial in a remote rural setting in northern Ethiopia, to extract lessons relevant to other investigators balancing the demands of practicality and community acceptability with internal and external validity in clinical trials. Methods We explain in detail the preparation for the trial, its setting in northern Ethiopia, the identification and selection of patients (inclusion and exclusion criterion, identifying and screening of patients at home, enrollment of patients at the health centres and health posts), and randomisation. Results We describe the challenges met, together with strategies employed to overcome them. Conclusions Examples given in the previous section are contextualised and general principles extracted where possible. We conclude that it is possible to conduct a trial that balances approaches that support internal validity (e.g. careful design of proformas, accurate case identification, control over data quality and high retention rates) with those that favour generalisability (e.g. ‘real world’ setting and low rates of exclusion). Strategies, such as Rapid Ethical Assessment, that increase researchers’ understanding of the study setting and inclusion of hard-to-reach participants are likely to have resource and time implications, but are vital in achieving an appropriate balance. Trial registration ISRCTN67805210, registered 24/01/2013.

The Dawn mission orbited and explored Ceres and Vesta, the two largest objects in the main asteroid belt. One of the key enabling technologies was solar electric propulsion. After more than 11 years in flight, Dawn completed operations in October 2018. I describe some lessons from the perspective of chief engineer and mission manager/mission director. • Dawn operated in deep space from 2007 to 2018. • Dawn orbited and explored Ceres and Vesta, the largest objects in the asteroid belt. • The mission was enabled by solar electric propulsion. • Dawn provides lessons for missions with electric propulsion and for other missions. [ABSTRACT FROM AUTHOR]

To expand coverage to those without it, Democrats in 2010 sacrificed cost control methods that might have helped those already insured. The law therefore did not offer most Americans what they wanted most. President Obama and those who thought like him convinced themselves the legislation would control costs by reforming how health care is organized, but any such effects have been both weak and unpopular. Now many commentators are accusing Democratic candidates of making the same mistake by prioritizing an ideological vision of "Medicare for All" over voters' worries about out-of-pocket costs. Yet Medicare for All, unlike less "radical" approaches, addresses those concerns directly. Unfortunately, neither elites (outside the industry!) nor voters seem to understand that, and it is politically risky because of the same fears about change, industry opposition, and distrust of government that inhibited more effective action a decade before. [ABSTRACT FROM AUTHOR]

Environmental governance is characterized by complex dynamic issues where new knowledge is constantly emerging that can shape how we understand the system and what kinds of policies and strategies are most effective. As a result, targeted mechanisms to acquire, translate, and disseminate knowledge into new policies are critical for adaptive environmental governance. The scholarship on learning in environmental governance has exploded in the past two decades leading to new empirical and theoretical insights. However, lacking from this literature is an examination of how these insights can inform practice. Here we explore evidence from the scholarship studying learning in environmental governance that can inform practitioners who engage in and manage environmental planning and decision-making processes. Three key factors are drawn from the scholarship that may foster learning: face-to-face dialog that is open and ongoing; cross-scale linkages; and investments in institutional rules, norms, and shared strategies for intentional learning. We translate these findings into strategies for environmental governance practitioners and explore how to mitigate some of the factors that constrain learning across many governance contexts. [ABSTRACT FROM AUTHOR]

Amid the current COVID‐19 crisis, everyone has been called upon to offer assistance. What can historians contribute? One obvious approach is to draw on our knowledge of the history of epidemics and proclaim the lessons of history. But does history offer clear lessons? To make their expertise relevant, some historians assert that there are enduring patterns in how societies respond to all epidemics that can inform our experiences today. Others argue that there are informative analogies between specific past epidemics and our present crisis, for instance between COVID‐19 and prior outbreaks of SARS or influenza. Both strategies can be pursued, but each must be done with care. It is certainly possible to map COVID‐19 onto the classic dramatic structure of an epidemic, but we cannot yet know how it will end, a failure of prognostication that constrains the advice we can offer. It is likewise possible to draw on the history of medical therapeutics and public health interventions to identify the risks we face of both underuse and overuse of our remedies, but we cannot yet judge whether our current commitment to heroic social distancing is warranted. While historians can offer insight, we must temper our contributions with humility. [ABSTRACT FROM AUTHOR]

Covid-19 has once again brought into focus our limited preparedness to deal with epidemics. Most nations, across the globe, have responded with a resolve to come stronger out of this crisis and leaderships across the world have shown great commitment to protecting its people from Covid-19. Covid-19 has also taught us a few things for the future. One such learning has been that a strong shift in focus towards non-communicable diseases driving health infrastructure across the globe for the last few decades has come at neglect of communicable diseases. In that sense, therefore, the current pandemic has been a wake-up call. Organised Medicine Academic Guild (OMAG), an umbrella organization of professional associations gathered a group of health experts to develop a policy document on epidemic preparedness to limit the influence of epidemics like Covid-19. [ABSTRACT FROM AUTHOR]

Multi-use (MU) has been promoted as a viable approach to the effective planning and mitigation of user-conflicts in the marine realm. Despite several research and pilot projects demonstrating the approach's feasibility and benefits, commercially viable MU applications remain patchy and few. Further, MU is neither systematically applied nor purposively planned for even in the imminent event of incompatible and conflicting use of marine space. This paper seeks to identify barriers and opportunities for mainstreaming MU based on desktop study and iterative stakeholder consultation. The findings reveal that the MU concept was frequently framed as 'co-location' or 'co-existence' and aimed toward mitigating conflict among users. Practice was ahead of theory with little attention to synergistic and efficiency aspects. Barriers for MU application include shortcomings in legislation, sectoral thinking, and burdensome administrative procedures. The main opportunity lies in creating a conducive policy environment where MU risks and transaction costs become low and competitive, respectively. Solutions at the sea basin and national level, upon which further MU application can be anchored, are proposed. [ABSTRACT FROM AUTHOR]

The proposed lesson was developed in the program for the 10th grade of the secondary school, which comes into force from the 2019-2020 school year. It presents de Broglie‘s hypothesis about the particle wave properties, numerical estimates of the de Broglie wavelength of micro- and macro-objects in order to clarify the conditions under which their wave properties may manifest, the experimental proof of de Broglie waves is analyzed. Particular attention is paid to the physical nature of the de Broglie waves. Several questions and problems have been suggested on the material presented to assist in understanding and mastering the material. [ABSTRACT FROM AUTHOR]

A few years ago, research focused on the study of emotions experienced in academic contexts emerged. In the present study, we focused on identifying and describing the academic emotions experienced by a group of secondary school students faced with reading tasks proposed in the subject Language and Literature in 2018. For the data collection we made observations of the classes corresponding to a didactic sequence, we administered a questionnaire that evaluates emotions in classes (AEQ) and we interviewed the students. The results are organized in three axes: description and analysis of the tasks proposed in the observed classes; emotional profile of students and their expressions about their emotions in relation to the sequence. To conclude, we refer to the objectives achieved and the contributions made by the study, and we also mention some future lines of research. [ABSTRACT FROM AUTHOR]

Background: Evaluators are cognisant of the need to determine the effects of an intervention within its context. Objectives: In education evaluations, there was a gap in context-specific assessment tools to determine the status of school functionality with the ultimate aim of examining whether there is a relationship between school functionality context and teaching and learning outcomes. To meet evaluation standards, evaluators must ensure that evaluation tools and data are accurately measuring the indicators and variables. The focus of the article is on lessons learned from a tool validation process. These are shared to guide evaluators in similar settings. Method: Khulisa Management Services (Khulisa) has conducted research and evaluations in South African schools since 1993. In 2011, Khulisa developed a school functionality tool based on local and international literature, engagement with key stakeholders, and through a series of implementation phases over various evaluations. The tool identifies high functional, functional, stagnant but functional and dysfunctional schools. The authors of this article undertook a reflection process to evaluate the evidence gathered to support the meaningfulness, usefulness and appropriateness of the tool properties. Results: Lessons from the validation process include the need to build time and resources for validation from the beginning, validating a tool over time and across evaluations adds value, training of data collectors is critical, and analysis is important towards establishing the consistency and reliability of a tool. Conclusion: While reliability analysis and the validation process are ongoing, preliminary results show that the tool has potential to document context appropriately. [ABSTRACT FROM AUTHOR]

Zimbabwe has been affected by the outbreak of the COVID-19 pandemic like the rest of the world. In the last decade, Zimbabwe has also faced a number of disasters such typhoid, cholera and flooding. In this paper, we argue that Zimbabwe could tap into its past experiences of managing the 2018 cholera outbreak in the fight against the COVID-19 pandemic. The paper draws insights from a qualitative study that sought to understand the challenges and strategies associated with cholera disaster response that happened in 2018. We identify five strategies used by various stakeholders to combat the 2018 cholera outbreak. These strategies include; awareness campaigns, family and contact tracing, coordination meetings, food and non-food items distribution, and setting up treatment and isolation centres. The article juxtaposes the strategies used to combat cholera in 2018 with the World Health Organisation (WHO) recommended COVID-19 strategies and we come to the conclusion that the cholera management strategies could be useful in guiding Zimbabwe's COVID-19 and future pandemics' response strategies. [ABSTRACT FROM AUTHOR]

Reconciliation in Zimbabwe remains a recurring question despite several interventions by the government to respond to the challenge. Such efforts stretch as far back as the ¦rst decade of independence. A key observation about the failure of the interventions is the weak utilisation of localism. Yet other countries with similar historical experiences as Zimbabwe have recorded better progress by embracing community-based methods. Indeed, the traditional liberal view that there is a universal set of approaches to reconciliation has for long been discredited and it is now widely accepted that due to diverse cultural values, practices and norms, communities should approach reconciliation in diverse ways. The National Peace and Reconciliation Commission (NPRC) of Zimbabwe has the opportunity to learn from other developing countries on how community approaches unfolded, and apply such lessons in enriching its own programmes in the country. The East Timor and Sierra Leone cases are adduced as providing practical and valuable insights upon which the NPRC can benchmark and re¦ne its strategy, and take advantage of the idle pool of indigenous methods in the country. [ABSTRACT FROM AUTHOR]

Partnerships in Global Surgery have evolved over several decades and continue to do so based on reports from different experiences and collaborations. These should be characterised by their objectives, leadership and "championship," communication, ethics and equity. Partnerships take the form of academic collaborations or clinical support whose details vary with the different stakeholders involved. Over time, these have evolved based on challenges, successes, and failures. Recently, quality improvement activities have been increasingly initiated with locally derived information. This has come from local databases in low and middle income country (LMIC) settings whose maintenance and analysis have been done through academic collaborations. For many sites in LMICs, there would be very little advance in paediatric surgery without collaborations. Despite this, problems still arise from collaborations due to failure to learn from past problems, lack of local championship, poor communication, and externally driven objectives. For success and longevity, the collaboration must pay attention to unique the needs of the site, champions and equity. [ABSTRACT FROM AUTHOR]