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Focussing on the experiences and perceptions of parents and volunteer caregivers of children with disabilities, this paper reports on a study that explored the provision of early childhood development and inclusive education for children with disabilities in rural Malawi. Drawing on a community-based participatory research (CBPR) design, ten local community researchers and two Malawian researchers collaborated to interview forty caregivers and parents of children with disabilities attending ten Community Based Care Centres (CBCCS) in Southern Malawi. Findings are reported through four key themes: experiences of disability, inclusion, learning and developmental progress; factors influencing non-enrolment and absenteeism; barriers to learning and progress; and accountability and support channels. Five key components were highlighted: (1) relevance of peer interactions for learning outcomes and wellbeing; (2) the importance of the CBCC as (a model for) a safe space against discrimination; (3) relevance of quality education and pre-school teacher training; (4) necessity of material support to decrease absenteeism; and (5) the need for greater community and state support for children with disabilities. The implications of the study's findings are discussed, including the importance and relevance of considering the perspectives of community based actors in program and policy design.

With rapidly changing ecology, urbanization, climate change, increased travel and fragile public health systems, epidemics will become more frequent, more complex and harder to prevent and contain. Here we argue that our concept of epidemics must evolve from crisis response during discrete outbreaks to an integrated cycle of preparation, response and recovery. This is an opportunity to combine knowledge and skills from all over the world--especially at-risk and affected communities. Many disciplines need to be integrated, including not only epidemiology but also social sciences, research and development, diplomacy, logistics and crisis management. This requires a new approach to training tomorrow's leaders in epidemic prevention and response. We need to integrate the knowledge and skills from different disciplines and from communities all over the world to enable effective responses to future epidemics., Author(s): Juliet Bedford [sup.1] , Jeremy Farrar [sup.2] , Chikwe Ihekweazu [sup.3] , Gagandeep Kang [sup.4] , Marion Koopmans [sup.5] , John Nkengasong [sup.6] Author Affiliations: (1) Anthrologica, Oxford, UK [...]

IntroductionAlthough social scientists have long worked in public health emergencies, the value of including social science intelligence in response strategies became highly visible during the epidemic of Ebola virus disease [...]

IntroductionWhile the outbreak of Ebola virus disease (EVD) in Equateur Province presented a series of logistical and contextual challenges to community-based work, it provided unique opportunities to strengthen risk communication, [...]

To identify reasons why women who access health facilities and utilise maternal newborn and child health services at other times, do not necessarily deliver at health facilities. Forty-six semi-structured interviews were conducted with mothers who had recently delivered (n = 30) or were pregnant (n = 16). Thematic analysis of the interview data resulted in emerging trends that were critically addressed according to the research objective. Of the 30 delivered cases, 14 had given birth at a health facility, but only 3 of those had planned to do so. The remaining 11 had attended due to long or complicated labours. Five dominant themes influencing location of delivery were identified: perceptions of a normal delivery; motivations encouraging health facility delivery; deterrents preventing health facility deliveries; decision-making processes; and level of knowledge and health education. Understanding the socio-cultural determinants that influence the location of delivery has implications for service provision. Alongside timely health education and maximising the contact between women and healthcare professionals, these determinants should be actively incorporated into maternal newborn and child health policy and programming in ways that encourage the utilisation of health facilities, even for routine deliveries. Keywords Maternal health * Care-seeking behaviour * Facility delivery * Childbirth * Ethiopia * Qualitative methods, Introduction Maternal health is assuming an increasingly prominent position on the stage of international health. As the World Bank's recently published Reproductive Health Action Plan emphasises, there is renewed global [...]

Some evidence suggests that balanced energy protein (BEP) supplements taken during pregnancy and lactation can have positive effects on birth outcomes such as small‐for‐gestational age and birthweight, but more evidence is needed on the long‐term use and acceptability of such supplements. We conducted a mixed‐methods formative research study to assess and compare compliance with and acceptability of two BEP supplements, a lipid‐based peanut paste and a biscuit, to identify BEP supplements for subsequent inclusion in an efficacy trial. We conducted an 8‐week feeding trial of daily supplementation among two groups of 40 pregnant women each in rural Nepal. Compliance data were collected and supplements distributed at the weekly visits. Sensory properties of the supplements were assessed using a 7‐point Likert scale. In addition, in‐depth interviews with women (n = 16), family members (n = 6) and health workers (n = 6) and focus group discussions (FGDs) (n = 4) were conducted to explore themes related to general use and intention of future use of the supplement. Overall self‐reported compliance was high: medians of 91.1% in the lipid‐based peanut paste group and 96.4% in the biscuit group. Both supplements were rated highly on overall likability (median score 6/7) and sensory properties. Qualitative findings showed that sustained use of the supplements was attributed to expected health benefits, favourable sensory attributes, and family support. The FGDs suggested providing the option to choose between more than one type/flavour of supplements to improve compliance. Sharing was mostly evident in the first week with higher sharing reported in the biscuit group. Key messages: Both the lipid‐based peanut paste and the vanilla biscuit were well accepted by pregnant women in rural Nepal during an 8‐week home feeding trial.The compliance measurements showed high overall compliance in both supplement groups with the reasons being the perceived health benefits to the mother and baby, favourable sensory properties, enabling environment at home for product consumption (privacy and family support) and ease of product use.Before an efficacy trial of a nutritional food supplement, it is important to conduct a mixed‐methods feeding trial in the study population to understand the contextual factors that enable and prevent the use of supplements to inform ways to improve compliance with the supplements. [ABSTRACT FROM AUTHOR]

In response to a number of growing global health challenges, New York University and UNICEF designed a Behavioral Communication Strategies for Global Epidemics course that brings together United Nations professionals, government staff, and MPH (Master of Public Health) students to design innovative social behavior change communication (SBCC) strategies that address disease outbreaks and humanitarian challenges around the world. Applying a systems approach, participants in the course work on interdisciplinary teams to design strategies, develop skills, and engage in global learning. At the culmination of the course, all teams present strategies to UNICEF country offices for implementation. This innovative model for disease outbreak, public health education, and humanitarian response provides professionals with an opportunity to develop a wide range of competencies, including systems thinking, behavior change, and human-centered design and equips them with the necessary tools to develop more novel approaches to SBCC. As the number of outbreaks and humanitarian challenges increase each year, this format for learning can serve as a model for how professionals can effectively address these complex crises. [ABSTRACT FROM AUTHOR]

Poor maternal nutrition contributes to poor birth outcomes, including low birth weight and small for gestational age births. Fortified balanced energy protein (BEP) supplements may be beneficial, although evidence is limited. This mixed method study, conducted among pregnant women in Burkina Faso, is part of a larger clinical trial that seeks to understand the impact of fortified BEP supplements on pregnancy outcomes and child growth. The formative research reported here, a single‐meal rapid assessment of 12 product formulations, sought to understand product preferences for provision of BEP supplements and contextual factors that might affect product acceptability and use. Results indicate a preference for products perceived as sweet rather than salty/savoury and for products perceived as familiar, as well as a sensitivity to product odours. Women expressed a willingness and intention to use the products even if they did not like them, because of the health benefits for their babies. Data also indicate that household food sharing practices may impact supplement use, although most women denied any intention to share the products. Sharing behaviour should therefore be monitored, and strategies to avoid sharing should be developed during the succeeding parts of the research. [ABSTRACT FROM AUTHOR]

Balanced energy protein (BEP) supplementation for pregnant and lactating women in low- and middle-income countries is a promising strategy to improve birth outcomes and child growth. The objective of this study was to assess and compare the acceptability of new formulations of two fortified BEP supplements, a lipid-based peanut paste and a vanilla biscuit, among 80 pregnant women in rural Burkina Faso, prior to an efficacy trial. A 10-week individually randomized cross-over study was designed, in which women received a weekly supply of each supplement for 4 weeks, and a daily choice between the supplements in the last 2 weeks. Questionnaires to assess daily consumption and supplement acceptability (n = 80) and home observations (n = 20) were combined with focus group discussions (n = 6) and in-depth interviews with women (n = 80) and stakeholders (n = 24). Results showed that the two supplements were well accepted. Quantitative findings indicated high compliance (>99.6%) and high overall appreciation (Likert score >6 out of 7) of both supplements. The assessment of preferred choice in Weeks 9 and 10 indicated a slight preference for the vanilla biscuit. Qualitative findings indicated that perceived health benefits, support from household members and educational messages from health professionals were important drivers for acceptance and compliance. Sharing was not often reported but was identified during interviews as a possible risk. We recommend that future studies use a combination of methods to identify appropriate food supplements and context-specific factors that influence acceptability, compliance and subsequent impact of nutritious food supplements., (© 2021 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Recent outbreaks of Ebola virus disease (2013-2016) and Zika virus (2015-2016) bring renewed recognition of the need to understand social pathways of disease transmission and barriers to care. Social scientists, anthropologists in particular, have been recognised as important players in disease outbreak response because of their ability to assess social, economic and political factors in local contexts. However, in emergency public health response, as with any interdisciplinary setting, different professions may disagree over methods, ethics and the nature of evidence itself. A disease outbreak is no place to begin to negotiate disciplinary differences. Given increasing demand for anthropologists to work alongside epidemiologists, clinicians and public health professionals in health crises, this paper gives a basic introduction to anthropological methods and seeks to bridge the gap in disciplinary expectations within emergencies. It asks: 'What can anthropologists do in a public health crisis and how do they do it?' It argues for an interdisciplinary conception of emergency and the recognition that social, psychological and institutional factors influence all aspects of care., Competing Interests: Competing interests: JB is director of a consultancy specialised in the applied anthropology of global health.