A Report on Sickle Cell in Sierra Leone

Sierra Leone is thought to be one of the West African countries most affected by sickle cell disorders. Estimates state that one in four people carry the gene for sickle cell and between 1 to 2% of births are of children with the condition. Despite this, there has been a general public health and social neglect of the condition, so that prevalence is poorly understood and policy non-existent. This participatory qualitative research project, conducted in 2018 in two districts in the country, sought to understand both women’s experiences caring for children with the condition, as well as what the needs were of women who had the condition. The findings illustrated that a historical memory of the condition and its effects exists in the intergenerational memories and practices of people. This is important to learn from to combat stigmatisation of women and people who have the condition. However, past expertise and medical knowledge currently co-exist in isolation from each other, with access to proper healthcare unavailable in most parts of the country. This has led to an inability to get a correct medical diagnosis, no advice about how to live with the condition and an inability to access specialized medical and rehabilitative services. These failures in care have led to early deaths and disablement, with the result that the general public fear the condition. A neglect of reproductive justice and the relational implications for women with the condition was also apparent in the high number of deaths of women and infants with sickle cell. Lastly, due to the work of the voluntary and medical sector, there is increasing awareness in parents, schools and communities of how the total environment is crucial for holistic management of sickle cell conditions in a low- income country. However, it is women who are still mostly responsible for ensuring that their children access a better quality of life and women who still incur moral blame and shame for their ill-health and that of their children

Conflict Prevention through Post Conflict Housing Reconstruction: Good Practices and Lessons Learned

The concept of ‘DRR’ within natural and technological disasters context conform to the concept of ‘conflict prevention and peace building’ within conflicts or wars context. Similar to DRR measures within disaster context, it is important to study conflict prevention measures within conflicts or wars. This paper presents such measures within post conflict housing reconstruction. Literature identifies a number of implications of post conflict housing reconstruction contributes on development and peace building including economic development and poverty alleviation, gender equity and empowerment, integrating displaced communities, restoring security, trust and faith in future and legitimacy. An empirical study conducted in post conflict Sri Lanka identified the good practices and lessons learned in preventing conflicts and building peace within post conflict housing reconstruction. Study involved 37 in-depth interviews with policy makers, practitioners, beneficiaries and academics. The approach to reconstruction of housing in the original places over relocation and traditional construction over pre-fabricated housing enhanced beneficiary satisfaction and occupancy. Low income and vulnerable people were prioritised in accessing housing assistance while beneficiaries’ livelihoods were enhanced though livelihood support packages and construction craftsmen training. These as well as the involvement of local labour and material developed the local economy. Furthermore, local construction materials and local labour involvement in housing reconstruction enhanced the community linkages. Participatory approach to construction promoted a sense of ownership towards housing while reducing the cost of construction. Nevertheless, low income families faced with difficulties in completing the construction, which hindered privacy and security. Also, female head households faced difficulties in contributing unskilled labour and constructing a habitable house with the grant provided. Therefore, suggestions were made to tailor the financial grant based on the special requirements of vulnerable families such as female head households

Addressing housing needs in minimising the problems of post conflict housing reconstruction

Depleted human and social capital, displacement of people, destruction of property, weakened institutions and ruined economy are some of the legacies of conflicts. Within this context, post conflict reconstruction contributes to overcome the legacies of conflict through reactivating the development process that has been disrupted by the conflict. Among the post conflict reconstruction interventions, post conflict housing reconstruction is paramount important as it contributes to development and peace through restoring the economic and social life of conflict affected people. Despite the importance, the success of post conflict housing reconstruction is hindered by a number of problems such as lack of strategies to address the unique challenges faced by vulnerable households, lack of involvement of local people, lack of use of local building material and technology, lack of local economic development, lack of community linkages, lack of cultural and local consideration, overlooked socio-economic conditions of occupants, standardised housing models, housing models imported from different cultures, lack of beneficiary consultation, poor performance of agencies, bribery and corruptions and lack of post occupancy evaluation. If not properly managed, these issues lead to hinder the success of post conflict housing reconstruction and its contribution to the development and peace. This paper argues that lack of concern on housing needs has directly or indirectly given rise for most of these issues through a comprehensive literature review on post conflict housing reconstruction and housing needs. The paper establishes the link between the problems of housing reconstruction and lack of addressing housing needs. Accordingly, it concludes that adequate housing measures provide a general guideline in addressing housing needs and addressing such needs leads to minimise the problems of post conflict housing reconstruction

Diffusion of e-health innovations in 'post-conflict' settings: a qualitative study on the personal experiences of health workers.

BACKGROUND: Technological innovations have the potential to strengthen human resources for health and improve access and quality of care in challenging 'post-conflict' contexts. However, analyses on the adoption of technology for health (that is, 'e-health') and whether and how e-health can strengthen a health workforce in these settings have been limited so far. This study explores the personal experiences of health workers using e-health innovations in selected post-conflict situations. METHODS: This study had a cross-sectional qualitative design. Telephone interviews were conducted with 12 health workers, from a variety of cadres and stages in their careers, from four post-conflict settings (Liberia, West Bank and Gaza, Sierra Leone and Somaliland) in 2012. Everett Roger's diffusion of innovation-decision model (that is, knowledge, persuasion, decision, implementation, contemplation) guided the thematic analysis. RESULTS: All health workers interviewed held positive perceptions of e-health, related to their beliefs that e-health can help them to access information and communicate with other health workers. However, understanding of the scope of e-health was generally limited, and often based on innovations that health workers have been introduced through by their international partners. Health workers reported a range of engagement with e-health innovations, mostly for communication (for example, email) and educational purposes (for example, online learning platforms). Poor, unreliable and unaffordable Internet was a commonly mentioned barrier to e-health use. Scaling-up existing e-health partnerships and innovations were suggested starting points to increase e-health innovation dissemination. CONCLUSIONS: Results from this study showed ICT based e-health innovations can relieve information and communication needs of health workers in post-conflict settings. However, more efforts and investments, preferably driven by healthcare workers within the post-conflict context, are needed to make e-health more widespread and sustainable. Increased awareness is necessary among health professionals, even among current e-health users, and physical and financial access barriers need to be addressed. Future e-health initiatives are likely to increase their impact if based on perceived health information needs of intended users

A Wake-Up Call: Lessons from Ebola for the World's Health Systems

The report ranks the world's poorest countries on the state of their public health systems, finding that 28 have weaker defenses in place than Sierra Leone where, alongside Liberia and Guinea, the current Ebola crisis has already claimed more than 9,500 lives. The report also advises that prevention is better than cure, finding that the international Ebola relief effort in West Africa has cost $4.3bn, whereas strengthening the health systems of those countries in the first place would have cost just$1.58bn. Ahead of an Ebola summit attended by world leaders in Brussels today, the charity warns that alongside immediate much needed support to Sierra Leone, Liberia and Guinea, lessons need to be learned and applied to other vulnerable countries around the world

AFL-CIO Key Votes Survey: How Investment Managers Voted in the 2004 Proxy Season

[Excerpt] Like other investment management decisions, pension funds generally delegate the authority to vote their shares to a money manager or a specialized proxy voting consultant. Because proxies are a plan asset, ensuring that they are voted in the interests of beneficiaries is part of a trustee’s fiduciary duty. The Key Votes Survey is intended to help trustees fulfill this duty by reviewing the voting records of these investment managers and proxy consultants

APPROACHES TO IMPROVING THE DELIVERY OF SOCIAL SERVICES IN DIFFICULT ENVIRONMENTS

Institutional and Behavioral Economics,

The Role of Cultural Landscapes in the Delivery of Provisioning Ecosystem Services in Protected Areas

The aim of this paper is to assess and highlight the significance of cultural landscapes in protected areas, considering both biodiversity and the delivery of provisioning ecosystem services. In order to do that, we analyzed 26 protected areas in Andalusia (Spain), all of them Natural or National Parks, regarding some of their ecosystem services (agriculture, livestock grazing, microclimate regulation, environmental education and tourism) and diversity of the four terrestrial vertebrate classes: amphibians, reptiles, mammals, and birds. A cluster analysis was also run in order to group the 26 protected areas according to their dominant landscape. The results show that protected areas dominated by dehesa (a heterogeneous system containing different states of ecological maturity), or having strong presence of olive groves, present a larger area of delivery of provisioning ecosystem services, on average. These cultural landscapes play an essential role not only for biodiversity conservation but also as providers of provisioning ecosystem services