Maternal death and obstetric care audits in Nigeria: A systematic review of barriers and enabling factors in the provision of emergency care.

Acknowledgements We would like to thank Yutaka Osakabe for co-ordinating the retrieval of full text articles. The John D. and Catherine T. MacArthur Foundation supported this study, grant number 12-100074-000-INPPeer reviewedPublisher PD

Using developmental evaluation to enhance continuous reflection, learning and adaptation of an innovation platform in Australian Indigenous primary healthcare

Effective efforts to strengthen health systems need diverse, multi-stakeholder networks working together on complex or 'wicked' problems such as prevention and control of chronic diseases, solutions to which go beyond the role and capability of one organisation. The contextual complexities inherent in 'wicked' problems mean that solutions warrant a systems approach that encompasses innovation and new ways of thinking about, facilitating and implementing collective decision-making processes and change practices. Innovation platforms are a mechanism for facilitating communication and collaboration among diverse stakeholders, promoting joint action and stimulating innovation. Developmental evaluation is an approach that is increasingly being used to evaluate innovative and emergent programmes and projects, as it enables evaluators to provide real-time feedback so that evaluation findings can be used to guide development and adaptations. Developmental evaluation emphasises learning and adaptation, and aligns well with the implementation of innovation platforms that have continuous reflection, learning and adaptation as a specific design principle. Here, we outline our rationale for applying a developmental evaluation to enhance the formation, functioning and outcomes of an innovation platform aimed at accelerating and strengthening large-scale quality improvement efforts in Australian Aboriginal and Torres Strait Islander primary healthcare. We provide examples to explain how the developmental evaluation findings were used for adaptation of the innovation platform and assess to what extent our application of developmental evaluation was consistent with, and reflective of, its essential principles. Our evaluation aligned strongly with the principles of developmental evaluation, and the approach we took was well suited to situations with a developmental purpose, innovation niche and complexity such as innovation platforms. As a result, along with the increasing interest in multi-stakeholder platforms (e.g. innovation platforms) and the inherent challenges with evaluating these complex networks, we anticipate our use of this approach being of interest globally

Comparing and contrasting 'innovation platforms' with other forms of professional networks for strengthening primary health care systems for Indigenous Australians

Efforts to strengthen health systems require the engagement of diverse, multidisciplinary stakeholder networks. Networks provide a forum for experimentation and knowledge creation, information exchange and the spread of good ideas and practice. They might be useful in addressing complex issues or ‘wicked’ problems, the solutions to which go beyond the control and scope of any one agency. Innovation platforms are proposed as a novel type of network because of their diverse stakeholder composition and focus on problem solving within complex systems. Thus, they have potential applicability to health systems strengthening initiatives, even though they have been predominantly applied in the international agricultural development sector. In this paper, we compare and contrast the concept of innovation platforms with other types of networks that can be used in efforts to strengthen primary healthcare systems, such as communities of practice, practice-based research networks and quality improvement collaboratives. We reflect on our ongoing research programme that applies innovation platform concepts to drive large-scale quality improvement in primary healthcare for Aboriginal and Torres Strait Islander Australians and outline our plans for evaluation. Lessons from our experience will find resonance with others working on similar initiatives in global health

Comparing and contrasting 'innovation platforms' with other forms of professional networks for strengthening primary health care systems for Indigenous Australians

Efforts to strengthen health systems require the engagement of diverse, multidisciplinary stakeholder networks. Networks provide a forum for experimentation and knowledge creation, information exchange and the spread of good ideas and practice. They might be useful in addressing complex issues or ‘wicked’ problems, the solutions to which go beyond the control and scope of any one agency. Innovation platforms are proposed as a novel type of network because of their diverse stakeholder composition and focus on problem solving within complex systems. Thus, they have potential applicability to health systems strengthening initiatives, even though they have been predominantly applied in the international agricultural development sector. In this paper, we compare and contrast the concept of innovation platforms with other types of networks that can be used in efforts to strengthen primary healthcare systems, such as communities of practice, practice-based research networks and quality improvement collaboratives. We reflect on our ongoing research programme that applies innovation platform concepts to drive large-scale quality improvement in primary healthcare for Aboriginal and Torres Strait Islander Australians and outline our plans for evaluation. Lessons from our experience will find resonance with others working on similar initiatives in global health

A coincineração de resíduos em fornos de cimento: riscos para a saúde e o meio ambiente Co-incineration in cement kilns: health and environmental risks

O objetivo do artigo é discutir a forma como a coincineração de resíduos em fábricas de cimento vem crescendo no Brasil, bem como seus impactos sobre a saúde humana e o meio ambiente. Informações gerais sobre mercado e efeitos sobre a saúde foram obtidas através de revisão bibliográfica e alguns estudos de caso, escolhidos a partir de debate com integrantes da Rede Brasileira de Justiça Ambiental, foram construídos para ilustrar a situação no Brasil. Os estudos encontrados mostraram que, independente do nível de desenvolvimento tecnológico dos países, a saúde dos trabalhadores e das pessoas que moram próximas às fábricas de cimento vem sendo prejudicada pela poluição emitida pelas empresas de cimento, em especial por aquelas que praticam a coincineração. Além disso, no contexto brasileiro, a vulnerabilidade das instituições e populações afetadas tende a agravar este problema. Como conclusão, defende-se o aumento da capacidade institucional dos órgãos brasileiros responsáveis pelo monitoramento das atividades industriais, bem como uma rediscussão mais aprofundada dos aspectos políticos e éticos ligados ao transporte e comércio de resíduos industriais.<br>In this article we discuss the development of hazardous waste co-incineration in cement kilns in Brazil as well as its impacts on health and the environment. Information was gathered through an extensive review on social and environmental impacts of co-incineration, and case studies, chosen after discussion with social movement representatives concerned with the co-incineration issue and related to the Brazilian Network on Environmental Justice, are described to illustrate the reality of co-incineration in Brazil. Studies showed that workers and community health suffers negative impacts from such practices in high-, middle- and low-income countries. In the Brazilian context, the institutional and social vulnerability intensifies these problems. To conclude, we argue for the necessity of increasing the institutional capacity of health and environmental agencies in Brazil, through staff training and better infra-structure. Additionally, we also propose a return of the debate about political and ethical aspects of industrial waste trade