Factors associated with patient and health system delay in diagnosis and commencement of treatment for pulmonary tuberculosis in the Middle East and North Africa (MENA): systematic review

This MPH dissertation undertakes a systematic review on factors associated with patient and health system delay in diagnosing and commencing treatment for pulmonary tuberculosis in Middle East and North Africa (MENA). The dissertation is composed of three main parts: namely parts A, B and C. Part A is the research protocol, which give brief background to research topic and the process of this review. This systematic review aims to assess factors associated with patient and health system delay for diagnosis and initiation of treatment of pulmonary tuberculosis in Middle East and North Africa (MENA). Part B elaborates on the background and highlights the importance of this research by examining the existing theoretical and empirical literature relevant to the topic. Part C presents the entire research project in a format suitable for PLOS journal submission. The background of this research project is summarized and the results are presented and discussed

Galvanizing collective action to accelerate reductions in maternal and newborn mortality and prevention of stillbirths

Every day, there are an estimated 810 maternal and 7,000 newborn deaths, and more than 5,000 stillbirths, most of which are preventable.1-3 While progress has been made in reducing maternal and neonatal morbidity and mortality and preventing stillbirths worldwide, inequities and gaps in quality of care persist4 and are disproportionately most dire in countries affected by conflict.5 In 2020, the coronavirus disease (COVID19) pandemic and response exposed multiple system vulnerabilities, exacerbated inequities to accessing care, and caused widespread disruption in reproductive, maternal, newborn, and child health services.6,7 Emerging evidence and modeling estimates of the indirect effects of the COVID-19 pandemic on maternal and newborn mortality in low- and middle-income countries (LMICs) reflect a sobering picture of what could lay ahead, with additional deaths estimated to be in the tens of thousands for mothers and hundreds of thousands for stillbirths and children aged under 5 years.3, 8-10 A dedicated, focused effort must be made to ensure maternal and newborn health (MNH) and prevention of stillbirths remain a priority

Present and future drinking water security and its impacts on maternities: a multi-scale assessment of Sudan

Adequate access to drinking water for hydration and hygiene depends on many factors. We developed the Drinking Water Security Index (DWSI) to assess relative multifactorial drinking water security at different spatial and temporal scales. DWSI is a function of four key indicators of drinking water security: water quality, water accessibility, water continuity, and water availability. We built DWSI with a total of 10 variables and applied the new index in Sudan to assess historical and future drinking water security at state, local, and maternity levels. Analyses at the state level found that the Red Sea and River Nile states are most vulnerable, with the lowest DWSI for both historical and future periods. The 1 km2 pixel level analysis shows large differences in water security within the major states. Analyses at the maternity level showed that nearly 18.97 million people are affected by the 10% of maternities with the lowest DWSI, a number projected to increase by 60% by 2030. Current and future DWSI of maternities providing Emergency Obstetric and Newborn Care was assessed to identify those where urgent action is needed to ensure quality health care in water-secure conditions. This work provides useful information for stakeholders in the health and drinking water sectors in Sudan, to improve public health, reduce preventable mortality, and make the population more resilient to projected environmental changes.</p