The effects of educational intervention on fathers' relationships with their infants

The purpose of this study was twofold: (1) to examine the impact educational intervention during the postpartum period has on fathers' attitudes toward involvement with their babies, their knowledge of infant capabilities, and their caregiving of their babies; and (2) to validate a research instrument for use with mothers and fathers of newborn infants. It was hypothesized that fathers participating in the educational intervention as compared to a control group would have scores indicating more positive parenting on five Theoretical Factors--(I) Parental knowledge of infant capabilities, (II) Parental perception of infant needs for affection and stimulation, (III) Parental perception of caregiving competence, (IV) Sex-role division of caregiving tasks, and (V) Negative affects of having a new baby. It was also hypothesized that fathers with maternal partners with higher expectations for fathers' involvement in daily caregiving would report more involvement than would those whose maternal partners had lower expectations

Crippling Violence: Conflict and Incident Polio in Afghanistan.

BACKGROUND:Designing effective public health campaigns in areas of armed conflict requires a nuanced understanding of how violence impacts the epidemiology of the disease in question. METHODS:We examine the geographical relationship between violence (represented by the location of detonated Improvised Explosive Devices) and polio incidence by generating maps of IEDs and polio incidence during 2010, and by comparing the mean number of IED detonations in polio high-risk districts with non polio high-risk districts during 2004-2009. RESULTS:We demonstrate a geographic relationship between IED violence and incident polio. Districts that have high-risk for polio have highly statistically significantly greater mean numbers of IEDs than non polio high-risk districts (p-values 0.0010-0.0404). CONCLUSIONS:The geographic relationship between armed conflict and polio incidence provides valuable insights as to how to plan a vaccination campaign in violent contexts, and allows us to anticipate incident polio in the regions of armed conflict. Such information permits vaccination planners to engage interested armed combatants to co-develop strategies to mitigate the effects of violence on polio

A cross-case comparative analysis of international security forces’ impacts on health systems in conflict-affected and fragile states

Background: Destruction of health systems in fragile and conflict-affected states increases civilian mortality. Despite the size, scope, scale and political influence of international security forces intervening in fragile states, little attention has been paid to array of ways they may impact health systems beyond their effects on short-term humanitarian health aid delivery. Methods: Using case studies we published on international security forces’ impacts on health systems in Haiti, Kosovo, Afghanistan and Libya, we conducted a comparative analysis that examined three questions: What aspects, or building blocks, of health systems did security forces impact across the cases and what was the nature of these impacts? What forums or mechanisms did international security forces use to interact with health system actors? What policies facilitated or hindered security forces from supporting health systems? Results: We found international security forces impacted health system governance, information systems and indigenous health delivery organizations. Positive impacts included bolstering the authority, transparency and capability of health system leadership. Negative impacts included undermining the impartial nature of indigenous health institutions by using health projects to achieve security objectives. Interactions between security and health actors were primarily ad hoc, often to the detriment of health system support efforts. When international security forces were engaged in health system support activities, the most helpful communication and consultative mechanisms to manage their involvement were ones that could address a wide array of problems, were nimble enough to accommodate rapidly changing circumstances, leveraged the power of personal relationships, and were able to address the tensions that arose between security and health system supporting strategies. Policy barriers to international security organizations participating in health system support included lack of mandate, conflicts between security strategies and health system preservation, and lack of interoperability between security and indigenous health organizations with respect to logistics and sharing information. Conclusions: The cases demonstrate both the opportunities and risks of international security organizations involvement in health sector protection, recovery and reconstruction. We discuss two potential approaches to engaging these organizations in health system support that may increase the chances of realizing these opportunities while mitigating risks

Greater IED density overlaps with high risk polio districts.

<p>(A) The thirteen “high-risk” districts, as identified by the Afghanistan members of the Global Polio Eradication Initiative. Adapted from GPEI 2010 Annual Report. (B) Incidence density map created by plotting 3,414 IED detonations from 2009.</p

Comparison of mean number of IED detonations in non-polio high-risk districts vs. polio high-risk districts, by year.

<p>Comparison of mean number of IED detonations in non-polio high-risk districts vs. polio high-risk districts, by year.</p

Comprehensive Medical Support in Complex Emergencies (CMSCE):pilot course review

Global threats to health and health security are growing. Fragile and failed states, armed groups, ungoverned spaces, outbreaks and potential unknown “Disease X” threats, antimicrobial resistance (AMR), hybrid and gray zone conflict all exacerbate complex medical emergencies. These growing threats increase preventable morbidity and mortality of the most vulnerable populations. In an effort to promote best practices, standardize responses, and prevent excess death and disability in these contexts, The Kofi Annan International Peacekeeping Training Centre (KAIPTC), with support from multiple international partners and a volunteer facilitator faculty, administered the pilot course for military and civilian health officers involved in U.N. peacekeeping missions entitled, “Comprehensive Medical Support in Complex Emergencies (CMSCE 19).” This brief review paper provides a description of the process in designing and delivering an interdisciplinary course for providers and decision makers responding to complex emergencies. We conclude with best practices and next steps for course evolution