Who should be undertaking population-based surveys in humanitarian emergencies?

<p>Abstract</p> <p>Background</p> <p>Timely and accurate data are necessary to prioritise and effectively respond to humanitarian emergencies. 30-by-30 cluster surveys are commonly used in humanitarian emergencies because of their purported simplicity and reasonable validity and precision. Agencies have increasingly used 30-by-30 cluster surveys to undertake measurements beyond immunisation coverage and nutritional status. Methodological errors in cluster surveys have likely occurred for decades in humanitarian emergencies, often with unknown or unevaluated consequences.</p> <p>Discussion</p> <p>Most surveys in humanitarian emergencies are done by non-governmental organisations (NGOs). Some undertake good quality surveys while others have an already overburdened staff with limited epidemiological skills. Manuals explaining cluster survey methodology are available and in use. However, it is debatable as to whether using standardised, 'cookbook' survey methodologies are appropriate. Coordination of surveys is often lacking. If a coordinating body is established, as recommended, it is questionable whether it should have sole authority to release surveys due to insufficient independence. Donors should provide sufficient funding for personnel, training, and survey implementation, and not solely for direct programme implementation.</p> <p>Summary</p> <p>A dedicated corps of trained epidemiologists needs to be identified and made available to undertake surveys in humanitarian emergencies. NGOs in the field may need to form an alliance with certain specialised agencies or pool technically capable personnel. If NGOs continue to do surveys by themselves, a simple training manual with sample survey questionnaires, methodology, standardised files for data entry and analysis, and manual for interpretation should be developed and modified locally for each situation. At the beginning of an emergency, a central coordinating body should be established that has sufficient authority to set survey standards, coordinate when and where surveys should be undertaken and act as a survey repository. Technical expertise is expensive and donors must pay for it. As donors increasingly demand evidence-based programming, they have an obligation to ensure that sufficient funds are provided so organisations have adequate technical staff.</p

Health Issues Affecting Displaced Populations: The Evolution of Public Health Response in Emergency and Post-Emergency Phases of Complex Emergencies

The field of humanitarian response has made tremendous strides over the past decade. In the Cambodian refugee camps in the 1980s, the establishment o

Notes from the Field in Kigoma, Tanzania

In these short notes the authors provide some insight to their visit to displaced persons camps in Kigoma, Tanzania. This trip marks the fourth set of camps examined in the Post Emergency Phase Indicators Project, a joint collaboration between the Johns Hopkins Center for Refugee and Disaster Studies, and the International Emergency and Refugee Health Branch at the Centers for Disease Control.Dans ces brèves notes, les auteurs fournissent un aperçu de leur visite au camps pour personnes deplacees de Kigoma, en Tanzanie. Ce voyage marque la conclusion de la quatrième série de visites de camps de réfugiés examinés dans Ie cadre du Projet sur les Indicateurs d'Etapes en Situation Post- Urgente (Post-Emergency Phase Indicators Project), une collaboration conjointe du Centre John Hopkins pour les Etudes sur les Réfugiés et les Désastres, et la Section pour la Santé des Réfugiés et l'Urgence Internationale, du Centre pour Ie Contrôle Epidemique

AIDS, conflict and the media in Africa: risks in reporting bad data badly

BACKGROUND: Conflict, poverty and HIV disproportionately affect people in sub-Saharan Africa. The manner in which governments, national and international organisations and the media report on the HIV epidemic in situations of conflict, post-conflict and reconstruction can have unintended and negative consequences for those affected populations. The media in particular has a huge influence on how the world observes and reacts to the HIV epidemic among conflict-affected and displaced populations. DISCUSSION: Three case studies focused on Sudan, Uganda and Guinea describe what the media reported and why the reports were incomplete, misleading or incorrect. The exploration of possible ways to ensure that the media do not unwittingly inflame delicate and complicated situations of HIV among conflict-affected and displaced populations is then undertaken using epidemiological and journalistic principles. The discussion is divided into four sections: 1) Avoid stigmatising statements and ensure a balanced view; 2) Avoid accurate but misleading statements; 3) Avoid inaccurate statements by clearly stating sources and verifying their credibility; and 4) Do not repeat data and conclusions from other news sources without checking their accuracy. The aim of this manuscript is to stimulate awareness and debate among persons and organisations working on HIV/AIDS as well as the media in order to improve dialogue and ultimately to reduce stigma and discrimination amongst an already vulnerable group – conflict-affected and displaced persons. SUMMARY: The media and humanitarian organisations have published misleading and inaccurate HIV data and statements on conflict-affected and displaced populations in Sudan, Uganda and Guinea. Given the unique characteristics of the HIV epidemic and conflict-affected and displaced populations, the media have a special obligation to report in a balanced and non-discriminatory manner that may go beyond the accepted standards of journalism. The media may wish to have the HIV data and their interpretation reviewed by technical experts before going to press. Specific training for reporters and editors regarding ethical issues and basic epidemiological methods may help them to better understand the complexity of the situation and report more accurately; similar training for media watch groups and human rights organisations may improve the monitoring of such situations and possibly reduce misreporting and subsequent discrimination. More rigorous HIV biological and behavioural surveillance should be undertaken in situations of conflict and displacement and humanitarian guidelines should be integrated with guidance on media relations and reporting responsibilities of humanitarian agencies. Finally, humanitarian agencies must ensure the data they release are sound and that any biases are clearly stated. Improved communication with the media will help to ensure more accurate reporting and interpretation

A Spectral Conversion Approach to the Iterative Wiener Filter for Speech Enhancement

The Iterative Wiener Filter (IWF) for speech enhancement in additive noise is an effective and simple algorithm to implement. One of its main disadvantages is the lack of proper criteria for convergence, which has been shown to introduce severe degradation to the estimated clean signal. Here, an improvement of the IWF algorithm is proposed, when additional information is available for the signal to be enhanced. If a small amount of clean speech data is available, spectral conversion techniques can be applied for esimating the clean short-term spectral envelope of the speech signal from the noisy signal, with significant noise reduction. Our results show an average improvement compared to the original IWF that can reach 2 dB in the segmental output Signal-to-Noise Ratio (SNR), in low input SNR\u27s, which is perceptually significant

Nonparallel Training for Voice Conversion Based on a Parameter Adaptation Approach

The objective of voice conversion algorithms is to modify the speech by a particular source speaker so that it sounds as if spoken by a different target speaker. Current conversion algorithms employ a training procedure, during which the same utterances spoken by both the source and target speakers are needed for deriving the desired conversion parameters. Such a (parallel) corpus, is often difficult or impossible to collect. Here, we propose an algorithm that relaxes this constraint, i.e., the training corpus does not necessarily contain the same utterances from both speakers. The proposed algorithm is based on speaker adaptation techniques, adapting the conversion parameters derived for a particular pair of speakers to a different pair, for which only a nonparallel corpus is available. We show that adaptation reduces the error obtained when simply applying the conversion parameters of one pair of speakers to another by a factor that can reach 30%. A speaker identification measure is also employed that more insightfully portrays the importance of adaptation, while listening tests confirm the success of our method. Both the objective and subjective tests employed, demonstrate that the proposed algorithm achieves comparable results with the ideal case when a parallel corpus is available

Continuous Quality Improvement Applied to Outpatient Health Care Delivery in Displaced Persons Camps

Continuous Quality Improvement (CQI) has been shown to be a highly effective approach for the evaluation and management of hospitals in developed countries, but it has barely begun to be utilised in less developed countries. This article defines the principles and the main tools of CQI and then applies them to the postemergency phase of a displaed persons camp situation, specifically towards improving the utilisation and the quality of care in an out patient department.L'Accroissement Continu de la Qualité s'est révélé une approche très efficace pour l'évaluation et la gestion des hôpitaux dans les pays développés, mais n'a à toutes fins pratiques jamais été mise à profit dans les pays moins développés. Cet article définit les principes et les principaux instruments, Accroissement Continu de la Qualité, et les applique à la phase post-urgente dans la situation des camps pour personnes déplacées. L'attention porte plus spécifiquementsur les possibilités d'amélioration de l'utilisation des services et de la qualité des soins en clinique externe

Non-Parallel Training for Voice Conversion by Maximum Likelihood Constrained Adaptation

The objective of voice conversion methods is to modify the speech characteristics of a particular speaker in such manner, as to sound like speech by a different target speaker. Current voice conversion algorithms are based on deriving a conversion function by estimating its parameters through a corpus that contains the same utterances spoken by both speakers. Such a corpus, usually referred to as a parallel corpus, has the disadvantage that many times it is difficult or even impossible to collect. Here, we propose a voice conversion method that does not require a parallel corpus for training, i.e. the spoken utterances by the two speakers need not be the same, by employing speaker adaptation techniques to adapt to a particular pair of source and target speakers, the derived conversion parameters from a different pair of speakers. We show that adaptation reduces the error obtained when simply applying the conversion parameters of one pair of speakers to another by a factor that can reach 30% in many cases, and with performance comparable with the ideal case when a parallel corpus is available

Self-force on a scalar charge in radial infall from rest using the Hadamard-WKB expansion

We present an analytic method based on the Hadamard-WKB expansion to calculate the self-force for a particle with scalar charge that undergoes radial infall in a Schwarzschild spacetime after being held at rest until a time t = 0. Our result is valid in the case of short duration from the start. It is possible to use the Hadamard-WKB expansion in this case because the value of the integral of the retarded Green's function over the particle's entire past trajectory can be expressed in terms of two integrals over the time period that the particle has been falling. This analytic result is expected to be useful as a check for numerical prescriptions including those involving mode sum regularization and for any other analytical approximations to self-force calculations.Comment: 22 pages, 2 figures, Physical Review D version along with the corrections given in the erratu