Association between Anaemia during Pregnancy and Blood Loss at and after Delivery among Women with Vaginal Births in Pemba Island, Zanzibar, Tanzania

The study sought to identify determinants of blood loss at childbirth and 24 hours postpartum. The study was nested in a community-based randomized trial of treatments for anaemia during pregnancy in Wete Town, Pemba Island, Zanzibar, United Republic of Tanzania. Status of anaemia during pregnancy, nutritional information, obstetric history, and socioeconomic status were assessed at enrollment during routine antenatal care. Pregnant women presented for spontaneous vaginal delivery, and nurse-midwives collected information on labour and delivery via partograph. Blood-stained sanitary napkins and pads from childbirth and 24 hours postpartum were quantified using the alkaline hematin method. Moderateto-severe anaemia (Hb <90 g/L) at enrollment was strongly associated with blood loss at delivery and the immediate postpartum period, after adjusting for maternal covariates and variables of biological relevance to blood loss. Greater blood loss was associated (p<0.10) with duration of the first stage of labour, placental weight, receipt of oxytocin, preterm birth, and grand multiparity. The findings provide unique evidence of a previously-suspected link between maternal anaemia and greater blood loss at childbirth and postpartum. Further research is needed to confirm these findings on a larger sample of women to determine whether women with moderate-to-severe anaemia are more likely to experience postpartum haemorrhage and whether appropriate antenatal or peripartum care can affect the relationships described here

Gendered health systems: evidence from low- and middle-income countries

Background Gender is often neglected in health systems, yet health systems are not gender neutral. Within health systems research, gender analysis seeks to understand how gender power relations create inequities in access to resources, the distribution of labour and roles, social norms and values, and decision-making. This paper synthesises findings from nine studies focusing on four health systems domains, namely human resources, service delivery, governance and financing. It provides examples of how a gendered and/or intersectional gender approach can be applied by researchers in a range of low- and middle-income settings (Cambodia, Zimbabwe, Uganda, India, China, Nigeria and Tanzania) to issues across the health system and demonstrates that these types of analysis can uncover new and novel ways of viewing seemingly intractable problems. Methods The research used a combination of mixed, quantitative, qualitative and participatory methods, demonstrating the applicability of diverse research methods for gender and intersectional analysis. Within each study, the researchers adapted and applied a variety of gender and intersectional tools to assist with data collection and analysis, including different gender frameworks. Some researchers used participatory tools, such as photovoice and life histories, to prompt deeper and more personal reflections on gender norms from respondents, whereas others used conventional qualitative methods (in-depth interviews, focus group discussion). Findings from across the studies were reviewed and key themes were extracted and summarised. Results Five core themes that cut across the different projects were identified and are reported in this paper as follows: the intersection of gender with other social stratifiers; the importance of male involvement; the influence of gendered social norms on health system structures and processes; reliance on (often female) unpaid carers within the health system; and the role of gender within policy and practice. These themes indicate the relevance of and need for gender analysis within health systems research. Conclusion The implications of the diverse examples of gender and health systems research highlighted indicate that policy-makers, health practitioners and others interested in enhancing health system research and delivery have solid grounds to advance their enquiry and that one-size-fits-all heath interventions that ignore gender and intersectionality dimensions require caution. It is essential that we build upon these insights in our efforts and commitment to move towards greater equity both locally and globally

Geoscience Education Perspectives on Integrated, Coordinated, Open, Networked (ICON) Science

Practitioners and researchers in geoscience education embrace collaboration applying ICON (Integrated, Coordinated, Open science, and Networked) principles and approaches ICON principles and approaches have been used to create and share large collections of educational resources, to move forward collective priorities, and to foster peer-learning among educators. These strategies can also support the advancement of coproduction between geoscientists and diverse communities. For this reason, many authors from the geoscience education community have co-created three commentaries on the use and future of ICON in geoscience education. We envision that sharing our expertise with ICON practice will be useful to other geoscience communities seeking to strengthen collaboration. Geoscience education brings substantial expertise in social science research and its application to building individual and collective capacity to address earth sustainability and equity issues at local to global scales The geoscience education community has expanded its own ICON capacity through access to and use of shared resources and research findings, enhancing data sharing and publication, and leadership development. We prioritize continued use of ICON principles to develop effective and inclusive communities that increase equity in geoscience education and beyond, support leadership and full participation of systemically non-dominant groups and enable global discussions and collaborations

Negotiating identity and heritage through authorised vernacular history, Limpopo National Park

In this paper, we assess vernacular history, traditional authority and the use of heritage places as mediums for negotiating ancestry, identity, territory and belonging based on conversations, interviews and visitations to heritage places together with residents in Limpopo National Park. We explore how particular vernacular histories become dominant village history through the authorisation of traditional leaders and their lineage histories and how traditional leaders use heritage places to mediate narratives. Authorised vernacular histories are narratives about mobility and identity, but they are also localised narratives about ‘home’ in terms of access to resources and heritage places. We discuss how lineage histories and traditional authority are mobilised or questioned in the context of the ongoing displacement of local residents through resettlement programmes and make comparisons with the historical experiences of evictions in the neighbouring Kruger and Gonarezhou National Parks. We emphasise the need for residents to remain connected to and in control of heritage places; otherwise, the linkages between these places, ancestral authority, and present-day authority risk being severed.Landscape transformations and socio-ecological management in Limpopo National Park, Mozambique

Stay in Place or Migrate: A Research Perspective on Understanding Adaptation to a Changing Environment

Bronen R, Chandrasekhar D, Amor Conde D, et al. Stay in Place or Migrate: A Research Perspective on Understanding Adaptation to a Changing Environment. In: Oliver-Smith A, Shen X, eds. SOURCE: Linking Environmental Change, Migration, and Social Vulnerability. SOURCE. Vol 12. Bonn: United Nations University Institute for Environment and Human Security; 2009: 12-22

Stay in Place or Migrate: A Research Perspective on Understanding Adaptation to a Changing Environment

Bronen R, Chandrasekhar D, Amor Conde D, et al. Stay in Place or Migrate: A Research Perspective on Understanding Adaptation to a Changing Environment. In: Oliver-Smith A, Shen X, eds. SOURCE: Linking Environmental Change, Migration, and Social Vulnerability. SOURCE. Vol 12. Bonn: United Nations University Institute for Environment and Human Security; 2009: 12-22