Support, networks, and relationships: Findings from a mixed-methods evaluation of a mentorship programme for early career women researchers in sexual and reproductive health and rights

Low research output among women researchers in health research has been linked to inadequate mentorship opportunities for early career women researchers and particularly in sexual and reproductive health and rights (SRHR) field. Mentorship has been recognized as a contributor to strengthening research capacity and as beneficial for both mentors and mentees. Women researchers oftentimes experience negative impacts of organizational and structural gender inequities related to formal and informal mentoring. In 2020, the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction at WHO launched a mentorship programme for early career SRHR women researchers from low- and middle-income countries. The programme sought to provide professional skill-building, promote and share networking opportunities, and offer support in navigating personal and professional life. We conducted a convergent parallel mixed-methods evaluation of the 2020 pilot programme, which included 26 participants, through an online survey and semi-structured in-depth interviews (IDIs). Data collection occurred between March and May 2022. Nineteen responded to the online survey (12 mentees, 7 mentors) and 11 IDIs (7 mentees, 4 mentors) were completed. Based on a preliminary framework, we used deductive and inductive methods to identify six themes: views on mentorship; reasons for applying and expectations of participation in the programme; preferred aspects of programme implementation; challenges with the programme implementation; perceived lasting benefits of the programme; and recommendations for improvement. All participants found the initial training useful, most discussed work-life prioritization throughout the mentorship relationship, and most planned to continue with the relationship. There appear to be ample benefits to mentorship, especially when planned and implemented in a structured manner. These attributes can be particularly beneficial when they are conceived as a two-way relationship of mutual learning and support, and especially for women at the start of their research careers as they navigate structural gender inequities

Diseño de Modelo de Negocio Digital: SERVICIOS ADUANALES DIVERSOS.

Al identificar que el emprendimiento en El Salvador se ha convertido en una actividad comercial popular entre los salvadoreños y que la demanda de realizar trámites aduanales como: importación y exportación de bienes, permisos ante entes reguladores, logística y transporte, asesorías para realizar trámites de importación, entre otros. Permite que Servicios Aduanales Diversos, un negocio cien por ciento digital pueda formar parte de la solución para los emprendedores, micro, pequeñas y medianas empresas a fin de brindarles el servicio esperado para que puedan materializar los tramites que requieran para la puesta en marcha de sus negocios. Realizando un análisis general de la situación de nuestro país, y siendo visionarios, se puede tener una perspectiva de que el porcentaje del mercado clasificado como emprendimientos seguirá creciendo cada año, lo que podemos traducir como nuevos clientes potenciales que demanden nuestros servicios. Gracias a la naturaleza de Servicios Aduanales Diversos, no se requiere de una mayor inversión de capital y esto lo convierte en un negocio rentable, según los análisis realizados basados en la proyección de ventas durante los primeros cinco años

La prohibición constitucional del derecho a la sindicalización de los miembros de la “Policía Nacional Civil” como limitante al derecho de libre ejercicio a la libertad sindical

Históricamente la situación de la corporación policial se ha visto siempre al margen del régimen militar, concepto que en nuestros días ha sido de gran controversia respecto a las funciones desempeñadas por la policía y la fuerza armada, es decir que sus funciones son independientes y que no deben verse estructuralmente de la misma forma; lo cual en gran parte influye al desarrollo de la temática. Por tal motivo se deriva la situación normativa ya que centra un eje muy importante en la forma que el Estado salvadoreño ha regulado dicha problemática y es que mediante la norma suprema los policías están exentos de gozar el derecho al libre ejercicio de la libertad sindical ya que desde el punto de vista del legislador estos no poseen derechos laborales debido al cargo que estos desempeñan. Se pretende demostrar la situación actual de las condiciones laborales de la Policía, así como también la regulación ineficaz que nuestra normativa constitucional posee referente al tema, en comparación a la normativa de otros países. A demás se analiza la normativa internacional que sustentan el derecho de sindicalización caracterizándose como un derecho humano por excelencia, la ratificación del convenio 87 regula el derecho a formar sindicatos, pero es necesario hacer referencia que si en la actualidad cabe la posibilidad de hacer una reforma al artículo 47 inc. Segundo de la constitución y permitirles a los policías el poder conformar sindicatos, con el objeto de demostrar que las mejoras laborales para la corporación se podrían lograr permitiendo dicha reforma, y que estos puedan exigir mejores condiciones laborales sin el temor de represalias de parte de sus jefaturas

Infection-related severe maternal outcomes and case fatality rates in 43 low and middle-income countries across the WHO regions: results from the Global Maternal Sepsis Study (GLOSS)

The highest toll of maternal mortality due to infections is reported in low and middle-income countries (LMICs). However, more evidence is needed to understand the differences in infection-related severe maternal outcomes (SMO) and fatality rates across the WHO regions. This study aimed to compare the burden of infection-related SMO and case fatality rates across the WHO regions using the Global Maternal Sepsis Study (GLOSS) data. GLOSS was a hospital-based one-week inception prospective cohort study of pregnant or recently pregnant women admitted with suspected or confirmed infection in 2017. Four hundred and eight (408) hospitals from 43 LMICs in the six WHO regions were considered in this analysis. We used a logistic regression model to compare the odds of infection-related SMOs by region. We then calculated the fatality rate as the proportion of deaths over the total number of SMOs, defined as maternal deaths and near-misses. The proportion of SMO was 19.6% (n = 141) in Africa, compared to 18%(n = 22), 15.9%(n = 50), 14.7%(n = 48), 12.1%(n = 95), and 10.8%(n = 21) in the Western Pacific, European, Eastern Meditteranean, Americas, and South-Eastern Asian regions, respectively. Women in Africa were more likely to experience SMO than those in the Americas (aOR = 2.41, 95%CI: [1.78 to 2.83]), in South-East Asia (aOR = 2.60, 95%CI: [1.57 to 4.32]), and the Eastern Mediterranean region (aOR = 1.58, 95%CI: [1.08 to 2.32]). The case fatality rate was 14.3%[3.05% to 36.34%] (n/N = 3/21) and 11.4%[6.63% to 17.77%] (n/N = 16/141) in the South-East Asia and Africa, respectively. Infection-related SMOs and case fatality rates were highest in Africa and Southeast Asia. Specific attention and actions are needed to prevent infection-related maternal deaths and severe morbidity in these two regions

The process of developing a joint theory of change across three global entities: can this help to make their efforts to strengthen capacity for implementation research more effective?

Introduction A Theory of Change is a visual representation of the pathway by which a programme anticipates it will achieve its goal. It usually starts with discussions around the goal and works backwards through outcomes and outputs to activities. Methods We used a Theory of Change to improve coherence across three research entities at the World Health Organisation. Part of the remit of all three entities is to strengthen capacity in low- and middle-income countries for implementation research. Results Representatives from the three entities were able to formulate a joint goal for strengthening capacity in implementation research. They identified three pathways by which this could be achieved: a) conducting implementation research, b) strengthening implementation research systems and c) utilising implementation research for public health priorities. Conclusion The process of developing the Theory of Change and the logic framework it created, provided a means to track progress towards the goal and to guide improvements in programmes within their lifetime. The process we used to develop the Theory of Change and the pathways to achieve the joint goal, are adaptable and could be used by other organisations that also aim to strengthen research capacity. This would lead to more coherence, better translation of research findings into decision-making and ultimately improvements in public health

The construction of a situated curriculum for teacher training in the province of Santiago del Estero, Argentina

En este trabajo realizamos una sistematización de la experiencia de acercamiento, durante el 2016, entre grupos de dos instituciones: una universitaria y otra de formación docente. El propósito fue contribuir a la construcción de una propuesta pedagógica para la formación docente que incorpore saberes construidos desde la academia sobre la historia social y educativa de Santiago del Estero, detectados como contenidos ausentes en los programas de los profesorados. Dicho proceso consistió en retomar la información registrada durante los encuentros, formulando a partir de ésta preguntas-guías orientadas a interrogar esta experiencia a fin de constituir ejes problemáticos y articulaciones posibles. En este sentido analizamos los siguientes ejes: a) la necesidad de incorporar una historia local y provincial a la enseñanza; b) la decisión de fusionar ambas cátedras para recuperar una visión integradora de los contenidos; c) la incorporación de una perspectiva narrativo-biográfica en la enseñanza; d) el Hablar, Leer y Escribir en Ciencias y e) la reflexión que suscitó esta experiencia como una instancia de formación permanente del profesorado y de los y las becarias de investigación.In this work we made a systematization of the approach experience, during 2016, between groups of two institutions: a university and a teacher training institution. The purpose was to contribute to the construction of a pedagogical proposal for teacher training that incorporates knowledge built from the academy about the social and educational history of Santiago del Estero, detected as absent contents in the teaching training curricula. Such process consisted in retaking the information recorded during the meetings, formulating from it, questions-guides aimed at questioning this experience in order to constitute possible problematic axes and articulations. In this sense, we analyze the following axes: a) the need to incorporate a local and provincial history into teaching; b) the decision to merge both chairs to recover an integrating vision of the contents; c) the incorporation of a narrative-biographical perspective in teaching; d) the Speaking, Reading and Writing in Science and e) the re! ection that gave rise to this experience as an instance of ongoing training for teachers and research scholars.Facultad de Humanidades y Ciencias de la Educació

Cognitive testing of a survey instrument to assess sexual practices, behaviours, and health outcomes: a multi-country study protocol

BACKGROUND: Population level data on sexual practices, behaviours and health-related outcomes can ensure that responsive, relevant health services are available for all people of all ages. However, while billions of dollars have been invested in attempting to improve sexual and reproductive health (including HIV) outcomes, far less is understood about associated sexual practices and behaviours. Therefore, the World Health Organization embarked on a global consultative process to develop a short survey instrument to assess sexual health practices, behaviours and health outcomes. In order for the resulting draft survey instrument to be published as a 'global' standard instrument, it is important to first determine that the proposed measures are globally comprehensible and applicable. This paper describes a multi-country study protocol to assess the interpretability and comparability of the survey instrument in a number of diverse countries. METHODS: This study will use cognitive interviewing, a qualitative data collection method that uses semi-structured interviews to explore how participants process and respond to survey instruments. We aim to include study sites in up to 20 countries. The study procedures consist of: (1) localizing the instrument using forward and back-translation; (2) using a series of cognitive interviews to understand how participants engage with each survey question; (3) revising the core instrument based on interview findings; and (4) conducting an optional second round of cognitive interviews. Data generated from interviews will be summarised into a predeveloped analysis matrix. The entire process (a 'wave' of data collection) will be completed simultaneously by 5+ countries, with a total of three waves. This stepwise approach facilitates iterative improvements and sharing across countries. DISCUSSION: An important output from this research will be a revised survey instrument, which when subsequently published, can contribute to improving the comparability across contexts of measures of sexual practices, behaviours and health-related outcomes. Site-specific results of the feasibility of conducting this research may help shift perceptions of who and what can be included in sexual health-related research

Aetiology and use of antibiotics in pregnancy-related infections: results of the WHO Global Maternal Sepsis Study (GLOSS), 1-week inception cohort

Background Pregnancy-related infections are important contributors to maternal sepsis and mortality. We aimed to describe clinical, microbiological characteristics and use of antibiotics by source of infection and country income, among hospitalized women with suspected or confirmed pregnancy-related infections. Methods We used data from WHO Global Maternal Sepsis Study (GLOSS) on maternal infections in hospitalized women, in 52 low-middle- and high-income countries conducted between November 28th and December 4th, 2017, to describe the frequencies and medians of maternal demographic, obstetric, and clinical characteristics and outcomes, methods of infection diagnosis and causative pathogens, of single source pregnancy-related infection, other than breast, and initial use of therapeutic antibiotics. We included 1456 women. Results We found infections of the genital (n = 745/1456, 51.2%) and the urinary tracts (UTI) (n = 531/1456, 36.5%) to be the most frequent. UTI (n = 339/531, 63.8%) and post-caesarean skin and soft tissue infections (SSTI) (n = 99/180, 55.0%) were the sources with more culture samples taken and microbiological confirmations. Escherichia coli was the major uropathogen (n = 103/118, 87.3%) and Staphylococcus aureus (n = 21/44, 47.7%) was the commonest pathogen in SSTI. For 13.1% (n = 191) of women, antibiotics were not prescribed on the same day of infection suspicion. Cephalosporins (n = 283/531, 53.3%) were the commonest antibiotic class prescribed for UTI, while metronidazole (n = 303/925, 32.8%) was the most prescribed for all other sources. Ceftriaxone with metronidazole was the commonest combination for the genital tract (n = 98/745, 13.2%) and SSTI (n = 22/180, 12.2%). Metronidazole (n = 137/235, 58.3%) was the most prescribed antibiotic in low-income countries while cephalosporins and co-amoxiclav (n = 129/186, 69.4%) were more commonly prescribed in high-income countries. Conclusions Differences in antibiotics used across countries could be due to availability, local guidelines, prescribing culture, cost, and access to microbiology laboratory, despite having found similar sources and pathogens as previous studies. Better dissemination of recommendations in line with antimicrobial stewardship programmes might improve antibiotic prescription

Immigrant women’s and families’ views and experiences of routine postnatal care: findings from a qualitative evidence synthesis

Background: Uptake of postnatal care (PNC) is low and inequitable in many countries, and immigrant women may experience additional challenges to access and effective use. As part of a larger study examining the views of women, partners, and families on routine PNC, we analysed a subset of data on the specific experiences of immigrant women and families. Methods: This is a subanalysis of a larger qualitative evidence synthesis. We searched MEDLINE, PUBMED, CINAHL, EMBASE, EBM-Reviews and grey literature for studies published until December 2019 with extractable qualitative data with no language restrictions. For this analysis, we focused on papers related to immigrant women and families. Two reviewers screened each study independently; inclusion was agreed by consensus. Data abstraction and quality assessment were carried out using a study-specific extraction form and established quality assessment tools. Study findings were identified using thematic analysis. Findings are presented by confidence in the finding, applying the GRADE-CERQual approach. Findings: We included 44 papers, out of 602 full-texts, representing 11 countries where women and families sought PNC after immigrating. All but one included immigrants to high-income countries. Four themes were identified: resources and access, differences from home country, support needs, and experiences of care. High confidence study findings included: language and communication challenges; uncertainty about navigating system supports including transportation; high mental health, emotional, and informational needs; the impact of personal resources and social support; and the quality of interaction with healthcare providers. These findings highlight the importance of care experiences beyond clinical care. More research is also needed on the experiences of families migrating between low-income countries. Conclusions: Immigrant families experience many challenges in getting routine PNC, especially related to language, culture, and communication. Some challenges may be mitigated by improving comprehensive and accessible information on available services, as well as holistic social support. Trial registration number: CRD42019139183