scholarly journals Factors influencing rapid progress in child health in post-conflict Liberia: a mixed methods country case study on progress in child survival, 2000–2013

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e021879 ◽  
Author(s):  
Marie A Brault ◽  
Stephen B Kennedy ◽  
Connie A Haley ◽  
Adolphus T Clarke ◽  
Musu C Duworko ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Civil War ◽  
Child Health ◽  
Child Survival ◽  
Rapid Progress ◽  
African Region ◽  
Under Five ◽  
Post Conflict ◽  
Mdg 4

ObjectivesOnly 12 countries in the WHO’s African region met Millennium Development Goal 4 (MDG 4) to reduce under-five mortality by two-thirds by 2015. Given the variability across the African region, a four-country mixed methods study was undertaken to examine barriers and facilitators of child survival prior to 2015. Liberia was selected for an in-depth case study due to its success in reducing under-five mortality by 73% and thus successfully meeting MDG 4. Liberia’s success was particularly notable given the civil war that ended in 2003. We examined some factors contributing to their reductions in under-five mortality.DesignA case study mixed methods approach drawing on data from quantitative indicators, national documents and qualitative interviews was used to describe factors that enabled Liberia to rebuild their maternal, neonatal and child health (MNCH) programmes and reduce under-five mortality following the country’s civil war.SettingThe interviews were conducted in Monrovia (Montserrado County) and the areas in and around Gbarnga, Liberia (Bong County, North Central region).ParticipantsKey informant interviews were conducted with Ministry of Health officials, donor organisations, community-based organisations involved in MNCH and healthcare workers. Focus group discussions were conducted with women who have experience accessing MNCH services.ResultsThree prominent factors contributed to the reduction in under-five mortality: national prioritisation of MNCH after the civil war; implementation of integrated packages of services that expanded access to key interventions and promoted intersectoral collaborations; and use of outreach campaigns, community health workers and trained traditional midwives to expand access to care and improve referrals.ConclusionsAlthough Liberia experiences continued challenges related to limited resources, Liberia’s effective strategies and rapid progress may provide insights for reducing under-five mortality in other post-conflict settings.

“Do not Disturb the Peace!” Identities, Livelihoods and the Politics of Post-War Discontent in Sierra Leone

2019 ◽  
Vol 54 (4) ◽  
pp. 533-553
Author(s):  
Fodei Batty ◽  
Fredline M’Cormack-Hale
Keyword(s):  
Civil War ◽  
Collective Memory ◽  
Sierra Leone ◽  
The State ◽  
Public Order ◽  
Present Evidence ◽  
Post Conflict ◽  
Post War

Although the collective memory of war is frequently invoked in post-war societies, who chooses to invoke it and to what effect has been less studied relative to other aspects of such societies. In this article we employ a case study of Sierra Leone to address this deficit in the post-conflict scholarship by illustrating how the collective memory of that country’s civil war is appropriated by diverse actors in the post-war society. Drawing from field interviews, we present evidence showing how, and why, several societal groups constituted as distinct post-war identities such as victims-rights groups, former defenders of the state, or perpetrators of the violence during the Sierra Leone civil war articulate dissatisfactions with their livelihoods and the reactions of state officials to their demands. The article explains why, and how, successive governments have selectively suppressed the discontent of some groups over livelihood insecurities that are construed as threats to public order while ignoring violent protests from other groups over similar issues, in spite of a 1965 public order act restricting protests. Thus, the article argues that state officials in Sierra Leone have not demonstrated superior commitment to peacebuilding than societal groups that make demands on the state.

Warlords, Politicians and the Post-First Civil War Election in Liberia

2011 ◽  
Vol 10 (2-3) ◽  
pp. 83-99 ◽  
Author(s):  
George Klay Kieh
Keyword(s):  
Civil War ◽  
Scholarly Literature ◽  
Post Conflict ◽  
Vexing Problem

AbstractThe issue of post-conflict elections has become one of the major areas in both the scholarly literature and in policy circles. This is because post-conflict elections are considered critical to the peacebuilding process in war-torn societies. The rationale is that post-conflict elections can be used to address the vexing problem of choosing the leadership for states recovering from war. With the leadership chosen in the context of free, fair and transparent elections, it can then shepherd the arduous process of rebuilding the society. In this vein, using the first post-conflict election in Liberia as a case study, this article examines the electoral landscape, and the factors that led to the Taylor-led National Patriotic Party (NPP) winning a landslide victory.

scholarly journals The introduction of new policies and strategies to reduce inequities and improve child health in Kenya: A country case study on progress in child survival, 2000-2013

PLoS ONE ◽  
2017 ◽  
Vol 12 (8) ◽  
pp. e0181777 ◽  
Author(s):  
Marie A. Brault ◽  
Kenneth Ngure ◽  
Connie A. Haley ◽  
Stewart Kabaka ◽  
Kibet Sergon ◽  
...  
Keyword(s):  
Child Health ◽  
Child Survival ◽  
Improve Child Health ◽  
Country Case Study ◽  
New Policies

scholarly journals Impact of a critical health workforce shortage on child health in Zimbabwe: a country case study on progress in child survival, 2000–2013

2017 ◽  
pp. czw162 ◽  
Author(s):  
Connie A. Haley ◽  
Sten H. Vermund ◽  
Precious Moyo ◽  
Aaron M. Kipp ◽  
Bernard Madzima ◽  
...  
Keyword(s):  
Child Health ◽  
Health Workforce ◽  
Child Survival ◽  
Workforce Shortage ◽  
Country Case Study

scholarly journals Causes of Morbidity and Mortality among Neonates and Children in Post-Conflict Burundi: A Cross-Sectional Retrospective Study

Children ◽  
2018 ◽  
Vol 5 (9) ◽  
pp. 125 ◽  
Author(s):  
Imelda Moise
Keyword(s):  
Regional Distribution ◽  
Morbidity And Mortality ◽  
World Health ◽  
African Region ◽  
Cross Sectional ◽  
Under Five ◽  
Post Conflict ◽  
District Hospitals ◽  
All Cause Mortality ◽  
Health Organization

The risk of a child dying before age five in Burundi is almost 1.6 times higher than that in the World Health Organization (WHO) African region. However, variations in the all-cause mortality rates across Burundi have not yet been measured directly at subnational levels, age group and by gender. The objective of this study was to describe the main causes of hospitalization and mortality in children during the neonatal period and at ages 1 to 59 months, for boys and girls, and to assess the total annual (2010) burden of under-five morbidity and mortality in hospitals using hospitalization records from 21 district hospitals. We found variation in the gender and regional distribution of the five leading causes of hospitalization and death of children under five. Although the five causes accounted for 89% (468/523) of all neonatal hospitalizations, three causes accounted for 93% (10,851/11,632) of all-cause hospitalizations for children ages 1 to 59 months (malaria, lung disease, and acute diarrhea), malaria accounted for 69% (1086/1566) of all deaths at ages 1 to 59 months. In Burundi, human malarial infections continue to be the main cause of hospitalization and mortality among under-five children.

scholarly journals The impact of child health interventions and risk factors on child survival in Kenya, 1993–2014: a Bayesian spatio-temporal analysis with counterfactual scenarios

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Peter M. Macharia ◽  
Noel K. Joseph ◽  
Robert W. Snow ◽  
Benn Sartorius ◽  
Emelda A. Okiro
Keyword(s):  
Risk Factors ◽  
Child Health ◽  
Child Survival ◽  
Ecological Factors ◽  
Temporal Analysis ◽  
Infection Prevalence ◽  
Intervention Coverage ◽  
Under Five ◽  
Maternal Autonomy ◽  
The Impact

Abstract Background During the millennium development goals period, reduction in under-five mortality (U5M) and increases in child health intervention coverage were characterised by sub-national disparities and inequities across Kenya. The contribution of changing risk factors and intervention coverage on the sub-national changes in U5M remains poorly defined. Methods Sub-national county-level data on U5M and 43 factors known to be associated with U5M spanning 1993 and 2014 were assembled. Using a Bayesian ecological mixed-effects regression model, the relationships between U5M and significant intervention and infection risk ecological factors were quantified across 47 sub-national counties. The coefficients generated were used within a counterfactual framework to estimate U5M and under-five deaths averted (U5-DA) for every county and year (1993–2014) associated with changes in the coverage of interventions and disease infection prevalence relative to 1993. Results Nationally, the stagnation and increase in U5M in the 1990s were associated with rising human immunodeficiency virus (HIV) prevalence and reduced maternal autonomy while improvements after 2006 were associated with a decline in the prevalence of HIV and malaria, increase in access to better sanitation, fever treatment-seeking rates and maternal autonomy. Reduced stunting and increased coverage of early breastfeeding and institutional deliveries were associated with a smaller number of U5-DA compared to other factors while a reduction in high parity and fully immunised children were associated with under-five lives lost. Most of the U5-DA occurred after 2006 and varied spatially across counties. The highest number of U5-DA was recorded in western and coastal Kenya while northern Kenya recorded a lower number of U5-DA than western. Central Kenya had the lowest U5-DA. The deaths averted across the different regions were associated with a unique set of factors. Conclusion Contributions of interventions and risk factors to changing U5M vary sub-nationally. This has important implications for targeting future interventions within decentralised health systems such as those operated in Kenya. Targeting specific factors where U5M has been high and intervention coverage poor would lead to the highest likelihood of sub-national attainment of sustainable development goal (SDG) 3.2 on U5M in Kenya.

Why Should 5,000 Children Die in India Every Day? Major Causes of Death and Managerial Challenges

2010 ◽  
Vol 35 (2) ◽  
pp. 9-20 ◽  
Author(s):  
K V Ramani ◽  
Dileep Mavalankar ◽  
Sanjay Joshi ◽  
Imran Malek ◽  
Tapasvi Puvar ◽  
...  
Keyword(s):  
Child Health ◽  
Service Providers ◽  
Average Rate ◽  
Child Death ◽  
Infant Mortality Rate ◽  
Child Health Services ◽  
Under Five ◽  
The Government ◽  
Mdg 4 ◽  
Health Programmes

Globally, more than 10 million children, under five years of age, almost all in poor countries, die every year (20 children per minute), mostly from preventable causes. The major causes of child death include neonatal disorders (death within 28 days of birth), diarrhoea, pneumonia, and measles with malnutrition being a major contributing factor for childhood illnesses. India alone accounts for almost 5,000 deaths of under-five years children (U5) every day. In 1975, the Integrated Child Development Scheme (ICDS) was launched in the country to provide integrated health and nutrition services focusing upon the holistic development of children at the village level. Yet by 2005, 50 per cent of the children in India were still malnourished. India's neonatal mortality, which accounts for almost 50 per cent of the U5 deaths, is one of the highest in the world. India launched the Universal Immunization Programme (UIP) in 1985. Yet full immunization in India had reached only 43.5 per cent by 2005-06, as per the NFHS 31. This paper, besides discussing the status of mortality of children and the situation of child health services, examines the managerial challenges of the child health programmes in India. There is a need for improving the management capacity amongst health service providers, specifically the planning and implementation of child health programmes such as immunization, control of diarrhoea, and pneumonia. The analysis of the trends of the past decline shows that during 1990-2008, India achieved a decrease in infant mortality rate (IMR) at a very low annual average rate of 1.9 per cent. To achieve Millennium Development Goals (MDG) 4, between 2009— 2015, the rate of reduction of IMR needs to be increased to a very high level — at 6.74 per cent every year. This means that the government and the private sector need to improve the effectiveness and efficiency of the child health programmes substantially. Incremental improvement over “business-as-usual” will not help in achieving MDG 4. Effective and efficient management of child health programmes would require focused political and administrative attention and managerial capacity.

scholarly journals Anatomising Syrian crisis: Enumerating actors, motivations, and their strategies (2011-2019)

2021 ◽  
Vol 5 (1) ◽  
pp. 41-54
Author(s):  
Muhammad Nadeem Mirza ◽  
Hussain Abbas ◽  
Irfan Hasnain Qaisrani
Keyword(s):  
Civil War ◽  
Great Powers ◽  
System Level ◽  
Main Question ◽  
Effective Governance ◽  
Syrian Crisis ◽  
Strategic Competition ◽  
Post Conflict ◽  
Syrian Civil War

Syrian crisis started as a domestic uprising against President Bashar-ul-Assad, and soon engulfed not only the neighbouring states, but also extra-regional great powers. This study tries to anatomise the crisis by addressing the nature of the actors lying at domestic, regional, and system levels, who have rendered the conflict its multifaceted nature. The main question this study addresses is: What are the actors and factors that have contributed to the complexity of the Syrian Civil War and why has this conflict degenerated into a prolonged violent engagement between different groups? While using the theoretical prism of contentious theory of civil war developed by Adrian Florea and in-depth qualitative case study as methodological tool, this study hypothesizes that grievances at the domestic level have resulted in the onset of the conflict in Syria, which was later exacerbated and prolonged by the rise of ISIS and strategic competition among the regional and system level powers. The study concludes that, though the crisis is not over yet, increasing interests and overtures by Saudi Arabia and the domestic growing Syrian animosity towards Iran has opened new avenues for regional and extra-regional involvement in the post-conflict reconstruction for effective governance, peace, and stability in Syria.

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