Negotiating South–South cooperation for mental health: the World Health Organization and the African Mental Health Action Group, 1970s–90s

This article explores the African Mental Health Action Group (AMHAG), one of the earliest examples of the World Health Organization’s (WHO) attempts to promote ‘ownership’ over development through the South–South cooperation envisaged in Technical Cooperation in Developing Countries. Formed in 1978, the AMHAG was intended to guide national and regional policy on mental health, while also fostering national and collective self-reliance. For a short period, between the late 1970s and the early 1990s, it was central to the WHO’s strategy for promoting policies of mental health in primary healthcare in Africa. It was a largely ineffective tool, with national governments having different opinions on the value of mental health, and poor coordination between AMHAG countries. Approaching the AMHAG as a regional project and transnational network, however, the article provides explores the importance of regions and regionalism in international health cooperation, as well as the inequities of participation in health development. Drawing on WHO archival material spanning over twenty countries and two national liberation movements, it argues that participating countries were differently positioned not only to navigate relationships between countries, but also to contend with the shifting landscape of international assistance, as well as – for some – contexts of war, violence and political and economic instability. The article not only serves as a case study of power imbalances in a failed development initiative, but also sheds light on the WHO’s engagement with mental health during a period that historians of psychiatry in Africa have tended to overlook.

Childhood undernutrition inequalities in empowered action group states of India: evidence from NFHS, 2006-2016

Background: Child undernutrition is a major public health problem in many low and middle income countries and malnutrition alone accounted for 45% (3 million deaths annually) deaths among under-five children. Malnutrition is the concealed cause of one out of every two such deaths. A study was undertaken to examine the trends, determinants and socioeconomic-related inequalities in childhood undernutrition in empowered action group (EAG) states, India. The secondary data of the two rounds of National Family Health Survey, NFHS-3 (2005-06) and NFHS-4 (2015-16) comprising of 16,802 and 128,400 children aged 0-59 months respectively was analysed.Methods: Non-linear Fairlie decomposition was used to identify and quantify the separate contribution of different socioeconomic characteristics in gap of childhood malnutrion between 2006 and 2016.Results: Results show that the prevalence of undernutrition has decreased in EAG states during the last one decade, but the prevalence of wasting is remained almost same as 10 years back. The decomposition analysis shows that maternal education, household wealth and place of residence were contributing to socioeconomic inequality in childhood undernutrition from 2006 to 2016.Conclusions: There is a need to adopt different strategies of health policy intervention. It is important to have policies towards improving female literacy in the EAG states because maternal education plays a vital role in child health and literacy rate is very low among women in EAG states. The existence of a functional health insurance system and increasing universal coverage are recommended to mitigate child undernutrition, so that the vulnerable and deprived populations who are not able to access health care facilities, can easily access health care services for early detection and treatment of undernutrition without any financial constraint.

Maternal health situation in the empowered action group states: how far we reached: a comparative analysis of national family health survey-3 and 4

Background: Maternal health constitutes the health of women during pregnancy, childbirth, and the post-partum period. India is one the biggest contributor to maternal mortality, among all the states of India, the Empowered Action Group (EAG) states contributes 61.5% of total mortality, keeping in this view the study compared the NFHS-3 and NFHS-4 survey of the maternal health condition of EAG states of India and evaluated the relationship between maternal health status and predictors of EAG states of India in NFHS-3 and NFHS-4.Methods: This cross-sectional study adopted descriptive secondary data analyses of two rounds of nationally representative sample surveys NFHS-3 and NFHS-4. The data were obtained by the demographic and health survey website after proper procedures and compared for various maternal health indicators of EAG states.Results: In this investigation, progress has been observed from NFHS-3 to NFHS-4 however, the progress is very positive promising to growth. Where their full (antenatal care) ANC indicator growth is very steady. Education and domestic violence are still hampering the growth of full maternal health wellbeing.Conclusions: Given the status of maternal health in India and more especially in EAG states, more improvement in the performance of maternal health-related activities is highly necessary for which health system strengthening coupled with strong political will and community mobilization are some of the urgent strategies required in the EAG states. Above all community, awareness has a greater role in improving the health status in these.

Differential in infant, childhood and under-five death clustering among the empowered and non-empowered action group regions in India

Background With 8,82,000 deaths in the under-five period, India observed varied intra-state and inter-regional differences across infant and child mortality in 2018. However, scarce literature is present to capture this unusual concentration of mortality in certain families by examining the association of the mortality risks among the siblings of those families along with various unobserved characteristics of the mother. Looking towards the regional and age differential in mortality, this paper attempts to provide evidence for the differential in mortality clustering among infants (aged 0–11 months), children (12–59 months) and under-five (0–59 months) period among mothers from the Empowered Action Group (EAG) and non-EAG regions of India. Methods The study used data from the National Family Health Survey (2015–16) which includes all the birth histories of 475,457 women aged 15–49 years. Bivariate and multivariate analyses were used to fulfil the objectives of the study. A two-level random intercept Weibull regression model was used to account for the unexplained mother (family) level heterogeneity. Results About 3.3% and 5.9% of infant deaths and 0.8% and 1.6% of childhood deaths were observed in non-EAG and EAG regions respectively. Among them, a higher percentage of infant and child death was observed due to the death of a previous sibling. There were 1.67 times [95% CI: 1.55–1.80] and 1.46 times [CI: 1.37–1.56] higher odds of infant and under-five mortality of index child respectively when the previous sibling at the time of conception of the index child was dead in the non-EAG regions. In contrast, the odds of death scarring (death of previous sibling scars the survival of index child) were 1.38 times [CI: 1.32–1.44] and 1.24 times [CI: 1.20–1.29] higher for infant and under-five mortality respectively in the EAG regions. Conclusion The extent of infant and child mortality clustering and unobserved heterogeneity was higher among mothers in the non-EAG regions in comparison to their EAG region counterparts. With the growing situation of under-five mortality clustering in non-EAG states, region-wise interventions are recommended. Additionally, proper care is needed to ameliorate the inter-family variation in mortality risk among the children of both EAG and non-EAG regions throughout their childhood.

The functioning of the local group of actions “Brama Lubuska” in thre opinion of residents of member communes

The aim of the article is to present the level of knowledge about the Leader programme and the Local Action Group among the inhabitants of the LAG “Brama Lubuska” area consisting of 14 member communes. The study was carried out by means of a questionnaire survey on a sample of 200 inhabitants of communes comprising the LAG “Brama Lubuska” in 2015 and 2020. Most of the inhabitants have heard about the Leader programme and the Local Action Group. In addition, respondents are positive about the group’s initiative and activities. It is possible to notice an increase in satisfaction with the quality of advice provided at the LAG headquarters. The inhabitants are beginning to notice the undertakings carried out under the Leader initiative in the area of member communes. As the main source of information on the LAG and Leader, the respondents indicate the media, leaflets and information received in commune offices.

Boundary Scan Architecture for a Double Precision Floating Point Subtractor

The boundary scan logic for testing was developed in order to make the process of testing easier for System-on-Chip (SoC) [1] architectures. The proposed work focuses on designing a boundary scan logic for a 64-bit floating-point subtractor unit. The TAP controller designed is capable of executing the three mandatory Joint Test Action Group (JTAG) instructions of the IEEE 1149 standard. The testing architecture has the potential to not only test the functionality of the core logic but also to test single stuck-at faults for all the inputs and outputs of the core logic. A provision for bypassing the core logic was made in order to skip the IC while testing numerous ICs together. A simulation was also performed to demonstrate the above procedures. The designed module can further be used in a larger circuit with other ICs [2]containing a similar boundary scan structure with individual TAP controllers.