Feasibility of Establishing a Core Set of Sexual, Reproductive, Maternal, Newborn, Child, and Adolescent Health Indicators in Humanitarian Settings: Results from a Multi-Methods Assessment in the Democratic Republic of Congo

Background: Reliable and rigorously collected sexual, reproductive, maternal, newborn, child, and adolescent health (SRMNCAH) data in humanitarian settings are often sparse and variable in quality across different humanitarian settings. To address this gap in quality data, the World Health Organization (WHO) developed a core set of indicators for monitoring and evaluating SRMNCAH services and outcomes and assessed their feasibility in four countries, including the Democratic Republic of Congo (DRC) with the goal of aggregating information from global consultations and field-level assessments to reach consensus on a set of core SRMNCAH indicators among WHO partners. Methods: The feasibility assessment in DRC focused on the following constructs: relevance/usefulness, feasibility of measurement, systems and resources, and ethical issues. The multi-methods assessment included five components; a desk review, key informant interviews, focus group discussions, facility assessments, and observational sessions. Results: The findings suggest that there is widespread support among stakeholders for developing a standardized core list of SRMNCAH indicators to be collected among all humanitarian actors in DRC. There are numerous resources and data collection systems that could be leveraged, built upon, and improved to ensure the feasibility of collecting this proposed set of indicators. However, the data collection load requested from donors, the national government, international and UN agencies, coordination/cluster systems must be better harmonized, standardized, and less burdensome. Conclusions: Despite stakeholder support in developing a core set of indicators, this would only be useful if it has the buy-in from the international community. Greater harmonization and coordination, alongside increased resource allocation, would improve data collection efforts and allow stakeholders to meet indicators’ reporting requirements.

World Health Organization and knowledge translation in maternal, newborn, child and adolescent health and nutrition

The World Health Organization (WHO) has a mandate to promote maternal and child health and welfare through support to governments in the form of technical assistance, standards, epidemiological and statistical services, promoting teaching and training of healthcare professionals and providing direct aid in emergencies. The Strategic and Technical Advisory Group of Experts (STAGE) for maternal, newborn, child and adolescent health and nutrition (MNCAHN) was established in 2020 to advise the Director-General of WHO on issues relating to MNCAHN. STAGE comprises individuals from multiple low-income and middle-income and high-income countries, has representatives from many professional disciplines and with diverse experience and interests.Progress in MNCAHN requires improvements in quality of services, equity of access and the evolution of services as technical guidance, community needs and epidemiology changes. Knowledge translation of WHO guidance and other guidelines is an important part of this. Countries need effective and responsive structures for adaptation and implementation of evidence-based interventions, strategies to improve guideline uptake, education and training and mechanisms to monitor quality and safety. This paper summarises STAGE’s recommendations on how to improve knowledge translation in MNCAHN. They include support for national and regional technical advisory groups and subnational committees that coordinate maternal and child health; support for national plans for MNCAHN and their implementation and monitoring; the production of a small number of consolidated MNCAHN guidelines to promote integrated and holistic care; education and quality improvement strategies to support guidelines uptake; monitoring of gaps in knowledge translation and operational research in MNCAHN.

At War in Swaddling Clothes: Stirner’s Unique One as a Conative Existence

In its simplest and primary sense, conatus is about self-preservation. It further involves the obligation, the duty, the imperative even, deriving from the Law of Nature for man to do whatever within his power to maintain his life. Even though this idea has been an old one, it was reintroduced in a more sophisticated form by modern philosophy as no longer a cruel necessity of life but ontologically tied to Reason and Natural law. It was with Hobbes that the idea of self-preservation was put at the core of his anthropological narration (with well known political connotations) and with Spinoza that conatus was delved into within his ontological universe. Regardless of their ontological starting points, both philosophers ended up eventually in a resolution with regard to that primary anthropological tension between individuals, whether this was a common legislator, the political society or the state. Somewhat radical at the beginning, Hobbes and Spinoza had to make some mitigations in order to arrive at a resolution. Yet, that was not Stirner’s case. On the contrary, Stirner’s opening ontological statement was rather too extreme and inconceivable even: it is also the newborn child that gets to war with the world and not only the other way around. It is the purpose of this paper to argue that this extreme trailhead leads the Stirnerian egoist to his fulfillment as the Unique One through ownership and that this agonistic tremendous striving constitutes the Stirnerian notion of conatus. That notion offers no resolution to the ontological animosity between individuals; on the contrary, that animosity is required as ontological precondition and prefiguration of conatus' conclusion as well.

He Shall Repay the Lamb Fourfold

When retributive divine punishment against David in 2 Samuel 12 includes the death of David and Bathsheba’s newborn child, troubling issues surrounding God’s character are identified by many commentators. In order to examine the divine violence against David’s household in 2 Samuel 11–20 in Part 1, the terms punishment and retribution are defined. Punishment is pain imposed on a person judicially determined as guilty, either through declaration by an authorised party or through transgression of an established law. By this definition, David’s newborn is not individually punished but either collectively punished as part of David’s household, or the victim of collateral damage. Retribution is distinguished from natural consequences that proceed from transgressions, and defined as backward looking, proportional payback for an offence. Elements of Kant’s formulation for retributive punishment are introduced.

Successful treatment of neuroblastoma in a newborn baby

Neuroblastoma is a malignant embryonic tumor of childhood originating from progenitor cells of the sympathetic nervous system. It accounts for 50% of all tumors in the first year of life with a high mortality rate. The development of the tumor process in this nosology is based on genetic disorders that may be associated with segmental breakdowns in chromosomes or a change in their number. The presence of aberrations of 1p and 11q loci serves as a criterion for determining the risk group, and amplification of the NMYC oncogene is an indicator of the aggressiveness of the disease. The main cause of death in neuroblastoma is hepatomegaly as a result of liver metastasis and the development of severe life-threatening complications. The presented case demonstrates a positive outcome of the disease in a newborn child with prognostically unfavorable factors, with early complex treatment, including polychemotherapy, surgical removal of the tumor and bone marrow transplantation.

Parent - Child Resemblance: Genetics, Education and Chance

In this article, it is argued that it makes sense to define and distinguish three levels of human intelligence: intelligence as genotypical potential, intelligence as actualised in environmental interaction, and intelligence as measured by tests (IQ). This raises the questions of what is meant by the term “intelligence as potential”, and how and in what sense does a child’s cognitive potential express the parents’ potential and genetics? The larger the number of genes involved in a certain trait, the more possibilities emerge for the formation of new combinations for that trait. The degree of similarity between a child and their parents depends on the unique combination of innate genes in each newborn child. The more genes are connected with a human trait or ability, the more refined or intricate the structure of the distribution for that trait in a population will be. The question of how a parents’ genes relate to their children’s genes has been studied, among other things, in ‘twin studies’. Another relevant, but complicated question concerns the relation between genetics (nature) and environment (nurture). Nature appears to be at work in nurture, while nurture influences processes of nature. In psychological research, some DNA differences can be used to predict psychological differences, called polygenic scores. In this context, it is argued that individual cognitive growth comes about by all kinds of influences; psychologists call such influences ‘bidirectional’ influences. It is also argued that, ultimately, it is the individual human explorative activity that is responsible and a strong catalyst for the development and mastery of human traits and for the cognitive qualifications of all newborn children.

Exploring the feasibility of establishing a core set of sexual, reproductive, maternal, newborn, child and adolescent health indicators in humanitarian settings: a multimethods, multicountry qualitative study protocol

IntroductionIn 2019, over 70 million people were forcibly displaced worldwide. Women and girls comprise nearly half of this population and are at heightened risk of negative sexual and reproductive health outcomes. With the collapse of health systems, reduced resources and increased vulnerabilities from displacement, there is a need to strengthen current practices and ensure the delivery of comprehensive sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) services. Recognising the need for consistency in data collection, analysis and use, the WHO developed a list of core SRMNCAH monitoring and evaluation indicators for services and outcomes in humanitarian settings. This research will explore the feasibility of collecting this core set of SRMNCAH indicators in displacement contexts.Methods and analysisWe will undertake a multimethods qualitative study in seven humanitarian settings: Afghanistan, Albania, Bangladesh, Cameroon, the Democratic Republic of the Congo, Iraq and Jordan. We selected sites that reflect diversity in geographic region, sociocultural characteristics, primary location(s) of displaced persons and nature and phase of the crisis. Our study consists of four components: key informant interviews, facility assessments, observational sessions at select facilities and focus group discussions with front-line healthcare personnel. We will analyse our data using descriptive statistics and for content and themes. We will begin by analysing data from each setting separately and will then combine these data to explore concordant and discordant results, triangulate findings and develop global recommendations.Ethics and disseminationThe University of Ottawa’s Research Ethics Board and the Research Project Review Panel (RP 2) of the World Health Organization-Department of Sexual and Reproductive Health as well as local IRBs of PIs’ research institutions reviewed and approved this protocol. We intend to disseminate findings through workshops at the WHO country, regional and headquarter levels, as well as through local, national and international conferences, workshops, peer-reviewed publications, and reports.

ACCULTURATION OF LOCAL CULTURE AND RELIGION IN THE LEKLEK-AN TRADITION IN THE SEI KEPAYANG ASAHAN COMMUNITY

<p class="03Afiliasi"><em>This </em><em>research is a form of living hadith study that discusses the acculturation of local culture and religion in the implementation of the lek-lekan tradition in the Sei Kepayang community, Asahan Regency, North Sumatra. This study uses a descriptive qualitative method with an ethnographic approach. Data collection techniques in this study using the method of observation, interviews and documentation. And the informants are the government, ulama, community leaders, event organizers and the Sei Kepayang community in general. The results of this study, that the tradition of lek-lekan which is carried out at the birth of a baby by holding activities at the place of the baby's parents. The tradition of lek-lekan is perfected with a wedding ceremony for the baby. The main foundation for the community in carrying out the tradition of lek-lekan, namely in the form of carrying out the traditions of the local community continuously and practicing the sunnah of the Prophet Muhammad related to the akikah worship of a newborn child.</em></p><p class="03Afiliasi"><strong><em> </em></strong></p>

COMMENTS ON THE OFFENCE OF KILLING OR INJURING A NEWBORN CHILD BY A MOTHER

The paper examines the problem of in vitro fertilization of the female egg and the male sperm, after which the resulting substance is inseminated into the body of the wife or of a mother engaged for this purpose, and also raises theoretical and practical problems, especially when the couple has not otherwise succeeded in giving birth to a child.