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Kabul, Afghanistan

Sissoko K.,Care International | Traore M.,University of Bamako | Dumont A.,CIRAD - Agricultural Research for Development
Bulletin of the World Health Organization | Year: 2013

Objective To investigate the frequency of catastrophic expenditures for emergency obstetric care, explore its risk factors, and assess the effect of these expenditures on households in the Kayes region, Mali. Methods Data on 484 obstetric emergencies (242 deaths and 242 near-misses) were collected in 2008-2011. Catastrophic expenditure for emergency obstetric care was assessed at different thresholds and its associated factors were explored through logistic regression. A survey was subsequently administered in a nested sample of 56 households to determine how the catastrophic expenditure had affected them. Findings Despite the fee exemption policy for Caesareans and the maternity referral-system, designed to reduce the financial burden of emergency obstetric care, average expenses were 152 United States dollars (equivalent to 71 535 Communauté Financière Africaine francs) and 20.7 to 53.5% of households incurred catastrophic expenditures. High expenditure for emergency obstetric care forced 44.6% of the households to reduce their food consumption and 23.2% were still indebted 10 months to two and a half years later. Living in remote rural areas was associated with the risk of catastrophic spending, which shows the referral system's inability to eliminate financial obstacles for remote households. Women who underwent Caesareans continued to incur catastrophic expenses, especially when prescribed drugs not included in the government-provided Caesarean kits. Conclusion The poor accessibility and affordability of emergency obstetric care has consequences beyond maternal deaths. Providing drugs free of charge and moving to a more sustainable, nationally-funded referral system would reduce catastrophic expenses for households during obstetric emergencies. Source

Lowicki-Zucca M.,AVSI | Walugembe P.,FHI360 | Ogaba I.,Care International | Langol S.,AVSI
Children and Youth Services Review | Year: 2014

Background: Increasing interest is concentrating in the investigation of whether socioeconomic interventions yield results for children in the area of protection. AVSI Foundation, in Uganda, leads a consortium implementing the "Sustainable, Comprehensive Responses for Vulnerable Children and their Families" (SCORE) Project. The project targets 25,000 moderately and critically vulnerable households in Uganda and addresses them through a multisectoral intervention package encompassing socio-economic, food security, protection and family strengthening. Data from SCORE's monitoring and evaluation system and the mid-term assessment has become available and is used to investigate the topic. Objective: This paper contributes original data and analysis to the discussion of socioeconomic strategies for vulnerability reduction and protection of children. Methods: Statistical analysis of Village Savings and Loan Association Management Information System (VSLA MIS) data from 741 VSLAs was supported by the SCORE Project between 2012 and 2013. Statistical analysis of SCORE Vulnerability Assessment Tool (VAT) data covering 13,327 beneficiary households enrolled by SCORE in its first phase (last quarter 2011-first quarter 2012) and corresponding second assessment (second quarter 2013). Data analysis was carried out using Statistical Package for Social Sciences (SPSS). Results: Between 2011 and 2012, SCORE supported the establishment of 743 Village Savings and Loan Associations (VSLAs), with a total membership of 20,818. Total saving stands at 1,113,185,960 Uganda Shillings. Saving and loans per capita are at 53,754 and 50,093 Uganda Shillings respectively, with regional variation (ranging 33,008-83,073 for savings, and 24,005-93,280 for lending). The overall loan to saving ratio is at 84.45%, with regional variation and range 60.83%-97.97%. Vulnerability data concerning the protection for 13,326 households supported by SCORE shows a reduction by 52%, with regional variation (range 42%-71%). Conclusion: Results show that the VSLA approach can be used, besides community development, for direct vulnerability reduction strategies. VSLA approach can be made more inclusive of the most disenfranchised members of the community without losing in efficiency or effectiveness. SCORE Project data is highly suggestive of a positive linkage between socioeconomic interventions and protection outcomes, thereby reinforcing the current literature. More detailed analysis of SCORE databases may allow further understanding of the pathways linking the two result dimensions. © 2014 Elsevier Ltd. Source

De Sherbinin A.,Columbia University | Castro M.,Harvard University | Gemenne F.,Institute for Sustainable Development and International Relations IDDRI | Cernea M.M.,Brookings Institution | And 15 more authors.
Science | Year: 2011

Mitigation and adaptation projects will lead to increased population displacement, calling for new research and attention to past lessons. Source

News Article
Site: http://news.yahoo.com/green/

Stephen O’Brien, Under-Secretary-General for Humanitarian Affairs and Emergency Relief, speaks during the meeting on the humanitarian situation in Syria January 27, 2016 at the UN in New York (AFP Photo/UN Photo/Manuel Elias) Geneva (AFP) - Some 60 million people worldwide need assistance due to havoc wreaked by the El Nino climate phenomenon, but a shortage of funding could threaten the delivery of life-saving aid, the UN warned Tuesday. "The numbers are truly alarming," UN humanitarian chief Stephen O'Brien told reporters in Geneva. The El Nino effect, which comes with warming sea surface temperatures in the equatorial Pacific, causes heavy rains in some parts of the world and drought elsewhere. The 2015-2016 El Nino was one of the most powerful on record, and has caused significant damage across 13 countries across Africa, Asia, Central and South America and the Pacific, sending malnutrition levels spiralling and leading to greater spread of diseases. In addition to the some 60 million people directly affected by El Nino, "there will be millions more who are at risk," O'Brien said, following a meeting in Geneva with representatives of affected countries and aid organisations. Floods and failed rains caused by El Nino have sparked a dramatic rise in the number of people going hungry in large parts of Africa, with some 32 million people in the southern part of the continent alone in need of some form of assistance. Ethiopia, which is experiencing its worst drought in half a century, is considered "ground zero" in the crisis, with some 10 million people in need of aid, Care International Secretary General Wolfgang Jamann said. But getting aid to all those in need is no easy task. The UN estimates that at least $3.6 billion is required to meet critical needs for food and agricultural support, as well as health and emergency water and sanitation needs linked to El Nino, and O'Brien warned that figure was likely to rise. But even if the needs remain stable, less than half of what is required -- only $1.4 billion -- has been provided. "So far what has been raised is far short of what we need," he said, cautioning that "lifesaving programmes, including the food pipeline in Ethiopia, are at risk of being cut short." "We have weeks, not months to get this right." Making matters worse, the communities still reeling from the impact of El Nino are likely to get slammed again later this year by a return swing of the pendulum with its opposite number, La Nina. In addition to providing desperately needed aid, the world should now be preparing for La Nina, which is characterised by unusual cool ocean surface temperatures in the central and eastern tropical Pacific, said the UN's Izumi Nakamitsu. "If La Nina happens, the local community level coping mechanism is already quite low, because they have been coping with El Nino impact," she told reporters. "So when that hits, the community will be again devastated, and possibly even much worse," she said.

Bartel D.,Care International | Rubardt M.,Care International
Global Public Health | Year: 2012

Using samples of reproductive aged men and women from rural Ethiopia and Kenya, this study examines the associations between two scales measuring balances of power and equitable attitudes within relationships and modern contraceptive use. The scales are developed from the Sexual and Reproductive Power Scale (SRPS) and Gender Equitable Male (GEM) scale, which were originally developed to measure relationship power (SRPS) among women and gender equitable attitudes (GEM) among men. With the exception of Ethiopian women, a higher score on the balance of power scale was associated with significantly higher odds of reporting modern contraceptive use. For men and women in both countries, a higher score on the equitable attitudes scale was associated with significantly higher odds of reporting modern contraceptive use. However, only the highest categories of the scales are associated with contraceptive use, suggesting a threshold effect in the relationships between power, equity and contraceptive use. The results presented here demonstrate how elements of the GEM and SRPS scales can be used to create scales measuring balances of power and equitable attitudes within relationships that are associated with self-reporting of modern contraceptive use in two resource-poor settings. However, further work with larger sample sizes is needed to confirm these findings, and to examine the extent to which these scales can be applied to other social and cultural contexts. © 2012 Taylor & Francis. Source

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