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Zamawe C.O.F.,Initiative Capital | Zamawe C.O.F.,The Ministry of Health | Banda M.,MaiMwana Project | Dube A.N.,Initiative Capital | Dube A.N.,University of Malawi
BMC Pregnancy and Childbirth | Year: 2016

Background: Mass media is critical in disseminating public health information, improving health knowledge and changing health behaviours. However, most of the mass media public health interventions do not sufficiently engage the local people; they are externally determined. Due to this, very little is known about the effects of locally instigated mass media promotion. Therefore, the aim of this study was to examine the impact of a community driven mass media campaign called Phukusi la Moyo (tips of life) on the utilisation of maternal health care services. Methods: A community-based cross-sectional study involving 3825 women of reproductive age (15-49 years) was conducted in rural Malawi to evaluate the Phukusi la Moyo (PLM) campaign. To do this, we compared the utilisation of maternal health care services between women who were exposed to the PLM campaign and those who were not. Respondents were identified using a multistage cluster sampling method. This involved systematically selecting communities (clusters), households and respondents. Associations were examined using Pearson chi square test and a multivariable logistic regression model. Results: The likelihood of using contraceptives (AOR = 1.61; 95 % CI = 1.32-1.96), sleeping under mosquito bed-nets (AOR = 1.65; 95 % CI = 1.39-1.97), utilising antenatal care services (AOR = 2.62; 95 % CI = 1.45-4.73) and utilising postnatal care services (AOR = 1.59; CI = 1.29-1.95) were significantly higher among women who had exposure to the PLM campaign than those who did not. No significant association was found between health facility delivery and exposure to the PLM campaign. Conclusion: Women exposed to a community driven mass media campaign in rural Malawi were more likely to utilise maternal health care services than their unexposed counterparts. Since, the use of maternal health care services reduces the risk of maternal morbidity and mortality, community-led mass media could play a significant role towards improving maternal health outcomes in low-and-middle-income countries. Therefore, we recommend the use of locally driven mass media in disseminating public health information in limited resource settings. © 2016 Zamawe et al.


Gunn J.S.,Initiative Capital | Saah D.S.,Spatial Informatics Group | Hagan J.M.,Manomet Center for Conservation science
Journal of Sustainable Forestry | Year: 2013

Policies based on assumed carbon neutrality fail to address the timing and magnitude of the net greenhouse gas (GHG) changes from using wood for energy. We present a "debt-then-dividend" framework for evaluating the temporal GHG impacts of burning wood for energy. We also present a case study conducted in Massachusetts, USA to demonstrate the framework. Four key inputs are required to calculate the specific shape of the debt-then-dividend curve for a given region or individual biomass facility. First, the biomass feedstock source: the GHG implications of feedstocks differ depending on what would have happened to the material in the absence of biomass energy generation. Second, the form of energy generated: energy technologies have different generation efficiencies and thus different life cycle GHG emissions profiles. Third, the fossil fuel displaced: coal, oil, and natural gas each have different emissions per unit of energy produced. Fourth, the management of the forest: forest management decisions affect recovery rates of carbon from the atmosphere. This framework has broad application for informing the development of renewable energy and climate policies. Most importantly, this debt-then-dividend framework explicitly recognizes that GHG benefits of wood biomass energy will be specific to the forest and technology context of the region or biomass energy projects. © 2013 Copyright Taylor and Francis Group, LLC.


Ducey M.J.,University of New Hampshire | Gunn J.S.,SIG | Gunn J.S.,Initiative Capital | Whitman A.A.,Initiative Capital
Forests | Year: 2013

Restoration of old-growth forest structure is an emerging silvicultural goal, especially in those regions where old-growth abundance falls below the historic range of variability. However, longitudinal studies of old-growth dynamics that can inform silvicultural and policy options are few. We analyzed the change in structure, including stand density, diameter distribution, and the abundance of large live, standing dead, and downed dead trees on 58 late-successional and old-growth plots in Maine, USA, and compared these to regional data from the U.S. Forest Inventory and Analysis program. Structural dynamics on the late-successional plots reflected orderly change associated with density-dependent growth and mortality, but dynamics on the old-growth plots were more variable. Some plots experienced heavy mortality associated with beech bark disease. Diameter distributions conformed poorly to a classic exponential distribution, and did not converge toward such a distribution at the plot scale. Although large live trees showed a broad trend of increasing density in regional forests, recent harvesting patterns offset a considerable fraction of those gains, while mean diameter was static and the number of large dead trees was weakly declining. Even though forests of the northeast are aging, changes in silviculture and forest policy are necessary to accelerate restoration of old-growth structure. © 2013 by the authors.


Gunn J.S.,Initiative Capital | Ganz D.J.,Lowering Emissions in Asias Forests LEAF | Keeton W.S.,University of Vermont
GCB Bioenergy | Year: 2012

In the current debate over the CO2 emissions implications of switching from fossil fuel energy sources to include a substantial amount of woody biomass energy, many scientists and policy makers hold the view that emissions from the two sources should not be equated. Their rationale is that the combustion or decay of woody biomass is simply part of the global cycle of biogenic carbon and does not increase the amount of carbon in circulation. This view is frequently presented as justification to implement policies that encourage the substitution of fossil fuel energy sources with biomass. We present the opinion that this is an inappropriate conceptual basis to assess the atmospheric greenhouse gas (GHG) accounting of woody biomass energy generation. While there are many other environmental, social, and economic reasons to move to woody biomass energy, we argue that the inferred benefits of biogenic emissions over fossil fuel emissions should be reconsidered. © 2011 Blackwell Publishing Ltd.


Gunn J.S.,Initiative Capital | Ducey M.J.,University of New Hampshire | Whitman A.A.,Initiative Capital
Forest Ecology and Management | Year: 2014

Comprehensive data on the capacity and rates of change for carbon pools in managed and unmanaged forests is essential for evaluating climate change mitigation options being considered by policy makers at regional and national levels. We currently lack real and long-term data on forest carbon dynamics covering a wide range of forest management practices and conditions. Because of this, selecting the best policies for conserving forest carbon must rely on forest growth and yield models such as US Forest Service (USFS) Forest Vegetation Simulator (FVS) to predict the future forest carbon impacts of management actions. FVS may underestimate the capacity of older stands to accumulate carbon because the model relies on USFS Forest Inventory and Analysis data that lack data from late-successional and old-growth (LSOG) stands. Improving these models will increase the likelihood of selecting policies that successfully use forests to reduce atmospheric carbon. From 1995 to 2002, Manomet Center for Conservation Sciences conducted research on 65 10m by 50m permanent plots to evaluate forest structure (standing live and dead trees, and down coarse woody material) in LSOG stands across northern Maine. We re-measured these plots in 2011 to assess long-term carbon sequestration trends in LSOG stands of common forest types in the Northern Forest region for above ground alive, standing dead, and coarse woody material carbon pools. Late-successional (LS) and Old-growth (OG) aboveground live carbon (C) stocks were very high relative to regional mean C stocks (2.0-2.5 times the mean), LS plots were accumulating aboveground live C at a positive rate (0.61Mgha-1 year-1), while C stocks on OG plots are declining (-0.54Mgha-1 year-1). This change is driven by the presence of beech bark fungus (Nectria sp.) that is leading to mortality in larger diameter American beech (Fagus grandifolia) trees. We also found that the Northeast Variant of the Forest Vegetation Simulator is not a reliable predictor of aboveground live carbon accumulation rates in Northeastern LS and OG stands. This work provides important baselines for understanding the role of older forests and forest management within climate change mitigation strategies in the northeastern US. Late-successional and old-growth forests can play an important role in mitigating climate change, but understanding and quantifying natural disturbance risk to forest carbon stocks is critical for successful implementation of mitigation strategies. Further, regional forest carbon models will need calibration to accurately predict carbon accumulation rates in older forests. © 2013 Elsevier B.V.


PubMed | Initiative Capital and MaiMwana Project
Type: | Journal: BMC pregnancy and childbirth | Year: 2016

Mass media is critical in disseminating public health information, improving health knowledge and changing health behaviours. However, most of the mass media public health interventions do not sufficiently engage the local people; they are externally determined. Due to this, very little is known about the effects of locally instigated mass media promotion. Therefore, the aim of this study was to examine the impact of a community driven mass media campaign called Phukusi la Moyo (tips of life) on the utilisation of maternal health care services.A community-based cross-sectional study involving 3825 women of reproductive age (15-49 years) was conducted in rural Malawi to evaluate the Phukusi la Moyo (PLM) campaign. To do this, we compared the utilisation of maternal health care services between women who were exposed to the PLM campaign and those who were not. Respondents were identified using a multistage cluster sampling method. This involved systematically selecting communities (clusters), households and respondents. Associations were examined using Pearson chi square test and a multivariable logistic regression model.The likelihood of using contraceptives (AOR=1.61; 95% CI=1.32-1.96), sleeping under mosquito bed-nets (AOR=1.65; 95% CI=1.39-1.97), utilising antenatal care services (AOR=2.62; 95% CI=1.45-4.73) and utilising postnatal care services (AOR=1.59; CI=1.29-1.95) were significantly higher among women who had exposure to the PLM campaign than those who did not. No significant association was found between health facility delivery and exposure to the PLM campaign.Women exposed to a community driven mass media campaign in rural Malawi were more likely to utilise maternal health care services than their unexposed counterparts. Since, the use of maternal health care services reduces the risk of maternal morbidity and mortality, community-led mass media could play a significant role towards improving maternal health outcomes in low-and-middle-income countries. Therefore, we recommend the use of locally driven mass media in disseminating public health information in limited resource settings.


PubMed | Initiative Capital, Umeå University and University College London
Type: Journal Article | Journal: Cost effectiveness and resource allocation : C/E | Year: 2015

Understanding the cost-effectiveness and affordability of interventions to reduce maternal and newborn deaths is critical to persuading policymakers and donors to implement at scale. The effectiveness of community mobilisation through womens groups and health facility quality improvement, both aiming to reduce maternal and neonatal mortality, was assessed by a cluster randomised controlled trial conducted in rural Malawi in 2008-2010. In this paper, we calculate intervention cost-effectiveness and model the affordability of the interventions at scale.Bayesian methods are used to estimate the incremental cost-effectiveness of the community and facility interventions on their own (CI, FI), and together (FICI), compared to current practice in rural Malawi. Effects are estimated with Monte Carlo simulation using the combined full probability distributions of intervention effects on stillbirths, neonatal deaths and maternal deaths. Cost data was collected prospectively from a provider perspective using an ingredients approach and disaggregated at the intervention (not cluster or individual) level. Expected Incremental Benefit, Cost-effectiveness Acceptability Curves and Expected Value of Information (EVI) were calculated using a threshold of $780 per disability-adjusted life-year (DALY) averted, the per capita gross domestic product of Malawi in 2013 international $.The incremental cost-effectiveness of CI, FI, and combined FICI was $79, $281, and $146 per DALY averted respectively, compared to current practice. FI is dominated by CI and FICI. Taking into account uncertainty, both CI and combined FICI are highly likely to be cost effective (probability 98% and 93%, EVI $210,423 and $598,177 respectively). Combined FICI is incrementally cost effective compared to either intervention individually (probability 60%, ICER $292, EIB $9,334,580 compared to CI). Future scenarios also found FICI to be the optimal decision. Scaling-up to the whole of Malawi, CI is of greatest value for money, potentially averting 13.0% of remaining annual DALYs from stillbirths, neonatal and maternal deaths for the equivalent of 6.8% of current annual expenditure on maternal and neonatal health in Malawi.Community mobilisation through womens groups is a highly cost-effective and affordable strategy to reduce maternal and neonatal mortality in Malawi. Combining community mobilisation with health facility quality improvement is more effective, more costly, but also highly cost-effective and potentially affordable in this context.


Gunn J.S.,Initiative Capital | Saah D.S.,Spatial Informatics Group LLC | Fernholz K.,Dovetail | Ganz D.J.,Nature Conservancy
Forest Science | Year: 2011

We evaluated the implications of area regulation of harvest on eligible carbon under both the Voluntary Carbon Standard (VCS) and the Chicago Climate Exchange (CCX) for public forest lands in north central Minnesota (89,840 ha total). We used data from the carbon submodel of the US Forest Service Forest Vegetation Simulator (Lake States variant) to evaluate changes in forest carbon stocks under different management scenarios. Baseline harvest intensity was defined by considering the manager's short-range tactical plans and the distribution of harvests by cover type and intensity class then became the "business as usual" (BAU) for use in the calculation of eligible carbon under the VCS and CCX. Under VCS, the most effective way to increase carbon stocks while meeting other management objectives was to shift harvest practices to lower intensity entries and retain higher residual basal areas. The carbon stock change rates for each manager varied significantly under the BAU scenario and resulted in a mean annual net decrease. Because CCX carbon credit eligibility requires a net increase of carbon stocking from the base year, area regulation may create periods of time where there is no eligible carbon volume. An alternate management strategy that uses the area regulation method, reduces harvest intensity, and decreases overall acreage harvested was able to provide higher postharvest carbon stocks versus the BAU scenario under VCS. © 2011 by the Society of American Foresters.


Chan K.M.A.,University of British Columbia | Ruckelshaus M.,Initiative Capital
F1000 Biology Reports | Year: 2010

The benefits of marine ecosystems for people are increasingly being characterized through the concept of ecosystem services, with the promise to aid decision making from marine spatial planning to ecosystem-based management. The characterization of changes in marine ecosystem services is central to the application of ecological science to policy contexts, and this field is quickly evolving with innovations in frameworks for integrating science, understanding of ecosystems and human benefits, and innovations in tools for the modeling of services. In this article, we review efforts to characterize changes in marine ecosystem services, including recent advances, and we propose five key future directions for research: cultural values, qualitative or semi-quantitative modeling approaches, cumulative impacts, model evaluation, and markets. © 2010 Faculty of 1000 Ltd.


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