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PubMed | Korea International Cooperation Agency, Seoul Development Institute, Health Bureau and Center for Development Research
Type: Journal Article | Journal: Trials | Year: 2016

Diarrhea is one of the leading causes of death, killing 1.3 million in 2013 across the globe, of whom, 0.59 million were children under 5years of age. Globally, about 1 billion people practice open defecation, and an estimated 2.4 billion people were living without improved sanitation facilities in 2015. Much of the previous research investigating the effect of improved sanitation has been based on observational studies. Recent studies have executed a cluster-randomized controlled trial to investigate the effect of improved sanitation. However, none of these recent studies achieved a sufficient level of latrine coverage. Without universal or at least a sufficient level of latrine coverage, a determination of the effect of improved latrines on the prevention of diarrheal disease is difficult. This cluster-randomized trial aims to explore the net effect of improved latrines on diarrheal prevalence and incidence in children under five and to investigate the effect on the diarrheal duration.A phase-in and factorial design will be used for the study. The intervention for improving latrines will be implemented in an intervention arm during the first phase, and the comparable intervention will be performed in the control arm during the second phase. During the second phase, a water pipe will be connected to the gotts (villages) in the intervention arm. After the second phase is completed, the control group will undergo the intervention of receiving a water pipe connection. For diarrheal prevalence, five rounds of surveying will be conducted at the household level. The first four rounds will be carried out in the first phase to explore the effect of improved latrines, and the last one, in the second phase to examine the combined effects of improved water and sanitation. For documentation of diarrheal incidence and duration, the mother or caregiver will record the diarrheal episodes of her youngest child on the Sanitation Calendar every day. Of 212 gotts in the project area, 48 gotts were selected for the trial, and 1200 households with a child under 5 will be registered for the intervention or control arm. Informed consent from 1200 households will be obtained from the mother or caregiver in written form.To our knowledge, this is the second study to assess the effects of improved latrines on child diarrheal reduction through the application of Community-Led Total Sanitation.Current Controlled Trials, ISRCTN82492848.


PubMed | Ketu South Municipal Health Directorate Ghana Health Service, Korea International Cooperation Agency, Devtplan Consult Ltd and Seoul Development Institute
Type: Journal Article | Journal: BMC public health | Year: 2017

In many low- and middle-income countries, community health volunteers (CHVs) are employed as a key element of the public health system in rural areas with poor accessibility. However, few studies have assessed the effectiveness of CHVs in improving child health in sub-Saharan Africa through randomized controlled trials. The present study aims to measure the impact of health promotion and case management implemented by CHVs on the health of under-5 children in Ghana.This study presents the protocol of a cluster-randomized controlled trial assessing the impacts of CHVs, in which the community was used as the randomization unit. A phase-in design will be adopted, and the intervention arm will be implemented in the intervention arm during the first phase and in the control arm during the second phase. The key intervention is the deployment of CHVs, who provide health education, provide oral rehydration solutions and zinc tablets to children with diarrhea, and diagnose malaria using a thermometer and a rapid diagnostic test kit during home visits. The primary endpoints of the study are the prevalence of diarrhea and fever/malaria in children under 5years of age, as well as the proportion of affected children receiving case management for diarrhea and malaria. The first and second rounds of household surveys to collect data will be conducted in the first phase, and the final round will be conducted during the second phase.With growing attention paid to the roles of CHVs as an essential part of the community health system in low-income countries, this study will contribute valuable information to the body of knowledge on the effects of CHVs.ISRCTN49236178 . (June 16th, 2015).


PubMed | Yonsei University, University of Ghana, Korea International Cooperation Agency and Ministry of Health
Type: Journal Article | Journal: Ghana medical journal | Year: 2016

Ghanas maternal mortality ratio continues to decline, but is not expected to meet the Millennium Development Goal (MDG) 5 target. The Ghana Health Service and Ministry of Health have displayed a high commitment to the improvement of maternal health in the country. One of the most recent partnerships directed at this is with the Korea International Cooperation Agency.This study was conducted among women between ages 15 and 49 resident in Keta Municipal, Ketu North and Ketu South districts in the Volta Region of Ghana who were pregnant or who had children aged less than five. Ethical approval was obtained from the Ghana Health Service Ethical Review Committee. Data were collected using questionnaires, entered into Stata version 12 and analyzed using frequency distribution and assessment of means. Comparisons among districts were conducted using chi square test and one way analysis of variance (ANOVA).The study covered 630 women whose mean age was 28.4 years. Almost all participants (99.1%) from Ketu North knew where to obtain family planning services. Use of modern contraception was highest in Ketu North with 31% of respondents using a modern method. Delivery in a health facility was highest in Keta Municipal (62.3%) with overall institutional delivery being 57.6%. Delivery by a skilled birth attendant (SBA) was also highest in Keta Municipal.Indicators used to assess maternal health services show a coverage of over 50% but we need to improve institutional delivery, use of modern contraception and education about danger signs in pregnancy.This work was supported by the National Research Foundation of Korea Grant funded by the Korean Government (NRF-2013S1A5B8A01055336) and the Korea International Cooperation Agency(2013).


Cha S.,Korea International Cooperation Agency | Cha S.,London School of Hygiene and Tropical Medicine | Kang D.,Vision-1 | Tuffuor B.,Training Research and Networking for Development | And 7 more authors.
International Journal of Environmental Research and Public Health | Year: 2015

Although a number of studies have been conducted to explore the effect of water quality improvement, the majority of them have focused mainly on point-of-use water treatment, and the studies investigating the effect of improved water supply have been based on observational or inadequately randomized trials. We report the results of a matched cluster randomized trial investigating the effect of improved water supply on diarrheal prevalence of children under five living in rural areas of the Volta Region in Ghana. We compared the diarrheal prevalence of 305 children in 10 communities of intervention with 302 children in 10 matched communities with no intervention (October 2012 to February 2014). A modified Poisson regression was used to estimate the prevalence ratio. An intention-to-treat analysis was undertaken. The crude prevalence ratio of diarrhea in the intervention compared with the control communities was 0.85 (95% CI 0.74–0.97) for Krachi West, 0.96 (0.87–1.05) for Krachi East, and 0.91 (0.83–0.98) for both districts. Sanitation was adjusted for in the model to remove the bias due to residual imbalance since it was not balanced even after randomization. The adjusted prevalence ratio was 0.82 (95% CI 0.71–0.96) for Krachi West, 0.95 (0.86–1.04) for Krachi East, and 0.89 (0.82–0.97) for both districts. This study provides a basis for a better approach to water quality interventions. © 2015 by the authors; licensee MDPI, Basel, Switzerland.


PubMed | Korea International Cooperation Agency, Training Research and Networking for Development and Vision-1
Type: Journal Article | Journal: International journal of environmental research and public health | Year: 2015

Although a number of studies have been conducted to explore the effect of water quality improvement, the majority of them have focused mainly on point-of-use water treatment, and the studies investigating the effect of improved water supply have been based on observational or inadequately randomized trials. We report the results of a matched cluster randomized trial investigating the effect of improved water supply on diarrheal prevalence of children under five living in rural areas of the Volta Region in Ghana. We compared the diarrheal prevalence of 305 children in 10 communities of intervention with 302 children in 10 matched communities with no intervention (October 2012 to February 2014). A modified Poisson regression was used to estimate the prevalence ratio. An intention-to-treat analysis was undertaken. The crude prevalence ratio of diarrhea in the intervention compared with the control communities was 0.85 (95% CI 0.74-0.97) for Krachi West, 0.96 (0.87-1.05) for Krachi East, and 0.91 (0.83-0.98) for both districts. Sanitation was adjusted for in the model to remove the bias due to residual imbalance since it was not balanced even after randomization. The adjusted prevalence ratio was 0.82 (95% CI 0.71-0.96) for Krachi West, 0.95 (0.86-1.04) for Krachi East, and 0.89 (0.82-0.97) for both districts. This study provides a basis for a better approach to water quality interventions.


Cha S.,Korea International Cooperation Agency | Cha S.,London School of Hygiene and Tropical Medicine | Cho Y.,Seoul National University
Asia-Pacific Journal of Public Health | Year: 2015

Under-5 child mortality decreased throughout the world by 49% from 1990 to 2013. However, it is unknown if this reduction was more effectively achieved in countries with a higher child mortality burden. We investigated the reduction of cause-specific global child mortality burden in 2000-2010. A total of 195 countries were selected for this analysis. A random-effect or fixed-effect model was chosen based on the Hausman test. Countries with a higher child mortality rate performed better with regard to the prevention of child deaths from major infectious diseases, but cause-specific progress was highly variable by disease within each country. Pneumonia-specific progress was much slower than that for diarrhea, and neonatal-specific child mortality increased in some countries. With a few exceptions, the overall performance in the countries with the largest share of child deaths was not good. This study identified priority interventions for child survival in the post-2015 period. © 2015 Asia-Pacific Academic Consortium for Public Health.


Lee Y.-H.,Chungnam National University | Jeong H.G.,Korea Association of Health Promotion | Kong W.H.,Korea Association of Health Promotion | Lee S.-H.,Korea Association of Health Promotion | And 6 more authors.
PLoS Neglected Tropical Diseases | Year: 2015

Schistosomiasis remains a major public health concern in Sudan, particularly Schistosoma haematobium infection. This study presents the disease-reduction outcomes of an integrated control program for schistosomiasis in Al Jabalain locality of White Nile State, Sudan from 2009 through 2011.The total population of the project sites was 482,902, and the major target group for intervention among them was 78,615 primary school students. For the cross-sectional study of the prevalence, urine and stool specimens were examined using the urine sedimentation method and the Kato cellophane thick smear method, respectively. To assess the impacts of health education for students and a drinking water supply facility at Al Hidaib village, questionnaire survey was done.The overall prevalence for S. haematobium and S. mansoni at baseline was 28.5% and 0.4%, respectively. At follow-up survey after 6–9 months post-treatment, the prevalence of S. haematobium infection was reduced to 13.5% (95% CI = 0.331–0.462). A higher reduction in prevalence was observed among girls, those with moderately infected status (around 20%), and residents in rural areas, than among boys, those with high prevalence (>40%), and residents in urban areas. After health education, increased awareness about schistosomiasis was checked by questionnaire survey. Also, a drinking water facility was constructed at Al Hidaib village, where infection rate was reduced more compared to that in a neighboring village within the same unit. However, we found no significant change in the prevalence of S. mansoni infection between baseline and follow-up survey (95% CI = 0.933–6.891).At the end of the project, the prevalence of S. haematobium infection was reduced by more than 50% in comparison with the baseline rate. Approximately 200,000 subjects had received either praziquantel therapy, health education, or supply of clean water. To consolidate the achievements of this project, the integrated intervention should be adapted continuously. © 2015 Lee et al.


News Article | November 11, 2016
Site: www.theguardian.com

Every morning before the sun rises, Stella Ampofo, a 25-year-old single mother of two boys, frantically gathers her belongings and sets off for work to beat the morning traffic in Ghana’s capital, Accra. If she doesn’t leave before daybreak, congestion during rush hour could extend her 40-minute journey from Accra’s suburbs towards downtown to three or four hours. “I’m in trouble if I leave my house around 6 or 6.30am,” Ampofo says. “I then won’t arrive at work until nine or 10am, and that creates a lot of problems with my manager because I’m supposed to get there by eight. If the government doesn’t do anything about the traffic, it’s not going to get any easier …” To ensure a punctual arrival, Ampofo, a seamstress at a manufacturing centre that converts plastic waste into reusable products, leaves her home at 4am every day and begins work an hour later – just as the road traffic starts to build up, as roughly 2 million daily commuters converge on the central business district in downtown Accra. Clouds of black exhaust fumes hover over the heads of impatient motorists. Cab drivers blast their horns, while pedestrians scurry on to rickety commercialised minibuses – referred to as “tro tros” by locals – that carry up to two-dozen passengers squeezed tightly together. Only motorcyclists who can skilfully manoeuvre between lanes are able to bypass the congestion. Although gridlock typically costs European economies billions of dollars annually, insufficient data in developing countries makes it difficult to assess the economic impact on cities such as Accra. A recent report by the World Bank measuring the cost of air pollution globally, however, provides some insight into how congestion affects people’s health. Gridlock causes longer travel times, which increases fuel use and emissions. In 2013, a total of 17,524 Ghanaians died from air pollution, a 107% increase from 1990. “Accra has struggled with the management of the mobility challenges and rising traffic congestion on almost all arterial routes to the central business district,” Lawrence Kumi, director of research, statistics and information management at Ghana’s Ministry of Transport, admits in an email. “The implementation of various remedial measures was on an ad-hoc basis and not well coordinated. There was the need for a holistic approach.” In 2014, the government of Ghana began developing a plan to reduce congestion and overhaul the urban transportation system in the Greater Accra Metropolitan Area (Gama), which includes Accra and its outskirts. The plan was in collaboration with the Korea International Cooperation Agency (Koica), and supported by a $1.5m grant from the South Korean government. Before the end of this year, the final transport master plan (TMP) is due to be presented to Ghana’s ministry of transport for implementation. The plan seeks to “bring together all modes of transport … not only by road” and “reduce traffic congestion and logistic costs” over the next 20 years. Greater Accra’s current population of around 4.3 million is predicted to almost double by 2035 – likewise the number of vehicles on the roads. While increased congestion can reflect a city’s growing economic vitality, the potential negative effects – low worker productivity, hours-long delays, more dangerous roads, commuter stress, pressure on road infrastructure and an unhealthy intake of dirty fuel emissions – will place a serious strain on the city if it is not addressed soon. Accra is not alone in facing transportation challenges. Nearby Lagos, the economic capital of Nigeria, is notorious for being one of the most gridlocked cities in the world. But its population is around five times Accra’s, and its economy greater than the whole of Ghana – so according to Kweku Amoasi, associate director for transport planning at the London-based engineering consultancy RSK, Accra should have no excuse when it comes to severe congestion. “With a small population, Ghana should be able to manage traffic much better,” Amoasi says. “There’s just been a total lack of foresight. The planners should sit down and realise they’re not doing this for themselves; they’re doing it for the nation.” Bernard Abeiku Arthur, a senior urban specialist with Belgium-based Cities Alliance, says it is this kind of regulatory neglect that has led to today’s unabating traffic troubles and dysfunctional transport system in Accra. “We knew the population was growing,” Arthur says. “We knew we were getting urbanised, but we ignored all the necessary ingredients and elements for planning our urban space properly.” Arthur says the new TMP is “very fanciful” on paper, but also too limiting geographically – excluding regions beyond Greater Accra from which much of the traffic originates. “The urban area is impacted by the fringes,” Arthur said. “So if you’re doing your calculation and you cut out the fringes, you might not be doing a very good calculation.” Francis Akakpo, programme officer at Koica in Ghana, says the planners were unable to conduct research on areas beyond the Greater Accra Metropolitan Area because of “limited time and resources”. Ghana’s first mass transit bus system, Omnibus Services Authority, was established in 1927 during the British colonial period. After independence, public transportation remained largely state-owned until the late 1980s and early 90s, when the government divested itself of assets amid financial mismanagement. This was when the privately run buses appeared to fill the gap: the tro tro, a significant contributor to congestion, has been the most common mode of mass transportation ever since. In September, however, the Greater Accra Passenger Transport Executive launched a pilot run of a new Bus Rapid Transport (BRT) system, unleashing city buses across several major routes throughout Greater Accra. In defiance of Ghana president John Mahama’s claims that this marked “the beginning of a new modern public transport network” for the city, tro tro operators and other commercial drivers threatened to strike over fears the new buses would force them out of operation. The final TMP proposes building on the city’s new bus network by replacing thousands of tro tros with high-capacity buses that promise to be safer, faster and more comfortable – a move that looks set to increase tensions with the existing transport providers. These buses will only be released “on a gradual, incremental basis, to make room for adoption and acceptance”, says Koica’s Francis Akakpo. But according to Abeiku from Cities Alliance, even a successful implementation of the public bus system will only provide minimal relief to congestion. For sustainable long-term improvements, he says, planners must commit to focusing on rail, tram and subway developments so commuters like Stella Ampofo aren’t forced to upend their daily lives just to get to work. “We have to envision what kind of city we want Accra to be,” Abeiku says. “Do we want a city that supports its economy, whose people feel free to move around? A city where public transportation is properly regulated? That is the kind of city I want.” Follow Guardian Cities on Twitter and Facebook and join the discussion


News Article | November 18, 2016
Site: en.prnasia.com

SEOUL, South Korea, Nov 18, 2016 /PRNewswire/ -- Sae-A Trading Co., Ltd (Sae-A), a leading global apparel manufacturer and exporter, led its fourth medical mission since 2012, to Northern Haiti. The mission provides free medical care to local area residents in the neighboring communities around the area each time averaging more than 3,000 people over a (five day) week. 25 medical professionals from the USA (George Washington University School of Nursing), South Korea (Pusan National University Yangsan Hospital) and Haiti (The Vision Plus Eye Clinic in Cap Haitian) spent the week treating local residents at the Sae-A supported, S&H Primary School, while the students were on fall break. The classrooms are converted into temporary medical treatment rooms. Sae-A provided transportation to area residents who needed care, but were unable to reach the school. The team of 25 medical professionals bring a wide variety of expertise across multiple disciplines including pediatrics, obstetrics, otolaryngology, urology, dermatology, pain management, ophthalmology and family medicine. Special attention is paid to mothers-to-be, infants and children who are not only screened for diseases, but also provided wellness examinations and health information on issues ranging from disease prevention to nutrition. The mission's goal is to both to provide best-in-class care to clinic patients, as well as help educate the community about best practices in hygiene to help prevent future diseases. A main focus of the educational programming, done in cooperation with local community hospitals, was the prevention and treatment of cholera and other infectious diseases that are present in the region. For the third time, ophthalmology has been one of the services provided. Vision Plus, based in Cap Haitian, conducted vision examinations on nearly 600 residents providing those with vision problems prescription corrective glasses as well as to provide treatment and screening for disorders that include dry eye, allergic conjunctivitis, eye trauma, infections, glaucoma and cataracts. "Sae-A is always working to be a beneficial member of the community," said Sae-A's Chairman Woong-Ki Kim. "Our goal through the medical mission is to provide primary health care services, screening and health education for as many adults and children in the communities around the Caracol Industrial Park. We are particularly happy to have partners from Korea, the United States and Haiti join us on our fourth medical mission since 2012. We are grateful to our neighbors for their gracious welcome and remain committed to their well-being. We are particularly proud that any additional supplies from the medical mission will be provided to the Government of Haiti to help treat victims of Hurricane Matthew." Sae-A, which marked its 30th year of operations earlier this year, regularly invests in various CSR programs in support of the communities in the areas where it operates. From supporting relief efforts to providing medical treatment to educating more than 400 local students, Sae-A takes its role in the community extremely seriously. Sae-A invested in and fully funds the operation of the S&H Primary School in a neighborhood near the Industrial Park. The S&H Primary School which provides a best-in-class (free) education to nearly 400 students. The school is led by a team of experienced local and international educators and includes a multi-lingual curriculum and leverages technology to create the best learning experience possible. Sae-A collaborated with the Government of Haiti, the Korea International Cooperation Agency, and local stakeholders to ensure national requirements would be met. The S&H Secondary School opened this past September which allows the graduates from the Primary School to continue receiving the same quality education without interruption. Each year the school will grow with its senior-most class through the completion of 12th grade essentially doubling enrollment. Moreover, S&H School's impact on the community goes beyond the class day. It will serve the Caracol-EKAM area by acting as a community center and hosting social events, and provide opportunities for area residents to participate in English and other adult education classes and activities that promote the concept that education begins at home and the community is an extension of the classroom. For more information on Sae-A's social responsibility programs and initiatives in Haiti, please visit: www.sae-a.com. About Sae-A Trading Co., Ltd Established in 1986, Sae-A Trading Co., Ltd is one of the world's largest apparel manufacturing companies employing over 60,000 associates throughout Southeast Asia, Central America and the Caribbean with exports of apparel and textiles exceeding $1.6 billion dollars. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/sae-a-and-partners-send-fourth-medical-mission-to-haiti-300363959.html


Lim S.,Korea International Cooperation Agency
Globalizations | Year: 2014

Abstract: This study raises the question of what determines compliance with the OECD DAC framework on the basis of a case study of South Korea. This research argues that fragmented institutional structures limit the bureaucratic capacity for greater compliance. At the same time, the findings illustrate that lack of interest from dominant institutions can limit the consolidation of political will for change at the national level. This study has implications for future DAC donors in that special and peer reviews can be useful methodologies to identify current limitations for change. Finally, the study emphasises the importance of consolidated political will in terms of readiness to adopt global standards at the domestic level before commencing membership and obligatory processes. © 2014, © 2014 Taylor & Francis.

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