Data Matters: PSI’s Resource Catalog

Jina Moore and Jake Naughton put together a list of resources for journalists reporting on reproductive help.  PSI’sresource catalog is among the recommendations.  In the above video, Dr. Nirali Shah, research adviser for reproductive health at PSI, discusses how studies are written for a wider audience and posted as a resource on our website.

Moore and Naughton call to attention the very important point that data is often very complex and imperfect.  It is why PSI aims to make our resources publicly accessible to researchers and journalists.  As Jay Lebowitz says in the K4Health blog, “The heart of knowledge management is sharing your knowledge and learning from others. This is also essentially the main tenet of public health. Better informing the world through capturing, sharing, applying, disseminating, and generating knowledge is what the public health and knowledge management fields have in common. “

Read on to see some of the advice gathered by Moore and Naughton.

Healthy Dose January 11, 2012

New Research: Developing Countries Lack Access to Basic Painkillers

Painkillers are plentiful for patients in countries like Canada, but fall well short in the Global South. Global News reports on recent research:

apothecaryThe University of Ottawa researchers condemned the International Narcotics Control Board, a global body that plays a dual role in doling out medicine around the world while policing the flow of illegal drugs.

While Canada offers its ailing patients morphine, oxycodene and fentanyl, other countries from Haiti to Iran, carry out surgeries, amputations and other severe medical procedures without offering any pain relief, says lead researcher Amir Attaran.

“We are neither consuming a ridiculously high or ridiculously low amount of (narcotics) relative to other rich countries. But relative to poorer countries, we’re kings,” he said.

Attaran, a law and medicine professor at the University of Ottawa, collaborated with his colleague Jason Nickerson in the study. Their complete findings were published in the medical journal PLoS (the Public Library of Science).

Canadians receive codeine for wisdom teeth removal, for example. If they’re battling the final stages of cancer, they do so with morphine to help ease the pain.

On the other hand, following the 2010 earthquake in Haiti, which marks its second anniversary Thursday, people whose limbs were crushed in the rubble were being amputated on without any painkillers.

“In Canada, your wisdom teeth can get more pain relief than a woman in West Africa suffering from breast cancer. We’re the exception here. Most of the world, if you’re a cancer patient, you die in pain,” Attaran said.

While Attaran says Canada faces “no shortage” of painkillers, Haiti, with a population of 9.7 million people, is only allocated 671 grams of morphine, 117 grams of codeine, 83 grams of fentanyl and 309 grams of pethidine.

Some countries receive as low as 1 gram of morphine a year for the entire population.

A gram, Attaran estimates, would be sufficient supply for a cancer patient for about two weeks.

Melinda Gates On Global Health Spending

Melinda Gates and New York Times journalist Nick Kristof allowed readers to submit questions about international development and global health.   The first part of the conversation was published yesterday; this question and answer caught the eye of us at Healthy Lives:

Question: I attended a talk once with the British economist Benny Dembitzer. He thinks that too much money is spent on the fight against malaria and other diseases, believing that a child may be saved from malaria today but could die from diptheria tomorrow. Instead, he’d rather see that money spend on primary education. As a molecular biologist, I think that the fight against insect transmitted diseases can be won, but I can understand the argument. Do you think that a point might be reached at which we have to say: Enough’s enough. Let’s give everyone bed nets and we can fight malaria through bringing people out of poverty? –ROBERT JONES

MELINDA: I hear that question a lot, and I don’t think it is either or. We have to do both. It is incredibly important not only to invest in health, but also to invest in efforts that stimulate economic growth, expand access to opportunity, and help the poor raise themselves out of poverty. Take agriculture, for example. We invest in agriculture because we believe that if smallholder farmers, the majority of whom are women, had access to better information and higher yielding and more resilient crops, they could better feed their families, earn higher incomes, and become self-sufficient.

Healthy Dose January 10, 2012

Studies Uncover Stillbirth Causes, Leave More Questions

Two new studies tracking the causes of stillbirths in the United States help to identify some of the causes, but also reveal unexplained trends. The New York Times reports:

Safe and healthy newbornsIn the first report, a team of scientists at several sites examined 512 babies born with no signs of life at 20 weeks’ gestation or later. The sample was diverse in ethnicity, race and geography, roughly approximating the population of the United States.

The researchers considered a number of possible causes, including placental abnormalities, infection in the mother or baby, and maternal medical conditions. They found a possible or probable cause of death in about 76 percent of the stillbirths.

Deaths during labor accounted for about 29 percent of cases. In this group, infections were more common, and genetic abnormalities less so, than in babies who died before labor.

Placental disease accounted for 24 percent of stillbirths over all. About 13 percent of deaths were caused by infection, almost 14 percent by genetic abnormalities, and more than 10 percent by umbilical cord conditions that prevented sufficient blood flow.

Hypertension and other maternal medical complications together accounted for 17 percent of the deaths.

There were significant racial and ethnic variations. African-American women were more likely to have a stillbirth, and it was more likely to occur early in pregnancy and after the onset of labor. Infections were also more common in black women. Umbilical cord abnormalities, on the other hand, were more frequent in white and Hispanic women.

Vaccinating Children is a Social Responsibility

The following posts is by Martha Kempner and originally appears on the RH Reality Check Blog. The opinions stated are that of the author and are not necessarily those of PSI.

Vaccines Save Lives: Every Child, EverywhereSo, I am that mom on the playground, the one who—while happy to play with my kids— craves adult interaction and looks for opportunities to strike up conversations with other parents.  It’s actually pretty easy (presumably because other mothers find pushing a toddler on a swing as mind-numbingly dull as I often do). I comment on similarities between our kids, something mine is doing, or something hers just said and nine times out of ten we are deep in discussion about our lives and experiences with motherhood within five minutes.  We trade stories and advice about sleep training, breast feeding, potty training, discipline techniques, daycare, and pediatricians.

Of course, I always try to be careful not to be too opinionated during these conversations.  In my liberal New Jersey town, I can be almost certain that the random playground mom agrees with my politics but parenting issues are so much trickier.  I never know who is going to agree with my stance on sleep training (just turn the monitor off, the kid will stop crying eventually) and who will think I’m barbaric; who will agree with me that jarred food is really just as good as pureeing it yourself and who will think I’m lazy; or who will view the sleep fairy (the one who gave my daughter a present every morning that she slept in her own bed the year she was three) as a cute invention by a desperate mother and who will think I was just too wimpy to get bedtime right.  And, yes, before you say anything, the reason I fear the judgment of other parents is clearly because behind the smiling and nodding I’m judging them as well.

Still, in nearly all of these conversations—even if our parenting styles are radically different—we can find a common ground on which to bond and commiserate. There is one topic, however, that I just try to avoid—vaccines. A friend once described it as the third rail of parenthood.  Just don’t touch it.

Why UNFPA Wants to Reach Young People

DFID kicked off a new global development podcast series this past October. Their first podcast coincided with the celebration of 7 billion people on earth and featured an interview with Dr Babatunde Osotimehin, Executive Director of the United Nations Population Fund.

In the short interview, Dr Osotimenhin discusses how family planning is one of the most important issues to address when trying to achieve stable population growth. “My major issue, as the director of the UNFPA, is to address the issue of young people.” Of the 7 billion people alive right now, 1.8 billion are children and 90% of that number live in ‘developing’ countries.

Listen to Dr Osotimenhin explain how and why he wants to reach young people. Incidentally, youth issues are the topic of the forthcoming issue of IMPACT magazine, so stay tuned for more on this topic.

Listen to DFID’s podcasts here.

Healthy Dose January 9, 2012

550,000 Haitians Still in Camps 2 Years Since Quake

A magnitude 7.0 earthquake struck Haiti two years ago this Thursday. Still, over half a million Haitians are not in permanent housing. This poses considerable health and social problems for a significant population. The AP reports:

Haiti IDP campsNew housing is still the most critical objective, yet the biggest official housing effort targets just 5 percent of those in need, and the encampments of cardboard, tarps and bed sheets that went up to cope with 1.5 million homeless people have morphed into shantytowns that increasingly look permanent.

More than 550,000 people are still living in the grim and densely packed camps that are squeezed into the capital’s alleyways and pitched on the side of rural roads. And many of those who left the camps, often being evicted or paid to go, say their new conditions are little better, and sometimes much worse.

“I certainly wouldn’t call (reconstruction) a success,” said Alex Dupuy, who has written books about Haiti and teaches at Wesleyan University in Connecticut. “Other than putting a government in place … I haven’t seen any concrete evidence of recovery under way.”

In the first year after the quake, the previous government never set up a housing agency or a clear housing strategy, and meanwhile the camps swelled because foreign aid groups were delivering what the government didn’t: water, latrines and electricity. Former President Rene Preval identified five plots of land for new housing but only obtained one, through eminent domain.

Of the 10 best-funded projects approved by a reconstruction panel, not one focuses exclusively on housing. A U.S.-financed $225 million industrial park includes housing for 5,000 workers. But it’s on the northern coast of Haiti, 240 kilometers (150 miles) outside the quake zone.

The highest-profile effort to house the displaced came three months after the quake, on the eve of the rainy season. The U.S. military and actor Sean Penn bused 5,000 people from a flood-prone golf course to a cleared field in Corail-Cesselesse, north of Port-au-Prince. It was supposed to be the country’s first planned community, with factories and houses for 300,000 people.
That never happened.

Today, the people of Corail-Cesselesse are ravaged by floods or bake in the heat in their timber-frame shelters. They are far from the jobs that sustained them before the quake. They speak of abandonment and lack of services.

Questions about ARVs as HIV Prevention

Earlier this week, we published a video of Dr Myron Cohen talking about his research study that showed how ARVs can prevent the spread of HIV in couples. Science magazine went as far as to call it the ‘Breakthrough of the Year,’ and there is no question that the trial was one of the most discussed in 2011. However, some have raised concerns about the trial design, the results and what this means for future HIV treatment.

A reader pointed out that USAID’s Dr. James D Shelton wrote an article that appeared in the very same edition of Science Magazine raising questions about the study. He questions if patients will be able to adhere to the protocols of the medication or if drug resistance will develop.

For ARVs as prevention to have a substantial impact, very large numbers of those persons testing positive—most symptom-free—would need to take them voluntarily and consistently for a lifetime. Even now, adherence is far from perfect, and some patients discontinue for a variety of reasons, including drug side effects ( 10).