Building a Solid Foundation for School: a communities approach

The flexibility of the MOOC service allows students to learn at their own time, place and pace, enhancing continuous communication and interaction between all participants in knowledge and community building. This model especially benefits people with disabilities, which can improve therefore their level of employability and social inclusion, reaching a better quality of life. Unfortunately the access to MOOC platforms present severe barriers: there is a lack of accessibility on the learning resources, the communicating tools and personalized user interfaces. All these issues add extra difficulties such as the need to develop specific digital or even social skills for students with functional diversity. In this context, MOOCs are leading a revolutionary computer and mobile-based scenario along with social technologies that will emerge new kinds of learning applications that enhance communication and collaboration processes. For that reason, this paper describes the need for designing an information model and related specifications to support a new strategy for delivering accessible MOOC courses to learners with special needs, in terms of their preferences and context of use based on a particular application profile. This user profile’s design is based on standard metadata schemas, data that provides information about other data, regarding the achievement of accessibility from content to user preferences.

Rwanda makes health-facility deliveries more feasible

To describe the incidence and mortality of invasive infections in Indigenous children admitted to paediatric and general intensive care units (ICUs) in Australia. Retrospective multi-centre cohort study of Australian and New Zealand Paediatric Intensive Care Registry data. All children under 16 years of age admitted to an ICU in Australia, 1 January 2002 - 31 December 2013. Indigenous children were defined as those identified as Aboriginal and/or Torres Strait Islander in a mandatory admissions dataset. Population-based ICU mortality and admission rates. Invasive infections accounted for 23.0% of non-elective ICU admissions of Indigenous children (726 of 3150), resulting in an admission rate of 47.6 per 100 000 children per year. Staphylococcus aureus was the leading pathogen identified in children with sepsis/septic shock (incidence, 4.42 per 100 000 Indigenous children per year; 0.57 per 100 000 non-Indigenous children per year; incidence rate ratio 7.7; 95% CI, 5.8-10.1; P <0.001). While crude and risk-adjusted ICU mortality related to invasive infections was not significantly different for Indigenous and non-Indigenous children (odds ratio, 0.75; 95% CI, 0.53-1.07; P = 0.12), the estimated population-based age-standardised mortality rate for invasive infections was significantly higher for Indigenous children (2.67 per 100 000 per year v 1.04 per 100 000 per year; crude incidence rate ratio, 2.65; 95% CI, 1.88-3.64; P <0.001). The ICU admission rate for severe infections was several times higher for Indigenous than for non-Indigenous children, particularly for S. aureus infections. While ICU case fatality rates were similar, the population-based mortality was more than twice as high for Indigenous children. Our study highlights an important area of inequality in health care for Indigenous children in a high income country that needs urgent attention.

The purpose of this research is to know (1) distribution; (2) potential coastal tourism; and (3) directions of coastal tourism development in Watu Karung Village and Sendang Village of Pacitan Regency.This research was developed using descriptive qualitative method with spatial approach. The population of in this study were tourism object and tourism subject in Watu Karung Village and Sendang Village, Pacitan Regency consisting of tourists, tourism managers, tourism industry/ tourism service providers, government, local community and non-governmental organizations. The sampling technique employed was purposive sampling and accidental sampling. Data collection techniques used was observation, interview and documentation. In analyzing the data, technique used was scoring parameter of tourism object potential and SWOT analysis for tourism development direction. Based on the result of the research, it can be concluded that: (1) there are 12 coastal tourism objects in Watu Karung Village and Sendang Village, Pacitan Regency which spread into 10 tourism objects in Watu Karung Village and 2 tourism objects in Sendang Village. (2) Based on the assessment of tourism potential, Watu Karung Village and Sendang Village, Pacitan Regency have potential class of 2 tourism objects including highly potential class, 3 tourism objects including sufficiently potential class, and 7 tourism objects including less potential class. (3) The development of tourism object is done by improving the tourism object attractions through the procurement of tourism facilities and infrastructure supported by the increase of accessibility to the tourism object. The government should provide basic tourism facilities such as tourist transportation, travel agency, tourist attraction and accommodation, as well as providing holiday packages of various destinations at affordable cost. Keywords: Tourism Object, Potential, Distribution, Coast, Tourism Development

Maternal health and nutritional Information form the cradle of healthy genetic development and population health, safeguarding the right to life and the quality of future livelihoods. Thus, this health and nutrition information often enables most females of reproductive age 15 to 49 years, globally, regionally and locally in western Kenya, to access quality, affordable and reliable health education on maternal health care and nutrition, and to mediate a primordial prevention and reduce maternal disease burden rates. It also promotes health demography and human development, through prevention and protection missions of public health, via community health awareness and capacity building, empowering population health and promote a healthy population. This is achieved by enabling regular health education on maternal and child nutrition, for better primary prevention than cure among rural females of the reproductive age and the larger population health through synergistic community participation. It was these reasons that led to the study, which aimed to evaluate the factors influencing increased accessibility to maternal and nutritional health information and their effects on reproductive health practices among rural females of reproductive age (15–49 years) in Western Kenya. Specifically, the study focuses on determining the prevalence of population health in the accessibility to affordable maternal health and balanced diet nutrition practices, determining the level of community participation in the promotion on maternal child health nutritional health education/information for quality primordial prevention and decrease of maternal child health and nutrition, and lastly assessing how social economic, social cultural and religious beliefs influence the increased accessibility of maternal child health and nutrition health information on maternal health nutrition practices among rural females of the reproductive age in Western Kenya. The study also aimed to achieve in global health goals number 3 and 17 of Vision 2030 and beyond, in global health. Over 80% of community households have limited access to efficient, affordable, reliable, and sustainable quality maternal child health and nutrition information to promote primordial prevention in the general basic health population, especially in Sub Saharan Africa (SSA), through capacity building of health service providers and community health workers (CHWs), as their main sources of accessibility of maternal child health information, in the large diversified society of demographic health population and development, to improve the health population of the population health and their health live hoods. The study exploited descriptive, cross-sectional, cohort and triangulation designs. Purposive clusters, census retrospective and prospective sampling techniques were used to explore the ante and postnatal mothers with children aged 0-24 months as the target population. The questionnaire used as tool of survey and key informant interview and focused group discussion (FGD) was used in interview guides. Data was managed by SPSS version 27 and analysed by cross-tabulation of descriptive and inferential statistics to provide a significant inference. Results showed that health service providers and community health workers were the main sources of providing quality health education/information 97 (46.2%) and 69 (32.9%) respectively, with significant support from the global health of RR (0. 463, 0.335). The prevalence of the increased accessibility of maternal health nutrition was health/education information 101 (48%). Community awareness on the uptake of balance dietary intake from both animal proteins and plant was 67%, and majority opined significant uptake of animal protein was determined by social cultural with P value of 0.025, 95 % CI, and social economic has an influence remain insignificant with OD 1.0 and RR (0.25, 0.345), due to existing synergistic public private partnership global health to decrease unmated needs in the inequality at maternal health and nutrition community households. Need to advocate for more global health in public-private partnership participation to mediate the unmet basic needs of maternal health, nutrition and need to partner with urban reproductive of reproductive in issues of maternal health and nutrition, mediate global maternal health and nutrition global health goals number 3 and 17 of Vision 2030 and beyond to sustain quality global livelihoods and population health development.

Recent studies highlight futile efforts to improve maternal health in Sub-Saharan countries over the years. Kenya is among the countries with the highest burden of maternal deaths in the world, and in East Africa, with huge disparities between the various counties (WHO, 2019). The estimated maternal mortality rate of 342 maternal deaths per 100,000 live births translates to approximately 7,000 maternal deaths each year (WHO, 2019), most of which can be prevented by access to utilization of quality maternal healthcare services. In Kenya, maternal healthcare services are provided by public health facilities, non-governmental organizations, and to a lesser extent, emerging social enterprises. Despite concerted efforts by ongoing maternal health initiatives to increase skilled birth attendance, high maternal mortality persists. Existing research in the developing context demonstrates inequality in women’s and men’s health indicators, life expectancy, education, and command over economic resources - translating to a loss in human development due to gender-based inequalities. Women’s lower education attainment, acquisition of economic resources, and early age at childbirth predict lower agency and well-being. Limited studies have uncovered the maternal healthcare experience in developing countries in relation to agency. Additionally, there is scarce evidence on the influence of institutions on the maternal healthcare experience. This study explores the role of institutions in influencing women’s agency as a strategy to reduce gender inequality and improve maternal health. The guiding research questions are, “How does women’s agency in health influence their maternal healthcare experience? And, “How do institutions influence women’s maternal healthcare experience?” Data was collected from public, non-governmental, and social enterprise organizations. Ethical guidelines from the Monash University Human Research Ethics Committee and the National Commission for Science, Technology and Innovation of the Government of Kenya were adhered to throughout the data collection stage. A total of 79 interviews with 48 women and 31 health workers were conducted and analyzed using thematic analysis and NVivo software. Preliminary findings revealed three themes that described the maternal health experience in relation to agency: passivity, cultural practices, and maternal education. This research offers a glimpse into institutional perspectives of maternal healthcare in rural, and peri-urban areas in terms of challenges, strengths, and recommendations.

Editors' choice.

Reproductive health needs to be front and centre in development

BackgroundThis research prioritization aimed to identify major research gaps in maternal, newborn, child and adolescent health (MNCAH) to help mitigate the direct and indirect effects of the COVID-19 pandemic.MethodsWe adapted the Child Health and Nutrition Research Initiative methodology. We defined scope, domains, themes and scoring criteria. We approached diverse global experts via email to submit their research ideas in MNCAH and MNCAH-related cross-cutting/health systems area. We curated the research ideas as research questions (RQs) and sent them to the consenting experts for scoring via the online link. For each RQ, the research priority score (RPS) was calculated as an average of individual criterion scores and ranked based on RPS in each area.ResultsWe identified top-ranked 10 RQs in each maternal, newborn, and child and adolescent health and 5 in the cross-cutting/health systems area. In maternal health, indirect effects on care, measures to improve care, health risks and outcomes, and preventing and managing SARS-CoV-2 infection/COVID-19 disease were priority RQs. In newborn health, clinical characterization and managing SARS-CoV-2 infection/COVID-19 disease, mode of transmission and interventions to prevent transmission were the focus. For child and adolescent health, top-ranked RQs were indirect effects on care, clinical status and outcomes, interventions to protect against SARS-CoV-2 infection/COVID-19 disease, and educational institute-related RQs. The cross-cutting RQs were the effects of the pandemic on availability, access, care-seeking and utilization of MNCAH services and potential solutions.ConclusionsWe call on partners, including governments, non-governmental organizations, research institutes, and donors, to address this urgent research agenda.

Creating a framework towards integrated health syndromic surveillance and response in Africa

Transportation is an important part of human life. Transportation is the driving force for socio-economic activities that must be accessible to all people. Transportation access is the heart of the development of an area, if transportation access is easy then the development of an area is easier to achieve. One of the most popular means of transportation in Indonesia and being a mass transportation that is very effective for human and goods mobilization is the train. So that the existence of train access can be a determining factor and support the accessibility of an area. This research was conducted to determine the role of trains in supporting the accessibility of the region. Research data collection was carried out by conducting observations, interviews, and literature reviews. Based on the results of the study it was found that since the first time it was built by the Dutch East Indies government in 1864, 26 km in the Kemijen Tanggung area currently has 25,361 employees. The vision is to become the best rail service provider that focuses on customer service and meets stakeholder expectations. Good and smooth transportation growth is a collaboration between three supporting forces in the form of good spatial planning, policies or regulations in the field of road network infrastructure and multi-modal transport, road traffic behavior and law enforcement. PT. KAI tries to give choices so that the community is fulfilled its accessibility in carrying out activities to the destination

This article explores the diversity of services designed for young children currently operating in Australia in remote Northern Territory (NT) Indigenous communities as a provocation for the renewal and revitalisation of mainstream (typical Australian conventional, Western values oriented and urban-based) child care services. Australian society has accepted a standardised model of child care and conceptualised it as a service designed primarily for parents who work. It has become remarkably uniform in look, nature and purpose, regardless of where it is located. The article refers specifically to ‘Innovative’ Indigenous Children's Services (the term ‘Innovative’ refers to a federally funded government initiative called the ‘Innovative Child Care Scheme’, an initiative stemming from the 1992–96 National Child Care Strategy) as a new kind of children's space in the child care landscape. The authors reflect on the findings of recent research which explored what could be learned from remotely located Indigenous children's services staff, particularly in relation to the important questions the research raised for the social agendas and public policies that underpin development and theory currently shaping mainstream centre-based long day care programs.

In response to the 2020 COVID-19 pandemic, a nongovernmental organization in Nepal piloted a maternal and newborn health helpline program in partnership with the Government of Nepal and the Nepal Society of Obstetricians and Gynaecologists. The program connected service providers in remote areas with real-time clinical support during obstetric and neonatal emergencies via telephone consultations with clinical experts. 551 primary health care facilities across 14 districts of Nepal were included in the program and connected to a roster of 33 clinical expert volunteers from district or tertiary care hospitals. To assess the results of the program, we collected both quantitative and qualitative data, including monthly health facility record reviews from July 2020 to June 2021 and semi-structured interviews with clinical experts and service providers conducted in June 2021. Of the 551 health facilities included in the program, 160 facilities (29%) reported using the helpline during the study period, with 429 teleconsultation cases recorded. We found that 21% of these cases that otherwise would have been referred to a hospital were effectively managed by telephone on-site at rural health facilities, revealing the promising potential for impact using a low-tech solution. Of the health facilities that participated in the program, the helpline was predominantly used in remote facilities where access to higher-level referral centers for emergencies was limited. Feedback from both experts and service providers revealed that the program helped to improve clinical decision-making during emergencies, build confidence and skills of service providers, and improve referral efficiency. Implementation challenges included service providers' underreporting of helpline utilization, a lack of essential drugs at primary health care facilities, unreliable phone signals, and a lack of financial incentives for clinical experts. The results and implementation experiences shared in this article provide a template for the design and implementation of similar support programs for service providers managing clinical emergencies in rural contexts.

This literary study argues that South Africa’s three government tiers have failed the majority of the country’s citizens in their efforts to provide adequate security and combat xenophobia. The study upon which this article is based focused on non-governmental organisations (NGOs) and some international organisations (IOs) collaborating with governments to address xenophobia, particularly in South Africa. The study aimed to critically analyse and discuss the government’s, IOs’ and NGOs’ role in combating xenophobia in South Africa. The study utilised a qualitative approach with a historical design. Data were collected from secondary sources, which included books, journals and the Internet and were discussed in themes after performing textual analysis. The available published, reviewed articles were utilised to debate, argue and discuss governments’, IOs’ and NGOs’ role in xenophobia in some African countries. The results revealed that governments, NGOs, IOs and other stakeholders have provided support to ensure economic and social stability, but xenophobia persists in South Africa and several other African countries. One of the government's roles in preventing xenophobia is the provision of adequate security where xenophobic violence occurs. The study explained governments’, IOs’ and NGOs’ role in addressing xenophobia in South Africa and other African countries with a focus on issues relevant to addressing xenophobia in South Africa. The study was anticipated to inform government programmes and IOs’ and NGOs’ efforts to alleviate poverty among local citizens in South Africa and prevent hostility towards foreign nationals.

ABSTRACTHealth problems may occur in mothers and can persist during the postpartum. Life event stress (LES) is a risk factor for poor maternal health. We examined the relations of LES and rise in LES over time to maternal health during the first three years postpartum. We used data from 1,364 mothers obtained between 1991 and 2007 in the U.S. National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Information on maternal sociodemographics and early postpartum health was collected 1 month after childbirth. Maternal reports on health status and LES were obtained at 6, 15, 24, and 36 months postpartum. Latent growth curve analyses were performed, with maternal sociodemographics and early postpartum health as covariates for which statistical adjustment was made. Maternal health declined steadily in a linear pattern with marked individual differences, whereas maternal LES increased gradually in a linear pattern. Moreover, faster maternal health decline was associated with poorer early health at 1 month postpartum, greater exposure to LES at 6 months postpartum, and faster rise in LES exposure over time. Decline in maternal health may be explained at least in part by the deleterious effects of exposure to stressful life events.