It never rains but pours in global health. After a few years of lamenting that there really is no journal for a lot of good research that gets done in our discipline – whatever that is – in the next few months we will see the entry of 2 new kids on the block.

First, the Lancet, the world’s oldest medical journal, will be launching a new open-access, peer-reviewed online journal simply called The Lancet Global Health.

Second, USAID and the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs will next week launch a new journal called Global Health: Science and Practice, which will also be open-access, peer-reviewed online journal. According to its website the journal “aims to improve health practice, especially in low- and middle-income countries”. Sounds promising.

Both seem to be a big departure from the medical journal model of publishing, which is great, and emphasize things that were not well covered or hard to publish in other journals, which is also great.

On a related note, I also think that the editorial changes at Health Policy & Planning that were announced a while back have already strengthened the quality of papers coming out there, so kudos to the editors.

Now to get my papers out…

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Blowing white smoke

On March 13, 2013, in family planning, religion, by Karen Grepin

Although I was raised Protestant, through marriage I have recently become a practicing Catholic, and despite the fact that I clearly have divergent views on certain issues – contraception to name a big one – I remain loyal to my new religion. So, like many others, I was gripped to CNN the past few days waiting to see white smoke out of the Sistene Chapel. A few hours ago the white smoke blew and Jorge Mario Bergoglio of Argentina has been named the new Pope of the Catholic Church.

So what do we know about the new Pope’s view on contraception and public health? In this new piece, I learned that the new Pope believes that condoms are “permissible” to prevent the spread of infection. There has been confusion about exactly where the Church stands on the use of condoms and in which cases it is permissible or not. If the condom is used to prevent infection and inadvertently prevents conception, is that permissible?

Conincidentally, I also learned today on Humanosphere, that in the most recent round of their grant program, the Gates Foundation has recently launched a new “Grand Challenges Exploration” challenge to design the next generation condom in order to increase the use of condoms globally. Among the criteria for acceptable grant applications includes:

Application of knowledge from other fields (e.g. neurobiology, vascular biology) to new strategies for improving condom desirability.

So if by other fields they mean Theology, and by strategies they might include clarifying where the Church stands on the issue, then perhaps the new Pope might be in the running for the 100,000 prize! Welcome to the world of Global Health Pope Francis.

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Last June, then Secretary of State Hillary Clinton announced a new partnership to address the persistent burden of maternal mortality, called Saving Mothers, Giving Life. The ambitious program aimed to reduce maternal mortality by 50% in 8 districts in Zambia and Uganda in just one year. As some of you may know, I have been working with a fabulous group of researchers up at Columbia SPH this year on the external evaluation of this program. Over the past year, however, whenever I have mentioned to colleagues that I have been working on this project, I have been struck by how few people have never heard about the project.

But the program is starting to generate some interest, even outside of the maternal survival community. Over the next few months, we will also begin to learn more about the impact that this program has had on health outcomes and health systems more broadly. Janet Fleischman and some colleagues at the Center for Strategic and International Studies recently visited Zambia and put together this video which provides useful overview of the program, including some of the important challenges it has faced in trying to reach its ambitious goals.

I’ll be posting more on this soon, once our own evaluation results have been made public, but in the meantime, I encourage you to learn more about this important program. Plus, click here to watch the Saving Mothers, Giving Life Video

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The nicest houses in town

On March 4, 2013, in health human resources, Rwanada, by Karen Grepin

Butaro, Rwanda

At first I thought I was looking at a picture of a new eco-design hotel somewhere in Africa, but before I was able to pin it to my “places I want to go” board on Pinterest, I realized that that was not at all what I was looking at. No, in fact, what I was looking at was the new doctors’ residences in Butaro, Rwanda built as part of the new Partners in Health led redesign of the health delivery system in Northern Rwanda.

Attracting health workers to rural areas has always been a big challenge (not just in developing countries, but everywhere). In Sub-Saharan Africa the problem is more acute and even basic shelters are sometimes not available. The lack of housing for health workers is believed to contribute to the low density, migration, and even absenteeism of health workers.

Enter MASS, a design firm from Massachusetts who somehow got involved with the PIH project and exit these beautiful little houses that I think most people would agree constitute pretty nice digs. From an article in the Architectural Record:

The two-bedroom houses—roughly 1,300 square feet each—mimic the hospital buildings’ low-slung forms with clay-tile roofs. While they spill down a steep hill, they cluster together in plan. As Dushimimana explained by e-mail: “Courtyards and backyards are important to Rwandan houses. They are where the family and close friends gather.” The houses were constructed with reinforced-concrete frames to make them seismically sound, and with a total of 29,000 compressed stabilized earth blocks (CSEBs) made by local workers with soil from the site. The CSEB walls are covered with plaster and white paint. Some have a second layer of local volcanic stone. Inside, whitewashed walls contrast with muvura-wood roof trusses, cypress and pine furniture, and metal light fixtures—all made by local artisans. The project cost $400,000, a figure that includes the construction of a road, extensive pedestrian paths, and infrastructure to bring water and electricity to the site.

Although I am not quite sure what to make of this project, and my perpetual internal critic of aid projects is already rambling off a list of potential problems with this approach, I am going to turn all of that off for a few moments to just admire these houses. Clearly this experiment with the redesign of the health delivery system is not a standard approach nor is it something that would have ever happened had PIH not been involved, it will be interesting to see if any of it makes any difference (not that they will be able to measure it…argh, stop it critic) and if it doesn’t, well maybe it will be good for tourism. Pin.

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