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Li et al. Chin J Cancer  (2017) 36:4 
DOI 10.1186/s40880-016-0172-5
CASE REPORT
Novel germline mutations in FLCN gene 
identified in two Chinese patients  
with Birt–Hogg–Dubé syndrome
Teng Li, Xianghui Ning, Qun He and Kan Gong*
Abstract 
Birt–Hogg–Dubé (BHD) syndrome, a hereditary renal cancer syndrome caused by mutations in the folliculin (FLCN) 
gene, is characterized by the presence of fibrofolliculomas, pulmonary cysts, spontaneous pneumothorax, and renal 
cell carcinoma (RCC). Few BHD syndrome cases have been reported in Asian countries, and cutaneous presenta-
tions are relatively rare in Asian patients. Asian BHD patients may be misdiagnosed due to their atypical manifesta-
tions. Here, we report two Chinese BHD patients with novel FLCN mutations (c.946-947delAG in exon 9 and c.770-
772delCCT in exon 7). Both of them had RCC and spontaneous pneumothorax without fibrofolliculomas. In patients 
with RCC and pulmonary cysts but without cutaneous lesions, screening for mutations in the FLCN gene should be 
performed, especially for those with a family history of RCC or pulmonary cysts (pneumothorax).
Keywords: Birt–Hogg–Dubé syndrome, The folliculin (FLCN) gene, Mutation, Renal cell carcinoma
© The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License 
(http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, 
provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, 
and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/
publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Background
Birt–Hogg–Dubé syndrome (BHD, OMIM #135150) 
is a rare autosomal dominant hereditary disease first 
described by Birt et al. in 1977 [1]. This syndrome is char-
acterized by the presence of fibrofolliculomas (FFs), pul-
monary cysts, spontaneous pneumothorax, and renal cell 
carcinoma (RCC) [2]. Germline mutations in the follicu-
lin (FLCN) gene mapped to chromosome 17p11.2 were 
identified in BHD patients in 2002 [3]. FLCN mutations 
have also been detected in isolated familial spontaneous 
pneumothorax and familial clear cell carcinoma [4]. FLCN 
is considered a tumor suppressor gene and interacts with 
the mammalian target of rapamycin (mTOR) and adeno-
sine monophosphate-activated protein kinase (AMPK) 
signaling pathways. The spectrum of FLCN gene muta-
tions has been outlined in several reports and has been 
summarized in a database (http://www.lovd.nl/flcn) [5]; 
however, the genotype-phenotype associations between 
the FLCN gene and BHD syndrome are not well known.
Most BHD cases have been identified in Caucasians. 
Only several reports of compiled BHD cases in the lit-
erature have been from Asia, and most of them have 
been from Japan [6–8]. Many of the BHD patients from 
Asia have not had all symptoms (FFs, pulmonary cysts, 
spontaneous pneumothorax, and RCC) [8]. The most 
life-threatening manifestation of BHD syndrome is renal 
cancer, which is present in 27%–41% of patients [2, 9, 
10]. RCCs in BHD patients can be multiple or bilateral 
and include various histopathologic types, such as hybrid 
oncocytic tumor, chromophobe RCC, clear-cell RCC, 
oncocytoma, and papillary RCC [10, 11].
Here, we report two Chinese BHD patients with two 
novel germline FLCN mutations. Analysis of these 
patients was approved by the Medical Ethics Commit-
tee of Peking University First Hospital. Written informed 
consent was obtained from the patients and their 
families.
Case report
Case 1
A 54-year-old man was found to have asymptomatic, 
bilateral renal tumors by ultrasonography and computed 
tomography (CT) (Fig.  1a, b). CT scan also showed left 
Open Access
Chinese Journal of Cancer
*Correspondence:  gongkan_pku@126.com 
Department of Urology, Institute of Urology, National Urological Cancer 
Center, Peking University First Hospital, Peking University, No. 8, Xishiku 
Street, Xicheng District, Beijing 100034, P. R. China
Page 2 of 4Li et al. Chin J Cancer  (2017) 36:4 
pneumothorax (Fig.  1c). No apparent cutaneous lesions 
were found by careful inspection and palpation of the 
skin. The patient had a history of spontaneous pneumo-
thorax at the age of 30. His son also had a history of spon-
taneous pneumothorax at the age of 17. Open bilateral 
and partial nephrectomies were performed. Histopatho-
logic examination revealed that the tumor in the left 
kidney was chromophobe RCC, nuclear grade G2 (par-
tial G1), and 1.7 cm × 1.5 cm × 1.5 cm in size (Fig. 1d); 
the tumor in the right kidney was clear-cell RCC, nuclear 
grade G2, and 5.0 cm × 4.7 cm × 4.5 cm in size (Fig. 1e).
Genomic DNA was extracted from blood samples col-
lected from the patient and his son. Mutation examina-
tion revealed that the proband and his son carried a 
deletion of two bases (AG) at nucleotides c.946-947 in 
exon 9 (c.946-947delAG) of the FLCN gene (Fig.  1f ), 
which caused a frameshift mutation starting at the 316th 
amino acid (p.316fs388x). No RCC was detected by 
abdominal CT scan on the son.
Case 2
A 37-year-old man presented with an asymptomatic right 
renal mass detected by ultrasonography and CT (Fig. 2a). 
No apparent cutaneous lesions were found by careful 
inspection and palpation of the skin. The patient had a 
history of spontaneous pneumothorax on both sides and 
underwent pulmonary bullectomy on the right side at the 
age of 30. His father had a history of recurrent spontane-
ous pneumothorax starting at the age of 28 and died of 
stoke at the age of 63. His uncle had a history of recurrent 
spontaneous pneumothorax starting at the age of 24 and 
died of an accident at the age of 56. Open partial nephrec-
tomy was performed on the patient. Histopathologic 
examination revealed that the tumor was chromophobe 
RCC, nuclear grade G2, and 2.2 cm × 2.0 cm × 2.0 cm in 
size (Fig. 2b).
Genomic DNA was extracted from blood samples col-
lected from the patient and his family members. Muta-
tion examination revealed that the proband carried a 
deletion of three bases (CCT) at nucleotides c.770-772 in 
exon 7 (c.770-772delCCT) (Fig. 2c), resulting in deletion 
of the 257th serine residue (p.257delS). No FLCN muta-
tions were found in any other members of the patient’s 
family.
Discussion
Most reported cases of BHD have been from Western 
countries, and reports of cases from Asia are rare, likely 
due to the lack of awareness and atypical manifestations 
of this disease in Asian patients. Identification of BHD 
patients is usually based on dermatologic signs. How-
ever, Kunogi et al. [6] found that among 30 Japanese BHD 
patients, only 6 (20.0%) had cutaneous lesions, 1 (3.3%) 
was histologically diagnosed with FFs, and 29 (96.7%) 
Fig. 1 Lesions and folliculin (FLCN) mutation in case 1. a Abdominal computed tomography (CT) scan with intravenous contrast reveals a renal 
mass in the upper pole of the left kidney (arrow). b Abdominal CT scan with intravenous contrast reveals a renal mass in the right kidney (arrow). c 
CT scan shows left pneumothorax (arrow). d Histopathology of the left renal tumor shows a monotonous cellular pattern with mild nuclear pleo-
morphism and abundant, partly eosinophilic cytoplasm with a perinuclear halo (chromophobe renal cell carcinoma). e Histopathology of the right 
renal tumor shows clear cytoplasm surrounded by a distinct cell membrane (clear cell carcinoma). f Both the patient and his son have a deletion 
of AG (c.946-947delAG) in exon 9 of the FLCN gene, which causes a frameshift mutation starting at the 316th amino acid (p.316fs388x). The deleted 
bases are underlined in the normal sequence
Page 3 of 4Li et al. Chin J Cancer  (2017) 36:4 
had pneumothorax. Further, Furuya and Nakatani [7] 
reported that 13 (28.8%) patients had FFs, 40 (88.9%) 
had pulmonary cysts, and 9 (20.0%) had RCC among 
45 BHD patients from 19 Japanese families. In addition, 
Murakami et  al. [8] compiled 62 BHD cases from Asia 
and found that FFs were detected in 17 (27.4%), pulmo-
nary cysts in 49 (79.0%), and RCC in 11 (17.7%). In com-
parison, Toro et al. [9] found that among 51 BHD families 
in the United States, 46 (90.2%) had FFs, 45 (88.2%) had 
pulmonary cysts, and 25 (49.0%) had renal tumors. 
Kluger et al. [12] reported 22 patients from ten unrelated 
families with BHD in France; 18 (81.8%) patients had FFs, 
16 (72.7%) had pulmonary cysts or a history of pneu-
mothorax, and 10 (45.5%) had renal tumors. Therefore, 
the incidence of FFs may be lower among Asian BHD 
patients compared with the higher incidence of 80%–90% 
reported among patients from the United States and 
Europe, whereas the pulmonary cyst incidences are simi-
lar between patients from Asian and Western countries. 
FLCN mutation screening is recommended for patients 
with RCC and pulmonary cysts without cutaneous 
lesions, especially for those with a clear family history of 
RCC or pulmonary cysts/pneumothorax.
In this report, case 1 had two pathologic types (chromo-
phobe and clear-cell) of RCC. BHD patients are each likely 
to have various types of RCC [13], especially those with 
tumors with composite oncocytoma or chromophobe 
RCC histology [14]; these pathologies include the known 
familial hereditary RCCs, such as von Hippel-Lindau 
(VHL) syndrome, BHD syndrome, hereditary papillary 
renal cell carcinoma (HPRCC), hereditary leiomyomato-
sis renal cell carcinoma (HLRCC), and tuberous sclerosis 
complex (TSC). Pavlovich et al. [10] summarized clinical 
data of 124 BHD patients with 84 resected renal tumors, 
of which 56 (67%) were hybrid oncocytic tumors, 19 (23%) 
were chromophobe RCC, 6 (7%) were clear-cell RCC, and 
3 (4%) were renal oncocytoma. Urologists should thus be 
aware that the presence of chromophobe/oncocytic renal 
neoplasms, especially those that are bilateral or multifo-
cal, may indicate a diagnosis of BHD syndrome, even if 
dermatologic lesions are absent [11].
Over 100 unique mutations in the coding region of 
FLCN have been identified. Most of these mutations are 
frameshift, nonsense, insertion/deletion, or splice site 
mutations, resulting in truncation and inactivation of the 
encoded protein folliculin [15]. However, no clear geno-
type–phenotype associations between FLCN mutation 
type or location and skin, lung, or renal manifestations 
have been identified to date; only a significantly lower fre-
quency of renal neoplasia has been reported in patients 
with a deleted cytosine in the exon 11 mutational “hot 
spot” compared with the patients with an inserted cyto-
sine at this location [15, 16]. A definite diagnosis of BHD 
can only be made when a pathogenic germline FLCN 
mutation is detected. Detection of an FLCN gene muta-
tion not only confirms the diagnosis in suspected patients 
but also enables the diagnosis of at-risk family members 
with this disease. Once RCC is detected in BHD patients, 
it can be closely monitored as long as the dominant lesion 
is less than 3 cm in diameter. Surgical resection is recom-
mended when the solid lesion or solid portion of a mixed 
lesion exceeds the threshold diameter of 3  cm [10]. For 
patients with bilateral renal tumors measuring greater 
than 3  cm, staged surgeries in two separate settings are 
recommended [11]. The tumor growth rate and location 
are additional factors that should be considered [2, 11]. 
Recently, a kidney-specific knockout model was devel-
oped by disrupting mouse FLCN in proximal tubules 
[17]. This model provides a valuable tool for further study 
of FLCN-deficient renal tumorigenesis and for tests of 
new drugs (such as mTOR inhibitors) for the treatment 
of BHD-associated renal tumors.
Here, we report two Chinese patients with RCC and 
spontaneous pneumothorax who were diagnosed with 
Fig. 2 Lesion and FLCN mutation in case 2. a CT scan reveals a mass in the right kidney (arrow). b Histopathology of the resected tumor shows 
tumor cells with transparent, slightly reticulated cytoplasm with prominent cell membranes (chromophobe renal cell carcinoma). c The patient has 
a deletion of CCT (c.770-772delCCT) in exon 7 of the FLCN gene, which results in deletion of the 257th serine residue (p.257delS). The deleted bases 
are underlined in the normal sequence
Page 4 of 4Li et al. Chin J Cancer  (2017) 36:4 
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BHD syndrome. Both patients underwent FLCN gene 
mutation screening and were found to have two novel 
mutations (c.946-947delAG and c.770-772delCCT) that 
have not been reported previously. Importantly, skin FFs 
were absent in both patients. These findings demonstrate, 
particularly to urologists, the importance of performing 
FLCN gene mutation screening for patients with RCC 
and pulmonary cysts.
Authors’ contributions
The work presented here was carried out in collaboration between all authors. 
TL performed the gene test and drafted the manuscript. XN analyzed and 
interpreted the patient data. QH analyzed the pathologic data. KG designed 
this case report, and revised the manuscript. All authors read and approved 
the final manuscript.
Acknowledgements
To Prof. Dingfang Bu, with thanks, for critical reading and helpful discussions. 
Thanks to Dr. Kai Zhao and Dr. Yuan Jiang for the assistance with medical 
imaging. The authors would also like to acknowledge the patients’ contribu-
tion in this report.
Competing interests
The authors declare that they have no competing interests.
Funding
This work was supported by the National Natural Science Foundation of China 
(Grant Number: 81172418) and the Beijing Municipal Natural Science Founda-
tion (Grant Number: 7142160).
Received: 13 January 2016   Accepted: 15 April 2016
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Novel germline mutations in  gene identified in two Chinese patients with Birt–Hogg–Dubé syndrome

Performance of new adjustments to the TRISS equation model in developed and developing countries

Kim et al. BioData Mining  (2017) 10:8 
DOI 10.1186/s13040-017-0128-6ERRATUM Open AccessErratum to: Meta-analytic support vector
machine for integrating multiple omics
data
SungHwan Kim1,2, Jae-Hwan Jhong1, JungJun Lee1 and Ja-Yong Koo1** Correspondence:
jykoo@korea.ac.kr
1Department of Statistics, Korea
University, Anam-dong, 136-701
Seoul, South KoreaErratum
After publication of the original article [1], the author noticed errors to Table 1. The
errors occurred in the fourth and seventh columns labelled ‘Youden’. The correct
version of Table 1 is included in this erratum.
Author details
1Department of Statistics, Korea University, Anam-dong, 136-701 Seoul, South Korea. 2Department of Statistics,
Keimyung University, Dalseoku, 42601 Daegu, South Korea.
Received: 5 February 2017 Accepted: 5 February 2017
References
1. Kim SH, Jhong JH, Lee JJ, Koo JY. Meta-analytic support vector machine for integrating multiple omics data.
BioData Mining. 2017;10:2. doi:10.1186/s13040-017-0126-8.© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International
License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium,
provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/
publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Table 1 Shown are the results of experimental studies to compare the meta-logistic model with
the meta-analytic SVM
Meta-SVM Meta-logistic regression
Variance (R) Sensitivity (SE) Specificity (SE) Youden Sensitivity (SE) Specificity (SE) Youden
No inclusion of random study
0.1 0.828 (0.001) 0.9843 (0) 0.812 0.1073 (0) 1 (0) 0.107
0.3 0.8127 (0.002) 0.8707 (0.001) 0.683 0.2087 (0.001) 0.996 (0) 0.205
0.5 0.76 (0.002) 0.867 (0.001) 0.627 0.2633 (0.001) 0.9123 (0.001) 0.176
Inclusion of one random study
0.1 0.8007 (0.011) 0.9837 (0.002) 0.784 0.102 (0.004) 0.997 (0.001) 0.099
0.3 0.6673 (0.013) 0.8497 (0.009) 0.517 0.2113 (0.009) 0.966 (0.005) 0.177
0.5 0.6013 (0.017) 0.852 (0.009) 0.453 0.2527 (0.01) 0.8667 (0.008) 0.119
Inclusion of two random studies
0.1 0.624 (0.016) 0.9737 (0.009) 0.598 0.0847 (0.005) 0.994 (0.001) 0.079
0.3 0.51 (0.016) 0.8433 (0.006) 0.353 0.1727 (0.011) 0.9317 (0.005) 0.104
0.5 0.4167 (0.012) 0.85 (0.009) 0.267 0.256 (0.012) 0.8193 (0.006) 0.075
Kim et al. BioData Mining  (2017) 10:8 Page 2 of 2


Erratum to: Meta-analytic support vector machine for integrating multiple omics data

Anomalous transport from holography: part II

COMMENTARY Open Access
A new resource for developing and
strengthening large-scale community
health worker programs
Henry Perry1* , Lauren Crigler2, Simon Lewin3,4, Claire Glenton3, Karen LeBan5 and Steve Hodgins6
Abstract
Large-scale community health worker programs are now growing in importance around the world in response to the
resurgence of interest and growing evidence of the importance of community-based primary health care for improving
the health of populations in resource-constrained, high-mortality settings. These programs, because of their scale
and operational challenges, merit special consideration by the global health community, national policy-makers,
and program implementers. A new online resource is now available to assist in that effort: Developing and Strengthening
Community Health Worker Programs at Scale: A Reference Guide and Case Studies for Program Managers and Policymakers
(http://www.mchip.net/CHWReferenceGuide). This CHW Reference Guide is the product of 27 different collaborators who,
collectively, have a formidable breadth and depth of experience and knowledge about CHW programming around the
world. It provides a thoughtful discussion about the many operational issues that large-scale CHW programs need to
address as they undergo the process of development, expansion or strengthening. Detailed case studies of 12 national
CHW programs are included in the Appendix—the most current and complete cases studies as a group that are
currently available. Future articles in this journal will highlight many of the themes in the CHW Reference Guide
and provide an update of recent advances and experiences. These articles will serve, we hope, to (1) increase
awareness about the CHW Reference Guide and its usefulness and (2) connect a broader audience to the critical
importance of strengthening large-scale CHW programs for the health benefits that they can bring to
underserved populations around the world.
Keywords: Community health workers, Primary health care, Community health, Community-based primary health
care
Background
Commentary
The rapid growth of interest in and development of com-
munity or lay health worker (CHW) programs in low-
income settings over the past decade [1–3] is a welcome
development for so many of us who have long seen the
potential for stronger community-based programs to im-
prove the health of populations and particularly the health
of mothers and children. There is growing evidence that
impressive gains can be made in smaller populations with
well-trained and well-supported CHWs implementing
discrete interventions over a relative short period of time,
including interventions for health promotion and for the
prevention and treatment of serious conditions that are
leading causes of mortality [4, 5]. Furthermore, a substan-
tial number of countries with strong, large-scale CHW
programs—for example, Bangladesh [6, 7], Brazil [7],
Ethiopia [7–10], Malawi [11], and Nepal [7]—have made
remarkable progress in expanding the coverage of key ma-
ternal and child health interventions. These countries have
shown impressive gains in reducing maternal and child
mortality and in expanding the coverage of family plan-
ning services with concomitant reductions in fertility.
The resurgence in CHW programming has been slow
in coming. An important initial upswing of enthusiasm
and experience with large-scale CHW programs in the
late 1970s and early 1980s was associated with their en-
dorsement at the International Conference on Primary
* Correspondence: hperry2@jhu.edu
1Department of International Health, Johns Hopkins Bloomberg School of
Public Health, Baltimore, MD, United States of America
Full list of author information is available at the end of the article
© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Perry et al. Human Resources for Health  (2017) 15:13 
DOI 10.1186/s12960-016-0178-8
Health Care and in the Declaration of Alma-Ata [12].
However, this was followed in the later 1980s by the im-
plosion of many of these programs, disillusionment with
the approach, and an increased focus on vertical programs
for the delivery of key health interventions [13–15].
There were many reasons for this turn of events—-
from politics to the global economic recession of the
1980s to the influence of donors with a strong technical,
vertical approach for improving population health. Also
important was that the planning and scale-up of pro-
grams was often hurried, there was not a strong appreci-
ation of the critical need for strong supervision and
logistical support, and the cost required for effective
functioning was underestimated. In addition, monitoring
and evaluation of these programs was lacking, and there
was a lack of strong commitment to the use of monitor-
ing and evaluation findings for program strengthening.
A new reference guide
A recently released reference guide [16], drawing on a
number of case studies of large-scale CHW programs, at-
tempts to address some of these earlier challenges by pro-
viding a thoughtful discussion about the structure and
function of such CHW programs. This guide is intended to
assist policy-makers, planners, and program implementers
in strengthening existing large-scale programs and in de-
signing and scaling up new programs. Entitled, Developing
and Strengthening Community Health Worker Programs at
Scale: A Reference Guide and Case Studies for Program
Managers and Policymakers, it is the product of 27 differ-
ent collaborators who, collectively, have a formidable
breadth and depth of experience and knowledge about
CHW programming around the world. It was made pos-
sible by funding from USAID, through the MCHIP project.
The CHW Reference Guide, as we refer to it, is available
online at http://www.mchip.net/CHWReferenceGuide, and
can be downloaded in its entirety of 468 pages or chapter
by chapter. It contains chapters in four main sections: (1)
Setting the Stage (with chapters on history of CHW pro-
grams, planning, governance, financing, and national
coordination and partnerships), (2) Human Resources
(roles and tasks, recruitment, training, supervision, and
incentives), (3) CHW Programs in Context (relationships
with other parts of the health system, and relationships with
the community), and (4) Achieving Impact (scaling up and
sustainability, and measurement and data use). An exten-
sive appendix contains case studies, perspectives from key
informants, and important resources. There are case studies
of national CHW programs in 12 different countries
(Afghanistan, Bangladesh, Brazil, Ethiopia, India, Indonesia,
Iran, Nepal, Pakistan, Rwanda, Zambia, and Zimbabwe). As
a group, these case studies are the most current and
complete descriptions of these programs available. The
appendix also contains a summary of key informant
interviews that provide important insights into challenges
that large-scale CHW programs face.
The Reference Guide addresses issues and challenges
that all large-scale CHW programs face, and it offers
many examples of how specific programs have addressed
these issues. It does not try to present a simple (or a sin-
gle) solution, but rather raises questions that need to be
considered by policy-makers and program implementers
in their own particular context, along with possible
options and resources for addressing these questions.
The Guide does not address specific technical issues re-
lated to specific interventions (such as the range of
interventions that CHW can provide, the training and
logistical support required for specific interventions, and
so forth).
Over the next few months, Human Resources for
Health will be publishing a series of papers that are de-
rived from the CHW Reference Guide and that address
in more critical detail broad issues facing large-scale
CHW programs. Our hope is that these articles will
serve to highlight some of the important issues ad-
dressed in the CHW Reference Guide and to raise fur-
ther interest in the use of the Guide itself.
Conclusion
The recently released CHW Reference Guide is an
important resource for policy-makers, planners, and
program implementers in strengthening existing large-
scale programs and in designing and scaling up new
programs. This resource and forthcoming articles in
Human Resources for Health will provide much
needed support to the important task ahead of making
large-scale national CHW programs as effective as
possible.
Abbreviations
CHW: Community health worker; MCHIP: Maternal and Child Health
Integrated Program; USAID: United States Agency for International
Development
Acknowledgements
The USAID/MCHIP Project provided support for the development of
Developing and Strengthening Community Health Worker Programs at Scale: A
Reference Guide and Case Studies for Program Managers and Policymakers.
Funding
Not applicable
Availability of data and materials
Not applicable
Authors’ contributions
HP wrote the first draft and all authors contributed to subsequent drafts.
All authors read and approved the final manuscript.
Competing interests
The authors declare that they have no competing interest.
Consent for publication
All the authors have reviewed this manuscript and consent to its publication
Perry et al. Human Resources for Health  (2017) 15:13 Page 2 of 3
Ethics approval and consent to participate
Not applicable
Author details
1Department of International Health, Johns Hopkins Bloomberg School of
Public Health, Baltimore, MD, United States of America. 2Crigler Global
Consulting, Durham, NC, United States of America. 3Global Health Unit,
Norwegian Knowledge Centre for the Health Services at the Norwegian
Institute of Public Health, Oslo, Norway. 4Health Systems Research Unit,
Medical Research Council of South Africa, Cape Town, South Africa. 5The
CORE Group, Washington, DC, United States of America. 6Saving Newborn
Lives/Save the Children, Washington, DC, United States of America.
Received: 13 May 2016 Accepted: 27 December 2016
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