4 research outputs found
Engendering agricultural research
No full textThis paper makes a case for gender equity in the agricultural R&D system. It reviews the evidence on exactly why it is important to pay attention to gender issues in agriculture and why it is necessary to recognize women�s distinct food-security roles throughout the entire value chain�for both food and nonfood crops, marketed and nonmarketed commodities. The authors examine whether women are factored into the work of research institutions, and whether research institutions effectively focus on women�s needs. In short, are these institutions conducting research by and for women? The paper�s conceptual framework demonstrates the need to integrate gender into setting agricultural priorities; conducting the research itself; designing, implementing, and adopting extension services; and evaluating their impacts. It concludes with recommendations regarding how to make these suggested changes.Agriculture, extension services, Gender equity, nonmarket commodities, Priority setting, R&D, value chains,
An evaluation of a provider-initiated HIV testing and counselling (PITC) intervention for patients with sexually transmitted infections in Cape Town, South Africa
No full textThe objectives of the study were to assess the impact of a PITC intervention on HIV test uptake rates and on access to HIV care, to evaluate the extent to which ethical principles were upheld in its implementation, and to examine the influence of implementation factors on the intervention
Maternal and neonatal outcomes after caesarean delivery in the African Surgical Outcomes Study: a 7-day prospective observational cohort study
No full textSummary: Background: Maternal and neonatal mortality is high in Africa, but few large, prospective studies have been done to investigate the risk factors associated with these poor maternal and neonatal outcomes. Methods: A 7-day, international, prospective, observational cohort study was done in patients having caesarean delivery in 183 hospitals across 22 countries in Africa. The inclusion criteria were all consecutive patients (aged ≥18 years) admitted to participating centres having elective and non-elective caesarean delivery during the 7-day study cohort period. To ensure a representative sample, each hospital had to provide data for 90% of the eligible patients during the recruitment week. The primary outcome was in-hospital maternal mortality and complications, which were assessed by local investigators. The study was registered on the South African National Health Research Database, number KZ_2015RP7_22, and on ClinicalTrials.gov, number NCT03044899. Findings: Between February, 2016, and May, 2016, 3792 patients were recruited from hospitals across Africa. 3685 were included in the postoperative complications analysis (107 missing data) and 3684 were included in the maternal mortality analysis (108 missing data). These hospitals had a combined number of specialist surgeons, obstetricians, and anaesthetists totalling 0·7 per 100 000 population (IQR 0·2–2·0). Maternal mortality was 20 (0·5%) of 3684 patients (95% CI 0·3–0·8). Complications occurred in 633 (17·4%) of 3636 mothers (16·2–18·6), which were predominantly severe intraoperative and postoperative bleeding (136 [3·8%] of 3612 mothers). Maternal mortality was independently associated with a preoperative presentation of placenta praevia, placental abruption, ruptured uterus, antepartum haemorrhage (odds ratio 4·47 [95% CI 1·46–13·65]), and perioperative severe obstetric haemorrhage (5·87 [1·99–17·34]) or anaesthesia complications (11·47 (1·20–109·20]). Neonatal mortality was 153 (4·4%) of 3506 infants (95% CI 3·7–5·0). Interpretation: Maternal mortality after caesarean delivery in Africa is 50 times higher than that of high-income countries and is driven by peripartum haemorrhage and anaesthesia complications. Neonatal mortality is double the global average. Early identification and appropriate management of mothers at risk of peripartum haemorrhage might improve maternal and neonatal outcomes in Africa. Funding: Medical Research Council of South Africa
