UNICEF’S Accelerated Child Survival and Development Program (ACSD) has been applied to selected focus districts in several West African countries. A retrospective analysis of the impact of this initiative in Benin, Ghana and Mali has just been published¹. The results are disappointing. Between 2001 and 2005 child (0-5yrs) mortality did decrease in the focus groups of all 3 countries, but in Benin and Mali, no significant advantage was conferred by the ACSD interventions when analysed against data from comparison groups. In Ghana comparison groups were not available. Improvements in expanded immunization coverage and in antenatal care were significant in response to the interventions but, unfortunately, care for children with malaria or pneumonia did not improve.

In a presentation to a May 2009 conference held in Canada entitled “Putting Science Into Action” Daniel Telfor Ph.D. provided a fascinating analysis of 2 American studies of early childhood intervention programs.¹

High quality programs of this nature are expensive, $15,000 per child, but he shows that the return on this investment (ROI) represents a net gain.

What is it? Certainly not growing your children under a cabbage at the bottom of the garden or living in a hole in the hillside with no electric or running water (I do admit this may be attractive to some, although I personally prefer a fully insulated house with four walls whether that be wood, straw or brick). Neither is it depriving your children of every modern convenience and reverting to the lifestyle of 200 yrs past. There were reasons for modern advances, they improved our health, education, our standards of living improved but has it gone too far? Yes.

Kidney transplant donor sources - expanding the options and the debate

I can’t help but noticing that World Kidney Day came and went last week, and two items in particular caught my attention. In the New England Journal of Medicine (March 12, 2009), Rees and colleagues described a “chain of 10 kidney transplants initiated by a single altruistic donor (i.e. a donor without a designated recipient)” (1). This single act of generosity provoked a chain reaction whereby patients with willing but incompatible donors “swapped “with others in "paired transplant programs", the end-result being 10 kidney transplants over a period of 8 months. According to the authors of the report, their goal was to “highlight the potential of this strategy” of living donor recruitment. 



Somali Piracy – Can Law of the Sea be an issue in child health?

Just last month, I was saddened to read several news reports describing how illegal overfishing by foreign fleets has severely depleted fish stocks within the national waters of Sierra Leone and Namibia. Apparently, declining harvests there have meant that once prosperous local communities are starving and fisherman can no longer feed their own families. According to some estimates, even fisher-families have had to cut back from three protein meals per day to one, with predictable consequences for nutrition status, general health and susceptibility to the usual gamut of childhood illnesses.

((english / french invitation cards)):

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On Saturday, November 29th, please join us for an informal discussion panel bringing together Scientists, Technologists and Designers to weigh in about the current and future influence of each of these disciplines on one another. The Mother-Child Health International Research Network, The World Association of Young Scientists and the Canadian Centre for Architecture invite you to a public conversation on collaboration between these three critically important – and increasingly interdependent - fields of knowledge.

This session will be structured around a series of questions posed to our guest panelists, followed by a discussion and open exchange with the audience.

• Saturday November 29th, 2008, from 2:30pm until 4:00pm
• Canadian Centre for Architecture: 1920 rue Baile, Montréal, Québec – Shaughnessy House.
• Refreshments will be provided.
• Contact Us for more information.

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I completed my pediatric training in 1989, the same year that the Canadian parliament voted unanimously to eradicate child poverty in this country by the year 2000. At that time, the LICO poverty rate was 15.1% (LICO = low-income cut-off, or the proportion of the population who spend more than 2/3 of their pre-tax income on basic food, shelter and clothing). As of 2006, the rate was still 15.8%, suggesting that we’ve failed to honor our legislative commitment, with 700,000 Canadian children still below the LICO threshold. Lest I be accused of exaggerating, we do even worse by other metrics, such as the low-income measure (LIM, or the proportion living on less than half the median income), which saw 1.6 million (23.1%) of Canadian children living below the poverty line.

Is the Advanced Market Commitment (AMC) a good model for technology transfer, and why we should care?

Background link: http://en.wikipedia.org/wiki/Advance_market_commitments

A couple of weeks ago, our local newspaper ran a rather indignant editorial on the subject of gasoline price fixing, with the unambiguous title “Price fixing is bad no matter who does it”, a sentiment I happen to whole-heartedly endorse. It did however remind me of a related story that may be even closer to home for members of this list, since it touches on important public health issues and how theyʼre dealt with in the popular press. It also highlighted --- to my non-journalist eyes at least --- a rather disturbing lack of editorial consistency. Since the related story is currently makings its tangled way through the courts in several countries with members on this list, I was curious as to how well the media were covering it in other jurisdications.