Assessment of the WHO non-communicable diseases kit for humanitarian emergencies in South Sudan: a retrospective, prospective, observational study.

BACKGROUND: The WHO Non-Communicable Diseases Kit (NCDK) was developed to support care for non-communicable diseases (NCDs) in humanitarian settings. Targeting primary healthcare, each kit contains medicines and supplies that are forecasted to meet the needs of 10,000 people for 3 months. This study aimed to evaluate the NCDK deployment process, contents, usage and limitations, and to explore its acceptability and effectiveness among healthcare workers (HCWs) in South Sudan. METHODS: This mixed-method observational study captured data from pre-and-post NCDK deployment. Six data collection tools included: (i) contextual analysis, (ii) semi-structured interviews, in addition to surveys measuring/assessing (iii) healthcare workers' knowledge about NCDs, and healthcare workers' perceptions of: (iv) health facility infrastructure, (v) pharmaceutical supply chain, and (vi) NCDK content. The pre- and post-deployment evaluations were conducted in four facilities (October-2019) and three facilities (April-2021), respectively. Descriptive statistics were used for quantitative data and content analysis for open-ended questions. A thematic analysis was applied on interviews findings and further categorized into four predetermined themes. RESULTS: Compared to baseline, two of the re-assessed facilities had improved service availability for NCDs. Respondents described NCDs as a growing problem that is not addressed at a national level. After deployment, the same struggles were intensified with the COVID-19 pandemic. The delivery process was slow and faced delays associated with several barriers. After deployment, poor communications and the "push system" of inventories were commonly perceived by stakeholders, leading to expiry/disposal of some contents. Despite being out-of-stock at baseline, at least 55% of medicines were found to be unused post-deployment and the knowledge surveys demonstrated a need for improving HCWs knowledge of NCDs. CONCLUSIONS: This assessment further confirmed the NCDK role in maintaining continuity of care on a short-term period. However, its effectiveness was dependent on the health system supply chain in place and the capacity of facilities to manage and treat NCDs. Availability of medicines from alternative sources made some of the NCDK medicines redundant or unnecessary for some health facilities. Several learnings were identified in this assessment, highlighting barriers that contributed to the kit underutilization.

Cost and community acceptability of enhanced antibiotic distribution approaches for trachoma in the Republic of South Sudan: enhancing the A in SAFE (ETAS) study protocol.

BACKGROUND: The World Health Organization targeted trachoma for global elimination as a public health problem by 2030. Reaching elimination thresholds by the year 2030 in the Republic of South Sudan will be a considerable challenge, as the country currently has many counties considered hyper-endemic (> 30% trachomatous inflammation-follicular [TF]) that have yet to receive interventions. Evidence from randomized trials, modeling, and population-based surveys suggests that enhancements may be needed to the standard-of-care annual mass drug administration (MDA) to reach elimination thresholds in a timely manner within highly endemic areas. We describe a protocol for a study to determine the cost and community acceptability of enhanced antibiotic strategies for trachoma in South Sudan. METHODS: The Enhancing the A in SAFE (ETAS) study is a community randomized intervention costing and community acceptability study. Following a population-based trachoma prevalence survey in 1 county, 30 communities will be randomized 1:1 to receive 1 of 2 enhanced MDA interventions, with the remaining communities receiving standard-of-care annual MDA. The first intervention strategy will consist of a community-wide MDA followed by 2 rounds of targeted treatment to children ages 6 months to 9 years, 2 weeks and 4 weeks after the community MDA. The second strategy will consist of a community-wide biannual MDA approximately 6 to 8 months apart. The costing analysis will use a payer perspective and identify the total cost of the enhanced interventions and annual MDA. Community acceptability will be assessed through MDA coverage monitoring and mixed-methods research involving community stakeholders. A second trachoma-specific survey will be conducted 12 months following the original survey. DISCUSSION: ETAS has received ethical clearance and is expected to be conducted between 2022 and 2023. Results will be shared through subsequent manuscripts. The study's results will provide information to trachoma programs on whether enhanced interventions are affordable and acceptable to communities. These results will further help in the design of future trachoma-specific antibiotic efficacy trials. Enhanced MDA approaches could help countries recover from delays caused by conflict or humanitarian emergencies and could also assist countries such as South Sudan in reaching trachoma elimination as a public health problem by 2030. TRIAL REGISTRATION: This trial was registered on December 1st, 2022 (clinicaltrails.org: NCT05634759).

Of Peacekeepers and Pandemics

Little is known about the role social media can play in support of peacekeeping missions, especially in times of crisis. Looking at the use of Facebook by the UN Mission in South Sudan (UNMISS) before and during the Covid-19 pandemic, this article reconstructs social media practices of a peacekeeping mission in a global crisis. To assess how UNMISS used Facebook, it first connects research on discursive legitimation efforts by international organizations with work on strategic communication. Second, it provides a content analysis on Facebook posts published by UNMISS between 2018 and 2022 to determine how the mission engaged with its audience, how it framed its engagement, what topics were being addressed, and how the Covid-19 pandemic changed these communication patterns. Results show a conscious "propaganda for peace"strategy of the peacekeeping mission as UNMISS framed itself as a positive force for the peace process, using tailored communication strategies that rarely engaged in two-way communication, even in times of crisis. © 2023 Brill Academic Publishers. All rights reserved.

Special report - 2020 FAO/WFP Crop and Food Security Assessment Mission (CFSAM) to the Republic of South Sudan

An FAO/WFP Crop and Food Security Assessment Mission (CFSAM) conducted an analysis from 7 to 16 December 2020 to estimate the cereal production in South Sudan during 2020, based on a review of data and information collected by the Ministry of Agriculture and Food Security (MAFS). The Mission also reviewed secondary data from a variety of sources in order to produce an overview of the overall food security situation in the country. Due to COVID-19-related travel restrictions, the analysis was performed remotely through several video-conferences with relevant staff of the FAO Office in South Sudan. The CFSAM reviewed the findings of several Crop Assessment Missions conducted at harvest time from August, following the removal of COVID-19-related travel restrictions, to December 2020, in different agro-ecological zones of the country.

South Sudan emergency livelihood response programme 2021-2023

The situation in South Sudan has proven to be unpredictable and volatile. New hotspots of violent conflict and civil unrest have continued to emerge and levels of severe acute food insecurity have become progressively worse. In addition to years of fighting and political instability, the country faces natural hazards, disease and pests, such as the desert locust, and the coronavirus disease 2019 (COVID-19) pandemic. Collectively, these risks have had and continue to have a catastrophic impact on the lives and livelihoods of South Sudanese, the majority of whom rely on agriculture, livestock, forestry and fisheries as their main source of income. To respond to humanitarian needs, the Food and Agriculture Organization of the United Nations (FAO) has launched the latest iteration of its Emergency Livelihood Response Programme (ELRP) in South Sudan, which was first introduced in early 2014. The document presents the multiyear Programme for 2021-2023 and outlines how FAO aims to save lives, to enhance households' livelihoods and own food production, and to improve their resilience to future shocks. FAO revises its strategy each year to address the ever-emerging challenges facing food security and agriculture, integrate lessons learned and adapt modalities to the prevailing situation.

Acute malnutrition recovery rates improve with COVID-19 adapted nutrition treatment protocols in South Sudan: a mixed methods study.

BACKGROUND: Globally, emergency nutrition program adaptations were implemented as part of COVID-19 mitigation strategies, but the implications of the adoption of all protocol changes at scale in the context of deteriorating food security are not yet well characterized. With ongoing conflict, widespread floods, and declining food security, the secondary impacts of COVID-19 on child survival in South Sudan is of great concern. In light of this, the present study aimed to characterize the impact of COVID-19 on nutrition programming in South Sudan. METHODS: A mixed methods approach including a desk review and secondary analysis of facility-level program data was used to analyze trends in program indicators over time and compare two 15-month periods prior to the onset of COVID-19 (January 2019 - March 2020; "pre-COVID period") and after the start of the pandemic (April 2020 - June 2021; "COVID" period) in South Sudan. RESULTS: The median number of reporting Community Management of Acute Malnutrition sites increased from 1167 pre-COVID to 1189 during COVID. Admission trends followed historic seasonal patterns in South Sudan; however, compared to pre-COVID, declines were seen during COVID in total admissions (- 8.2%) and median monthly admissions (- 21.8%) for severe acute malnutrition. For moderate acute malnutrition, total admissions increased slightly during COVID (1.1%) while median monthly admissions declined (- 6.7%). Median monthly recovery rates improved for severe (92.0% pre-COVID to 95.7% during COVID) and moderate acute malnutrition (91.5 to 94.3%) with improvements also seen in all states. At the national level, rates also decreased for default (- 2.4% for severe, - 1.7% for moderate acute malnutrition) and non-recovery (- 0.9% for severe, - 1.1% for moderate acute malnutrition), with mortality rates remaining constant at 0.05-0.15%. CONCLUSIONS: Within the context of the ongoing COVID-19 pandemic in South Sudan, improved recovery, default, and non-responder rates were observed following adoption of changes to nutrition protocols. Policymakers in South Sudan and other resource-constrained settings should consider if simplified nutrition treatment protocols adopted during COVID-19 improved performance and should be maintained in lieu of reverting to standard treatment protocols.

Overview of Research Project: Assistive Technology in Humanitarian Settings

There are 240 million children with disabilities in the world, half of them are out of school. Many are invisible, stigmatized, hidden by their families and abandoned by their governments. Children with disabilities, especially in humanitarian settings, are among the poorest members of the population and one of the most marginalized and excluded groups in society. With only an estimated 1 in 10 children with a need for assistive devices having access, UNICEF's Office of Research -- Innocenti undertook a study to better understand the nature and drivers of Assistive Technology (AT) access in humanitarian settings. This document provides a synthesis of the project's various reports and papers: (1) a thematic literature review summarizes the academic evidence base regarding the provision of AT in humanitarian settings, including the nature and scale of provision and barriers and facilitators of access and provision, and (2) three case studies of countries affected by crisis to triangulate the findings of the literature review and fill identified knowledge gaps with real-world examples: Afghanistan, South Sudan, and the State of Palestine. [For the literature review, see ED620416. For the Afghanistan and South Sudan case studies, see ED620403 and ED620415, respectively.]

The impact of the COVID-19 pandemic on healthcare access and utilisation in South Sudan: a cross-sectional mixed methods study.

BACKGROUND: Indirect effects of the COVID-19 pandemic on communities in fragile and conflict-affected settings may be severe due to reduced access and use of healthcare, as happened during the 2015 Ebola Virus Disease outbreak. Achieving a balance between short-term emergency response and addressing long-term health needs is particularly challenging in fragile and conflict-affected settings such as South Sudan, given the already significant barriers to accessing healthcare for the population. This study sought to characterise the effect of COVID-19 on healthcare access and South Sudan's healthcare response. This can inform efforts to mitigate the potential impacts of COVID-19 or other epidemiological threats, and contribute to understanding how these may be balanced for greater health system resilience in fragile contexts. METHODS: We conducted a mixed methods study in three of South Sudan's states, combining data from a cross-sectional quantitative household survey with qualitative interviews and Focus Group Discussions. RESULTS: Even though some fears related to COVID-19 were reported, we found these did not greatly dissuade people from seeking care and do not yield significant consequences for health system programming in South Sudan. The pillars of the response focused on risk communication and community engagement were effective in reaching communities through different channels. Respondents and participants reported behaviour changes that were in line with public health advice. We also found that the implementation of COVID-19 response activities sometimes created frictions between the national government and international health actors, and that COVID-19 caused a greater reliance on, and increased responsibility for, international donors for health planning. CONCLUSIONS: Given the fact that global priorities on COVID-19 are greatly shifting, power dynamics between international health agencies and the national government may be useful to consider in further COVID-19 planning, particularly for the vaccine roll-out. South Sudan must now navigate a period of transition where COVID-19 vaccine roll-out continues and other domestic health burdens are re-prioritised.

Use of Project ECHO in Response to COVID-19 in Countries Supported by US President's Emergency Plan for AIDS Relief.

The US Centers for Disease Control and Prevention, with funding from the US President's Plan for Emergency Relief, implements a virtual model for clinical mentorship, Project Extension for Community Healthcare Outcomes (ECHO), worldwide to connect multidisciplinary teams of healthcare workers (HCWs) with specialists to build capacity to respond to the HIV epidemic. The emergence of and quick evolution of the COVID-19 pandemic created the need and opportunity for the use of the Project ECHO model to help address the knowledge requirements of HCW responding to COVID-19 while maintaining HCW safety through social distancing. We describe the implementation experiences of Project ECHO in 5 Centers for Disease Control and Prevention programs as part of their COVID-19 response, in which existing platforms were used to rapidly disseminate relevant, up-to-date COVID-19-related clinical information to a large, multidisciplinary audience of stakeholders within their healthcare systems.

South Sudan's road to universal health coverage: a slow but steady journey.

Amidst the myriad of challenges that constrain good quality health care services delivery in the World's youngest nation, South Sudan, there is a beacon of hope. The country's revitalized peace agreement offers a new impetus for rebuilding the country, including its health system. Key achievements in the health care sector of the country such as development and implementation of a health sector strategic and health sector stabilization and recovery plans and implementation of a Boma Health Initiative programme which aims to scale up health services delivery at the community level provide a foundation on which acceleration of universal health coverage could rest. Other key achievements include polio-free certification of the country, significant reductions in the prevalence of Guinea Worm and other neglected tropical diseases and timely detection and response to the ongoing COVID-19 outbreak. Moving forward, attainment of universal health coverage in the country requires a strong and people-centred primary healthcare approach which will ensure that services reach the last mile. Bridging the humanitarian-development nexus is required to ensure accelerated recovery of the country's health system. Furthermore, scaling up of community-based health initiatives such as the Boma Health Initiative as platforms for taking good quality health services to the hard-to-reach areas is imperative. This Journal Supplement highlights the key achievements and challenges on the road to universal health coverage in South Sudan and provides evidence-based information for rapidly scaling up health services provision.

Use of mobile medical teams to fill critical gaps in health service delivery in complex humanitarian settings, 2017-2020: a case study of South Sudan.

The vulnerable populations in the protracted humanitarian crisis in South Sudan are faced with constrained access to health services and frequent disease outbreaks. Here, we describe the experiences of emergency mobile medical teams (eMMT) assembled by the World Health Organization (WHO) South Sudan to respond to public health emergencies. Interventions: the eMMTs, multidisciplinary teams based at national, state and county levels, are rapidly deployed to conduct rapid assessments, outbreak investigations, and initiate public health response during acute emergencies. The eMMTs were deployed to locations affected by flooding, conflicts, famine, and disease outbreaks. We reviewed records of deployment reports, outreach and campaign registers, and analyzed the key achievements of the eMMTs for 2017 through 2020. Achievements: the eMMTs investigated disease outbreaks including cholera, measles, Rift Valley fever and coronavirus disease (COVID-19) in 13 counties, conducted mobile outreaches in emergency locations in 38 counties (320,988 consultations conducted), trained 550 healthcare workers including rapid response teams, and supported reactive measles vaccination campaigns in seven counties [148,726, (72-125%) under-5-year-old children vaccinated] and reactive oral cholera vaccination campaigns in four counties (355,790 vaccinated). The eMMT is relevant in humanitarian settings and can reduce excess morbidity and mortality and fill gaps that routine health facilities and health partners could not bridge. However, the scope of the services offered needs to be broadened to include mental and psychosocial care and a strategy for ensuring continuity of vaccination services and management of chronic conditions after the mobile outreach is instituted.

Integrated disease surveillance and response in humanitarian context: South Sudan experience.

Introduction: decades of instability continue to impact the implementation of the Integrated Disease Surveillance and Response (IDSR) strategy. The study reviewed the progress and outcomes of rolling out IDSR in South Sudan. Methods: this descriptive cross-sectional study used epidemiological data for 2019, 2020, and other program data to assess indicators for the five surveillance components including surveillance priorities, core and support functions, and surveillance system structure and quality. Results: South Sudan expanded the priority disease scope from 26 to 59 to align with national and regional epidemiological trends and the International Health Regulations (IHR) 2005. Completing the countrywide rollout of electronic Early Warning Alert and Response (EWARS) reporting has improved both the timeliness and completeness of weekly reporting to 78% and 90%, respectively, by week 39 of 2020 in comparison to a baseline of 54% on both timeliness and completeness of reporting in 2019. The National Public Health Laboratory confirmatory testing capacities have been expanded to include cholera, measles, HIV, tuberculosis (TB), influenza, Ebola, yellow fever, and Severe Acute Respiratory Syndrome 2 (SARS-COV-2). Rapid response teams have been established to respond to epidemics and pandemics. Conclusion: since 2006, South Sudan has registered progress towards using indicator and event-based surveillance and continues to strengthen IHR (2005) capacities. Following the adoption of third edition IDSR guidelines, the current emphasis entails maintaining earlier gains and strengthening community and event-based surveillance, formalizing cross-sectoral one-health engagement, optimal EWARS and District Health Information Systems (DHIS2) use, and strengthening cross-border surveillance. It is also critical that optimal government, and donors' resources are dedicated to supporting health system strengthening and disease surveillance.

WASH responses to COVID-19 in Ethiopia, Somalia and South Sudan

In the face of COVID-19, innovation, adaptation, and learning from experience have all been crucial to meeting the needs of those who have been displaced. In order to respond to this new disease, the humanitarian community had to get familiar with COVID-19. It was understood from the beginning that basic hygiene precautions, such adequate handwashing, could aid in preventing its transmission. However, a lot of displacement settings lack the infrastructure needed to put household and community-level infection prevention and control (IPC) measures into place. They might also have inadequate governance structures for overseeing and maintaining WASH services. Some of the hardest-to-reach populations are found in displacement contexts like Ethiopia, Somalia, and South Sudan, where people lack the resources to defend themselves and deal with health threats. Disease vulnerability may be exacerbated by overcrowding and restricted access to proper WASH facilities. In the meantime, xenophobia and stigma can develop due to the fear surrounding COVID-19 as well as the dissemination of false information. As new information became available and lessons were discovered, IOM teams operating in these environments had to modify their Risk Communication and Community Engagement (RCCE) and IPC efforts. Any disaster response has traditionally included funding for capacity building for hygiene promotion to strengthen local responses, but COVID-19 demanded more localisation because of the absence of international travel. It demonstrated how supporting local structures can help solidify hygiene promotion capacities while obviating the requirement for a high degree of international assistance in the event of future outbreaks by highlighting considerable local capacity and willingness in some communities.

Drought-resistant crops sought to tackle food crisis

In response to the report, the International Center for Agricultural Research in the Dry Areas (ICARDA) is launching a new initiative with partners including the Food and Agriculture Organization (FAO) to improve livestock and plant production, says Aladdin Hamwieh, breeder, biotechnologist and Egypt country manager for ICARDA. See PDF] “The initiative is based on developing plants that tolerate drought and salinity, such as wheat, barley and chickpeas, through cross-breeding and transfer of genetic traits between different plants to benefit from them,” explains Hamwieh. Ukraine The number of people facing hunger is expected to increase this year as a result of several drivers, including the Russia-Ukraine war, according to the food crisis report released by the Food Security Information Network and the Global Network Against Food Crises.

Exploring the intentional behaviour of refugees in participating in micro-enterprise support programmes (MESP): is theory of planned behaviour (TPB) still relevant?

Purpose>This study aims to investigate the relevance of the theory of planned behaviour (TPB) in predicting the intentional behaviour of refugee entrepreneurs. This paper uses key components of the theory on attitude, subjective norms and perceived control to explore the willingness of refugees to participate in microenterprise support programmes (MESP) in refugee camps.Design/methodology/approach>This study used a positivist research approach, comprising a quantitative basis of enquiry and gathered data via survey questionnaires. In total, 400 usable questionnaires were completed and used for analysis. This study uses descriptive and inferential analysis with SPSS and confirmatory factor analysis with AMOS to test three key TPB hypotheses.Findings>The structured model revealed acceptable high goodness-of-fit indices. Also, the findings indicated that out of three hypotheses, two hypotheses (attitude and perceived control) were substantial, positive and significant. However, the relationship between subjective norms of refugees and their intention to participate in MESP was insignificant. The findings of this study indicate the low-profile refugees give to the views and opinions of the surrounding communities when it comes to determining their intentional behaviour. As such, some poignant implications may relate to microfinance and microcredit programmes targeting refugees.Practical implications>The present study illustrates the interrelationships between the proposed variables. Also, by understanding the relationships between the selected variables, the findings would be useful for the concerned authorities to ameliorate and upgrade the well-being of refugees along with empowering their environment, which would facilitate their engagement in business and entrepreneurship.Originality/value>This study explores the relevance of TPB and its components in the context of the intentional behaviour of refugee entrepreneurs. It further illuminates the distinction of refugee behaviour towards entrepreneurship and MESP.

Why an early Belt and Road Initiative East Africa hub? Economic, demographic and security factors

Purpose>This purpose of this paper is to explore China’s choice to focus early Belt and Road Initiative (BRI) Africa outreach on Eastern Africa. The BRI specifically seeks to achieve ten economic and policy objectives, as outlined in the two launch speeches of 2013. In terms of realising these, the economic development and digitisation levels, that progress of the demographic transition, and the important security context of the sub-region, logically make East Africa relatively important to BRI in continental context. Kenya specifically is important in being an African frontier therein, and, also, because it shares a few important borders with landlocked countries, including Ethiopia, Sudan and Uganda, alongside a strategic coast and ports. From this lens, as well the fact that in the Ming Dynasty Chinese fleets reached what is modern-day Kenya, China’s early BRI outreach to Africa having had a historical precedent in initially focusing on Eastern Africa, might be usefully understood.Design/methodology/approach>To realise that aim a comprehensive survey of related literature and policy documents, in Chinese, English and Swahili, was undertaken and relevant data compiled and analysed.Findings>To the best of the authors’ knowledge, first, this paper is the first to argue that the Belt and Road Initiative in Africa may build on long-run logic in terms of economics, demographic change and security. This provides a contrary perspective to the pre-existing established “debt trap diplomacy” and no consistent logic narratives. Second, it is the first to offer a synthesised analysis of the BRI in Africa, East Africa specifically, looking across economic, demographic and security angles.Research limitations/implications>The paper is a synthesis of development and regional economics literature that forges some prospective rationales only. It is not an empirical research paper drawing very specific and definitive conclusions.Practical implications>Amid widespread geo-economic tensions and uncertainty, around the Belt and Road Initiative in particular, this paper offers a new economic development-oriented logic for the choice of an important node of the China's Belt and Road Initiative, that of East Africa, Kenya especially. This may impact existing related narratives and policy responses.Social implications>Equivalently to the above this may then have an impact on the ground in East Africa and beyond.Originality/value>The first such or even close to synthesis.

Determinants of Household Nutrition Security in Countries in Protracted Crisis: Evidence from South Sudan

Undernutrition is a considerable challenge in sub-Saharan Africa, especially in countries affected by a protracted crisis, but the literature lacks information on the underlying mechanisms influencing micro- and macronutrients, and appropriate analytical tools are needed to assist policymakers and implementers. The paper contributes to filling this gap, focusing on the Western Bahr el Ghazal state in South Sudan and using primary data collected in May–June 2019 for a statistically representative sample of households. The literature typically uses one micro- or macronutrient as a proxy of nutritional status. On the contrary, the study applied a MANCOVA with an artificial dependent variable, including protein, vitamin A, and heme iron, in a single experiment to discover the variables that better explain household nutritional status. Dietary diversity explains the largest proportion of variance in household nutritional status. The importance of the variables in explaining the variance in the specific micro- and macronutrients depends on the explanatory variable. Therefore, the results suggest the possible misinterpretation of undernutrition using one nutrient. Moreover, they highlight the importance of a multisectoral approach to the problem with a central role played by agriculture and the urgency of the reinforcement of the humanitarian–development–peace nexus to improve household nutrition security in South Sudan.

Pathway and interaction analysis of IMCHA Model: An initiative of implementation research in Uganda and South Sudan

L'initiative Innovation pour la santé des mėres et des enfants d'Afrique (ISMEA) a mis en œuvre des recherches visant å améliorer la santé des mėres, des nouveau-nés et des enfants et a adopté un modéle de recherche composé de : un chercheur principal (CP) d'un établissement africain, un co-CP affilié a un établissement canadien, un Co-CP en position de décision, et deux Organismes de politiques et recherche en matiėre de santé, en Afrique. Le présent article décrit le modéle de l'Initiative ISMEA qui a été utilisé pour la mise en œuvre de la recherche en Ouganda et au Soudan du Sud. Les méthodes utilisées sont l'examen des documents et les expériences de BRAC (Building Resources Across Communities) Ouganda dans la mise en œuvre de la recherche utilisant le modéle de l'initiative ISMEA. L'expérience de la mise en œuvre du modéle de l'ISMEA démontre un appui pour l'accés å l'environnement politique, la traduction des données et la production de résultats de la recherche pour les politiques. Les trajectoires dans le modéle par la communication et les interactions dans la connectivité de la collaboration avec les intervenants politiques pertinents ont constitué une expérience spéciale. Le modéle a grandement contribué a ancrer la recherche dans le contexte local et å établir des liens avec l'environnement politique. L'expérience ougandaise a montré l'utilité du modéle. L'article recommande l'utilisation du modéle de l'ISMEA dans la réalisation de la recherche sur la mise en œuvre pour permettre l'accés å l'environnement politique depuis le début de l'étude et tout au long de la période de recherche.Alternate :The Innovating for Maternal and Child Health in Africa (IMCHA) initiative implemented research to improve maternal, newborn and child health and adopted a research model that was composed of: Principal Investigator of an African institution;Co- Principal Investigator affiliated with a Canadian institution, Co-PI in a decision-making position, and Health Policy and Research Organisation in Africa. This paper describes the IMCHA Initiative model that was used in implementing the research in Uganda and South Sudan. The methods used are documents review and experiences by BRAC (Building Resources Across Communities) Uganda in implementing the research using the IMCHA initiative model. The experiences in implementing IMCHA model show support in accessing policy space, translating data and producing outputs from the research for policy. The pathways in the model through communication and interactions in the connectedness of working with the relevant policy stakeholders was a special experience. The model contributed greatly to the grounding of research in the local context and connecting to the policy space. The Ugandan experience has exhibited the usefulness of the model. The Paper recommends use of the IMCHA Model in conducting implementation research for enabling access to policy space from study inception through the research period.

Community health worker-led treatment for uncomplicated wasting: insights from the RISE study and practice

South Sudan, Nigeria, Malawi, Kenya. What we know: Delivery of treatment for uncomplicated wasting by community health workers (CHWs) is a simplified approach that can ensure continuity of detection and treatment, particularly in the context of the COVID-19 pandemic. What this article adds: This article summarises operational insights developed by the RISE study consortium, a multi-partner, multi-country initiative to develop and test a simplified treatment protocol, tools and job aids for literate and low-literate CHWs to deliver treatment for uncomplicated wasting treatment services through the integrated community case management (iCCM) platform in several locations. The following operational aspects must be considered before embarking on this model: context-specific underlying epidemiology (burden of malnutrition and seasonality), extent to which the model will remove top barriers to treatment in the context, existence of a community health system to embed the model within and the presence of a supply chain, supervision and financing. Once deemed appropriate, recommendations to improve implementation and uptake include the simplification of protocols to streamline CHW decision-making, the simplification and integration of CHW tools, the strengthening of referral mechanisms for complicated cases, the provision of motivations and incentives for CHWs, the tracking and addressing of defaulting, enhancing CHW training and supervision and engagement of communities. Full quantitative and qualitative results will be submitted for peer review publication in 2021. Further application of the considerations and recommendations listed here is needed to inform the operational feasibility, scalability and sustainability of the approach.

Pregnancy and young child feeding in South Sudan during the COVID-19 pandemic. (Special Issue: Coronavirus pandemic.)

This report serves as guidelines for pregnant women and young child feeding in South Sudan amidst the COVID-19 pandemic.