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Purpose: As Covid-19 became a pandemic, numerous people were forced to stay at home, leading to increased intimate partner violence (IPV) in many countries, particularly in developing and least-developed ones. This paper aims to highlight the IPV based on 15 different cases formed from the practical evidence of five developing countries. Design/methodology/approach: The authors interviewed 15 women from five countries who were the victims of IPV during the early periods of Covid-19 outbreak. Due to geographical remoteness, the authors conducted informal telephone interviews to collect the participants' personal experiences. The conversations were recorded with participants' permission; afterwards, the authors summarized participants' experiences into 15 different cases without revealing their original identities (instead, disguised names were used). Findings: It was revealed that the women were the primary victims of such violence, particularly from their intimate partners (husbands). In most cases, such IPV, as reported by the interviewees, originated or increased after the pandemic when they were forced to stay at home, losing their partners' jobs or income sources. Originality/value: The authors summarized the causes of IPV and put forward a few action recommendations based on the interviewees' practical experience and existing literature. This paper will open a new window for research investigations on IPV during emergencies such as Covid-19 outbreak. [ABSTRACT FROM AUTHOR]

Research on positionality and accessing field work for researchers studying their own communities in Lower Middle-Income Countries (LMICs) is scant. The majority of the literature on this topic emanates from High-Income Countries (HICs). Drawing on ethnographic field work conducted in Kenya and Pakistan, the authors have explored ways in which dialectic relationships between the researcher and participants in various social spaces (SSs) within the place of research (PoR) influences access to the field and data quality. The authors analysed reflective narratives from their f ieldwork using Gibbs's Reflective Cycle (GRC). The findings show that, accessing field work in LMICs where the research agenda is not fully developed with respect to funding and government support presents not only social and practical issues concerning the fieldwork but also ethical dilemmas. SSs in a PoR are powerful in determining both access to the field and data quality. For researchers returning from HICs to study the communities of their origin, being a native does not grant automatic access to research spaces. Gender and power dynamics are not only crucial for accessing the communities which are studied and from which data are collected but can also bring a degree of bias to the data collected. This paper sheds light on issues around positionality, access and doing field work in these contexts. The findings show the complex context in which research is conducted and how positionality is contested. This paper is useful for professionals from LMICs, early career researchers and professionals working in international development. [ABSTRACT FROM AUTHOR]

Water management and distribution rules in flood-based livelihood systems (FBLS) have a key role in enhancing system-wide productivity and livelihoods. While such potential has to a certain extent been harnessed in DG Khan FBLS in Pakistan, it has not yet been fulfilled in the Tana River and Fogera FBLS in Kenya and Ethiopia, respectively. These three systems are considered among the major sources of water and food security in their respective regions by the local governments and communities. Drawing from 105 individual interviews with Pakistani FBLS farmers, the paper establishes that a package of water management and distribution rules have significantly contributed to (a) mitigating excessive upstream floodwater use, (b) reducing downstream water scarcity and (c) realizing nearly 4 tons ha-1 harvest of the major wheat crop across the upstream and downstream areas. This yield is about 20% higher than the country-wide average, and two-third of the maximum achievable. Furthermore, 86% of the upstream and three in four of the downstream farmers have managed to cover their livelihood needs that included health, school, housing, transportation, energy and food expenses. On the other hand, the analyses based on individual interviews with 94 and 147 FBLS farmers from Kenya and Ethiopia respectively, uncovered the negative consequences of the absence of a comprehensive package of water management and distribution rules. In Kenya, the downstream small-scale farmers that account for two-third of the Tana River FBLS population frequently suffer from floodwater scarcity. They could not cultivate the high return rice crop and their staple maize yield was low at about 1.25 tons ha-1 or 20% of the maximum attainable. Four in five reported poor livelihoods. The upstream largescale farmers however often diverted excessive floodwater; over 90% usually grow rice as well as maize as a second crop for home consumption. The situation in Fogera is similar. The water distribution rules prioritized the upstream rice cultivation introduced a decade back to boost economic growth. This, as informed by 95% of the interviewed farmers, has caused downstream floodwater scarcity, about 30% maize yield reduction and livelihood deterioration. These findings on the impacts of water distribution rules can contribute to formulating investments that better achieve the productivity and livelihood potentials of FBLS across Africa and globally. [ABSTRACT FROM AUTHOR]

The study aims to understand the foremost challenges in the transition to online teaching and learning during the COVID-19 pandemic. The study adopts the PRISMA approach to screening the selection of journal articles and review papers according to the research aims and the inclusion criteria. The journal articles and review papers were extracted and stored in Microsoft Excel and Google Scholar, Academic. Microsoft, Semantic Scholar, Elsevier, and Emerald Insight databases searched relevant documents using formulated keywords. A statistical technique was applied using the M.S. Excel analysis tool (PivotTable and an independent t-Test) to analyze data and determine the differences between teachers and students. The review revealed the evidence that the majority of the studies were primarily focused on the individual developing countries and results from other developing countries were not considered. In addition, the foremost challenges in the transition to online teaching and learning during the COVID-19 pandemic were inadequate skills and training, inadequate Internet/Infrastructure, lack of supporting resources and lack of online student engagement and feedback. Finally, the independent t-test reveals there is no statistically significant difference in challenges in the transition to online teaching and learning during the COVID-19 pandemic. Both teachers and students encounter similar challenges. The systematic review raised concerns that higher learning needs to effectively implement long term strategies and support teachers and students in getting into online teaching and learning.

This paper examines and reviews the current literature on mobile learning in developing countries. Mobile device is becoming a more popular interface for connecting with the world and mode of digital presence than the desktop computing devices. Mobile technologies in the developing world enable people to connect to the Internet, become more conversant with the digital world, and network globally via social networking forums. Mobile technologies in developing countries such as India, Indonesia, Pakistan, Kenya and South Africa have significantly increased and advanced. In spite of limited Information and Communications Technology (ICT) resources and an unstable infrastructure, good telecom services exist in the form of cellular networks which provide a favorable environment for mobile learning. The literature suggests that there is pervasive use of mobile devices that would facilitate the uptake of mobile learning in developed countries. However, few researchers have looked into the potential use of mobile devices in learning environments in developing countries. To ascertain the extent of mobile learning in developing countries, this paper examines the current literature on mobile learning research in developing countries including projects, implementations, theories and conceptualizations of mobile learning for these countries. [ABSTRACT FROM AUTHOR]

Purpose: Albeit the growing academic research on emerging economies corporate governance (CG) environments within accounting and finance literature, there exists a dearth of cross-country studies using a qualitative approach to understand practitioners' behaviour vis-a-vis diffusion of international CG practices in emerging economies. This study aims to fill this oversight through a comparative analysis of the divergence and convergence of CG systems operational in three emerging economies (Cameroon, Kenya and Pakistan) while highlighting different institutional and contextual impacts on behaviour of governance actors. The paper uses an interface between critical realism and new institutional economics theory to explore the implementation and execution of CG in Cameroon, Kenya and Pakistan. Design/methodology/approach: The study analysed 24 in-depth semi-structured interviews and conducted with key governance practitioners across the three countries. Findings: The findings show that CG implementation processes in Cameroon, Kenya and Pakistan are nascent and driven by international forces rather than local initiatives. CG lacks institutional identity across the three countries as regulatory coercion acts as a key driver for CG adoption and practitioner accounts are mixed regarding the impact of CG on firm performance. Practical implications: The paper evidences that the lack of governance identify, compliance and slow implementation process of governance regulations and its impact on firm performance in emerging economies is caused by the fact that local institutional characteristics prevalent in these economies may not be suitable for a "copy and paste" of Western form of governance regulations. Furthermore, governance actors do not see the relevance of recommended CG practices except as a regulatory burden. Originality/value: The paper contributes to close the lacuna in the seemingly little qualitative comparative study that has examined practitioner's perception vis-à-vis the diffusion of international governance practices in emerging economies. Specifically, it uncovers how different institutional and contextual factors impact on the behaviour of governance actors and how their behaviours may constrain adoption, implementation and compliance with recommended governance practices. [ABSTRACT FROM AUTHOR]

Background: Globally, the lack of availability of psychological services for people exposed to adversities has led to the development of a range of scalable psychological interventions with features that enable better scale-up. Problem Management Plus (PM+) is a brief intervention of five sessions that can be delivered by non-specialists. It is designed for people in communities in low- and middle-income countries (LMIC) affected by any kind of adversity. Two recent randomized controlled trials in Pakistan and Kenya demonstrated the effectiveness of individually delivered PM+. A group version of PM+ has been developed to make the intervention more scalable and acceptable. This paper describes the protocol for a cluster randomized controlled trial (c-RCT) on locally adapted Group PM+ in Nepal.Methods/design: This c-RCT will compare Group PM+ to enhanced usual care (EUC) in participants with high levels of psychological distress recruited from the community. The study is designed as a two-arm, single-blind c-RCT that will be conducted in a community-based setting in Morang, a flood affected district in Eastern Nepal. Randomization will occur at ward level, the smallest administrative level in Nepal, with 72 enrolled wards allocated to Group PM+ or to EUC (ratio 1:1). Group PM+ consists of five approximately 2.5-h sessions, in which participants are taught techniques to manage their stressors and problems, and is delivered by trained and supervised community psychosocial workers (CPSWs). EUC consists of a family meeting with (a) basic information on adversity and mental health, (b) benefits of getting support, (c) information on seeking services from local health facilities with mhGAP-trained staff. The primary outcome measure is levels of individual psychological distress at endline (equivalent to 20 ± 1 weeks after baseline), measured by the General Health Questionnaire (GHQ-12). Secondary outcome measures include levels of functioning, depressive symptoms, post-traumatic stress disorder symptoms, levels of social support, somatic symptoms, and ways of coping. We hypothesize that skills acquired will mediate any impact of the intervention.Discussion: This c-RCT will contribute to the growing evidence-base for transdiagnostic psychological interventions delivered by non-specialists for people in communities affected by adversity. If Group PM+ is proven effective, the intervention manual will be released for use, giving the opportunity for further adaptation and implementation of the intervention in diverse settings with communities that require better access to psychological interventions.Trial Registration: ClinicalTrials.gov, NCT03747055. [ABSTRACT FROM AUTHOR]

In this study, the variables having impact on the student motivation have been analyzed based on the articles, conference papers, master's theses and doctoral dissertations published in the years 2000-2017. A total of 165 research papers were selected for the research material and the data were collected through qualitative research techniques through document review and content analysis. According to the research results, the most important factors affecting student motivation are the fields of teacher, teachers' classroom management skills and their teaching methods. In this research, factors having less influence on the student motivation are parental communication, student characteristics and study fields. In addition, relational search type was used more than others, mostly students were selected as the study group and most researches were conducted in USA and Turkey.

In 2012, 2016 and 2018–2019, Pakistan threatened to expel Afghan refugees and in 2015, 2016 and 2019, Kenya threatened to demolish the Dadaab camp and expel Somali refugees. Following the threats, the governments extracted more than $300 million aid, combined. Why did these states succeed in extracting aid despite their relatively weak status and not bordering the target of their blackmail? This article first situates refugee expulsion within the literature on refugee policies, migration diplomacy and refugee rentier states. Second, in two cases – Somalis in Kenya and Afghans in Pakistan – I show how states used the threat of expulsion to construct and leverage the deportability of their refugee communities as a foreign policy tool. States used the legal uncertainty around deportability to channel threats and violence toward refugees, but the primary audience of the threats were not refugees, but the international community. Officials in Kenya and Pakistan used threats paired with six-month or one-year delays as negotiation tactics to extract aid. Surprisingly, states that were generous hosts to refugees become strategically important because of their role in providing regional stability, which turned otherwise weak states into important allies that could threaten expulsion and extract aid from superpowers. [ABSTRACT FROM AUTHOR]

The qualitative community embraces transparent dialogue through sharing knowledge to improve rigour and develop new initiatives. In this paper, we recognise there are many complexities within qualitative research, leading to important debates. We explore the benefits and challenges, as well as the practicalities and technicalities, of conducting research that 1) employs multiple methods within the qualitative paradigm, 2) is interdisciplinary, and 3) examines a sensitive research topic 4) with a vulnerable group of participants. Specifically, when research is also 5) cross-cultural and 6) utilises participatory techniques. Through our discussion, we draw upon an existing project and examine the complexity of designing and completing intra-paradigmatic mixed methods research with children from different sociocultural contexts, underpinned by interdisciplinary perspectives, in a complex area like mental health.

Financial inclusion, defined as the adequate access and usage of formal financial services to improve people's lives, is a crucial area for the economic development of a country through its various angles. This paper analyzes the impact of selected FinTech companies on financial inclusion in their respective countries to obtain lessons of their business models and country environments that can help Peruvian financial inclusion. The selected FinTechs are M-PESA in Kenya, Nubank in Brazil, GCASH in the Philippines, and Easypaisa in Pakistan, which revolutionized the financial sector in their respective countries. However, a comparative study of their impact on financial inclusion in their respective country has not been conducted yet; therefore, the lessons obtained are helpful for the Peruvian situation due to their practical implications and because they raise possible areas for further and deeper research. The approach of this study considered a qualitative and quantitative method (to find a Pearson correlation between the percentage of the population of Country (A) that are users of FinTech (a) and the six selected demand-side indicators per country retrieved from the Global Findex Database) analysis to understand the results obtained. The results obtained indicate that M-PESA and GCASH, companies specialized in providing basic mobile money transactions such as remittances and withdrawals, did not impact the provision of other financial services such as savings or credit cards. In Easypaisa's case, this company positively impacts the studied indicators, probably due to its original partnership with a microfinance institution. Regarding Nubank, despite its remarkable growth in the last years, the company does not affect financial inclusion in Brazil yet. Nonetheless, after its recent expansion to provide more financial services, future research could assess the impact of this company on Brazilian financial inclusion. [ABSTRACT FROM AUTHOR]

This paper applies Information and Communication Technologies (ICT) as well as data analysis to gain a better understanding of the existing perception on the education system. 45,278 tweets were downloaded and processed. Using a lexicon-based approach, examining the most frequently used words, and estimating similarities between terms, we detected that a predominantly negative perception of the education system exists in most of the analysed countries. A positive perception is identified in certain low-income nations. Men exhibit a more positive sentiment than women as well as a higher subjectivity in some countries. The countries that exhibit the most positive perceptions India, Canada, Pakistan, Australia, South Africa and Kenya are also those that manifest the highest subjectivity.

Learning analytics is a domain that has been constantly evolving throughout recent years due to the acknowledgement of its importance by those using intelligent data, learner-produced data, and analysis models to discover information and social connections for predicting and advising people's learning [1]. Learning analytics may be applied in a variety of different cases, but their role in understanding the multilingual requirements of users of learning portals is of an outstanding significance. As the adaptation of existing portals in multilingual environments is a cost- and time-consuming aspect of the development of a portal, the outcomes of learning analytics may provide the requirements on which further multilingual services of a portal will be built, ensuring their efficiency. This paper aims to identify and interpret the behavior of users from developing countries in a multilingual learning portal using the log files of the portal by applying the methodology defined in a previous work by Stoitsis et al. [2] The paper also aims to identify the aspects that should be studied by future related works by focusing on specific regions and countries that exhibit special interest for further adaptation of the portal to additional multilingual environments.

This paper seeks to provide historical context for discussions of language planning in postcolonial societies by focusing on policies which have influenced language in three former British colonies. If we measure between the convenient markers of John Cabot's Newfoundland expedition of 1497 and the 1997 return of Hong Kong to Chinese sovereignty, the British Empire spanned 500 years, and at its greatest extent in the 1920s covered a fifth of the world's land surface. Together with the economic and military emergence of the United States in the 20th century, British colonialism is widely regarded as the main reason for the global role played by English today. It is also an indispensable element of debates about imperialism in general and linguistic imperialism in particular. [ABSTRACT FROM AUTHOR]

Background: Problem Management Plus (PM+) is a brief multicomponent intervention incorporating behavioral strategies delivered by lay health workers. The effectiveness of PM+ has been evaluated in randomized controlled trials in Kenya and Pakistan. When developing interventions for large-scale implementation it is considered essential to evaluate their feasibility and acceptability in addition to their efficacy. This paper discusses a qualitative evaluation of PM+ for women affected by adversity in Kenya. Methods: Qualitative interviews were conducted with 27 key informants from peri-urban Nairobi, Kenya, where PM+ was tested. Interview participants included six women who completed PM+, six community health volunteers (CHVs) who delivered the intervention, seven people with local decision making power, and eight project staff involved in the PM+ trial. Results: Key informants generally noted positive experiences with PM+. Participants and CHVs reported the positive impact PM+ had made on their lives. Nonetheless, potential structural and psychological barriers to scale up were identified. The sustainability of CHVs as unsalaried, volunteer providers was mentioned by most interviewees as the main barrier to scaling up the intervention. Conclusions: The findings across diverse stakeholders show that PM+ is largely acceptable in this Kenyan setting. The results indicated that when further implemented, PM+ could be of great value to people in communities exposed to adversities such as interpersonal violence and chronic poverty. Barriers to large-scale implementation were identified, of which the sustainability of the non-specialist health workforce was the most important one. [ABSTRACT FROM AUTHOR]

Over the last two decades, education privatization has become a widespread phenomenon, affecting most education systems and giving place to a consistent increase in private school enrolment globally. However, far from being a monolithic phenomenon, privatization advances through a variety of context-sensitive policy processes that translate into multiple policy outcomes. This paper aims at understanding why and how education privatization unfolds in a broad variety of settings and, to this purpose, examines the different manifestations of education privatization on the light of Cultural Political Economy (CPE). The conceptual and analytical tools provided by CPE prove to be particularly well suited to explore such a multi-faceted and multi-scalar phenomenon. CPE has helped us to capture the intersect and tension between different drivers (global and local, material and ideational) of education privatization through the evolutionary mechanisms of variation, selection and retention. On the basis of a systematic literature review methodology, encompassing 227 research papers, the article identifies and systematizes six different paths towards education privatization--understood as groups of frequently associated circumstances, mechanisms and courses of action leading to privatization. Conceived as ideal types, these different paths ultimately allow for a richer understanding of education privatization and show that the international diffusion of education privatization norms and discourses is far from producing policy convergence at a global scale.

Background: In 2014, Gavi and partners developed a global Immunization Supply Chain (iSC) Strategy, 2015-2020, which prioritized functioning cold chain equipment (CCE) and additional storage capacity. In 2016, Gavi launched the Cold Chain Equipment Optimization Platform (CCEOP) as a funding mechanism to improve CCE availability. In 2018, Gavi commissioned an evaluation of CCEOP in Guinea, Kenya and Pakistan. The global iSC Strategy has recently been revised, drawing on findings from effective vaccine management assessments and practical experiences. This case study presents the CCEOP evaluation and how its findings reinforced the revision of the iSC strategy.Methods: The CCEOP evaluation used a prospective mixed-methods research design in all three countries involving key informant interviews at multiple levels of the health system, document reviews, direct observation (as and when possible), and a health facility assessment.Results: Results show that CCEOP was effective at increasing the number of available and reliable CCE, and establishing improved management processes using the project management team (PMT) approach for country management systems and the service bundle provider approach for installation and maintenance. CCEOP also extended the iSC and immunization services in countries. The evaluation results also show gaps in the overall supply chain system, including CCE maintenance.Discussion: Gavi has recently revised its iSC strategy, which has addressed gaps identified through assessments and practical experiences from stakeholders. Results of the CCEOP evaluation reinforce many of these findings. The strategy now provides more emphasis on supporting the fundamental infrastructure and establishing strong processes for maintenance. It also emphasizes strategic planning and forward thinking for iSC decisions, building on the processes established for the PMT through CCEOP. The original iSC strategy was an impetus for the establishment of CCEOP. The new strategy reflects shifting trends and priorities to fill gaps identified through practical experience, advocated for by stakeholders and thought leaders engaged in the iSC, and validated by the evaluation. It demonstrates the importance of aligning stakeholders with clear objectives and a sound strategy. [ABSTRACT FROM AUTHOR]

Third, the authors did not appropriately disentangle research costs from intervention costs in analysing data from the Zambia randomized controlled trial. We recognize and appreciate the vast undertaking that TorresReudaetal. has taken on with this analysis and reiterate that we believe costing analyses of interventions are vital for scaling up effective VAWG interventions. Not all costs should be treated equally: Commentary on the article 'What will it cost to prevent violence against women and girls in low- and middle-income countries?. [Extracted from the article]

Background: The study aims to predict and assess cardiovascular disease (CVD) patterns in highly affected countries such as Pakistan, India, China, Kenya, the USA, and Sweden. The data for CVD deaths was gathered from 2005 to 2019. Methods: We utilized non-homogenous discrete grey model (NDGM) to predict growth of cardiovascular deaths in selected countries. We take this process a step further by utilizing novel Synthetic Relative Growth Rate (RGR) and Synthetic Doubling Time (Dt) model to assess how many years it takes to reduce the cardiovascular deaths double in numbers. Results: The results reveal that the USA and China may lead in terms of raising its number of deaths caused by CVDs till 2027. However, doubling time model suggests that USA may require 2.3 years in reducing the cardiovascular deaths. Conclusions: This study is significant for the policymakers and health practitioners to ensure the execution of CVD prevention measures to overcome the growing burden of CVD deaths. [ABSTRACT FROM AUTHOR]

Treaties are agreements between States negotiated by government executives. They are primarily meant to govern the relationship between States, but may have implications for the economic, political, and fundamental rights of citizens. As treaties create binding legal obligations for States enforceable under international law, this article primarily argues that Parliamentary oversight of treaties is necessary for their democratic legitimacy. It analyses the Ratification of Foreign Agreements by Parliament Bill (the 'Bill') which is currently being debated in the Senate of Pakistan. Offering critical overview of the existing treaty making procedures in Pakistan, the article evaluates several aspects of the Bill including its definition of foreign agreements and the proposed treaty ratification procedures in comparison with international law of treaties and relevant laws of the UK, Australia, and Kenya. Based on the comparative examination of the Bill, the article makes proposals for changes in the Bill's substantive provisions and make further suggestions for improvement, such as guiding principles on treaty negotiations and procedure for treaty withdrawals. The article concludes by giving a comprehensive package of practical recommendations for further development of the Bill's provisions on treaty ratification in accordance with international best practices. [ABSTRACT FROM AUTHOR]

Optimal complementary feeding practices including consumption of multiple micronutrient powders (MNP) are recommended to improve micronutrient intake by infants and young children (IYC) 6–23 months. Formative research was used to design the behaviour change strategy to improve IYC micronutrient intake for the multicountry ENRICH project in rural impoverished areas of Tanzania, Kenya, Bangladesh and Pakistan. Employing a qualitative approach with multiple methods and guided by a social ecological framework, the study was conducted in several phases: data collection in the community, household and health facilities, initial analysis and household trials (HHT). Results found limited use of animal source foods (ASF) for feeding IYC and MNP largely unavailable. Although cost constrained access to ASF, potential more affordable context‐specific ASF options were identified in each setting. Caregivers associated ASF with many positive attributes for IYC, but barriers to feeding them included lack of caregiver time and knowledge of specific preparation techniques, and limited advice from health workers. Feeding practices were identified that used time‐efficient, specific preparations for eggs and other ASF, and demonstrated good initial acceptability and feasibility during HHT. Testing MNP in HHT found good initial feasibility and acceptability and provided an understanding of the facilitators and constraints for preparing, feeding and promoting MNP. In conclusion, formative research led to the design of context‐specific ASF and MNP complementary feeding promotion strategies to improve IYC consumption of micronutrients by identifying the practices, benefits, motivations and alternative actions to overcome the barriers in each setting. [ABSTRACT FROM AUTHOR]

Background: Few studies have shown how the move toward institutional delivery in low and middle-income countries (LMIC) impacts stillbirth and newborn mortality. Objectives: The study evaluated trends in institutional delivery in research sites in Belagavi and Nagpur India, Guatemala, Kenya, Pakistan, and Zambia from 2010 to 2018 and compared them to changes in the rates of neonatal mortality and stillbirth. Methods: We analyzed data from a nine-year interval captured in the Global Network (GN) Maternal Newborn Health Registry (MNHR). Mortality rates were estimated from generalized estimating equations controlling for within-cluster correlation. Cluster-level analyses were performed to assess the association between institutional delivery and mortality rates. Results: From 2010 to 2018, a total of 413,377 deliveries in 80 clusters across 6 sites in 5 countries were included in these analyses. An increase in the proportion of institutional deliveries occurred in all sites, with a range in 2018 from 57.7 to 99.8%. In 2010, the stillbirth rates ranged from 19.3 per 1000 births in the Kenyan site to 46.2 per 1000 births in the Pakistani site and by 2018, ranged from 9.7 per 1000 births in the Belagavi, India site to 40.8 per 1000 births in the Pakistani site. The 2010 neonatal mortality rates ranged from 19.0 per 1000 live births in the Kenyan site to 51.3 per 1000 live births in the Pakistani site with the 2018 neonatal mortality rates ranging from 9.2 per 1000 live births in the Zambian site to 50.2 per 1000 live births in the Pakistani site. In multivariate modeling, in some but not all sites, the reductions in stillbirth and neonatal death were significantly associated with an increase in the institutional deliveries. Conclusions: There was an increase in institutional delivery rates in all sites and a reduction in stillbirth and neonatal mortality rates in some of the GN sites over the past decade. The relationship between institutional delivery and a decrease in mortality was significant in some but not all sites. However, the stillbirth and neonatal mortality rates remain at high levels. Understanding the relationship between institutional delivery and stillbirth and neonatal deaths in resource-limited environments will enable development of targeted interventions for reducing the mortality burden. Trial registration: The study is registered at clinicaltrials.gov. ClinicalTrial.gov Trial Registration: NCT01073475. [ABSTRACT FROM AUTHOR]

As the contract cheating market has become more sophisticated and competition has intensified, the contract cheating industry has had to redevelop its approach to gain custom. The industry has developed new models of internal operation and providers are using more sophisticated techniques to reach potential customers. This paper discusses contract cheating industry workflows and introduces terminology to allow complexities of the industry to be more consistently discussed. Examples are provided throughout to indicate the scale and challenge of the contract cheating industry operations. An analysis of contract cheating operations on the micro-outsourcing website Fiverr.com is presented, using comparative data collected in June 2016 and October 2018. The analysis of the data demonstrates how the contract cheating industry is seeing continual change. Specifically, on Fiverr.com, this includes an increase in the number of providers offering essay writing services, particularly those from Kenya and Pakistan. The increase in service availability is accompanied by an associated reduction in essay pricing. The advertised pricing per 1000 words has dropped substantially, from $31.73 USD to $5.73 USD. The accounts used by contract cheating providers are also being replaced at an increased rate. Based on the data, contract cheating providers on Fiverr.com are currently estimated to be taking a minimum of $92,001 USD per year in revenue. This is an example calculated from only one search term on which contract cheating providers advertise on only one micro-outsourcing site used for contract cheating. The actual industry income from micro-outsourcing web sites is likely to be substantially higher. [ABSTRACT FROM AUTHOR]

Violence against women and girls (VAWG) is a global problem with profound consequences. Although there is a growing body of evidence on the effectiveness of VAWG prevention interventions, economic data are scarce. We carried out a cross-country study to examine the costs of VAWG prevention interventions in low- and middle-income countries. We collected primary cost data on six different pilot VAWG prevention interventions in six countries: Ghana, Kenya, Pakistan, Rwanda, South Africa and Zambia. The interventions varied in their delivery platforms, target populations, settings and theories of change. We adopted a micro-costing methodology. We calculated total costs and a number of unit costs common across interventions (e.g. cost per beneficiary reached). We used the pilot-level cost data to model the expected total costs and unit costs of five interventions scaled up to the national level. Total costs of the pilots varied between ∼US $208 000 in a small group intervention in South Africa to US $2 788 000 in a couples and community-based intervention in Rwanda. Staff costs were the largest cost input across all interventions; consequently, total costs were sensitive to staff time use and salaries. The cost per beneficiary reached in the pilots ranged from ∼US $4 in a community-based intervention in Ghana to US $1324 for one-to-one counselling in Zambia. When scaled up to the national level, total costs ranged from US $32 million in Ghana to US $168 million in Pakistan. Cost per beneficiary reached at scale decreased for all interventions compared to the pilots, except for school-based interventions due to differences in student density per school between the pilot and the national average. The costs of delivering VAWG prevention vary greatly due to differences in the geographical reach, number of intervention components and the complexity of adapting the intervention to the country. Cost-effectiveness analyses are necessary to determine the value for money of interventions. [ABSTRACT FROM AUTHOR]

The concept of resilience is increasingly influential in the development of interventions and services for young people, yet there is limited knowledge of how resilience-building strategies are conceptualized by young people across different cultures, particularly in low- and middle-income countries. The aim of this study was to capture 274 young people’s voices in disadvantaged communities in Kenya, Turkey, Pakistan, and Brazil through participatory research methods. Young people defined strategies in response to 4 adversity scenarios reflecting socioecological systems (young person, family, school, and community). Template analysis, underpinned by thematic design, was used to establish three broad themes of intrapersonal (self-management, cognitive re-appraisal, agency), interpersonal (social engagement, informal supports, formal supports), and religious resources. Proposed strategies were largely similar across the sites, with some contextual differences depending on the scenario (stressor) and cultural group. The findings support an ecological systems approach to resilience, which is consistent with the development of multimodal interventions for vulnerable youth and their families in disadvantaged communities in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

As the contract cheating market has become more sophisticated and competition has intensified, the contract cheating industry has had to redevelop its approach to gain custom. The industry has developed new models of internal operation and providers are using more sophisticated techniques to reach potential customers. This paper discusses contract cheating industry workflows and introduces terminology to allow complexities of the industry to be more consistently discussed. Examples are provided throughout to indicate the scale and challenge of the contract cheating industry operations. An analysis of contract cheating operations on the micro-outsourcing website Fiverr.com is presented, using comparative data collected in June 2016 and October 2018. The analysis of the data demonstrates how the contract cheating industry is seeing continual change. Specifically, on Fiverr.com, this includes an increase in the number of providers offering essay writing services, particularly those from Kenya and Pakistan. The increase in service availability is accompanied by an associated reduction in essay pricing. The advertised pricing per 1000 words has dropped substantially, from $31.73 USD to $5.73 USD. The accounts used by contract cheating providers are also being replaced at an increased rate. Based on the data, contract cheating providers on Fiverr.com are currently estimated to be taking a minimum of $92,001 USD per year in revenue. This is an example calculated from only one search term on which contract cheating providers advertise on only one micro-outsourcing site used for contract cheating. The actual industry income from micro-outsourcing web sites is likely to be substantially higher.

Background: There are currently various methods of delivery that can improve adherence on under-five childhood immunization schedule. The methods differ significantly and there is the conventional method of providing a health education module, reminders and recalls to improve adherence and some other non-conventional methods to improve adherence. A systematic review was conducted on the effectiveness of methods of delivery and reminder of health education module to improve adherence on childhood immunization schedule. Materials and Methods: The systematic review performed utilized searched on available electronic databases and bibliographies of studies and also previous reviews. The databases were broad search and began with the use of generic terms to identify search terms that were relevant. The PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) by Moher et al (2009) was used. Databases including PubMed, Science Direct, Medline and CINAHL were utilized for this systematic review. Results: The studies in the review conducted was conducted in various countries with the United States of America (USA) contributing 7 studies, followed by the United Kingdom and Pakistan with 3 studies each and Kenya, Australia, New Zealand and India with 1 study respectively. The lowest number of respondents was 12 while the most was 9213 respondents. All studies were Randomized Control Trial’s (RCT’s) and 1 Quasi Experimental study. Conclusion: The studies showed multiple factor and effective methods of delivery with reminders for health education. Utilizing technology showed to be one of the most effective methods. [ABSTRACT FROM AUTHOR]

This forum seeks to problematise issues related to the lack of resources to adequately finance public education systems. It explores potential solutions based on increased domestic resource mobilisation through progressive taxation in order to meet the growing financing gap needed to achieve Sustainable Development Goal (SDG) 4. While many governments in poor countries are already demonstrating a strong commitment to funding education, the papers will argue that they could raise more money by broadening their tax base--for example, by reducing the prevalence of harmful tax incentives or tackling tax avoidance. Steven Klees's contribution examines the proposals made by the International Commission on Financing Global Education Opportunity as well as the potential for global taxation mechanisms to be used to finance the education and other SDGs. David Archer argues that SDG4 requires a rebuilding of confidence in the capacity of governments to finance good-quality public education through progressive taxation. Finally, Maria Ron Balsera's contribution uses Pakistan, Ghana, Kenya and Uganda as case studies to analyse the effect of the inadequate financing of education and to explore sustainable and equitable solutions.

Background: Antenatal corticosteroids are commonly used to reduce neonatal mortality, but most research to date has been in high-resource settings and few studies have evaluated its impact on stillbirth. In the Antenatal Corticosteroids Trial (ACT), a multi-country trial to assess impact of a multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth, we found an overall increase in 28-day neonatal mortality and stillbirth associated with the intervention. Methods: The ACT was a cluster-randomized trial conducted in 102 clusters across 7 research sites in 6 countries (India [2 sites], Pakistan, Zambia, Kenya, Guatemala and Argentina), comparing an intervention to train birth attendants at all levels of the health system to identify women at risk of preterm birth, administer corticosteroids and refer women at risk. Because of inadequate gestational age dating, the <5th percentile birth weight was used as a proxy for preterm birth. A pre-specified secondary outcome of the trial was stillbirth. Results: After adjusting for the pre-trial imbalance in stillbirth rates, the ACT intervention was associated with a non-significant increased risk of stillbirth (aRR 1.08, 95 % CI, 0.99-1.17, p-0.073). Additionally, the stillbirth rate was higher in the term births (1.20 95 % CI 1.06-1.37, 0.004) and among those with signs of maceration (RR 1.18 (1.04-1.35), p = 0.013) in the intervention vs. control clusters. Differences in obstetric care favored the control clusters and maternal infection was likely more common in the intervention clusters. Conclusions: In this pragmatic trial, limited data were available to identify the causes of the increase in stillbirths in the intervention clusters. A higher rate of stillbirth in the intervention clusters prior to the trial, differences in obstetric care and an increase in maternal infection are potential explanations for the observed increase in stillbirths in the intervention clusters during the trial. Trial registration: clinicaltrials.gov (NCT01084096) [ABSTRACT FROM AUTHOR]

Background: The Antenatal Corticosteroid Trial (ACT) assessed the feasibility, effectiveness, and safety of a multifaceted intervention to increase the use of antenatal corticosteroids (ACS) in mothers at risk of preterm birth at all levels of care in low and middle-income countries. The intervention effectively increased the use of ACS but had no overall impact on neonatal mortality in the targeted <5th percentile birth weight infants. Being in the intervention clusters was also associated with an overall increase in neonatal deaths. We sought to explore plausible pathways through which this intervention increased neonatal mortality. Methods: We conducted secondary analyses to assess site differences in outcome and potential explanations for the differences in outcomes if found. By site, and in the intervention and control clusters, we evaluated characteristics of the mothers and care systems, the proportion of the <5th percentile infants and the overall population that received ACS, the rates of possible severe bacterial infection (pSBI), determined from clinical signs, and neonatal mortality rates. Results: There were substantial differences between the sites in both participant and health system characteristics, with Guatemala and Argentina generally having the highest levels of care. In some sites there were substantial differences in the health system characteristics between the intervention and control clusters. The increase in ACS in the intervention clusters was similar among the sites. While overall, there was no difference in neonatal mortality among <5th percentile births between the intervention and control clusters, Guatemala and Pakistan both had significant reductions in neonatal mortality in the <5th percentile infants in the intervention clusters. The improvement in neonatal mortality in the Guatemalan site in the <5th percentile infants was associated with a higher level of care at the site and an improvement in care in the intervention clusters. There was a significant increase overall in neonatal mortality in the intervention clusters compared to the control. Across sites, this increase in neonatal mortality was statistically significant and most apparent in the African sites. This increase in neonatal mortality was accompanied by a significant increase in pSBI in the African sites. Conclusions: The improvement in neonatal mortality in the Guatemalan site in the <5th percentile infants was associated with a higher level of care and an improvement in care in the intervention clusters. The increase in neonatal mortality in the intervention clusters across all sites was largely driven by the poorer outcomes in the African sites, which also had an increase in pSBI in the intervention clusters. We emphasize that these results come from secondary analyses. Additional prospective studies are needed to assess the effectiveness and safety of ACS on neonatal health in low resource settings. Trial registration: Trial registration: clinicaltrials.gov (NCT01084096) [ABSTRACT FROM AUTHOR]

Background: Possible severe bacterial infections (pSBI) continue to be a leading cause of global neonatal mortality annually. With the recent publications of simplified antibiotic regimens for treatment of pSBI where referral is not possible, it is important to know how and where to target these regimens, but data on the incidence and outcomes of pSBI are limited. Methods: We used data prospectively collected at 7 rural community-based sites in 6 low and middle income countries participating in the NICHD Global Network's Maternal and Newborn Health Registry, between January 1, 2010 and December 31, 2013. Participants included pregnant women and their live born neonates followed for 6 weeks after delivery and assessed for maternal and infant outcomes. Results: In a cohort of 248,539 infants born alive between 2010 and 2013, 32,088 (13 %) neonates met symptomatic criteria for pSBI. The incidence of pSBI during the first 6 weeks of life varied 10 fold from 3 % (Zambia) to 36 % (Pakistan), and overall case fatality rates varied 8 fold from 5 % (Kenya) to 42 % (Zambia). Significant variations in incidence of pSBI during the study period, with proportions decreasing in 3 sites (Argentina, Kenya and Nagpur, India), remaining stable in 3 sites (Zambia, Guatemala, Belgaum, India) and increasing in 1 site (Pakistan), cannot be explained solely by changing rates of facility deliveries. Case fatality rates did not vary over time. Conclusions: In a prospective population based registry with trained data collectors, there were wide variations in the incidence and case fatality of pSBI in rural communities and in trends over time. Regardless of these variations, the burden of pSBI is still high and strategies to implement timely diagnosis and treatment are still urgently needed to reduce neonatal mortality. Trial registration: The study was registered at ClinicalTrials.gov (NCT01073475). [ABSTRACT FROM AUTHOR]

Background: The Antenatal Corticosteroid Trial assessed the feasibility, effectiveness, and safety of a multifaceted intervention to increase the use of antenatal corticosteroids (ACS) in mothers at risk of preterm birth at all levels of care in low and middle-income countries. The intervention effectively increased the use of ACS but was associated with an overall increase in neonatal deaths. We aimed to explore plausible pathways through which this intervention increased neonatal mortality. Methods: We conducted a series of secondary analyses to assess whether ACS or other components of the multifaceted intervention that might have affected the quality of care contributed to the increased mortality observed: 1) we compared the proportion of neonatal deaths receiving ACS between the intervention and control groups; 2) we compared the antenatal and delivery care process in all births between groups; 3) we compared the rates of possible severe bacterial infection between groups; and 4) we compared the frequency of factors related to ACS administration or maternal high risk conditions at administration between the babies who died and those who survived 28 days among all births in the intervention group identified as high risk for preterm birth and received ACS. Results: The ACS exposure among the infants who died up to 28 days was 29 % in the intervention group compared to 6 % in controls. No substantial differences were observed in antenatal and delivery care process between groups. The risk of pSBI plus neonatal death was significantly increased in intervention clusters compared to controls (2.4 % vs. 2.0 %, adjusted RR 1.17, 95 % CI 1.04-1.30, p = 0.008], primarily for infants with birth weight at or above the 25th percentile. Regarding factors related to ACS administration, term infants who died were more likely to have mothers who received ACS within 7 days of delivery compared to those who survived 28 days (26.5 % vs 17.9 %, p = 0.014), and their mothers were more likely to have been identified as high risk for hypertension and less likely for signs of preterm labor. Conclusions: These results suggest that ACS more than other components of the intervention may have contributed to the overall increased neonatal mortality. ACS may have also been involved in the observed increased risk of neonatal infection and death. Further trials are urgently needed to clarify the effectiveness and safety of ACS on neonatal health in low resource settings. [ABSTRACT FROM AUTHOR]

Objective To determine population-based neonatal mortality rates in low- and middle income countries and to examine gestational age, birth weight, and timing of death to assess the potentially preventable neonatal deaths.Methods A prospective observational study was conducted in communities in five low-income countries (Kenya, Zambia, Guatemala, India, and Pakistan) and one middle-income country (Argentina). Over a 2-year period, all pregnant women in the study communities were enrolled by trained study staff and their infants followed to 28 days of age.Results Between October 2009 and March 2011, 153,728 babies were delivered and followed through day 28. Neonatal death rates ranged from 41 per 1000 births in Pakistan to 8 per 1000 in Argentina; 54% of the neonatal deaths were >37 weeks and 46% weighed 2500 g or more. Half the deaths occurred within 24 hours of delivery.Conclusion In our population-based low- and middle-income country registries, the majority of neonatal deaths occurred in babies >37 weeks' gestation and almost half weighed at least 2500 g. Most deaths occurred shortly after birth.With access to better medical care and hospitalization, especially in the intrapartum and early neonatal period, many of these neonatal deaths might be prevented. [ABSTRACT FROM AUTHOR]

After a decade-long hunt, Osama bin Laden was killed by US special forces in Pakistan, which knew nothing of the raid and denied knowledge of his whereabouts. The Sri Lankan government was accused of violating human rights by a UN panel investigating the civil war. In Nigeria, the incumbent, Goodluck Jonathan, a southern Christian, beat his northern rival, Muhammadu Buhari, in the presidential election. After worldwide protests, Ugandan MPs suspended a bill introducing the death penalty for homosexuals. Top Kenyan politicians were arraigned for trial at the International Criminal Court. Swaziland stepped up its crackdown on civil rights activists. Canada's political landscape was transformed by the federal elections. Samoa leapt into the future. [ABSTRACT FROM AUTHOR]

Pakistan was hit by the worst natural disaster in its history-five million people lost their homes in the floods. Paul Kagame was re-elected with 93% of the vote in Rwanda's presidential election but there were concerns about his increasingly authoritarian government. Australia's close elections led to Julia Gillard remaining prime minister at the head of a minority government. Kenyans celebrated the introduction of their new constitution. New Zealand was rocked by an earthquake. [ABSTRACT FROM AUTHOR]

Pakistan's President Pervez Musharraf resigned as impeachment proceedings were due to begin. Talks on a power-sharing deal in Zimbabwe became bogged down amid the further disintegration of the economy. Bangladesh held its first elections since the army seized power last year. The Indian government survived a critical vote of confidence over a controversial nuclear deal with the US. Levy Mwanawasa, the Zambian president, died. Kenya's finance minister, a key ally of the president, resigned over the allegedly dubious sale of a state-owned hotel to Libya. The Nigerian president sacked military chiefs in a further distancing of the government from the previous regime. Rare public opposition to the absolute rule of the Swazi king erupted over a shopping trip to Europe and the Middle East by his wives. [ABSTRACT FROM AUTHOR]

The tsunami hits eight Commonwealth countries from Malaysia to Kenya—Sri Lanka worst of all. Huge stretches of its eastern and southern coasts are laid waste. Severely damaged Maldives manages to hold an election only a month late. The Commonwealth Ministerial Action Group keeps Pakistan on its agenda and Africans remain unhappy about its lifted suspension. Bush visits Canada, but Prime Minister Martin refuses to join his ballistic missile system. The UK pushes Kenya even harder to clean up corruption. Chissano steps down and Mozambique has a new president. Mugabe chooses a woman vice-president for Zimbabwe after upheaval within Zanu-PF. Spain and Britain give Gibraltar a seat at the negotiating table. And the first underground trains begin to run in New Delhi. [ABSTRACT FROM AUTHOR]

Background: Quality assurance (QA) is a process that should be an integral part of research to protect the rights and safety of study participants and to reduce the likelihood that the results are affected by bias in data collection. Most QA plans include processes related to study preparation and regulatory compliance, data collection, data analysis and publication of study results. However, little detailed information is available on the specific procedures associated with QA processes to ensure high-quality data in multi-site studies. Methods: The Global Network for Women's and Children's Health Maternal Newborn Health Registy (MNHR) is a prospective population-based registry of pregnancies and deliveries that is carried out in 8 international sites. Since its inception, QA procedures have been utilized to ensure the quality of the data. More recently, a training and certification process was developed to ensure that standardized, scientifically accurate clinical definitions are used consistently across sites. Staff complete a web-based training module that reviews the MNHR study protocol, study forms and clinical definitions developed by MNHR investigators and are certified through a multiple choice examination prior to initiating study activities and every six months thereafter. A standardized procedure for supervision and evaluation of field staff is carried out to ensure that research activites are conducted according to the protocol across all the MNHR sites. Conclusions: We developed standardized QA processes for training, certification and supervision of the MNHR, a multisite research registry. It is expected that these activities, together with ongoing QA processes, will help to further optimize data quality for this protocol. [ABSTRACT FROM AUTHOR]

Background: Due to high fertility rates in some low and lower-middle income countries, the interval between pregnancies can be short, which may lead to adverse maternal and neonatal outcomes. Methods: We analyzed data from women enrolled in the NICHD Global Network Maternal Newborn Health Registry (MNHR) from 2013 through 2018. We report maternal characteristics and outcomes in relationship to the inter-delivery interval (IDI, time from previous delivery [live or stillborn] to the delivery of the index birth), by category of 6–17 months (short), 18–36 months (reference), 37–60 months, and 61–180 months (long). We used non-parametric tests for maternal characteristics, and multivariable logistic regression models for outcomes, controlling for differences in baseline characteristics. Results: We evaluated 181,782 women from sites in the Democratic Republic of Congo, Zambia, Kenya, Guatemala, India, and Pakistan. Women with short IDI varied by site, from 3% in the Zambia site to 20% in the Pakistan site. Relative to a 18–36 month IDI, women with short IDI had increased risk of neonatal death (RR = 1.89 [1.74, 2.05]), stillbirth (RR = 1.70 [1.56, 1.86]), low birth weight (RR = 1.38 [1.32, 1.44]), and very low birth weight (RR = 2.35 [2.10, 2.62]). Relative to a 18–36 month IDI, women with IDI of 37–60 months had an increased risk of maternal death (RR 1.40 [1.05, 1.88]), stillbirth (RR 1.14 [1.08, 1.22]), and very low birth weight (RR 1.10 [1.01, 1.21]). Relative to a 18–36 month IDI, women with long IDI had increased risk of maternal death (RR 1.54 [1.10, 2.16]), neonatal death (RR = 1.25 [1.14, 1.38]), stillbirth (RR = 1.50 [1.38, 1.62]), low birth weight (RR = 1.22 [1.17, 1.27]), and very low birth weight (RR = 1.47 [1.32,1.64]). Short and long IDIs were also associated with increased risk of obstructed labor, hemorrhage, hypertensive disorders, fetal malposition, infection, hospitalization, preterm delivery, and neonatal hospitalization. Conclusions: IDI varies by site. When compared to 18–36 month IDI, women with both short IDI and long IDI had increased risk of adverse maternal and neonatal outcomes. Trial registration: The MNHR is registered at NCT01073475. [ABSTRACT FROM AUTHOR]

Background: Understanding injury patterns specific for paediatric casualties of armed conflict is essential to facilitate preparations by organizations that provide medical care in conflict areas. The aim of this retrospective cohort study is to identify injury patterns and treatment requirements that are specific for paediatric patients in conflict zones. Methods: Characteristics of children (age < 15 years) treated in medical facilities supported by the International Committee of the Red Cross (ICRC) between 1988 and 2014 in Kabul, Kao-i-Dang, Lokichogio, Kandahar, Peshawar, Quetta and Goma were analysed; patient characteristics were compared between treatment facilities and with those of adult patients (age ≥ 15 years). Results: Of the patients listed in the database, 15% (5843/38,088) were aged < 15 years. The median age was 10 years (IQR 6–12); 75% (4406/5843) were male. Eighty-six percent (5012/5,843) of the admitted children underwent surgery, with a median of 2 surgeries per patient (IQR 1–3). When compared with adult patients, children were more frequently seen with fragment injuries, burns and mine injuries; they had injuries to multiple body regions more often and had higher in-hospital mortality rates. Conclusions: Children more often sustained injuries to multiple body regions and had higher in-hospital mortality than adults. These findings could have implications for how the ICRC and other organizations prepare personnel and structure logistics to meet the treatment needs of paediatric victims of armed conflicts. [ABSTRACT FROM AUTHOR]

Background: Health service and health outcome data collection across many low- and middle-income countries (LMICs) is, to date largely paper-based. With the development and increased availability of reliable technology, electronic tablets could be used for electronic data collection in such settings. This paper describes our experiences with implementing electronic data collection methods, using electronic tablets, across different settings in four LMICs., Methods: Within our research centre, the use of electronic data collection using electronic tablets was piloted during a healthcare facility assessment study in Ghana. After further development, we then used electronic data collection in a multi-country, cross-sectional study to measure ill-health in women during and after pregnancy, in India, Kenya and Pakistan. All data was transferred electronically to a central research team in the UK where it was processed, cleaned, analysed and stored., Results: The healthcare facility assessment study in Ghana demonstrated the feasibility and acceptability to healthcare providers of using electronic tablets to collect data from seven healthcare facilities. In the maternal morbidity study, electronic data collection proved to be an effective way for healthcare providers to document over 400 maternal health variables, in 8530 women during and after pregnancy in India, Kenya and Pakistan., Conclusions: Electronic data collection provides an effective platform which can be used successfully to collect data from healthcare facility registers and from patients during health consultations; and to transfer large quantities of data. To ensure successful electronic data collection and transfer between settings, we recommend that close attention is paid to study design, data collection, tool design, local internet access and device security.