Perspectives is a series of books that will provide the most comprehensive and current sources of... more Perspectives is a series of books that will provide the most comprehensive and current sources of information on a wide range of topics related to global maternal and child health, written by a collection of international experts.The health of pregnant women and their children are among the most significant public health, medical, and humanitarian problems in the world today. Because in developing countries many people are poor, and young women are the poorest of the poor, persistent poverty exacerbates maternal and child morbidity and mortality and gender-based challenges to such basic human rights as education and access to health care and reproductive choices. Women and their children remain the most vulnerable members of our society and, as a result, are the most impacted individuals by many of the threats that are prevalent, and, in some cases, increasing throughout the world. These include emerging and re-emerging infectious diseases, natural and man-made disasters, armed conflict, religious and political turmoil, relocation as refugees, malnutrition, and, in some cases, starvation. The status of indigenous women and children is especially precarious in many regions because of ethnic, cultural, and language differences, resulting in stigmatization, poor obstetrical and neonatal outcomes, limitations of women's reproductive rights, and lack of access to family planning and education that restrict choices regarding their own futures. Because of the inaccessibility of women to contraception and elective pregnancy termination, unsafe abortion continues to result in maternal deaths, morbidity, and reproductive complications. Unfortunately, maternal deaths remain at unacceptably high levels in the majority of developing countries, as well as in some developed ones. Stillbirths and premature deliveries result in millions of deaths annually. Gender inequality persists globally as evidenced by the occurrence of female genital mutilation, obstetrical violence, human trafficking, and other forms of sexual discrimination directed at women. Many children are routinely exposed to physical, sexual, and psychological violence. Childhood and teen marriages remain at undesirably high levels in many developing countries. Global Maternal and Child Health: Medical, Anthropological, and Public Health Perspectives is unique in combining the opinions and expertise of public health specialists, physicians, anthropologists and social scientists, epidemiologists, nurses, midwives, and representatives of governmental and non governmental agencies to comprehensively explore the increasing challenges and potential solutions to global maternal and child health issues.
Background Despite tremendous progress on Ebola Virus Disease (EVD), challenges remain in the imp... more Background Despite tremendous progress on Ebola Virus Disease (EVD), challenges remain in the implementation of holistic strategies to quickly stop outbreaks. We investigated the effectiveness of a community-based con nement strategy to limit the spread of EVD during the tenth documented EVD outbreak in the Democratic Republic of the Congo (DRC), 2018-2020. Methods We did a community-based, open-label, two-group, unrandomized controlled intervention. Eligible participants were EVD contacts registered by epidemiological surveillance teams from November 2019 to May 2020 in the two last hotspots (Beni and Mabalako Health Zones). Intervention group participants were con ned in speci c community sites of their preference for the duration of their follow-up. Control group participants underwent CT without con nement and were allowed to continue their daily activities. The primary outcome was the number of con rmed secondary cases in the two groups. Secondary outcomes included delay between symptom onset and isolation, case fatality rate, survival rate, and vaccination rate. Data were analyzed using various quantitative methods. Findings A total of 27,324 EVD contacts were included in the study. 585 contacts were con ned and followed up ('the intervention group'), and 26,739 were followed up without con nement. The intervention group generated 32 con rmed cases (5.5%) in the rst generation, while the control group generated just 87 (0.3%). However, the 32 con rmed cases from the intervention contacts did not generate any onward transmission (R=0.00), whereas the 87 con rmed cases from the non-intervention group generated 99 secondary cases (R = 1.14). Results for the secondary outcomes showed signi cant difference between the two groups. The delay between symptom onset and case isolation was shorter (1.3 vs 4.8 days; p<0.0000), CFR lower (12.5% vs. 52.9%; p=0.0001), and vaccination rate higher (86.0% vs 56.8%; p<0.0000) in the intervention group compared to the control group. A signi cant difference was also found between intervention and control groups in survival rate at the 16-day follow-up (87.9% vs. 47.7%, respectively; p=0.0004). Interpretation The community-based con nement strategy used in DRC is effective for the rapid cessation of EVD transmission, highlighting the importance of rapidly implemented, innovative and community-oriented control strategies. Research In Context Evidence before this study The identi cation and management of contacts of cases is centrally important to the interruption of epidemics of Ebola virus disease (EVD). Implications of all the available evidence Applied in various infectious disease contexts, a community-based con nement strategy can save lives of con ned contacts that develop infection, and also prevent onward transmission to others. Further, especially if implemented early in an outbreak response, this strategy may slow transmission, thereby providing time for other important interventions to be organized and implemented (e.g., timely vaccination and treatment). These ndings demonstrate the importance of a community-based approach in implementing con nement and have relevance for policy choices regarding whether to con ne contacts or entire populations, which is particularly pertinent in resource-limited settings.
This paper reports on the success of a communication programme among 26 rebellious villages in Fo... more This paper reports on the success of a communication programme among 26 rebellious villages in Forest Guinea during fieldwork in June-July 2014. This was based on listening to complaints and taking into account the customs and culture of those concerned. The main methodologies were socio-anthropological enquiry and action research, based on bibliographic research, observations, formal and informal interviews with resource persons and political leaders from Forest Guinea; women , young and very old people of both sexes, street vendors, restaurateurs, local personal response.
... Dans beaucoup de sociétés tradi-tionnelles africaines, ces rôles sont flexibles ; ils peuvent... more ... Dans beaucoup de sociétés tradi-tionnelles africaines, ces rôles sont flexibles ; ils peuvent même quelque-fois changer. 2 : Lourdes Beneria, 1987:46, citée par Maria Teresa Caramés Garcia, 2004: 47 « Processus de socialisa-tion en sciences de la santé ». - 11 - Page 12. ...
Rapport de mission conjoint de Julienne Anoko et Alain Epelboin en Guinee lors de l'epidemie ... more Rapport de mission conjoint de Julienne Anoko et Alain Epelboin en Guinee lors de l'epidemie de maladie a virus Ebola
The emerging field of outbreak analytics calls attention to the need for data from multiple sourc... more The emerging field of outbreak analytics calls attention to the need for data from multiple sources to inform evidence-based decision making in managing infectious diseases outbreaks. To date, these approaches have not systematically integrated evidence from social and behavioural sciences. During the 2018–2020 Ebola outbreak in Eastern Democratic Republic of the Congo, an innovative solution to systematic and timely generation of integrated and actionable social science evidence emerged in the form of the Cellulle d’Analyse en Sciences Sociales (Social Sciences Analytics Cell) (CASS), a social science analytical cell. CASS worked closely with data scientists and epidemiologists operating under the Epidemiological Cell to produce integrated outbreak analytics (IOA), where quantitative epidemiological analyses were complemented by behavioural field studies and social science analyses to help better explain and understand drivers and barriers to outbreak dynamics. The primary activity...
Background An infodemic is an overflow of information of varying quality that surges across digit... more Background An infodemic is an overflow of information of varying quality that surges across digital and physical environments during an acute public health event. It leads to confusion, risk-taking, and behaviors that can harm health and lead to erosion of trust in health authorities and public health responses. Owing to the global scale and high stakes of the health emergency, responding to the infodemic related to the pandemic is particularly urgent. Building on diverse research disciplines and expanding the discipline of infodemiology, more evidence-based interventions are needed to design infodemic management interventions and tools and implement them by health emergency responders. Objective The World Health Organization organized the first global infodemiology conference, entirely online, during June and July 2020, with a follow-up process from August to October 2020, to review current multidisciplinary evidence, interventions, and practices that can be applied to the COVID-19...
On May 8, 2018, the Government of the Democratic Republic of the Congo reported an outbreak of Eb... more On May 8, 2018, the Government of the Democratic Republic of the Congo reported an outbreak of Ebola virus disease in Équateur Province in the northwest of the country. The remoteness of most affected communities and the involvement of an urban centre connected to the capital city and neighbouring countries makes this outbreak the most complex and high risk ever experienced by the Democratic Republic of the Congo. We provide early epidemiological information arising from the ongoing investigation of this outbreak. We classified cases as suspected, probable, or confirmed using national case definitions of the Democratic Republic of the Congo Ministère de la Santé Publique. We investigated all cases to obtain demographic characteristics, determine possible exposures, describe signs and symptoms, and identify contacts to be followed up for 21 days. We also estimated the reproduction number and projected number of cases for the 4-week period from May 25, to June 21, 2018. As of May 30, ...
Sante publique (Vandoeuvre-les-Nancy, France), Jan 2, 2017
Anthropologists contributed to the response to the 2014-2016 Ebola outbreak in three ways : as Eb... more Anthropologists contributed to the response to the 2014-2016 Ebola outbreak in three ways : as Ebola experts, cultural mediators between populations and caregivers, and researchers. This article presents a preliminary review of approaches, contributions and related issues based on a literature review, case studies and debates. The anthropological research discussed in this article concerns four themes : epidemiological contexts of transmission ; cultural interpretation of illness and social responses ; social construction of stakeholders' experience ; critical analysis of public health interventions. In addition to insightful contributions, particularly regarding the socio-political contexts and their interfaces with global public health measures, anthropologists tested forms of communication to facilitate access of public health actors to their results. However, these heterogeneous forms of engagement raise a number of questions, especially when they reflect anthropological int...
Perspectives is a series of books that will provide the most comprehensive and current sources of... more Perspectives is a series of books that will provide the most comprehensive and current sources of information on a wide range of topics related to global maternal and child health, written by a collection of international experts.The health of pregnant women and their children are among the most significant public health, medical, and humanitarian problems in the world today. Because in developing countries many people are poor, and young women are the poorest of the poor, persistent poverty exacerbates maternal and child morbidity and mortality and gender-based challenges to such basic human rights as education and access to health care and reproductive choices. Women and their children remain the most vulnerable members of our society and, as a result, are the most impacted individuals by many of the threats that are prevalent, and, in some cases, increasing throughout the world. These include emerging and re-emerging infectious diseases, natural and man-made disasters, armed conflict, religious and political turmoil, relocation as refugees, malnutrition, and, in some cases, starvation. The status of indigenous women and children is especially precarious in many regions because of ethnic, cultural, and language differences, resulting in stigmatization, poor obstetrical and neonatal outcomes, limitations of women's reproductive rights, and lack of access to family planning and education that restrict choices regarding their own futures. Because of the inaccessibility of women to contraception and elective pregnancy termination, unsafe abortion continues to result in maternal deaths, morbidity, and reproductive complications. Unfortunately, maternal deaths remain at unacceptably high levels in the majority of developing countries, as well as in some developed ones. Stillbirths and premature deliveries result in millions of deaths annually. Gender inequality persists globally as evidenced by the occurrence of female genital mutilation, obstetrical violence, human trafficking, and other forms of sexual discrimination directed at women. Many children are routinely exposed to physical, sexual, and psychological violence. Childhood and teen marriages remain at undesirably high levels in many developing countries. Global Maternal and Child Health: Medical, Anthropological, and Public Health Perspectives is unique in combining the opinions and expertise of public health specialists, physicians, anthropologists and social scientists, epidemiologists, nurses, midwives, and representatives of governmental and non governmental agencies to comprehensively explore the increasing challenges and potential solutions to global maternal and child health issues.
Background Despite tremendous progress on Ebola Virus Disease (EVD), challenges remain in the imp... more Background Despite tremendous progress on Ebola Virus Disease (EVD), challenges remain in the implementation of holistic strategies to quickly stop outbreaks. We investigated the effectiveness of a community-based con nement strategy to limit the spread of EVD during the tenth documented EVD outbreak in the Democratic Republic of the Congo (DRC), 2018-2020. Methods We did a community-based, open-label, two-group, unrandomized controlled intervention. Eligible participants were EVD contacts registered by epidemiological surveillance teams from November 2019 to May 2020 in the two last hotspots (Beni and Mabalako Health Zones). Intervention group participants were con ned in speci c community sites of their preference for the duration of their follow-up. Control group participants underwent CT without con nement and were allowed to continue their daily activities. The primary outcome was the number of con rmed secondary cases in the two groups. Secondary outcomes included delay between symptom onset and isolation, case fatality rate, survival rate, and vaccination rate. Data were analyzed using various quantitative methods. Findings A total of 27,324 EVD contacts were included in the study. 585 contacts were con ned and followed up ('the intervention group'), and 26,739 were followed up without con nement. The intervention group generated 32 con rmed cases (5.5%) in the rst generation, while the control group generated just 87 (0.3%). However, the 32 con rmed cases from the intervention contacts did not generate any onward transmission (R=0.00), whereas the 87 con rmed cases from the non-intervention group generated 99 secondary cases (R = 1.14). Results for the secondary outcomes showed signi cant difference between the two groups. The delay between symptom onset and case isolation was shorter (1.3 vs 4.8 days; p<0.0000), CFR lower (12.5% vs. 52.9%; p=0.0001), and vaccination rate higher (86.0% vs 56.8%; p<0.0000) in the intervention group compared to the control group. A signi cant difference was also found between intervention and control groups in survival rate at the 16-day follow-up (87.9% vs. 47.7%, respectively; p=0.0004). Interpretation The community-based con nement strategy used in DRC is effective for the rapid cessation of EVD transmission, highlighting the importance of rapidly implemented, innovative and community-oriented control strategies. Research In Context Evidence before this study The identi cation and management of contacts of cases is centrally important to the interruption of epidemics of Ebola virus disease (EVD). Implications of all the available evidence Applied in various infectious disease contexts, a community-based con nement strategy can save lives of con ned contacts that develop infection, and also prevent onward transmission to others. Further, especially if implemented early in an outbreak response, this strategy may slow transmission, thereby providing time for other important interventions to be organized and implemented (e.g., timely vaccination and treatment). These ndings demonstrate the importance of a community-based approach in implementing con nement and have relevance for policy choices regarding whether to con ne contacts or entire populations, which is particularly pertinent in resource-limited settings.
This paper reports on the success of a communication programme among 26 rebellious villages in Fo... more This paper reports on the success of a communication programme among 26 rebellious villages in Forest Guinea during fieldwork in June-July 2014. This was based on listening to complaints and taking into account the customs and culture of those concerned. The main methodologies were socio-anthropological enquiry and action research, based on bibliographic research, observations, formal and informal interviews with resource persons and political leaders from Forest Guinea; women , young and very old people of both sexes, street vendors, restaurateurs, local personal response.
... Dans beaucoup de sociétés tradi-tionnelles africaines, ces rôles sont flexibles ; ils peuvent... more ... Dans beaucoup de sociétés tradi-tionnelles africaines, ces rôles sont flexibles ; ils peuvent même quelque-fois changer. 2 : Lourdes Beneria, 1987:46, citée par Maria Teresa Caramés Garcia, 2004: 47 « Processus de socialisa-tion en sciences de la santé ». - 11 - Page 12. ...
Rapport de mission conjoint de Julienne Anoko et Alain Epelboin en Guinee lors de l'epidemie ... more Rapport de mission conjoint de Julienne Anoko et Alain Epelboin en Guinee lors de l'epidemie de maladie a virus Ebola
The emerging field of outbreak analytics calls attention to the need for data from multiple sourc... more The emerging field of outbreak analytics calls attention to the need for data from multiple sources to inform evidence-based decision making in managing infectious diseases outbreaks. To date, these approaches have not systematically integrated evidence from social and behavioural sciences. During the 2018–2020 Ebola outbreak in Eastern Democratic Republic of the Congo, an innovative solution to systematic and timely generation of integrated and actionable social science evidence emerged in the form of the Cellulle d’Analyse en Sciences Sociales (Social Sciences Analytics Cell) (CASS), a social science analytical cell. CASS worked closely with data scientists and epidemiologists operating under the Epidemiological Cell to produce integrated outbreak analytics (IOA), where quantitative epidemiological analyses were complemented by behavioural field studies and social science analyses to help better explain and understand drivers and barriers to outbreak dynamics. The primary activity...
Background An infodemic is an overflow of information of varying quality that surges across digit... more Background An infodemic is an overflow of information of varying quality that surges across digital and physical environments during an acute public health event. It leads to confusion, risk-taking, and behaviors that can harm health and lead to erosion of trust in health authorities and public health responses. Owing to the global scale and high stakes of the health emergency, responding to the infodemic related to the pandemic is particularly urgent. Building on diverse research disciplines and expanding the discipline of infodemiology, more evidence-based interventions are needed to design infodemic management interventions and tools and implement them by health emergency responders. Objective The World Health Organization organized the first global infodemiology conference, entirely online, during June and July 2020, with a follow-up process from August to October 2020, to review current multidisciplinary evidence, interventions, and practices that can be applied to the COVID-19...
On May 8, 2018, the Government of the Democratic Republic of the Congo reported an outbreak of Eb... more On May 8, 2018, the Government of the Democratic Republic of the Congo reported an outbreak of Ebola virus disease in Équateur Province in the northwest of the country. The remoteness of most affected communities and the involvement of an urban centre connected to the capital city and neighbouring countries makes this outbreak the most complex and high risk ever experienced by the Democratic Republic of the Congo. We provide early epidemiological information arising from the ongoing investigation of this outbreak. We classified cases as suspected, probable, or confirmed using national case definitions of the Democratic Republic of the Congo Ministère de la Santé Publique. We investigated all cases to obtain demographic characteristics, determine possible exposures, describe signs and symptoms, and identify contacts to be followed up for 21 days. We also estimated the reproduction number and projected number of cases for the 4-week period from May 25, to June 21, 2018. As of May 30, ...
Sante publique (Vandoeuvre-les-Nancy, France), Jan 2, 2017
Anthropologists contributed to the response to the 2014-2016 Ebola outbreak in three ways : as Eb... more Anthropologists contributed to the response to the 2014-2016 Ebola outbreak in three ways : as Ebola experts, cultural mediators between populations and caregivers, and researchers. This article presents a preliminary review of approaches, contributions and related issues based on a literature review, case studies and debates. The anthropological research discussed in this article concerns four themes : epidemiological contexts of transmission ; cultural interpretation of illness and social responses ; social construction of stakeholders' experience ; critical analysis of public health interventions. In addition to insightful contributions, particularly regarding the socio-political contexts and their interfaces with global public health measures, anthropologists tested forms of communication to facilitate access of public health actors to their results. However, these heterogeneous forms of engagement raise a number of questions, especially when they reflect anthropological int...
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