The Tour de Kruger: a wild ride

first_imgThe Tour de Kruger takes bikers on a70-kilometre ride every day for five days,through pristine African bushveld. A close encounter with elephants.(Image: Children in the Wilderness)Fiona McIntosh“You’re going to cycle for five days through wild game reserves?” exclaimed my friends when I told them of the bush adventure that I’d just discovered. “Are you crazy? What about the elephants? And the lions? You’ve clearly got a death wish.”But I could think of nothing more exciting than getting up close and personal with the big herds of elephant, buck and other game of the southern African bush. As for seeing lion … we’d be lucky.I’d signed up for the annual mountain-bike tour that supports the Children in the Wilderness programme. Our route would take us from northern Tuli Game Reserve in Botswana, through the World Heritage Site of Mapungubwe, finishing up in the Pafuri concession of the Kruger National Park.It was a once-in-a-lifetime opportunity – where else in the world can you ride for five days through wilderness, knowing that at any moment you might encounter one of the big five? This was to be a real immersion in Africa yet, outside South Africa, the tour seemed to be a well-kept secret. I suspected a conspiracy – the locals didn’t want foreigners snapping up the limited places!Previous tours had been held in the Great Limpopo Transfrontier Park, through western Mozambique and the Pafuri concession of northern Kruger, but this route from the Tuli block approached Pafuri from the west, so was entirely new ground even for tour veterans.Most riders took advantage of the transfers laid on from Johannesburg, hopping on their bikes at the reserve gate to stretch their legs on the final few kilometres to camp. We spent our first night under canvas next to the airstrip and were treated to the impressive sight of a classic aircraft, a shiny DC-3, swooping in to collect some of the reserve’s guests. Our kit bags, numbers and detailed race manifest were waiting on arrival and, once we’d labelled and parked our bikes, we were guided to our tents, all neatly numbered into respective groups.Then it was time for the pre-race briefing. We were out to have fun, but there were ground rules designed to ensure our safety. I’ll admit to being a bit nervous as we rode to camp, but now my fears about riding through elephant country the next day were allayed.Each group of 15 or so riders would stick together as a tight unit behind an experienced, rifle-toting front guide. The back guide was also trained in the ways of the bush and was in constant radio contact with the front guide, the other groups and HQ. They carried satellite phones just in case there was no radio contact. I slept well that night. This was one well-organised operation.Close encountersThe importance of the tight drill was soon evident. After a long, 70-kilometre day in the saddle we were less than five kilometres from the South African border and our camp. The thought of a cold beer was putting new life into my weary legs. Suddenly our lead guide stopped in his tracks.“Over there,” he whispered. Just about to cross the track we were following was a big breeding herd of elephant – females with tiny calves that looked as if they were going to be stomped upon any minute. It was not a happy group. They’d clearly sensed our presence, and were becoming increasingly anxious.“There’s another group in the trees to our right,” whispered the guide. “We’ll back off.” Suddenly loud trumpeting and the crashing of branches broke the silence of the bush and we mounted our bikes and fled back to the nearest group of big trees. So close, and yet so far: the herd was between us and camp, so we retraced our route until we found a safe place to cross the sandy riverbed.Some of the guides from an earlier group were sitting out in a hide on the South African bank as we took off our shoes and carried our bikes across the narrow channel of the Limpopo.“Was that you the elephant were revving?” they laughed. “We heard all the commotion then saw a load of riders retreating at speed.” I’d been praying for some intimate bush encounters, but that was a trifle too exciting for my liking.Mountain-bike countryThat was our third encounter with elephant that day. We’d also been treated to sightings of giraffe, impala, scuttling warthog and a ridiculously raucous display of snorting and histrionics from the clowns of the bush, a big herd of galloping wildebeest, as we followed the game trails through the mopane forest.It’s classic mountain-bike country, with wide open spaces and a seemingly endless network of single track – the work of elephant matriarchs carving out paths for their young to follow down to the water sources.The paths weaved through dense sections of bush, forcing us to bunny-hop over fallen branches and dodge thorn trees. There were a few technical sections – the odd rocky downhill, stretch of sand or loose gravel climb, but on the whole it was easy flowing riding past towering baobabs and over dry, stony riverbeds.This part of southern Africa is not only famous for its elephant, but is rich in history and home to important paleontological remains such as the dinosaur footprints of Vhembe in South Africa and the dinosaur skeletons of Sentinel in Zimbabwe. Our second night was spent at Mapungubwe – a place as seeped in history as it is prolific in game.The camp was in an incredible spot high up on an escarpment, and the dramatic rock formations of the park glowed in the late sun as we walked to the viewpoint where a bar had been set up.We toasted surviving the first day and our unscheduled detour from the route. It was an atmospheric place. Below us was the confluence of the Limpopo and Shashe rivers and the point where Zimbabwe, Botswana and South Africa meet. Now that the day visitors had left we had the park to ourselves, and I began to appreciate the privilege of being part of the tour.Bush cuisineAlthough you ride hard by day, Tour de Kruger is a charity ride to raise funds for Children in the Wilderness, not a race. Groups are arranged according to rider ability and fitness with the speed freaks and the odd professional cyclist breaking the trail and social riders like myself bring up the rear. The emphasis is on enjoying the bush, game sightings and the bush cuisine – a legendary feature of the tour.You can easily gain weight over the five days despite cycling around 75 kilometres a day in the hot sun. After the first 25 to 35 kilometres of each day there’s a morning tea stop where encouraging Wilderness Safaris staff hand out copious quantities of fruitcake, muffins, hot-cross buns, biltong and sweets, as well as wetwipes, sunscreen, lube and tender loving care.Lunch is a proper cooked meal, and then there’s another tea stop before you reach camp, where, if you’re still hungry, another cooked lunch awaits. And the spoiling continues once you’ve finished for the day, with abundant quantities of energy drinks, massage and bike repair services, hot showers, a bar and a slap-up dinner.MapungubweDay two took us through the impressive koppies of Mapungubwe National Park. The archaeological site of Mapungubwe was discovered in 1932, unearthing a long history of human habitation in the region including the earliest recorded archaeological gold in southern Africa.Among the human remains were golden ornaments, gold beads and wire jewellery. The most famous find was that of a single-horned golden rhinoceros. All southern African rhinos have two horns, so this find has intrigued archaeologists – some of whom suggest that it’s a representation of a rhino from Asia, where one-horned species exist. As you ride through the park you can’t help being somewhat overawed by this incredible place.For the second half of the day we cruised the sandy tracks of a privately owned section of the park, the Venetia Limpopo Nature Reserve, a De Beers property which is well stocked with big game and an integral component of the World Heritage Site.Our camp that night was on the Limpopo River, a truly glorious setting right on the sandy cliff. We sat listening to the soothing sound of running water as we sipped our sundowners then ate out under the stars. The handful of foreign riders couldn’t believe the beauty of the African bush – the tour had exceeded all their expectations.The next day started with a rollercoaster ride along the river cliff – some of the most demanding riding of the event with steep down- and uphills. The rising sun created a dappled effect in the trees and we flew along, happy, if a trifle saddle-sore. That afternoon we rode into Kruger National Park, through a back gate and into an area that visitors to the park do not see.We were now in serious big five country. The briefing had been fierce – stick together at all costs and keep moving. The final day through the Pafuri Concession was magnificent. We left our bikes at the tea-stop and climbed up to Lanner Gorge for a view out over the gorge cut in the Luvuvu River. The sight of the great chasm was worth every ounce of energy expended on the 6.4-kilometre sandy trail.We rode through great forests of glowing fever trees, enjoyed the antics of baboons and saw kudu, impala, warthog as well as some great sightings of tuskers in Elephant Alley.Our final detour was to Crooks Corner – the point where South Africa, Zimbabwe and Mozambique meet. We watched a breeding herd of elephant come down to the water to drink then, once they’d left, scrambled down onto the sand bank for a team photo keeping a wary eye open for crocs.Early in the afternoon we arrived at Pafuri Camp where, in the usual slick manner to which we’d been accustomed, our bikes were taken off to be loaded onto the appropriate transfer vehicles – back to the start in Tuli, the Wilderness offices in Joburg or, for those with flights the following evening, onto the coaches that were taking us back the next day.Taking leaveClean and refreshed, we lounged around the camp watching buck graze next to the raised platforms of the tented rooms and elephant drinking in the river. The event ended with a slide show and presentation and we relived the thrills and spills.It had been a magnificent ride that had brought together people from all walks of life, united in their wish to intimately experience the African bush, to rise to the challenge of the ride and to support Children in the Wilderness. It was hard to leave – after five days together the members of each cycling group and the support staff had become a close-knit family.So was I mad to sign up? Well, it certainly wasn’t a walk in the park, but anyone who’s reasonably fit and with a bit of mountain-biking experience would enjoy the ride. The distances are manageable for recreational bikers, and the presence of guides and technicians means that you can seek assistance in the event of bike problems, or hop in a back-up vehicle if you’ve had enough for the day.The organisers go out of their way to make your life as easy and as much fun as possible. But for all that it’s a challenging ride, largely along fairly straightforward single track or dirt road with a few more tricky sections to amuse the downhill addicts – most of which I walked, and felt no shame.What makes the ride really special is the opportunity to journey through bits of the reserves that most visitors never see. You can help but feel privileged that these areas have been opened up for the tour to come through. Makes me want to get on my bike again.Related articlesSouth Africa’s national parksThe adventure starts hereThe biggest nature park in the world Holidays that save the worldTracking elephants across AfricaUseful linksChildren in the WildernessWilderness SafarisKruger National Parklast_img read more

Ohio farm custom rates 2018

first_imgShare Facebook Twitter Google + LinkedIn Pinterest By Barry Ward, Leader, Production Business Management, Department of Agricultural, Environmental and Development Economics & John Barker, Extension Educator Agriculture/Amos Program, County Director, Ohio State University Extension Knox CountyFarming is a complex business and many Ohio farmers utilize outside assistance for specific farm-related work. This option is appealing for tasks requiring specialized equipment or technical expertise. Often, having someone else with specialized tools perform a tasks is more cost effective and saves time. Farm work completed by others is often referred to as “custom farm work” or more simply, “custom work”. A “custom rate” is the amount agreed upon by both parties to be paid by the custom work customer to the custom work provider.Ohio Farm Custom RatesThis survey summary reports custom rates based on a statewide survey of 352 farmers, custom operators, farm managers, and landowners conducted in 2018. These rates, except where noted, include the implement and tractor if required, all variable machinery costs such as fuel, oil, lube, twine, etc., and the labor for the operation.Some custom rates published in this study vary widely, possibly influenced by:Type or size of equipment used (e.g. 20-shank chisel plow versus a 6-shank) Size and shape of fields, Condition of the crop (for harvesting operations) Skill level of labor Amount of labor needed in relation to the equipment capabilities Cost margin differences for full-time custom operators compared to farmers supplementing current income Some custom rates reflect discounted rates as the parties involved have family relationships or are strengthening a relationship to help secure the custom farmed land in a cash or other rental agreement. Some providers charge differently because they are simply attempting to spread their fixed costs over more acreage to decrease fixed costs per acre and are willing to forgo complete cost recovery.The measures shown in the summary tables are the summaries of the survey respondents. The measures are the average (or mean), range, median, minimum, and maximum. Average custom rates reported in this publication are a simple average of all the survey responses. Range identified in the tables consists of two numbers. The first is the average plus the standard deviation, which is the variability of the data from the average measure. The second number of the range is the average minus the standard deviation. The median represents the middle value in the survey responses. The minimum and maximum reported in the table are the minimum and maximum amounts reported from the survey data for a given custom operation.The complete summary of part 1 is available online at the Farmoffice website:https://farmoffice.osu.edu/farm-management-tools/custom-rates-and-machinery-costslast_img read more

Geocaching HQ Employee Spotlight: Nate Irish

first_img SharePrint RelatedGeocaching Employee Spotlight: Tom, Veep of Marketing & MerchApril 10, 2016In “Community”Inside Geocaching HQ Podcast Transcript (Episode 18): Geocaching Map/Search, Adventure Lab app, plus nostalgia!December 20, 2018In “Community”Geocaching HQ Employee Spotlight: Senior Software Developer, Dave (Wilson)May 8, 2016In “Community” This is part of a series of blog posts shining a spotlight on the people of Geocaching HQ. We hope to show you the “geo-who” behind the “geo-what”. 🙂What is your name? Nate IrishYeah, but what’s your Username?I have two: My lackey name is OpinioNate, and my player name is Nate the Great. In the old days most Lackeys had two usernames but I think now it’s more common to have one.Nate the Great on a mountain highHow did you come up with your username?Nate the Great was a nickname given to me by my grandfather when I was little. He used to make short little poems about me like, “Nate the Great is never late to eat the food that’s on his plate”. That is still mostly true, but I try to make the plate smaller and have more green things on it. Being a grown-up can be a drag sometimes. OpinioNate because I have a lot of opinions, obviously.What is your job title?Currently, I’m the Product Manager. I’ve had around five different titles in my twelve years at Geocaching HQ. In the past I have been a project manager, quality assurance tester, community manager, discussion forum moderator, merchandise distributor manager, and way back in the day I stuffed Trackables into little yellow envelopes and drove them to the post office. These days the postman comes to us. We’re in the big leagues now baby!We’re in the big leagues now, baby!What does your job title actually mean? In other words, how do you explain what you do to someone that has no idea what you do?I lead a team of six people whose mission is to identify product opportunities to support the game of geocaching. The product in this case is our website and mobile apps. When we do our job correctly, the output is new features that simultaneously serve the needs of our community, our company, and the game of geocaching itself. That’s a very tough thing to do, but we work hard to achieve that balance.Tell us about your geocaching style (exotic locations / quality over quantity)?I’m definitely a less-is-more cacher. Usually when I travel, I sort by Favorite and look for a cache that is high terrain and is medium or large in size. I love to see the best and most extreme of what geocaching has to offer. Gadget caches are pretty high on my list, as well as anything inside a cave.Nate the Great PapaWhat’s something that surprises you about geocaching – whether it’s the game itself, working at headquarters, or anything else?I love learning about some new local geocaching lingo or hiding style. For instance, in the Chicago area they used to have a lot of “Superman” caches. It’s when you tie a fishing line to a preform container and sling it over the branch of a tree. Then you reel in the line so the container is way overhead and secure the line against a tree knot or whatever. Everyone there knows what to look for when “Superman” is the hint.Nate the Great – Superman geocacherWhat’s the best piece of geocaching advice or information you ever learned?Let someone else stick their hand in there first. Share with your Friends:Morelast_img read more

Apple Denies PRISM Knowledge, Explains Releases Of Customer Data

first_imgA Web Developer’s New Best Friend is the AI Wai… Tags:#Apple#cyberwar#nsa#Prism Related Posts Apple today released a statement revealing that it, too, has received requests for consumer data from Federal, state and local authorities in the United States, even as it denied participation in the alleged PRISM program conducted by the NSA.Apple joins Facebook and Microsoft as companies that have made public batch data of requests from U.S authorities.Between December 1, 2012 and May 31, 2013, Apple saw between 4,000 and 5,000 requests from U.S. law enforcement for customer data. Those requests totaled between 9,000 and 10,000 Apple accounts or devices. Apple said the requests ranged from criminal investigations to matters of national security with the most common being local police investigating robberies, searching for missing children or trying to locate patients with Alzheimer’s disease.Apple said:Regardless of the circumstances, our Legal team conducts an evaluation of each request and, only if appropriate, we retrieve and deliver the narrowest possible set of information to the authorities. In fact, from time to time when we see inconsistencies or inaccuracies in a request, we will refuse to fulfill it.Apple insists that it knew nothing of PRISM, the clandestine project by the federal government where it supposedly has the power to access the servers of major tech companies (like Yahoo, Google, Microsoft etc.) for consumer data related to matters of national security.Apple reiterated its stance on protecting its consumer data and said that, “we don’t collect or maintain a mountain of personal details about our customers in the first place.”For example, conversations which take place over iMessage and FaceTime are protected by end-to-end encryption so no one but the sender and receiver can see or read them. Apple cannot decrypt that data. Similarly, we do not store data related to customers’ location, Map searches or Siri requests in any identifiable form.Last Friday, both Facebook and Microsoft (both of which had negotiated with the Federal government for the right to report on data requests) released data on government requests. Over the last six months, Facebook saw 9,000 to 10,000 requests regarding 18,000 to 19,000 accounts while Microsoft said it saw 6,000 to 7,000 requests, affecting up to 32,000 accounts. Both Google and Twitter have said that the batch data that the government allowed the likes of Apple, Facebook and Microsoft to report is not enough. Google would like to see more detail and volume of the data requests including the ability to separate federal government requests from those of local authorities.  dan rowinskicenter_img 8 Best WordPress Hosting Solutions on the Market Why Tech Companies Need Simpler Terms of Servic… Top Reasons to Go With Managed WordPress Hostinglast_img read more

Simply Kolkata decodes the hottest fashion and accessories trends in the city.

first_imgBack to weaves handloomMeghna Nayak, fashion designer, wearing her label LataSita.If you are in Kolkata during the Durga Puja, it seems unthinkable, impossible even to celebrate those days without turning to traditional and ethnic wear. And while there maybe a plethora of cuts, styles and fabrics to choose from, you can never go wrong with a handloom weave-a classic choice that can be repeated year after year. Popular social media movements like the “I wear handloom” campaign started by Union Minister of Textiles Smriti Irani on National Textile Day, or the ‘100sareepact’-a movement started on Facebook-are making the humble nine yard drape a runway favourite now.”I think the very thought of having direct access to, or wearing your heritage, your roots and your tradition on your skin that makes the idea of wearing handlooms so great,” says Meghna Nayak, 31, designer and founder of sustainable fashion label LataSita. If you find wearing a sari or for that matter any kind of unstitched handloom cloth too cumbersome to drape, then there are plenty of other ways of wearing it too.Nayak has taken a simple red bordered tangail sari, a mainstay on Durga Puja days for mothers and grandmothers, and turned it in to a strapless dress. “Even youngsters who do wear a sari perhaps wouldn’t turn to such a simple basic weave. It’s such a pleasure to get an 18-yearold, who would never wear a sari, show interest in this skirt, and now they are quite literally wearing a bit of Bengal,” says Nayak. At facebook.com/latasitaadvertisementMake a statement minimalist wardrobeIn this festive season of shopping frenzy, a movement is slowly making brand toting fashionistas veer towards minimalism and focus on classics. Inspired by the supposedly French concept of a ten-piece wardrobe, the idea is steadily gaining ground in the city. Its details are in its simplicity.Instead of just amassing clothing and accessories, one should have a wardrobe of a few key pieces which may be more expensive than an average high street brand, but serve as investment pieces. “I think it’s more practical to prize quality over quantity. It makes more sense to have a good pair of heels or a classic bag instead of hording many that won’t last long,” says Saachi Bhasin, 19, model and actor. It also helps create a clean no-fuss look. “I think a good pair of jeans, a classic solid shirt or top, a good watch, a nice bag and simple jewellery can work for everyone.And with a little imagination one could make it work for most occasions,” says Bhasin. Indian staples you could add to the list of statement pieces are a few sari blouses in basic colours like black, red gold, silver and beige, suggests PR entrepreneur and consultant, Supreeta Singh, 35.”Kalamkari fabric blouses and multi-coloured check blouses also make for great contrasts that you can wear with nearly anything and would help maximise even a modest collection of saris,” says Singh. For a formal and corporate look, Singh suggests, “a couple of shirts, a few pairs of well-cut trousers and blazers, and a good watch could make for a smart office wardrobe, which works for any season”.Saachi Bhasin, model and actor, flaunts her favourite statement bags.Top five wardrobe staplesWell-cut Trousers BlazersStatement bags Designer watchesSari blouses in basic coloursModern Indian fusion wearKipling ay have predicted “never the twain shall meet”, but when it comes to our wardrobe, there is always a clash of traditional and contemporary. Crop tops aren’t just to be worn with western wear but as blouses for saris and dhoti pants that are currently in vogue can be teamed with fitted jackets. “One of my favourite pieces is this outfit by Abhishek Ray which can be worn as an anarkali as well as a gown.It all depends on how one wears it and how one styles it. It can work both ways,” says dancer Sreenanda Shankar. Another favourite of hers is an ivory and black asymmetric hemline, cotton voile kalidaar kurta. “It has a jamavar yoke and ombre dyed churi sleeves. This look was conceptualised to break the traditional norms of ethnic dressing and put in western elements in terms of styling with fishnet stockings, knee-high boots and chains in the ears. Yet the traditional nath and vermillion binditake us back to our roots.For me it was a powerful look which signifies the modern Indian woman who is deeply rooted in her culture, yet trendy, bold and experimental,” says Shankar. Fusion also makes ethnic wear more accessible for all body types.advertisementLadies who aren’t very comfortable sporting a fully Western silhouette, would find a tunic and palazzos flattering and yet modern. Women who are not quite inclined to wear a sari or battle a heavy dupatta while pandal hopping on Durga Puja, could easily wear an ethnic kurta as a tunic with white trainers for a hip new look. But it’s a look that can go wrong so wear it with care. “Fusion is a very common and happening word. My father Ananda Shankar, who was known for popularising fusion music across the world, used to tell me that if one doesn’t get it right then it can sound like cacophony. I think it’s the same with clothes,” says Shankar.Jewels of desire Offbeat JewelleryEina Ahluwalia, jewellery designer, wearing her own creation.Accessories are not just adornments anymore but conversation starters, feels fashion designer Sakshi Jhunjhunwala, 24. “I think people want to make a statement rather than just wearing the same old pieces. Which is why head gears and harnesses are huge hits right now,” says Jhunjhunwala.Polki, Meenakari, enamelled jewels have taken a backseat. What has replaced them, are quirky designs, experiments with various metal, wood as well as fabric. Kolkata’s fashionistas are no more sticking to the traditional bangles, rings and eleaborate neck pieces. Instead, earcuffs, bodychains, maangtikas in unconventional designs, waist chains, armlets and handcuffs are all the rage. Jewellery designer, Eina Ahluwalia, 41, too feels that there is a big shift towards the contemporary. Customers not just want to flaunt their jewellery, but understand the story behind it as well.With her new collection titled, Battlecry, Ahluwalia aims to show the transience of life. A recurring motif in the collections is that of the legendary creature-the Griffin. “The griffin’s body is shaped in a way that the hind is that of a lion and the head and wings are that of an eagle. It is a majestic combination of intelligence and strength.It is a symbol of divine power, known for guarding priceless possessions and treasures in the worlds beyond,” she explains Ahluwalia. Offbeat jewellery, like haathphools, maangtika and waist chains owe their current popularity to the fact that they aren’t as heavy as their older traditional avatars. The jewellery that was earlier restricted to weddings or formal functions is now being worn as an everyday essential.Ahluwalia also spots body positivity in this trend. “For women who have fuller figures, wearing a waist chain or a long necklace shows body confidence. It’s like a celebration of even our imperfections, which is wonderful,” she says, adding, “I had never made bodychains as part of my regular wear collection. Now I know people who just wear it through the day, eating sleeping and bathing in it”.Top jewellery trendsOffbeat lightweight jewelleryStatement pieces with a historyNew materials like wood and fabricTrending pickshaathphools, maangtika, waist chains, armlets, handcuffslast_img read more

Placing Women at the Center: Rethinking the RMNCH Continuum of Care

first_img ShareEmailPrint To learn more, read: Posted on January 22, 2013June 12, 2017By: Ann Starrs, President and Co-Founder, Family Care InternationalClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)This post is cross-posted from the FCI Blog and the PMNCH website.Last week’s Global Maternal Health Conference (GMHC), held in Arusha, Tanzania, was both inspiring and sobering. Twenty-five years after the Safe Motherhood Initiative was launched at an international conference held in neighboring Kenya, maternal mortality has finally begun to decline, and there are many and diverse examples of how countries are addressing the challenge of preventing deaths of women and newborns from complications of pregnancy, childbirth, and the postnatal period. But as the conference highlighted, huge challenges remain — in improving the quality of care, the conference’s core theme; in strengthening the functionality and capacity of health systems; in addressing major inequities in access to care, within and across countries; and in ensuring that maternal and newborn health receives the political support, increased funding, and public attention that it needs.The majority of the conference’s breakout sessions featured informative and often fascinating presentations on research findings and promising programmatic and technical innovations. One session, however, took a different tack — a debate on “Has the ascendance of the RMNCH continuum of care framework helped or hindered the cause of maternal health?”  I proposed this session to the Maternal Health Task Force, which organized the GMHC, because for me and the organization I head, Family Care International, maternal health has been at the core of our institutional mission since we planned the first Safe Motherhood conference in 1987. For much of the past decade, however, I have been closely involved with the Partnership for Maternal, Newborn and Child Health (PMNCH) and Countdown to 2015, two coalitions that are dedicated to promoting an integrated, comprehensive approach to the reproductive, maternal, newborn and child health (RMNCH) continuum of care. Have our efforts to define and advance the continuum of care framework contributed to progress in improving maternal health? If so, how much? If not, what can be done about it?These questions were debated by a stellar panel I moderated, which included Wendy Graham, Professor of Obstetric Epidemiology at the University of Aberdeen; Marleen Temmerman, the new head of the Department of Reproductive Health and Research at WHO; Friday Okonofua, Professor of Obstetrics and Gynaecology at the University of Benin, Nigeria; and Richard Horton, Editor in Chief of The Lancet, as well as a fantastic and diverse audience. To start the discussion I shared the definition of the continuum of care that PMNCH has articulated, based in part on the World Health Report 2005: a constellation of services and interventions for mothers and children from pre-pregnancy/adolescence, through pregnancy, childbirth and the postnatal/postpartum period, until children reach the age of five years. This continuum promotes the integration of services across two dimensions: across the lifespan, and across levels of the health system, from households to health facilities. Key packages of interventions within the continuum include sexuality education, family planning, antenatal care, delivery care, postnatal/postpartum care, and the prevention and management of newborn and childhood illnesses.It is, of course, impossible to conduct a randomized control trial on the impact of the RMNCH continuum of care on maternal health, so the discussion was based more on perceptions than on hard evidence. Nevertheless, there are a few data points to consider in debating the question. From an advocacy perspective, panelists generally agreed, the adoption of the continuum of care framework has helped the cause by appealing to multiple constituencies related to women’s and children’s health. Attribution is always a challenge; there are many other developments over the past 5-7 years that have also had an impact, such as the two Women Deliver conferences held in 2007 and 2010 (with the third one taking place in May of this year). But participants generally agreed that linking women’s and children’s health, and defining their needs as an integrated whole, has appealed to policy-makers and politicians on an intuitive and practical level, as demonstrated by the engagement of heads of state, celebrities, private corporations, and other influential figures.Let’s look at the money: during the period 2003-2010 overseas development assistance (ODA) has doubled for MNCH as a whole, according to Countdown to 2015 (Countdown’s analysis did not look at funding for reproductive health, but a new report later in 2013 will incorporate this important element). Maternal and newborn health, which are examined jointly in the analysis, have consistently accounted for one-third of total ODA, with two-thirds going to child health. Given the significant funding that GAVI has mobilized and allocated for immunization over this time period, the fact that maternal and newborn health has maintained its share of total MNCH ODA is noteworthy.And let’s look at how maternal health has fared within the UN Secretary General’s Every Woman Every Child initiative, launched in September 2010: a recent report summarizes each of the commitments made to Every Woman Every Child in the two years since it was launched. Of the 275 commitments included, 147, or 53%, had specific maternal health content. If we look at the commitments according to constituency group, developing country governments had by far the largest percentage of commitments that had specific maternal health content — 84% — compared to 39% for non-governmental organizations, 24% for donors, and 52% for multilateral agencies and coalitions. Clearly, maternal health has not been marginalized within the continuum from a broad policy, program and funding perspective, despite the fear some had expressed that it would be pushed aside in favor of child health interventions that are perceived as easier and less costly to implement.Another benefit of the continuum of care framework, as noted by Dr. Okonofua, has been increased collaboration among the communities that represent its different elements. While there were tensions and rivalries when PMNCH and Countdown were first established, especially between the maternal and child health communities, today groups working on advocacy, policy, program implementation, service delivery, and research within the continuum generally work together more frequently, cordially and effectively than they did before, especially at the global level. PMNCH and Countdown, as well as Every Woman Every Child, have brought together key players to define unified messages and strategies that have achieved widespread acceptance.That was the good news; but panelists and participants at the session also saw a number of problems with the continuum of care concept. The concern articulated by Richard Horton, and echoed by many of the session participants, was that the continuum views women and adolescents primarily as mothers or future mothers. This narrow view contributes to a range of gaps and challenges; it means crucial cultural, social and economic determinants of health and survival, including female education and empowerment, are not given adequate weight. Gender-based violence deserves much more attention, both for its own sake and for its impact on maternal, newborn and child health. Politically sensitive or controversial elements of the continuum, especially abortion but also, in some cases, family planning and services for adolescents, may be neglected in policy, programming, and resource allocation.The fragmentation inherent in the continuum of care also contributes to what Wendy Graham called the compartmentalization of women. As Countdown’s analysis of coverage has demonstrated, the continuum of care doesn’t guarantee continuity of care; coverage rates are much higher for interventions like antenatal care and child immunization than for delivery or postnatal/postpartum care. Women’s needs for a range of interventions and services, available in a single health facility on any day of the week, are not being met in many countries.Other concerns that emerged during the discussion were that the RMNCH continuum of care framework does not explicitly or adequately reflect the importance of quality of care, which in turn depends on a range of factors: skilled, compassionate health care workers, functional facilities, adequate supplies and equipment, and an effective health information system that tracks not just whether interventions are being provided, but also whether individual women and their families are receiving the care they need throughout their lives.Dr. Okonofua, in his comments, focused on how the continuum of care concept has been implemented, or hasn’t, in countries. The implications of the continuum of care for on-the-ground program implementation have not been fully articulated and communicated; more effort, he noted, needs to be invested in making the concept relevant and useful for policy-makers, program managers, and service providers.Despite these gaps, however, participants in the session – and the panelists themselves – agreed that the continuum of care is a valid and valuable concept, and that the inadequacies identified should be addressed. “Don’t throw the baby out with the bathwater,” said one member of the audience. The continuum of care, as a concept, has already evolved; initially, for example, it did not fully integrate reproductive health elements. As Marleen Temmerman commented, the continuum of care concept is a tool; what is important is what is done with it.As 2015 approaches, the global health community is struggling to articulate a health goal for the post-2015 development framework that will resonate widely and guide accelerated, strategic action to prevent avoidable deaths and improve health of people around the world. The RMNCH community — or communities — needs a framework that more fully reflects the realities and complexities of the lives of women and children, and that enables us to reach out to other health and non-health communities, including HIV/AIDS, NCDs, and women’s rights and empowerment, for a common cause. To do this, we need to revise the continuum of care framework to maximize its relevance and utility for countries, and to incorporate the following missing elements:Recognition of the importance of quality of careResponsiveness to the needs of girls and women throughout the life cycle, not just in relation to pregnancy and childbirthLinks to the cultural, social and economic determinants of women’s and children’s healthRichard Horton’s call for a manifesto to emerge from the GMHC included 10 key points; redefining the RMNCH continuum of care was one of them, inspired by the panel. The challenge has been issued; it is now up to us to meet that challenge.Share this:last_img read more

Manifesto for Maternal Health: Highlights From Women Deliver and Population Council

first_imgPlease join the conversation! Tell us about your work to improve maternal health over the past year and how it relates to the calls to action from the manifesto. Send an email to Kate Mitchell or Natalie Ramm or join the dialogue on Twitter using the hashtag #MHmanifesto and help us celebrate the anniversary of the manifesto for maternal health!Share this: Posted on March 4, 2014November 14, 2016By: Natalie Ramm, Communications Coordinator, Maternal Health Task Force, Women and Health InitiativeClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)Continuing the celebration of the one-year anniversary of the “Manifesto for Maternal Health,” this post showcases the work of Women Deliver and the Population Council to improve global maternal health.Women DeliverIn 2013, Women Deliver organized its third global conference in Kuala Lumpur, Malaysia. It was one of the largest gatherings of policymakers, advocates, and researchers focused exclusively on women’s health and empowerment to date, bringing together over 4,500 participants from 149 countries.Women Deliver’s work focuses primarily on the Manifesto’s first and second principles, as we work to influence the post-2015 agenda. We are pushing for the post-2015 development framework to prioritize gender equality, with a specific focus on education and health, including access to reproductive health and family planning information and services.Last year, Women Deliver and the World Bank published a report highlighting the significant social and economic benefits of investing in girls and women and recommending specific policies to improve reproductive health outcomes. We also published a report about our 2013 global conference, including information about panelists, attendees, and sessions.Population CouncilA crucial gap in improving the quality of maternal health services is that the validity of many global benchmarks, including skilled attendance at birth, is largely unknown. To improve measurement of maternal health care received during labor and delivery (core area 10 in the Manifesto for Maternal Health), investigators at the Population Council, led by PI Ann Blanc, are conducting research to identify a set of indicators that that have the potential for valid measurement and integration into population-based data collection systems in developing country contexts. ShareEmailPrint To learn more, read:last_img read more

Manifesto for Maternal Health: In-Country Perspective From the White Ribbon Alliance Tanzania

first_img ShareEmailPrint To learn more, read: Posted on April 24, 2014November 4, 2016By: Rose Mlay, National Coordinator, The White Ribbon Alliance TanzaniaClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)Throughout my career as a midwife, I am all too familiar with the challenge of women arriving too late to the hospital to give birth. Over and over again, I have attended to women who had traveled for days to reach care. It is so heart breaking to know that these women’s lives could be saved if only they could reach quality professional care faster. We, at the White Ribbon Alliance, have advocated strongly over the years to our government in Tanzania to focus on maternal and newborn health, and great promises have been made! Now, we are faced with the challenge of making sure these promises are delivered. And we are working hard on that front!In recognition of the one-year anniversary of the publication of the Manifesto for Maternal Health, I’d like to take this opportunity to share some of our recent efforts to ensure that promises to women and newborns are kept.Just last year the White Ribbon Alliance Tanzania brought together national leaders engaged in maternal and newborn health ranging from the media, government, non-governmental organizations, and professional associations to set out a strategy for holding the government of Tanzania accountable for delivering on commitments made to our women and newborns. More specifically, we collectively set out a plan for holding the government accountable on promises to provide comprehensive emergency obstetric care (CEmONC) in at least half of all health centers by 2015. Together, we concluded to focus our efforts on the commitment to CEmONC because we listened to our citizens who have asked for these services to be closer to their homes. In addition, we know that the majority of the 24 women who die every day in childbirth die due to the lack of access to quality emergency care.In order to make our case, we knew we would need strong evidence to show the government just how off track their promises are, so we carried out a full facility assessment in 10 government-run facilities in Rukwa region. We engaged with community leaders, media and district officials as we moved through the region. Rukwa is beautiful with its rolling hills and great lakes, but it is a treacherous journey through the dirt tracks to get to rural health centers, with many being so remote that they are out of reach of telephone signals.As we gathered the data, we found that for a population of 1 million people, and over 10 health centers throughout the district, there was not a single health center that was providing the level of care that the government had promised.According to plan, we shared the evidence with the district government teams, and we pushed the district leadership to budget adequately for emergency obstetric care. In the meantime, we also set up meetings with national leaders and the Parliamentary Safe Motherhood Group to make sure emergency obstetric care is budgeted for adequately in the 2014-2015 budget cycle.We also made this film about the situation in Rukwa which Dr. Jasper Nduasinde, our White Ribbon Alliance focal person from the region took to the United Nations General Assembly to get global attention on the gap between promises and implementation.We called on our politicians to act. The Safe Motherhood Group in Parliament is working to get all politicians to sign a petition to the government to prioritize this issue.We called for a meeting with the Prime Minister. We spoke for an hour and a half on what could be done now to change this critical situation. He promised to take action.We also made this film about Elvina Makongolo, the midwife in Mtowisa who works tirelessly to save women’s lives.As we move to make these critical changes happen, we are faced with very sad news that motivates us even more. Shortly after this film was made with Elvina, the teacher of her grandchildren died in childbirth. Leah Mgaya died because Mtowisa health center does not have a blood bank. In the maternity ward of the health center ,a big refrigerator stands tall but the electricity to power it is missing. The closest blood supply is 100 km away at the regional hospital, reached only by a 4×4 vehicle due to the rough terrain.Leah’s husband, Cloud Kissi, said: ‘My wife has left a big gap in my life and she has left three children without a mother. It has left me with trauma as every time I see a woman carrying a baby I feel that if my wife could have survived, she could have been carrying a baby like the one I am seeing. I am quite sure that if we had a good operating theater, availability of safe blood and a reliable ambulance, we would have surely saved my wife’s life.’We continue to hear the personal accounts of husbands losing their wives, children losing their mothers, families losing their aunties, sisters and nieces and, in Leah’s case, a community losing their teacher. Citizens want change and they are pushing for it.In Rukwa alone, over 16 thousand citizens have signed a petition pushing the district officials and their MP to prioritize a budget for CEmONC.Recently, on White Ribbon Day in Rukwa, the Minister of Health spoke on behalf of the Prime Minister to say that this budget must be prioritized across the country.We now believe that the Prime Minister has become this campaigns’ greatest ally! And we know that our President Kikwete cares about the women of our nation. He has committed greatly to preventing these tragic deaths. But we cannot let up until women can access emergency life saving care near their homes. It is their right.As critical decisions are being made on budget allocation for 2014-2015, we are urging our leaders to listen to the citizens of our nation and budget adequately for comprehensive emergency obstetric and newborn care.If you would like to share your in-country story with us, please email Natalie Ramm or join the conversation on Facebook and Twitter.Share this:last_img read more

Over 28,000 Deaths in the First Day of Life in Bangladesh Reminds the Urgency of MNH Services Integration

first_img ShareEmailPrint To learn more, read: Posted on November 6, 2014June 23, 2017By: Mohammod Shahidullah, Professor and Chairman of the Department of Neonatology, Bangabandhu Sheikh Mujib Medical UniversityClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)This post is part of the Maternal and Newborn Integration Blog Series, which shares themes of and reactions to the “Integration of Maternal and Newborn Health: In Pursuit of Quality” technical meetingA new mother and her six-day-old baby receive a postnatal check up at the new government clinic in Badulpur, Habijganj, Bangladesh. Photo: CJ Clarke/Save the ChildrenThe continuum of care has become a rallying call to reduce the maternal deaths, stillbirths, neonatal deaths, and child deaths. Continuity of care is necessary throughout the lifecycle (adolescence, pregnancy, childbirth, the postnatal period, and childhood) and also between places of caregiving (including households and communities, outpatient and outreach services, and clinical-care settings). Within the continuum, all women should have access to care during pregnancy and childbirth, and all babies should be able to grow into children who survive and thrive.Unfortunately in the modern era of medical science, the program efforts addressing the health of mothers and newborns are often planned, managed, and delivered separately; though, from a biological perspective, maternal and newborn health are intimately linked.Integration of maternal and newborn health is an important approach to avoid separation between a mother and her newborn baby, places of service delivery, or at any event of health services. A persistent divide between training, programs, service delivery, monitoring, and quality improvement systems on maternal and newborn health limits effectiveness to improve outcomes. But it is evident that at the public health level, even with scarce human and financial resources, integrated service packages can maximize the efficiency for health services.In the last two decades Bangladesh has demonstrated extraordinary progress in reducing maternal and child deaths, but unfortunately, newborn mortality declined in a much slower pace and reduction of stillbirths was not even on the agenda. Fortunately, the country recently prioritized newborn survival and incorporated some priority interventions to reduce neonatal death. Improved delivery care services became one of the key strategies for improving child survival in addition to overall development of the health service delivery system.The following newborn-specific interventions are prioritized to achieve the commitment of ending preventable child deaths by 2035:Ensure essential newborn care, including neonatal resuscitation and application of chlorhexidine in the umbilical cordIntroduce and promote kangaroo mother care (KMC) for premature and low birth weight infantsEnsure proper management of newborn infection with antibiotics at the primary care levelsEstablish specialized newborn care unit at the sub-district and district levelEnsuring delivery by skilled birth attendants at the community levels and establishing an effective referral linkage to ensure continuum of care from community clinics to the sub-district, district and higher level hospitals—which can provide round the clock emergency obstetric and newborn care—are actions incorporated in the declaration. These give a clear indication of the government vision on integrated approaches to improve maternal and newborn health.Intra-partum complication, prematurity-related complications and newborn sepsis are the major causes of newborn death is Bangladesh. Without integration of maternal and newborn health we cannot reduce mortality especially due to the fact that intra-partum complications and prematurity-related complications together cause 67% of all newborn deaths in the country. Bangladesh recently scaled up the Helping Babies Breathe initiative and that is a unique example of integration of maternal and newborn health.Every year in the first day of life, 28,100 newborns of Bangladesh die indicating the importance of integration of maternal and newborn services in pursuit of quality of care.This post originally appeared on the Healthy Newborn Network Blog and has been lightly edited.Share this:last_img read more

Maternal Health Jobs

first_img ShareEmailPrint To learn more, read: Posted on November 21, 2014August 10, 2016Click to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)Looking for a job in maternal health? Here’s a round up of what’s available:Jhpiego – Maternal Health Team Leader; Program Officer IICARE – Senior Technical Advisor for Maternal and Child Health; Senior Technical Advisor for Maternal and Child NutritionBill & Melinda Gates Foundation – Senior Program Officer, Maternal Newborn and Child HealthMerck for Mothers – DirectorTo apply, go to this link. Select “Merck Kenilworth” as Location and “Long Term Assignment” as Position Type. Click “search” and select Job Number 301.Share this:last_img read more