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When health data go dark: the importance of the DHS Program and imagining its future
Background
The suspension and/or termination of many programmes funded through the United States Agency for International Development (USAID) by the new US administration has severe short- and long-term negative impacts on the health of people worldwide. We draw attention to the termination of the Demographic and Health Surveys (DHS) Program, which includes nationally representative surveys of households, DHS, Malaria Indicator Surveys [MIS]) and health facilities (Service Provision Assessments [SPA]) in over 90 low- and middle-income countries. USAID co-funding and provision of technical support for these surveys has been shut down.
Main body
The impact of these disruptions will reverberate across local, regional, national, and global levels and severely impact the ability to understand the levels and changes in population health outcomes and behaviours. We highlight three key impacts on (1) ongoing data collection and data processing activities; (2) future data collection and consequent lack of population-level health indicators; and (3) access to existing data and lack of support for its use.
Conclusions
We call for immediate action on multiple fronts. In the short term, universal access to existing data and survey materials should be restored, and surveys which were planned or in progress should be completed. In the long term, this crisis should serve as a tipping point for transforming these vital surveys. We call on national governments, regional organisations, and international partners to develop sustainable alternatives that preserve the principles (standardised questionnaires, backward compatibility, open access data with rigorous documentation) which made the DHS Program an invaluable global health resource.
Journal Article
A spear-carrier in Viet Nam : memoir of an American civilian in country, 1967 and 1970-1972
\"Part history, part memoir, this book chronicles an overlooked aspect of U.S. involvement in Vietnam, with a focus on the war victims and refugees most tragically affected by the carnage. The author recounts his two years \"in-country\" as an aid worker and describes how the humanitarian effort was conducted and why it failed\"-- Provided by publisher.
Book
China's Expanding Footprint in Nigeria: Implications of USAID's Suspension on Development and Geopolitical Alignments
This analysis examines the implications of the United States Agency for International Development (USAID)'s 2025 aid suspension in Nigeria and China's expanding role in its development landscape. Using a desktop research methodology, the study employs comparative analysis to assess the development models of USAID and China, drawing from peer-reviewed literature and policy reports. Findings indicate that while China's infrastructure investments address Nigeria's economic needs, they do not fully replace USAID's social sector contributions. The study concludes that Nigeria must adopt a balanced donor strategy, leveraging Chinese investments while securing alternative funding for human development programmes to ensure long-term sustainability.
Journal Article
Killing with Kindness
After Haiti's 2010 earthquake, over half of U.S. households donated to thousands of nongovernmental organizations (NGOs) in that country. Yet we continue to hear stories of misery from Haiti. Why have NGOs failed at their mission?Set in Haiti during the 2004 coup and aftermath and enhanced by research conducted after the 2010 earthquake,Killing with Kindnessanalyzes the impact of official development aid on recipient NGOs and their relationships with local communities. Written like a detective story, the book offers rich enthnographic comparisons of two Haitian women's NGOs working in HIV/AIDS prevention, one with public funding (including USAID), the other with private European NGO partners. Mark Schuller looks at participation and autonomy, analyzing donor policies that inhibit these goals. He focuses on NGOs' roles as intermediaries in \"gluing\" the contemporary world system together and shows how power works within the aid system as these intermediaries impose interpretations of unclear mandates down the chain-a process Schuller calls \"trickle-down imperialism.\"
eBook
Food insecurity, social and behaviour change and distribution model: key considerations for implementation of small quantity lipid-based nutrient supplement programmes
The objectives of this study were to (1) document factors that promoted or hindered the successful implementation of small quantity lipid-based nutrient supplements (SQ-LNS) for children 6-23 months and pregnant and lactating women (PLW) and (2) gather programme staff perspectives on considerations for expanding SQ-LNS programmes in their context.
We used qualitative methods to interview programme staff (
23), conduct distribution site observations (
9) and facilitate focus group discussions with caregivers of children 6-23 months (
9) and PLW (
6) with 6-8 participants per group across the three countries.
The study was conducted in SQ-LNS programme sites in Honduras, Niger and Somalia.
We found high acceptability of SQ-LNS among caregivers of children 6-23 months and PLW women. However, caregivers and PLW were dissatisfied with the size of the product in Niger and Somalia and PLW disliked the aftertaste of iron in Honduras. In Somalia, PLW referred to high levels of food insecurity. We also found variation in how the partners designed their SQ-LNS programmes (e.g. enrolment and exit criteria), the level of communication around SQ-LNS and problem-solving to support appropriate use of SQ-LNS. Partners tracked anthropometric measurements in all countries and used the information to assess changes and, in some cases, noted improvements in child anthropometry and vaccination rates.
Programmes need to consider several operational factors during implementation, such as securing household food access in highly food-insecure areas, counselling on the use of SQ-LNS and evidence-based criteria for enrolment, exit and supplementation duration.
Journal Article
Civilian Casualties, Humanitarian Aid, and Insurgent Violence in Civil Wars
Indiscriminate violence against civilians has long been viewed as a catalyst for new rounds of violence in civil wars. Can humanitarian assistance reduce violence after civilians have been harmed? Crossnational studies are pessimistic, drawing a connection between humanitarian aid and increased civil war violence, lethality, and duration. To date, however, we have few subnational studies of wartime aid and subsequent violence. To examine this relationship, I draw on the Afghan Civilian Assistance Program (ACAP II), a USAID-funded initiative that investigated 1,061 civilian casualty incidents (2011–13). Aid was assigned as if randomly to about half (55.8%) of these incidents, facilitating counterfactual estimation of how assistance affected Taliban attacks against the International Security Assistance Force, Afghan forces, and civilians. Challenging prior studies, I find that ACAP was associated with an average 23 percent reduction in attacks against ISAF, but not Afghan forces or civilians, at the village level for up to two years after the initial incident.
Journal Article
Recurrent aseptic meningitis in adults: a potential indicator of undetermined autoinflammatory disease
Autoinflammatory diseases (AIDs) are characterized by recurrent episodes of inflammation caused by primary immune system dysregulation. Central nervous manifestations, including aseptic meningitis (AM), are rare in AIDs. In this study, we identified six patients with undetermined AIDs characterized by recurrent aseptic meningitis (RAM).
Patients referred to Centre National de Référence des Maladies Auto-Inflammatoires for AM with an undetermined diagnosis were included. AIDs with RAM were defined by two or more episodes of aseptic meningitis (>10 leukocytes) with a predominance of neutrophils (>50%) and an association with autoinflammatory elements (i.e., fever, C-reactive protein [CRP] elevation) and the absence of an alternative diagnosis.
Six patients (four men, two women) were included, all of whom presented with fever and elevated CRP levels (≥30 mg/L), and five patients had clinical meningitis syndrome. The median patient age at disease onset was 41 years (range, 28-49). The frequency of AM was 1-24 episodes/year, and the duration of episodes was ≤8 days. Associated clinical symptoms included cutaneous manifestations (rash [n = 3], Raynaud's syndrome [n = 1]), arthromyalgia (n = 2), and central neurological or ophthalmologic manifestations (n = 2). All patients underwent genetic analysis focusing on AIDs, and variants of undetermined significance within four autoinflammatory genes were noted in three patients. All patients benefited from classical therapeutic regimens of AIDs including corticosteroids, colchicine, and anti-interleukin (IL)-1 receptor or anti-IL6 antibodies.
RAM was identified as a potential indicator for undetermined AIDs. Physicians should be aware of this condition and provide adequate analysis and treatment.
Journal Article
United States Government-Supported Family Planning and Reproductive Health Outreach in the Democratic Republic of the Congo: Lessons Learned and Recommendations Corrigendum
Ibrahimi S, Youssouf B, Potts C, et al. Open Access J Contracept. 2024 Mar 5:15:13-21.
Our authors have updated this article to include a disclaimer statement in the \"Funding\" section on page 20 of the published paper. The funding statement should read as follows.
Funding
This research was funded by United States Agency for International Development (USAID) in accordance with the USAID Integrated Health Program. Contract No: AEP-C-72066018C00001. This journal article is made possible by the support of the American People through USAID. The authors' views do not necessarily reflect the views of USAID.
The authors apologize for any inconvenience caused to the readers.
Journal Article
Arad and the 5 Stars Cities
In 2000, Arad city was included in the 5 Stars Cities project, initiated by the US Embassy in Bucharest through USAID and IRIS, in partnership with the Romanian Government, a project of good administrative practices addressed to SMEs aimed at reducing bureaucracy, reducing the authorization procedures and terms for SME operation, streamlining the endorsement process, and building a base for business-to-business assets. A five-step process that once went to the first local government to complete its 5 Stars City title.
Journal Article