The review has been registered with PROSPERO (registration number CRD42014009768).

Farid Dahdouh-Guebas holds an MSc biology, an MSc human ecology and a PhD sciences from the Vrije Universiteit Brussel. His previous and current research is on tropical coastal ecosystems and includes remote sensing of seagrass distributions, feeding ecology and behavioral ecology of mangrove crabs and ongoing research on mangrove vegetation structure dynamics (using very high resolution remote sensing) and biocomplexity (incl. human factors). His address: Laboratory of General Botany and Nature Management, Mangrove Management Group, Vrije Universiteit Brussel, Nico Koedam was trained as a biologist and started physio-ecological research on temperate forest plants. Besides an ecology, biogeography and nature management teaching assignment, he is now heading the research unit General Botany and Nature Management of the Vrije Universiteit Brussel, which has major ongoing vegetation research programs (remote sensing and field analysis) on Kenyan, Sri Lankan and Indian mangrove ecosystems (Indian Ocean);

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Potential long-distance dispersal of eelgrass seeds via floating generative shoots from a 256 ha meadow in the Ems Estuary (Wadden Sea) was studied by means of computer-simulation modelling. Flowering shoot density (peaking at 7.8 m -2 ) and total seed production (1094 million seeds yr -1 ) of this meadow was determined in the field and used as model input. Dispersal of floating generative shoots dislodged by increased water turbulence during autumn was modelled using a 3D transport model (Delft3D-WAQ). Transport of eelgrass seeds contained in floating reproductive shoots with the prevailing hydrodynamic regime revealed maximum dispersal distances of up to 130 km from the source of seed production. The effect of wind speed and direction on seed transport was assessed by applying a wind drag function (3% of wind speed) on surface currents in the model using actual wind data from 10 consecutive years (1993 to 2002). Main transport direction under average autumn wind conditions was northeastward. Easterly winds (occurring at an average frequency of 15%) were responsible for some westward transport of eelgrass seeds (at densities > 0.2 seeds m -2 ) up to 20 km from the estuary. Westward eelgrass colonization of suitable areas in the Dutch Wadden Sea appears to be limited by seed supply due to transport limitations posed by the prevailing hydrodynamic regime. Extreme events, such as prolonged Eastern storms, might promote seed dispersal further westwards, allowing for natural recovery of eelgrass in this area; this theory is supported by observations of localized eelgrass patches up to 40 km west of the estuary. KEY WORDS: Seed dispersal · Zostera marina · Transport modelling · Wind effects · Recruitment limitation · Wadden SeaResale or republication not permitted without written consent of the publisher Mar Ecol Prog Ser 358: 115-124, 2008 exists (McMillan 1991), Zostera marina seeds are not viable beyond their first season (Orth et al. 2000). Successful eelgrass regeneration will therefore depend on the dispersal of seeds from existing eelgrass stands, the subsequent retention of these seeds in potentially suitable locations, and their successful germination and establishment (Hootsmans et al. 1987, Greve et al. 2005.The potential for reproductive shoots of eelgrass to become dislodged and raft over great distances was investigated in Chesapeake Bay (USA) by Harwell & Orth (2002). Dislodgement of reproductive shoots under the influence of extreme hydrodynamic conditions depended on their biomechanical properties, such as breaking stress, breaking strain, elasticity modulus and toughness (Patterson et al. 2001). Once detached, floating reproductive shoots were found to remain positively buoyant for 2 to 3 wk and to retain mature seeds for up to 3 wk before release, allowing for substantial transport of seed-containing, floating generative shoots from source populations by a combination of tidal currents and wind influences (Harwell & Orth 2002).Recent genetic and field studies have shown greater variati...

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Background There is broad agreement that antenatal care (ANC) interventions, skilled attendance at birth and management of complications arising after delivery are key strategies that can tackle the high burden of maternal mortality in sub-Saharan Africa. In Kenya, utilisation rate of these services has remained low despite a government policy on free maternal care. The present study sought to understand what factors are leading to the low healthcare seeking during pregnancy, child birth and postnatal period in Siaya County in Kenya. Methods Six Focus Group Discussions were conducted with 50 women attending ANC in 6 public primary healthcare facilities. Participants were drawn from a sample of 200 women who were eligible participants in a Conditional Cash Transfer project aimed at increasing utilization of healthcare services during pregnancy and postnatal period. Interviews were conducted at the health facilities, recorded, transcribed and analysed using thematic analysis. Results Multiple factors beyond the commonly reported distance to health facility and lack of transportation and finances explained the low utilization of services. Emergent themes included a lack of understanding of the role of ANC beyond the treatment of regular ailments. Women with no complicated pregnancies therefore missed or went in late for the visits. A missed health visit contributed to future missed visits, not just for ANC but also for facility delivery and postnatal care. The underlying cause of this relationship was a fear of reprimand from the health staff and denial of care. The negative attitude of the health workers explained the pervasive fear expressed by the participants, as well as being on its own a reason for not making the visits. The effect was not just on the woman with the negative experience, but spiraled and affected the decision of other women and their social networks. Conclusions The complexity of the barriers to healthcare visits implies that narrow focused solutions are unlikely to succeed. Instead, there should broad-based solutions that focus on the entire continuum of maternal care with a special focus on ANC. There is an urgent need to shift the negative attitude of healthcare workers towards their clients.