The sisterhood method is an indirect method of estimating maternal mortality that has, in comparison with conventional direct methods, the dual advantages of ease of use in the field and smaller sample-size requirements. This report describes how to calculate a standard error to quantify the sampling variability for this method. This standard error can be used to construct confidence intervals and statistical tests and to plan the size of a sample survey that employs the sisterhood method. Statistical assumptions are discussed, particularly in relation to the effective sample size and to effects of extrabinomial variation. In a worked example of data from urban Pakistan, a maternal mortality ratio of 153 (95 percent confidence interval between 96 and 212) deaths per 100,000 live births is estimated.

Foot and mouth disease (FMD) is the most economically important disease of livestock that still affects extensive areas of the world. This study described the use of participatory appraisal tools such as pair-wise ranking, matrix scoring and proportional piling to assess the perception of livestock keepers about the clinical signs and epidemiological features of cattle diseases with particular emphasis on FMD. Strong agreement among informant groups (W = 0.710; P = 0.000) in pair wise ranking indicated that the diseases were common problem to all the selected districts. Matrix scoring of disease indicators/signs also showed strong agreement (W = 0.504 to 0.955; P = 0.000) that implied significant current veterinary knowledge by Afar pastoralists. Age specific means of annual incidence rates estimated by proportional piling were significantly (P < 0.05) different but negatively correlated for FMD, CBPP and pasteurellosis. However, correlation was not significant for anthrax, blackleg and other important diseases. Age specific means of annual mortality was significantly (P < 0.05) but negatively correlated for FMD, CBPP, pasteurellosis and other important cattle diseases with correlation coefficients of -0.72, -0.81, -0.8 and -0.55, respectively. However, correlation (r = 0.12) was not significant for anthrax and not correlated at all for blackleg. This study indicated that pastoralists have detailed knowledge about their livestock health problems, and hence the combined use of participatory appraisal and conventional methods is essential for an ultimate disease control strategy.

An experiment was conducted at Dugda district in the Central Rift Valley of Ethiopia under field conditions to determine the impacts of tillage levels, N and P fertilizers on growth and yield of maize (Zea mays L.). Two tillage levels; (1) Conventional and (2) Minimum tillage and four N and P fertilizer levels; (1) No fertilizer (control treatment), (2) 64 kg N haG ) were laid out in split plot design by assigning tillage levels to the main plots and fertilizers to the subplots and replicating three times. Data collected on growth and yield parameters was analyzed using the GLM procedure of SAS Version 9.2. N and P fertilizers had highly significant effects on growth parameters: plant height and leaf area. They also significantly affected yield parameters: biomass yield and grain yield of maize but the effects of tillage levels as well as the interaction between tillage levels and fertilizers were not significant. For the majority of the growth and yield parameters, the treatment with 64 kg N haG ). The results of the correlation analysis also indicated that biomass yield was significantly and positively correlated with grain yield and grain yield was also significantly and positively correlated with harvest index. This indicated that N and P fertilizer treatments with higher biomass yield and harvest index could result in higher grain yield of maize. According to the current results, it can be concluded that N and P fertilizers significantly affected the growth and yield of maize but tillage levels have no significant effect. Therefore, the use of 64 kg N haG 1 +20 kg P haG 1 (100 kg DAP haG 1 +100 kg urea haG 1 ) and minimum tillage could be recommended for optimum growth and yield of maize and also save the precious soil, money and time of resource poor small holder farmers, of the study area.

Background: Providing care for pregnancy is compounded by high HIV prevalence in Zambia. Approximately 10% of new HIV infections in children 0-14 years old occur as mother to child transmission (MTCT). Objective: To establish the capacity of the community to screen for HIV in pregnant women with saliva test and provide PMTCT, in a continuum of care. Methods: This study is a sub-set of a community based prospective cluster randomized controlled trial, (RCT) conducted 2008 to 2013. Oraquick, an FDA approved technology uses saliva to screen for HIV1 and HIV2. CBAs were trained, supervised and provided with job aids. Results: From 3846 pregnant women in the RCT, 2018 were screened. Among the 2018, 1089 (45.8%) were screened using Oraquick saliva test. Of the total tested for HIV, 23.8% had Oraquick only testing, 46% routine tests only and 30.2% had both tests done. Of the 1089, 608 participants (55.85%) screened using Oraquick, also had their test results confirmed with routine antibody tests at nearby health centers. The community based agents counselled, screened, dispensed nevirapine and referred appropriately. Eighty two (4%) out of the 2018 women were recorded as HIV positive. These include 47 (5.93%) women tested with Oraquick and 35 who were tested at the health centres using routine HIV testing. Conclusion: CBAs demonstrated that when trained, equipped and supported with incentives, they are able to screen the community for HIV utilizing Oraquick saliva testing and provide PMTCT.They provided increased access to HIV screening and PMTCT services.

Objective: To assess a home based continuum of pregnancy and neonatal care package, delivered by community based agents (CBAs), to improve maternal and neonatal outcomes. Method: The package was developed and tested in a randomized controlled trial conducted from 2009 to 2013. The unit of randomization was the Neighborhood Health Committee (NHC), within one hour from the client, and serving 150 -200 households with 900 to 1200 persons. The 48 CBAs in10 RHCs, made up 40 clusters. 3846 pregnant women were enrolled and tracked for one year. The intervention group received care from trained, equipped and supported CBAs while the control group received the Standard national health care. Results: The 3486 pregnant women were tracked, 2767 in the intervention group and 1079 in the control group. By the 12th month, 2000 women had delivered, with 1282 (33%) completing 28 days postnatal care, 934 in the intervention and 348 in the control group. A total of 673 (66%) women in the intervention group and 236 (58%) women in the control group were identified with danger signs, among whom 49.3% had institutional deliveries, availing newborn care in addition. The 2013 New Born Framework of the Ministry of Health utilised findings for policy. Conclusion: evidence shows that when trained, equipped and supported, community based caregivers are effective during pregnancy and early newborn care. Geographically disadvantaged populations can benefit from adopting the continuum of care as standard practice to improve maternal and newborn outcomes, within the community.Keywords: Cluster Randomised Trial, continuum of care in pregnant women, Zambia