Currently, there are no set standards or quantitative guidelines available in the U.S. for arsenic levels in rice cereal, one of the most common first solid foods for infants. The objective of this study was to evaluate whether the detected levels of inorganic arsenic (Asi) in rice cereal in the U.S. market are safe for consumption by infants and toddlers. A risk assessment was conducted based on literature reviews of the reported Asi in rice cereal from the U.S. Food and Drug Administration’s (FDA) survey and the recommended daily intake of rice cereal by body weight, for infants and toddlers between four and 24 months old. As a part of risk management, a maximum contaminant level (MCL) for Asi in rice cereal was computed considering overall exposure sources including drinking water, infant formula, and other infant solid foods. Hazard quotients (HQs) for acute and chronic exposures were calculated based on the U.S. Agency for Toxic Substances and Disease Registry’s (ATSDR) Minimal Risk Level (MRL)acute (5.0 × 10−3 mg/kg/day) and MRLchronic (3.0 × 10−4 mg/kg/day). A cancer slope or potency factor of 1.5 mg/kg/day was used to predict an incremental lifetime cancer risk (ILCR). Exposure assessment showed that the largest source of Asi for infants and toddlers between four and 24 months old was rice cereal (55%), followed by other infant solid food (19%), and drinking water (18%). Infant formula was the smallest source of Asi for babies (9%) at the 50th percentile based on Monte Carlo simulations. While HQacute were consistently below 1.0, HQchronic at the 50 and 75th percentiles exceeded 1.0 for both rice cereal and total sources. ILCR ranged from 10−6 (50th) to 10−5 (75th percentile). MCLs for Asi in rice cereal ranged from 0.0 (chronic) to 0.4 mg/kg (acute exposures).

The study objective was to examine barriers and facilitators of maternal health services utilization in Myanmar with the highest maternal mortality ratio in Southeast Asia. Data for 258 mothers with children under five were extracted from a community health survey administered between 2016 and 2017 in Mandalay, the largest city in central Myanmar, and analyzed for associations between determinants of maternal health care choices and related outcomes. The study showed that late antenatal care was underutilized (41.7%), and antenatal care attendance was significantly associated with geographical setting, household income, education, and access to transportation (p ≤ 0.05). Less than one-third of women gave birth at home and 18.5% of them did so without the assistance of traditional birth attendants. Household education level was a significant predictor for home delivery (p < 0.01). Utilization of postnatal care services was irregular (47.9%–70.9%) and strongly associated with women’s places of delivery (p < 0.01). Efforts geared towards improving maternal health outcomes should focus on supporting traditional birth attendants in their role of facilitating high-quality care and helping women reach traditional health facilities, as well as on maternal health literacy based on culturally appropriate communication.

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BackgroundThe number of university global health training programs has grown in recent years. However, there is little research on the needs of the global health profession. We therefore set out to characterize the global health employment market by analyzing global health job vacancies.MethodsWe collected data from advertised, paid positions posted to web-based job boards, email listservs, and global health organization websites from November 2015 to May 2016. Data on requirements for education, language proficiency, technical expertise, physical location, and experience level were analyzed for all vacancies. Descriptive statistics were calculated for the aforementioned job characteristics. Associations between technical specialty area and requirements for non-English language proficiency and overseas experience were calculated using Chi-square statistics. A qualitative thematic analysis was performed on a subset of vacancies.ResultsWe analyzed the data from 1007 global health job vacancies from 127 employers. Among private and non-profit sector vacancies, 40% (n = 354) were for technical or subject matter experts, 20% (n = 177) for program directors, and 16% (n = 139) for managers, compared to 9.8% (n = 87) for entry-level and 13.6% (n = 120) for mid-level positions. The most common technical focus area was program or project management, followed by HIV/AIDS and quantitative analysis. Thematic analysis demonstrated a common emphasis on program operations, relations, design and planning, communication, and management.ConclusionsOur analysis shows a demand for candidates with several years of experience with global health programs, particularly program managers/directors and technical experts, with very few entry-level positions accessible to recent graduates of global health training programs. It is unlikely that global health training programs equip graduates to be competitive for the majority of positions that are currently available in this field.

Background Women left behind by migration represent a unique and growing population yet remain understudied as key players in the context of migration and development. Using a unique longitudinal survey of life in Bangladesh, the Matlab Health and Socioeconomic Surveys, we examined the role of spousal migration in healthcare utilization for women. The objective of this study was to assess realized access to care (do women actually get healthcare when it is needed) and consider specific macrostructural, predisposing, and resource barriers to care that are related to migration. Methods and findings In a sample of 3,187 currently married women, we estimated multivariate logistic and multinomial regression models controlling for a wide range of baseline sociodemographic factors measured as far back as 1982. Our analyses also controlled for selection effects and explored two mechanisms through which spousal migration can affect healthcare utilization for women, remittances and frequent contact with spouses. We found that women with migrant spouses were approximately half as likely to lack needed healthcare compared to women whose spouses remained in Bangladesh (predicted probability of not getting needed healthcare 11.7% vs. 21.8%, p<0.001). The improvements in access (logistic regression coefficient for lacking care for left-behind women -0.761 p<0.01) primarily occurred through a reduction in financial barriers to care for women whose spouses were abroad. Conclusions Wives of international migrants showed significantly better access to healthcare even when accounting for selection into a migrant family. While the overall story is one of positive migration effects on healthcare access due to reductions in financial barriers to care, results also showed an increase in family-related barriers such as not being permitted to get care by a family member or travel alone to a facility, indicating that some of the benefits of migration for women left behind may be diluted by gendered family structures.