BackgroundEfforts to end preventable newborn deaths will fail if the poor are not reached with effective interventions. To understand what works to reach vulnerable groups, we describe and explain the uptake of a highly effective community-based newborn health intervention across social strata in Asia and Africa.MethodsWe conducted a secondary analysis of seven randomised trials of participatory women's groups to reduce newborn mortality in India, Bangladesh, Nepal and Malawi. We analysed data on 70 574 pregnancies. Socioeconomic and sociodemographic differences in group attendance were tested using logistic regression. Qualitative data were collected at each trial site (225 focus groups, 20 interviews) to understand our results.ResultsSocioeconomic differences in women's group attendance were small, except for occasional lower attendance by elites. Sociodemographic differences were large, with lower attendance by young primigravid women in African as well as in South Asian sites. The intervention was considered relevant and interesting to all socioeconomic groups. Local facilitators ensured inclusion of poorer women. Embarrassment and family constraints on movement outside the home restricted attendance among primigravid women. Reproductive health discussions were perceived as inappropriate for them.ConclusionsCommunity-based women's groups can help to reach every newborn with effective interventions. Equitable intervention uptake is enhanced when facilitators actively encourage all women to attend, organise meetings at the participants’ convenience and use approaches that are easily understandable for the less educated. Focused efforts to include primigravid women are necessary, working with families and communities to decrease social taboos.

Most populations live in spatially structured environments and that structure has the potential to impact the evolutionary dynamics in a number of important ways. Theoretical models tracking evolution in structured environments using a range of different approaches, suggest that local interactions and spatial heterogeneity can increase the adaptive benefits of motility, impact both the rate and extent of adaptation, and increase the probability of parallel evolution. We test these general predictions in a microbial evolution experiment tracking phenotypic and genomic changes in replicate populations of Pseudomonas fluorescens evolved in both well-mixed and spatially-structured environments, where spatial structure was generated through the addition of semi-solid agar. In contrast to the well-mixed environment, populations evolved in the spatially-structured environment adapted more slowly, retained the ability to disperse more rapidly, and had a greater putatively neutral population genomic diversity. The degree of parallel evolution measured at the gene-level, did not differ across these two types of experimental environments, perhaps because the populations had not evolved for long enough to near their fitness optima. These results confirm important general impacts of spatial structure on evolutionary dynamics at both the phenotypic and genomic level.

Ever married women are more vulnerable group to sexually transmitted diseases (STDs), HIV/AIDS infection, and unplanned pregnancies. The aims of this study are to assess the level of awareness among ever married women on HIV/AIDS and to determine the affecting factors influenced knowledge and awareness about HIV/AIDS regarding its prevention and control. The data on 10,996 ever married women in their reproductive span (15-49 years) was taken from the Bangladesh Demographic and Health Survey (BDHS), 2007. The statistical tools, Chi square (χ 2) test and binary logistic regression analysis have been performed to analyse the data. Both bivariate and multivariate analyses identified that respondent's education, husband's education, husband's occupation, age at marriage, watching TV, electricity in the household, marital status, and residence are found to have statistically significant effects with HIV/AIDS awareness (p<0.01). Marriage in the older age (>18 years), education, and mass media campaigns are strongly suggested for increasing knowledge and awareness to be controlled the spread of HIV/AIDS as well as STDs among ever married women in Bangladesh.

Female migrant workers are susceptible for economic exploitation, physical violence and sexual abuse. They are at risks of sexually transmitted diseases, unwanted pregnancy, illegal termination of pregnancy and related problems. They also spread the diseases knowingly and unknowingly. There are about five millions registered and undocumented migration workers are in Malaysia. The Malaysian government is committed to stop the illegal trafficking of women and under aged girls. The health education programme and screening procedures are important to prevent the spread of HIV/AIDS.

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