BackgroundEnsuring the quality of malaria medicines is crucial in working toward malaria control and eventual elimination. Unlike other validated tests that can assess all critical quality attributes, which is the standard for determining the quality of medicines, basic tests are significantly less expensive, faster, and require less skilled labour; yet, these tests provide reproducible data and information on several critical quality attributes, such as identity, purity, content, and disintegration. Visual and physical inspection also provides valuable information about the manufacturing and the labelling of medicines, and in many cases this inspection is sufficient to detect counterfeit medicines. The Promoting the Quality of Medicines (PQM) programme has provided technical assistance to Amazon Malaria Initiative (AMI) countries to implement the use of basic tests as a key screening mechanism to assess the quality of malaria medicines available to patients in decentralized regions.MethodsTrained personnel from the National Malaria Control Programmes (NMCPs), often in collaboration with country’s Official Medicine Control Laboratory (OMCL), developed country- specific protocols that encompassed sampling methods, sample analysis, and data reporting. Sampling sites were selected based on malaria burden, accessibility, and geographical location. Convenience sampling was performed and countries were recommended to store the sampled medicines under conditions that did not compromise their quality. Basic analytical tests, such as disintegration and thin layer chromatography (TLC), were performed utilizing a portable mini-laboratory.ResultsResults were originally presented at regional meetings in a non-standardized format that lacked relevant medicines information. However, since 2008 information has been submitted utilizing a template specifically developed by PQM for that purpose. From 2005 to 2010, the quality of 1,663 malaria medicines from seven AMI countries was evaluated, mostly collected from the public sector, 1,445/1,663 (86.9%). Results indicate that 193/1,663 (11.6%) were found not to meet quality specifications. Most failures were reported during visual and physical inspection, 142/1663 (8.5%), and most of these were due to expired medicines, 118/142 (83.1%). Samples failing TLC accounted for 27/1,663 (1.6%) and those failing disintegration accounted for 24/1,663 (1.4%). Medicines quality failures decreased significantly during the last two years.ConclusionsBasic tests revealed that the quality of medicines in the public sector improved over the years, since the implementation of this type of quality monitoring programme in 2005. However, the lack of consistent confirmatory tests in the quality control (QC) laboratory, utilizing methods that can also evaluate additional quality attributes, could still mask quality issues. In the future, AMI countries should improve coordination with their health authorities and their QC lab consistently, to provide a more complete picture of malaria medicines quality and s...

Participation in out-of-school learning programs has been shown to generate significant academic, social/emotional, and institutional benefits for young learners, and today's wealthy families are disproportionately reaping these benefits. This paper presents the results of an assetbased/human-centered design research process and pilot aimed at connecting low-income families in a Southern California city with local low-cost out-of-school learning opportunities. Based on background research including qualitative interviewing, home visits, technology inventories and use walkthroughs with 40 low-income, majority Latinx families, we created and piloted a free subscription SMS service that automatically pushes bilingual SMS messages with curated information on local low-cost enrichment learning opportunities to low-income families. We framed our human-centered design process through an intersectional, "asset-based approach," which recognizes that marginalized communities have already developed robust, culturally-specific social practices to enable them to navigate the world, seeks to amplify them, and refrains from imposing a top-down or preconceived "idea" of intervention.

Design/Build project delivery mechanisms have become increasingly popular because they offer advantages in speed of completion, efficiency, and in many cases, cost savings over conventional design/bid/build project delivery. However, there are cases where the promise of design/build has not been delivered, and accompanying painful lessons learned. There are particular difficulties in executing a design/build project for a public agency because there are strict constraints on procurement, budgeting and project tracking.This paper will explore the lessons learned during the execution of a design/build delivery of a wetlands mitigation project for the Port of Houston Authority. The project is a medium-sized undertaking (less than $2 million total cost) with an aggressive initial schedule and considerable dependence on weather conditions. The paper will outline the preparation steps that led to the decision to execute the work on a design/build basis; the selection process and contracting; the advantages that resulted from using this delivery mechanism; and a list of suggestions for future projects where this method of delivery is required.