BackgroundIn Bangladesh, female paramedics known as Family Welfare Visitors (FWVs), conduct normal deliveries in first-level primary care facilities, or Union Health and Family Welfare Centres (UH&FWC). Utilization of partographs allow for early identification of abnormal labour and referral for advanced care to Emergency Obstetric Care (EmOC) facilities. A systematic assessment of the quality of partograph utilization in clinical-decision making will contribute to understanding the use of the tool by health workers.MethodsIn 2013, the USAID supported MaMoni HSS project, led in country by Save the Children, trained FWVs on the use of partographs in five UH&FWCs in Habiganj district. As part of the follow-up after training, intrapartum case record forms, accompanying partographs, and referral registers for all obstetric cases managed in these five facilities from July 2013 to June 2014 were reviewed. Partographs were reviewed to identify abnormal labour cases based on pre-defined indications. All referred cases were ascertained from the case records in the referral registers. Five health workers were interviewed to assess their knowledge, attitude and experience in partograph use and to explore the challenges for referral decision making associated with the tool.ResultsA total of 1,198 deliveries were managed at the study sites, of which 663 presented with cervical dilatation of 8 cm or less. Partographs were initiated in 98% of these cases. Indication of abnormal labour was found in 71 partographs (11%) and among them, only 1 was referred to a higher-level facility. Foetal heart rate and cervical dilatation were appropriately recorded in 61% and 70% of the partographs, respectively. Interviews with health workers revealed poor interpretation of referral indications from the partographs. Limited accessibility to the nearest EmOC facility, inadequate time for referral, and non-compliance to referral by clients were identified by the interviewed health workers as the key barriers for referral decision making.ConclusionsSupporting the health workers at first-level primary care facilities to better interpret and act on partograph data in a timely manner, and strengthening the referral systems are needed to ensure that women in labour receive the prompt quality care they and their babies require to survive.

The impact of a range of different threats has resulted in the listing of six out of seven sea turtle species on the IUCN Red List of endangered species. Disease risk analysis (DRA) tools are designed to provide objective, repeatable and documented assessment of the disease risks for a population and measures to reduce these risks through management options. To the best of our knowledge, DRAs have not previously been published for sea turtles, although disease is reported to contribute to sea turtle population decline. Here, a comprehensive list of health hazards is provided for all seven species of sea turtles. The possible risk these hazards pose to the health of sea turtles were assessed and “One Health” aspects of interacting with sea turtles were also investigated. The risk assessment was undertaken in collaboration with more than 30 experts in the field including veterinarians, microbiologists, social scientists, epidemiologists and stakeholders, in the form of two international workshops and one local workshop. The general finding of the DRA was the distinct lack of knowledge regarding a link between the presence of pathogens and diseases manifestation in sea turtles. A higher rate of disease in immunocompromised individuals was repeatedly reported and a possible link between immunosuppression and environmental contaminants as a result of anthropogenic influences was suggested. Society based conservation initiatives and as a result the cultural and social aspect of interacting with sea turtles appeared to need more attention and research. A risk management workshop was carried out to acquire the insights of local policy makers about management options for the risks relevant to Queensland and the options were evaluated considering their feasibility and effectiveness. The sea turtle DRA presented here, is a structured guide for future risk assessments to be used in specific scenarios such as translocation and head-starting programs.

Despite the growing evidence linking social capital to improvements in health and health behaviors, reliable measures of social capital are lacking in low-income countries. To accurately measure social capital in new contexts, there is a need to validate social capital survey questions in each new cultural setting. In this article we examine the content validity of the measurement of social capital in Bangladesh using qualitative methods. In December 2012, we conducted four focus group discussions and 32 cognitive interviews in one rural subdistrict (Durgapur) and one urban slum (Mirpur). We used the findings from the focus groups and cognitive interviews to create a new social capital survey instrument that can be used by health and development organizations in Bangladesh. Furthermore, in this article we provide insight into social capital survey research in general, including suggestions for the measurement of group membership, social support, collective action, and social trust.

49The impact of a range of different threats has resulted in the listing of six out of seven sea turtle 50 species on the IUCN Red List of endangered species. Disease risk analysis (DRA) tools are designed to 51 provide objective, repeatable and documented assessment of the disease risks for a population and 52 measures to reduce these risks through management options. To the best of our knowledge, DRAs 53 have not previously been published for sea turtles, although disease is reported to contribute to sea 54 turtle population decline. Here, a comprehensive list of health hazards is provided for all seven 55 species of sea turtles. The possible risk these hazards pose to the health of sea turtles were assessed 56 and "One Health" aspects of interacting with sea turtles were also investigated. The risk assessment 57 was undertaken in collaboration with more than 30 experts in the field including veterinarians, 58 microbiologists, social scientists, epidemiologists and stakeholders, in the form of two international 59 workshops and one local workshop. The general finding of the DRA was the distinct lack of 60 knowledge regarding a link between the presence of pathogens and diseases manifestation in sea 61 turtles. A higher rate of disease in immunocompromised individuals was repeatedly reported and a 62 possible link between immunosuppression and environmental contaminants as a result of 63 anthropogenic influences was suggested. Society based conservation initiatives and as a result the 64 cultural and social aspect of interacting with sea turtles appeared to need more attention and 65 research. A risk management workshop was carried out to acquire the insights of local policy makers 66 about management options for the risks relevant to Queensland and the options were evaluated 67 considering their feasibility and effectiveness. The sea turtle DRA presented here, is a structured 68 guide for future risk assessments to be used in specific scenarios such as translocation and head-69 starting programs. 70 71 72 73 3 74 101 Species Survival Commission in 2014. The manual addresses different scenarios for endangered 102 species and translocating them for conservation purposes and enables the pros and cons of these 103actions to be thoroughly investigated (11). In order to accommodate the unique biology of sea 104 turtles, the DRA process as described in this manual requires certain modifications to realistically 105 articulate with situations such as translocating animals or investigating the risks of disease for a 106 population in its normal habitat. A 2015 study describes a systematic approach to investigate 107 disease-related population decline without confining the assessment to a particular scenario or 108 location (6). This method is a modified version of a DRA based on epidemiological principles (6) for 109 any declining wildlife population. A successful DRA considers the study population in the context of 110 the environment. 111In the 1960's, Calvin Schwabe coined the term "One Medicine" which then extended ...