Browsing by Author "Gabrysch, Sabine"

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    Introducing urine‑enriched biochar‑based fertilizer for vegetable production: Acceptability and results from rural Bangladesh
    (Springer Link, 2/19/2022) Sutradhar, Ipsita; deGrafenried, Meredith Jackson; Akter, Sayema; McMahon, Shannon A.; Waid, Jillian L.; Schmidt, Hans‑Peter; Wendt, Amanda S.; Gabrysch, Sabine
    Improved agricultural practices that increase yields and preserve soils are critical to addressing food insecurity and undernutrition among smallholder farmer families. Urineenriched biochar has been shown to be an accessible and efective fertilization option in various subtropical countries; however, it is new to Bangladesh. To better understand attitudes and experiences preparing and using urine-enriched biochar fertilizer, mixed-methods research was undertaken among smallholder farmers in northeastern Bangladesh in 2016/2017. In-depth interviews were conducted with 25 respondents who had compared the production of crops grown with biochar-based fertilizer to usual practice. In addition, in areas where trainings on biochar-based fertilization had been ofered, 845 farmers were asked about their experience through a quantitative survey. Interview results indicated that cow urine-enriched biochar was favored over human urine because cow urine was perceived as clean and socially acceptable, whereas human urine was considered impure and disgusting. Respondents praised biochar-based fertilizer because it increased yields, cost little, was convenient to prepare with readily available natural materials, produced tastier crops, and allowed families to share their larger yields which in turn enhanced social and fnancial capital. Comparative feld trials indicated a 60% yield beneft in both cabbage and kohlrabi crops. Challenges included uneven access to ingredients, with some respondents having difculty procuring cow urine and biomass feedstock. The low social, health, and fnancial risk of adoption and the perceived benefts motivated farmers to produce and apply biochar-based fertilizer in their gardens, demonstrating strong potential for scale-up of this technology in Bangladesh.
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    The quality of clinical maternal and neonatal healthcare – a strategy for identifying ‘routine care signal functions’
    (Plos One, 4/15/2015) Brenner, Stephan; Allegri, Manuela De; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S.
    Background A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the ‘EmOC signal functions’, a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. Methods We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Results Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants’ adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. Conclusion The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period.We hope our suggested indicators for essential routine care processes will contribute to streamlining MNH program evaluations in LMICs.