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The following presents a brief analysis of the mortality and nutrition situation in the Democratic Republic of Congo from 2000-2006 based on a summary of surveys, academic articles, and UN documentation over that period. The information was collected for the purpose of analysis in CRED's Complex Emergency Database (CEDAT). At the present time the database has only limited information for the years prior to 2000 and so has not included them in the analysis, although we acknowledge that the conflict began in 1998. N.B. There were ten provinces plus Kinshasa until February 2006 when the government changed the Constitution to include 26 provinces. However as this is not yet reflected in documentation for DRC we will maintain the previously used 11 provinces.

The following presents a brief analysis of the mortality and nutrition situation in the Democratic Republic of Congo from 2000-2006 based on a summary of surveys, academic articles, and UN documentation over that period. The information was collected for the purpose of analysis in CRED's Complex Emergency Database (CEDAT). At the present time the database has only limited information for the years prior to 2000 and so has not included them in the analysis, although we acknowledge that the conflict began in 1998. N.B. There were ten provinces plus Kinshasa until February 2006 when the government changed the Constitution to include 26 provinces. However as this is not yet reflected in documentation for DRC we will maintain the previously used 11 provinces.

The exact number of deaths in the Darfur region due to the conflict will probably never be known. But most certainly, it is far too many. Estimating mortality in conflicts is a notoriously difficult exercise, even more so in Darfur where the conditions causing death are extremely variable. Malnutrition, epidemics and violence occur sporadically, claiming many lives in some areas and none in others. Recognising the importance of tracking mortality and estimating deaths, humanitarian aid agencies working in the region have undertaken mortality surveys among their beneficiaries at different times to assess the condition of their status and the severity of the crises. These are based on sound statistical and epidemiological techniques and provide insights into the varying levels of mortality over the entire region. Estimating numbers of deaths from surveys depends on representativeness of the sample, double counting of deaths, under or over-reporting by respondents. Another key concern is that intensity of the conflict varies over time and in different areas of Darfur and therefore a blanket application of rates from a few surveys will invariably distort results. The humanitarian assistance, although slow in early stages, since the first half of 2004 in Darfur has been massive and is widely acknowledged to have saved many lives. As humanitarian needs continue to grow the situation today is deteriorating again and it is clear to the authors that humanitarian aid has to be increased and important international measures to end the aggression must be taken. From a majority of deaths being caused by military/violence in the wars in the first half of the 20th century, armed conflicts over the last 20 years have taken their toll among the civil populations. Disease and malnutrition have been the main causes of deaths among civilians in most of the major conflicts of the past two decades. These include deaths due to lack of access to health care, to food or harvests leading to starvation, dehydration and disease during displacement. Direct war-related violence on civilians leading to death (massacres, shootings), while heinous, contributes a small part of the total deaths, but remains the only direct evidence of the blunt hostility of armed groups on unarmed inhabitants. 6 In this paper we present two alternate methods that were used to calculate estimations of mortality in Darfur. The first one was elaborated by epidemiologists at the Brussels-based Centre for Research on the Epidemiology of Disasters (CRED). The second one was performed by the Bureau of Intelligence and Research of the US Department of State. In summary, the CRED method estimated approximately 134,000 total deaths in Darfur and Eastern Chad over the 17 months from September 2003 to January 2005. Of these deaths, 120,000 were excess deaths directly attributable to the conflict, 35,000 of which were violent deaths. The US State Department method estimated a possible range of 98,000 – 181,000 total deaths over 23 months - from March 2003 to January 2005. Estimates of excess deaths due to the conflict ranged from 63,000 – 146,000 over the same period.

The exact number of deaths in the Darfur region due to the conflict will probably never be known. But most certainly, it is far too many. Estimating mortality in conflicts is a notoriously difficult exercise, even more so in Darfur where the conditions causing death are extremely variable. Malnutrition, epidemics and violence occur sporadically, claiming many lives in some areas and none in others. Recognising the importance of tracking mortality and estimating deaths, humanitarian aid agencies working in the region have undertaken mortality surveys among their beneficiaries at different times to assess the condition of their status and the severity of the crises. These are based on sound statistical and epidemiological techniques and provide insights into the varying levels of mortality over the entire region. Estimating numbers of deaths from surveys depends on representativeness of the sample, double counting of deaths, under or over-reporting by respondents. Another key concern is that intensity of the conflict varies over time and in different areas of Darfur and therefore a blanket application of rates from a few surveys will invariably distort results. The humanitarian assistance, although slow in early stages, since the first half of 2004 in Darfur has been massive and is widely acknowledged to have saved many lives. As humanitarian needs continue to grow the situation today is deteriorating again and it is clear to the authors that humanitarian aid has to be increased and important international measures to end the aggression must be taken. From a majority of deaths being caused by military/violence in the wars in the first half of the 20th century, armed conflicts over the last 20 years have taken their toll among the civil populations. Disease and malnutrition have been the main causes of deaths among civilians in most of the major conflicts of the past two decades. These include deaths due to lack of access to health care, to food or harvests leading to starvation, dehydration and disease during displacement. Direct war-related violence on civilians leading to death (massacres, shootings), while heinous, contributes a small part of the total deaths, but remains the only direct evidence of the blunt hostility of armed groups on unarmed inhabitants. 6 In this paper we present two alternate methods that were used to calculate estimations of mortality in Darfur. The first one was elaborated by epidemiologists at the Brussels-based Centre for Research on the Epidemiology of Disasters (CRED). The second one was performed by the Bureau of Intelligence and Research of the US Department of State. In summary, the CRED method estimated approximately 134,000 total deaths in Darfur and Eastern Chad over the 17 months from September 2003 to January 2005. Of these deaths, 120,000 were excess deaths directly attributable to the conflict, 35,000 of which were violent deaths. The US State Department method estimated a possible range of 98,000 – 181,000 total deaths over 23 months - from March 2003 to January 2005. Estimates of excess deaths due to the conflict ranged from 63,000 – 146,000 over the same period.

This study aimed to descript the Belgian COVID-19 responses process according to the WHO's (World Health Organization) Health Emergency and Disaster Risk Management Framework (Health EDRM Framework) and to present the measures taken and epidemic impact in the different phases of COVID-19 in Belgium. The WHO's EDRM Framework was used for reviewing the Belgian Public health emergency preparedness and responses in the context of COVID-19. Information on the measures taken was collected through the literature review including all government's communication, reports, and scientific papers. All epidemic data were extracted from a national open database managed and published by the Sciensano. Additionally, two authors closely followed the Belgian situation since the beginning of the pandemic and updated the data every day. During the COVID-19 pandemic, the anti-epidemic strategy was mainly to avoid medical resources exceeding the upper limit. Belgium issued a series of emergency decrees to limit the spread of the virus. An existing structure of "federal-region-municipal" as the framework of public health emergency preparedness and response was adapted. The emergency response process in Belgium was divided into four phases: information-evaluation-coordination-decision-making at the region level and the final decision-making at the federal level. Belgium also implemented a phased plan in the process of setting up and lifting the lockdown. However, it was vulnerable in early response, due to the shortage of medical equipment supplies in general, and more particularly for the long term care facilities (LTCFs). Belgium has achieved an intensive cooperation between stakeholders based on an existing multisectoral emergency organization framework. Legislation, medical insurance, and good communication also played a role in limiting the spread of viruses. However, the authorities underestimated the risk of an epidemic and did not take quarantine measures among people suspected affected by SARS-COV-2 in the early stages, ...

Background Maternal mortality, of which 6.7% is attributable to abortion complications, remains high in Mozambique. The objective of this paper is to assess the level of induced abortion at the community, as well as to assess awareness of and attitudes towards the new abortion law among women of reproductive age in suburban areas of Maputo and Quelimane cities. Methods A cross-sectional household survey among women aged 15-49 years in Maputo and Quelimane cities was conducted using a multi-stage clustered sampling design. Data on sociodemographic characteristics, maternal outcomes, contraceptive use, knowledge and attitudes towards the new abortion law were collected. Bivariate and multiple logistic regression analysis using the complex samples procedure in SPSS were applied. Results A total of 1657 women (827 Maputo and 830 Quelimane) were interviewed between August 2016 and February 2017. The mean age was 27 years; 45.7% were married and 75.5% had ever been pregnant. 9.2% of the women reported having had an induced abortion, of which 20.0% (17) had unsafe abortion. Of the respondents, 28.8% knew the new legal status of abortion. 17% thought that the legalization of abortion was beneficial to women's health. Having ever been pregnant, being unmarried, student, Muslim, as well as residing in Maputo were associated with higher odds of having knowledge of the new abortion law. Conclusion Reports of abortion appear to be low compared to other studies from Sub-Saharan African countries. Furthermore, respondents demonstrated limited knowledge of the abortion law. Social factors such as education status, religion, residence in a large city as well as pregnancy history were associated with having knowledge of the abortion law. Only a small percentage of women perceived abortion as beneficial to women's health. There is a need for widespread sensitization about the new law and its benefits. ; This research was supported by VLIR-UOS through cooperation between Ghent University, Belgium and Eduardo Mondlane University, Mozambique. The funding body had no role in the design of the study and data collection; analysis and interpretation of data; in writing and review of the manuscript; as well as on the decision to submit the manuscript for publication. ; Frederico, M (corresponding author), Eduardo Mondlane Univ, Ctr Estudos Africanos, Maputo, Mozambique; Univ Ghent, Fac Med & Hlth Sci, Dept Publ Hlth & Primary Care, Int Ctr Reprod Hlth ICRH, Ghent, Belgium. monica.frederico@ugent.be

Background: Cervical cancer claims 311,000 lives annually, and 90% of these deaths occur in low- and middle-income countries. Cervical cancer is a highly preventable and treatable disease, if detected through screening at an early stage. Governments have a responsibility to screen women for precancerous cervical lesions. Yet, national screening programmes overlook many poor women and those marginalised in society. Under-screened women (called hard-to-reach) experience a higher incidence of cervical cancer and elevated mortality rates compared to regularly-screened women. Such inequalities deprive hard-to-reach women of the full enjoyment of their right to sexual and reproductive health, as laid out in Article 12 of the International Covenant on Economic, Social and Cultural Rights and General Comment No. 22. Discussion: This article argues first for tailored and innovative national cervical cancer screening programmes (NCSP) grounded in human rights law, to close the disparity between women who are afforded screening and those who are not. Second, acknowledging socioeconomic disparities requires governments to adopt and refine universal cancer control through NCSPs aligned with human rights duties, including to reach all eligible women. Commonly reported- and chronically under-addressed- screening disparities relate to the availability of sufficient health facilities and human resources (example from Kenya), the physical accessibility of health services for rural and remote populations (example from Brazil), and the accessibility of information sensitive to cultural, ethnic, and linguistic barriers (example from Ecuador). Third, governments can adopt new technologies to overcome individual and structural barriers to cervical cancer screening. National cervical cancer screening programmes should tailor screening methods to under-screened women, bearing in mind that eliminating systemic discrimination may require committing greater resources to traditionally neglected groups. Conclusion: Governments have human rights obligations to refocus screening policies and programmes on women who are disproportionately affected by discrimination that impairs their full enjoyment of the right to sexual and reproductive health. National cervical cancer screening programmes that keep the right to health principles (above) central will be able to expand screening among low-income, isolated and other marginalised populations, but also women in general, who, for a variety of reasons, do not visit healthcare providers for regular screenings. ; publishersversion ; published