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2019 Summary Report - Born On Time
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2019 Summary Report “We used to sell the crops and fruits we harvested. We didn’t realize that we needed to consume some of them for our own health. After BOT trained me on adolescent nutrition, I started planting crops and fruits for consumption. My friends were surprised and took my advice and followed in my footsteps. Now, my neighbors are also planting their own gardens in their backyard and using the food from their backyard to prevent malnutrition.”
2 SUMMARY REPORT 2019 SUMMARY REPORT 2019 3 Every mother has the right to a healthy, full- term pregnancy, and every newborn has the right to thrive. Preterm Birth - Why Prevention? E very year, approximately 15 million These countries have some of the highest preterm babies are born too soon. Preterm birth birth rates globally and combined, account for an complications are now the leading cause estimated 1,069,644 preterm births every year of death in children under 5 years, with (Lancet, 2019). an estimated one million premature babies dying each year (WHO, 2018). As preterm birth Born on Time targets risk factors related statistics rise in many low- and middle-income to unhealthy lifestyles, maternal infections, countries, prevention of preterm birth is emerging inadequate nutrition, and limited access to as a critical catalyst towards healthier, thriving contraception that can lead to babies being children around the world. born too soon. We support the empowerment of women and adolescent girls, and engage men, We know that more than 75% of preterm birth boys and community leaders to address gender- deaths can be prevented without intensive care based discrimination and barriers that can have (WHO, 2012). Interventions that promote family long-lasting impacts on maternal and newborn planning, empower women and adolescent girls, health, as well as the realization of women’s and and improve the quality of health care before, adolescent girls’ rights. Born on Time has made during and after pregnancy, significantly reduce significant strides towards preterm birth rates. Working closely with local governments and implementing effective community stakeholders, Born on Time brings Born on Time – the first public-private partnership together the collective expertise and resources of approaches that address the risk dedicated to the prevention of preterm birth – is a World Vision Canada, Plan International Canada, factors associated with preterm five-year, CAD $30.6 million project, working across Save the Children Canada, the Government of births and improving care for Bangladesh, Ethiopia and Mali. Canada, and Johnson & Johnson, supporting the United Nations’ global movement to ensure every premature babies. child is Born on Time.
4 SUMMARY REPORT 2019 SUMMARY REPORT 2019 5 Born on Time At a Glance M ore than 55 dedicated, passionate In 2019, Born on Time and highly-specialized project team members in four countries and supported: across three continents are helping to change the narrative around prevention of preterm birth. Their work is creating a Prenatal services for 206,879 positive, measurable difference across a continuum pregnant women and of changemakers – adolescent girls and boys are adolescent girls speaking out against child, early and forced marriage; women and men are advocating for women and adolescent girls’ health and wellbeing; healthcare Skilled delivery for 119,775 workers and communities are being empowered with critical skills; and even Ministers of Health are seeing pregnant women and that although prevention work can be nuanced and adolescent girls challenging, it matters in ways that deeply shape a society’s notions of wellness, equality, and the dignity of all. Newborn care for 111,133 newborns To address prematurity, Born on Time targets what are known as the LINC factors related to preterm birth – unhealthy Lifestyle, maternal Family planning for 637,477 Infections, inadequate Nutrition and limited access adolescents and adults to Contraception. L ifestyle: addressing unhealthy lifestyle and harmful gender discriminatory behaviours such as heavy workloads for women and adolescent girls, gender-based violence, smoking, alcohol abuse, female genital mutilation/cutting, and child, early and forced marriage. I nfections: supporting the diagnosis and treatment of infections during pregnancy such as malaria, sexually transmitted diseases (such as syphilis), HIV/AIDS, bacterial vaginosis and urinary tract infections. N utrition: promoting good nutrition among women and adolescent girls, increasing micronutrient supplementation during pregnancy, and addressing harmful beliefs/ taboos around dietary practices. Across Bangladesh, Ethiopia, and Mali, community leaders and members mobilized in C ontraception: improving availability and access to modern methods of 2019 to promote gender equality and raise awareness on preterm birth prevention and contraception. Family planning helps to prevent teenage pregnancy, gaps response. These activities – conducted through community-based platforms such as between pregnancies of less than six months, and advanced maternal age, peer-to-peer adolescent groups, male and female engagement groups, and fairs that which are risk factors of preterm birth. Contraception also supports women bring together daughters-in-law and mothers-in-law – reached more than 841,067 and adolescent girls in making their own reproductive choices. adolescent girls and boys and more than 1.18 million adults.
6 SUMMARY REPORT 2019 SUMMARY REPORT 2019 7 Improving Health Service Delivery In all three countries in 2019, B orn on Time works to improve the health services that Born on Time supported communities depend on, and community healthcare workers to that address the risk factors of preterm birth, by: reach 143,897 women, adolescent girls and newborns through Training healthcare providers 1 and community health workers household visits. These intimate, to provide services that individual appointments are address LINC factors, safe and clean delivery, antenatal and postnatal care critical in the health of pregnant for adolescent girls and women, women and adolescent girls, before, during and after pregnancies. new moms and babies as they Improving local health cover issues like the danger signs 2 facilities with essential of premature labour, how to equipment and supplies. Strengthening referral systems In 2019, Born on Time trained and supported more than 12,393 health care workers working reach health facilities for a safe 3 for high risk pregnancies and in hospitals, clinics and across communities; and delivery, breastfeeding support deliveries, and preterm babies. upgraded and equipped 67 health facilities with key medical equipment and supplies such as and family planning. Ensuring health services delivery beds, maternity beds, radiant warmers, 4 are gender responsive and fetal monitors, weight scales, trolleys, suction adolescent friendly. machines, autoclave machines, stethoscopes and blood pressure apparatuses, to better serve women and men and adolescent girls and boys across Bangladesh, Ethiopia and Mali. “I’m part of a system that’s taking In Bangladesh, the percentage of facility-based healthcare providers who knew at least four risk factors for preterm births was care of people. Women suffer a lot in 90% after training in 2019, a 39-percentage point increase from our communities, especially during pre-test (51%). pregnancy and delivery. Through Born In Ethiopia, the percentage of women who were visited by a community health worker for prenatal counselling at least once in on Time, they now know that there are each trimester during their last pregnancy increased from 16.7% at services [at health clinics] and that these baseline to 57.8% at the end of 2019. are for free. When I see a mother deliver In Mali, evaluation results suggest an improvement in health a healthy baby that I have counselled facilities achieving gender-responsive standards for healthcare delivery to women of reproductive age, increasing from an through a pregnancy, it makes me so average of 39% at baseline to 54% at midterm. proud. It is my happiness.” - Mukta, Community Health Worker, Bangladesh Ethiopian midwives pilot portable ultrasound device
8 SUMMARY REPORT 2019 SUMMARY REPORT 2019 9 “My dream, and what I’m fighting for, is for girls to thrive.” Priest Jejaw lost his eldest daughter to pregnancy-related causes when she was just a teenager. He now educates Christian and Muslim faith leaders in Ethiopia about the dangers of early marriage for adolescent girls and their babies. Here, he holds his three- Increasing year-old granddaughter, Nardos. In 2019, Born on Time: • Established more than 2,418 adolescent support groups, focused on raising awareness about sexual and reproductive health and rights, including preterm birth risk factors, for 25,937 adolescent girls and boys. Use of Health Services • Reached 43,858 people through fathers’ and mothers’ groups on shared decision making, gender equality, and mutual engagement in maternal health and wellbeing. A s Born on Time increases the quality of Tackling issues of gender inequality • Held over 60,149 awareness sessions with 1,153,378 health services to address the risk factors of 2 through the empowerment of women community religious leaders, gatekeepers within families, such as “I love this health centre and the preterm birth, it’s also important to ensure and adolescent girls by building their self- grandmothers and mothers-in-law, and elders, chiefs and male that women and girls, men and boys, are confidence, strengthening their decision-making community members on gender equality issues, the importance of professionals take good care of aware of these services, are comfortable accessing skills and developing their leadership potential. male engagement, preventing preterm birth, and preterm taboos me. I tell other pregnant ladies them and are part of building an environment where and harmful practices such as child, early and forced marriage. all community members can make decisions about Engaging men through male-to-male in my area to come here to their health. We support this by: 3 dialogue groups, highlighting their key role • Conducted 250 meetings with 10,111 local government officials follow up on their progress and in supporting the health and well-being of and Community Health Committees to advocate for investments Promoting behaviour change around their partners and families. This includes men’s in the prevention of preterm births. to check the well-being of their 1 unhealthy lifestyle choices, addressing involvement in accompanying their partners to health baby to come.” taboos around preterm birth and working services, reducing gender-based violence, sharing • Trained over 44,464 peer educators, social mobilizers, local Mulu Dilnesahu, Ethiopian mother with community and religious leaders, youth decision making, taking on more household chores champions and change-makers in communities on preterm birth expecting her third child groups and radio broadcasters to raise awareness. and child care to promote maternal rest, and risk factors, sexual and reproductive health and rights, as well as preventing child, early and forced marriage. gender equality.
10 SUMMARY REPORT 2019 SUMMARY REPORT 2019 11 Strengthening Preterm Birth Data Collection and Utilization I mproving data collection on preterm birth in Born on Time also undertook a consortium- communities, as well as in health facilities, is wide Learning and Sharing Workshop, held in an important element towards the prevention Bangladesh, where more than 40 participants of preterm births. Born on Time is working to shared project progress to date, best practices, increase the capacity of healthcare providers to lessons learned and challenges, as well as key utilize age and sex-disaggregated, preterm birth issues of focus for the final year. data for maternal and newborn health in planning and management strategies at both national and Key takeaways included the need for greater inter- subnational levels. country dialogue to support ongoing learning, innovation sharing and knowledge management In 2019, Born on Time developed and adapted data dissemination, addressing unintended consequences collection systems to introduce and share preterm of project interventions on gender equality, and birth data at all levels in Bangladesh and organized the importance of sustainability discussions in the multiple dissemination meetings to share available coming months. preterm birth data with relevant stakeholders across all countries. In Ethiopia, Born on Time launched online real time data collection and monitoring using Open Data Kit, or ODK, to generate monthly and annual reports. In 2019, Born on Time’s midterm report was finalized. The overall objective of this study was to conduct a Quality of Care study, complemented by a qualitative assessment, across all three countries in order to assess progress towards intended outcomes; findings were shared with key stakeholders, project implementers and donors, and utilized for ongoing learning and course correction. In addition, the first phase of Born on Time’s global research was completed, comprised of a qualitative The extent to which preterm birth data and best study exploring the lifestyle risk factors and gender practices are disseminated at local, national and barriers that contribute to preterm birth; from which global levels ranged from ratings of “satisfactory” findings will inform the second, quantitative phase of to “strong” in the three countries in 2019. This the research study being undertaken in 2020. composite indicator is made up of three advocacy domains – Planning, Dissemination, and Level of Engagement. The project’s target is to reach “strong” across all three countries by the end of 2020.
12 SUMMARY REPORT 2019 SUMMARY REPORT 2019 13 The empowerment of women and adolescent girls is critical to preterm birth prevention and the realization of gender equality and women’s and adolescent girls’ rights. We work to transform unequal gender relations and power dynamics by: Supporting the empowerment 1 of women and adolescent girls as decision makers over their own sexual and reproductive health and rights, and as change agents towards gender equality that benefits everyone. Engaging men and boys, as 2 well as religious, traditional and community leaders as active partners of change. This fosters an understanding of the critical role fathers, husbands, male peers and community leaders play to support the health, and promote and advocate for the rights, of women, adolescent girls and children. “We can all use our power for good Making newborn and 3 reproductive health services and to achieve a more gender responsive more gender equal by building the capacity of health services providers, decision makers and world.” community health workers, to support the Mahenur Alam Chowdhury, delivery of quality, gender-responsive and Capacity Development Specialist, adolescent-friendly maternal, newborn Born on Time Bangladesh and reproductive health services. Transforming discriminatory social norms and shifting power imbalances The Power of Gender are essential components of Born on Time. In 2019, the project worked to: Address the knowledge gaps of adolescent girls and women around gender equality, sexual and reproductive health and rights, as well as risk factors associated with preterm birth. Equality to Reduce Train male dialogue facilitators and establish male engagement groups in communities to address issues such as gender-based violence, preterm birth and support for women during pregnancy, childbirth and the postnatal period. Preterm Birth Support the integration of gender equality considerations in the services offered by health facilities, monitor the effectiveness of gender-responsive and adolescent-friendly health services, and include these criteria in supervision and follow-up visits.
14 SUMMARY REPORT 2019 SUMMARY REPORT 2019 15 Amplifying the Preterm Local Engagement: Birth Prevention Agenda Born on Time commemorated international days in all three countries, including International Women’s Day in March, International Day of the Girl in October, and World Prematurity Day and International Day for the Eradication of Violence As a part of a growing movement aimed at helping women and adolescent girls deliver healthy babies, Against Women, both held in November 2019. Born on Time is amplifying the World Health Organization’s Global Strategy for Women’s, Children’s and Adolescents’ Health, in support of the United Nations’ Every Woman, Every Child campaign. • In Mali, events were held during these international days to celebrate women and Global Engagement adolescent girls in sport, combined with gender equality messaging, including a marathon • Participated in a photo exhibit and panel for adolescent girls. In addition, Born on Time discussion – Respect and Dignity in Gender- contributed as a member of the Prematurity Transformative Storytelling – during Canada’s Working Group to plan national-level celebrations International Development Week in February of World Prematurity Day, which were chaired by 2019. the Minister of Health. • In Ethiopia, Born on Time hosted a side event and presented at the 2nd annual Reproductive, • Photographs and stories from Born on Time Maternal, Newborn, Child and Adolescent Health were featured in a curated art exhibit at World and Nutrition Research Conference in August Health Day celebrations in April 2019, hosted 2019, under the theme Advancing the quality by Canadian Partnership for Women and agenda in maternal, neonatal, child and youth Children’s Health (CanWaCH), entitled Health health care through evidence translation. White for All: The Journey to Empower Every Woman Ribbon Day and the International Day for the and Child to Thrive. Eradication of Violence against Women were celebrated in Ethiopia’s West Gojam zone on • Engagement at Women Deliver conference in November 25, 2019 in collaboration with the Canada in June 2019 included an interactive zonal government Women, Child and Youth Affairs booth with Preterm Birth Initiative and Global Bureau. Over 2,800 people attended this event, Alliance to Prevent Prematurity and Stillbirth; including government and religious leaders, and a side event entitled A Question of Rights: The school communities. Power of Gender Equality to Prevent Preterm Birth; and multiple speaking engagements on panels and with media outlets. • Joined Partnership for Maternal, Newborn and • In Bangladesh, 62 daughter-in-law and mother-in- Child Health, March of Dimes, UNICEF, and law fairs, known as Bou-Shashuri Melas, reached other dedicated partners in a global Twitter a total of 321,692 people with messages on Chat to mark #WorldPrematurityDay in gender equality; male engagement in maternal, November 2019. newborn and child health; dangers of child, early and forced marriage; and prevention of intimate • Presentation at the 2nd International Symposium partner violence. These key messages plus on Community Health Workers held in November preterm birth risk factors were also shared during 2019 in Bangladesh: From preterm births to World Prematurity Day celebrations. non-communicable diseases: CHWs’ potential to tackle prevention through nutrition.
16 SUMMARY REPORT 2019 SUMMARY REPORT 2019 17 Ruth: Celebrating the Powerful Work of Midwives W omen make up more than 70 per cent Ruth has been trained by Born on Time as a trainer of the global health workforce (WHO, in the Lifestyle, Infection, Nutrition, Contraception 2019). Although they play a critical role (LINC) approach to preventing preterm birth and in improving and saving people’s lives, on gender equality, as well as Kangaroo Care, female health workers are often unrecognized, newborn care and sexual and reproductive health underpaid or unpaid (Lancet, 2015). Roopa Dhatt, and rights. She says she puts her knowledge into Executive Director of Women in Global Health, shared practice in the fight against preterm birth, and this information during a Women Deliver 2019 trains midwives, obstetric nurses, matrons and session hosted by Johnson & Johnson, entitled The community health workers. Under-Recognized Power of Women in the Health Workforce. Participants had the privilege of hearing directly from a panel of midwives and nurses, including Born on Time delegate, Ruth Dite Mah Diassana, from Mali. Ruth is an activist for gender equality and a midwife in charge of the Reproductive Health Service, and Manager of the Family Planning Department at the Sikasso Referral Health Centre in southern Mali. She has also worked as a midwife for Mali’s Ministry of Health. She and her husband have three children, aged 15, 9 and 4 years. Up to 83 per cent of all maternal deaths, stillbirths and newborn deaths could be averted with the full package of midwifery care, including family planning (Lancet, 2014). Ruth is proud of her career choice and her role in providing a continuum of skilled care during pregnancy, childbirth and in the postnatal period. She provides knowledge, comfort “We are working with the government to give and critical health care to women when they need it equal opportunities [to those] who are working in and are at their most vulnerable. health to have adequate training to grow in the health workforce,” she explained. “As a midwife, I am proud to accompany As part of her role, Ruth encourages women in her community to attend regular antenatal Across Bangladesh, Ethiopia and Mali, midwives pregnant women throughout their lives, and appointments at the health centre, and to put into like Ruth are making a significant impact on women practice the knowledge they gain. Ruth believes and adolescent girls’ health and wellbeing. They are through delivering a baby to the world. that as she and other midwives counsel women part of a critical network of health care providers I want the world to recognize the marvellous and adolescent girls in their communities towards who are working to provide compassionate, gender- behaviour change, they are joining hands to ensure responsive and adolescent-friendly care in the and powerful work of midwives.” healthy pregnancies and safe deliveries. fight against preterm birth, aspiring to a day when every mother is able to realize a healthy, full-term - Ruth Dite Mah Diassana, pregnancy and every baby is born on time. midwife in charge of the Reproductive Health Service in Mali Excerpt from Girls’ Globe, “The Power of Female Health Workers.” June 7, 2019. Accessed March 10, 2020: https://www.girlsglobe.org/2019/06/07/the-power-of- female-health-workers/
18 SUMMARY REPORT 2019 SUMMARY REPORT 2019 19 Ending child marriage supports girls’ empowerment and reduces premature birth Born on Time has been supporting When Morion and her friends Once the call was placed, a I n August 2019, 14-year-old Hafcha these adolescent girls as they heard about Assamoni’s support team including law made one of the most courageous meet, trying to address many of impending marriage, they showed enforcement and community decisions she has ever made – a the risk factors of prematurity, up en masse at her home, trying leaders showed up in time to stop decision that changed the course of her including child, early and to convince her parents that this the marriage. friend Assamoni’s future. forced marriage. Marrying too was not only wrong but illegal. young often puts adolescent Morion is quick to give credit back In Bangladesh, more than half of all girls in increased danger of When her parents moved her to to Assamoni herself. “Assamoni led girls are married by the time they’re 18, intimate partner violence, early her grandmother’s village to try the process against her own child and 39 per cent before they’re even 15 pregnancies, and sexually- and hide the wedding, Assamoni marriage by speaking out in the years old. With little knowledge of their transmitted infections – all added was devastated. And when first place,” Morion exclaims. “We bodies or reproductive health, many risk factors for preterm birth. Assamoni didn’t show up for the just came together to support her.” end up as young mothers, often at risk group’s regular meeting, Hafcha of giving birth to premature babies “Our friendships are stronger here knew something was wrong. Assamoni’s face beams with or suffering from other complications because we can share openly pride. Sitting among these themselves, including fistulas, or in about what we’re going through,” That’s when she picked up the young women, I’m reminded worst cases, mortality. Morion notes. phone and dialled the country’s about the power of partnership, national hotline for child marriage. education and courage to change Assamoni learned through a family A born advocate, Morion is fiercely the narrative not only around member that she would join those loyal to the group of adolescent “We already know all the harmful women and adolescent girls’ ranks by force. “After I heard about my girls sitting in a circle in front of things that come with child empowerment, but also around marriage, I told my parents I wasn’t her. “If I only become an advocate, marriage,” Hafcha explains. “I preterm birth. ready. I wanted to keep studying, but that’s not good enough for me. I didn’t want one of my friends to they wouldn’t listen.” have to act.” go through that.” It is young women like Assamoni, Morion and Hafcha who are Assamoni and Hafcha became friends going to slowly chip away at the at an adolescent peer group that meets generational burden of gender every other week in a small community inequality and write a new room at the centre of their village in future for themselves and their future children, if they choose to have them. rural Bangladesh. The 20 teenagers cover topics across the Excited about how she can help sexual and reproductive health and rights spectrum, including others, Assamoni remarks, “I know how to handle peer pressure, menstrual hygiene management, I can mobilize others to do this gender equality, and the importance of increased decision- work as well. We are running and making over their own lives and futures. becoming stronger!” Leading the group through each session is 16-year-old Morion. She leads the group with confidence, passion and warmth – some things you don’t need a translator for. Morion is a peer-educator working to raise awareness among girls her age around their sexual and reproductive health and Excerpt from Bettings, Marie. “World Prematurity Day: Ending child marriage supports girls’ empowerment and reduces premature birth.” World Vision Canada, rights through the Born on Time project. November 14, 2019. Accessed March 10, 2020: https://www.worldvision.ca/stories/gender-equality/world-prematurity-day-2019
20 SUMMARY REPORT 2019 SUMMARY REPORT 2019 21 Meryem: A Child Bride Speaks Out Against Child Marriage M ore than 700 million women alive today were married before the age of 18 (UNICEF). More than one in three were married before the age of 15 (UNICEF). Almost half of all “child brides” live in south Asia and 17 per cent in Africa. Girls Not Brides: The Global Partnership to End Child Marriage says child marriage often ends girls’ education, reduces their lifelong income and exposes them to the risk of domestic violence. Complications during pregnancy and childbirth are the leading cause of death for 15- to 19-year-old girls globally (WHO). According to UNICEF, nine out of the 10 countries with the highest child marriage rates are fragile or extremely fragile states, with girls more vulnerable to child marriages during and after conflict, displacement, and natural disasters. Meryem Yusuf (pictured above) was married at While global NGOs campaign against child, early the age of 12 to a much older man. In June 2019, and forced marriage at a governmental and she travelled from Ethiopia to Women Deliver in international level, they recognize that one of Vancouver, Canada to share her story and inspire the most effective way to change attitudes and other advocates. “I was in grade five. I loved school, behaviour is within communities. In countries that but my family decided, without my knowledge, to give me into a marriage. They wanted the financial gain. When I tried to keep going to school, my mother threw stones at me.” Meryem had five children and ensured they all got an education. Later she decided she wanted to do something to help other girls. As a leader of a women’s Muslim association, she trained “I was in grade five. I loved school, but my family decided, with Born on Time and started working with her neighbours to dissuade them from marrying off their without my knowledge, to give me into a marriage. They daughters. She says she has directly prevented 10 wanted the financial gain. When I tried to keep going to child marriages and now works with other women’s groups, teachers and health workers at a local level. school, my mother threw stones at me.” don’t have proper child-protection systems or legal enforcement of marriage age, programs such as “Sometimes I hear what is happening from children at - Meryem, a former child bride Born on Time often work with faith leaders. The school and then I go to talk to the parents. I tell them Vancouver call to action asks them to speak out my life experience. I tell them I still blame my parents speaking about her marriage, Ethiopia against child marriage and refuse to perform and that their children will blame them in future.” marriage ceremonies. Excerpt from Ward, Margaret. “Don’t call it child marriage. It’s paedophilia.” The Irish Times, July 8, 2019. Accessed March 10, 2020, https://www.irishtimes.com/news/ world/don-t-call-it-child-marriage-it-s-paedophilia-1.3944336?mode=amp
22 SUMMARY REPORT 2019 SUMMARY REPORT 2019 23 OUR 2019 FINANCIALS The budget for Year 4 of the five-year Born on Time project was CAD $8,953,886, over a quarter of the total project budget of CAD $30.6 million. Despite challenges in all three countries – including marketing campaigns by private clinics in Bangladesh that recruited pregnant women at field level to have unnecessary Caesarean deliveries at cost; instability in certain Ethiopian districts that impacted day-to- day activity implementation; and the presence of internally-displaced populations fleeing jihadist attacks in northern and central Mali – the project was able to expend 88% of its Year 4 budget: CAD $7,869,706. As the project enters its fifth year, Born on Time is well-positioned to remain on track fiscally. The project’s priorities in 2020 are quality programmatic implementation through a sustainability lens, knowledge management and dissemination, and strategic communications. The consolidated financial statement for 2019, ending December 2019, is presented below. This fiscal year, the project registered an annual spending of more than CAD $7.8 million. Total Spending: $7,869,706 $8,953,886 $7,869,706 Direct Spending: $7,024,238 Year 4 Budget Year 4 Spending Overhead Cost: $845,468 SPENDING BY OUTCOME 89% 35 % DIRECT SPENDING Outcome 1: $2,751,176 40 % Improved availability of quality, gender-responsive/ adolescent-friendly maternal, newborn and reproductive health services Outcome 2: $3,135,723 to prevent and care for preterm births among Increased utilization of adolescent girls and women quality, gender-responsive/ of reproductive age adolescent-friendly maternal, newborn and reproductive health services 25 % to prevent and care for preterm births among Outcome 3: $1,982,807 adolescent girls and women of reproductive age Enhanced utilization of evidence-based, gender- specific information on preterm birth data for decision making by staff at various levels of health systems
Born on Time is the first public-private partnership dedicated to the prevention of preterm birth, bringing together the collective expertise of World Vision Canada, Plan International Canada, Save the Children Canada, the Government of Canada and Johnson & Johnson. bornontime.org Photo credits: Paul Bettings, Benjamin Eagle, Girls’ Globe/Marta Miklinska, Asaduzzaman Rassel
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News Game-Based Paperman Anime's Digest Video Streamed
posted on 2011-08-16 10:15 EDT
The Japanese game news site 4Gamer began streaming a 57-second digest video of the Paperman anime short on Tuesday. The anime adapts Gamepot's Japanese first-person shooter game for Microsoft Windows; even though the game and the anime are set in a 3D environment, it features characters made of "paper" that can be customized like paper dolls.
The anime itself will formally premiere online on Wednesday, when Paperman game players can purchase the anime within the game itself and download it online.
[Via Moon Phase]
Image © Gamepot
Reviews Include: Gamers! - Classroom of the Elite - My First Girlfriend is a Gal - Magic Circle Guru-Guru - In Another World with my Smartphone - New Game!! - Angel's 3Piece! - Chronos Ruler - Princess Principal - A Centaur's Life - Hitorijime My Hero - Action Heroine Cheer Fruits - and much more! ― Welcome t...

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Released: 2008, Pure Steel Records
Reviewer: Luxi Lahtinen
The German Pure Steel Records releases pure old school metal. Enchanter, this band from New England, USA, is one of those bands that have made an attraction to the label owner with their Cirith Ungol, Manilla Road, Brocas Helm influenced back-to-the-roots metal. SYMBOLS IN STONE, which is Enchanter´s self-released debut album, has now finally been re-released as a remaster together with the band´s new album, SECRETS VOL. 1, on one CD. This is definitely a good move from the label as SYMBOLS IN STONE has been sold-out quite a long time already, and kinda hard to find from anywhere.
As said, Enchanter pays lotsa homage to pure old school heavy metal/rock sounds, which at least warms me up quite a bit - being a fan of their abovementioned band influences. The music comes out as a very easy listen, and therefore it´s simply very easy also just to enjoy these records; the old school vibe that has been so well captured in both of them. The songs overall sound late 70´s/early 80´s influenced (we talk about the ´old school´ sound here - remember?), it´s thoroughly well-presented and whenever such songs like "The Limit", "Atlantis", "Dark River" or "Norse Trilogy" hit me, it´s kinda impossible to avoid becoming a teeny-weeny nostalgic in the name of the old times. Enchanter´s debut, SYMBOLS IN STONE, is a more mean, obscure and heavier sounding effort than SECRETS VOL. 1 (which was recorded in 2002, but remained unreleased ´til Pure Steel Records stepped into the picture and decided to put it out together with SYMBOLS...), and that´s why I also find it more appealing to my musical likings than their 2nd album.
Enchanter may not be the final musical definition for the word ´old school´, but I guess no band can make an exact definition for that style. However, whatever is about to come to your mind when mentioning the word ´old school´, Enchanter have at least left a noteworthy challenge by their albums to get that terminology fitted into their leather boots. Good stuff.


PurobeachNew Digital Franchise Ecosystem doubles direct online-reservations and makes Purobeach the N°1 Beachclub in EMEA.
- Repositioning Puro Hotel, Restaurants & Beach Clubs
- Guideline for social media and content production
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- Development of a digital Franchise-Ecosystem (Franchisees Hilton, Minor Tivoli-Hotels etc.)
- Centralisation of data and automation of client processes and -dialog
- Strategy for future revenue streams, expansion & Merchandising
The vision & result
Doubling Online Direct Sales
Puro is a sea oasis with the mission to deliver happiness. The doubling of online direct sales for both the beach club business and its associated hotels enabled all partners & franchisees to generate cash flow online before visit and pre season, defending margins against OTAs for hotels and revenue for the beach clubs.
The new digital ecosystem has enabled Puro to collect and centralise customer data across all businesses and their channels. Cross- & up-selling within and between the hotel and beach club concept is increasing clients & company equity. New digital services to improve the clients experience (online reservation, WiFi, gift cards, etc.) resulted in an active, constantly growing database of active customers, partly replacing the traditional acquisition costs with a more efficient CRM model.
The new content strategy helped to replace the costly performance & promotion model with a seamless online customer experience from the first online contact through events to their return to the clubs. CRM and automation of processes such as satisfaction rating increases online reputation and the SEO ranking. Puro Experiencer and Copa Del Rey Women Regatta were media first events. These campaigns were mainly digital and therefore scalable, increasing reach, traffic and reservations.
Both campaigns were the most successful ones to date in terms of ROI and did not require classic paid media.
Private Label Optimisation & Campaign
Repositioning & Omnichannel Experience
Digital Community Roadmap
Pure Online Player
Calle de la Victoria 4, 1° 07001
Palma de Mallorca Spain
DE: +49 162 577 2587
ES: +34 871 115 957
ES: +34 644 388 100
Oliver Eckart | LinkedIn


Quality Amboina Wood Burl Handmade Italian Gentleman's Pocket Knife with Hammered Titanium Bolster
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When I hear the name ‘Sothebys’, I tend to think of the mega-rich buying famous paintings or jewels that empires have fought over. Today they’re selling DC Complete: The Ian Levine Collection.
That’s right; Sotheby’s are selling a comic book collection.
Can you imagine how impressive it must be? Well, Sotheby’s are calling it the Holy Grail of comic book collections. There are over 40,000 comics in it, and this includes every comic book released by DC from 1935 to 2014.
There are complete runs of Action Comics and Detective Comics, of Superman and Batman. It has the first appearance of Wonder Woman, The Flash, Green Lantern, Aquaman and the Justice League.
The collector is the producer and DJ Ian Levine, the same fan who helped return missing Doctor Who episodes to the BBC’s archives.
Richard Austin, Head of Sotheby’s Books & Manuscripts Department in New York, told press;
… Levine’s collection embodies the passion and fandom that has defined comics culture for generations, which today is best encapsulated not through printed issues but popular superhero films that regularly break box office records. Featuring some of the most valuable individual books as well as extremely rare promotional issues, the Levine Collection includes all the DC heroes that are among the most recognizable and versatile pop culture touchstones in the world.”
The collection nearly didn’t happen. According to Sotheby’s, there was a time in the 80s (pre-internet) in which Levine thought he’d never complete the set and so sold his rare comics. A change of mind was costly as he had to repurchase them at a 50% premium.
How much might this collection be worth now? Well, in 2014 a single issue of Action Comics #1 sold for $3.2 million and before that, in 2010, Detective Comics #27 sold for $1.075 million.
Let us know what you think in the discussion area below.


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As an AirPods owner, I know the frustration of when your mic isn’t working when you need it the most. After doing some research and testing, I’m here to share how I solved the issue and the other solutions I discovered. So if your AirPods mic is not working, read on to find out the causes and fixes.
Likely reasons why your AirPods mic is not working are that the Mic is not actually being used, you need to switch the mic that is being used, there is dirt or something covering the mic, a connection issue, they need a software update, low battery or your AirPods are connected to a different device.
- The mic on your AirPods might not be the one that is being used.
- It might be necessary to switch the mic that is being used.
- Dirt or something might be covering the mic.
- A connection issue might be the cause.
- They may need a software update.
- Low battery might be the cause.
- AirPods might be connected to a different device.
Why is the mic not working on my AirPods?
Below are possible reasons why your AirPods mic is not working and what can be done about it.
You need to switch which mic is being used
It could be the case that the mic on one of your AirPods is broken. However, only one mic is actually used at a time to record your voice. So, you could try using the other mic to see if it is due to a hardware fault.
To fix this try the following:
- Go to settings
- Go to Bluetooth
- Click the “i” next to your AirPods
- Click “Microphone”
- Change it from “Always left” or “Always right”
The mic is not being used
It might also be the case that you need to enable microphone access in the settings for the app within your iPhone’s settings app.
On Mac press “Option + A volume button” and make sure that your Airpods are selected as the input source.
Your AirPods are muted on your phone
Read more: Noise canceling not working on AirPods Pro
The issue could be that your AirPods are muted on your phone or that you have selected to use your phone’s mic instead of the AirPods mic.
It would help to make sure that they are not muted and that it is actually the AirPods mic that is being used.
Dirt covering the mic
It might be the case that your AirPods mic is dirty. The problem is that metal filings can easily get into the filing grill which can make it harder for the mic to hear your voice. To fix this do the following:
- Get some Blu-Tack
- Firmly press it into the microphone grill several times
Alternatively, just get a cotton swab and rub the microphone grill using that.
You can also suck on the microphone grill to dislodge dirt that way.
A connection issue
It is also possible that there is an issue with the connection that your AirPods have with your device.
It would help to try connecting your AirPods to a different device and to see if the mic is still quiet when using that device.
It would also help to disconnect your AirPods from all the other devices that they have a connection with in case their connection has been interfering with your AirPods.
Your AirPods need to be reset
Another possible cause is that your AirPods need to be reset and reconnected with the device you are using.
To reset and reconnect your AirPods, do the following:
- Forget the AirPods on the device you are using
- Put your AirPods in the case
- Press the button on the case for 15 seconds
- Wait 30 seconds
- Open the lid and hold the button on the case
- Reconnect your AirPods to your device
They need a software update
AirPods do receive software updates. It might be the case that your AirPods need to be updated. They do update automatically when you connect them to an Apple device.
If your AirPods are on low battery, it can sometimes cause the mic to not work properly. It would help to try charging your AirPods and to see if that helps.
AirPods are connected to a different device
Read more: Why won’t my AirPods disconnect?
It is also possible that your Airpods are actually connected to a different device and it would help to double check that your AirPods are actually connected to the device you think you are using.


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The San Elijo Ecological Preserve is one of the largest wetlands in San Diego County and it is conveniently located along both sides of interstate 5 in Solana Beach. The 1,000 acre reserve protects the land where Escondido and La Orilla creeks encounter the Pacific Ocean. The most popular hike in the preserve is Annie’s Canyon Trail, a super short, super narrow slot canyon, with a well built multi level metal ladder, which leads to beautiful views of the marsh and ocean below. It isn’t a long hike but the slot canyon is neat and it is close to home. We will be back.
4 thoughts on “San Elijo Lagoon Ecological Preserve, Solana Beach”
Neat photos! Is the rock mostly limestone? I notice that the color is lighter than I expected.
The rock is Torrey sandstone (which we have a lot of in this area). Very white, except for the rusted portions.
LikeLiked by 1 person
Okay, another cool Brady find added to our ever-growing list. I love this!!!
I could have sworn you have been! Seeing the path from the freeway all these years I was always curious about it. I had no idea the path leads to Annie’s Canyon which I have heard about forever!

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Fields are any column from table user wants to retrieve as part of the analytics query.
To specify fields set the input field
Fields can be set with an aggregate operator as follows.
If users wants to retrieve data without doing any aggregate operation like SUM/AVG/MIN then query can be executed as follows.
We can specify an alias for the fields as well by using
fieldsDetailed input field.